CC-000849-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: CC-000849-2016 Date Issued: Friday, December 23, 2016
This is to certify that work requested to be done as shown by Permit Number CC-000849-2016
has been completed.
Tax Map Number: 296.19-1-14.2
Location: 27 WOODVALE RD
Owner: 27 Woodvale Road LLC
Applicant: Belfor
This structure may be occupied as a: Commercial Alterations 2500 s.f.
Repairs from water damage after water sprinkler hose broke By Order of Town Board
TOWN OF QUEENSBBURY
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 Enforc ment
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: CC-000849-2016
Tax Map No: 296.19-1-14.2
Permission is hereby granted to: Belfor
For property located at: 27 WOODVALE 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
Owner Name: 27 Woodvale Road LLC Business Office-Alteration $25,000.00
Owner Address: 4500 Dorf ST Total Value $25,000.00
Toledo,OH 43615
Contractor or Builders Name/Address Electrical Inspection Agency
Belfar
2 Industry DR
Waterford,NY 12188
Plans&Specifications
Commercial Alterations 2500 s.f.
Repairs from water damage after water sprinkler hose broke
$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,December 20,2017
(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 ex rration date.)
Dated at the Town Queens �Tue 20,2016
SIGNED BY: ((GnnnM�__i"!ll���/// %for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
Date: I 'L—kc(- 16
Permit No. C - 7110
Tax Map ID L 9,6. 19 - I - I N, Z Permit Fee I GO '
Zone Historic? _Yes No Rec Fee Iv��-oku) tL�11-
Subdivision Name Lot# Site Plan#
Project Location Z7 W ooc( v�_ Ie n ce Subdivision#
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 not mobile homes. This is in addition to the
permit feels). II
Primary Owner(s) -Z Wood V c o L L C
Address T- 00 p e o y- �_S -V- -T-o ( L-d o O 14 L1 3 6 1 1
Phone/Email s I P-
Applicant
.lie► �o,-
Address
2 Iheli,s� �� W�ler�e.c� ✓1. Y I Zi 9 �
Phone/Email 91 ,f Cly-C) 031-4
Contractor 15e (
Address -)—
Phone/Email
)—
Phone/Email f r - Z2-0— k333 c
Contact Person for Building&Codes Compliance: P1. ( cS M i 47Lt Phone 1 Y K J U 03 )-'f
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration I"floor sf 2nd floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(#of units_) x
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
7 WN O NG gODES
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
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) $ p v o
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. 1 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. 1 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�ththe above:
PRINT NAME: 0` l i (�1^+1 DATE: I r� I Iii
SIGNATURE: G DATE: 1 114` 16
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
296.19-1-14.2 CC-000849-2016
The Landing/27 Woodvale Rd LLC
BELFOR Property Restoration 27 Woodvale Road
t•
Physical-2Industry Drive-Waterford,NY 12188 Comm. Alt. (water damage) 2500 s.f.
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
16-60-BROO_Q-REP-W-1
Main Level
ten-7
"'-
T Dining Room Height: 12'6"
T 6.� = a A
1T1W" 1 -e 2578.24 SF Walls 2206.92 SF Ceiling
4785.17 SF Walls&Ceiling 2206.92 SF Floor
- n n a = 245.21 SY Flooring 206.00 LF Floor Perimeter
T I 206.00 LF Ceil.Perimeter
ass• 1
ifs u•-�"
DESCREMON QTY
Prep Items
1. Floor protection-cloth-skid resistant,leak proof 2206.92 SF
2. Window blind-horizontal or vertical-Detach&reset Z4•00 EA
3. Window drapery-hardware-Detach&reset 12.00 EA
4, Content Manipulation charge-per hour 32.00 HR
NOTE:Labor to reset contents once repairs are completed
5. Sprinkler head/escutcheon-Detach and reset 26.00 EA
Electrical And Plumbing
6. Heat/AC register-Mechanically attached-Detach&reset 16.00 EA
7. (Install)Chandelier 5.00 EA
8. LED Bulb 28.00 EA
Rough Items
9. Batt insulation- 10"-R30-unfaced batt 640.00 SF
10. Foil vapor barrier-aluminum-double sided 640.00 SF
11. 1/2"drywall-hung,taped,floated,ready for paint 256.00 SF
12. Drywall Installer/Finisher-per hour 4.00 HR
NOTE:Additional time to install drywall at window returns
13. Polyethylene vapor barrier 400.00 SF
14. Batt insulation-6"-R19-unfaced batt 256.00 SF
15. Texture drywall-light hand texture 256.00 SF
16. 5/8"drywall-hung&fire taped only 2206.92 SF
17. 5/8"drywall-hung,taped,floated,ready for paint 2206.92 SF
18. Additional cost for high wall or ceiling- I1'to 14'high 4413.85 SF
16-60-BROO_Q-REP-W-1 12/20/2016 Page:2
®) BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
CONTINUED-Dining Room
DESCRIPTION QTY
19. Fill holes created by wall cavity drying 412.00 EA
Finishes
20. Baseboard-5 1/4" 206.00 LF
21. Window sill 5.00 LF
22. Prep wall for wallpaper 572.00 SF
23. (Install)Wallpaper 572.00 SF
NOTE:To re secure wall covering at top and bottom of affected walls
Painting
24. Seal the ceiling w/PVA primer-one coat 2206.92 SF
25. Paint more than the ceiling-two coats 3372.97 SF
26. Additional cost for high wall or ceiling- 11'to 14' 2206.92 SF
27. Paint baseboard,oversized-two coats 206.00 LF
28. Paint door or window opening-Large-2 coats(per side) 31.00 EA
29. Seal&paint window sill 60.00 LF
Flooring
30. Clean and deodorize carpet 2206.92 SF
NOTES:
16-60-BROO_Q-REP-W-1 12/20/2016 Page:3
�•� BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
IT Id' Office Height: 12'6"
IT 6'
757.20 SF Walls 223.13 SF Ceiling
oR H 980.33 SF Walls&Ceiling 223.13 SF Floor
1 24.79 SY Flooring 60.50 LF Floor Perimeter
60.50 LF Ceil.Perimeter
IT 10'
DESCRIPTION QTY
Prep Items
31. Floor protection-cloth-skid resistant,leak proof 223.13 SF
32. Window blind-horizontal or vertical-Detach&reset 4.00 EA
33. Window drapery-hardware-Detach&reset 2.00 EA
34. Content Manipulation charge-per hour 4.00 HR
NOTE:Labor to reset contents once repairs are completed
Electrical And Plumbing
35. Heat/AC register-Mechanically attached-Detach&reset 2.00 EA
36. (Install)Chandelier 1.00 EA
37. LED Bulb 4.00 EA
Rough Items
38. 5/8"drywall-hung&fire taped only 223.13 SF
39. 5/8"drywall-hung,taped,floated,ready for paint 223.13 SF
40. Additional cost for high wall or ceiling- 11'to 14'high 446.25 SF
41. Fill holes created by wall cavity drying 121.00 EA
42. 5/8"-drywall per LF-up to 4'tall 12.90 LF
43. Texture drywall-light hand texture 51.60 SF
Finishes
44. Baseboard-5 1/4" 60.50 LF
45. Crown molding-3 1/4" 60.50 LF
Painting
46. Seal the ceiling w/PVA primer-one coat 223.13 SF
47. Paint the walls and ceiling-two coats 980.33 SF
48. Additional cost for high wall or ceiling- 11'to 14' 223.13 SF
49. Paint baseboard,oversized-two coats 60.50 LF
16-60-BROO_Q-REP-W-1 12/20/2016 Page:4
®� BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#841309171
CONTINUED-Office
DESCRIPTION QTY
50. Paint door or window opening-Large-2 coats(per side) 8.00 EA
51. Seal&paint window sill 10.00 LF
52. Paint crown molding-two coats 60.50 LF
53. Paint chair rail-two coats 60.50 IF
Flooring
54. Clean and deodorize carpet 223.13 SF
NOTES:
—13.1•~ Height:8'
zr Activity Room
536.00 SF Walls 264.56 SF Ceiling
`_ nan�rx 800.56 SF Walls&Ceiling 264.56 SF Floor
29.40 SY Flooring 67.00 LF Floor Perimeter
F
67.00 LF Ceil.Perimeter
.—I3.1•
1
DESCRIPTION QTY
Prep Items
55. Contents-move out then reset-Extra large room 1.00 EA
56. Protect contents-Cover with plastic 132.28 SF
Rough Items
57. Fill holes created by wall cavity drying 20.00 EA
Finishes
16-60-BROO_Q-REP-W-1 12/20/2016 Page:5
BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#841309171
CONTINUED-Activity Room
DESCRH'TION QTY
58. Cove base molding-rubber or vinyl,4"high 20.00 LF
Flooring
59. Clean and deodorize carpet 264.56 SF
NOTES:
�."''' Height:8'
�s•v T Nurses Office
536.00 SF Walls 264.56 SF Ceiling
Nom 0 800.56 SF Walls&Ceiling 264.56 SF Floor
29.40 SY Flooring 67.00 LF Floor Perimeter
67.00 LF Ceil.Perimeter
amu•r�
DESCRH'TION QTY
Prep Items
60. Contents-move out then reset-Extra large room 1.00 EA
61. Protect contents-Cover with plastic 132.28 SF
Rough Items
62. Fill holes created by wall cavity drying 20.00 EA
Finishes
63. Cove base molding-rubber or vinyl,4"high 20.00 LF
Flooring
16-60-BROO_Q-REP-W-1 12/20/2016 Page:6
BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
B E LFO R (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
CONTINUED-Nurses Office
DESCRIPTION QTY
64. Clean and deodorize carpet 264.56 SF
NOTES:
'B'Y'
n9- , m
dLobby Height:8'
_ ry
i"r s- 1462.67 SF Walls 1440.06 SF Ceiling
Lobbya 2902.72 SF Walls&Ceiling 1440.06 SF Floor
i - 160.01 SY Flooring 182.83 LF Floor Perimeter
0 182.83 LF Ceil.Perimeter
I tit
DESCREMON QTY
Prep Items
65. Contents-move out then reset-Extra large room 1.00 EA
66. Protect contents-Cover with plastic 720.03 SF
Rough Items
67. Fill holes created by wall cavity drying 20.00 EA
Finishes
68. Cove base molding-rubber or vinyl,4"high 20.00 LF
Flooring
69. Clean and deodorize carpet 1440.06 SF
16-60-BROO_Q-REP-W-1 12/20/2016 Page:7
�.. •
BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
CONTINUED-Lobby
DESCRIPTION QTY
NOTES:
General Conditions
DESCRIPTION QTY
70. Scaffold-per section(per week) 8.00 WK
71. Labor to set up and take down scaffold-per section 8.00 EA
72. Neg.air fan/Air scrub.-Large(per 24 hr period)-No monit. 20.00 DA
NOTE:To control dust from entering kitchen and lobby during repairs.
73. Commercial Supervision/Project Management-per hour 40.00 HR
NOTE:Project manager to fast track completion of repairs.
74. Dumpster load-Approx.20 yards,4 tons of debris 1.00 EA
75. General Laborer-per hour 40.00 HR
NOTE:Daily cleanup of area and material handling
76. Cleaning Technician-per hour 48.00 HR
NOTE:Post construction cleanup
77. Overtime to fast track project 1.00 EA
78. Taxes,insurance,permits&fees(Bid Item) 1.00 EA
NOTES:
16-60-BR00_Q-REP-W-I 12/20/2016 Page:8
�•� BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
Grand Total Areas:
5,870.11 SF Walls 4,399.23 SF Ceiling 10,269.34 SF Walls and Ceiling
4,399.23 SF Floor 488.80 SY Flooring 583.33 LF Floor Perimeter
0.00 SF Long Wall 0.00 SF Short Wall 583.33 LF Ceil.Perimeter
4,399.23 Floor Area 4,543.73 Total Area 5,870.11 Interior Wall Area
3,215.77 Exterior Wall Area 281.00 Exterior Perimeter of
Walls
0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length
0.00 Total Ridge Length 0.00 Total Hip Length
16-60-BROO_Q-REP-W-1 12/20/2016 Page:9
•� BELFOR Property Restoration
Physical-2 Industry Drive-Waterford,NY 12188
Mailing-75 Virginia Road-North White Plains,NY 10603
BELFOR (518)320-8333 Tel. - (518)320-8434 Fax.
Fed ID#84-1309171
Insured: BROOKDALE-QUEENSBURY
Property: 27 WOODVALE ROAD
QUEENSBURY,NY 12804
Claim Number: Policy Number: Type of Loss: Water Damage
Date of Loss: Date Received:
Date Inspected: Date Entered: 12/17/2016 5:07 PM
Price List: NYWP8X_DEC16
Restoration/Service/Remodel
Estimate: 16-60-BROO_Q-REP-W-1