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HomeMy WebLinkAbout0126 OLD TOWN ROAD - Wood Stove Permit 10/12/79 TOWN OF BARNSTABLE 1 ssaaSrAUAUL : 4 039. ,� MASSACHUSETTS Wood Stove Permit /,®-- 62- 7 9 fy1y}��a r>J � DATE OF APPLICATION .................................^"" ............................... FIRE DEPT. ISSUING PERMIT .........,.................................................. NAME (owner) ! D .`f'T .�. w ..... NAME (Installer) .��..:�:;& ..............�;;,,A,;�+...............................: l ..... .........../........w. .._� .............^ ... ADDRESS ......./..�Z..... l Ia 4t/�� Ir ADDRESS ..I4=69............�.�Zh.......... _w,, L........�'r�...'....... ................... .............................5........................ STOVE TYPE ....... ..�%...�.•�l•.!`Ilk,............................................. CHIMNEY: NEW ........................ EXISTING ........ ...... 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 ./i /PkJ(. f-1............... Fire Department, .................................................................. ............................... and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. Issued By: nlJc� -�5 � �,n � / .�.-.. .��............................................................................................................................Title ..,..... ,.........:........p...........:.................................. Date ..................... ...... Permit to install expires 60 days after issue date Stove ............................1.............................................................................................................................................................................................................................................................................. Stove Clearance .........Q ....................................................................................................................................................................................................................................................................... Floor .............................................................................................................................................................................................................................................................................................................. Smoke Pipe ................................................................................................................................................................:............................................................................................................................. SmokePipe Clearance .......0.................................................................................................................................................................................................................................................. Chimney ........................................... ... ......................................................................................................................:.............................................................................:................................... SmokeDetector ............................J.............................................................................................................................................................................................. .......................................... The undersigned herebyyeerttifies that/,the installation of wood burning stove and equipment made under author- ity of permit dated ...�.// � as been made m accordance with rovisi..:.......T`. l.a.:. : �"'. ce ons off the Co manwealth. e , ��of Massachusetts State Building Code now currently in effect and pertaining thereto :...: .. .............................................. Installer �) ii ,,. INSTALLATION APPROVED /1 ° y•+ f� '` 0r/r4itle:'. �Jt?:!���+...���°:: B ......................................................................,..... .....�... .. .. ... r date 1 WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT