36-162 (4) MR.
0
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
INSPECTOR Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page Plot � _ Zone , Permit Number (ASIR
Location - S a p
Owne r 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 Appliance:
New 1/ Wood Burning
Used Coal 1e
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
Name of rm It
(Ad Tess)
Cost - Construction & Appliance:
Chimney _�� New Metal Bestos
U,.& Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data:
�Signature of Applicant: J �G
Building Inspector Approval:
Date: % �
Department of Building Inspections e
112 Main Street BUILDING
1
Z
h ° t�
9orth ..pton, Ma Mass. 01060 oa C)
PERMIT
36 - 162
VALIDATION
ROIQgN- DATE September 27E 19 83 PERMIT NO. &A
APPLICANT Linda & 4"*n Weeks ADDRESS I0A6 Rwrt4�Pit Rnad NSA
(N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wood Burnine StOVe �_) STORY One F miiy DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPO EO USE)
ZONING S
AT (LOCATION) 1086 Burts Pit Road,. Florence 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: Permit for the installation of a new wood AMIXXXXXXIEN burning ctnyP
AREA OR MIT
VOLUME ESTIMATED COST 5Z5 oo FEE
(CUBIC/SQUARE FEET) �`A /
OWNER ZUK Robert and Linda Weeks , `` f
arts t Road, Florence
ADDRESS B,�'L /TfZ fL
WHITE - FILE COPY ■ GREEN - FIELD COPY ■ CANARY - APPLICANT COPY PINK - ASSESSORS COPY