2006-146 Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: Time:
Phone: (518) 761-8206 Business Name:
Fax: (518) 745-4437 Location:
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
EVAC Plan
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign—normal
Sign-battery
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hung
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System
Fire Suppression—kitchen
Fire Suppression—Gas Island
Hood Installation
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed
Combustible Waste
Vehicle Impact Protection
Are Lane
F.D.Signage—Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
I], Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
❑ Denied
❑ Call for Recheck
Inspected By:
L:\FireMarshal\insptopermitto occupyform.doc
tur- kte,50(04-7 /-z 7/c.)7
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804 Scheduled Inspection Date: Time:
Phone: (518)761-8206 Business Name:
Fax: (518) 745-4437 Location: -
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure _
Exit Discharge
EVAC Plan
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal
Sign-battery
EVAC signs in rooms C.
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hung
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
Fire Sprinkler System
Fire Suppression-kitchen
Fire Suppression-Gas Island
Hood Installation
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed
Combustible Waste
Vehicle Impact Protection
Fire Lane
F.D.Signage-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
a Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
❑ Denied
❑ Call for Recheck
Inspected By:
L:\FireMarshal\insptopermitto occupyform.doc
6)
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. f'' ^ /'C
Town of Queensbury
742 Bay Road r
Queensbury,NY 12804 Scheduled Inspection Date: f Time: "
Phone: (518)761-8206 Business Name:
Fax: (518) 745-4437 Location:
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge CY?(14,-4, 4 y ° t EVAC Plan
AISLES: cc w-tc-st_cix,
Main Aisle Width c�
Secondary Aisle Width j
t
EXIT SIGNAGE ; ,,,tk mac. (- 1f'0'„$-t c{ Y'
Sign-normal
k 1
Sign-battery
EVAC signs in rooms
TRUSS ID SIGNAGE
l`�
EMERGENCY LIGHTING
FIRE EXTINGUISHER: C C'1 01.c.01,10 4 '
Hung
Inspection of extinguisher
Hydro extinguisher 19 c to '"?
FIRE ALARM SYSTEM
CO
Fan Shutdown �
Fire Sprinkler System
Fire Suppression-kitchen
Fire Suppression-Gas Island
Hood Installation
..., — . +r-
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed
Combustible Waste
Vehicle Impact Protection
Fire Lane
F.D.Signage-Utility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
o Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
a Denied 7//,/
❑ Call for Recheck
Inspected By: l'\k4 --~�
L:\FireMarshal\insptopermitto occupyform.doc
Inspection for Permit to Occupy
Fire Marshal's Office Request Rec'd Permit No. (-11-- 1 C:2
Town of Queensbury 742 Bay Road ,)/ ' ? _c
Queensbury,NY 12804 Scheduled Inspection Date: V Time:
Phone: (518)761-8206 Business Name:
Fax: (518) 745-4437 Location: L.v c it rti d ;-v C.... w.t_
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure _
Exit Discharge , 4" S w l r S O ir'4 T-S
EVAC Plan fir''0n
AISLES: '
Aisle Width i~ - . le w o Uk
Main Secondary Aisle Width ',
EXIT SIGNAGE 0 C ` u''` .e 1 5 is 0 1n-t, t. c
Sign-normal `x; ,
Sign-battery t W r_\ t4L- S t yA • V1(°'41
EVAC signs in rooms ✓ %,,4 S r c`
TRUSS ID SIGNAGE X,
EMERGENCY LIGHTING _ ~� -i ,�*r ��
1:. : JACA,^v‘QtirL.
FIRE EXTINGUISHER:
Hung — Li C.,`,:"'," • cc, u
Inspection of extinguisher
Hydro extinguisher #.‘v r"c a\ A L...,,, ,V
FIRE ALARM SYSTEM , QC A
Fan Shutdown i_. '._� \r«?r�1 L
{"k'1 . k,-N 1 '1'`j
Fire Sprinkler System ,j
Fire Suppression-kitchen ,?cv rw K 1 i r. `)-1 s--1ovv.s,
Fire Suppression-Gas Island ,
.1U
Hood Installation s,C. _ 0 ('i ts
Interior Finishes ) 7"\-t.- LI(.4crt.c i i he i,,k,*L
Storage
Compressed Gas r f @DL a, L{„_0-+ ,1 I(c G
Clearance to Sprinklers \ p
Clearance to Electrical k
Electric Wiring Enclosed X I u s s Li 0 4. l l_ " i S C t n, c,
Combustible Waste _C
Vehicle Impact Protection
Fire Lane () 0 CF1r4 15 4-,...,,.IN
t 44 --15 S i L,t
F.D.Signage-Utility Rooms •}/ h itr
No Smoking Signs
v Cy, Coy
Maximum Occupancy Sign It -•- ,r.4*
Emergency Evacuation Plan
° J Pt.-,S 4 LP' +='`-3 S i (404"*: -..
❑ Approved (If no other approvals apply,the B&C Office will issue the Certificate of Occupancy)
R Denied
❑ Call for Recheck
Inspected By: I' �-°—
D ik QC,A,4`.r LJ' ( 5 :4c , ,L G
S.
L:\FireMarshal\insptopermitto occupyform.doc I...-(C `'" c'� b i-,,,,, ; rr�
'I' t' " /06 sbAkie c /7 707
..01111ft, Town of Queensbury Fire Marshal
clitrztai 742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Fireplace/Stove Inspection Report
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.
/ I/
Permit# Schedule Inspection Time am pm anytime Inspector
Name 4/' Address / ( 4" Rough In Final
Appliance Manufacturer / -1:31- 11) _ Model# f7 •/11•1.,.9—
Direct Vent Factory Built Chimney Flue Size r'< Double Wall Triple Wall Insulated
_
Yes No N/A Comments
Floor Protection
eii 00), 1/zi/ N,
Clearances to Combustibles (all sides)
if 2-44
Firestop(s) Vertical Chase__
r
Wall Penetration •ei
Vent Clearances to Combustibles
Vent/Chimney Termination F
IT r—
Chimney height must be 3 feet above roof V V
penetration;2 feet above any combustible ‘00t)"..rt"
construction within 10 feet
•
Gas Shut-Off Valve Ke4„ea, a4)fry
Combustion Air
Hearth Extension (if any)
Mantel toj ,. 35— 7:-;:j
Height above f/p opening
Witness Operation 1(,/ (_1fri
Tank Placement(if LP)
White—Building Dept. Yellow-Costumer Pink—Fire Manila