Wood Burning Equipment Permit Application

Newbury Fire Department
PO Box 373, Newbury NH 03255
Permit to Install and Operate Wood Burning Equipment

Click here to download a printable version of this form to mail to the Newbury Fire Department

To the Chief of the Fire Department:

The undersigned hereby applies for a permit to install and operate or wood burning equipment in compliance with R.S.A. 153.5 (State Fire Code) and NFPA 211 (Standard for Chimneys, Fireplaces, Vents and Solid Fuel Burning Appliances) as follows:

Address:

Address # Posted

Map and Lot Number

Type of Occupancy:

Resident Other

Number of Stories

Owner:

Contact Phone*:

Address of Owner:

Contact Email*:

Occupant's name:

Check Here is this is a rental

Does the building have Smoke & Carbon Monoxide detectors?

Make, Model & Serial Number of Wood Burning Equipment:

Name of Installer

Business Name:

Phone:

E-Mail:

Address:

Town:

Zip:

State: