RC-000613-2017 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: RC-000613-2017 Date Issued:
This is to certify that work requested to be done as shown by Permit Number RC-000613-2017
has been completed.
Tax Map Number: 303.20-1-88
Location: 70 BOULEVARD
Owner: Linda Polunci
Applicant: Kelly Homes
This structure may be occupied as a: Residential Alterations
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000613-2017
Tax Map No: 303.20-1-88
Permission is hereby granted to: Linda Polunci
For property located at: 70 BOULEVARD
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
Tyne of Construction
Owner Name: Linda Polunci Single Family-Alteration $25,000.00
Owner Address: 70 Boulevard Total Value $25,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Kelly Homes
PO Box 4381
Queensbury,NY 12804
Plans&Specifications
Residential Alterations
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,October 4,2018
(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 ueensbu /jedn y, 4,2017
SIGNED BY: 6K for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Uiily
Zvi
ADDITION/ALTERATION PERMIT Peri�.iY#: /
APPLICATIONP2rmi�i dee: tv
Town of Queensbury ((�� (� vtll(��
742 Bay Road,Queensbury,NY 12804 � E C lhE
P: 516-761-8256 www.gueensburV.net
Project Location: 7o (3ov 1 -e v-yi SEP 2 8 2017
v _\! TOWN OF QUEENSBURY
M.
Tax Map ID , ES
CONTACT INFORMATION:
® Applicant:
Name(s): �l✓ 1 -�S
Mailing Address, C/S/Z: e X Lf 6+ .Q '*4
Cell Phone: VY-) 2 - 2-- Land Line: � )
Email: /ef/
Primary Owner(s): r
Name(s):
Mailing Address, C/S/Z: ��` i, 674
Cell Phone: Land Line: � )
Email:
® Contractor(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z: C' r $ l
Cell Phone: Land Line:
Email:
@ Architect(s)/Engineer(s):
Business Name: /
Contact Name(s): (Lei e .e/
Mailing Address, C/S/Z:
Cell Phone: ) .4 5 �' GLand Line: � )
Email:
Contact Person for Build ng 8 de Compliance:
Cell Phone: j Land Line: � )
Email:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
.PROJECT INFORMATION:
TYPE: CornmerciaResidential
WORK CLASS-
Single-Family Two-Family Multi-Family (#of units )
Townhouse Business Office Retail
_ Industrial/Warehouse _Garage (# of cars ) Other (describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
2nd floor: 2nd floor:
3rd floor: 3rd floor:
4th floor: 4th floor:
Total square feet: Total square feet: �7
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $
2. If Commercial project, what is the proposed use: //A
3. Source of Heat (circle one): Gas Oil Propane Solar Other
Fireplaces need a separate Fuel Burning Appliances & Chimney Application
4. Are there any structures not shown on the plot plan? YES NO Explain:
5. Are there any easements on the property? YES NO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel?
b. Is this a corner lot? YES NO
c. Will the grade be changed as a result of the construction? YES NO
d. What is the water source? PUBLIC PRIVATE WELL
e. Is the parcel on SEWS or a PRIVATE SEPTIC system?
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
DECLARKrIO:
1. 1 acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If thework is not completed 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 and/or
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. 1 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 the above:
PRINT NAME:
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Addition/Alteration Application Revised February 2017
IMPROVEMENTS S i O
70 Boulevard
Queensbury, hY 12804
5ECEOVE
PRO
LindaYj' WNER TOWN OF QUEENSBURY
Lind ��` SEP 2$ 2017 BUILDING DEPARTMENT
70 Bo I Based on our limited examination,compliance
Queen bury UEENSBURY with our comments shall not be construed as
LD1NG&CODES indicating the plans and specifications are in
Phone; 3 - full compliance with the Building Codes of
New York State.
-:� FtL� COPY
{ !4 Y
j
NOTE 1: All wort: 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 USED.
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
..........Reduction 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 35).
Risk Assessment
A risk assessment has been performed for this property and project (attached) which has identified lead
70 Boulevard 1
hazards which roust be corrected. These hazards and the rehabilitation work to remedy these hazards is
spelled out in the work specifications. The Contractor is responsible for Beading the attached Load-
Rased 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 .C ertificatior.
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
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. bust wipes shall be taken in
all rooms 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,
I. Wet scraping and wet sanding, or
2. Removed and replaced, or
3. Kept intact and covered with an impermeable layer(vinyl, aluminum, etc.)
70 Boulevard 2
1. LEAD-13ASED PAINT INTE I[CONTROLS
VVet scrape and wet sand in the following locations.
Prime and paint with 7 (two, coats of good quality late;; paint.
