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BOTH-000066-2016 TOWN OF QUEENSBURY 4W 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 — EW ommunity Development-Building& Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: BOTH-000066-2016 Date Issued: Monday, February 13, 2017 This is to certify that work requested to be done as shown by Permit Number BOTH-000066-2016 has been completed. Tax Map Number: 226.19-1-84 Location: 218 LAKE PKWY Owner: Cathy Hodgkins,JOHN HODGKINS Applicant: Witt Construction Inc. This structure may be occupied as a: Demo,asbestos report received Cross Ref. AV PZ-049-2015 and SP PZ-041-2015 By Order of Town Board TOWNOFQUEENNSSBURY Issuance of this Certificate of Compliance DOES NOT relieve the ( r 4t Variance,property owner of the responsibility for compliance with Site Plan, -`f/�)avjY 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 ddW Community Development-Building& Codes (518)761-8256 BUILDING PERMIT Permit Number: BOTH-000066-2016 Tax Map No; 226.19-1-84 Permission is hereby granted to: Cathy Hodgkins,JOHN HODGKINS,Witt Construction Inc. For property located at: 218 LAKE PKWY 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: JOHN HODGKINS Demolition $0.00 Owner Address: 20 N Kings RD Total Value $0.00 Lake George,NY 12845 Contractor or Builder's Name 1 Address Electrical Inspection Agency Witt Construction Inc. 563 N Broadway Saratoga Springs,NY 12866 Plans&Specifications Demo,asbestos report received Cross Ref. AV PZ-049-2015 and SP PZ-041-2015 530.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,February 13,2017 (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 expiration date.) Dated at the Town ofueensbu riday F b 016 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Town of Queensbury Building & Codes Office Use Only Received Permit �'�'��1"b` �►_� _ DEMOLITION PERMIT APPLICATION Perm -- ------ NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee $LID.�_`�n_v_o_+tom Provide 2 plot plans drawn to scale, showing lot boundaries with dimensions and adjacent roads/ streets. Show all existing structures on property and indicate which are to be demolished. Indicate the location of all utilities Date Demolition Location4 _ � �__„,�, J Tax Map 1D 3!1_�L(�_�= r 201h APPLICANT �J __ id _ OWNER &14J_L,fi (ALt_`, Address �1 � ' � 1'_ { L �� __ Address ' ___-- � lY .CGC. srLC�n ' Phone _51�_`>,k Il ----------- Phone -------- CONTACT PER50N FOR BUILDING & CODES COMPLIANCE: _______________________________ Phone: ---------- 1. Person Responsible for Work Joi YI f CA- Li5vbo fl Irf I Vec I 2. Where will demolition material be disposed? 1 All buildings to be demolished require an Asbestos Survey 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 with our office before demolition begin a) Is there any asbestos In the building to be demolished -___ YesI�_ o b) if Yes, our office needs the following information ____ Yes ____ No Name of firm removing the asbestos License number of firm Indicate where the asbestos material will be disposed b. Structure Information a) Indicate the structure(s) to be demolished _ Residence -_- Garage Business -__ Storage Bldg, __- Other b) Size of Structure c) Number of Stories d) Foundation Type e) Foundation f) Structure(s) 7. Utilities Information a) Indicate utilities for this structure 1Gas ___ Electric -__ Propane ___ Public Water ___ Public Sewer ___ On-site well water pump a) Have you notified the Town Water Department for public water and sewer disconnect? Yes ____ No b) Have all utilities been disconnected? _ Yes ____ No 8. Signature 5 Print Name: ��_`_= .� --------- Date --- - __- Signature: } �; :. L .,L�_ j'j�. ,t^ Date --= _L ---- Town of Queensbury Building& Codes- Demolition Permit - December 2014 Town of Queensbury Conununity De\c lnl7nient Office 742 Bay Road, Queensbury. NY 1_1804 Town of Queensbury Planning Board RESOLUTION—Grant Site Plan Approval for Site Plan PZ-0041-2015 JOHN & CATHY HODGKINS Tax Map ID: 226.19-1-84 /Property Address: 218 Lake Parkway/Zoning: WR The applicant has submitted an application to the Planning Board for Site Plan approval pursuant to Article 9 of the Town zoning Ordinance for: Applicant proposes construction of a single family home of 2,927 sq. ft. Project includes demolition of 1,081 sq. ft. footprint; project will include new storm water, new septic, new plantings and grading on site. Project occurs within 50 ft. of 15% slopes and hard surfacing within 50 ft. of shore. Project includes retaining an existing garage where only one is allowed and two are proposed. Pursuant to Chapter 179-6-060 and 179-6-050 of the Zoning Ordinance work within 50 ft. of 15% slope and hard surfacing within 50 ft. of the shoreline shall be subject to Planning Board review and approval. Pursuant to relevant sections of the Town of Queensbury Zoning Code-Chapter 179-9-080, the Planning Board has determined that this proposal satisfies the requirements as stated in the Zoning Code; As required by General Municipal Law Section 239-m the site plan application was referred to the Warren County Planning Department for its recommendation; The Planning Board opened a public hearing on the Site plan application on 1/26/2016 and continued the public hearing to 1/26/2016 when it was closed, The Planning Board has reviewed the application materials submitted by the applicant and all comments made at the public hearing and submitted in writing through and including 1/26/2016; The Planning Board determines that the application complies with the review considerations and standards set forth in Article 9 of the Zoning Ordinance for Site Plan approval, MOTION TO APPROVE SITE PLAN PZ-0041-2015 JOHN & CATHY HODGKINS. Introduced by Paul Schonewolf who moved for its adoption, seconded by David Deeb: Per the draft provided by staff conditioned upon the following conditions: 1) Waivers request granted: 2 Adherence to the items outlined in the follow-up letter sent with this resolution. a) The limits of clearing will constitute a no-cut buffer zone, orange construction fencing shall be installed around these areas and field verified by Community Development staff; b) If applicable, the Sanitary Sewer connection plan must be submitted to the Wastewater Department for its review, approval,permitting and inspection; c) If curb cuts are being added or changed a driveway permit is required. A building permit will not be issued until the approved driveway permit has been provided to the PIanning Office; d) If application was referred to engineering then Engineering sign-off required prior to signature of Zoning Administrator of the approved plans; Phone: 518.761.8220 1 Fax: S18.74S•4437 1742 Bay Road, Queensbury, NY 12804 1 www.queensbui-y.net e) If required,the applicant must submit a copy of the following to the Town: a. The project NOI (Notice of Intent)for coverage under the current "NYSDEC SPDES General Permit from Construction Activity" prior to the start of any site work. b. The project NOT(Notice of Termination)upon completion of the project; c. The applicant must maintain on their project site, for review by staff: i. The approved final plans that have been stamped by the Town Zoning Administrator. These plans must include the project SWPPP (Storm Water Pollution Prevention Plan) when such a plan was prepared and approved; ii. The project NOI and proof of coverage under the current NYSDEC SPDES General Permit, or an individual SPDES permit issued for the project if required. f) Final approved pians,in compliance with the Site Plan, must be submitted to the Community Development Department before any fiuther review by the Zoning Administrator or Building and Codes personnel; g) The applicant must meet with Staff after approval and prior to issuance of Building Permit and/or the beginning of any site work; h) Subsequent issuance of further permits, including building permits is dependent on compliance with this and all other conditions of this resolution; i) As-built plans to certify that the site plan is developed according to the approved plans to be provided prior to issuance of the certificate of occupancy. j) Resolution to be placed on final plans in its entirety and legible. Duly adopted this 26th day of January,2016, by the following vote: AYES: Mr. Deeb, Mr. Schonewolf, Ms. White, Mr. Magowan, Mr. Ferone,Mr. Traver, Mr. Hunsinger NOES: NONE Phone: 5i8.761.82201 Fax: Si8.74S•4437 1742 Bay Road,Queensbury, NY 128041 www.queensbury.net Town of Queensbury Community [development Office 742 Bav Road. Queensbury, NY 12804 Town of Queensbury Planning Board RESOLUTION -Planning Board Recommendation to Zoning Board of Appeals Area Variance PZ-0049-2015 for John& Cathy Hodgkins Tax Map ID: 226.19-1-84/Property Address: 218 Lake Parkway/Zoning: WR The applicant has submitted an application for the following: Applicant proposes construction of a single family home of 2,927 sq. ft. Project includes demolition of 1,081 sq. ft. footprint; project will include new storm water, new septic, new plantings and grading on site. Project occurs within 50 ft. of 15% slopes and hard surfacing within 50 ft, of shore. Project includes retaining an existing garage where only one is allowed and two are proposed. Pursuant to Chapter 1796-060 and 179-6-050 of the Zoning Ordinance, work within 15% slope and the hard surfacing within 50 feet of the shoreline shall be subject to Planning Board review and approval. Variance: Relief requested for second garage. Planning Board shall provide a recommendation to the Zoning Board of Appeals. The Town of Queensbury Zoning Ordinance, per Section 179-9-070 J 2 b. requires the Planning Board to provide a written recommendation to the Zoning Board of Appeals for projects that require both Zoning Board of Appeals & Planning Board approval; The Planning Board has briefly reviewed and discussed this application, the relief request in the variance application as well as the potential impacts of this project on the neighborhood and surrounding community, and found that: MOTION TO MAKE A RECOMMENDATION ON BEHALF OF THE PLANNING BOARD TO THE ZONING BOARD OF APPEALS FOR AREA VARIANCE NO. PZ-0049-2015 JOHN &c CATHY HODGKINS: Introduced by Paul Schonewolf who moved its adoption, seconded by Stephen Traver; and a) The Planning Board, based on a limited review, has not identified any significant adverse impacts that cannot be mitigated with current project proposal - Duly adopted this 19th day of January, 2016 by the following vote: AYES: Mr. Traver, Mr. Ferone, Mr. Magowan, Mr. Schonewolf, Ms. White, Mr. Hunsinger NOES: NONE ABSENT: Mr. Ford Phone: 518.761.8220 1 Fax: 518.745.4437 1 742 Bay Road,Queensbury,NY 12804 1 www.queensbury.net FtiLE. CQPY L ANSON GEOLOGIC & ENVIRONMENTAL CONSULTANTS AN V'LEET, LLC'_' FEB 1 ti ?Ut6 November 6, 201 J Mr. John Hodgkins 20 King Road Lake George,NY 12845 RE: Pre-Demolition Asbestos Survey 218 Lake Parkway Town of Lake George,Warren County, NY Dear Mr. Hodgkins: Hanson Van Vleet, LLC conducted an asbestos containing material (ACM) survey of the residential structure at 218 Lake Parkway, Tax ID: 226.19-1-84 in the Town of Lake George, Warren County, New York (See Figure 1). HVV is authorized by the New York State Department of Labor under license# 05-0220 to perform asbestos inspections, sample collection and surveys. Samples of each type of suspected asbestos containing material (SACM) were collected. All samples were collected by a NYSDOL licensed Class D Inspector, in accordance with 12 NYCRR Part 56, (referred to as Industrial Code Rule 56) and 29 CFR fart 1910. The sampling was conducted on October 21, 2015. A copy of the NYSDOL Asbestos license is attached to this letter. Methods Prior to initiating sampling, an on-site walk through inspection of the house was performed in accordance with Subpart 56-5(e) of 12 NYCRR Part 56. Building plans were not available for review. Based on the site inspection, sampling of materials was performed to evaluate for suspect asbestos containing materials(SACM). Bulk samples were collected following standard sampling procedures. The samples were placed in sealed sample bags and delivered by Federal Express to EMSL Analytical for analysis under formal chain of custody procedures. Friable type materials were analyzed by Polarized Light Microscopy (PLM) via the NY State ELAP 198.1 method. Non-organically bound (NOB) materials were analyzed by PLM via NYS method 198.6 NOB. If the NYS method 198.6 NOB was inconclusive, the NOB materials were then analyzed by transient electron microscopy(TEM) via NYS method 198.4 NOB. Inspection Results The inspection revealed a one story seasonal residential structure, approximately 1050 square feet in size. The structure was of wood framed construction, on a concrete crawlspace foundation,with an asphalt shingle roof. The exterior was sided with wood clapboard and trim. The windows had been previously removed by the homeowner. 902 Route 146 (518)371-7940 Clifton 'Park, New York 12065 Fax(518)371-5885 , Pre-Demolition ACM Survey 218 Lake Parkway Lake George,NY Page 2 of 2 The interior construction consisted of tongue and groove pine walls,wood floors and open wood famed ceilings. Suspect ACM materials identified on the exterior of the house included only asphalt roof shingles. No suspect ACM materials were identified on the interior of the house. Bulk samples were collected of the asphalt roof shingles. Asbestos Containing Material Sampling Results A minimum of three samples of each type of suspected ACM was collected. The samples and results are summarized in Table 1 below. The Analytical results and chain of custody are attached to this letter. Table 1 Asbestos Sampling Locations and Analytical Results 218 Lake Parkway Lake George,NY Sample No. Type of Material Location Approximate Quantity Result (square feet S-lA Asphalt Shingle Exterior-Roof NA ND S-IB Asphalt Shingle Exterior-Roof NA ND S-IC Asphalt Shine Exterior-Roof NA ND Conclusions Materials are considered asbestos containing if they contain 1 % or more of asbestos. No asbestos containing materials were identified within the structure at 218 Lake Parkway Lake George,NY. No asbestos abaiement is required prior to demolition of the structure. If you have any questions regarding this survey,please contact us at(518)371-7940. Very truly yours, sonjt— es Vleet,LLC WJ Gironda NYSDOL Class D Inspector Certificate#07-05263 CC: NYSDOL � � A�alyioal, Inc. EMSL Order. 041531751 Gustomerld: HAAIS22 200 Route 130 North,Cinnaminson,NJ 08077 Phone/Fax: (800)220-36751(856)786-5974 CustamerPO: htto11vwAt,.EMSL,comm cinnasblabQEMSL.com ProjeetlD: Attn: Jaynes Gironda Phone: (518)371-7940 Hanson Ilan Vleet, LLC Fax: (518)371-5885 902 Route 146 Received: 10/23/15 9:25 AM Clifton Park, MY 12065 Analysis Date: 10130/2015 Collected: 1012112015 Project: 218 Lake Pkwy _ Test Report:Ashestos Analysis of Bulk Material Analyzed Non Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample ID SAA Description Roof-Sh`.r.S'e 041531751-0001 Homogeneity Homogenea:s PLM NYS 196.1 Friable Not Analyzed ......... . PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 10/29/2095 Black Inconclusive:None Detected TEM NYS 198.4 NOS 1013012015 Black None Detected Sample ID S-113 Description Roof-Shingle 041531751-0002 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 10129/2015 Blade Inconclusive:None[]elected TEM NYS 196,4 NOB 10130/2015 Black Atone Detected Sample ID SAC Description Roof-Shingle 041531751-0003 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOS 10/29/2015 Black Inconclusive:None Detected TI=M NYS 198.4 NOB 10/30/2015 Black None Detected Analyst(s) exts Kum Jul/ Patel Ted Young Benjamin Ellis,Laboratory Manager or other approved signatory NOB=Non Friable Organically Bound NIA=Not Applicable VCM=Vermiculite Containing Material -in New York State,TEM is currently the only method that can be used to determine if NCS materials can be considered or treated as non-asbestos containing. All samples examined for the presence of vermiculite when analyzed via NYS 198.1. -NYS Guidelines for Vermiculite containing samples are available at htt :/Amwl.wadsu,mrth.or it rtlela rerUformsNemiimliteirtte6mGui nee Rev070913. f IF_M5L maintains liability limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced,except in full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. interpretation and use of test results are the responsibility of the client.Samples were received in good condition unless otherwise noted. This report must not be used by the diem to claim product certification,approval,or endorsement by NVLAP,NIST,or any agency of the federal government.This report may contain data that is not covered by the NVLAP accreditation. Samples analyzed by EMSL Analytical,Inc.Cinnaminson,NJ NYS ELAS 101372.PA ID#66-00367 Initial'Report From 10/30/2015 09:25:21 Test Report 198VCM-7.30.0 Printed:1013012015 9:25:21 AM THIS IS THE LAST PAGE OF THE REPORT. Page 1 x Rip)ey.. wit '`•� fRt r} Clever a3e'tr r'� .s`E'lteldon 'r •� flojnt /' • �, t B «4. `tri•; a:'a i,' t �. Assembly ►.`semi�.� ISpeCer# eck '•r` 7 ' t• f Isiand om's ��•',;tip f Bal r•t �t i/ { • � - - .� � F � i �� �t � "' �; (ALL - .. � `.r ,' �`• f�- �, ;..�_.}� jam. i ; `''`y*, fS� 'Y ,1. ;_ t(, 1. � ";'—� •� Happy Farn f 1�L %• 's i •• ,rye lC.,rrry ,:t ` r . tj f•h _ �``—`��-�`fes• —� A lk /* 29 34 a ���,�,�,,�����L 4tJti •.�'f. r -" i �'L�'c' •` •+`; : 1 rTl i��, tx� ~�.. :m. •fir Rao SITE LOCATION MAP FIG-1 H ANSON WATER SUPPLY a 218 LAKE PARKWAY -- _ _. ENVIRONMENTAL GON$UITQNT3 302 LAKE GEORGE, NEW YORKvANVLEET, ��c ROUTE 146 CLIFTON PARK,NEWYORK 125 (518)371-7940 FAX(518)371-5365 m - - .. .. � . v.l r�) i tipw York State—Department of Labor Division of Safety and Health, License and Certificate Unit State C.�rnpus',BAding 12'; Albany,NY 12240 ASBESTOS HANDLING LICENSE y Hanson Van Vleet, LLC FILE NUMBER: 05-0220., LICENSE NUMBER' 28463 902 Route 146 LICENSE CLASS: RESTRICTED DATE OF ISSUE: 03/09%2015 Clifton Park, NY 12065 1 EXPIRATION DATE: 03/31/2016 Duty Authorized Representative 'D Kirby Vanvleet: This license has been issued in accordaf cd iyith applicable provisions of Article 30 of the Labor Law of New York State and of the New_York State Codes,Rules and Regulations(12 NYCRR Part 56). It is subject to suspension or revocation for a(1) serious violation of state,federal or local'laws with regard to the conduct of an'asbestos prosect,or(2)demonstrated lack of responsibility ifs the conduct of any job,involving asbestos or asbestos nbAterial. This license is valid only for tl a contractor named above and this license ora photocopy must be promineritly displayed'at the asbestos pLcject worksite. This license verities that all�persons employed by the licensee on an asbestos project in New Ybrk State have been issued an Asbestos Certificate,appzropriate for the,type of work thiry perform,by the New York State Department of Labor. Eileen M.Franko, Director SH 432(8/12) For the Commissioner of Labor 1