HomeMy WebLinkAbout0205 BETH LANE - Wood Stove Permit 08/05/80 WVI
TOWN OF BARNSTABLE
Z BAH3lT�BL � i - -
'�, 6 v`• MASSACHUSETTS
Wood Stove Permit
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-,DATE OF APPLICATION //0 ..1, FIRE: DEPT. ISSUING PERMIT
NAME (owner) ........:.:....:........... NAME (Installer) ...........:.........:...:............................................................................
ADDRESS .........................::.:...............................:..................................................:............ ADDRESS ...:..:............:...........:...........................................................................................
STOVE TYPE !.. ... {r?-r- .................................................: CHIMNEY: NEW EXISTING ........................
Manufacturer ..........................................,.......................................................................... CHIMNEY: Masonry ........................................................................................
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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.
IssuedBy: ............................................................................................:.................................Title .............................................................................. Date ................................................
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Permit to install expires 60 days after issue date
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Stove .............................................................................................................................................................................................................................................................................................................
StoveClearance zn............ ................................................................................................................................................................................... ..............................................................
M Floor ..............................................................................................................................................................................................................................................................................................................
SmokePipe .......................................
.........................................................................................................................................................................................................................................................
SmokePipe Clearance .............................................................................................................................................................................................................................................................
Chimney ......:........................................................................................................................
.........................................................................................................................
SmokeDetector i.:..............................................................................................................................................................................................................................................................................
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
Y .
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INSTALLATIONAPPROVED r , `.........'............................................. By:.............................................:.................:.., ............ Title: ......................................................
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT