Newark, MT · Essex County
Chimney Verification Form
This form records chimney details and inspection certifications for an applicant seeking work connected with a chimney or heating appliance.
What this form is
The form collects the applicant’s information, property address, permit details, chimney type, and heating or fuel information. The applicant or contractor certifies the chimney’s condition and suitability for the listed work; the form says it must be presented to the code official before final inspection.
Who needs it
Applicants or contractors completing work involving a chimney or heating appliance use this form to provide chimney information and certify its condition.
How to submit it
Present the completed form to the code official before final inspection, as directed by the form.
About notarization
This document is signed and dated without a notary; it includes no notarized or sworn attachment or related step.
How to submit this form
- 1
Download The Form
Download the Chimney Verification Form PDF.
- 2
Complete The Form
Fill in the applicant, property, permit, chimney, and heating details, and complete the certifications.
- 3
Gather Attachments
The form does not identify attachments to gather.
- 4
Present It To The Code Official
Present the completed form to the code official before final inspection.
Frequently asked questions
- What is the Chimney Verification Form for?
- It records applicant, property, permit, chimney, and heating details and includes certifications about the chimney’s condition and suitability for the work.
- Who completes the Chimney Verification Form?
- The form is for applicants and contractors to provide chimney and heating information and certify the chimney’s condition.
- How do I submit the Chimney Verification Form?
- Present the completed form to the code official before final inspection, as directed by the form.
- Do I need a notary for the Chimney Verification Form?
- No. This form is signed and dated without a notary, and it does not identify a notarized or sworn attachment or related step.
Need something notarized?
This Chimney Verification Form doesn’t need a notary — but if you have another Newark form that does, a commissioned online notary can help.