Woodland Township, MT · Burlington County
Chimney Verification for Replacement of Fuel-Fired Equipment
This form documents chimney or vent condition and sizing for fuel-fired equipment work; the verifying individual completes it for permit or inspection purposes.
What this form is
This form records verification of a chimney or vent for replacement, conversion, or installation of fuel-fired equipment. 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 the work-site and verifying individual’s details, appliance and vent information, applicable verification statements, and signatures and dates.
Who needs it
A verifying individual completes this form for fuel-fired equipment work covered by its listed replacement, conversion, or appliance-installation options.
How to submit it
For minor and emergency work, provide this form with the permit application. For other work, present it to the code official before final inspection; include liner documentation with the permit application when installing a liner.
About notarization
No notary is required; the applicable verification signer signs and dates the form, and it identifies no notarized or sworn attachment.
How to submit this form
- 1
Download The Form
Download the Chimney Verification Form PDF.
- 2
Complete The Form
Provide the requested work-site, verifying individual, appliance, vent, and verification information.
- 3
Gather Liner Documents
If installing a chimney liner, include all documentation on the liner with the permit application.
- 4
Submit The Form
For minor and emergency work, provide it 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 has no notary block; the applicable verification signer signs and dates it. The form identifies no notarized or sworn attachment.
- 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.
- When is this form required?
- The form says it must accompany the permit application for minor and emergency work. For all other work, it must be presented to the code official before final inspection.
- What should I include if installing a chimney liner?
- The form says all documentation on the liner must accompany the permit application when a chimney liner is being installed.