HomeMy WebLinkAbout0003 BROOKSHIRE ROAD - Wood Stove Permit 02/21/80 TOWN OF BARNSTABLE
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Wood.Stove Permit '
DATE OF APPLICATION .............................. FIRE DEPT. ISSUING PERMIT
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NAME owner I a��y P , -'r'`r�� (. ) ............................................................`�"----
........`.'....:.......... .......................... ...................................... NAME Installer ` ..........................
ADDRESS .................. ADDRE��S .
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STOVE TYPE .............!'fir:!..../ A A/`� CHIMNEY NEW EXISTING
......................................................................... .�"
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Manufacturer .... ^..old o P CHIMNEY: Masonry -^'
......y. .............................................................................. ....................................................................................
Mass. Approval .................. !1. .J............................................................................... 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 f '`�'� Fire Department,
........................................................_............................................................
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
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Issued By. ( '"i �/U /� Title 1�Jp_ 'J�t� ! ..�'..ti.. ....... Date :�J.....� .�............�.... ....................... . `j ..... p .... .L......... ......... ...
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Permit to install expires 60 days after issue date
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Stove ............. .............................................................................................................................................•.....................................................................................................................................
StoveClearance .. .................................................................................. .................... .............................................................................................................................................
Floor .............1:........................:...........................................................................................................:.........................................................................................................................................................
SmokePipe ......1 ..........................ii ................................................................................................................................................................................:...........................................:.....................
SmokePipe Clearance ....:Y...................................................................................................................................................................................................................................................
Chimney .................. .........................................................................................................:.............................................................................................................................................................
SmokeDetector ..5.......................................................................................................................................................................................................................................................
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 provisionsvof the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto,r:....:r.::...:........`.:: -... ................ '...:...
/Installer P-
INSTALLATION APPROVED �j
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.. }.. ..�`?.................... By:.,.O.
..�,. ........ A;../;.....-..;''..... _.... Title:......................................... ..
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT