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FMGAS-003554-2019 06132019INSPECTION WORKSHEET (FMGAS-003554-2019) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:RC-000173-2017Case Module:Permit Inspection Date:Thu Jun 13, 2019Inspection Status:Partial Pass Inspector:Gary StillmanInspection Type:Gas Fireplace/Stove Job Address:42 GRAND VIEW DRParcel Number:289.16-1-14 Queensbury, NY 12804 Contact TypeCompany NameName ArchitectDonovan, Andrew Granted PermissionMichaels, J. Primary OwnerMichaels, J. ApplicantMichaels, J. ContractorMichaels, J. Checklist ItemPassedComments Fire Marshal NotesYESHEAT&GLO MODEL # TRUE42H SERIAL # LC5042615 Building Inspector NotesNOINSTALLED IN GREAT ROOM VERIFY NON-COMBUSTIBLE FACING MATERIAL USED PER INSTALLATION MANUAL Floor ProtectionYES Clearances to Combustibles (all sides)YESOk Firestop(s) - Vertical ChaseYESOK- ATTIC INSULATION SHIELD INSTALLED Jun 13, 2019Page (1) INSPECTION WORKSHEET (FMGAS-003554-2019) Checklist ItemPassedComments Vent Clearance to CombustiblesYESOk Vent Chimney TerminationYESOk Gas Shut-off ValveNOSHUTOFF IN BASEMENT - VERIFY PERMANENT LABELING Combustion AirYES Hearth Extension (if any)YESHEARTH NOT REQUIRED- UNIT RAISED 13 INCHES ABOVE FLOOR (MANUAL REQUIRES 3 INCHES) Mantel-height above fp openingNORETURN TO VERIFY- REFER TO PAGE 50 OF INSTALLATION MANUAL FOR MANTLE CLEARANCES Witness OperationNORETURN TO VERIFY CO DetectionNORETURN TO VERIFY CSST BondingYES Stillman, Gary (Inspector) Jun 13, 2019Page (2)