FMP-0265-2022 FUEL BURNING APPLIANCE & office use Only
CHIMNEY APPLICATION Permit#: 0215— ?JO?.Z
Permit Fee:$ 2
Torn of Queensbury
742 Bay Road, Queensbury, NY 12804 Invoice#:
P:518-761-8256 www.gueensbury.net
**ONE APPLICATION PER APPLIANCE**
Project Location: 10 Tee Drive, Queensbury, NY 12804Tax Map ID#:
Room of Install: Living room/basement Planned Install-Date: 5/24/29d,� -
_4
FUEL BURNING APPLIANCE INFORMATION: ��'
TYPE OF DEVICE:
Stove Fireplace Insert _Fireplace C(0) l'
Fuel Fired Equipment.(Garage Only: 18" clearance per IMC 304.3)
_Fireplace, factory built**
("Manufacturer's name: Regency Model#: Hampton Hi1150 )
SOURCE OF HEAT:
_�/Wood _Coal _ Pellet _Gas
CHIMNEY INFORMATION:
-A/Masonry (require plans to be submitted):
_block _brick stone
_Flue:
tile _steel _size, in inches
_Material*:
_double-wall —triple-wall_insulated
(*Manufacturer's name: Model #: )
Fuel Burning Appliance&Chimney Application Revised December 2020
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Chimney Heroes
Mailing Address, C/S/Z: 831 Route 67 Bldg 4113, Ballston Spa, NY 12020
Cell Phone: _�) Land Line: 518 ) 424-8620
Email: nicki(cDchimneyheroes.com
• Primary Owner(s):
Name(s): Maureen Whiting
Mailing Address, C/S/Z: 10 Tee Drive, Queensbury, NY 12804
Cell Phone: _( 518 ) 281-2667 Land Line: _( )
Email:_ mcwhiting55@hotmail.com
❑ Check if all work will be performed by property owner only
• Installer/Builder: Workers' Comp documentation must be submitted with this application
Contact Name(s): Chimney Heroes
Contractor Trade: Chimney& Fireplace Service, Maintenance, and Repair
Mailing Address, C/S/Z: 831 Route 67 Bldg 41B. Ballston Spa, NY 12020
Cell Phone: _( ) Land Line: _( 518 ) 424-8620
Email: nicki@chimneyheroes.com
Contact Person for any questions regarding this project: Nicki Valastro- Executive Assistant
Cell Phone:_() Land Line: 518 ) 424-8620
Email: nicki@chimneyheroes.com
ADDITIONAL INFORMATION:
1. Two (2) 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.
5. Workers' Comp insurance information is required with this application.
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:
SIGNATURE: DATE:
Fuel Burning Appliance&Chimney Application Revised December 2020
Chimney Heroes
831 Route 67 BLDG 41B
r Ballston Spa,NY 12020
•+ (518)424-8620
CHIMNEY
HEROES
BILL TO
Maureen Whiting
10 Tee Drive
Queensbury,NY 12804 USA
ESTIMATE
-- - -- - 18026377 . • •
JOB ADDRESS Project: 18021620
Maureen Whiting
10 Tee Drive
Queensbury,NY 12804 USA
ESTIMATE DETAILS
Installation of a Regency Hampton Hi1150 wood burning insert connected to an insulated stainless steel liner(Hampton
Hi1150):CHIMNEY HEROES PROPOSES TO:
Bring system up to NFPA 211 fire and safety standards by installing a Regency Hampton Hi1150 wood burning insert
connected to an insulated stainless steel liner
1)Proper equipment,and protection for property,persons
2)Prepare firebox and damper area for appliance installation
3)Cut and remove blower tubes
4)Remove doors AND seal in crack in hearth
5)Installation of a UL listed stainless-steel insulated liner
6)Installation of appliance and connect liner
7)Installation of faceplate,-blower- -
8)Clean area and remove construction debris,test draft
9)Show customer before and after pictures
10)Walk through operation of appliance and owner's manual.with customer
WARRANTY INFO:To maintain lifetime manufacturer warranty on Liner,system needs to be annually inspected by a certified
chimney sweep.This warranty does not include labor.Appliance has a separate warranty details in owner's manual.
TO SCHEDULE WE REQUIRE:
1)Payment preference(card,cash,check,financing)
2)Non-refundable deposit of$2,500
3)Signed proposal
4)Completion of capital improvement form
Estimate #18026377 Page 1 of 2
NOTES:
1)Proposal is valid of**14-days**from date above,after which time price will be subject to change.
2)Material escalation clause:due to the times,material has the ability to change.This is out of Chimney Heroes control.
3)If you would like to customize this proposal a change order is required.
4 This does not include the price of obtaining permit if required by town.Owner to pay permit separately.
5)Hidden damage clause:Any work that is required to be done due to any hidden damage or unforeseen circumstances that
could not have been reasonably ascertained at the time of inspection may be subject to a change order.
