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DEPARTMENT OP BUILDrNG INSPECTIONS
INSPECTOR 918 Main Street ' Municipal Building
Northampton, Mass. 01060
F�MIT
SOLID FUEL BURNING APPLIANCE 6 CHIMHEY APPLICATION
Page Plot Zone jU kA
Location 99 I
No. Street
Owner or 7 A r
Lessee Name (bailing Address) (Tel. No. Y
Contractor 4M41,j N j 3�6 r
(Name) (Address)� Tel. No.
RESIDENTIAL NONRESIDENTIAL
V/ One Family Home Business
Two or More Other
Number of Units Specify
Type of Appliance —"-'
New ✓✓ Wood Burning
_ Used Coal
Labeled Combination
Date of Purchase Other
Specify
Model or Type
Manufacturer � (`A ,�,�./� � •
Purchased From Lh}{�
masse of Firs
(Address) y'
Cost • Construction i Appliance $ 60D .
Chimney New ✓ Existing
_ Separate Flue -i Other Applianc Attached
To Flue vv ACAC-
y/ Masonry/Lined Metal 34820
Masonary/Unlined
Exterior Interior
Notes & Data: —'
Signature of Applicants
Nil (Address) D106 0
Approved By:
Title Date
DEPARTMENT OF BUILDING INSPECTIONS
212 MAIN STREET BUILDING _ // q( //I1
NORTHAMPTON, MA. 01060 PER I a ll yk
A - 97 VALIDATION
DATE December 14, 19 81 PERMIT NO. 6A7
APPLICANT Sandra Russell ADDRESS_, 997 Burts Pit Rd.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wnnd ctnvp (_) STORY Wnod b$ ino stnvp DWELLING UNITS 1 _
(TYPE OF IMPROVEMENT) NO. (PROPOSED US�f�_
ZONING
AT (LOCATION) 997 Burts Pit Road DISTRICT URA
(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: TnRtall weed burning stove in existing chimney
Wood stove connection to be minimum of 6" below gas furnace connection
AREA OR
VOLUME ESTIMATED COST $ 60-00 FEEMIT lO•QO
(CUBIC/SQUARE FEET)
OWNER RnC4P11 Damt+l3n BUILD ,+'
I G PT.
ADDRESS 997 Burts pit Rnad Nnrthamptnn, Ma. 01060 BY
WHITE - FILE COPY . GREEN ^ FIELD COPY . CANARY - APPLICANT COPY . PINK - ASSESSORS COPY