Maywood, MT · Bergen County
Chimney Verification for Replacement of Fuel-Fired Equipment
This form records chimney or vent verification for fuel-fired equipment work, and is completed by the verifying individual for a permit application or before final inspection.
What this form is
The form documents checks of a chimney or vent for fuel-fired equipment replacements, conversions, and new or additional appliances. For minor and emergency work, it must accompany the permit application; for other work, it must be presented to the code official before final inspection. It asks for work-site and verifier details, appliance and vent information, and a signed verification statement or a choice not to submit verification.
Who needs it
The verifying individual completes this form for fuel-fired equipment work involving the chimney or vent, including conversions, replacements, and new or additional appliances.
How to submit it
For minor and emergency work, provide this form with the permit application. For all other work, present it to the code official before final inspection.
About notarization
This document is signed without a notary; the verifying individual signs and dates the applicable statement, or signs and dates the choice not to submit verification.
How to submit this form
- 1
Download The Form
Download the Chimney Verification form.
- 2
Complete The Form
Fill in the work-site, verifier, appliance, and chimney or vent details, then sign and date the applicable statement.
- 3
Gather Liner Documentation
If a chimney liner is being installed, include all documentation on the liner with the permit application.
- 4
Submit The Form
For minor and emergency work, provide the form with the permit application. Otherwise, present it to the code official before final inspection.
Frequently asked questions
- Do I need a notary for the Chimney Verification form?
- No. This form does not require a notary; the verifying individual signs and dates the applicable statement or the choice not to submit verification.
- How do I submit the Chimney Verification form?
- For minor and emergency work, provide it with the permit application. For all other work, present it to the code official before final inspection.
- What information does the Chimney Verification form request?
- It requests work-site and verifier details, replacement and vent types, appliance fuel and BTU information, and chimney liner details if a liner is being installed.
- What happens if I choose not to submit verification?
- The form says you must be present for the inspection to remove and reinstall the chimney vent connector.