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TOWN OF QUEENSBURY
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742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
c��T Q ry,
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150256 Application Number: A20150256
Tax Map No: 523400-289-017-0001-025-000-0000
Permission is hereby granted to: RUSSELL CANTERBURY
For property located at: 29 CANTERBURY Dr
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: RM CANTERBURY REALTY, LLC Demolition
19 MEADOWVIEW Ln Total Value
NEW HARTFORD, CT 06057-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
DAVID JARVIS
518-932-9971
35 FITZGERALD Rd
OUEENSBURY NY 12804-0000
Plans&Specifications
BP 2015-256
Demolition of existing residence and garage. (Asbestos Report pending).
Structures will be replaced.
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 09, 2016
(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 own idyl /. s i ay, September 09, 2015
4
SIGNED BY for the Town of Queensbury.
Director of Building& Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit#: Lt "015
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee _
Provide 2 plot plans drawn to scale,sh wi ig lot boundaries with dimensions an adjacent roads I streets. Show all existing structures
on property and indicate which are to lished. Indicate the location:Qfl I utilities
JUN 17 ILI]
Date _L7 1U15 Deitl`olition Location __ _CAWaieLeilLiY_Vd.
�p� /'TOWN OF QUEENSBURY f
Tax Map ID 1.t1_Ls17_i_ 7 BUILDING&C`
APPLICANT _ tyJ si1rLi OWNER ___15AtY _ _ efil '
Address put l _14��yy��_��,� Address
_ Silt' _ 120P✓
Phone a(j_^-6-3:2.-.:-012..)2_%. Phone
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: A1J l.L /l
01.5 _ phone: b9kOdelfij
1. Person Responsible for Worke. Jpoki tS
2. Where will demolition material be disposed? 44'127t4•14 44O ) - p s- r.
3. All buildings to be demolished require an Asbestos Survey .» laii NG( t-AOLO
4. Any building substantially damaged by fire must obtain an Asbestos Removal Permit from the Department of Labor
5. Asbestos Information: The Asbestos Removal Report must be filed czn
CD c ith our office before demolition begin
a) Is there any asbestos in the building to be demolished __ _,Yes ____No
v/ N
b) If Yes,our office needs the following information ____ Yes ____ Nouj
Name of firm removing the asbestos VAa �vNOk - �1,-� rL t a_.. O +
License number of firm 4- c ` a co
Z
Indicate
MODE@►J L,�+ Drr�� yyM� t�,►�T C`�IRI'� a)where m ,
the asbestos material will be disposed ti,,,,z?„,.
6. Structure InformationYale Wit kikbL �, ,a) c0
a) Indicate the structure(s)to be demolished _t/'__ Residence Garage ___ Business '�
___ Storage Bldg. ___ Other w O
b) Size of Structure 4,7 C L o
c) Number of Stories I 'Az U N I—
d) Foundation Type Cm U l Gpa('— (D c 0 M
cm
e) Foundation V I r
J f to 0 oil -0
f) Structure(s) 40 Ce N 0 cia
7. Utilities Information
a) Indicate utilities for this structure ___ Gas Electric r_ Propane ___ Public Water ___ Public Sewer
___ On-site well water pump .... A (431 .
a) Have you notified the Town Water Department for public water and sewer disconnect? ____ Yes _% No 14/16►
b) Have all utilities been disconnected? ____ Yes _Z_ No ( w)it, .13
Signature /�Q�
Print Name: 0111,cid 1__
/Au- - A' ' 'Date
Signature: _ iloptleatita, Date _p _Ze?
Town of Queensbury Building&Codes - Demolition Permit -December 2014
i
P.O.Box 1024
\ Schenectady.NE 12301
(518)346-8374(Phone)
/. Environmental tlssoc ates, inc. (518)346-4062(Pax)
'EXCEEDING OUR CLIENTS EXPECTATIONS OF EXCELLENCE' www.4spectrum.com
September 5, 2015
Russell Canterbury
19 Meadowview Lane
New Hartford,CT 06057
rcanterbury(2 alliant.com
Re: Asbestos Monitoring
39 Canterbury Drive
Lake George,NY
Dear Mr. Canterbury:
Spectrum Environmental Associates, Inc. (Spectrum) is submitting this letter as our report for the
Final Visual Inspection(s)performed on the above referenced asbestos project.
New York State Department of Labor Industrial Code Rule 56 requires a final visual inspection
be performed by a New York State Certified Asbestos Project Monitor who is independent of the
asbestos abatement contractor. The final visual inspection is to confirm that all asbestos
materials have been removed and that the work area has been properly cleaned.
The scheduled asbestos containing materials for this project involved the removal of:
• Joint Compound
On September 5, Mr. Anthony Santa Maria (AH#01-00860) performed a final visual inspection
and collected clearance air samples. The work area passed the visual inspection and the air
sample results were below the clearance criteria 0.01 f/cc.
If you have any questions concerning this report,please contact our office at(518) 346-6374.
Respectfully Submitted,
FILE COPY
James A. Capasso II
Operations Manager
Environmental Consulting&Management Services • Health&Safety Training • Laboratory Services