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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER
Page fiygyy Plot .`� ' :� `� Zone
Location loil + `° y L Yom "
Owner or Lessee(}
(Name) (Mailing Address) (Tele. No.)
Contractor
(Name) (Address) (Tele. No.)
RESIDENTIAL NON-RESIDENTIAL
One family Home Business
Two or More Other
Number of Units Specify
Stories in Building
Type of Appliance /
New i,/ _ Wood burning
Used Coal
Labeled Combination
Date of Purchase Other
Specify
Model or Type �{r �
Manufacturer ✓�� > ?C! - � / I,y
Purchased From v({'1d u_)l�_tn'" '��ck L `
Name of-Firm
tO f ;
Ir
(Address)
Cost - Construction & Appliance
Chimney 1, New Metal Bestos
Existing Interior chimney
Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of App_ licant- '' � WIr)kr ��--j- 4 g rU'._
(Address)
Approved By: /
Title: ¢ � 2� Date:
1 a DEPT. OF BUILDING INSPECTIONS BUILDING °- /"�' 1)6 212 Main Street O
Northampton, MA 01060 PERMIT <a
36 - 77-24
VALIDATION
DATE January 4, 19 87 PERMIT NO. 3
APPLICANT Wolf Krakowski ADDRESS 64 Winterberry Lane Owner
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Wood Burning Stov e,,) STORY One Family NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 64 Winterberr Lane ZONING CIS
Y DISTRICT SR
(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)
C
REMARKS: Kermit for the installation of a new wood hurning Stove
AREA OR VOLUME ESTIMATED COST $ 1 .00(i no PERMIT $ 10 on
(CUBIC/SQUARE FEET)
OWNER Sap aq ADplirant (j/p;
ADDRESS Same as A�1 i Cant f s BUIL01� .7 -�•rT✓Y+� _
BY ��"1
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK ^ ASSESSORS COPY pw p