HomeMy WebLinkAbout0957 MAIN STREET - Wood Stove Permit 10/25/80 TOWN OF BARNSTABLE
BAHdlTABL
1639 ,� . MASSACHUSETTS
Wood Stove Permit
6v 3 ,
/,)At S 40 �'Tz�/ i
DATE OF APPLICATION .....................:....................................................... FIRE DEPT. ISSUING PERMIT ............................................................
The
NAME (owner) .. ...'�1 � � �' NAME (Installer) SUDB , �.,..... ...............:..... ................:. ...................
RHNG
ADDRESS `'l?/vAN( 'T C�}T7.l F tti ADDRESS ...................
............................................................................................... ........................... ......... ........ .....
P. O.
STOVE TYPE :�R+* ... "16-HIMNE'Y: . NEW ........................ EXISTING .....Y..............
.................................... ...................................................................
Manufacturer �Ar ........ ,CHIMNEY: .. .Masonry S .......
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 ........... ?r ..............................................).::........................ Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof. '
s4L �=
IssuedBy .....................;...........................................Title ....:.................... ...,... ................ Date .. ........... .... .......
Permit to install expires 60 days after tissue date
J
Stove )i
.....................................................................................................................................................................................................................................................
f
StoveClearance ..................................................... ................................... ... ..... ................................................................. ..... ............................ .................
Floor ..... .'................................................................................... .............. ... ...... .... ...... :................................................................................................................................
SmokePipe .... ........................................................................... ............. ........................................... .................................................................... .........................................
SmokePipe Clearance °'` M............................................:.................................................:...........................,...................................................................................................................
Chimney1.�.......................................................................................................................................................................................................................................................................................
SmokeDetector ...0..........................................................................................................................................................................................................................................................................
-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 provisionsfof the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto. .... T1.
..., ..............................................
Installer�'�
,r
INSTALLATION APPROVED A.. .".:Z...":.R) By:. /� t/7 Title
.................. ..
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT
r