29-295 (3) ~� (Ei#V of Nort4amp#on
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DEPARTMENT OF BUILDING INSPECTIONS =
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page Plot J _ Zone /q Permit Number
Location
� / Tom'
Owner or Lessee/ VGbIVl_L LL
Tele. No.)
Contractor
License Number)
Address
RESIDENTIAL NON-RESIDENTIAL
One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
New 4/' Wood Burning
Used Coal tt
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
Name of Firm
(Address)
Cost - Construction & Appliance: _ [9 ci c ® __
Chimney New Metal Bestos
Existing Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data: ?—/
4z,
Signature of Applicant:
Building Inspector Approval: 'lC
Date:
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Department of Building Inspections
212 main Street
kampton, Mass. 01060 BUILDING o°
PERMIT
M( 4t no
29 - 295
VALIDATION
DATE December 9, t9 83 PERMIT NO. 685
APPLICANT Ronald Verville ADDRESS 27 Pencasal Drive Owner
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO
Chimne y Stove& St O Family NUMBER OF
STORY One DWELLING UNITS
(,)
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
27 RXXXX?'IRZXENNINX Pencasal Drive, Florence ZONING URA
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 installation of a chimney and a wood burning stove
AREA OR 600.00 PERMIT 10,00
VOLUME ESTIMATED COST .$ FEE $
(CUBIC/SQUARE FEET)
Ron Verville
OWNER
ZJ pencasal Drive, Plorence, Mass. U106U BUIL PT
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY