Lincoln Park, MT · Morris County

No notary required

Chimney Verification For Replacement Of Fuel-Fired Equipment

Property owners or contractors use this form to verify chimney and vent conditions when replacing fuel-fired equipment or installing additional appliances.

What this form is

This form records the replacement type, appliance and vent details, and a verification statement about the chimney or vent. For minor and emergency work, provide it with the permit application; for other work, present it to the code official before final inspection. If installing a chimney liner, include all liner documentation with the permit application.

Who needs it

Anyone completing minor or emergency work involving replacement of fuel-fired equipment must provide this form with the permit application.

How to submit it

Provide the form with the permit application for minor and emergency work, or present it to the code official before final inspection for other work. Include chimney liner documentation with the permit application if a liner is being installed.

About notarization

This form is signed without a notary; it mentions no notarized or sworn attachment, so the signer just signs and dates it.

How to submit this form

  1. 1

    Download The Form

    Download the chimney verification form PDF.

  2. 2

    Complete The Form

    Provide the requested information, select the applicable replacement type and verification statement, and sign and date.

  3. 3

    Gather Liner Documentation

    If installing a chimney liner, include all documentation on the liner with the permit application.

  4. 4

    Submit Or Present The Form

    Provide it with the permit application for minor and emergency work, or present it to the code official before final inspection for other work.

Frequently asked questions

What is the chimney verification form for?
It records details about fuel-fired equipment replacement and verifies chimney or vent conditions for the appliance or appliances being installed.
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.
Do I need a notary for the chimney verification form?
No. This form is signed without a notary; it mentions no notarized or sworn attachment, so the signer just signs and dates it.
What if I am installing a chimney liner?
The form says all documentation on the liner must accompany the permit application.

Need something notarized?

This Chimney Verification For Replacement Of Fuel-Fired Equipment doesn’t need a notary — but if you have another Lincoln Park form that does, a commissioned online notary can help.