HomeMy WebLinkAbout0110 PRUDENCE LANE - Wood Stove Permit 10/06/80 TOWN OF BARNSTABLE
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.639. MASSACHUSETTS
Wood Stove Permit
DATE OF APPLICATION f' ........................ FIRE DEPT. ISSUING PERMIT :..;. .:a- :..:.
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NAME (owner) ........ ! i7 /1 �� R,I J %ro - NAME (Installer) ..�!..�. .� ..�+e, ... .A... ' .r.//[�..............
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ADDRESS 1/CJ �r t, cl P�t� (.. e ...F,i ...... ... ADDRESS
STOVE TYPE ..................l..1 1. .L... .&........Fs f.......P....k.....
............................. CHIMNEY: NEW ....................:... EXISTING ....................:...
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Manufacturer ......................................................... ......... CHIMNEY`: Masonry ...................A'
Mass. Approval ..........��,...f.-................................................................................. 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,
.......................................................................................
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
IssuedBy : r..........,,,.................. ...............-... ......................................................Title ........................ ,........,..............:......................... Date ........................ .....................
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Permit to install expires 60 days after issue date
Stove .:.................................................................................................................................................................................
Stove Clearance ..." ............ '..................:...
Floor ..... ............................................................................................................................................................................................................................................................................................
SmokePipe ................................................................................................................................................................................... .
SmokePipe Clearance ... .............................................................................................................................................................................................................................................
Chimney .........................................................................................................................................:.............................................................................................................................
..............................:
SmokeDetector ................Y.e..._s................................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity of permit dated .......................................I.......................... has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ...........................................................................
Installer
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INSTALLATION APPROVED v1��.'.. '�' B +/ - '�^:.:.�`'z Title:
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT
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