HomeMy WebLinkAbout0011 MARYALICE LANE - Wood Stove Permit 01/07/80 TOWN OF BARNSTABLE
L BAR STIUM IS '1 .
6 9 '1 MASSACHUSETTS
Wood Stove Permit
DATE OF APPLICATION —_77 `0................................ FIRE DEPT. ISSUING PERMIT %'�..'```..""`'"`�
NAMEowner ........................................................................................... NAME Installer ...........................................................................................
!� iqr?r��4Ll�^r_" .
ADDRESS ...........................:....................................� ................T..: ............. ADDRESS ...........................................................................................................................
•
STOVE TYPE ...........t /.Q ........... CHIMNEY NEW EXISTING
Manufacturer ................................`.................................................................................... CHIMNEY. Masonry .....................................................................................
Mass. Approval ..... .�"'.........l.... ......-9............................................ 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/tlre r�/ '"`' Fire Department,
................F.................. .....................................................
and subject to the provisions of the Commonwealth of Massa&husetts State Building Code and regulations made
under the authority thereof.
Issued By• !_MI^'" r� - Q. ,�Z ...............................................
'C . J .................Title
. .....:........................................................................r.... ... ..............r....................;.......................�........... Date
Permit to install expires 60 days after issue date
Stove .................................... ..................................................................................................................................................................................................................................................................
StoveClearance .............)............................................................................................................................................ .................................*,",...... ...........................................................
Floor ..................................... ...... .............................................................................................................................................................................................................................................................
SmokePipe ....................... ........................................................................................ .....................................:..........................................................................................................................
Smoke Pipe Clearance ..........1.
.........................................................................................................................................................................................................................
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
fo'
INSTALLATION APPROVED .. .� .... `" '� ' ' `!fs f � '................... By................................................................. ................. Title: ............,.................... ............c.r.r
date � /
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR -- PINK: APPLICANT