HomeMy WebLinkAbout0057 FIDDLERS CIRCLE - Wood Stove Permit 12/31/80 • °- TOWN OF BARNSTABLE
i BAR STABL
i�a 9 MASSACHUSETTS
Wood Stove Permit
DATE OF APPLICATION ............................................................................... .FIRE DEPT. ISSUING PERMIT
.NAME owner ............................................................................. NAME Installer ......................:....................................
ADDRESS t}-� '�� • �.� . � / CGS ADDRESS C ' ^-''r�.- ......... ..........................
. ....................................................................................................................... ............................................. ....... .......
STOVE TYPE'= ✓ �' .. ��.. ` ........ CHIMNEY NEW EXISTING
Manufacturer .............................................................:...........:........................................... CHIMNEY: Masonry .. :...................:...........:...............................................
Mass. Approval . .f..�...: ....:... .......................................................................... 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.
IssuedBy. ,..............................................Title Date ................................................
4 Permit to install expires 60 days after issue date
Stove ..................................... � ..............................................................................................................................................................................................................................................................
StoveClearance .................................................................................................................................................................. ......
Floor ...!�. .... ..... ...................................................................................................................................................................................................................... .................................
................ ......
Smoke Pipe `..
SmokePipe Clearance /14-.............................................................................................................................................................................................................................................................
Chimney ...............................`..............i::..................................................................................................................................................................................................................................................
SmokeDetector .........:.......P..1..................................................................:................................................................................................ .........................................................................
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
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INSTALLATION APPROVED .............................:.. By:................ .............. Title: ........................j............
date
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WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT
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