25A-147 (4) .e$i �
i '
�+,ri1�rt�Irfui., i+1
"WAL) Hjyl ",( N(r f."PLIC ZION
c?t (./ 7 _ V E.e rrt:i t to Yc t aL.�a
o x L e s t
(Tc�lee Nom }
C(")I t.rac for
RESIDENTIAL t<cxt<'-I L�ITJENTIAI.
W,--One Family Hoslie
TWO or More of Unf is Qthea (Specify)
floors, in Bldf,,.
"Iype of Appliance:
- New _ Yf Wood burning
✓ Used Cc,�
Labeled � Com1)1nat1on
Date of purchest � furnace
Fi rc-I l ece Insert
i
Model or Type of Appliance qMt. z0-:22o ?CIV
Manufacturer
Purchased From
Dame of Fir-nnt`
Address)
rr�
Cost - Construction & Appliance: 6Q
i
Chimney ZN(IW Metal Bestos
Existing Interior Chimney
Separate. Flue � Exterior Chimney
Other appliance attached to flue
'Masonary/lined '
Unlined
Notes b Data:
Signature of Applicant: / •_ .( __________
Building Inspector Approval:
Date: /V /
DEPT. OF BUILDING INSPECTIONS BUILDING ZD
212 Main Street Oa
Northampton, MA 01060 PERMIT
25A - 147 VALIDATION
DATE October 22, 198_ PERMIT NO. 625
APPLICANT Alan Kirouac ADDRESS 49 Northern Ave_ Owner
(NO.) (STREET) (CONTR'S LICENSE)OF
NUM PERMIT TO Wnod Rurni nn �tnVP (_) STORY nnP FAmi 1 v nwP1 1 i nq DWELLING UNITS
(TYPE OF IMPROV ENT) NO. (PROPOSED U )
AT (LOCATION) 49 XXXXNMkl-(KMXXXX Northern Ave_
ZONING
ISTR cT URB
(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 SMALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: 2Prm1 t fnr the i ncta 1 1 At i nn of a waod hurninTatny
AREA OR ESTIMATED COST $ 300,00 FEE MIT 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant -----
BUILDIN
ADDRESS P a c Ann l i ra nt I c BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ^ ASSESSORS COPY pjNT- P