HomeMy WebLinkAbout0112 CAPN SAMADRUS ROAD - Wood Stove Permit 10/16/79 °- TOWN OF BARNSTABLE
BARISTAIM i
'ooe,'26 L MASSACHUSETTS
Wood Stove Permit
DATE OF APPLICATION Of,:r Z9 �� ........ FIRE DEPT. ISSUING PERMIT ... u.. %.
NAME (owner) ;Lf.A.±/ r dead. hs /! ............ NAME (Installer) A��p�' �s �ocf�fa•..� .................
ADDRESS //a2 ei' O ' . 5i+�slFiAai/c'ws A�...................... ADDRESS .....11-2 .�'=IQ':. �..:... Si%A"4bI 4( !(�.
............................................................ .... . ..............................................................
STOVE TYPE G� ! �....4.......n .T— C.JO.001............................. CHIMNEY NEW EXISTING ............
Manufacturer ✓ A1 '�:oTl/ '�..�� frfcT%�L. ... �%........ 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: ra � :, Title cf.. 'r�a j ....... Date /0,� //... ; ��....
.......:r.. ................................................ ................................
Permit to install expires 60 days after issue date
Stove ................:...........................................................................................................................................................................................:................................................................................................
StoveClearance .L/.......................................................................................................................................................................:................................................................ .........................
Floor ... :�....................................................................................................................................................................................................................................................................................:...............
SmokePipe .`........................................................................................................................................................................:...................................................................................................................
SmokePipe Clearance .....................:.................................................:.................................:............................................................................................
Chimney ...........................................................................................................................................................................................................................................................................................
SmokeDetector ..........................................................................................................................................................................................:..........................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity of permit dated L.I...2. .............. has been made in accordance with provisions 000ff the
Commonwealth
of Massachusetts State Building Code now currently .in effect and pertaining thereto ............................................ r
'Installer
INSTALLATION APPROVED ...:. . By - --� � _ =-�• Title:
date.................. ............`.............................................................. .......................
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT