34-016 (4) C
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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 Zone _ Permit Number y`
Location
r
Owner or Lessee
Tele. No.
Contractor
License Number)
Address
RESIDENTIAL NON-RESIDENTIAL
V One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
New V Wood Burning
.' Used Coal
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance y ^
Manufacturer
Purchased From
Name of 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:
-r.
Signature of Applicant:
Building Inspector Approval:
Date:
DEPT. OF BUILDING INSPECTIONS BUILDING z° f
212 Main Street O<
Northampton, MA 01060 PERMIT 4a
34 - 16 VALIDATION
DATE January 14, (g 85 PER
28
APPLICANT Barbara Taylor/David Mc a in ADDRESS of ur ey Hi�j Roa
m er
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Wood Burning Stove Single Family Home NUMBER OF
1_I STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Lot #16 Turkey Hill Road ZONING RR
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CR03! 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 burning stove with a new chimney
AREA OR ESTIMATED COST 700.00 FEEMIT 10 00
VOLUME
(CUBIC/SQUARE FEET)
OWNER David McClaf lin
ADDRESS
Lot Turkey 1 Road, orence, Mass. BYILDING DE
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY ^ APPLICANT COPY • PINK ESSORS COPY p IIP