HomeMy WebLinkAbout0046 CIRCLE DRIVE - Wood Stove Permit 03/03/81 TOWN OF BARNSTABLE
RIST"L
-mug
039. MASSACHUSEWS
Wood Stove Permit
Ila /,57 7P
DATE OF APPLICATION ................ 21 ............................... FIRE DEPT. ISSUING PERMIT .?"64........................
NAME (owner) NAME - (Installer)
................................... ...................................................................................................
ADDRESS ............/�_
.......................................... ADDRESS .............................................................................................................................
STOVE TYPE Vr..4......................................................................... CHIMNEY: NEW ........................ EXISTING
Manufacturer ..................................................................................................................... C 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 ................................................ ............................ Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
Issued By:
.............................. .............................................................................................Title .............................................................................. Date 2.
f 6, . .................................................
Permit to install expires 60 days after issue date
Stove ................................................................./
.............................................................................................................................................................................................................................................
Stove Clearance .................................1-1--/
...............................................................................................................................................................................................................................................
Floor .............................................................................................................................................................................................................................................................................................................
SmokePipe .............................................................
...................................................................................................................................................................................................................................
SmokePipe Clearance ..........................................................................................................................................................................................................................................................
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 .................................................** '* '-***--
Installer
INSTALLATIONAPPROVED .....................................P-L By: ......................................................................... Title: ......................................................
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT