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HomeMy WebLinkAbout0003 BROOKSHIRE ROAD - Wood Stove Permit 02/11/80 TOWN OF BARNSTABLE 31JANSTMM AUL 1039. MASSACHUSETTS a VAIX Wood Stove Permit 12 DATE OF APPLICATION .............................................................................. FIRE DEPT. ISSUING PERMIT ............................................................ NAME (owner) NAME (Installer) .............................................................................................. ...................................................................... ADDRESS .� . , of) ADDRESS ...../....1.1..,— .6 F.............. ...............................1!............................................ STOVE TYPE ................. ......- CHIMNEY: NEW ........................ EXISTING y........... Manufacturer ...................J oe ..................................... HIMNEY: Masonry ....................................................................................... 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 va 14 (�� 7 ********"** Fire Department, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. Issued By: Date...................................... ...............................................................................Title .... .............................. .......................................... ............................... Permit to install expires 60 days after issue date Stove .............. .................................................................................................................................................................................................................................................. StoveClearance ..........I..........................................................................................................I.......................................................................................................................................................... Floor ...................................................................................................................................................................................................................................................................................6.......................... SmokePipe ................................................................................................................................................................................................6...........6................................................................... SmokePipe Clearance .................................................................................................................. ...........................................................................I........................................ Chimney ............................................................................................................................................................................:................. .................................................................... SmokeDetector ...................... .............................................................................................................................................................................................................................................. 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 f, ...............................................t........................ Installer �4 JA k' . ....... By: Title: ' ) INSTALLATION APPROVED ...................................i ........ ................... ................................................. ..........7............... ................. date WHITE: FIRE DEPARTMENT- — CANARY: BUILDING INSPECTOR PINK: APPLICANT