17A-125 (3) • (ritr of NadhauTfol
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street * Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT WMEF��
Page Plot Zone
Loca t ion
Owner or Lessee
(Name) '�7'�TMailing Address) (Tele. NO.)
Contractor -,;4-�""'
(Name) (Address) (Tole. 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 / '4
Manufacturer
Purchased From
(Name of Firm)
(Address)
Cost Construction & Appliance $
!Mimney new Metal lestas
Existing Interior chimney
—ILL Separate Flue Exterior chimney
Other appliance attached to flue
kasonary Lined *
Unlined
Notes A Data;
7
Si m guatw of App li tt / (Address)
Approved by:
Title: Date: / /
Department of Building Inspections
212 Main Street BUILDING ��D ��
Northampton, Ma. 01060 PERMIT
17A - 125 VALIDATION
DATE October 19, 19 82 PERMIT NO. 595
APPLICANT Tames Tewb`ev ADDRESS 277 Bri
(NO.) STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO� et•AV –(�._) STORY 411[fOd�h+rttinQ 3tAVe__ DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROP SED USE)
ZONING 7T
AT (LOCATION) 277 Bridge U Road DISTRICT_ A
(N0.) (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:
211F2
AREA OR �n
VOLUME ESTIMATED COST . PERMIT $_ FEE vsnn
w-
(CUBIC/SQUARE FEET)
OWNER J, moa R Ts+Whp,3[ -- BUILDING EPT
ADDRESS 977 Bridge Rd 11Tortgtm_p ton t MA- 011160 BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY K - ASSE
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