2014-469 "2" TOWN OF QUEENSBURY
la742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140469 Date Issued: Monday, October 20, 2014
This is to certify that work requested to be done as shown by Permit Number P20140469
has been completed.
Tax Map Number: 523400-309-013-0002-038-000-0000
Location: 284 CORINTH Rd
Owner: HUDSON HEADWATERS NETWORK
Applicant: HUDSON HEADWATERS NETWORK
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, gemP � �
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.
Oa. TOWN OF QUEENSBURY
N742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20140469 Application Number. A20140469
Tax Map No: 523400-309-013-0002-038-000-0000
Permission is hereby granted to: HUDSON HEADWATERS NETWORK
For property located at: 284 CORINTH Rd
in the Town of Queensbury, to construct or place
at the above location m 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: HUDSON HEADWATERS NETWOP Demolition
9 CAREY Rd Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans &Specifications
2014-469
Demo of 2 story house, garage & shed
530.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, October 06,2015
(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 f Que sbu ; M i ' 'a/. I _ 1 ber 06,2014
0
4
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SIGNED BY ♦ - -\ for the Town of Queensbury.
Director of Building& Code Enforcement
Town of Queensbury Building & Codes Office Use Only
DEMOLITION PERMIT APPLICATION Received: / qQQ
NO WORK MAY COMMENCE-UNTIL-PERMIT.IS ISSUED Permit No.: I <-I ` )
Fill in applicable spaces and submit two (2) plot plans, `ddrawri to scale,'showing of po
boundaries with dimensions and adjacent roads-iistreets,Showall existing sStures) Permit Fete( Q
on the property and indicate which are to bedd'em,,+o+ lished. Indicate on the plot plan he '
location of all utilities. /lu 11 u SEP 3 0 2014
Date el/z Ii/P1 Ity."::': COj flH f�0A0
BUIL DING& CODESRY �' sue i N� IZ$3ol t
Tax Map ID 3Oq. 13 -2 -313 'I I' 1I II
Applicant IbiMoN ttEADcrtKTas [fENLI Owner t1UOSON IfGp.DWDatts iC& ccH N oRk
Address 9. CAt=€`f RdP-b Address CAP-a`4 -0kD
Qut N5BOC.1 l�ftL\ U oJSBUre-f WA'
Phone 18 -S2,9 • ,(022 Phone 945 -£324 - 8 (022
Contact Person for Building&CodeeCCompliance:�Wl Mc Go cm.'cX / Day Phone: 824 - g 622
1. Person Responsible for work:—17111 McCoRYnmck WINO/EtS�7I/ OtQNNnfC �NrclatToi
C• 2. Where will demolition material be disposed? WIt Ijt7LLV W , (/�. AN 5ltst_T 1.3.i.
' 3. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begins.
dr a) Is there any asbestos within the building to be demolished ><Yes No
b) If Yes,our office need the following information:E� S I
• Name of firm removing the asbestos:
• License number of firm: 28449
• Indicate where the asbestos material will be disposed: {IGH Acnes LKUbFtLI-
4. Structure Information
a) Indicate the structure(s)to be demolished:X residence'garage _business Xstorage bldg. _Other
b) Size of structure: 30' x 30'
c) Number of stories: 2
d) Foundation Type: X full cellar crawl space slab
e) Foundation: _will be replaced X will not be replaced
f) Structure(s): will be replaced x will not be replaced
5. Utilities Information
a) Indicate utilities for this structure:
X Gas ›C Electric Propane
`K Public Water On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect?x Yes No
c) Have all utilities been disconnected? X Yes No
6. Signatures: `� }�/�
:::.e: 62
- tY Date: y Li'
Town of Queensbury Building&Codes Demolition Permit 1 518-761-8256
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Demolition Inspection Report
Inspection request received:
Name: 44 a Aso,,, .-/eyed w dJ`S Inspected on: tiO
Location:
a g ti n��.Jh Rai Arrive: a.m.I p.m.
Permit No.: / 9-4 9 Inspector's Initials:
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected V
Asbestos Removed/Documentation
Property Cleaned Up and Graded /.
Okay to Issue Certificate of Compliance VVV
Demolition Inspection_11 2012
Tow's of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Demolition Inspection Report
Inspection request received:
Name: -14 ( ath, 4/-QInspected on: /o/2f /:
Location: ,Qty r! Rd Arrive: �(( h a.m./p.m.
Permit No.: 141- y Cc 9 Inspector's Initials: (DA
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance
Demolition Inspection_11 2012
Tnipine AIR SAMPLE DATA REPORT
ENVIRONMENTAL SERVICES
CLIENT:WM:4M ZTCN TS PROJECT: ago( cowing- lap. PROJECT# [t1-iag63-4
ADDRESS: ettk44.sG wy,Ny LAN " Rio
ROTOMETER#: IVO& WORK AREA: A-T-GC COLLECTED BY:
ABATEMENT G.8uRlts
CONTRACTOR: ERSX DATE COLLECTED: (C-17-14
CONTRACTOR -
SUPERVISOR: *A QUANTITY: 2O NR VErld.Y• edti Ta
(Circle One) de TEM (Circle One) BACKGROUND PRE DURING
�I INMAL
SAMPLE LOG FLOW TOTAL FIBERS
START STOP TOTAL VOLUME /100 FIBERS FIBERS
QC
No NO. LOCATION TIME TIME MIN. FINAL :
Row (LITERS) FIELDS /mm cc
fLMMI _
I Nf$r!0 ZWA1 ®$so �� �� S •��) /!F j► ^.
fes" O o /• <o n
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5• Disyy doe sa '�
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di )G ✓I Sl� / / -.cool_
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C6 ow a 5 b7S90 /,1oU j __ v ,00 r*
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re. Eli_ r6-a- 7 7 / d . 00 `Rot
RELINQUI --, g ate. NATURE) RECEIVED BY:(SIGNATURE) DATE: TIME: - Comments: FB Ave.;.hfibers/100field L
. __' 2. /- ,„..---- 7• MU
1
##
SAMPLES PREPPED BY:(PRINT) DATE: TIME: - SAMPLES ANALYZED BY:(PRINT) DA E; START STOP I
rwr `c(['G�2C��---�r �,/ TIME TIhE.
Nick e Z� Lein .eovo F� , Y//DO //20
Sa pestes Recei�d Meet Lab Sample Acceptance Criteria(circle oneK/Y)N t
Below the limit of Detection [1 ' > 50% Particulate Matter, U fable []"•Sample Damaged or Missing
Microscope Used:,Olympus CH27L0215 [] Nikon 131-545 [] Olympus CH2700880
Standard Deviation es"
/Standard Dev ),ypy./rclStandard Dev Log# /Standard Der
NYS DOH ELAPN 11740;NIOSH Method 7400,A Rules,Rev.3,refue.2.EV15/94,Not Asbestos Soerelc
Field Area of Scopa=0.00785mm'Lab RSD:58255 fibers=0135.35663.7 Eters=EOM Jeffery Eames,Lab QA/QC Officer
>63.7 Fibers=0.116.Fibers/cc has been calculated after subtracting field blank average.
Please note that results of samples collected by the Olen?can be verified by Npene through t/mn'only. I
These results relate only to the items tested. Report may not be reproduced,incept In M,without written FF
permission of Alpine Environmental.BOL=Below Detectable Lana,Pb!•Paced By Background Craig Petreikls,CIH,Lab Director,Report Date
QC SignedOL_ Scanned DPD
438 New Kamer Road•Albany,New York 12205+Phone:(518)250-4047•Fax:(518)250-4353 Page 1 of (
I
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Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
j0/f0/!qf
Queensbury Building &Code Enforcement Arrive: am/pm D rt: 1_ 0,3 am m
742 Bay Rd., Queensbury, NY 12804[ Inspectors Initials:
//�
NAME: flJC' So \ rLi� {-t
i)L✓la' 5 PERMIT NO.: 1 `(_ 11(,C
LOCATION: ..P-X 4 (oft.. ,7\-\-- 0 r`t_h, INSPECT ON: U AU L-
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation ii/
t'!7 ( cQ YE
Property Cleaned Up and Graded _VVV/ i- tow �cr
Okay to Issue Certificate of Compliance ✓ — v'- 2
Demolition Inspection Report 11 27 12
A Page 1 of 1
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TOWN OF QUEENSBURY 1" � 1+ (inn
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BUILDING DEPARTMEnNT r
Based on our limited examination,compliance
with our c:mmeansshaiiano s ecificationslfa can
s
mdicaung the pl
full compliance with Ure uildmg Codes of
New York State.
http://www.queensbury.net/RPSlmages/Re12014/523400309013000203800000000001.jpg 9/30/2014
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Location Map SEP 30 2014 D
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Town of Queensbury, Warren County, New York
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284 Corinth Road
Sta ntec Town of Queensbury, Warren County, New York
Source: Warren County GIS
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284 Corinth Road
Stantec Town of Queensbury, Warren County, New York
Source: Warren County GIS
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