HomeMy WebLinkAbout0405 W MAIN STREET - Wood Stove Permit 01/24/80 TOWN OF BARNSTABLE
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Wood Stove Permit
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DATE OF APPLICATION .A........................................................................... FIRE DEPT. ISSUING PERMIT ........ .. ........
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NAME (owner) .............. NAME (]`.nstaller) E� �.F1 G 1..#,�
ADDRESS ........................................................................................................................... . ADDRESS ................................................................................
STOVE TYPE .... .. �� CHIMNEY NEW EXISTING................................................................................ ... ........... x.............
Manufacturer W R . Ox..... CHIMNEY: Masonry x ( CK
.......................... ........................................ ................ �............................... .................
Mass. Approval ......................../.I/ .."n�.................................................... 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. pA K
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Issued By: .....j.........:.......cl��il�/�Q-� 1•� 1 �'d�'.�. ............Title [ .rd//1,;& i't• ": .............. Date ..............................................
J............................ ........ ......y............. ...... .... .g... ..
Permit to install expires 60 days after 'issue date
Stove ................. .. .................................................................................................................................................................................................................f.....................:.......................:........ '
StoveClearance ....................................................................................................................................:.................................:..........:.......................:......................................................................
Floor ...........�................................................................................................................................................................................................................................................................
SmokePipe ............................................................................................................................................................................................................................................ ......
Smoke Pipe Clearance $ .................
Chimney (�............../...'.........................................................................................................................................................................................................................................................
SmokeDetector ............l....: .. ...............................:...............................................
... .......................................................
....... ..............................................
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 provision�s of: the Coina/,�fii�onwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ,t..................................................
ti Installer
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INSTALLATION APPROVED / -�n� ..... By. �h (� 3 f�Qn. !-�i Title: 7. � `rJ
........ ............
date , _ ,:
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT
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