HomeMy WebLinkAbout0010 QUEEN ANNE LANE - Wood Stove Permit 11/19/83 HE
TORN OF BARNSTABLE
t Beaaereac •
N6 q. MASSACHUSETTS
Solid Fuel Stove Permit
DATE OF APPLICATION � FIRE DEPT. ISSUING PERMIT ............................................................f
..:a ' ^ /...............................J. ..................:.-....c ..•....<NAME (owner) ....... .. .............................. .............�r'.-�..�:. NAME (Installer) ) ... ......
ADDRESS /l..... ;ter nr:�it�:o`F� tJ , r.L� f... ADDRESS .. j .. .: .:t.:... 1,+�:'.: p..... '....... ram:./t:'..
STOVE TYPE ..... r .%/................G?f� s� f ���j•! .
. .......................................... ...................... CHIMNEY: NEW ................ EXISTING ........................
Manufacturer ........... :.'....:......................................................................... CHIMNEY: Masonry .... .....................................................................................
Mass. Approval ...... r`... .......................................................................................... 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 ..........{...�.: i..:..:..t.t.......................................................... Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
Issued By .....................Title . ... ........................................ Date .
.....rJ. -.................................................V 'r v
0 .
.,4 Permit to install expires 60 days after issue date
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Stove ..................................................................................................................................................................................................................................................................................................
StoveClearance .......... :....:..................................................................................................................................................._...................................................................................................
Floor .: .:.�.1...............................................................................................................................................................................................................................................................................
SmokePipe .........C. ...............................................................................................................................................................................................................................................................................
SmokePipe Clearance -I. .................................................................................................................... . ...................................... .......................................................................
Chimney .............................................................................................................................................................. .......................................................................................................................
r
SmokeDetector ............!'.!t`. -_...........................................................................................................................................................................................................................................................
V
The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au-
thority of permit dated L K- ... has been made in accordance with provisions-of-the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ! ^j�..` ..........;..�...............
Installer
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INSTALLATION APPROVED ? .......................... By ...-..�""
Title: w ' 1 .....
date l
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT