HomeMy WebLinkAbout0065 LAKE STREET - Wood Stove Permit 10/21/80 TOWN OF BARNSTABLE
Z 331AH30TUL i
ib L MASSACHUSEWS
Wood Stove Permit
7397
DATE OF APPLICATION ..................... FIRE DEPT. ISSUING PERMIT ""
NAME (owner) X.!.f3.a;Xt„r�.S ..0 ............................................ NAME (Installer) ...`�*. r r�
1l.... .........................................................................
ADDRESS ................:......:..................................................................................................... ADDRESS .........................:.................................................................................................
STOVE TYPE .. 3 !.::- *1 ..:-'0C1s..n ..' .. CHIMNEY NEW EXISTING
Manufacturer .......................................................... -f... ..� . CHIMNEY: Masonry ..........................:..............................................
/>
Mass. Approval .......:................J �....... .....,3?....................................................................: CHIMNEY: Metal ...................................................................:............................
This is to certify that the above installer has permission to install a wood burning appliance at the listed addresser,l
in accordance with an application on file with the .................'...................... .... `....... ................................................ Fire Department„
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
Issued By:_? ' �!' .:-..a.....0_.:.x� ✓� ...........Title Date — ! .............r._ �. ... r.....Y............. ............................
Permit to install expires 60 days after issue date
Stove ... ...................................................................................................................................................................................................................................................................................................
Stove Clearance l ►'fi� 1i, .'.
.............. ...................................... ............ .. .......................................................................................... ................................. ..................
Floor ........................................................................................................................................:...................................................................................................................................................................
SmokePipe ..................................................................................................................................................................................
Smoke Pipe Clearance '�"'��
...............................................................................................................................:.............................................................................................................................
Chimney ''`
...i..................................................................................................................................................................................................................................................................
SmokeDetector ......... ......................................................................................................
The undersigned whereby certifies that the installation of wood burning stove and equipment made under author-
. :. .
ity of; permit dated ..A.7 J..` .......... has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ...........................................................................
�3 .t Installer
t a INSTALLATION APPROVED fl�' •�.................... By:.. � .—� .� Title: .. ,,�,.... . 1� ..4.
2 date .. ................. .......
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT