TOWN OF SCHODACK
265 Schuurman Rd.
CASTLETON, NEW YORK 12033
SCHODACK BUILDING DEPARTMENT

SOLID FUEL BURNING APPLICATION PERMIT

Owner: ___________________________________   Permit #_________________
Address: __________________________________   Fee __________
_________________________________ Telephone: _______________________________   Mason: ___________________
Gen. Contractor: __________________________   Phone: ___________________
Property Location: _____________________________________________

Items covered under this permit				Section
____a. Factory-built chimneys & chimney units		211-14
____b. Masonry chimneys					211-14
____c. Metal chimneys & smokestacks			211-18
____d. Chimney connectors & vent connectors		211-20
____e. Vents						211-26
____f. Fireplaces					211-29
____g. Solid fuel burning appliances			211-30
____h. Flue relining					 31.10
____I. Other_____________________________

Inspections are needed
a. Foundation and/or base
b. Through first floor
c. First flue set at top of smoke chamber
d. Through ceiling or second floor
e. Through roof on completion
Note: If being installed in a new home under construction
A and E will be combined with other inspections

I have read the above requirements, and agree to build and install the items listed above according to NFPA 211, and the New York State Building Code 1006 and 1260. I understand the inspection schedule, and agree to contact the Schodack Building Department for all listed inspections.

I do hereby agree to the above conditions:
Owner: ________________________________ Date: ______________________
Contractor: ______________________________ Date: ______________________
Building Inspector: _________________________ Date: ______________________

A.Factory Built Chimneys
____Listed: UL103,  ULCS629M,  UL127,  Other:___________________
____Installed to Manufactures Instructions
____Protection of vertical openings with 1 hour fire resistance

B. Masonry Chimneys
_____Foundation
_____Clean out opening
_____Structural Design
_____Thimble of fire clay
_____Clearances from combustible:  2 in. inside - 1 in. inside
_____Fore clay flue lining, set re-factory cement
_____ 1/2 in. air space around flues
_____Termination (Height) 2 ft. higher then surface (within 10 ft.)

3. Metal Chimneys  ____ As per NFPA 211   Comments:___________

4. Chimney Connectors & Vent Connectors
____As per NFPA 211         Comments:___________

5. 	Vents _____As per NFPA 211    Comments:___________

6. Fireplaces - (Masonry)
____Foundation
____Fire Chamber of fire clay brick
____Fire box of steel; listed ONLY Code 1006
____Clearance from combustible: 2 in. (front & Side) - 4 in. (back)
____Proper size hearth extension
____Air for combustion: Code 1006.4 (NFPA 211-30 8-4)
____Smoke Chamber must be lined with clay brick or the equivalent

7. Solid Fuel Burning Appliance
____Listed appliance
____Location of appliance being installed
____Proper air for combustion supplied
____Proper chimney supplied
____Proper clearance from combustible materials
____Other_____________________________________________________

8. Flue Relining
____Liner shall be listed or of approved material
____The relined chimney must meet the class of chimney service
____Installed in accordance with Section 3-2 of NFPA 211

Inspection Dates:
a.________________Done By______________f._________Done By_____________
b.________________Done By______________g.________ Done By_____________
c.________________Done By______________h.________ Done By_____________
d.________________Done By______________Comments_______________________
e.________________Done By_____________________________________________