25C-045 (5) Tit of Narthamptan
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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 ank Plot Zone( -
Location Z«,41
Owner or Lessee ' �' ? ! ,0� '✓/� /gam
(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 _L�ood burning
Used Coal
Labeled Combination
Date of Purchase Other
Specify
Model or Type 91
Manufacturer ,��"�
Purchased From a-lz7 0e)Z410,
(Name of Firm)
(Address)
Cost - Construction & Appliance $
Chimney New Metal Bestos
_X
xisting Interior chimney
G Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant: c2,—,--,i
(Address) ofd
Approved By:
Title: Date: r' f
DEPT. OF BUILDING INSPECTIONS BUILDING z° .
212 Main Street 0 4 A
Northampton, MA 01060 1 PERMIT
25C - 45 VALIDATION
DATE January 28, 85 PERMIT NO. 54
APPLICANT Dwight Church ADDRESS ••� i.ne Ave. Owner
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Wood Burning STove (_) STORY One Family Home NUMBER NG UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 17 Woodbine Ave. ZONING Tma
DISTRICT UM
(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 SMALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the installation of a new wood burning stove
AREA OR r 900.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE $_
(CUBIC/SQUARE FEET)
TOMW Same as Applicant
OWNER
ame as pp 1 BUILDING /j/zz'/�"o/
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0.11'