HomeMy WebLinkAbout0119 SKATING RINK ROAD - Wood Stove Permit 01/02/81 TOWN OF BARNSTABLE
Z BAR STABLAAUL
6 9 MASSACHUSETTS
Wood Stove Permit
/21
DATE OF APPLICATION / .............. FIRE DEPT. ISSUING PERMIT
NAME (owner) ...................................... NAME (Installer) ................................................. ........................... ............................................. ...................
ADDRESSI /� � + .r! � . . ADDRESS ...........................................................................................................................
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STOVE TYPE .........:............. ........ CHIMNEY NEW _ EXISTING..............
Manufacturer ........! / ...... CHIMNEY: Masonry ............
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Mass. Approval ........:................................................................................................ CHIMNEY: Metal ...................................................... ..........................................
This is to certify that the above installer has permission to install a wood burning appliance at the listed address
^� ..+} ........ Fire Department,
in accordance with an application on file- with the .........................:....................:................................................................ p
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
L ,�X� .�e rtal' i c vGr .r'Xlit , -� /,c�. r a�. J
sued By: ................. .. Date Title ...................................
Permit to install expires 60 days after issue date
Stove .............................................................................................................................................................................................................................................................................................................
StoveClearance ! .............................................................................................................................................................................................................................................................................
Floor :.............................................................................................................................................................................................................................................................................................................
SmokePipe ................................................................................................................................................................................................................................................................................................
SmokePipe Clearance '...:........................................................................................................................................................................................................................................................
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Chimney ......:...................................................................................... .......................................................
SmokeDetector .z-'................................................................... .....................................................................:..........................................................................................................
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
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INSTALLATION APPROVED ` '.............................................. Title: ....................:...
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT