Harrison Township, MT · Gloucester County
Chimney Verification for Replacement of Fuel-Fired Equipment Certification
This form records chimney and vent verification for replacement fuel-fired equipment and is completed by the verifying individual for a permit or inspection.
What this form is
Use this form to document chimney or vent verification for replacement fuel-fired equipment, including conversions, replacements, and new or additional appliances. It asks for the work-site and owner information, appliance and vent details, and a selected verification statement with signature and date. 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
A verifying individual completes this form for fuel-fired equipment replacement work; a homeowner may not submit it in place of the required inspection.
How to submit it
For minor and emergency work, provide this form with the permit application. For all other work requiring a full permit, present it to the code official before final inspection.
About notarization
This document is signed and dated without a notary; it does not mention any notarized or sworn attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the chimney verification form.
- 2
Complete The Form
Enter the work-site, owner, verifier, appliance, and vent information, then check the applicable verification statement and sign and date it.
- 3
Gather Liner Documentation
If installing a chimney liner, include all documentation on the liner with the permit application.
- 4
Provide The Form
For minor and emergency work, provide it with the permit application; for other full-permit work, present it to the code official before final inspection.
Frequently asked questions
- What does the chimney verification form document?
- It records verification of chimney or vent condition, lining, and sizing for fuel-fired equipment work, along with appliance and work-site details and the verifier’s signed statement.
- When must I provide the form?
- For minor and emergency work, provide it with the permit application. For all other work requiring a full permit, present it to the code official before final inspection.
- Do I need a notary for the chimney verification form?
- No. The form calls for a signature and date, not notarization. It does not mention any 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 requiring a full permit, present it to the code official before final inspection.
Need something notarized?
This Chimney Verification for Replacement of Fuel-Fired Equipment Certification doesn’t need a notary — but if you have another Harrison Township form that does, a commissioned online notary can help.