2004-132 TOWN OF QUE E NSB URY
IFIVO742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20040132 Date Issued: Friday, October 15, 2004
This is to certify that work requested to be done as shown by Permit Number P20040132
has been completed.
Tax Map Number: 523400-289-009-0001-073-000-0000
Location: 340 GLEN LAKE Rd
Owner: FRANK & ADRIANA BRENNEISEN JR
Applicant: FRANK & ADRIANA BRENNEISEN JR
This structure may be occupied as a:
By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
1)4
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
s 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Virg
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040132 Application Number: A20040132
Tax Map No: 523400-289-009-0001-073-000-0000
Permission is hereby granted to: FRANK& ADRIANA BRENNEISEN JR
For property located at: 340 GLEN LAKE Rd
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: FRANK& ADRIANA BRENNEISE Residential Addition $12,000.00
340 GLEN LAKE Rd Total Value $12,000.00
LAKE GEORGE, NY 12845
Contractor or Builder's Name /Address Electrical Inspection Agency
HAAKENSEN, PHILIP
RR3 BOX 3604
FORT ANN, NY
•
Plans&Specifications
2004-132
60 SQ FT RESIDENTIAL ADDITION (WALK-IN CLOSET)
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 01, 2005
(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 th own Qu sbyy; ,'• 1 ' • day, September 01, 2004
�d
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No.
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By:
application form.
Applicant: Pt„,'/ /-1a<(4.0i s&/y Owner: r a n K &�1 i s
Address: /3.7 (0 l‘, Address: 3.1/4, , ,c
rf Arlo 11/y i 2K 6,eccy
Phone#( ) Phone#( ) 7 /
Property Location: Lot Number: / House Number 3 /" /
Subdivision Name: Tax Map Number:.A J O9- /-7 3
o New Building: residence /commercial Estimated Market Value of Construction: $ f � '
- Addition: Lresid a commercial If an Addition,what will use of new addition be?
CI Alteration: residence/ commercial - L 4-s e 7`
o No change to exterior size: residence/com'l
o Other work(describe )
Check Occupancylnformation 1"Floor 2"Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
t Single fsrmily dwelling (0 )
o Two family dwelling
o Townhouse
o Multifamily dwelling
#of units
o Office
o Mercantile
• Manufacturing (4 ?U
O 1 car detached garage RI AR ,
0- 2 car detached garage OF CiUFENSBURY
0 3 car detached garage ►OVEN nl (1 AND DUDE
O 1 car attached garage BV�I
O 2 car attached garage
O 3 car attached garage
o Storage building-
commercial
o Storage building-
residential •
• Other •
What is the proposed height of the structure sE' feet c ` inches
Will any second-hand or ungraded lumber be used? If so,for what? /t/G
Type of Heating System: electric/ oil / gas/wood /forced hot air/ baseboard/other: t
Number of firevtaces to be installed / Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder lati,%,e J. ;-14,4 6 3 9-fdL-S-‘
Plumber
Mason P 4, J. i-/r,/ K-c/2� 4v
Electrician 87, T, ,! 1 r-t [ z i m x-v 6,S`
Declaration; please sign below after you have carefully read the statement:
To the best of my lmowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction.
Signature:4 /';_ 2J-Vf/_ft ZtV7 owner,owner's agent,architect ontractor
OV-/- / '3
ENERGY CODE COMPLIANCE APPLICATION
FooTOWN OF QUEENSBURY, WARREN COUNTYAba
44.16 9000 HEATING DEGREE DAYS
4
Compliance Methods:Part 5 -Acceptable Practice Method—1&2 Family Dwellingsyihly) < .
Part 6*-Thermal Rating—Component trade Offs l&2 Famil /6'4
Multi=Family Dwellings(3 Stories or less) C,/�/C �NSB�
Part 4*-Design by Component Performance,Commercial Buildings CO®RRy
Rise Residential
*Requires submission of worksheets
APPLICANT'S NAME: , PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area- E 6 square feet
2. Type of heat- Electric . Oil Gas Other Wc-
3. Is building mechanically cooled? yes No
4. Percentage of area of windows and doors Over 17% l'--Under 17%0
' 5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R VALUES AS
SHOWN ON PLANS SUBMI I"I'bD:
a. Roof R 31
b. Exterior walls R L
c. Glazed areas R
d. Exterior doors R
e. Floors over unheated spaces R
f. Edge of slab on grade(heated building) R
g. Basement/cellar walls(above grade) R
h. Basement/cellar walls(below grade) R
i. Heating/cooling-ducts-piping in unheated space R
6. Service(domestic)hot water heating device
Conforms to minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED
Applicant's Signatu a Date Phone Number
INSPECTOR'S REMARKS:
Queensbury Building & Code Enforcement - Reside i tial Final Inspection V -
Office No. (518)761-8256 Arrive: a, pm D-
Date Inspection request received: 1OI 14 Id Inspector's Initial•:
NAME: P ' IT#: QG 3 ,
LOCATION: Q r�� n._ l 'ATE: d 1 i C'�1(101.-
TYPE OF STRUCT RE: Lwq, -,iti ,cinati)
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Complete
Guard 30 in.or more @,stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in. or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum Y2"
Gypsum
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft.or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating •
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: i Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery backup:
Carbon Monoxide Detector
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/ hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Attic access 30 in.x 22 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 sq. ft.-150 sq. ft. vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept. Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C or C/0 [Temporary/Permanent]
L:\PamW\Building&Codes\Inspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545 P
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL 7
'emit No. p,�, Cert. 8 5 9 4 6 Cut-in Card No
)wner f •3 N-6 i '1 £ t7
gg .)
