17C-269 (6) eftj of Nadhnn ptan
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 Pit MI
SOLID FUEL BURNING APPLIANCE 6 CHIMEY APPLICATION a4
Page Plot Zone 114 RIB
Location
Owner or ,� 6 'Ss"ZS
Lessee Name Mailing A Tess Tel. No.
Contractor
ana Address Tel. No.
-T-
,- RESIDENTIAL NONRESIDENTIAL
1/ One Family Home Business
TWO or More Other
Number of Units Specify
Typo of Appliance
New _/Wood Burning
Used Coal
Labeled r Combination
Date of Purchase Other
Specify
Model or Type
Manufacturer
Purchased From#-10-41 JZW"
C10,0 A m = � CVO/
Address
Cost - Construction i Appliance $ de;ZI;S"4
Chimney New Existing
_ Separate Flue &Q, ,.Other Appliance Attached
To Flue
Masonry/Lined Metal Besto•
Masonary/Unlined
txterior r Interior
Notes 6 Data:
Signature of Applicant: r✓ � 7 �� ���
(Address)
Approved Byt
(Title) Da •
DEPARTMENT OF BUILDING INSPECTIONS / �� �,�7
212 MAIN STREET BUILDING o o �.
NOR"rHAMPTON, MA. 01060
PERMIT
lYI'� R a
17C - 269 11"G�4 lY' VALIDATION
DATE November 17, 19 81 PERMIT NO. 644
APPLICANTRiChard'S P11 & Heating Tnc ADDRESS_79 Tni nn_ En g thamn tnn
(NO.) (STREET 'T— (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wond burn iria furriaCP (_) STORY_ HOB water heatinc DWELLING UNITS 1
(TYPE OF IMPR VEMENT) NO. (PROPOSED USE)
ZONING iTRR
AT (LOCATION) 51 Lll'X T) —DISTRICT
(NO.) (STREE
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:
minimum of 6" below that of oil burner connection.
AREA OR PERMIT
VOLUME ESTIMATED COST $ 187_5 On FEE �
(CUBIC/SQUARE FEET)
OWNER John Smith BUILDING EP ,
ADDRESS 51 Lilly Street, F1or n , Ma 01060 BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY