BOTH-000397-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000397-2015 Date Issued: Thursday, December 17, 2015
This is to certify that work requested to be done as shown by Permit Number BOTH-000397-2015
has been completed.
Tax Map Number: 296.8-1-24.1
Location: 5 CHELSEA PL
Owner: RICHARD O'CONNOR
Applicant:
This structure may be occupied as a: Gas fireplace
By Order of Town Board
TOWN OF QUEENNSSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the _r/ %�
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000397-2015
Tax Map No: 296.8-I-24.1
Permission is hereby granted to: RICHARD O'CONNOR
For property located at: 5 CHELSEA PL
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
Owner Name: RICHARD O'CONNOR Fuel Burning&Chimney $0.00
Owner Address: 5 Chelsea PL Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
First Flame
475 CORINTH RD
Queensbury,NY 12804
Plans&Specifications
Gas fireplace
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,December 3,2016
(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 Townueen W s ember 9,2015
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
20 Is-515
Fuel Burning Appliance & Chimney Application Office Use Only
Received
DATE: /Z -Cj 3 - [ S Tax Map ID _
@@ Permit No. 3 T- ZOl
TAX MAP ID: DEC 0 :j, -20!5 Permit Fee �O,0t7
ZONE:
i
OWNER l N u n PHONE/E-MAIL -7 FA_ L 6 o q
ADDRESS
INSTALLER/ r',�5r XIA.. PHONE/E-MAIL
BUILDER Ll-�jcc)V,IV%t-VA lQ � q ?J'- z2110
CONTACT PERSON FOR BUILDING&CODE COMPLIANC : r/dy-O sr
PHONE/E-MAIL / 2 Z L b BUILDING ADDRESS
ROOM OF INSTALL: 6 t.Ai ry a n, PLANNED INSTALL DATE:
FUEL BURNING APPLIANCE INFORMATION WOOD COAL PELLET GAS OIL NOTE: ROUGH-IN&
STOVE FINAL INSPECTION ARE
FIREPLACE INSERT REQUIRED.
FIREPLACE,FACTORY BUILT* NOTE:
MANUFACTURER'S
FIREPLACE,MASONRY
INSTALLATION MANUAL
FURNACE(GARAGE ONLY) MUST BE AVAILABLE AT
TIME OF INSPECTION
*If factory built provide manufacturer name: Model#: _p 3 3
Listed by: Number:
CHIMNEY INFORMATION
Masonry** (check one) BLOCK —BRICK _STONE
Flue TIE STEEL Size in inches
Material _DOUBLE WALL _TRIPLE WALL _INSULATED 1('L� ✓eh
** 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.
I HAVE READ AND AGREE TO THE ABOVE:
PRINT NAME: C R fa _ 0 t(f,.jf j,3 DATE: / L - 0 3
SIGNATURE: r /,zz- DATE: / v 3
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
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P33-Vignette faceplate-Black Chrome P33-Vignette Faceplate-Black, P33-Vignette Faceplate-Black
Vignette Door Inlay-Black Chrome Vignette Door Inlay-Tuscan Sunset
Specifications(NG)* .P33CE P E i P33 Standard Features .__ Options
Input(OTU) 20,000 20, 20,000 Natural gas Verona glass or metal surrounds in various colors(P33CE)
Tum down to(BTU) 14,000 14 0 1 14,000 Safety screen Vignette surrounds in various colors(P33/P33E)
Ceramic glass Vignette door inlays in various colors(P33/P33E)
EnerGuideRating(Canadaonly) 67.41% 611 5.50% Log set with embers Vignette finishing trim(P33/P33E)
Efficiency(steady state)) 76% % 76% Fire grate Black louvers(P33/P33E)
_ Flame height adjustment control Brick panels in various colors and designs
Dimensions - ProFlame remote control Ember upgrade kit
Width 34-9/16" 33" Direct spark ignition(P33) Wall thermostat
Height 29-1/4" 29" Electronic ignition with SureFire•switch Variable speed blower
(P33E/P33CE) Vertical or horizontal ventterminations
Depth 16' 14" 12-374" 3 45°Flue for versatile installations Propane conversion kit
•ForpropaneRLP)specs pleasesm page 22. Limited lifetime warranty Heat Wave-power duct kit
Fordeniledspecificadons pleasesee pages 22-23. AstroCap•venting system ,