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TOWN OF HUDSON FIRE DEPARTMENT - INSPECTIONAL SERVICES (Town of Hudson)

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U.S.A. forms for Town of Hudson

BROWSE TOWN OF HUDSON (NH) FORMS

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Oil Burner Appliance Fees: $30.00 per appliance
INSP-55 - Rev. 3/2015
TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
OIL BURNING MECHANICAL PERMIT APPLICATION
Installation Address: _________________________________________________
Business Name: _________________________________ Unit: ______________
Type of Occupancy: Residential Commercial/Industrial
Estimated Cost: ______________ Permit Fee: _____________
Office Use:
Permit #: ________
Map: ________
Lot: ________
Zone: ________
Appliance: New Replacement
Furnace Hot Water Heater Boiler Other ___________________
Make : ____________________ Model: _______________________ Serial: _____________________________
Installation Date: ________________________________
Owner: _____________________________________
Mailing Address:_____________________________
_____________________________________________
Daytime Phone #: ___________________________
Cell Phone #: _______________________________
Email: ______________________________________
Contractor: _________________________________
Mailing Address:_____________________________
_____________________________________________
Daytime Phone #: ___________________________
Cell Phone #: _______________________________
Email: ______________________________________
Installer*: ____________________________________ Cell Phone #: _______________________________
*Installer must be qualified to install oil burning equipment
My signature below indicates that the above mentioned will be installed in compliance with R.S.A. 153:5
and National Fire Protection Association Standard # 31.
_____________________________________________ _________________________
Signature of Installer Date
_____________________________________________ _________________________
Signature of Permit Clerk Date
OIL BURNING APPLIANCE REQUIREMENTS
1. Instructions and installation guide shall be posted near appliance.
2. Appliance shall be installed to manufacturer’s installation requirements and NFPA-31.
3. If vented into a masonry chimney, chimney must have a liner.
4. Appliance must be vented per manufacturer’s installation guide.
5. Surroundings must provide adequate air for appliance.
6. Electrical service disconnect shall be at the unit and within view of the flame.
7. Remote shut off switch shall be outside of and adjacent to the entrance of the room.
Switch must be identified.
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TOWN OF HUDSON FIRE DEPARTMENT - INSPECTIONAL SERVICES (Town of Hudson)

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Completed 18 February 2021

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