.ocation r� /O X £ , c + 624z67/1
nstallation Consisting of,l 5(4)t 16t1 %/ze t) / S er-r.
A040/ rie,v,
nstalled By A7-4- -e/ "A. Lie.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
ancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
ntroduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making .ections at any time, and if its
ules are violated,the Company shall have the right to rev this ertifi at
q'fs#
)ate t� INSPECTOR
Member N.F.P.A.,1.A.E.I.
Rough Plumbing / Insulation Inspection Re $ ort
Office No. (518) 761-8256 Date Inspection reques ece. -•: ,, o
Queensbury Building&Code Enforcement Arrive: . p , s art: ` p .
742 Bay Road, Queensbury,NY 12804 Inspector's Init.41 • ,
Frea tr4 4:1--
NAME: ` . PERMIT #:, 6cl
LOCATION: ` a '-iade Pee INSPECT ON: 9 �Va V
TYPE OF STRUCT ✓
Y N N/A
PVC: R-1,R-2, R-3,R-4 Drain/Vents
Cast Iron, Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
1 lh inch min. Drain Size
Washing Machine Drain 2 inch min.
Head or Air Supply Test
Drain and Vents
5 PSI or 10 feet above highest
connection for 15 minutes
Cleanout every 100 feet/change of direction
Water Supply Piping
Cooper Commercial
CPVC,Pex One and Two-Family
Insulatio esidential Check/Commercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS:
L:\SueHemingwaylBuilding.Codes.lnspection.FORMS\Rough Plumbing Insulation Report.doc November 17,2003
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection requ•: eiv:,,,B
Queensbury Building&Code Enforcement Arrive: am/p rpart: `, it/a m
742 Bay Road, Queensbury,NY 12804 Inspector's Ini ials:
NAME: `C CANe. _ CJpl1 i PERMIT #:
1 ,i
LOCATION: 3' C� 1, INSPECT ON: )
TYPE OF STRUCTURE: Q\e S )
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain/Vents
Cast Iron, Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
1 % inch min. Drain Size
Washing Machine Drain 2 inch min.
Head or Air Supply Test
Drain and Vents
5 PSI or 10 feet above highest
connection for 15 minutes
Cleanout every 100 feet/change of direction
Water Supply Piping
Cooper Commercial
dnsulaoper,CPVC,Pex One and Two-Family
tion/Residential Check/Commercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly I No duct tape (t?�
COMMENTS: � ,,,,:,t4\.L11Cc—
Z \ J
L:\SueHemingway\Building.Codes.inspection.FORMS\Rough Plumbing Insulation Report.doc November 17,2003
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection req t recei
Queensbury Building& Code Enforcement Arrive: a' p, art: C m
742 Bay Road, Queensbury, NY 12804 Inspector's Initia
NAME: i� PERMIT#: ZGC - — 13Z_
LOCATION: y f, � � ;� � INSPECT ON: 9—1 6—Ot}
TYPE OF STRUCTURE:
Y N N/A COMMENTS
Framing
Jack Studs/Headers I
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %2 (w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side % inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Ai( ),,'„,
Framing / Firestopping Inspection Report "
Office No. (518) 761-8256 Date Inspection r=•ue.t re I •d:
Queensbury Building& Code Enforcement Arrive: _ am/p D- 'art:I:3 a
742 Bay Road, Queensbury, NY 12804 Inspector's Initi, • e-
NAME: Q.._.)f'e'nr\E,)<;_,ev-, \--(1-1\, PERMIT#: OL /3
LOCATION: '614,D L INSPECT ON: ().__A`t TYPE OF OF STRUCTURE:
Y N N/A COMMENTS
Framing
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %z (w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anch Bolts 6 ft. or less on center
ce and snow shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side %inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.lnspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Foundation Inspection Report
l U'VU�1L�
Office No. (518) 761-8256 Date Inspection re• - r/Depart:
Queensbury Building&Code Enforcement Arrive: _ ' ••
742 Bay Rd., Queensbury,NY 12804 Inspector's Initi.
ti`5�
NAME: r Y��`��01 ''ERMIT#:
LOCATION: all('� Gt-e, a
_ INSPECT ON: If 9 — -��9
TYPE OF STRUCTURE: i
Comments
gir
roofings
Piers
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump —�
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper T
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
4:\SueHemingway\Building.Codcs.Inspection.FORMS\Foundation Inspection Report.doe January 28,2003
•
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: //'2-(am/pm Depart: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector s Initials:
NAME: � / �/Ja� j PERMIT#: Ci • '/ t
LOCATION: ya Gfc� �_ ,e,/ INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A Framing COMMENTS
Jack Studs/Headers /
Bracing/Bridging Ned LLB-- /
Joist hangers F
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '/2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall
Fire separation 1,2, 3 hour
Fire wall 2, 3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side '/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
Y
. 'ft 1-.""'• ,,, '410 1
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1 TOWN OF QUEENSBURY
BUILDING AND CODE fiecv-e-
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COVERED BY NON-COMBUSTIBLE B!.. .:. BULDVI„,3 C- r''''
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