HomeMy WebLinkAbout0041 LAKE STREET - Wood Stove Permit 12/09/79 ---TOWN OF BARNSTABLE
'oo 16 v`• MASSACHUSETTS
Wood Stove Permit
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DATE OF APPLICATION .........../..".1........:.[q/.19....................... FIRE DEPT. ISSUING PERMIT ..
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� ./-}.../��..H..v(�.. �.,�....�..�`�...�..�-..�..(....'�...f....... NAME Installer
.;,. NAME (owner) �•�. . .. .... ....... ... .. ( ) .............,�;;.... ...........
ADDRESS ............ ..I........... -... ....k.E....S.�.......C4.... V..:.Z' ...:.. ADDRESS n: .'
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` ['�fY e`I,'�•'.tf s�a"ra-..,.,� ..-ACC,+ 7", I� '`
STOVE TYPE ...............................................................................:............................. CHIMNEY: NEW ........................ EXISTING ..........:.............
Manufacturer ....... .. ....... CHIMNEY: Masonry
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Mass. Approval :1.!�...... .3 �i - l�` 1-- .I r 1 1 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 � Fire Department,
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and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
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sued By: ....Title .... . '.x"".............................................. Date .s'`. .." ' -�
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Permit to install expires 60 days after' issue date
Stove ..... .............................................................................................................................................................................................................................................................................................
StoveClearance �.................................................................................................................................................................................:.:..............................................:..............................
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Floor ...... ................................................................................................................................................................................................................................................:.........................................
SmokePipe .. ......................................................................................................:.`.:........................................................................................................................................................................
SmokePipe Clearance .Y:�..................................................................................................................................................................................................................................................
Chimney ..........................................ti..,.....................................................................................................................................................................................................................................................
SmokeDetector ................................................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity of permit dated ....................................................6............. has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ...........................................................................
Installer
INSTALLATION APPROVED• ..1.2..a.2-da te. `k.. By.=��..... �...-.....-....?.. ' Title: '.Z1E.1141-7...................
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT