BOTH-000561-2016 TOWN OF QUEENSBURY
at 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000561-2016 Date Issued: Thursday, June 29, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000561-2016
has been completed.
Tax Map Number: 240.6-1-17
Location: 25 HANNEFORD RD
Owner: Chris Boyd
Applicant: Chris Boyd
This structure may be occupied as a: Demolition of House
Asbestos Report received and attached By Order of Town Board
Cross Ref. AV PZ-205-2016 and SP PZ--203-2016 TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the y
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 uilding&Code Enforce nem
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-000561-2016
Tax Map No: 240.6-1-17
Permission is hereby granted to: Chris Boyd
For property located at: 25 HANNEFORD 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: Chris Boyd Demolition $0.00
Owner Address: 7412 E Bonita DR Total Value $0.00
Scottsdale,AZ 85250
Contractor or Builder's Name/Address Electrical Inspection Agency
Crandall Excavating
63 WOODCHUCK HILL RD
Lake George,NY 12845
Plans&Specifications
Demolition of House
Asbestos Report received and attached
Cross Ref. AV PZ-205-2016 and SP PZ--203-2016
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,August 29,2017
(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 ofeens (.t�bt" anWAst29,2016
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#: M� 5(0/— a01(
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUE Permit Fee
�
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 a diS_—_____ Demolition Location
Tax Map ID Z42O.L_= _L-,—
APPLICANT _CU_ Rl}—I��)-------__— OWNER
AddressAddress
I b l esu, 1� II
---------- —1 — e-- --- ---- -- —L1--
------ -----
Phone ---------------------------- Phone —SA Zn
PERSON FOR BUILDING&CODES COMPLIANCE: _______________________________Phone: ----------
1. Person Responsible for Work \�R\ CR. bhX
2. Where will demolition material be disposed?
\ �bSk SuTw�
3. 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 __Yes —21—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 _Z Residence ___ Garage Business
kkiz <4f ___Storage Bldg. ___ Other
b) Size of Structure i
c) Number of Stories
d) Foundation Type c�h
e) Foundation
f) Structure(s)
7. Utilities Information
a) Indicate utilities for this structure Gas _ _Electric ___ Propane --- Public Water ___ Public Sewer
___On•slte 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? _I/-- Yes _ __ No
B. Signature CA i;A
Print Name: ____. �Rt� Q��----------------------- Date
Signature: — -----------------------------
- Date
--1� �1----------
Town of Queensbury Building & Codes - Demolition Permit - December 2014
240.6-1-17 BOTH-000561-2016
Boyd, Chris
25 Hanneford Road
HANSON Demo of SFD 1110 s.f.
GEOLOGIC& ENVIRONMENTAL CONSULTANTS
VAN VLEET, LLC
June 20,2016
Mr. Chris Boyd
AUG 19 2616
25 Hannaford Road
Lake George,New York
RE: Pre-Demolition Asbestos Survey Re-inspection
25 Hanneford Road
Queensbury,NY 12804
Dear Mr. Boyd:
Hanson Van Vleet, LLC conducted a follow up inspection for suspect asbestos containing materials
(ACM) at the residential structure at 25 Hanneford Road, Queensbury, Warren County, New York.
The initial survey and sampling was conducted on May 23,2016. The follow up survey re-inspection
was conducted on June 9, 2016 to confirm the removal of previously identified ACM by the
homeowner,prior to demolition of the structure.
Inspection Results
The initial survey identified 800 square feet of tar paper roof underlayment that was determined to be
ACM. An asbestos survey letter report dated June 6, 2016 describes the initial pre-demolition ACM
survey and laboratory analytical results. No Suspect ACM materials were identified associated with
the structure at the time of the re-inspection on June 9, 2016. The tar paper underlayment identified
as asbestos containing material and all associated roofing material was removed by the homeowner
prior to the follow up inspection on June 9, 2016. No suspect ACM was identified associated with
the structure on June 9, 2016.
Conclusions
No suspect ACM is present at the residential structure at 25 Hanneford Road Queensbury,NY. No
further abatement is required prior to demolition. If you have any questions regarding this survey,
please contact us at(518) 371-7940.
Very truly yours,
Hanson Van Vleet, LLC
W&t -
James Gironda
NYSDOL Class D Inspector Certificate# 07-05263
CC:NYSDOL
902 Route 146 (518) 371-7940
Clifton Park, New York 12065 Fax(518)371-5885
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FIGURE 1: SITE LOCATION HANSON WATERSUPPLV
25 Hanneford RoadVANVLEET, LLC ENVIRONMENTAL CONSULTANTS
Queensbury, NY 902 ROUTE 146 CLIFTON PARK.NEWYORK 12 5 (518)371-7940FAX(618)3715 S
STATE OF NEW YORK - DEPARTMENT OF LABOR ( N S
ASBESTOS CERTIFICATE
-
JAMES J GIRONDA
CLASS(EXPIRES)
D INSP(11/16)
1--05263
13045
MUST BE CARRIED ON ASBESTOS PROJECTS
New-York State-Department=pf.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: RESTWOTED
DATE OF ISSUE: 03/24/2016
,Clifton Park, NY 12065 EXPIRATION DATE: 03/31/2017
Duly Authorized Representative-D Kirby Vanvleet;-
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':(I2,NYCRR Part 56). itis subject to suspension or revocation for a(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 mv'olving asbestos or•asbestos material. 1r, -C..,
This license is valid only for the contractor r awed above and this license or a photocopy.mustbe-prominently displayed at the
asbestos project worksite Thielse verifies that all persons employed by the lie6nsee on an asbestos project in New York
State have b en issued an Asbestos CerttScate;-approp_ri&for the type o lk-fhey perform,by the New York State
Department of Labor.
< t L
Eileen M.Franko, Director
SH 432(8/12) For the Commissioner of Labor
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