HomeMy WebLinkAbout0019 PLYMOUTH AVENUE - Wood Stove Permit 10/09/79 10
TOWN OF BARNSTABLE
a DARNSTAX
03
:M"9L. MASSACHUSETTS
&M
Wood Stove Permit
DATE OF APPLICATION FIRE 'DEPT. ISSUING PERMIT
.....................................................................
NAME (owner) /T V) IVA//0 .............. NAME (Installer)...... ..................................................................................... . .........................................................................................
ADDRESS L! R&.MA.07*..........A.........V ..................................... ADDRESS ....................................
CHIMNEY: NEW ........................ EXISTING Z STOVE TYPE U./S..............................................................................................
Manufacturerk., t7l;;J 14A/a r: Masonry).......................................................................................
........................7. .... ....................................................................... CHIMNEi
Mass. Approval .............ve ............................................................................ 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 ate ................................................
................................................... D
Permit to install expires 60 days after issue date
Stove .............................................................................................................................................................................................................................................................................................................
Stove Clearance ............L!
....................................................................................................................................................................................................................................................
Floor .......................................................................................................................................I.......................................................................................................................................................................
r) k
Smoke Pipe ............................A.................................................................................................................................................................................................................................................................
SmokePipe Clearance .............................................................................................................................................................................................................................................................
Chimney ........................................(_i
.............................................................................................................................................................................................................................................................
Smoke Detector ..............
...............%................................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and eqiiipment 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- r ................L........................................
Installer
IZ
V-7" 4 INSTALLATION APPROVED ............................................. By:........................................................................4.......... Title: ...........................................
date / I
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT