17C-157 (3) Crit� of Wart4aurptan
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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 l�1 C _ Plot Zone L
l
Location
Owner or Lessee - e( -7 ' ! �.�� p S
/ 6
(Name) (� Mailing Address Tele. No.)
Contractor �)�0��f"",Y►' ttrj-("Q
(Name) (Address (Tele. ' No.)
RESIDENTIAL NON-RESIDENTIAL
One family Home Business
_ Two or More I,Y\'i�Af n� Other
Number of Units Specify
Stories in Building
Type of Appliance
New X_ Wood burning
Used Coal
Labeled Combination
Date of Purchase Other
Specify
Model or Type �,)ny-ADLon
Manufacturer
Purchased From
(Name of Firm)
(Address)
Cost - Construction & Appliance
Chimney �_ New Metal Bestos
Existing -�D _ Interior chimney
Separate Flue x Exterior chimney
Other appliance attached to flue
Masonary Lined
UnlinedI►�i
Notes & Data:
Signature of Applicant: v�
(Address)
Approved By: &404P
Title: ' ��' Date: l'a W NO
i.
DEPT. OF BUILDING INSPECTIONS Z
BUILDING
212 Main Street $a
Northampton, MA 01060 PERMIT <
17C - 157 VALIDATION
�(�(u V DATE December 5, 1g 86 PERMIT NO. 700
APPLICANT James �tOXXXXX Reis ADDRESS 76 High St. , Florence wner
Stove (STREET) (CONTR'S LICENSEI OF
NUM PERMIT TO Wood Burn i na Stove (_) STORY 2 Family Dwelling D ELLIRNG UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
AT (LOCATION) 76 High Street ZONING URB
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 wood burning stove (new) in barn
AREA OR VOLUME ESTIMATED COST $ 400.00 FEE MIT 10.00
(CUBIC/SOUARE FEET)
OWNER Samp as ATT 1 irant BUIL
ADDRESS XXX Sama as Ap licant I s BY U
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK ^ AS SSORS COPY po,..fp