2014-062 TOWN OF QUEENSBURY
.#0742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140062 Date Issued: Monday, March 17, 2014
This is to certify that work requested to be done as shown by Permit Number P20140062
has.been completed.
Tax Map Number: 523400-239-012-0002-095-000-0000
Location: 2760 State Rte 9L
Owner: G. CHARLES &LISAMUNZENMAIER
Applicant: G. CHARLES &LISA MUNZENMAIER
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, 00,404
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
di742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140062 Application Number: A20140062
Tax Map No: 523400-239-012-0002-095-000-0000
Permission is hereby granted to: G. CHARLES &LISA MUNZENMAIER
For property located at: 2760 State Rte 9L
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: G. CHARLES &LISA MUNZENMA] Fireplace
P.O. BOX 138 Total Value
2760 STATE RTE 9L
CLEVERDALE,NY 12820-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
FIRST FLAME FIREPLACES
475 CORINTH Rd
OUEENSBURY,NY 12804-0000
Plans&Specifications
2014-062
FIREPLACE gas stove
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,March 17,2015
(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 of eensbury 4Mo l 4 a Y March 17,2014
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
6 Pik-I-0(4
5JJL (I KR 1• 11
4/14/.2010
A
APPLICATION FOR-FUEL BURNING APPLIANCEr&j,C:HIMNEYS._, j ( I
Application is hereby made to the Building&Codes Office for the issuance of a Building&UsePermitpursuant-to the
•
New York State Fire Prevention & Building Code. 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 all inspectors to enter
premises to perform required inspections.
Important Note To Applicant: Rough-ln and Final inspections Are Required:
Ownerafbf j >k t •€tit tiLtati eAr Installer/Builder: fia,u4e- I t �
A f /�
Address: �'77r� -ta'fa ?L ki Address: . Co1M l 494 4t4 41a l'
. 'Phone Nos.:' 4C6 Phone Nos.:- . i [v 22Zo lI
Location of Property: Il2- Ir' c19S Subdivision Name:
Location of Proposed Construction and/or Installation: /f ile Ai/ 5
Contact Person for Building &Codes Compliance:
- Fuel Burning Applicance a Wood :Coal Pellet • Gas Oil
Information
Stove
Fireplace Insert
Fireplace,factory built*
Fireplace, Masonry
Furnace,(Garage Only)
* If Factory Built, Please Provide: Manufacturer Name: 144i ��, Model No. !T /51
Listed By: Number:
Chimney Information BLOCK BRICK STONE
Masonry** Check One✓ -
TILE STEEL SIZE IN
INCHES
Flue • ; Check One✓ �/ e d
DOUBLE WALL TRIPLE WALL INSULATED. •DIRECT CHMNEY
VENT LINER
Chimney Material Check Onel f
** If Non-Masonry, please provide: Manufacturer Name: 5I0r2i1I Model No. 1?VA-4
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
Town of Queensbury*Community Development Office*742 Bay Road, Queensbury NY 12804