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BOTH-000429-2015 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: BOTH-000429-2015 Date Issued: Monday, January 9,2017 This is to certify that work requested to be done as shown by Permit Number BOTH-000429-2015 has been completed. Tax Map Number: 239.12-2-19 Location: 61 ASSEMBLY POINT RD Owner: Jeffery Hamilton Applicant: Howland Construction This structure may be occupied as a: Demolition of 1135 s,f. SFD Asbestos report on file By Order of Town Board TOWN OF QUEENSS/BUR%Y Issuance of this Certificate of Compliance 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: BOTH-000429-2015 Tax Map No: 239.12-2-19 Permission is hereby granted to: Howland Construction For property located at: 61 ASSEMBLY POINT 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 Tvce of Construction Owner Name: Jeffery Hamilton Demolition $0.00 Owner Address: 1203 Aston CT Total Value $0.00 Chester Springs,PA 19425 Contractor or Builder's Name/Address Electrical Inspection Agency Howland Construction 7 IROQUOIS DR DR Queensbury,NY 12804 Plans&Specifications Demolition of 1135 s.f.SFD Asbestos report on file $30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,December 16,2016 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of QueenqYkes . tiondate,) Dated at the Town of m er 22,2015 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Town of Queensbury Building &Codes Office Use Only 2015 S2kS Received DEMOLITION PERMIT APPLICATION Permit NOWORKMAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee Provide 2 plot plans drawn to scale,showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures onproperty and indicate which are tobedemolished. IBdeteltl�l"� nofallutilities Date 12/16/15 LL��tll Demolition Location 61 Assembly pt. Rd. TaxMaplD 239.12-2-19 APPLICANT Howland Construction OWNER Jeffery Hamilton Address 7 Iroquois st Address 1203 Aston court Lake George NY 12845 Chester Springs, PA 19425 Phone 518-668-3185 Phone 215-275-8861 CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: Dean Howland Phone: 518-796-5196 1. Person Responsible for Work Howland Construction 2. Where will demolition material be disposed? Finch Pruyn in Northumberland 3. nil uuwiuniya iu i&ucn wuaiicu i cqunc of i nbu iva: uI vcy 4. Any building substantially damaged by fire must obtain an Asbestos Removal Permitfrom 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 _Yes -X—No 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 6. Structure Information a) Indicate the structure(s)to be demolished _X_Residence_Garage_Business _Storage Bldg._Other b) Size of Structure 1135 SF c) Number of Stories 1 d) FoundationType block e) Foundation f) Structure(s) 1 7. Utilities Information a) Indicate utilities for this structure—Gas -X-Electric -X-Propane _Public Water _Public Sewer _X On-site well water pump a) Have you notified the Town Water Department for public water and sewer disconnect? _Yes -X- No b) Have all utilities been disconnected?— -X-No Yes X-No 8. Signature Print Name: Dean Howland Date 12/16/15 Signature: Date Town of Queensbury Building&Codes-Demolition Permit-December 2014 ANSON GEOLOGIC & ENVIRONMENTAL CONSULTANTS AN VLEET, LLC 715 November 23,2015 Mr. Dean Howland Howland Construction 7 Iroquois Street Lake George,New York 12845 RE: Pre-Demolition Asbestos Survey 61 Assembly Point Road Tax ID: 239.12-2-19 Queensbury,New York Dear Mr. Howland: Hanson Van Vleet, LLC conducted an asbestos containing material (ACM) survey of the residence at 61 Assembly Point Road in the Town of Queensbury, Warren Country New York, Tax ID: 239.12-2-19 (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 (SACH) 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 Part 1910. The sampling was conducted on November 10, 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 structure 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 double 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, three bedroom, one bath, residence, approximately 850 square feet in size. The structure was of wood framed construction, on a concrete block foundation with an asphalt shingled roof. The exterior was sided with log siding. All exterior trim was wood. The windows were vinyl and/or wood framed,with no window glazing. 902 Route 146 (518)371-7940 Clifton Park, New York 12065 Fax(518)371-5885 Pre-Demolition Asbestos Survey 61 Assembly Point Road Tax ID:239.12-2-19 Queensbury,New York November 23,2015 Page 2 of 3 The interior construction consisted of drywall walls, wooden floors and acoustic ceiling tiles in the kitchen and three bedrooms. Materials in the living room consisted of wood paneled walls and ceiling, with wooden floors. A three season room also contained wood paneled walls and ceilings with carpeted wooden floors. The basement consisted of concrete floors with drywall walls. Suspect ACM materials identified on the exterior of the structure included: two layers of asphalt roof shingles (there was no underlayment). Suspect ACM materials identified in the interior of the structure included drywall from the kitchen, bathrooms and basement, mudded joints associated with the drywall, and acoustic ceiling tiles from the kitchen and bedrooms. Bulk samples were collected of 1) asphalt roof shingles, 2) drywall, 3) mudded joints, 4) and acoustic ceiling tiles. 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 61 Assembly Point Road Queensbury,NY Sample Type of Material Location Approximate Quantity Result No. (square feet S-lA Drywall Kitchen, NA ND Basement& Bedrooms S-IB Drywall Kitchen, NA ND Basement & Bedrooms S-IC Drywall Kitchen, NA ND Basement & Bedrooms S-2A Joint Compound Kitchen, NA ND Basement& Bedrooms S-2B Joint Compound Kitchen, NA ND Basement & Bedrooms S-2C Joint Compound Kitchen, NA ND Basement & Bedrooms S-3A Top Layer Asphalt Shingle Roof Roof NA ND. S-3B Top Layer Asphalt Shingle Roof Roof NA ND S-3C Top Layer Asphalt Shingle Roof Roof NA ND S-4A Bottom Layer Asphalt Shingle Roof Roof NA ND S-4B Bottom Layer Asphalt Shingle Roof Roof NA ND S-4C Bottom Layer Asphalt Shinpje Roof Roof NA ND S-5A Acoustic Ceiling Tiles Kitchen& NA ND Bedrooms S-5B Acoustic Ceiling Tiles Kitchen& NA ND Bedrooms S-5C Acoustic Ceiling Tiles Kitchen& NA ND Bedrooms Pre-Demolition Asbestos Survey 61 Assembly Point Road Tax ID:239.12.2-19 Queensbury,New York November23,2015 Page 3 of 3 Conclusions Materials are considered asbestos containing if they contain 1 % or more of asbestos. No asbestos containing materials were identified within the residential structure at 61 Assembly Point Road, Town of Queensbury, Warren County, New York. No asbestos abatement is required prior to demolition of the structure. If you have any questions regarding this survey,please contact us at(518) 371-7940. ry truly ours, son V Vle�LLC ames Giron a NYSDOL Class D Inspector Certificate# 07-05263 CC: NYSDOL Attachments , Canoe Islands �IiJ�Cy \� Fool n t. 0 Al,i d d I e/ Bay I Kattskill l ` ? Glecerdale ,t : Sheldon `J Point Sandy 1a .' $ay ; RoekhuYs' Assembiy q Poiri �. /Speaker Heck Island - .. Harris ^ ' n Diamonc{/ Island �I Y+ , �'1 Dick�151ands _ \"00`�_ 1 ��.. HAPPY Family ° / - Islands �l .,,) \\ •'-,= 7 , 329 ILL Untl d vv�,1�• Bu r1t�t Pont 4r q Hil , Dark Hai SITE LOCATION MAP FIG-1 HANSON WATERSUPPLY s 61 A55EMBLY POINT ROAD VANVLEET, LLC ENVIRONMENTAL CONSULTANTS QUEEN5BURY, NEW YORK 902 ROUTE 146 CLIFTON PARK,NEWYORK 12065 (518)]]1-7940 FAX(518)371-5885 EMSL Analytical, Inc. EMSL Order: 041533750 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22 Phone/Fax. (800)220-36751(856)786-5974 CustomerPO: Howland htto:/A~.EMSL.eom cinnasblabGDEMSL.com ProjectlD: Attn: dames Gironda Phone: (518)371-7940 Hanson Van Vleet, LLC Fax: (518)371-5885 902 Route 146 Received: 11/12/15 9:20 AM Clifton Park, NY 12065 Analysis Date: 11/18/2015 Collected: 11/10/2015 Project: 61 Assembly Point Road Test Report:Asbestos Analysis