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0621 MAIN STREET - Wood Stove Permit 09/09/80
TORN OF BARNSTABLE . Z IAI30TAIL i MASSACHUSETTS 0 YR! Wood Stove Permit ` DATE OF APPLICATION ..... '? ! ..��d FIRE DEPT ISSUING PERMIT ............................................................ Y. NAME (owner) Ic�t;l.r ' �2 a�ltil NAME (Installer) ........................................ ........................................................... ADDRESSADDRESS :.......................................................................................................................... STOVE TYPE ""; t +�...,�xnrlt...` �..-'-..��'�l�' CHIMNEY: NEW .... .............. EXISTING ........................ Manufacturer '►� .......................................................... !.a' : !'$ ` r .. ........... CHIMNEY: Masonry ....................:........................................................,......... Mass. Approval ,1��.,.,..... . - CHIMNEY: Meta`l-tS �,t',.t.�,�t;, ;�.... 1� i.,�; { ............. ............................................. Y. 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. `. ................ . �-�1"' ..........................,....,....,....� ..................................Title ..�.�•�. ...� ./............................ Date ©• ��,.�-� Permit to install. expires 60 days after issue date Stove , ............................................................................................:................................................................................................................................................................................................................ Stove Clearance .......✓........................................ ........ ........................ ::.. .....................:................................:... .......................................................................................................................... Floor ....4.:P.............................................................................................r.................................................................................................................................................................................................. SmokePipe ....! ' ................................................................................................................................................................................................................................................................................ SmokePipe Clearance ...k. ................................................................................................................................................................................................................................................ 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 a of Massachusetts State Building Code now currently in effect and pertaining thereto ...�:.:.. '' '�....................................................... Installer INSTALLATION APPROVED �, .......................................................[ By.;;.IF:y�:..........�...f�...�::r:............. Title: .:9..:��.....�:�-........... date WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT