17A-256 (2) �* VtV of Vveha Iipf n
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page P 1 " CSC Zone "Z
Location IJ
d e(Z
No. _ (Street)Owner or � � I t 1t? �T_ �'326(.9
Lessee fMailing Address) (Tel. No.)
Contractor tln LM
Name A dress} Tel. No.)
RESIDENTIAL NONRESIDENTIAL
One Family Home Business
Two or More Other
Number of Units Specify
Type of Appliance
New Wood Burning
Used Coal
Labeled Combination
� Date of Purchase Other
Specify
Model or Type
Manufacturer
Purchased From
Name of Firm
Address
Cost - Construction & Appliance $ Oo6
Chimney L. _New Existing
Separate Flue Other Appliance Attached
To Flue
_L,__�Masonary/Lined Metal Bestos
Masonary/Unlined
exterior Interior
Notes & Data:
-cre
i
f 1
Signature of Applicant:
g PP r
(Address) oc> �
Approved By:
(Title) ate �.'
Deaprtment of Building Inspections
212 Main Street
Nott�ton, Mass. 01060 BUILDING o°
�7
PERMIT as
17A � 256 VALIDATION
DATE July 27, ,e8_ PERMIT NO. 334
APPLICANT Robert Borawski ADDRESS 115 Oak St. N/A
(NO.) (STREET) (CONTR'S LICENSE)
Used Wood Burn7.nP, tO NUMBER OF
- PERMIT TO ��STORY One Family Hone DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING URB
AT (LOCATION) 115 Oak St. 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 used wood turning stove
AREA
VOLUME ESTIMATED COST .$ 2,000•0V FEEMIT .� 10.00
(CUBIC/SQUARE FEET)
OWNER Robert Borawski �
ADDRESS 115 XXXX Oak St. BYI I
WHITE - FILE COPY . GREEN - FIELD COPY s CANARY - APPLICANT COPY • PINK - ASSESSORS COPY