2014-549 011111KTOWN OF QUEENSBURY
..4
431 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140549 Date Issued: Wednesday, November 19, 2014
This is to certify that work requested to be done as shown by Permit Number P20140549
has been completed.
Tax Map Number: 523400-290-010-0001-005-001-0000
Location: 51 HIGHLAND Dr
Owner: JONATHAN M BOWERS
Applicant: JONATHAN M BOWERS
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, !, ), ,
f
Variance, or other issues and conditions as a result of approvals by the Director61Build g&Codet frirceStent
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
` a 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140549 Application Number: A20140549
Tax Map No: 523400-290-010-0001-005-001-0000
Permission is hereby granted to: JONATHAN M BOWERS
For property located at: 51 HIGHLAND Dr
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: JONATHAN M BOWERS
DAWN D. BOWERS Fireplace
51 HIGHLAND Dr Total Value
QUEENSBURY NY 12804-0000
Contractor or Builders Name /Address Electrical Inspection Agency
Plans&Specifications
2014-549
Fireplace (wood)
Basement installation
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, October 30, 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 ( tie sbury• Thin i a` October 30,2014
SIGNED BY / ' ATfor the Town of Queensbury.
if
Director of Building&Code Enforcement
Office Use Only
FUEL BURNING APPLICANCE &
CHIMNEY APPLICATION Received
Tax Map ID
�L 4 Permit No.
DATE aft , I, a I y Permit Fee
TAX MAP ID o1 cI D . 16 — I
ZONING M D lR
OWNER: Jana-r'han 130c ) .P,S PHONE/E-MAIL 5-I Is- 3 to Lv -a aoil
ADDRESS 5 I tQ od -v-e , Q Lt,L.u✓lwLI. 13 y ha OL
INSTALLER/BUILDER. SIGkn i-iu-1/u ran PHONE/E-MAIL 5 "g 17 - C )'y,71'"
ADDRESS: F. U Do K I a,/ , M.�CfCO(e Gro Ye ,o'J y ‘2-s-Q
IrS( '
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE:, "cal i o . ( �l k}-P}2,I PHONE 3 4'6' —
BUILDING ADDRESS: 5 I I- l ace -INA e, �e''-A- y�i ro`f la S'O a' V
Fuel Burning Appliance Information Wood Coal Pellet Gas Oil NOTE: ROUGH-IN & FINAL
Stove INSPECTIONS ARE REQUIRED.
Fireplace Insert
Fireplace, Factory built*
Fireplace, Masonry
Furnace (Garage Only)
*If Factory built provide manufacturer name: ; model#:
Listed by: Number:
Chimney Information
Masonry** (check one) Block Brick 7C Stone
Flue Tie ,X Steel Size in inches
Material Double wall Triple wall Insulated Direct Vent —k._Chimney Liner
**If Non-masonry provide manufacturer name: model#:
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 inspector's to enter premises to perform required
inspections.
-tel be5ode,r5I have read and agree to the above: Print Name: vh4l lGt. /r1 Date: /o ;VN
Signature:1,2,6,1�'f ��--- �✓ Date: MAI/ y
s
Town of Queensbury Building&Codes Principal Structure Application July 2014
Town of Queensbury Fire Marshal
742 Bay Road
ii�r 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
L instructions or specifications is allowed.
Permit# r L�'SACI Schedule Inspection r t I i X 1 i y Time i 1 am) pm anytime Inspector ' riVY9
Name C5;7'VIT-C Address 'J l Al\\1.aM Rough In Final A/
Appliance Manufacturer \J t\v1L,N` r&5i,*°) ' Model# � ( O'A c.
Masonry Chimney Factory Built Chimney) Flue Size Li Double Wall_Triple Wall_Insulated S 5 1..`
p hcr 53-1^-6
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides) )( C-5`\dv C: ► S C>ti
C`Ot•sLr\s\-- i- 1 6‘, ,(\ u-)
Safety Strip Installation(fireplaces only) i,Firestop(s) Vertical Chase
15 &v*kh s;
Wall Penetration N C
Chimney Clearances to Combustibles C � I\SNc-- C hk /
Chimney TerminationK b (-h`� .
3 feet above roof penetration;2 feet above
any combustible construction within 10 feet
Combustion Air S 1 o� C'1 l S A
Hearth Extension Ob` \-fb-)Cq '`N.5
Mantel(height above Vp opening) / ..--
Fireplace Doors/Screen (required) )( ,
Carbon Monoxide Detection
White—Building Dept. Yellen—Out-miler Pink—Fire Marshal