A. Exterior:
a. Front (Side A)
Porch trim, clapboard (white)
b. Left (Side B)
Porch horizontal trim, low(brown)
r Porch railing (brown)
ff Vertical trim (brown)
Window(r), trim (brown)
Window sill (m) (brown)
r Basement window frame (brown)
C. Back (Side C)
Porch beam (white)
Porch rafter(white)
d. Right(Side D)
Window(3), sill (brown)
Window(3), trim (brown)
Window(L), trim (brown)
B. Interior:
a. Living Room (Room 101)
z Inside track(white)
b. Dining room (Room 102)
• Window trough (brown)
LIST LEAD-BASED FAINT IMTERIM CONTROLS PRICE HERE Ti
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. ►herefore, any such items are to
be priced separately as indicated below.
70 Boulevard 3
2. EL.ECTIRICAL
All work is to be performed in accordance with manufacturer's instructions, NYS Building Code, Local
Building Code and attached (ELECTRICAL STANDARD SPECIFICATIONS.
A. Dining Room
Qb Install Lithium-ion battery operated smoke & CO detector
B. Bedroom#1 (first floor)
t Install battery operated smoke detector.
C. Kitchen
GFI protect all existing countertop receptacles, as required.
Provide dedicated 20 amp circuit& GFI protected receptacle for microwave.
Provide dedicated 20 amp circuit for refrigerator, as necessary.
rw Receptacle in wall, at left as entering kitchen, does NOT work. Determine cause
& correct, as required.
D. Upstairs hall:
Install smoke & CO detector, as above.
E. Bedroom 42 (Right as walk down hall)
install smoke detector, as above.
g Install wall sconce or ceiling fixture (approx. 30") with switch control at door. Include CFL
bulb(s). The use of wire mold is acceptable.
Provide 2 new duplex grounding receptacles at best possible locations.
F. Bedroom#3 (East)
Install smoke detector, as above.
Install light fixture, as above.
Provide 2 new receptacles, as above.
G. Bedroom#4
Install smoke detector, as above.
Install light fixture, as above.
Provide 2 new receptacles, as above.
H. Basement
+. Install battery operated smoke & CO detector.
Provide dedicated 20 amp circuit& GFI receptacle for sump pump.
install cover plate for open junction box in ceiling (new pine side).
I. Service
r In same location, install new 200 amp electrical service.
New main breaker panel will have sufficient spaces to accommodate all existing & new
branch circuits
Label all breakers.
Contractor will be responsible for all permits, inspections& service orders.
LIST ELECTRICAL PRICE HERE$
70 Boulevard 4
,. INTERIOR CARPENTRY
All work is to be performed in accordance with manuf'acturer's Instructions, ISYS Building Code, Local
Building Code and attached STAIRS STANDARD SPECIFICATIONS.
A. Livingroom:
Remove area of ceiling damaged by roof leak.
Patch with drywall of appropriate thickness.
r
Tape & finish
Prime new drywall & paint entire ceiling with good quality latex ceiling paint.
B. Bathroom
Same as livingroom.
C. Bedroorn fl
Same as livingroom &dining. Damage is more extensive.
D. Basement
Remove existing basement stairs entirely.
Build new pressure treated stairs, best possible rise & run.
k Provide graspable wood handrail at one side.
LIST INTERIOR CARPENTRY PRICE HERE
4. EXTERIOR CARPENTRY
A. Front Porch-
lb Install wrought iron railing at both sides of concrete steps.
LIST EXTERIOR CARPENTRY PRICE HERE �
5. STRUCTURAL
A. Attic Spaces (1St floor ceilings)
91 Repair any ceiling joists, plates, sills, etc prior to insulation.
LIST STRUCTURAL PRICE HERE $
70 Boulevard 5
6. ROOFING
A. Main roof, dormer, front porch, bay window
*7 Remove existing roofing & dispose of properly.
Repair or replace sheathing as necessary (damage may be extensive)
Repair, re-inforce or replace any damaged rafters.
a Install ice & water shield at eaves & in valleys to current local building code.
Install new drip edge, 15 Ib felt&all necessary flashings.
f Properly flash roof of bay window to side wall.
Install 30 year architectural shingles. Homeowner will have choice of stock color.
Maintain adequate ventilation at ridge.
Contractor will be required to submit progress photo graphs at various stages of project,
showing the roof stripped, shearing repaired, & ice &water shield installed.
LIST ROOFING PRIGS HERE t
MOTE, ANY FINISHED SURFACES DAMAGED DURING THE COURSE OF REHABILITATION WORK
SHALL BE REPAIRED ARID 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 PENCE HERE -- - -
70 Boulevard 6