05-039 e f �sssac4sn�tts -
City of Nart4amp#M
r --
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building �r
INSPECTOR Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION '
Page Plot � Zone --
Location 51 41 Y
No. (Street)
Owner or IRA- *6CF/94.D AoX a (14 L &C-f)-s W33
Lessee (Name) (Mailing Address) (Tel. No.)
Contractor
Name (Address) Tel. No.)
RESIDENTIAL NONRESIDENTIAL
i/ One Family Home Business
Two or More Other
Number of Units Specify
Type of Appliance
New 4---Wood Burning
Used Coal
Labeled Combination
/1Y Date of Purchase Other
Specify
Model or Type �< .7
Manufacturer VERh1041 CAS7ilL6S
Purchased From 6Lu6 1/,90661611 C#14UICf -Sly Cc 6 P
Name of Firm
yiD A/C-U,769/ s Im)t Ff
Address
Cost - Construction & Appliance $ 1NGr�
Chimney New r/ Existing
v' Separate Flue Other Appliance Attached
To Flue
y Masonary/Lined Metal Bestos
Masonary/Unlined
Exterior Interior
Notes & Data:
Signature of Applicant:, we 55 ( �(Etiy� y 421 °
Address
Approved By:
F
(Title) (Date)
ti a DEPT. OF BUILDING INSPECTIONS BUILDING z
1 ! 212 Main Street 04
Northampton, MA 01060 PERMIT
5 — 39 VALIDATION
DATE 9&s X October 2(-�, 84 PERMIT NO. 596
APPLICANT Ira Helfand ADDRESS enn y oad Owner
(NO.) (STREET) (CONTR•S LICENSE)
Wood Burning Stove One Famil y Home NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
Kennedy Br4se, Leeds ZONING RR
AT (LOCATION) 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 instalation of a new wood burning stove(interior)
AREA OR 1,400.00 PERMIT s 10.00
VOLUME ESTIMATED COST
(CUBIC/SQUARE FEET)
OWNER Ira Helfand
ADDRESS 551 Kennedy Drive,_Leeds, Mass. 01053 BBYILDIN
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK ' S ES IRS COPY pjNT SNP