17C-282 (5) <J •
►' '� ltit� of Xorthampton
� �1:asachnaetta
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER
Page Plot Zone
Location
l r--
Owner or Lessee , c
a Mai ing ddress Tele. No.
Contractor
(Name) (Address) (Tele. 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
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:
Signature of Applicant:
(Address)
Approved By:
Title: �� Date: 4 2 L�2
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771-1 7
a DEPT. OF BUILDING INSPECTIONS z
BUILDING °-
3 212 Main Street 0< �r
Northampton, MA 01060 PERMIT <a
7C - 282 q., VALIDATION
DATE February 13, 19 9 PERMIT NO. 85
APPLICANT Carol Ryd r ADDRESS 18 Lilly Street Own ar
(NO.) (STREET) (CONTR'S LICENSE)
Family NUMBER OF
PERMIT TO !r`ltlr( $ i1NYS1Y1C1_ (_1 STORY Oni � Family DWELLING UNITS
TYPE OF IMPROVE. NT) NO. (PROPOSED USE)
lb y btreez, FloreMce ZONING u k'
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
�? } I-y, 7 4 ,.( + (TYPE)
REMARKS. N+orm14 If or -the re-insatt-al latio� of wood burning stove due to fire
AREA OR ESTIMATED COST u FEEMIT $ 1 °
VOLUME
) (CUBIC/SQUARE FEET)
OWNER Carol Ryder al
ADDRESS
1 Y tree Florence BUILD
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P'i p