Randolph, MT · Morris 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 a permit or inspection.
What this form is
The form records information about the work site, replacement type, vent or chimney, appliances, and any chimney liner. The verifying individual checks a verification statement and signs and dates the form, or selects the option not to submit verification. 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.
Who needs it
A verifying individual completing fuel-fired equipment replacement work uses this form when providing chimney or vent verification for the permit or inspection.
How to submit it
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.
About notarization
This document is signed without a notary; the verifying individual signs and dates it, and no sworn or notarized attachment is identified.
How to submit this form
- 1
Download The Form
Download the Chimney Verification form for fuel-fired equipment replacement.
- 2
Complete The Form
Fill in the work site, equipment, vent or chimney details, select the applicable verification statement, and sign and date the form.
- 3
Gather Liner Documents
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 is the Chimney Verification form for?
- It records information about fuel-fired equipment replacement and the related chimney or vent, including the verifying individual’s selected verification statement and signature.
- When do I provide this 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.
- Do I need a notary for the Chimney Verification form?
- No. The verifying individual signs and dates this form; it identifies no sworn or notarized attachment.
- How do I submit the Chimney Verification form?
- Provide it with the permit application for minor and emergency work. 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 doesn’t need a notary — but if you have another Randolph form that does, a commissioned online notary can help.