HomeMy WebLinkAbout0042 CAPT COOK LANE - Wood Stove Permit 10/24/80 TOWN OF BARNSTABLE
R STAX
'M 9..UL MASSACHUSEWS
163
Wood Stove Permit
DATE OF APPLICATION ............... ........... FIRE DEPT. ISSUING PERMIT ............................................................
/ ..... ................ -. —1
16711VIP 7— —NAME (owner) 4� ......................................................................................Z!�/NAME (Installer). ............./01
�k-
ADDRESS ....... ......................................................
C411�/ /�)Q ADDRESS ..........................................................................................................................
Z�'v 4_ ) L I)
STOVE TYPE .................. 4-" �( 0 .................................................................................;........... CHIMNEY: NEW .......... EXISTING ........................
Manufacturer0..........e (............................................ CHIMNEY: Masonry .......................................................................................
Mass. Approval CHIMNEY: Metal
........../ S L /...........
...................................................................... .......................
This is to certify that the above installer has permission to install a wood burning appliance at the listed address
ly4lov.<la '-'aOxf, 4/5
in accordance with an application on file with the ...............................................................................................t.........Znire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
IssuedBy: ..............................................................................................................................Title .............................................................................. Date ................................................
Permit to install expires 60 days after issue date
Stove ....................................................................................................................... ......................................................................................................................................................................
StoveClearance v................................................................................................................................................................................................................................ ......................................
Floor1 .........................................................................................................................................................................................................................................................................................................
SmokePipe��.....................................................................................................................................................................................................................................................................................
SmokePipe Clearance ................................................................................................................................................................................................i.........................................
Chimney ...........................................................
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
INSTALLAT10N APPROVED Title: ...................................................................................... By:..................... ...........14"
.....................................
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR.— PINK: APPLICANT