RC-0201-2019TOWN OF QUEENSBURY
742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-0201-2019
Tax Map No: 289.10-1-13
Permission is hereby granted to: Tracy Taylor
For property located at:21 JAY 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: Tracy Taylor Single Family-Alteration 181500.00
Owner Address: PO Box 1344 ST Total Value 181500.00
Rutland,VT 05701
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans& Specifications
Residential Addition 64 s.f.
Residential Alteration 161 s.f.
porch with balcony)
450.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,April 20, 2020
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 Queensbury; Friday,April 19, 2019
SIGNED BY.for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
ADDITION/ALTERATION PERMIT Permit#: 2C — 02.0 2-01
APPLICATION Permit Fee: $ D(:)
Town of Qucensbury
742 Bay Road,Queensbury,NY 12804 Invoice It (.(311P:518-761-8256 www.queensbury.net
Project Location: - _1 cs-o-z_cc
Tax Map ID #:2 1,16 -i-1 Subdivision Name:
ECIEBWirtiI
CONTACT INFORMATION: lr:11 APR 1 2 2019 1
Applicant: TOWN OF OUEi-.LNSEitin.
Name(s): Tracy Taylor SUPtn;l€ "'` ''''' '`'
mow...........
Mailing Address, C/S/Z: PO Box 1344, Rutland VT 05701
Cell Phone: _(_802 )_770-9527 Land Line: _( N/A
Email: ttaylor@killington.com
Primary Owner(s):
Name(s): Tracy and Justine Taylor
Mailing Address, C/S/Z: PO Box 1344, Rutland, VT 05701
Cell Phone: _(_802 770-9527 Land Line: _( N/A
Email:ttaylor@killington.com
XX 0 Check if all work will be performed by homeowner only
Contractor(s):
Contact Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: _( Land Line: _(
Email:
List all additional contractors on the back of this form
Architect(s)/Engineer(s):
Business Name:Rice Design Services
Contact Name(s): _Mike Rice
Mailing Address, C/S/Z: 7 Robin Drive, Warrensburg,NY 12885
Cell Phone: _(_518 932-9951 Land Line: _(
Email: _michaelrice27@gmail.com
Contact Person for Building & Code Compliance: _Same
Cell Phone: _( Land Line: _(
Email:
Addition/Alteration Application Revised February 2019
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PROJECT INFORMATION:
TYPE: Commercial XXsidential
WORK CLASS:
X 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: 161 SF
2nd floor:_64 SF 2nd floor:
3rd floor: 3rd floor:
Basement (habitable space):Basement (habitable space):
Total square feet: 64 SF Total square feet: 161 SF
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $_$18,500
2. If Commercial project, what is the proposed use:
IX(3. Source of heat: Gas Oil Propane Solar Other Fireplaces need a separate Fuel
Burning Appliances & Chimney Application
4. Are there any structures not shown on the plot plan? YES ENO Explain:
5. Are there any easements on the property? YES ENO
6. SITE INFORMATION:
a. What is the dimensions or acreage of the parcel? _13,522 SF/.031 Acres
b. Is this a corner lot? YES X NO
c. Will the grade be changed as a result of the construction? YES ENO
d. What is the water source? PUBLIC X PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? _Private Septic
Addition/Alteration Application Revised February 2019
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DECLARATION:
1. I acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to
fees and department approval.
3. I certify that the application, plans and supporting materials are a true and complete statement and/or
description of the work proposed, that all work will be performed in accordance with the NYS Building
Codes, local building laws and ordinances, and in conformance with local zoning regulations.
4. I acknowledge that .prior to occupying the facilities proposed I, or my agents, will obtain a certificate
of occupancy.
5. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all
newly constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: Tracy Taylor
DATE: 4/9/2019
Addition/Alteration Application Revised February 2019
FUEL BURNING APPLIANCE & Office'luse Only
1 CHIMNEY APPLICATION Permit#: �c
� Permit Fee:$
Town of Qucensbury
742 Bay Road,Queensbury, NY 12804 Invoice#: �O
P:518-761-8256 www.gueensbury.net
I
**ONE APPLICATION PER APPLIANCE**
Project Location: i T4"1 us.. Tax Map ID#:
Room of install: �� C�./�-i" Planned Install Date:
9
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FUEL BURNING APPLIANCE INFORMATION: a
TYPE OF DEVICE:
—Stove —Fireplace Insert —Fireplace rss I'
{rl 00
—Fuel Fired Equipment (Garage Only: 18" clearance per IMC 304.3) f �`-
v Fireplace,factory built
(**Manufacturer's name: k�-V' Model#: �J,,J)C i 4Z-3(c1.LiF-B)
SOURCE OF HEAT: /
Wood Coal Pellet i, Gas
CHIMNEY INFORMATION:
Masonry (require plans to be submitted):
block brick stone
ZIF lue: �
—tile steel —size, in inches
_Material*:
—double-wall —triple-wall--insulated
(*Manufacturer's name: 4CW2-T`1J 4 �c*�'�1�� +-►��'�'-v��� Model#: ,byp \JE"ioG SyS S
Fuel Burning Appliance&Chimney Application Revised December 2020
1
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):
Mailing Address, C/S/Z: -2— l,c--1_t ()
Cell Phone: S( 02 Land Line:
Email:
• Primary Owner(s):
Name(s): �Arvl
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _( )
Email:
Check if all work will be performed by property owneronly
• Installer/Builder: Workers' Comp documentation must be submitted with this application
Contact Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: _( ) Land Line: _( )
Email:
Contact Person for any questions regarding this project:
Cell Phone: Land Line: �)
Email:
ADDITIONAL INFORMATION:
1. Two (2) inspections are required. A rough-in inspection, prior to installation and a final inspection,
after installation.
2. Manufacturer's installation manual must be available at the time of inspection.
3. Masonry fireplaces & chimneys require plans-to be submitted-. -
4. Twenty-four(24) hour notification is required for inspections.
S. Workers'Comp insurance information is required with this application.
Declaration: Construction/installation must conform to NYS Fire Prevention & Building Code and/or
manufacturer requirements. The applicant or owner agrees to comply with;all applicable laws, ordinances,
regulations and all conditions that are part of these requirements and also will allow the inspector to enter the
premises to perform the required inspections.
I have read and agree to the above:
PRINT NAME: ''�h
t
SIGNATURE: L— _ DATE: Z�
Fuel Burning Appliance&Chimney Application Revised December 2020
KYNENE
THE EVOLUTION OF INSULATION
MSULATION CERTIFICATE
i1 his�-Gr(M, rulust Pie fulled out and posted to cofflp)y vath bullidincg code Iregmavempn tz.
WIC-ets ORC, fi-Gogeuilremenitsa �00 Opts-4�a 10a. ,Pia a®a.4,G�9a 14Da
2009 DEC-Rl1 O-T.2,MT 10a.4,M11011.8
®a�u M110a.12
The following spray polyurethane foam product(s)has/have been installed.
❑LD-C-50 ❑LD-R-50 ❑MD-C-200 ❑MD-R-200 ❑MD-11-210 VOther i4fo c
Please consult International Building Code(IBC),Chapter 26-Plastic and International Residential
Code(IRC)2006 IRC R314,2009 IRC R316,2012 IRC R316-Foam Plastics for specific requirements.The
aforementioned Icynene spray polyurethane foam insulation system(s)has/have been installed in
accordance with manufacturer's processing guidelines to provide a thermal resistance of: -
ATC-a Onsolatcd Aged R-Va oue ThAckatess*
Attic Area R- at inches
Sloped Ceilings R- LJ at inches
Walls(location): l � 0 , � R-® at inches
Walls(location): R- at U inches
Floors(over an unheated crawl space) R- —� at inches
Crawl Space Perimeter R- at inches
Basement Walls R- at inches
other(location): (}p- —� R- at L +� inches
"Nominal thicknesses are representative of field,spray-applied foam material.
.lobsite Address ra
Date of Insulation Installation
Building Contractor
Insulation Contractor flo r lv Ll ronttl
Insulation Contractor Phone
Installed By Lab b bf lR
n�n�SULAMOM
n M N 1
Please post near electrical panel
UZMAN
E N G I N E E R I N G
June 24, 2019
Rice Design Services
7 Robin Drive
Warrensburg, New York 12885
Re: Taylor Residence Addition
Dear Mike:
have reviewed the plans for the Taylor Addition in Glen Lake, New York to size a beam
to open the wall between the existing house and addition.
The opening will be 20 foot. To support the loading, a 3 ply 1.75"z11.875" LVL will be
required. This will be supported by posts at each end.
Additionally, during the excavation of the foundation, it was discovered there was no
foundation under the existing wall. A new 10"x20"concrete foundation shall be poured
under the existing foundation and extending 12 feet down each side.
If you have any questions, please feel free to contact me.
Sincerely; e`5�,n;estga�iargq,JrJrr e
AIV
Zen B. U n, PE, SE, PEng, F.NSPE 'a.
.9Ht1itM'
Presi ent
zeyn@uzmanengineering.com 5cJ0� ,,�
116 E. • Street, . • 00