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DEMO-0340-2019TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518) 761-8201 Yry' u G" 4 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: DEMO-0340-2019 Tax Map No: 289.8-1-80 Permission is hereby granted to: Michael Willigan, Briana Willigan For property located at:18 SUNNYSIDE 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 Type of Construction Owner Name: Michael Willigan Demolition-Residential 0.00 Owner Address: 18 SUNNYSIDE RD Total Value 0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Demolition of SFD asbestos report received 150.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday, June 1, 2020 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 of Queensbury; Friday, May 31, 2019 SIGNED BY:for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only DEMOL 1C:04 IMFIA Permit#: MC -4 o ff.• i9 Permit Fee:$ t'jQFM—AY 2 8 2thtiTownofCZuecnsbury Invoice:#: 742 BayRoad, Queensbury, 12804 R kY, TOWN 0 QtJi*N88URzt P: 518-761-8256 www.queensbury.net BUILDING&COUR Demolition Location: i;I Mk.'cid Rad Tax Map ID #: 1 a - I ' AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** CONTACT INFORMATION: Applicant: , Name(s):V I C.6 Gt 1(IAA_ , : I )1 arl Mailing Address, C/S/Z: 15? Si i h ri /Si d-e_ er^.Gt Vieelai Sbtn' s Cell Phone: ( 7 I -- /'f - eako- Land Line: ( Email: fft..ZI 35'r hoinuL// COY) Primary Owner(s): c Name(s): V. I d,i&t-1 3 &it+14,14 /l•/a1 Mailing Address, C/S/Z: I Ci vi, 'Sl c.. l e.• ()Lie ee.Si-e- ,11I '' t Cell Pho e: _( V` J/ ) / -` I.31'`f (r .J-and Line: _( Email: ir-C-7--Zy .Y6) 114 irtet_t/ 1? Check if all work will be performed by homeowner only Contractor: Workers' Comp documentation must be submitted with this application Contact Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: _( Land Line: _( Email: List all additional contractors on the back of this form Contact Person for Building & Code Compliance: AlcAiciAircr Cell Phone: ( Land Line: , Email: Demolition Application Revised February 2019 DEMOLITION INFORMATION: 411(6` 1. Where will demolition material be disposed? ' 7kat 4,4)4.1‘ 2. Type of structure to be demolished: a. Residence b. Garage c. Business d. Storage Building 3. What type of utilities are connected to the structure: a. Gas b. Fuel Oil c. Propane d. Electric e. Public Water g 4r— f. Well-Water Pump Utz u y I 2 (A Kil 1cst g Public Sewer tur I-v S 1,4 tI 1 b ew u.nius.4- h. Other D1nc' v`)C Cot.n Ccy r.t +-- 4 1-6 4— '= i. None 4. Have ALL utilities been disconnected? Yes No 4 UV L ( A tyth+(i Ocrpyi *h-e- hc-iyr i -. `i s Jg .ciI,SL 1 5 6..12eI 0. i'(-ej t'JL C yryt,!Itbncj pt h u i 1 c +-Le. I :e e-Z ct ttt cuwr e-4,--"0 0 : be,m e i I I cum' uX1 I Z N 0 TA. 0.. —re.0 0-r CO rfrom r am a t J 1. Two inspections may be required: an inspection to determine that utilities are disconnected, if necessary, and a final inspection, after the structure is removed and the site is cleaned up and graded. 2. Twenty-four (24) hour notification is required for inspections. 3. Workers' Comp insurance information is required to be submitted with this application. Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued. I have read and agree to the above: PRINT NAME:E L"\4 1 iTt SIGNATURE:flL ,_ DATE:1 I Demolition Application Revised February 2019 TOWN OF QUEENSBURY BUILDING & CODES DEPT. E 0 enll 5 FILE COPY'\. -- Reviewed Ba : fr MAY\\____ 2 g 2019 sBUR A i nU O C c'° G ov\I Or 6.coU S Healthy Home Uttr RE: Briana Willigan 289.8-1-80 DEMO-0340-201918SunnySideRdWilligan, Briana & MichaelQueensbury, NY 12804 18 Sunnyside Rd Demolition of SFD To Whom It May Concern: Adirondack Healthy Home, LLC (ADK) completed an asbestos survey of the residential structure, located at 18 Sunny Side Rd Ave in Queensbury, New York on May 18, 2019. The inspection was performed by a NYS-DOL Certified Asbestos Inspector, and in accordance with New York Department of Labor Division of Saftey and Health and the Environmental Protection Agency (EPA) Requirements. A detailed summary table of the sampling is included; however, this report should be read in its entiret TOWN OF QUEENSBURY Y• BUILDING DEPARTMENT Based on our limited examination,compliance with our comments shall not be construed as Area Description/Scope of Work:indicating the plans and specifications are infullcompliancewiththewildingCodesof New York State. The structure, located at 18 Sunny Side Rd in Queensbury, New York is a two- story wood structure with a sloped shingled roof. ADK performed limited sampling at the structure on May 18, 2019 for renovation activities of the interior of the structure. Inspection Strategy/Sampling Protocol: The inspection consisted of grouping suspect asbestos containing materials into homogeneous areas based on the color and texture of the material, and then performing representative sampling of the materials included in those homogeneous areas. NYSDOL has requirements for the minimum number of samples that can be collected from each homogeneous area (three samples of each miscellaneous material, three samples of each type of thermal system insulation, and the sample requirements for surfacing are based on square footage). Following completion of the on-site inspection/sampling, samples were submitted to an New York State accredited laboratory for analysis. Results: NYSDOL and the EPA recognizes a material as Asbestos Containing Material (ACM) if an asbestos content of greater than one percent asbestos is detected in a representative sample analyzed by polarized light microscopy. Every effort was made to identify all materials in accessible areas. There is the possibility that suspect materials were not identified in inaccessible areas. If any suspect material is discovered that is not included within this report, it should be sampled before it is physically disturbed. Please be advised that I have inspected the property on the date indicated on the enclosed report and taken random samples as required. I have sent the samples to a New York State approved laboratory for testing. Based upon my inspection combined with the laboratory test results for the samples taken from the subject property, there are no asbestos containing materials (ACM's), found on the subject property or identified in the samples tested by the laboratory. 4-ven Grimaldi NYSDOL ASBESTOS INSPECTOR CERT# 18-44782 NYSDOL ASBESTOS HANDLING LICENSE# 110376 3—__ 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 Adirondack Healthy_.,Home, LLC FILE NUMBER: 18=110376 LICENSE NUMBER: 14..03761 P:.O. Box=4623 LICENSE CLASS: RESTRICTED_ DATE OF ISSUE: 04/18/2019 Queensbury"- NY 12804 EXPIRATION DATE: 04/30/2020 Duly Authorized:-Representative.—Steven Grimaldi: I its license=has been issued in accordance with:applicable provisions.of Article 30 of the Labor Law of New York State and of the N.ew.,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 project,or(2)demonstrated lack of responsibility in the conduct of anyjob involvingasbestos or asbestos material. Thus=license is.,valid oily 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 an asbestos project.=in New York State have been=issued an Asbestos Certificate,appropriate for the type of work they perform,by the New York State Department of Labor. Eileen M.Franko, Director SH 432(8/12)For the Commissioner of Labor l'D1 figait AVNItti l$ 4 I ' ,L ;#11005 ASBESTOS INSPECTION REPORT PROJECT INFORMATION ABBREVIATIONS KEY Friability Con,4...ition Damave Potential goo r ,5-6„,„v5,il, Rcr i-Ccr.:a::;--,•:7-.z.: Nc.,11-F:ial•.i., . 2-Daz::Etci S::4::::::an:;:.ii an::;4:::T Si NO:1,..P.:.n.tr.:i-,2 Da::Ins?-zcze 1 Badik-,Nam: l F S',,,,ys.V. Pc( Accessibility : - ---=------- -:-------• Siz::if:car.::,De.mazef:S,,::1,:i.i;Nr2:-z7iai : 3-Vi.c5atit::?,..*::-.:a: 0.1,-.,e,,:::::-.ific,--!--Da--:-'Nti:^ "------ . 5-Wa::::P,-_,:r.:izi Pace.i:- I fr..Tecten:51 EF:ciosez! ACB.`:"I•••-::h P•ntr.:ial fc;Darna.ze Ofht7:1:-..-,17-.:nmtnial Pc;mizal I \ of cI ''f.e..,.."-e..^ C.04;vvittit t • ACBM,i:h.9,-ner.:::-.2.-.,:•7 Signi:kara D1::-.a,lt --(....e:e:-?h-ii_z:Pezz:::!.:: z-iracce5sitit SAWLE IDENTIFICATION Functional Friability,' I Damage Bulk Homogeneous Areas Quantity Condition 1 Potential Sample r. Comments Space ID- Accessibility 1 Floor1 Wall 7114 C...1, /1a.c-F 1 P 1!I t i t i / cfo/ ; r", r(.... 1 Ceiling Other (4,„(1 105F 7---- / / f .. ( ; /6(0)_ Ts;‘r, - 64, Other 1.,...... I ( 10SF ;.F/i 1 4 a.) 7-,7 c.„ 6,6r)e- i Other Floor Wall Ceiling Other 1„,, dr , AO L.F F-7/1 Other (,,,,, / d,69 1,..r i f// Other pv,..,,dow., LI),/0 (..4:--- : re/i i Floor Wall Rr-_- ; .„,9(DosE 7/ , I, , f : ( `fe-)7 Ceiling „f-- ; aa...sf --/ 1 1 I pi 05) Other .0.(.7-- 44.0c)SF , 1 I ttl 01 clri,It.5 re, Other Rod c i ia,coST- ' r// ; 1 I ci I 0 : S kii0f te_ 1 Other *a t- ; esOoS F 1 t LIS II_j1_ ,' Floor I Wall Ceiling Other 1-7- 040,10.4/11„. ,... i., ciLr F--/i , 1 1 lc./a Other f--0,4„1,,,t/e., #%<-0L-1----: F/1 i Other --E.0,,,,,,(0,,,f,•,,,„ , 9-Q)4..p-- : Fy 1 , t _, . (4 ILI ! frpvt,,,,-- Floor Ceiling I:Other CIA)/Anei /(to t-r ; R / 1 i ( le irs---- . merc, Other k.lin..e.,/ ;, /CIO LF 1 F / 1 1 1 1( ci(Cp rvto- f- e, Other (/1. 1, 0.0,eiy ; 1_4(0 t.....I— LI- / 1 t i i / 40? Floor Wall 3aec / ( i .f I ( ( t Ceiling 3.)06cra'• F / % ' t Other 14, i( F3,020057-: / I I i . i(-1 go 1,e--.....-. 11 Other vvA,I( l oo 5'F '., f----- / 1 1 : 1 !I ct ( 1 1 Other c„,.`1,1 i dov 3 F j (-:" / f i a I 1 If 61 a 1r I I i I s i f : I r : 1 i r Ij i i V_ • r i 1 r r I I r s 4S... 0- hOt I ko, IIIIZIIIIIII v,- 1: 0 a 0.,,,,. 4, I '', -,.: ee -, i 1 40 q.,„,% 40k, 1 431' 4411ts, aoSistr4Zbistzta. v1 41et.- -- 4 1... g" 5447feEMP V0. 1,/ fiaria/ MKS.. P 4" Mbig Y .,....,.- 7 7. t....,-.- OCUIS....,...*, ensimeut....... tif. M• der t, A y MICROBIAL CONSULTING 1 020380 Analysis Report prepared for We would like to thank you for trusting Hayes Microbial for your analytical needs! We received 22 samples by FedEx in good condition for this project on May 23rd, 2019. Adirondack Healthy The results in this analysis pertain only to this job, collected on the stated date, and should not be used Horne in the interpretation of any other job. This report may not be duplicated, except in full,without the written consent of Hayes Microbial Consulting, LLC.. P.O. Box 4623 This laboratory bears no responsibility for sample collection activities, analytical method limitations, orQueensbury, NY 12804 your use of the test results. Interpretation and use of test results are your responsibility.Any reference to Phone: (518) 744-0415 health effects or interpretation of mold levels is strictly the opinion of Hayes Microbial. In no event, shall Hayes Microbial or any of its employees be liable for lost profits or any special, incidental or consequential damages arising out of the use of these test results. 1400 1 Briana Williggan 18 Sunnyside Rd Queensbur y NY, 12804 Collected: May 20, 2019 Steve Hayes,BSMT(ASCP) Received: May 23, 2019 Laboratory Director Reported: May 24, 2019 Hayes Microbial Consulting,LLC. v S lab 4 '"g m3 A s,:'-;, t 1,*.44 MV3A,@ DPH)) ELT C Cm ortieut Deportment EPA Laboratory ID: VA01419 Lab ID: #188863 NVLAP Lab Code: 500096-0 DPH License: #PH-0198 Hayes Microbial Consulting,LLC. 3005 East Boundary Terrace,Suite F. Midlothian,VA.23112 804) 562-3435 contact@hayesmicrobial.cor Page: 1 of 4 Steve Grimaldi 1 400 1 9020380 Adirondack Healthy Home Briana Willigan P.O. Box 4623 18 Sunnyside Rd Queensbury,NY 12804 Queensbury NY, 12804 Asbestos 1986,. Asbestos 198,1 518)744-0415 Subcontracted 1:Amerisci-Lab ID# 10984 Sample Material Description Non-Asbestos Fibers Asbestos Fibers 1 1401 -Tile Glue Bulk Material/Tan None Detected 2 1 402-Tile Glue Note: Insufficient Material for Prep. 3 1403-Tile Glue s1JIL ''),..--m di,Ig Note: Insufficient Material for Prep. 4 1404-Window Glazing Glazing/Tan None Detected 5 1405-Window Glazing Bulk Material/Tan None Detected 6 1406-Window Glazing Glazing/Tan None Detected 7 1 407-Roof Shingle Bulk Material/Black 25% Fiberglass None Detected 8 1 408-Roof Shingle Bulk Material/Black None Detected Bulk Material/Black None Detected 9 1409 -Roof Shingle Bulk Material/Black None Detected 10 1410-Roof Shingle Bulk Material/Black None watected 11 1411 -Roof Shingle Bulk Material/Black None Detected Collected:May 20,2019 Received:May 23,2019 Reported: May 24,2019 IID H A y E s Project Analyst: r"i Date Reviewed By' 7 Date. Rena°Drakes, 05-24-2019 Darien Williams, t, a„,",,MICROBIAL CONSULTING 12.) 05-24 :2019 3005 East Boundary TerrafeTSu i Ye'F. Midlothian,VA. 23112 804) 562-3435 contactphayesmicrobial.com Piqe:2 of 4 St,-ve Grimaldi 1400 1 9020380 Adirondack Healthy Home Briana Willigan P.O. Box 4623 18 Sunnyside Rd Queensbury,NY 12804 Queensbury NY, 12804 Asbest::;s 19&6, ,A sb sips 1981 518)744-0415 Subcontracted 1:Arnerisci-Lab ID# 10984 Sample Material Description Non-Asbestos Fibers Asbestos Fibers 12 1412-Foundation Mortar Cementitious/Gray 2% Cellulose Fibers None Detected 13 1413 -Foundation Mortar Cementitious/White None Detected 14 1414-Foundation Mortar Cementitious/White None Detected 15 1415 -Chimney Mortar Mortar/Black None Detected 16 1416-Chimney Mortar Mortar/ Black None Detected 17 1417-Chimney Mortar Mortar/Black None Detected 18 1418-Wall Plaster Plaster/White 3%Animal Hair None Detected 19 1419 -Wall Plaster Plaster/White 3%Animal Hair None Detected 20 1420-Wall Plaster Plaster/White 3%Animal Hair None Detected 21 1421 -Wall Plaster Plaster/White 3%Animal Hair None Detected 22 1422-Wall Plaster Plaster/White 3%Animal Hair None Detected collected:May20,2019 Received: May23,2019 Reported: May24,2019 Project Analyst: Date: Reviewed By' Date: Renaldo Drakes, 19 05-24-2019 Darien Williams, f '/ '• 05-24 -2019 MICROBIAL CONSULTING .. . 