HomeMy WebLinkAbout0051 LAKE STREET - Wood Stove Permit 10/01/79 gyp{ Tp``
TOWN OF ' BARNSTABLE
! asaaSrAU
10 9 ,� MASSACHUSETTS
IN
Wood Stove Permit
DATE OF APPLICATION ...............` ........:- . ............ 9 FIRE DEPT. ISSUING PERMIT ........�=..o..? ��
.................. ..............................
NAME (owner) .... r101, F :A- 44 10. f-f r .�. NAME (Installer) .....Ify , ,. r ,�...c"` �:... .. `..:..........- ..............................................................................;., ..... ........................ .r.
ADDRESS ..........` `......L'� �< s'7 Coo , 1, '7 ADDRESS ....`..�..................:. . : .......................
STOVE TYPE ..��.'.. '......1, l• AT � CHIMNEY: NEW �^'"�
.....;�:............................................................................ .........:.............. EXISTING ........................
Manufacturer . .......� ..... ..... CHIMNEY: Masonry .... '�.......................................................................
...
Mass. Approval --- .. --...................................................... CHIMNEY: Metal ...........................................:.......................I............................
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 f� �I I... ............................................. Fire Department,
. ............................................................. ......
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
Issued B • �� { ••.....Title "" Date '` `
y. .....................r...... :.......:......................... .-:N::............................ .............. ............. .......
Permit to install expires 60 days after issue date
Stove . ........................................................................................................................................:......................................................................................................................................................
��
Stove Clearance :.............................................................................................::?.........................................................................
Floor ..................................................:............................................................................:...............................................:...........................................
SmokePipe A .................................................................................................................................................................................................................................................................................
SmokePipe Clearance ''..............................................................................................................................:.................................................................................................
.....................
Chimney ✓
SmokeDetector .. ..... ........................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity of permit dated .... ..".f..."..% ... .................. has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto At^!^" s
....................................................
Installer
INSTALLATION APPROVED 3,.�... `-�� " 7 g By.:.: ........................................ I'll/ I", /-'- Title `��"���`,............................... ....................................
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT