RC-000245-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
OL Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000245-2016 Date Issued: Monday, June 20, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000245-2016
has been completed.
Tax Map Number: 302.14-3-51
Location: 57 DIXON RD
Owner: WILLIAM ST.JOHN
Applicant: Kelly Homes
This structure may be occupied as a: Residential Alteration
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy 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.
1-OWN OF QUEENSBURY
742 Bay Road.,Queensbury,NY 12.804-5004 (518)761-8201
Community Development- Building& Codes (5 18) 761-8256
BUILDING PERrvIIT
Permit Number RC-000245-2016
"fax Map No: 302.14-3-51
Permission is hereby granted to: Felly I lcnms
For property located at: 57 DIXON RD
ht the Town o�f QucensbUry,to construct or place at the:above location in accordancewith application together
with plot plans anti other inforrnadon hereto tiled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
"fyoe of Construction
Owner Name: WILLIAM ST.JOI IN Single Farnily-Alteration $0.00
Owner Address: 57 Rixon RD 'total.Value $0.00
Queensbury,N`a' 12804
Contractor or Builder's Name/Address F;lectrical Inspection Agency
Kelly Homes
110 Box 4381
Queensbury,NY 12804
Plans&Specifications
Residential Alteration
I IL117 Shelter Planning
$2.5.00 PIIRMIT FET' PAID-THIS PERMIT EXPIRES: Friday.April 2.8,2017'
(11'a longer period is required.an application for an extension must be made to the code.Enfiarcement Officer
ofthe'rowrr of°Queensbury belbre the expiration(ote.)
Dated at the Town ejeensbury; 016
SIGNED BY: 1`or the Town ol`Queensbury.
Director ol'Building cit Code :rufarcein t
.- " . — . _A . 1111.1k; uou 4J111 y
�atc: Ilermit No. ?-C - t�0
7 st Permit Fee 95 11-
Tax Map ID 3 .1y)Vz kck-,7
z1one Historic? Yes No Rec Fee a �q'464
Subdivision Name Lot# Site Plan 4
4' Subdivision
Project Location
TOWN BD. RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family, multiple family,
apartments,condominiums,townhouses,and/or manufactured&modular homes, but n tm,,obile:,b,omes–,This i--.in,addition to,the
permit fee(s). L U E E.
Primary Owner(s)
Address J U AITN Z' UID
el /ul
Phone/Email
I C; c n F:s
Applicant
2 p 47
y Ile
Address
Phone/Email Y)"
Contractor
C C
Address
4�"
Phone/Email 0
Contact Person for Building& Codes Compliance:,_S'4'
TYPE OF CONSTRUCTION
v"Cheek all that apply New Addition Alteration V floor sf 2nd floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(4 of units
C/
Townhouse
Business Office
A"r I It Lt
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 20116
If commercial or industrial please indicate name of business
Proposed use of building or addition
Source of Heat(circle one) Gas Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys
Are there structures not shown on plot plan?
Are there easements on the property?
Site Information:
a. Dimensions or acreage of lot
b. Is this a corner lot? Yes No
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well(circle one) Public Private
e. Sewer or Private Septic System(circle one) Sewer. Private
Value of all work to be performed(labor or materials) $ o
DECLARATION.-
1.
DECLARATION.1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. I certify that the application, plans and supporting materials are a true and complete statement /
description of the work proposed, that all work will be performed in accordance with the NYS
Building Codes,local building laws and ordinances,and in conformance with local zoning regulations
4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate
of occupancy.
5. I also understand that I /we are required to provide an as-built survey by a licensed land surveyor of
all newly constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: 4 qce- 4 DATE: el'
SIGNATURE: DATE:
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
TOWN OF QUEENSBIJRY
M.Jllw.DNG rD&�AW1�IEtl'l' IMPROVEMENTS TO
Based On Ot kr' l rE ��;d��r�duir��rtA��u'r,��rd��rl�Ud�nrd'���a 57 Dixon Rd.
With sl ,,DRi pial car a it dduu aQueensbury, NY 12804
h flM r'I� rg aue un
Ild���"�I dil)ViwgI ,,dllddcth : agi it 4rul d wry i'
PROPERTY OWNER
William St..John
57 Dixon Rd.
Cueensbury, N�Y 92St
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Phone: 538-0999,-1-1111
TOWN F RY �
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NOTE 1: All work is to be performed in accordance with manufacturer's 'instructions, NYS
building and local building codes and attached standard specifications in addition to below.
NOTE 2: UNLESS OTHERWISE NOTED, "INSTALL" MEANS TO PROVIDE AND INSTALL. ALL NEW
MATERIALS ARE TO BE USEDC.
Some or all of the rehabilitation work called for in these specifications is subject to HUD
regulations governing the reduction of lead-based paint hazards and must be accomplished
pursuant to lead-safe work practices.
LEAD-BASED PAINT HAZARDS
Regulations
The Department of Housing & Urban. Development (HUD) has issued regulations regarding the
,......."Red'uction of Lead-Based Paint Hazards in .... .. Housing Receiving Federal Assistance."
The rehabilitation work called for by these work specifications will be paid for in whole or part with Federal
assistance. Therefore HUD's regulations governing the reduction of lead-based paint hazards apply to
this project(24 CFR Part 3 )..
Risk Assessment
A risk assessment has been performed for this property and project(attached) which has identified lead
hazards which must be corrected. These hazards and the rehabilitation work to remedy these hazards is
spelled out in the work specifications. The Contractor is responsible for reading the attached Lead-
Based Paint Risk Assessment Report. This is one reason why the report is attached to this document.
The contractor is responsible for addressing all property components listed as lead hazards.
Contractor Certification
This project will require the contractor to undertake improvement activities that require lead-safe work
practice. Therefore the contractor must be trained and certified in accordance with regulations issued by
the US Environmental Protection Agency (EPA). The contractor must provide the Village of Scotia or its
representative with evidence of such certifications prior to execution of the contract for improvements.
Interim Controls
The work to be done in accordance with these specifications that addresses identified lead hazards is
302.14-3-51 RC-0100245-2016 57 Dixon Rd. 1
St. John, William
57 Dixon Road
Res. Alt.--HUD Shelter Planning
designed to result in a lead-safe dwelling. The measures called for to reduce temporarily human
exposure or likely exposure to lead-base paint hazards are called Interim Controls.
Clearance Examination
A visual inspection and dust wipe sampling is required after the lead-based paint has been rendered
intact. The inspector will look for visible dust and debris in areas where the defective lead-based paint
has been stabilized. Dust wipe samples in at least four rooms are required. Dust wipes shall be taken in
all roams where lead-based paint has been stabilized.
The contractor is responsible for obtaining a Lead-Based Paint Clearance from a certified firm. The
contractor is required to provide the owner/and the Town of Queensbury with evidence that a
Lead Hazard Clearance Examination was done after completion of the rehabilitation work.
Clearance is required before final payment to the contractor will be approved.
This Clearance Examination must be done by an individual or firm licensed or certified to conduct such an
examination and must certify that the hazard reduction activities are complete and that no soil lead
hazards or settled dust lead hazards exist in the dwelling unit or work site. The cost of such Clearance
Examination is to be Included as part of the contract total bid price for the rehabilitation work. It is
the contractor's responsibility to obtain such clearance. Final payment for completed work will be
withheld until such clearance is provided.
Recommendations
Please refer to the risk assessment report for recommendations, which are also incorporated into
specifications for each work element.
Following each days work and at the end of the project, any areas affected shall be properly cleaned
using HEPA vacuums and wet wiping. Shop vacuums are usually NOT HEPA vacuums. It is the
contractor's responsibility to keep the site cleaned throughout the work process and pass final dust wipe
sampling and/or soil sampling at completion.
All defective lead-based paint areas should be rendered intact by the following methods:
1. Wet scraping and wet sanding,or
2. Removed and replaced,or
3. Kept intact and covered with an impermeable layer(vinyl,aluminum,etc.)
LEAD-BASED PAINT INTERIM CONTROLS
1. Garage
• Wet scrape and install vinyl siding over appropriate backing.
• Homeowner will have choice of stock color. (f
• Prepare walls,as required, prior to siding. Lo'Y4
2. Trim
• Wet serape and install white coilstock at all trim.
1. Side Porch
• Wet scrape and safid interior window sill that has deteriorated paint
LIST LEAD-BASED PAINT INTERIM CONTROLS PRICE HERE$
57 Dixon Rd. 2
NOTE: Refer to the attached lead-based paint risk assessment report pertaining to areas that have
tested positive for defective lead-based paint. The items listed above note where lead-based paint
interim controls need to be followed. The original intent of the specifications for such items as listed
below was to require work for energy efficiency, health and/or safety/security reasons and would have
been specified whether or not deteriorated lead-based paint was found.Therefore, any such items are to
be priced separately as indicated below.
ELECTRICAL
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached ELECTRICAL STANDARD SPECIFICATIONS.
1. Kitchen
• GFI protect all existing countertop receptacle,as required. z'
• Provide dedicated 20A circuits for dishwasher, microwave and refrigerator,as required.
2. Dining Room
• Provide 2 new duplex grounding receptacles,in double gang box,at computer desk, on dedicated
20A circuit l„I
3. First Floor Hall
• install Lithium-ion battery operated smoke and CO detector.
4. Bedroom#1 (1s'Floor)
• Install Lithium-ion battery operated smoke and CO detector.
5. Second Floor Hall
• Install smoke and CO detector,as above.
6. Bedroom#2
• install smoke detector,as above.
7. Bedroom#3
• Install smoke detector,as above.
8. Basement
• Install hard wired smoke and CO detector with battery back up.
• GFI protect existing receptacle at panel.
• Dryer and washing machine are on same circuit Separate dryer and provide new GFI protected
receptacle for washer on dedicated 20A.circuit.
• Secure loose Romex cable to floor joist(back comer).
• Provide cover for junction box in ceiling, between boiler and water heater.
9. Back Porch
• Secure and cover loose junction box above entry door.
• Eliminate fuse for garage circuit.
• Provide new wiring back to panel, as required.
10. Exterior(Deck)
• GFI protect existing receptacle and provide appropriate weatherproof cover.
LIST ELECTRICAL PRICE HERE$
57 Dixon Rd. 3
♦ WINDOWS
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached WINDOW REPLACEMENT STANDARD SPECIFICATIONS.
• Install new white vinyl, Energy Star-rated replacement windows(Pella Therma Star or equivalent)
in the following locations.
• Window U factor will not be greater than.30.
• All new windows will have full screens.
• Where combination storm windows are removed, exterior stops will be covered with coil stock or
painted to match existing trim.
o Kitchen(Slider) -1 (replace caseme
• Basement(Slider) -4 Ak q mo of
Replacement Windows -5
LIST WINDOWS PRICE HERE$
ENTRY DOORS
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached DOORS STANDARD SPECIFICATIONS.
Lead-Based Paint Hazards: The Risk Assessment identified the front entry(main)and side porch entry
exterior doors,with lead-based paint hazards. Lead-Safe Work Practices to be followed as required.
1. Back Porch:
• Install new pre-hung, 94ite, steel or fiberglass, Energy Star-rated (Pease,Therma Tru or
equivalent)entry door.
• Finish according to manufacturer's specifications with good quality latex paint.
• Provide new entry lockset and deadbolt(Kwikset or equivalent), keyed alike.
2. Small Entry Area:
• Install new entry door,as above.
• Install new white vinyl-clad,wood-core storm door, mid 4iew style,with self-storing glass and
screens(Larson or equivalent)
3. Living Room:
• Install new entry door, as above.
• Install new storm door, as above.
Entry Door -3
Storm Door -2
LIST DOORS PRICE HERE$
NOTE: It is likely that these doors are not a standard size.
57 Dixon Rd. 4
INTERIOR CARPENTRY
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached STAIRS STANDARD SPECIFICATIONS.
1. Basement: t
• Install graspable handrail at stairs. i 7-
• Door to basement is insulated with foil-faced board. Cover with plywood or other suitable
material for fire code.
2. Attic:
• Same as basement door.
LIST INTERIOR CARPENTRY PRICE HERE$
EXTERIOR CARPENTRY
t
1. Front Porch-
• Install wrought iron railing at one side of steps.
UST EXTERIOR CARPENTRY PRICE HERE$
PLUMBING
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached PLUMBING STANDARD SPECIFICATIONS
• install new gas water heater of same capacity. '�� "
• Provide all electrical and plumbing connections to current building code.
LIST PLUMBING PRICE HERE$
SIDING
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached SIDING STANDARD SPECIFICATIONS
Lead-Based Paint Hazards: The Risk Assessment identified exterior siding,and exterior window sills
and frames,with lead-based paint hazards. Lead-Safe Work Practices to be followed as required.
1. Main House Dormer Front Porch
• install vinyl siding over appropriate backing.
• Homeowner will have choice of stock color.
• Back dormer has slate on sidewalls. Remove slate and save for homeowner,as possible.
Prepare walls,as required, prior to siding.
2. Trim
• Install white coilstock or vinyl at eaves,fascia,soffits, casing,and all other trim.
• Wrap 2 posts at front porch.
LIST HOUSE SIDING PRICE HERE$
57 Dixon Rd. 5
NOTE:ANY FINISHED SURFACES DAMAGED DURING THE COURSE OF REHABILITATION WORK
SHALL BE REPAIRED AND FINISHED TO MATCH ORIGINAL CONDITION. CONSIDER THIS IN
YOUR BIDS, DO NOT INCLUDE AS EXTRAS.
Extras
1. Identify additional separate cost to install or remove additional items not mentioned in specifications
that may be necessary to comply with code and complete the job in a satisfactory manner and list
separately here.
2. Items not listed as additional are assumed to be included in contractors bid price.
LIST EXTRAS PRICE HERE$
57 Dixon Rd. 6