***NO PROMOTIONS CAN BE APPLIED TO THIS PROJECT*
OFFICE USE ONLY:
2ts.2t.2.5k
28'ladder off back deck
TASI( DESCRIPTION QTY PRICE TOTAL
Installation Installation of Hi1150: 1.00 $7,959.00 $7,959.00
of Hi1150 Installation of a Regency Hampton Hi1150 wood burning insert connected
to an insulated stainless steel liner,with a faceplate and blower
FIN01 12-month interest free financing: 1.00 $0.00 $0.00
This project qualifies for 12-month interest free financing with approved
credit
SUB-TOTAL $7,959.00
TAX $0.00
TOTAL $7,959.00
Please note the following*
(1)All Estimate pricing is valid for 30 days from receipt.(2)Price is not included if a permit is required by your town or city.
(3)LIMITED WARRANTY:All materials,parts,and equipment are warrantied by manufacture's or supplier's written warranty
only.Any warranty-by Chimney Heroes is-outlined-and documented on a separate form for specific repairs and requires
annual maintenance and inspection.(4)Please inquire about our financing options.
CUSTOMER AUTHORIZATION
This invoice$7,959.00 is agreed and acknowledged.Payment is due upon completion of work.I hereby authorize Chimney
Heroes to conduct work at 10 Tee Drive,Queensbury,NY 12804 USA.
Sign here Date 4/2/2022
Estimate #18026377 Page 2 of 2
µ� Chimney Heroes
831 Route 67 BLDG 41B
Ballston Spa,NY 12020
• (518)424-8620
CHIMNEY
H E R O E S
BILL TO
Maureen Whiting
10 Tee Drive
Queensbury,NY 12804 USA
ESTIMATE
- - - 18020792 -- . • •
JOB ADDRESS Project: 18021620
Maureen Whiting
10 Tee Drive
Queensbury,NY 12804 USA
ESTIMATE DETAILS
Installation of a lifetime warranty stainless steel liner for your main heating system:CHIMNEY HEROES PROPOSES TO
COMPLETE THE FOLLOWING REPAIRS:
INSTALLATION OF A STAINLESS STEEL LIFETIME WARRANTY LINER FOR YOUR MAIN HEATING SYSTEMS TO CONTAIN THE
DANGEROUS OFF GASES
Proper equipment set up,used to protect property,persons during repair
Sweep flue before installing liner
Installation of a stainless steel liner,adhering to NFPA standards
Installation of UL listed stainless steel components(top plate,tee,snout)
Make the necessary connections to your furnace
-Seal up thimble hole - - -
Test draft,clean area before leaving
Show homeowner pictures of process
***WARRANTY INFO:To maintain lifetime manufacturer warranty on venting system,system needs to be annually inspected
by a certified chimney sweep.This warranty does not include labor*
TO SCHEDULE WE REQUIRE:
1)Payment preference(card,cash,check,financing)
2)Non-refundable deposit of$500
3)Signed proposal
4)Completion of capital improvement form
Estimate #18020792 Page 1 of 2
NOTES:
1)Proposal is valid of**14-days**from date above,after which time price will be subject to change.
2)Material escalation clause:due to the times,material has the ability to change.This is out of Chimney Heroes control.
3)If you would like to customize this proposal a change order is required.
4 This does not include the price of obtaining permit if required by town.Owner to pay permit separately.
5)Hidden damage clause:Any work that is required to be done due to any hidden damage or unforeseen circumstances that
could not have been reasonably ascertained at the time of inspection may be subject to a change order.
***NO OTHER PROMOTIONS CAN BE APPLIED TO THIS PROJECT*'
OFFICE USE ONLY:
2ts.2t.500
28'ladder off of back deck
TASK DESCRIPTION QTY PRICE TOTAL
Liner Liner installtion for oil appliance due to cracks in flue tile: 1.00 $2,975.00 $2,975.00
installtion Code requires every chimney to be lined.This chimney has cracked tiles
for oil and does*NOT*adhere to the minimum standard for venting oil fired
appliance appliances.Chimney Heroes would be installing a lifetime warranty
due to stainless steel liner connected to UL listed components to contain the off
cracks in gases to make your system more efficient and up to minimum NFPA 31 and
flue tile 211 venting codes,standards for your main heating system
FIN01 12-month interest free financing: 1.00 $0.00 $0.00
This project qualifies for 12-month interest free financing with approved
credit
SUB-TOTAL $2,975.00
TAX $0.00
TOTAL $2,975.00
Please note the following*_
(1)All Estimate pricing is valid for 30 days from receipt.(2)Price is not included if a permit is required by your town or city.
(3)LIMITED WARRANTY:All materials,parts,and equipment are warrantied by manufacture's or supplier's written warranty
only.Any warranty by Chimney Heroes is outlined and documented on a separate form for specific repairs and requires
annual maintenance and inspection.(4)Please inquire about our financing options.
CUSTOMER AUTHORIZATION
This invoice$2,975.00 is agreed and acknowledged.Payment is due upon completion of work.I hereby authorize Chimney
Heroes to conduct work at 10 Tee Drive,Queensbury,NY 12804 USA.
Sign here Date 4/2/2022
Estimate #18020792 Page 2 of 2
FIRE MARSHAL'S OFFICE
Tozvn of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Maureen Whiting
10 Tee Drive
FMP-0265-2022
5/11/2022
Wood burning insert
The following comments are based on a review of submittals:
• Notify FM office one day in advance of the install
• FM office to witness insert clearances, liner connection to insert, liner
termination w/rain cap
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal 's Office Phone: 518-761-8206 • Fax: 518-745-4437
,firemarshal fteensbunf.net • zvz Mqueensbunt net