Keyport, MT · Monmouth County
Chimney Verification for Replacement of Fuel-Fired Equipment
This form records chimney or vent verification for fuel-fired equipment replacement and is completed by the verifying individual for the permit or inspection process.
What this form is
The form documents the condition, lining, and sizing of a chimney or vent for replacement or installation of fuel-fired appliances. For minor and emergency work, provide it with the permit application; for other work, present it to the code official before final inspection. It requests work-site and appliance details and a signed verification statement, or a choice not to submit verification.
Who needs it
The verifying individual completes this form for fuel-fired equipment work involving a replacement, conversion, or new or additional appliance.
How to submit it
For minor and emergency work, provide the form with your permit application; for all other work, present it to the code official before final inspection.
About notarization
This form is signed and dated without a notary; liner documentation must accompany the permit application when a liner is installed, but the form does not say that documentation must be notarized.
How to submit this form
- 1
Download The Form
Download the Chimney Verification for Replacement of Fuel-Fired Equipment form.
- 2
Complete The Form
Fill in the work-site, verifying-individual, appliance, and chimney or vent details that apply.
- 3
Gather Liner Documentation
If installing a chimney liner, include all documentation on the liner with the permit application.
- 4
Submit For Your Work
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
- Do I need a notary for the Chimney Verification?
- No. The form is signed and dated without a notary. If a chimney liner is installed, its documentation must accompany the permit application, but the form does not require notarization.
- How do I submit the Chimney Verification?
- For minor and emergency work, provide it with your 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 and vent types, appliance fuel and BTU ratings, and chimney or liner measurements where applicable.
- What if I choose not to submit verification?
- The form includes a statement for that choice. It says you understand you must be present for the inspection to remove and reinstall the chimney vent connector.
Need something notarized?
This Chimney Verification for Replacement of Fuel-Fired Equipment doesn’t need a notary — but if you have another Keyport form that does, a commissioned online notary can help.