HomeMy WebLinkAbout0245 SCUDDER AVENUE - Wood Stove Permit 01/17/80 TOWN OF BARNSTABLE
I ]SAIL STM
139. MASSACHUSETrS
Wood Stove Permit
DATE OF APPLICATION Z_J ............ FIRE DEPT. ISSUING PERMIT.................................. .............................. .......
NAME (owner) ............................................... ................................a.,Q............... NAME (Installer) ......................................................................................................
ADDRESS .............................�2................................................................................ ADDRESS ...........................................................................................................................
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STOVETYPE .......................................................................... ............... CHIMNEY: I%MW ............................................... .................EXISTING
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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 ....................... ................................................... Fire Department,
................... ..... .............
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
IssuedBy: 4................ Date.......................... ................................................... Title .........................................I.,-i
.............. ................................................
.............
Permit to install expires.60 days after 'issue date
Stove ..................4
....I.....................................................................................................................................................................................................................................................................................
Stove Clearance A /r
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Floor ..............?...........................................................................................................................................................................................................................
Smoke Pipe ....a K
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SmokePipe Clearance 12A...............................................................:.............................................................................................................................................I...............................
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
0#"e
of Massachusetts State Building Code now currently in effect and pertaining thereto(::n� ............................A...........
16 to
nstaller
INSTALLATION APPROVED ................................... By:..; ............. .......... .............................
Ili 6 ',Title
-�.........A ..............i.............i.........................
date.
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WHITE: FIRE DEPARTMENT CANARY: BUILDING INSPECTOR — PINK: APPLICANT