HomeMy WebLinkAbout0530A W MAIN - Wood Stove Permit 08/18/79 -
�"'�`� TOWN OF BARNSTABLE
S BsaaerARAUL
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639. MASSACHUSETTS
Wood Stove Permit
DATE OF APPLICATION .
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.............................................................................. FIRE DEPT. ISSUING PERMIT ..................................................:......:.
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/� . ..�,.......................... NAME Installer
NAME (owner) ............................... .............................................. (Installer) 4 .......................................................................................
ADDRESS ........................................................................................................................... ADDRESS ...........................................................................................................................
STOVE TYPE ...............................................� `-,� � CHIMNEY: NEW ...............:........ EXISTING................... ................................ ........................
Manufacturer __ '1-1!.................................................................... CHIMNEY:- Masonry.........................
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A"',,L CHIMNEY: Metal ....... - ........ ..........................................................( /lJaL*
Mass. Approval ................................................................................ ..-
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This is to certify that the above installer has permission to install a wood burning appliance at the listed address
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in,raccordance with an application on file with the ..`' AA-W`'
.......................!......................................................... Fire Department,
and.-s.ubject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof..
Issued By: ......... ...\................. .. F. '� Title L.. � � ......... ::... .:E .... Date ....................................... ...
�... ..... r r r� Y
Permit to install expires 60 days after issue date
Stove .......................... ........`....................................................................................................................................................................................................................................................................... ,
StoveClearance ......... ... .................................................................................................................................................................................................... .............................................
Floor ...................................................................�...........................:....................................................................................................................................................................................................................
SmokePipe ........................................ .gj::............................................................................................................................................................
.............................................................................
SmokePipe Clearance ......... �......................................................................................................................................................................................................................................
.� 'Chimney .............................................:..................s..>..............ts.......................................... •............................... ....... ...............................................................................................................................
Smoke Detector .............. /'
......, ...:.............................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of wood burning stove and equipment made under author-
ity of permit dated -..................._ 1) l�............. has been made in accordance with provisions of Commonwealth
......... ioions the e ,
of Massachusetts State Building Code now currently in effect and pertaining thereto W& 1. ut.il� ..........................
:................:
Installer
INSTALLATION APPROVED � r / + y�� '� � �' �T oe st
......................................... By.................................................................................... Title: ...... ........................................
r C date` `'
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT