HomeMy WebLinkAbout0059 COACH LANE - Wood Stove Permit 12/23/81 0�yp{ X E tO�w
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MASSACHUSETTS
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Solid Fuel Stove Permit
Dec.: 11'
DATE OF APPLIC TION .. . ......................... FIRE DEPT. ISSUING PERMIT
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NAME (owner) �.��
( e ) ........:..... .... .......................................................................... ...1........ NAME (Installer) ............:.........................................................................................
ADDRESS ....... ADDRESS
STOVE TYPE ........:....�..�`!....:..."".`...........................��2k1S........................... CHIMNEY: NEW ........................ EXISTING ........................
Manufacturer ...........................................................: CHIMNEY: Masonry .....:..............t �
......................................................... ..................................................................
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Mass. Approval ................:............................................................................................. CHIMNEY: Metal ...................................................................................................
This is to certify that the above installer has permission to install a so«liid, fuel burning appliance at the listed
address in accordance with an application on file with the ....11.1 .�(`°""s•�^.................................... Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof. r
IssuedBY: ... ...................................................................................................................Title .................................................................................... Date .............................
6permit to install expires 60 days after issue date
Stove .................. ......................... ................................................................................................
rStove Clearance ............. .................................................................................. ..................................................................................................................................................
Floor ....... .................................................................................................................................................................................................................................................................
Smoke Pipe ................. .6<...:.....:.........
Smoke Pipe Clearance .............
...........................................................................................................................................................................................................................
.. 1/ 1
.
Chimney .....................................................................................................................................................................:................................................................................................
Smoke Detector .................. A ................................................
The undersigned hereby certifies that thef installation of\solid fuel burning stove and equipment made under au-
thority of permit dated .................... .................... has been made in accordance with provisions.o4thei Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto
1 ....:
..................................... _ .....................
rr Installer
INSTALLATIONAPPROVED B........................ y.................................................. ...................................... Title: ... .........................
date /
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR —!PINK: APPLICANT
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