HomeMy WebLinkAbout0102 LINCOLN ROAD - Wood Stove Permit 11/06/79 TOWN OF . BARNSTABLE
33"ISTUL
AUL
MASSACHUSETTS
Wood Store Permit
DATE OF APPLICATION .. FIRE DEPT. ISSUING PERMIT
......................... ............................................... ...............
NAME (owner) NAME (Installer) ........... .........................................................
ADDRESS .......... ............f.1,VK4,.,-_Z1V9ADDRESS ...........................................................................................................................
STOVE TYPE .................... ......................��o.................................. CHIMNEY: NEW ........................ EXISTING ........................
................... .. .............
Manufacturer . .....................................................................................I.................... 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 ........................................................................................................................ 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 ..............................................
Permit to install.expires .60 days after issue date
0
Stove .............................................................................................................................................................................................................................................................................................................
StoveClearance ........................................................................................................................................................................................................................................................................
Floor ...............................0. /�
......................................................................................................................................................................................................................................................................
Smoke Pipe .......................K ),
..............................................................................I...............................................................................................................................................................................
SmokePipe Clearance a.A................................................................................................................................................................................................................................................
Chimney ......................................r)
.......................................................................................................................................................................................................................................;..........................
SmokeDetector ........... �S...............................................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 A-4x'��4_1
...........................................................................
Installer
INSTALLATION APPROVED ...................................................... By:.
................ ................................................................. Title ..............,
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT