25C-115 (3) t
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�1A88$CI11IStItB u - -=
DEPARTMENT OF BUILDING INSPECTIONS -=
•
INSPECTOR 212 Main Street ' Municipal Building - o•
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page ,2SG Plot 11%r Zone Permit Number
Location �p y �
Owner or Lessee
Tele. No.)
Contractor '�� r A 0-t.erw'/1"
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 Wood Burning
Used Coal "
9 Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
Name of Firm
(Address)
Cost - Construction & Appliance: $ o. O C�
Chimney New Metal Bestos
4"d EX/S77�vcj= Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data:
Signature of Applicant:
Building Inspector Approval:
Date:
'16.ftr6ent of Building Inspections
zip Main Street
Northampton$ Ma. 01060 BUILDING o° I 0,of
25C - 115 PERMIT as
VALIDATION
DATE Nnv mbp 19, -T9 R2 PERMIT NO. 654
APPLICANT _Tnanne Rood ADDRESS 6 rwant Avenue
(NO.) (STREET) (CONTR'S LICENSE)
•- PERMIT TO NUMBER OF 1
Stt�XB ch3mue�c—�—► STORY DWELLING UNITS
(TYPE OF IMPROVEMEN NO. (PROPOSE 5E1
AT (LOCATION) 64 rrant Aven + ZONING
� DISTRICT fig
(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: New metal haetoS_Chimney jandi Wood hji3Ming_to3Xe Ingf-Al„latinn
AREA
VOLUME ESTIMATED COST $ 300_00 FEEMIT s IO.00
(CUBIC/SQUARE FEET)
OWNER
10=12- Dead BUI I
ADDRESS BY ff
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