Name*: Telephone*: Email Address*:

Address*:

Fireplace Dimensions:

Style of Fireplace*: Please choose Bolection Classic Victorian Contemporary Country Tudor Deaconsfield Elizabethan Fluted French Gothic Classic Jacobean Kingminster Regency Bullseye Choice of Stone*: Please choose Bath Limestone Cotswold Limestone Portland Stone

Please enter the measurements indicated in the image on the left in centimetres: 1. Height of opening*: cm 2. Width of opening*: cm 3. Overall Height: cm 4. Overall width: cm 5. Depth of inner hearth: cm 6. Depth of outer hearth: cm 7. Width of outer hearth: cm

Additional information:

Do you have a chimney breast: Yes No
If yes, what is the width of the chimney breast ? cm
If no, what is the width of the wall ? cm

Finish on hearth:
Kerb Rounded Chamfer Square
Other: Please specify

What type of fire do you intend to use in your fire surround?
Dog Basket Inset Gas Stove
Other: Please specify

All measurements will be checked by Pinckney Green Stoneworks for good proportions, and you will be contacted before any work is undertaken.