HomeMy WebLinkAbout0113 CANTERBURY CIRCLE - Wood Stove Permit 01/15/80 TOWN OF -BARNSTABLE
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Wood Stove Permit
DATE OF APPLICATION ........l .. .......... ............................. FIRE DEPT. ISSUING PERMIT ................................ ..:.:.......�...>
NAME (owner) ........................................ ......... ... ............................... NAME (Installer) ......................................'1'/ '4 1 .......................................
ADDRESS .... ADDRESS` s
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STOVE TYPE .....:f .. r CHIMNEY NEW �....... ` ...................... y......,.....:...::: EXISTING
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Manufacturer ............................... .....:...:...................:...................................................... CHIMNEY: 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 pp ........................................................................................................................ 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• ..............................................................................................................................Title .............................................................................. Date ................................................
.
Permit to install expires 60 days after issue date
Stove,............................................................................................................................................................................................................................................................................................................
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StoveClearance ..........................................................................................................................................................................................................................:.....................................................
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
INSTALLATION APPROVED / 1
By ....... Title
...............................:............... :.......... .......................
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT
SAVIOAEA
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Ir c A if*A-411 C.9
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