29-259 (4) i
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DEPARTMENT OF BUILDING INSPECTIONS '
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01000
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER _SdL
Page � Plot .1SY Zone w✓l,
Location /1-1 17 0 G;J=i2L Vora 7)Zf 1/—Q-
Owner or Lessee L" u,,r iqi as
(Name) Mailing Address) Tele. No.)
Contractor 'A-�04'L ,%����� � � -661' 7'1U t'e�CfC�-
(Name) (Address) (Tele. No. )
RESIDENTIAL NON-RESIDENTIAL
I/ One family Home Business
Two or More Other
Number of Units Specify
Stories in Building
Type of Appliance
New Wood burning
Used Coal
Labeled Combination
Date of Purchase Other
/Specify
Model or Type &J^n,1 /Z
Manufacturer
Purchased From
(Name of Firm)
(Address)
Cost - Construction & Appliance
Chimney New Metal Bestos
,i Existing Interior chimney
Separate Flue i/ Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant:
(Address) �/cc�y���
Approved By: Y
;-
Title: Date:
yam► y DEPT. OF BUILDING INSPECTIONS gUtLDiNG z°-
! 212 Main Street oa 111 1 .
Northampton, MA 01060 PERMIT 1
29 - 259 VALIDATION
DATE Nnvember Jr;, �kP6rM,T PpbP'�TR 730 T
APPLICANT Paul Judd ADDRESS
Stove (STREET) (CONTR'S LICENSE)
PERMIT TO Wood Burning StoVe (i) STORY One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 127 Overlook Dr. orence ZONING UKA
DISTRICT
(NO.) (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: Wood burning stove installation (Used)
AREA OR r 500 QO PERMIT s 10.00
VOLUME ESTIMATED COST W FEE
(CUBIC/SQUARE FEET)
OWNER Same as XX MR Applicant au1A- x&w:
ADDRESS Same as Applicant' s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pOP