FMP-0757-2018
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: FMP-0757-2018Date Issued: Thursday, January 10, 2019
This is to certify that work requested to be done as shown by Permit Number
FMP-0757-2018
has been completed.
289.8-1-3
Tax Map Number:
56 NOTTINGHAM DR
Location:
Mark Smith
Owner:
Mark Smith
Applicant:
This structure may be occupied as a: Gas FP Insert
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,
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: FMP-0757-2018
Tax Map No: 289.8-1-3
Permission is hereby granted to: Mark Smith
For property located at: 56 NOTTINGHAM 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
Owner Name: Mark Smith Solid Fuel $0.00
Owner Address: 56 NOTTINGHAM DR 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 FP Insert
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,December 2,2019
(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 date.)
Dated at the To f Quee bury; Fri,a ,6 -user 30,2018
I
SIGNED BY: ' \ for the Town of Queensbury.
Director of Building&Code Enforcement
FUEL BURNING APPLIANCE & Office Use Only
rt;;o CHIMNEY APPLICATION Permit#: f 0 '5�'- 2Q
� Fz 125
Permit Fee:$
town of(Zycensbury
742 Bay Road, Queensbury, NY 12804 Invoice:#: )O O
P:518-761-8256 www.queensbury.net
Project Location: 56 Al l�i �1Cwv� Tax Map ID #:
Room of Install: I 1 i 1 (" Planned Install Date: )
/J
**ONE APPLICATION PER APPLIANCE**
CONTACT INFORMATION:
• Applicant:
Name(s): m i�"�
Mailing Address, C/S/Z: 16 NI6 t-11 ►•✓/1c, Q( v-eZlJ , . .`•(.
Cell Phone: (F3) ) 10 07 ( 7 V Land Line: ( )
Email: MM,t/ric 3(41 (J 0,e, .
• Primary Owner(s): f
Name(s): S Ct vy-t�i
Mailing Address, C/S/Z: D E C LE I V
Cell Phone:_( ) Land Line: _(
Email: NOV 30 2018
J
• Installer/Builder: TOWN OF QUEENSBURY
Business Name: %‘,.-a j- '(�v,,_�.� ..�..BUILDING&CODFS
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _(
Email:
Contact Person for Building & Code Compliance: NA CrAd-1P"-
Cell Phone: (‘-2I ) q02 69 I Land Line: (
Email:
Fuel Burning Appliance&Chimney Application Revised March 2017
FUEL BURNING APPLIANCE INFORMATION:
TYPE OF DEVICE:
Stove f Fireplace Insert _ Fireplace
Fuel Fired Equipment (Garage Only, 18" clearance per IMC 304.3)
Fireplace,factory built**
(**Manufacturer's name: Model#:
SOURCE OF HEAT:
Wood _Coal _Pellet C'Gas
CHIMNEY INFORMATION:
Masonry(require plans to be submitted):
block brick stone
Flue:
tile steel _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: p.rk_
SIGNATURE: (----VA DATE: It Z f r
Fuel Burning Appliance&Chimney Application Revised March 201
INSPECTION WORKSHEET (FMGAS-008958-2018)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
FMP-0757-2018Permit
Case Number:Case Module:
Thu Dec 20, 2018Passed
Inspection Date:Inspection Status:
Gary StillmanGas Fireplace/Stove
Inspector:Inspection Type:
56 NOTTINGHAM DR289.8-1-3
Job Address:Parcel Number:
Queensbury, NY 12804
Contact TypeCompany NameName
Primary OwnerSmith, Mark
Granted PermissionSmith, Mark
ApplicantSmith, Mark
ContractorFirst Flame
Checklist ItemPassedComments
Fire Marshal NotesYESEMPIRE COMFORT SYSTEMS
MODEL #DVC26IN31P-2
SERIAL # 1822737743
Building Inspector NotesYESINSTALLED IN LIVING ROOM
Floor ProtectionYESN/A
Clearances to Combustibles (all sides)YES
Firestop(s) - Vertical ChaseYESN/A
Vent Clearance to CombustiblesYESPRE-EXISTING MASONRY FIREPLACE
Dec 20, 2018Page (1)
INSPECTION WORKSHEET (FMGAS-008958-2018)
Checklist ItemPassedComments
Vent Chimney TerminationYESPRE-EXISTING MASONRY CHIMNEY WITH LINER
INSTALLED AND NEW CHIMNEY CAP
Gas Shut-off ValveYES
Combustion AirYES
Hearth Extension (if any)YESPRE-EXISTING
Mantel-height above fp openingYES
Witness OperationYES
CO DetectionYESOk
CSST BondingYESN/A - PROPANE
Stillman, Gary (Inspector)
Dec 20, 2018Page (2)