2014-321 TOWN OF QUEENSBURY
ow742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140321 Date Issued: Wednesday, November 05, 2014
This is to certify that work requested to be done as shown by Permit Number P20140321
has been completed.
Tax Map Number: 523400-239-015-0001-006-000-0000
Location: 15 WILD TURKEY Ln
Owner: CHARLES MACKEY
Applicant: CHARLES MACKEY
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 (---- avzPo /+/
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
`/// w 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140321 Application Number: A20140321
Tax Map No: . 523400-239-015-0001-006-000-0000
Permission is hereby granted to: CHARLES MACKEY
For property located at: 15 WILD TURKEY Ln
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: CHARLES MACKEY
69 UPPER FONT GROVE Rd Fireplace
SLINGERLAND NY 12159-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
MOHAWK HEATING CO. INC.
518-374-3894
1694 DUANESBURG Rd
DUANESBURG NY 12056-0000
Plans&Specifications
2014-321
Fireplace - gas
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 18,2015
(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 Town + ' -nsbu 0.1 . Fri: : ,, my 18,2014
SIGNED BY �./ r ;rte for the Town of Queensbury.
Director of Building&Code Enforcement
KADateii'me 07/17/2014 17:02 P.002
07/17/2019 THU 17: 22 FAX
t� i �� 0002/002
ICiiL is $ 201 Office Uset)nN
Town of Queensbury Building!&Codes _Received:
TOWNO Cb-3 r ;FIJI."
xMp ID: QZ�9 ^/n
FUEL BURNING APPLIANCE& CHIMNEY APPLICATION C� emlilNo.: w I �%
• _ Permit Pee: _ ' �
•
Alli P I, ar
i 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 ad conditions that are part of these j 14
requirements and also will allow all inspectors to enter premises to perform required inspections. ?T.1 g
Important Note To Applicant:iRough-In and Final Inspections Are Required:• I
Date 1�1 18 /f l-/ /� /���� /�
Owner OnnS aria iace ' Installer/Builder / / 0--tacy-o
Address b f,1 0 'r Address /(/aq /` v o
•w ._ eo pi,o_neshu-c &y
• Phone h . Phone SI 8S i U 8&Ct z L'
Location of proposed construction and for installation: .f7Gt.k_-t
Contact Person for Budding&Codes Compliance:
Subdivision Name:
Fuel Burning Appliance Information Wood Coal Pellet Gas Oil
Stove
Fireplace Insert ,/
Fireplace,factory buds'
Fireplace,Masonry
. Furnace,(Garage Only)
•If Factory Built,Please Provide: Manufacturer Name:r strn aithth C Model No. w TJ V (PO() Prse_
Listed By: Number:
Chimney Information
Masonry" ✓check one _Block _Brick _Stone
Flue ✓check one The _Steel _Size in Inches
Material ✓check one _Double Wall _Triple Wall _Insulated V-Direct Vent _Chimney Liner
"If Non-Masonry,please provide: Manufacturer Name: VV&JJ.JOh C Model No. i&YQV(Pov P TS...
Signatures:
Print Name: h r'377 r1/4-0\-- "z-0
� o/c �L - 1/1-7 // l
Signature: 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.
AlNW
Town of Queensbury Fire Marshal
air" Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Fireplace/Stove Inspection Report
Notice:Not yncic_Stat. requires that all UL Listed,factory built appliances be installed according to the instructions and
specificSfions contained Installation Manual accompanying the appliance.No deviation from the manufacturer's
y-3 instructions or specifications is allowed.l ��
Permit# "‘3114+3- 78 Schedule Inspection "‘3114+ `/,d�9' amp/m anytime InspectoJtC
Name 67106710S aek, Address 16 /.44 tel hake", /, Rough In_Final J/
Appliance Manufacturer ihrfrie7 i ...14,7* Model# N/ P V 610 PS C'
/6 //
Direct Vent Factory Built Chimne�✓S Flue Size Double Wall Triple Wall Insulated_
( Yes No N/A Comments
Floor Protection X
Clearances to Combustibles (all sides) X i sr_z 3 , 40/*' �-
Firestop(s) Vertical Chase X b 1.1-1/7P !�
Wall Penetration
Vent Clearances to Combustibles X
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve A/
Combustion Air v
Hearth Extension (if any) l X
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if LP) x
CO Detection
CSST Bonding X
White—Building Dept Yellen—Cult nner Pink—Fire Marshal
Town of Queensbury Fire Marshal
f -j 742 Bay Road
`1 �jJ Queensbury,NY 12804
v 761-8205/761-8206
�� 6''I Al fax 745-4437
PI i
yy,3 0I� N Factory Built Gas Fireplace/Stove Inspection Report
'O: New
York State requires that all UL Listed,factory built appliances be installed according to the instructions and
catios-con 'ned in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
3 -q/��?-7/0/ chedule Inspection b / Time pm anytime Inspect°
Name Bibi '7k Address _ / /1.,_...- _,,b," Rough In Final_
l5 --DAppliance Manufacturer 1//' (.t/' /li at Model# W d/i)I /91-5 --
Direct
irect Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated
Yes No N/A Comments
Floor Protection XX
. 'Si/3--F.-9 vYz7b
Clearances to Combustibles (all sides) /�'
Firestop(s) Vertical Chase_ `
Wall Penetration�/ X
Vent Clearances to Combustibles K
Vent/Chimney Termination
X Chimney height must be 3 feet above roof
penetration; 2 feet above any combustible
construction within 10 feet
Gas Shut-Off ValveXv
Combustion Air
Hearth Extension (if any) gULSa sf7(teib
Mantel / A/O/ �Lc L't 'rn 5r
Height above Up opening / v
Witness Operation '/
Tank Placement(if LP) yVVVI c l����/'
t" ' 1 JG�.
CO Detection V Vat/
CSST Bonding 177
�J
White—Building Dept. Yellow—Cast merPink—Fire Marshal