HomeMy WebLinkAbout2211 MAIN STREET - Wood Stove Permit 11/01/79 TOWN OF BARNSTABLE
i Beaa�r�r, �•
39. ,� MASSACHUSETTS
a.
Wood Stove Permit
DATE OF APPLICATION ... �.V. / FIRE DEPT. ISSUING PERMIT ..r.:.'... �.�? `�
.............. ....... ..............................
/ / y'�!..?.�.......':.................. NAME Installer ..................:.................:.�..-.-:.
NAME (owner)f !.'.!.... ."...r^c�f � t :.... n' (Installer) �c T�rIS:S..............................................
...................................
�2"I/ .f ?�. J l ra ,r .�a /
ADDRESS ......................�...................................................... ADDRESS .:.........::..............................................................................................................
STOVE TYPE S ...a CHIMNEY NEW EXISTING
Manufacturer :.:`...�'.r CY '................... CHIMNEY: Masonry.......................................................... .............................................................................
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.
IssuedBy Title ......:....................... ................. Date ..:%..........................................
Permit to install expires 60 days after issue date
i
Stove ............................. . ..... ............ ................................................................................................................................................................................................................................................ ..
StoveClearance ..................................:...:.........................................................................................................................................................................................................................................
-i
Floor i['.� � . ................................................
............................................................................................................................................................
Smoke Pipe l
............................................................................................................................................................................................................................:.................................................................
Smoke Pipe Clearance .`
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 acid pertaining thereto ........ .................................................................
Installer
1
INSTALLATION APPROVED r
,. .... ......... .... ...... ... By: .....:........................ ...................: '................. Title: ......................................................
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT