36-119 (3) T
s' •a T. x#ji of Narthun ptor
DEPARTMENT OF BUILDIXG INSPECTIONS q
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER bdq
Page J& Plotj� Zone 4(jG4.
Location
d
Owner or Lessee
a e Mailing Addr s) Tele. No.
Contractor 4A jffd4AM4 as
(Name) (Address) (Tele. No. )
RESIDENTIAL N4.RESIDENTIAL
f�One family Home Business
Two or More Other
Number of Units Specify
Stories in Building
Type of Appliance
je�ew Aellood burning
Used Coal
Labeled Combination_
Date of Purchase Other
(� Specify
Model or Type
Manufacturer VLJ
Purchased From
(Name of Firm)
(Address)
Cost - Construction & Appliance $ _j ao 0
Chimney New Metal Bestos
Existing Interior chimney
Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant:
[[pp W� , (Address)
Approved By: 944450E &-4--=
Title: �' `� ` Date: ` ��
w
i a DEPT. OF BUILDING INSPECTIONS gU1LDING ZD- �� ���
212 Main Street <
Northampton, MA 01060 PERMIT 40
VALIDATION
36 119 Sept. 29, 88 629
DATE 19 7 MI NO-
APPLICANT
Raymond Leary ADDRESS �ks �ir.Owner
(N0.) (STREET) (LDNTR'S LICENSE)
One Family
Wood Burning �tovp STORY OWELLRNG UNITS
PERMIT TO
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
XXAKNXX 240 Brookside Cir. ZONING URA
AT (LOCATION) 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 installation of a wood burning stove
AREA OR $' 2,000.00 PER $
ESTIMATED COST 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant IL 6! 0
ADDRESS
Same as Applicant BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY ONIP