of Bulk Material Analyzed Non Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample ID SIA Description -Drywall 041533750-Ml Homogeneity Homogeneous PLM NYS 198.1 Friable 11/18/2015 Broum/Whlte 20.00%Cellulose 80.00%Non-fibrous(other) None Detected PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed SamplelD SIB Description -Drywall 041533750-0002 Homogeneity Homogeneous PLM NYS 198.1 Friable 11/18/2015 Brown/White 20.00%Cellulose 80.00%Non-fibrous(other) None Detected Sample tabled as S-2C PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed SamplelD SIC Description -Drywall 041533750-M Homogeneity Homogeneous PLM NYS 198.1 Friable 11/18/2015 White 15.00%Cellulose 85.00%Non-fibrous(other), None Detected PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198A NOB Not Analyzed Sample ID S2A Description -Joint Compound 041533750-0004 Homogeneity Homogeneous PLM NYS 198.1 Friable 11118/2015 White 100.00%Non-fibrous(other) None Detected Limited material PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed Sample ID S2B Description -Joint Compound 041533750-0005 Homogeneity Homogeneous PLM NYS 198.1 Friable 11/18/2015 White 100.00%Non-fibrous(other) None Detected Limited material PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed Initial Report From 11/1812015 20:20:35 Test Report 198VCM-7.30.0 Printed: 11/1812015 8:20:35 PM Page 1 EMSL Analytical, Inc. EMSLOrder: 041533750 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22 Phone/Far.. (800)220-36751(856)7865974 CustomerPG: HOWland httolA�.EMSL.com cinnasblabldEMSL.com ProjectlD: Test Report:Asbestos Analysis of Bulk Material Non Asbestos Test Color Fibrous Non-Fibrous Asbestos Sample ID S2C Description -Joint Compound 041533750-0006 Homogeneity Homogeneous PLM NYS 198.1 Friable 11/18/2015 White 100.00%Non-fibrous(other) None Detected PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed Sample ID SM Description -Top Layer Asphalt Shingle Roof 041533750-M7 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Black 12.7% Glass Inconclusive:None Detected TEM NYS 198.4 NOB 11/18/2015 Black None Detected Sample ID S36 Description -Tap Layer Asphalt Shingle Roof 041533750-0008 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Black 15.2% Glass Inconclusive:None Detected TEM NYS 198A NOB 11/18/2015 Black None Detected Sample ID S3C Description -Top Layer Asphalt Shingle Roof 041533750-0009 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM - Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Black 19.4% Glass Inconclusive:None Detected TEM NYS 198.4 NOB 11/18/2015 Black None Detected Sample ID S4A Description -BottomLayerAsphaltShingleRoof 041533750-0010 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Black 18.1% Glass inconclusive:None Detected TEM NYS 198.4 NOB 11/18/2015 Black None Detected Sample ID S4B Description -Bottom Layer Asphalt Shingle Roof 041533750-0011 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Black 15.4% Glass Inconclusive:None Detected TEM NYS MA NOB 11/18/2015 Black None Detected Initial Report From 11/18/2015 20:20:35 Test Report 198VCM-7.30.0 Printed:11/18/2015 8:20:35 PM Page 2 EMSL Analytical, Inc. EMSL Order. 041533750 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22 Phone/Far. (800)220-36751(856)7885974 CustomerPO: Howiand htt%/Aumv.EMSL.cem cinnasblab(MEMSL.com ProjectlD: Test Report:Asbestos Analysis of Bulk Material Non Asbestos Test Color Fibrous Non-Fibrous Asbestos Sample ID S4C Description -Bottom Layer Asphalt Shingle Roof 041533750-0012 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analysed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Black 21.9% Glass Inconclusive:None Detected TEM NYS 198.4 NOB 11/18/2015 Black None Detected Sample ID S5A Description -Ceiling Tiles 041533750-0013 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Tan 15.0% Min.Wool Inconclusive:None Detected TEM NYS 198.4 NOB 11/18/2015 Tan None Detected Sample ID S5B Description -Ceiling