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IM Inspection Worksheet_27-10-2023_11-51-37INSPECTION WORKSHEET (FMWOOD-028580-2023) RC-0900-2021Case Number:Case Module:Permit Management 10/27/2023 Partial PassInspection Status:Inspection Date: Factory Built Wood Burning FP/StoveInspection Type:Inspector:Charles Dyer Job Address:Parcel Number:25 Otter Track Queensbury, NY 12804 316.14-1-9 Company Name NameContact Type Applicant Mario Profita Architect Blackbird Group Architect LLC Contractor Superior Walls of Upstate NY Wittig Construction Granted Permission Wittig Construction Primary Owner Mario Profita Maria Lasala Checklist Item CommentsPassed Floor Protection False See manual pg 30 Chimney height 3 ft above roof penetration True Safety Strip Installation (fireplaces only)True Firestop(s) - Wall Penetration False Triple wall True Insulated False Connected to flue: flue gases not mixing w/rm air False Factory built chimney True Chimney Clearances to Combustibles True Flue size True 8-10" Model True SB100 / manufactured date 8/3/22 Hearth/Hearth Extension False verify at final / see manual Fireplace Doors Screen (required)True Combustion Air True Manufacturer True Majestic / serial 9226185 Mantel/Trim False verify at final Clearances to Combustibles (all sides)True Double wall False Firestop(s) - Vertical Chase True Chimney Termination True Carbon Monoxide Detectors:False verify at final 2 ft above any combustible const within 10 ft False October 27, 2023 Page 1 of 1