HomeMy WebLinkAbout0110 SKATING RINK ROAD - Wood Stove Permit 08/14/81 ypf d TOWN OF BARNSTABLE
i 33AIINSTABL
'S OY 9. MASSACHUSETTS
Wood Stove Permit
6b ���ci p'�t�i Geltvq 1/Y5741 '15 C� '
DATE OF APPLICATION . 1 .................... FIRE DEPT. ISSUING PERMIT.......................................................... ............................................................
NAME (owner) 1-.aJI rrl k l-J t►'J7r�Tnr� C NAME` (Installer)'............................. f [wrr�.,.
... .................................. .�.................... ......... .....................................................
ADDRESS Ij .........Sk T,^�r�- IE" vk ........$(4 ADDRESS ........�.F �.......=Jrt... � �..7+� "�.`.•�..................................
.................... ........r.... ... .... ........ ... ..
STOVE TYPE 7 � CHIMNEY: NEW EXISTING�(,./fin 1'� ............................... ........................ ........................
Manufacturer .....M—) h/A l.1.. 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.
Issued By• ........................................................ ..................................Title ......................:....................................................... Date ................................................
. ....................................
Permit to install expires 60 days after issue date
Stove .. .............................................................................................................................................:...............................................................................................................................................
StoveClearance. .....:... ...�...........................:......................................................................................................................................................................................................................................
Floor. ..............................................................................................................................................................................................................................................................................................................
SmokePipe ................................................................................:..............................................................................................................................................................................................................
SmokePipe Clearance ............................................................................................................................................................................................................................................................
Chimney ...........nr'...�............................................................................................................................................................................................................................................................................
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
2
INSTALLATION APPROVED . ,..., .:................... By Title ......................................................
date'--.WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT