HomeMy Public PortalAboutStove Permit Application
TOWN OF BREWSTER
2198 MAIN STREET
BREWSTER, MA 02631
PHONE: (508) 896-3701 EXT 1125
FAX: (508) 896-8089
WWW.BREWSTER-MA.GOV
Office of
Building Department
This is an APPLICATION ONLY – your stove is NOT approved until you receive a signed permit.
The stove CANNOT be used without being inspected.
The permit and installation inspection are limited to the stove installation and not to the stove construction.
If listed and labeled, then stove must be installed according to the
Manufacturer’s Installation Instructions, otherwise according to
International Mechanical Code (IMC and IRC)
DATE: ________ PERMIT # _____________________ FEE $50.00:________________________
APPLICANT NAME: _________________________________________________________________________
ADDRESS: _______________________________________________ MAP: ___________ LOT:______________
TELEPHONE #: ______________________________________________________________
SIGNATURE: _______________________________________________________________
STOVE INFORMATION:
NEW OR USED: ________ ____________________________________________________________________
MANUFACTURER/MODEL:____________________________________________________________________
CHIMNEY TYPE (Circle those that apply): MASONRY METAL LINED UNLINED INSULATED
NEW OR EXISTING: ___________________ SIZE (FLUE AREA): _______________
HEIGHT (refer to diagrams): _______________
HEARTH (non-combustible):
MATERIALS: _________________________ SUB-FLOOR CONSTRUCTION: _____________________________
MINIMUM DIMENSIONS:_____________________________________________________________________
NAME OF INSTALLER: __________________ _____________ TELEPHONE #:___________________________
CONSTRUCTION SUPERVISOR LICENSE #: ________________ OTHER #:_______________________________
SIGNATURE:______________________________________________________________________________________
OVER
FIREPLACE STOVES AND SOLID FUEL TYPE ROOM HEATERS SHALL BE LISTED AND LABELED AND
INSTALLED IN ACCORDANCE WITH THE LISTING.
PLEASE HAVE THE MANUFACTURERS INSTRUCTIONS ON SITE FOR INSPECTION.
OFFICIAL USE ONLY
Town of Brewster Building Department: ______________________________________________
Date Issued:_____________________________________________________________________