Hazlet, MT · Monmouth County
Chimney Verification for Replacement of Fuel-Fired Equipment
This form records chimney and vent verification for fuel-fired equipment replacements and is completed by the individual verifying the installation.
What this form is
Use this form to document chimney and vent conditions for replacement or installation of fuel-fired appliances. For minor and emergency work, the form must accompany the permit application; for other work, it must be presented to the code official before final inspection. It asks for replacement type, appliance and vent details, work-site information, and a signed verification statement.
Who needs it
The individual verifying the chimney and vent for fuel-fired equipment work must complete and sign the applicable statement.
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, and the form identifies no sworn or notarized attachment.
How to submit this form
- 1
Download The Form
Download the chimney verification form.
- 2
Complete The Form
Check the applicable replacement type, enter requested appliance and vent information, and sign and date the appropriate verification 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
- What is the chimney verification form for?
- It records chimney and vent verification for fuel-fired equipment replacements or installations, including details about appliances, venting, and the work site.
- When must I provide this 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.
- Do I need a notary for the chimney verification form?
- No. The form calls for the applicable verification statement to be signed and dated, with no notary or sworn attachment specified.
- How do I submit the chimney verification form?
- Provide it with the permit application for minor and emergency work. For all other work, present it to the code official before final inspection.
Need something notarized?
This Chimney Verification for Replacement of Fuel-Fired Equipment doesn’t need a notary — but if you have another Hazlet form that does, a commissioned online notary can help.