HomeMy WebLinkAbout0168 MELBOURNE ROAD - Wood Stove Permit 10/22/80 -_ '.. ...� '-'S -,.'.��.a iS - a y -;.. t�_...� .G.—•i .�ti:. .� 7
TOWN OF BARNSTABLE 7 �-
i BsaaerAN
6 9 MASSACHUSE'I'TS
Wood Stove Permit
r
DATE OF APPLICATION {.... ..:.. Z FIRE DEFT. ISSUING PERMIT ...............�. ��....
...................................................
NAME (owner) !tM Q........ ......: NAME (Installer) '/......... .. ..... z............
ADDRESS G
............ ................... ADDRESS ........................................ ... .. .......... ........... :..... Q......
...... ................. ................................... .........
STOVE TYPE .... .... :. .....:.........:......... ................................ .:....... CHIMNEY: NEW .........:.............. EXISTING
Manufacturer ..........:...... ....... 0.............4.................................................. CHIMNEY: Masonry v
Mass. Approval -7 " 7 / Y s-7, CHIMNEY: Metal ......................................................!. . .........................................+. .........................................
This is to certify that the above installer has permission ton ,all a wood .burning appliance at the listed address
in accordance with an application on file with the ..................... :... .............. c ✓................................................... Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.-
Issued B .. ................................Title ... .......................................................ll.............. Date .../..�./........... .
w
Permit to install expires 60 days after issue date
Stovej:` .............................................................................:......................................................................................................:.............................................................................................................
StoveClearance ..:J...........................................................................................................................................................................................................................................................................
Floort, :.....................................................................................................................................................................................................................................................................................:..................
SmokePipe t-i'..'........................................................................................................................................................................................................................................................................................
SmokePipe Clearance ':...........................................................................................................................................................................................................................................................
Chimneyt-'...................................................................................................................................................................................................................................................................................................
r
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
r ,r ...
INSTALLATION APPROVED .:....................' By:................... .... +. fi Title
date
WHITE: FIRE DEPARTMENT — CANARY:,BUILDING INSPECTOR — PINK: APPLICANT