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FMP-0693-2018
TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: FMP-0693-2018 Tax Map No: 227.13-2-5 Permission is hereby granted to: William DeGasperis For property located at: 12 DUNCAN CV 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: William DeGasperis Fuel Burning&Chimney $0.00 Owner Address: 20 Frissell TER Total Value $0.00 Sparta,NJ 08771 Contractor or Builder's Name/Address Electrical Inspection Agency The Fireplace Company 2951 Lake Shore DR Lake George,NY 12845 Plans&Specifications Gas Fireplace Insert $ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,November 4, 2019 (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 d.te. Dated at the Town ,Quee ury; 4Fri ., • 'ern e er 2, 2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Dat6 fe , /Yjo FUEL BURNING APPLIANCE & Office Use Only 011111K'' CHI MNEY APPLICATION Permit#: FA1 P £4 3 cOl ? Permit Fee:$ Town of Queensbury 742 Bay Road,Queensbury, NY 12804 Invoice:#: P:518-761-8256 www.queensbury.net ke ve_c Aalke Project Location: I a, �'(\c: y-, Cic ' 1\UC&cs Tax Map ID#: 1 3- 5 Room of Install: Mast ' 10 f'0011 Planned Install Date: --Dec e✓v _ i **ONE APPLICATION PER APPLIANCE** CONTACT INFORMATION: • Applicant: Name(s): 4�� I��a on, 4.�.1� E�4:..C • t5 Mailing Address, C/S/Z: 2 e Fe zzel( I �� tr k o 7r l Cell Phone: ( 73 ) — s- Land Line: ( q 73 ) 7 2 Y— `t3 Email: [; I l (k i 3 i'A et(A>;): k d (cry) • Primary Owner(s): Name(s): &ct4EL) Mailing Address, C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: • Installer/Builder: Business Name: . h e p lace. <41/At/Ai -Tn e Contact Name(s): Pcal //a v:4 Mailing Address, C/S/Z: z LI s I LctK _S hoc . T)- vz Lit ke. Gee^i j Z .'4/5 Cell Phone:_( ) Land Line: _( 5-1 ' ) Email: Contact Person for Building & Code Compliance: Cell Phone: _( ) Land Line:_( ) Email: Fuel Burning Appliance&Chimney Application Revised March 2017 FUEL BURNING APPLIANCE INFORMATION: TYPE OF DEVICE: Stove Fireplace Insert Fireplace Fuel Fired Equipment(Garage Only, 18"clearance per IMC 304.3) 7 V Fireplace,factory built** (**Manufacturer's name: F(e.pIcccQ..XfrO ci I (VA t C Model#: X 21 -I-RV G-6 R) . SOURCE OF HEAT: Wood Coal Pellet V"Gas CHIMNEY INFORMATION: Masonry(require plans to be submitted): block brick stone Flue: tile steel 2-size, in inches Material*: double-wall triple-wall insulated (*Manufacturer's name: Model#: ) ADDITIONAL INFORMATION: 1. Two inspections are required. A rough-in inspection, prior to installation and a final inspection, after installation. 2. Manufacturer's installation manual must be available at the time of inspection. 3. Masonry fireplaces&chimneys require plans to be submitted. 4. Twenty-four(24) hour notification is required for inspections. 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 the inspector to enter the premises to perform the required inspections. I have read and agree to the above: PRINT NAME: ( ict04 TI16?5f*::J') SIGNATURE: f i% .._ DATE: /vk '�' Fuel Burning Appliance&Ch coney Application Revised March 2017 The Fireplace Company,Inc_ THE Estimate 2951 Lake Shore Drive Lake George,NY 12845 t ' ' ""`A Y Date 10/23/2018 Phone: (518)668-9300 Fax: (518)668-9380 j-''� h�` Estimate# 7620 "{We Keep the Frame Fires Boring" Phone: 973-222-9248 Customer Work/Cell: Bill DeGasperis Fax: Job Location: 12 Duncan Cove Road Cleverdale,NY 12820 Qty Item Description Total Scope of work:The sale and installation of a Fireplace X 21 TRV Bed&Breakfast gas fireplace into your residence in Cleverdale, NY.To include the fireplace,face,Beehive brick kit,LP gas conversion,venting system thru the wall and the labor to complete the installation.Framing,gas line and electric done by others. 1 TI-98500236 Fireplace X 21 TRV GSR2 Gas Fireplace 2,745.00T 1 TI-95700168 French Country Arch,Black 300.00T 1 TI-98500669 Liner-Beehive Brick 222.00T 1 TI-250-01463 Stepper Motor for LP gas conversion 77.00T I ICC-5DE90 Direct Vent 90 Degree Elbow 77.00T 1 ICC-SHT Direct Vent Horizontal Termination 212.00T 1 ICC-5WT DV Insulated Wall Thimble 90.00T 1 ICC-SDLI Direct Vent 12"Length 49.00T 1 TFCIALR Installation Labor 795.00T n i,crr;rl is guaranteed to be as specified All work to be completed in a workmanlike manner according to standard practices. This is an estimated proposal. Any alteration or deviation from above spec f cations and discussed installation will be billed as time and material.It will become an extra charge over and above this estimate. Deposit and payment arrangements are as specified below. Final payment is required on the day Subtotal $4,567.00 of installation and any additional billing adjustments will be made on or after installation date. When using a credit card for payment,you authori_e us to charge the balance of this estimate the day of Installation All Sales Tax(7.0© ) S319.69 agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance. Our workers are fully covered by Workers'Compensation Insurance. Total $4,886.69 Manufacturers are liable for the warranties on their products. Customers will be responsible for any costs incurred above manufacturer's warranty reimbursement. We warranty our installations for i mnr:rned .• the installation invoice data. Payment to be made as follows: 50% deposit due upon signing, -Balance Due Day of Completion Acceptance of Estimate-The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Authorized Signature: Customer Signature: Date of Acceptance: Note: This estimate may be withdrawn by us if not accepted within 30 days. Special orders,fireplaces stoves,stone and electrical parts are non-returnable and non-rerndable. 25%restocking fee on returned items A service charge of 1.5%(18%APR)will be added monthly to all amounts over 30 days with a$15 minimum charge.