HomeMy WebLinkAbout0111 NICKERSON ROAD - Wood Stove Permit 11/03/82 • •}1. .t,.�. . . . . . . . . . . . . .
TOWN OE BARNSTABLE
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.q. MASSACHUSETTS
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Solid Fuel Stove Permit
Cente l�.e—
� /DATE OF APPLICATION .....a f�.�:...�............................................ FIRE DEPT. ISSUING PERMIT ........n..�.�-.-:..- -= ��..::.........
NAME (owner)/0,r!0 ,.g,.� AelN ,/.2:-:�............... .............. NAME (Installer) ......X.���}..�*�.�!.......��.�...��'.�!.................................................. .
5 ADDRESS .... ......11/i c. .. A... �: ADDRESS ;/�,/....../�! .,c e.,.s® AJ
.......................... ...................................................................................................
STOVE TYPE .................... A...?.................... CHIMNEY: NEW ....... ........ EXISTING ........................
Manufacturer is q..' ..'. ...............°. ....................."�.�.............. CHIMNEY: Masonry .....�............ .................................................................
Mass. Approval .... ................................:........................................................................ CHIMNEY: Metal ...................................................................................................
This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed
address in accordance with an application on file with the ................. r ............ '"`.............................. f ..... Fire Department,
'
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
. 'dispatcher eIssued By: .....w....:.....:........ ........... Title .......... . ...................................................... a... ........................................ ....::...........Permit to install expires 60 days after issue date
Stove ...............................................................................................................................................................................................................................................................
StoveClearance .......('75-/r ...........................................................................................................................................................................................................................................................
Floor . .. ........................................................................................................................................................................................................................................................................................
SmokePipe ...... ..........................................................................................................................................................................................................................................................................
SmokePipe Clearance ....... ........................................................................................................................................................................................................................................
Chimney ^.................................:.............................................................................................................................................................................................................................................
SmokeDetector ... ...... __�.:- f.{'......�n: ...... :f ?a............................................................................................................................................................................
The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au-
thority of permit dated `.�.................. has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto
Installer
i
INSTALLATION APPROVED 11 �............................................................ By: ............ ................................................... Title: ............u�rtd`..........:....
date
WHITE:
} FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT
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