HomeMy WebLinkAbout0188 COUNTRY CLUB DRIVE - Wood Stove Permit 08/15/79 TOWN OF BARNSTABLE
-M 9 MASSACHUSETTS
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Brood Stove Permit
DATE OF APPLICATION ................................................................... .... FIRE DEPT. ISSUING PERMIT ............................................................
NAME (owner) AL'704- 44W,f 0... ....... NAME (Installer) ...... �' *..:r�..°.`:..... ���:��'
............................................................................................ ...rP ... .................
ADDRESS ....... .. ..: Cc7��T�f y ��urs /�/I. ADDRESS .......`?(3.......1...;. :?R.. .... .=`.....�..... :�..'.:..............`�.....
............................... ...
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STOVE TYPE .................................. ....... CHIMNEY NEW E%ISTING
Manufacturer .................. .. ?.�.....'�Q..................................................................... CHIMNEY: Masonry ......... ...:. ::.................. .................................................
Mass. Approval ..........................�111
................................................................................. CHIMNEY: Metal
This is to certify that the above installer has permission to install a wood burning appliance at the listed address
in accordance with an application on file with the lV,411A. / �? (r_.................................................. Fire Department,
r .. . ..... ........ ...............
and subject to the -provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
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Issued By: ........... '�........'` � .. !/ ....Title ..........C' /<= ..�-�........ .....:.............................................. Date ..... :............. .....
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-Permit�to install expires 60 days after issue date
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Stove ........................................�.......................................................................................................................................................,..................o........................................................
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StoveClearance .................................�.I..:.............................................................................................................................................................................................:...................................
Floor ..!`.:......................................................................................................................................................................................................................................
Smoke Pipe ....:.................................... ........ .........................................................:.......................................................................................................................................................................
.
SmokePipe Clearance ....................C�..., ...........................:........................ ......................................
Chimney ............................................................... .., ................................................. ...................................................................................................................................................................
SmokeDetector .....................................:.....................�..............................................................................................................................................................................................................
The undersigned hereby certifies that the installation,of wood burning stove and equipment made under author-
ity of permit dated _l S_ 7 ..... has been made in accordance with provisions of the Commonwealth
........................................:............... �
of Massachusetts State Building Code now currently in effect and pertaining thereto ..�.�..f, .. .`�
f' I..-- fl,l.......... .. .:... ..................
Installer
INSTALLATION APPROVED .........II�.`......�rs2.�, .. B :..................................> !T.......�:-1.a�.:!`.:!:�..... Title: ......................."............................
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date.
WHITE: FIRE DEPARTMENT - CANARY:`BUILDING INSPECTOR - PINK: APPLICANT