HomeMy WebLinkAbout0028 OWENS STREET - Wood Stove Permit 02/09/81 TOWN OF BARNSTABLE 3 30
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Wood Stove Permit
DATE OF APPLICATION ... :..../��.............................:................ FIRE DEPT.. ISSUING PERMIT rG�-� .*�t............................................
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NAME (owner) � ' � NAME (Installer) t '} K' /e �a
................................................... ...... ..................... ........................................`.'................. ......................
ADDRESS �'� .S � �. ADDRESS ..............y�� �� � r � ,u r' •
�................... ........................ f...f.................. ..............................................................
STOVE TYPE C 0 f9 ............��.............................. CHIMNEY: NEW ........................ EXISTING .....� .......
Manufacturer ................1:�. ... ...............��/�G.....f....................................... CHIMNEY: Masonry .......................Y..............................................................
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
StoveI'Z...........................................................................................................................................................................................................................................................................................
StoveClearances.�...........................................................................................................................................................................................................................................................................
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
INSTALLATION APPROVED l By ............. Title
............................. ...............................................................
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT