36-102 (4) l r
r
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building „o°t
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page ?67 Plot _ Zone�� Permit Number
Location T ,r��rf, 7� %'.
Owner or Lessee
Tele. No.)
Contractor �,, �,.,,,�1�
License Number)
Address �' ,rte- ,��
RESIDENTIAL NON-RESIDENTIAL
G� One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
New Wood Burning
Used Coal "
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
Name of Firm
(Address)
Cost - Construction & Appliance: $4,aJ),
Chimney New Metal Bestos
%s$d �X/�%�/�� '" Interior Chimney
Separate Flue ,i Exterior Chimney
Other appliance attached to flue
t--- Masonary/lined
Unlined
Notes & Data:
_-L'?Za�--7-ACI-6,
f y�� Yt mil
Signature of Applicant: °. �
Building Inspector Approval:
Date:
T�
Wpartment of Building Inspections
112 Main Street BUILDING Z°
' Northampton, Ma. 01060 O<
PERMIT
36 - 102
VALIDATION
DATE JAnuary 10, )s 83 PERMIT NO. 14
APPLICANT Wi]1 iasn H_ cl,gytpn ADDRESS_95S RurtS Pit RA,
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (_�) STORY DWELLING UNITS 1
(TYPE OF IM ROVEMENT) NO. (PROPOS D USE)
ZONING tTRA
AT (LOCATION) 955 Berta Pit Rd. 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: TnetalI Wood h1srn-0ng -toV- iA existinS chimney-in haceMer1t area
Separate flue and chimney
AREA OR $
VOLUME ESTIMATED COST $ 20Q_00 FEEMIT 10-00
(CUBIC/SQUARE FEET)
OWNER W41 1 i am H_ Cl A ton BU
ADDRESS 955 Rnrts Bit RA Northampton Me 01060 BYI IN �
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY PINK - ASSESSORS COPY