2013-416 TOWN OF QUEENSBURY
fora 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130416 Date Issued: Tuesday, January 27, 2015
This is to certify that work requested to be done as shown by Permit Number P20130416
has been completed.
Tax Map Number: 523400-302-014-0003-021-000-0000
Location: 41 PARK VIEW Ave
Owner: ROBERT L MCARTHUR
Applicant: ROBERT L MCARTHUR
This structure may be occupied as a:
Fireplace
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, ����,,,,,�� 4
Variance, or other issues and conditions as a result of approvals by the Directo uu"ilding& Co.: nfor anent
Planning Board or Zoning Board of Appeals.
0.14 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130416 Application Number: A20130416
Tax Map No: 523400-302-014-0003-021-000-0000
Permission is hereby granted to: ROBERT L MCARTHUR
For property located at: 41 PARK VIEW Ave
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 Value
Owner Address: ROBERT L MCARTHUR Fireplace
41 PARK VIEW Ave Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-416
Fireplace - Wood burning
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, September 10,2014
(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 Tow of Que nsbu T d , September 10,2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes Received:
2013
Tax Map ID:'‘'Ei r Q /�c`� --3--4/
FUEL BURNING APPLIANCE & CHIMNEY APPLICATION Permit No.: / 3
Permit Fee: $ ;j D 00
Application is hereby made to the Building & Codes Office for the issuance of a Building & Use Permit pursuant to the NYS Fire Prevention &
Building Code. 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 all inspectors to enter premises to perform required inspections.
Important Note To Applicant: Rough-In and Final Inspections Are Required:
Date
Owner cM--(f L, /41/-14k/ Installer/Builder g24A6/4 MIA
Address �t�lw,!✓w ��yy„,e, Address 4--(( 4�c/�I/,L
ao-ea(,5,1?t,r)/ f'V_/ /RV" 7k / 7w1
L/
Phone 3(0) (`7 33 Phone
Location of proposed construction and/or installation: e,(--`7c- .e n 4 fn47 Di S I-OvP
Contact Person for Building&Codes Compliance: arJ { 6-4- /
Subdivision Name:
Fuel Burning Appliance Information Wood Coal Pellet Gas Oil
`' Stove
Fireplace Insert
Fireplace,factory built*
Fireplace, Masonry
Furnace,(Garage Only)
*If Factory Built, Please Provide: Manufacturer Name:V(L((M d n} L
Model
go.
Listed By: Number:
Chimney Information
Masonry** /check one \ lock Brick Stone
Flue /check one Tile Steel Size in Inches
Material /check one _Double Wall _Triple Wall _Insulated _Direct Vent _Chimney Liner
**If Non-Masonry,please provide: Manufacturer Name: Model No.
Signatures:
Print Name: .-4111/11-1- /�C 6,A4-
Signature:
,MSignature: Date: ).
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION & BUILDING CODE
AND/OR MANUFACTURER REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING
REQUIRED INSPECTIONS.
Town of Queensbury Fire Marshal
742 Bay Roadcq C
Queensbury,NY 12804
WIQ ry�
761-8205/761-8206
fax 745-4437 5I 0 (0e/q0 ' Cit-y
Factory Built Wood Burning 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.
Permit# 13. LI ! T Schedule Inspection 913,-))1-1 Time Ii `/wpm anytime Inspector 1
/Y\r0
Name R' I C 1 f ily4 Address( ( Pt hl(Gr'ct ) Rough In Final .�
Appliance Manufactu r ( e14,L\[1 `�1., ''�` Model# ~� S r
Masonry Chimney Factory Built Chimney Flue Size Double Wall_Triple Wall_Insulated_
Yes No N/A Comments
Floor Protection )c-- So )' ' Cc„r-C h 1 C-- --
Clearances
iClearances to Combustibles (all sides) X
Safety Strip Installation (fireplaces only) . )e
Firestop(s) Vertical Chase , r -� 1' bi L `A`,
M
n r , `
Wall Penetratio
. C 6,� C Thr'
N� `—
Chimney Clearances to Combustibles X
Chimney Termination kL W` f C bi V"
3 feet above roof penetration;2 feet above
any combustible construction within 10 feet
Combustion Air X
Hearth Extension
../)(
Mantel(height above f/p opening)
Fireplace Doors/Screen (required)
Carbon Monoxide Detection
?.(
White—Building Dept. Yellow—Customer Pink—Fire Marshal
Town of Queensbury Fire Marshal
742 Bay Road
1W fail Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Wood Burning 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.
t3 � >,
Permit# Schedule Inspection -6 a ,,lTime 'v am )nytime Inspector
Name ab a1 1/(71 \Address Ll 1 74a nu J/it.; A...16' Rough In Jt Final
Appliance Manufacturer Model#
Masonry Chimney Factory Built Chimney Flue Size Double WallTriple Wall_Insulated
Yes No N/A Comments
Floor Protection
bZ\ 'k /I t
Clearances to Combustibles (all sides)
Safety Strip Installation (fireplaces only)
Firestop(s) Vertical Chase
Wall Penetration 01 it fr.. a (.t%
Chimney Clearances to Combustibles \().i YNAFG
Chimney Termination
3 feet above roof penetration;2 feet above rkiE
any combustible construction within 10 feet `��
}( n
Combustion Air 6
,(\ 04)-li CY\
Hearth Extension '� v V� l 1 O
Mantel (height above f/p opening) `�r 1^`� t/
1/ V`Nti\itet (
Fireplace Doors/Screen (required)
Carbon Monoxide Detection
White—Building Dept. Yellofl—Customer Pink—Fire Marshal