HomeMy WebLinkAbout0121 STERLING ROAD - Wood Stove Permit 02/06/81 ST BLE i
TOWN OF BARN A
'oo .1,6 v`•M MASSACHUSETTS-
Wood Stove Permit t4L� Te , 3 � ,
DATE OF APPLICATION ' , .....
:-'.... ... ....!1.....` ...................... FIRE DEPT.:ISSUING PERMIT ............................................................. 'C
NAME (owner) ... /fir ( ' t�C(,rffyl......................... NAME (Installer) r� I C �x ieo'. CIG
...................................................................... .......................................
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v./' rt r / /-0 5.1 �..n ..
ADDRESS ..........
........................................... ..................:............................... ADDRESS
STOVE TYPE ...... /!" ...................... ................: CHIMNEY: NEW EXISTING
Manufacturer ...........�'C � CHIMNEY: Masonry "............................................................................................... ....................................................................................
Mass. Approval ....... ....................................................................................... CHIMNEY: Metal ................................................................................................
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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 .............
`f .. Fire Department,
and subject to the provisions of the Commonwealth--of Massachusetts,State Building Code and regulations made
under the authority thereof.
Issued By• /�I �t4�a Title �.�w�? ,� !................. Date ................................................y '
............................................................................................................. .......... ......
Permit to install expires 60 days after issue date
StoveY...........................................................................................:.................................................................................................................................................................................................................
Stove Clearance----...........................................................:......................................................................................................................................................................
............................................
Floor 'L.:...............................................................................................................................................................................................I......................................................;..!..................................................
SmokePipe`....:.................................................................................................................................................................................................:........................................................................................
SmokePipe Clearance ......................................................................................::......................................:........................:..........:......:..........:..........................:..............:...:................:.........
Chimney ..�''.................................................................................................................................................................:.................................................................................................................................
SmokeDetector ...r.. .......................................................................................................... ...............................................................................................................................................................
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
� t
INSTALLATIONAPPROVED :..........�4.......... ..:............. By,.•:.. ............................ ......... ................... Title: , ...........................:............
- ..date w! y
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR PINK: APPLICANT
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