HomeMy WebLinkAbout0030 ARBOR WAY - Wood Stove Permit 12/04/80 TOWN OF BARNSTABLE _
6 9 ,� MASS, HUSEWS .
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-Wood Stove Permit
DATE OF APPLICATION FIRE DEPT. ISSUING PERMIT ...........................................
NAME (owner) .0 /l /��.,Q�.� �J��,+� %..::�� NAME (Installer) ..............r... ................. ............
ADDRESS '..:..............;........................ .ADDRESS ...........................................................................................................................
,r
STOVE TYPE ............... ..�.:� c............................/..................................... CHIMNEY: NEW ........................ EXISTING ........L'.
Manufacturer 7-9-I 0 COW CHIMNEY: Masonry �`, ick' ll�• CG zltlre
.............................. ..... ....................................................................... ........................................................................ .............
Mass. Approval ........................�................................................................................... 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.
Issued By r jll f ......................................Title Date
................................................. .......................................................................... ................................................
Permit to instal7l' expires 600 days after issuey date
Stove
StoveClearance L- .. ......... ............................................................................ ............................. ..........................................................................................................................................
Floor
..............................:.......:.......................... .............f...:.......:.......:...............................................................................................................................................................................................
SmokePipe ....... ..:........-.......................................................................................................................................................................................................................................................................
SmokePipe ClearanceL'."...!.................................................................................................................................................................................................................................................
Chimney ....... a ..............................................................................................................................................................................................................................................................................
SmokeDetector . ..v .................................................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity 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
" INSTALLATI �` hv. `��`' .i ON APPROVED .............. .................................. By:...........................,....................................................... Title
dateI f .......................................
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT