Tenafly, MT · Bergen County
Chimney Verification for Replacement of Fuel-Fired Equipment
This form records chimney and vent verification for fuel-fired equipment work and is completed by the verifying individual for a permit or inspection.
What this form is
Use this form for replacement or installation of fuel-fired equipment to record appliance, chimney, vent, and liner details and the applicable verification. It asks for the work site, owner and verifying individual information, equipment and vent specifications, and a signed verification statement or an indication that verification is not submitted. For minor and emergency work, provide it with the permit application; for other work, present it to the code official before final inspection.
Who needs it
The verifying individual for fuel-fired equipment work completes this form for submission with a permit application or presentation before final inspection.
How to submit it
For minor and emergency work, provide this form with your permit application; for all other work, present it to the code official before final inspection. If installing a chimney liner, include all liner documentation with the permit application.
About notarization
This form is signed and dated without a notary; liner documentation may accompany the permit application, but no notarized attachment is identified.
How to submit this form
- 1
Download The Form
Download the Chimney Verification for Replacement of Fuel-Fired Equipment form.
- 2
Complete The Form
Provide the requested work site, owner, verifying individual, appliance, chimney, and vent information.
- 3
Gather Liner Documentation
If a chimney liner is being installed, include all documentation on the liner with the permit application.
- 4
Submit For Your Work
For minor and emergency work, provide the form with your 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. The form is signed and dated without a notary. If a chimney liner is being installed, its documentation must accompany the permit application; the form does not identify it as notarized.
- How do I submit the chimney verification form?
- For minor and emergency work, provide it with the permit application. For other work, present it to the code official before final inspection.
- What information does the form ask for?
- It requests work site and verifying individual details, replacement type, appliance and vent information, and a signed verification statement or a choice not to submit verification.
Need something notarized?
This Chimney Verification for Replacement of Fuel-Fired Equipment doesn’t need a notary — but if you have another Tenafly form that does, a commissioned online notary can help.