HomeMy WebLinkAbout0019 CAPT COOK LANE - Wood Stove Permit 09/10/79 r -
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TOWN OF 11 BARNSTABLE
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16 9 �,� MASSACHUSEWS
Wood Stove Permit
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DATE OF APPLICATION .............................................................................. FIRE DEPT. ISSUING PERMIT ............................................................
NAME (owner) .... ............................ NAME (Installer) 62 Y& `` .
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ADDRESS ..... ..1.....................:. C`.. .................................... ADDRESS f..j .....: 57 Q14dA)G,7nnJ 57; �lf�/j/f�YU
STOVE TYPE l� liGtJ% — WD CHIMNEY: NEW. ........................ EXISTING ....... ............
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Manufacturer �uiJL=`-J CHIMNEY: Masonry �iRG.....���.�.�s....................
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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
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.
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. .......................................................Issued By .(.(' Title s� ' FV) ... Date ........ .......
Permit to "install expires 60 days after issue date
Stove --��
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Stove Clearance ......................
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Floor
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SmokePipe ... ...........w.......................................................................................................................................................................................................................................
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Smoke Pipe Clearance .. �r
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Chimney ....................................... a :...:.......................................................................................................................................................................................................................................
Smoke Detector ................................ ,. ' ,.c'�..................... ........................
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. ....._..... ...........
Jnstalle
INSTALLATION APPROVED ....: / ~•. ''. By:..;.. a::ea....:�: � .�i.�'t`` ' .`.:...... Title: .............................................'
...................... .......r..................................I. ...ti.. .
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT