24C-066 A.'60
O
(Eitu of Xort4awp!on --
f �ASiAfhtlstt�! - -
DEPARTMENT OF BUILDING INSPECTIONS r
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page / Ao_ Plot Zone Permit Number
Location r
Owner or Lessee
- Tele. No.)
Contractor
License Number
Address
RESIDENTIAL NON-RESIDENTIAL
One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Afppliance:
New Wood Burning
Used Coal "
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From _ .
Name a Firm)
(Address)
Cost - Construction & Appliance:
Chimney New Metal Bestos
Existing Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data:
Signature of Applicant: �' try iv>
Building Inspector Approval:
t
Date: k 'Ikri�C
.PT. OF BUILDING INSPECTIONS BUILDING ;°
212 Main Street <a !
Northampton, MA 01060 PERMIT
"04W*24C - 66 VALIDATION
DATE December 21, 19 84 PERMIT NO. dXX 694
APPLICANT Suzanne Henson ADDRESS 76 Massa Gni t StrAPt
[NO.) (STREET) '(CON q'!U CENBEI
Wood Burning Stove NUMBER OF
PERMIT TO (_) STORY One mile Home DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. IPROP0310 USE)
AT (LOCATION) 76 MnsgaGiot ZONING U{l�
t.rPpt DISTRICT
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: -permit for the installaXtion of a new wood bunrning stove
AREA VOLUME ESTIMATED COST $ 1 200.00 PERMIT 0.00
(CUBIC/SQUARE FEET)
OWNER Suzanne Henson
assol ree , or tampton, ass. 0 BYI
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P1" P