HomeMy WebLinkAbout0022 NEWTON AVENUE - Wood Stove Permit 11/30/79 ' ' � 1� TOWN OF BARNSTABLE
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DATE OF APPLICATION FIRE DEPT. ISSUING PERMIT ..../11bgA)�.... ...................................... ..................................
NAME (owner) ...................................................................................................... NAME (Installer) ...............................,........... ................ .................. ..................
ADDRESS ........................................................................................................................... ADDRESS ............................................................. ...... .... ........................
STOVE TYPE � � �1)/� CHIMNEY: ' NEW ........................ EXISTING .....................................................................................
Manufacturer ..................................................................................................................... CHIMNEY: Masonry ........ -.:.....................................................:....
Mass. Approval .....//4:--�........................�..:.�...../.................................... CHIMNEY: Metal .................................
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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 .....................................................MONA) �............................. Fire Department......................._ ,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
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IssuedBy: .\; ._ ...........................................................................................Title. ..............:.. I►',r .:.................................. Date ..✓... ........................... ...;I�
Permiit to install expires 60 days after issue date
Stove .............. ...�.............................................................................................................................................................................................................................................................................
Stove Clearance '
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Floor ........................(�................................................................................................................................................................................................................................................................................
SmokePipe .......... ..............................................................................................................................................................................................................................................................................
SmokePipe Clearance ................:.......................................................................................................................................................................................................................
Chimney ..............................i-:1.f......`......................................................................................................................................................................................................................................................
Smoke Detector ..................................................................................................................................................................................................:.......................................
....... /„C�................. ..........
The undersigned hereby certifies that .the installation of wood burning stove and equipment mmade under author-
it of ............`..'............................ has been made in accordance with p;isio ofP the Commonwealth
y permit dated ��....:�� ��
of Massachusetts State Building Code now currently m effect and pertaining thereto` ...:............��! A�!!� 4 : ...
..... ........
Installer
INSTALLATION APPROVED /...: .......Ll .........� ` B .�"`� , t"d!� ' !�-..........................................'
.................. y......................................................::;..............`............ Title: ..... .
date / V
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT