FMP-0699-2018 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: FMP-0699-2018 Date Issued: Monday, November 5, 2018
This is to certify that work requested to be done as shown by Permit Number FMP-0699-2018
has been completed.
Tax Map Number: 301.12-2-43
Location: 39 HEINRICK CIR
Owner: Joan Decaro, Mark Decaro
Applicant: Chimney Heroes
This structure may be occupied as a: Gas Insert Fireplace
Living Room By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the (..w 4 „ot___
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.
1101.4.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: FMP-0699-2018
Tax Map No: 301.12-2-43
Permission is hereby granted to: Chimney Heroes
For property located at: 39 HEINRICK CIR
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
Owner Name: Joan Decaro Solid Fuel $0.00
Owner Address: 39 HEINRICK CIR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Chimney Heroes
PO Box 774
Saratoga Springs,NY 12866
Plans&Specifications
Gas Insert Fireplace
Living Room
$ 0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,November 7,2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town bury; We 14 s• '•vember 7,2018
4 1
SIGNED BY: ' ' for the Town of Queensbury.
Director of Building&Code Enforcement
FUEL BURNING APPLIANCE & Office Use Only
IIlir • f CHIMNEY APPLICATION Permit#: P MP " O to`ici • Vatt,
Permit Fee:$ 125
Town of(beens.ury
742 Bay Road,Queensbury, NY 12804 Invoice:#: . �01
P: 518-761-8256 www.queensbury.net
Project Location: 3i c 1 ck C,'r Tax Map ID #:
Room of Install: Fc•rr''`‘`‘"' Planned Install Date: II)'S I lit
**ONE APPLICATION PER APPLIANCE**
CONTACT INFORMATION:
• Applicant:—G^d i ns lte-r
Name(s): 40t1\&c.& fCrcj \4trc8--S
Mailing Address, C/S/Z: 'OS 43rcos-c PO Sof, `17 L Cern-id
Cell Phone: (SW )14t( -2sC.2-() Land Line: ( )
Email: acGc t,es?,rkIrnncx.pcs-oc-S.
• Primary Owner(s):
Name(s): r &ft 64n lJL��-0
Mailing Address, C/S/Z: 3e.)4L1 Ci.'.
Cell Phone:_( S12e ) CMc,1C,) Land Line: ( S Imo-) 2—act • .( (5n.)
Email: :) ccLrcJ n1cA.e,. (b
• Installer/Builder:
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _( )
Email:
Contact Person for Building & Code Compliance) �,�. kvr�
Cell Phone: S I kc 9) Line:_( ) 1%� of Land Line. (
Email: jor $ et+6 �c�,,r,,.+ca� �rt
Fuel Burning Appliance&Chimney Application Revised March 2017
FUEL URNING APPLIANCE INFORMATION:
TYPE OF DEVICE:
Stove X Fireplace Insert' S Fireplace
Fuel Fired Equipment (Garage Only, 18"clearance per IMC 304.3)
Fireplace,factory built**
**Manufacturer's name: Model#:
SOURCE OF HEAT:
Wood Coal Pellet x Gas
—
CHIMNEY INFORMATION:
X Masonry:
block ' brick stone
Flue:
Y. tit& steel size, in inches
X Material*: AtuLve+icuv, C�6—11f(LAr 11 rid 1 (A4-1% e.C.)-i inItt CA
double-wall triple-wall insulated $)
1c, Cb-bwjm- 3 pi-
(*Manufacturer's name: 1•1 6 A ali S Model#:1-�"'� )
1 ' Vi 1 yoga/ 3 S& 3 /3
ADDITIONAL INFORMATION:
1. Two inspections are required. A rough-in inspection, prior to installation and a final inspection,after
installation.
2. Manufacturer's installation manual must be available at the time of inspection.
3. Masonry fireplaces& chimneys require plans to be submitted.
4. Twenty-four(24) hour notification is required for inspections.
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 the inspector to enter the premises to perform the
required inspections.
I have read and agree to the above:
PRINT NAME: 3 n i t- (ilkt.itteki,--4-1
SIGNATURE: _, kiv
DATE: ii iiR /iv
Fuel Burning ppliance&Chimney Application Revised March 2017
INSPECTION WORKSHEET (FMGAS-008120-2018)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
FMP-0699-2018Permit
Case Number:Case Module:
Fri Nov 16, 2018Passed
Inspection Date:Inspection Status:
Gary StillmanGas Fireplace/Stove
Inspector:Inspection Type:
39 HEINRICK CIR301.12-2-43
Job Address:Parcel Number:
Queensbury, NY 12804
Contact TypeCompany NameName
Primary OwnerDecaro, Mark
ApplicantChimney Heroes
ContractorChimney Heroes
Primary OwnerDecaro, Joan
Granted PermissionChimney Heroes
Checklist ItemPassedComments
Fire Marshal NotesYESREGENCY LRI4E
SERIAL #434010815
NG
Installed in living room
Building Inspector NotesYES
Floor ProtectionYESPre-existing masonry fireplace-OK
Clearances to Combustibles (all sides)YES
Firestop(s) - Vertical ChaseYESPre-existing masonry fireplace-new gas fireplace insert
installed In living room of Ranch style house
Nov 16, 2018Page (1)
INSPECTION WORKSHEET (FMGAS-008120-2018)
Checklist ItemPassedComments
Vent Clearance to CombustiblesYESPre-existing masonry chimney, two stainless liners to be
installed
Vent Chimney TerminationYES
Gas Shut-off ValveYESGas shut off outside by meter
Combustion AirYES
Hearth Extension (if any)YESN/A
Mantel-height above fp openingYESExceeds installation manual 35" required from base- actual
55"
Witness OperationYES
CO DetectionYESVerified
CSST BondingYESN/A - BLACK IRON
Stillman, Gary (Inspector)
Nov 16, 2018Page (2)
PICTURES (may not be applicable)
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