17C-315 (3) I
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s• z#�r of Nort4aniptcm
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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 Plot , Zone
��! t
Location
Owner or Lessee �•, (,t. ( G* �%`' t'�'(_ _ '
Name), � r� Mailing ddres Tele. No. )
Contractor
(Name) �1 (Address) Tele. No. )
RESIDENTIAL NON-RESIDENTIAL
One family Home Business
Two or More � � Other
Number of Units Specify
Stories in Building
Type of Appliance
New '� Wood burning
Used Coal
Labeled Combination .
Date of Purchase Other
Specify
Model or Type J /
Manufacturer
I�
Purchased From
G\ (Na e ))f Firm)
(Address)
Cost - Construction & Appliance
Chimney New Metal Bestos
Existing Interior chimney
✓ Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant:
/� �✓ (Address)
Approved By:
Title: y j�'' ,� 7 �� /� '9 Date:
it ..
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g o �oy� City of Northampton REQUIRED INSPECTIONS
$ 1 . Footings and Walls
s
,.
BUILDING DEPARTMENT 2 - Structural Components in
Place
3 . Complete Building
No. 821 Office of the Building Inspector
Date November 16, 19 89
BUI DING P RMIT
THIS MAY CERTIFY THAT Mary A. Depaola Insp. on Site — Foundations
has permission to install wood burning stove (new) Insp. of Plumbing — Rough
situated on 19 Lake Street, Florence Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE THE PREMISES
Certificate of Occupancy
Building Inspector
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