2015-394 TOWN OFQ UEENSBURY
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742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150394 Date Issued: Monday, August 31, 2015
This is to certify that work requested to be done as shown by Permit Number P20150394
has been completed.
Tax Map Number: 523400-302-018-0002-022-000-0000
Location: 3 RIPLEY P1
Owner: GARY& KATHERINE CANALE
Applicant: GARY& KATHERINE CANALE
This structure may be occupied as a:
Fireplace
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the ( J 4 4't
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
•AOlitai
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150394 Application Number: A20150394
Tax Map No: 523400-302-018-0002-022-000-0000
Permission is hereby granted to: GARY&KATHERINE CANALE
For property located at: 3 RIPLEY P1
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: GARY&KATHERINE CANALE
3 RIPLEY PI Fireplace
QUEENSBURY NY 12804-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-394
Wood Fireplace Insert
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 31,2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbu before the ex.'ration date.)
Dated at the Town f Qu s I u p F s f./ ugust 28,2015
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
Fuel Burning Appliance & niierakiEpliaaoiE Office Use Only
Received
DATE: ./2-7/15 AUG 2 7 2015 J Tax Map ID
TAX MAP ID: Permit No.
TbWN OF QUEENSB RY Permit Fee r-)
ZONE: RUII DING&CODES
OWNER �O j J J�1 c PHONE/E-MAIL 7112/0Z gS � �uv,"j�q'
�6ADDRESS fhtuu(
INSTALLER/ I "'' PHONE/E-MAIL
BUILDER 37-6- V
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE:
PHONE/E-MAIL BUILDING ADDRESS
ROOM OF INSTALL: PLANNED INSTALL DATE: 6) 7 2 ( ;
FUEL BURNING APPLIANCE INFORMATION WOOD COAL PELLET GAS OIL NOTE: ROUGH-IN&
STOVE FINAL INSPECTION ARE
• FIREPLACE INSERT REQUIRED.
FIREPLACE,FACTORY BUILT* NOTE:
MANUFACTURER'S
FIREPLACE,MASONRY
INSTALLATION MANUAL
FURNACE(GARAGE ONLY) MUST BE AVAILABLE AT
TIME OF INSPECTION
*If factory built provide manufacturer name: ; Model #:
Listed by: Number:
CHIMNEY INFORMATION
Masonry** (check one) 'BLOCK BRICK STONE
Flue TIE STEEL Size in inches
Material DOUBLE WALL TRIPLE WALL INSULATED
** If non-masonry provide manufacturer name: _ ; Model#:
DECLARATION: Construction/installation must conform to NYS Fire Prevention & Building Code and/or
manufacturer requirements. The applicant or owner agrees to comply with all applicable laws, ordinances,
regulations,and all conditions that are part of these requirements and also will allow inspector's to enter premises
to perform required inspections.
I HAVE READ AND AGREE TO THE ABOVE:
PRINT NAME: �,L., C ' Ni L DATE: /S
SIGNATURE: // / IVI DATE:
i for -
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
Town of Queensbury Fire Marshal
!IIIIIK 742 Bay Road
*IVO Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Wood Burning Fireplace/ Stove Inspection Report -- ���T--
Notice: New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
_ �, of
Permit# R5 . t�II Schedule Inspection 31201 -a. Time Iv am m anytime Inspector
Name ea 1..101 L Address J R k191-17-4/ Rough In Final X
Appliance Manufacturer �C.•>c-`I Model# –3100
il
Masonry Chimney/( Factory Built Chimney Flue Size LP Double Wall Triple Wall Insulated_
I yll Eli
Yes No N/A Comments
Floor Protection ---- ma`'`y
Clearances to Combustibles (all sides) '-t r.ci?LAC Ce AD Clot m 41_
Safety Strip Installation (fireplaces only) L —
r
Firestop(s) Vertical Chase \/ �C U' 1),J2Wall Penetration /J�, J
J
Chimney Clearances to Combustibles
ll „ -y.n W env CS_S L1ru .�
Chimney Termination �L��ti�
3 feet above roof penetration; 2 feet above
any
�'�h ��
any combustible construction within 10 feet C orr44 TiuN OF v•-) YL
Combustion Air "=-N
viD� IL' it
Hearth Extension lU,,�r`s aZ' RL-..--,c)..,1 +tc.
`
Mantel (height above f/p opening) G4-1 ''�L �� 1 G
Fireplace Doors / Screen (required)
?( ..."—‘,(NrN -- .......1.... p
Carbon Monoxide Detection \--
White—Building Dept. Yellon—Customer Pink—Fire Marshal
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