Tiles 041533750-W14 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Tan 19.3% Min.Wool Inconclusive:None Detected TEM NYS 198.4 NOB 11/18/2015 Tan None Detected Sample ID S5C Description -Ceiling Tiles 041533750-0015 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/18/2015 Tan 21.7% Min.Wool Inconclusive:None Detected TEM NYS 198A NOB 11/18/2015 Tan None Detected Analyst(s) Chits Little Patrick Cafr Steven Quinn Benjamin Ellis,Laboratory Manager or other approved signatory NOB=Non Friable,Organicatly Bound NIA=Not Applicable VCM=Vermlculite Contalning Matedal -In New York State,TEM Is currently the only method that can be used to determine 9 NOB 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 httDVAvmvwadsworth omAabcert/elaocert/fonnsAfermimiiteinte'mGuidanoe Rev07O9l3 odf EMSL maintalns riability 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 talent.Samples were received in good condition unless otherwise noted. This report must not be used by the client 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 ELAP 10672,PA to#6M0367 Initial Report From 11/18/2015 20:20:35 Test Report 198VCM-7.30.0 Printed:11/18120158:20:35 PM THIS IS THE LAST PAGE OF THE REPORT. Page 3 IM . . s � A> x . .� . - � 'CLAS - - } i ) ` § ;.""JST B\ /, H-dR JECTS « New York State— Department of Labor Division of Safety and Health, License and Certificate Unit State Campus,Building 12 Albany, NY 12240 ASBESTOS HANDLING LICENSE 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 ` EXPIRATION DATE: 03/31/2016 Duly Authorized Representative D KirbYVaveet. , This license has been issued in accordance With applicable provisions of Article 30 of the Labor Law of New York State and of the New York State Codes,Rules and Regulations(12NYCRR Part 56). It is subject to suspension or revocation fora(1) serious violation of state,federal or local'laws with regard to the conduct of an asbestos project,or(2)demonstrated lack of responsibility in the conduct of any job n�olving asbestos or asb8stosmaterial , This license is valid only for the contractor named above and this license or a photocopy must.be prominently displayed at the asbestos project worksite. This license verifies that all persons employed by the licensee on as asbestos project in New'York State have been issued an Asbestos Certificate,appropriate for the type of work-tifey perform,by the New York State Department of Labor. Eileen M.Franko, Director SH 432(8/12) For the Commissioner of Labor EXISTNG LAYOUT HOUSE ' TOWN OF OUEENSBURY ," — ,�Q (1" = 10' 22x34" paper) BUILDING DEPARTMENT / Based on our limited examination,compliance with our comments sll2ii not be construed as Lake George / indicating the plans and specifications are in 50't along shoreline as it winds & turns. full campliance with the 5uilding Codes of Lake Elevation 9-29-15 = 319.07' New York State. 7h �sn�ls a1sodo�d ..1N�cIO&I 3Hi 331 S6)° �tlibNOS�{3 Sod i _.n �. 332 3 , . . , 333 Qba�( c I I fij 3d Dock &Boathouse334 per Bolster survey / 0°� 35 336 a 1 me Fri,,f /77 Zt � 337 '� ° 338s•1' B 339 Area= 0.21s °° 340 341 342 343 5.s' / / 344 /�/O' 331 / 1 HOUS 332 3 3 / 54.7' 346 /84,39 33 f / I 2 335 1 / PT 2 36 / sate P�o�k 3 337 * 338 49.9' 339 PA 770 340 20. ' 4 Map HOUSE 341 342 � / PT#1 of a proposed plot plan for 343 jefl'ey & Da rn Hamilton. Silt fence to be instal►ed as ;7��ted, 44 5itu to in Installation must be corl'Pleted &inspected '<P) ' Town of Queensbu County of Warren R[k to beginning demolition. State o New York Please contact this nffice fir,Cchedule an N Scale: as shown Da 12 October 2015 i►�peeNon of the it,,+`,"`C"! rL,any demolt�on. �o by 21 October 2015 --�-.� 1 .Di Ilb�r NOTE: Boundary information reproduced from _ b ��� I �4 a survey performed by David J. Bolster for iVec YM 12045 Jeffrey M. Hamilton & Dawn. M. Hamilton, t dated 14 December 2012. rq q Topographic survey performed by D.L. QU: 6_1_14 (old) Dickinson Associates, 29 September 2015. QU: 239.12-2_19 (new)