1. --.. 3005 East Boundary TerraceeSui'e F. Midlothian,VA. 23112 804) 562-3435 contact©hayesrnicrobial.com Page:3 of 4 Steve Grimaldi 1400 190203W Adirondack Healthy Home Briana Willigan P.O. Box 4623 18 Sunnyside Rd Queensbury,NY 12804 Queensbury NY, 12804 Asbest•s Analysis inforinItion 518)744-0415 Subcontracted 1: Arnerisci-Lab ID# 10984 Analysis Details All samples were received in acceptable condition unless otherwise noted on the report.This report must not be used by the client to claim product certification, approval,or endorsement by AIHA,NIST,NVLAP,NY ELAP,or any agency.The results relate only to the items tested. Hayes Microbial Consulting reserves the right to dispose of all samples after a period of 60 days in compliance with state and federal guidelines. PLM Analysis All Polarized Light Microscopy(PLM) results include an inherent uncertainty of measurement associated with estimating percentages by PLM. Measurement uncertainty data can be provided when requested. Definitions None Detected'-Below the detected reporting limit of 1%unless point counting is performed,then the detected reporting limit is .25%. New York ELAP Per NY ELAP198.6(NOB),TEM is the only reliable method to declare an NOB material as Non-Asbestos Containing. Any NY ELAP samples that are subcontracted to another laboratory will display the name and ELAP Lab Identification number in the report page heading of those samples.The original report provided to Hayes Microbial Consulting is available upon request. H AyE s MICROBIAL CONSULTING 3005 East Boundary Terrace,Suite F. Midlothian.VA.23112 804) 562-3435 contachZ0havesrnicrobial.com Pale:4 of 4 Company. SF_P: FEGEX t V SC3 A:5$t:5T45 Y> Ar,r i N[V i[.; HEAL FM rit.)f1c. LA?c: l35 Z7 Z8Z5 Address: a. i 78 TUT HILLL kb 4 _ ; MICROBIAL CONSULTING QUEENSBURY,Ni 1.2804 8133 1745 5746 Job Number: 1400 Job Name: Briana willigan Collector: Steven Grimaildi 18 Sunnyside Rd Mobile: 518-744-0415 1 Email: Info©adkhealthyhom e.com 11 Queensbury NY,12804 e__ t t Date Collected:' 5-18-2019 Note:1 Analysis Type Analysis Methods Turnaround Times PLM { Bulk EPA 600 3 Hour Same Day I 1 Day 2 Day f 3 Day 5 Day Point Count 400 Point, 1000 Point 3 Hour Same Day 1 Day 2 Day i 3 Day 5 Day Vermiculite CARB 435 3 Hour ( Same Day 1 Day 2 Day I 3 Day 5 Day TEM Air EPA AHERA,NIOSH 7402 1 Same Day 1 Day 2 Day 3 Day 5 Day _ Chatfield 1 Day 2 i Bulk M Same Day .. _ VDay !_3 Day 5 Day Wipe ASTM 06480-05 LSame Day 1 Day 2 Day 1 3 Day 5 Day Microvac ASTM D5755-09 Same Day 1 Day 2 Day ; 3 Day I 5 Day PCM Air NIOSH 7400 i Same Day 1 Day 2 Day 1 3 Day 5 Day !i 1k Group Number Sample Name Analysis Type Turnaround volume/Area Stop(+)___.. 1 1 1401 Tile Glue j 198.1 24 FIRS YES 1! 2__.._._v1_.__. ____ 1402 F Tile Glue 198.1 I _ ___1311403TileGlue198.1 4 t 2 1404 Window Glazing 198.1 5 I 2 1405 Window Glazing 198.1 6 _ 2 1406 Window_Glazing 198.1 11._71. 3 —^ 1407 _____ __. Roof Shingle 198.E 8 3 1408 t Roof Shingle 198.6 198.6 _ 1-9 3 1409 Roof Shingle 198.E j 10 3 1410 Roof Shingle 198.6 I-__....._ 11 3 1411 Y Roof Shingle _.,_ 198.6 J_ 12 4 1412 Foundation Mortar 198.6 13 4 1413 Foundation Mortar 198.6 I 11441414FoundationMortar198.6 15 5 1415 Chimney Mortar 198.E 16 y-- 5 1416 ChimneyMortar 198.6i___.._ 1__ 17 ] 5 ; 1417 Chimney Mortar 198.E f - jate: 5-20-19 ReceivedB zdj: i ' Reasedby Date:G` i e I layt s irlic,c,br:il Consulting,LLC. 3005 Eat Boundary Terrr,ct.,Suits. ;.Midlolhi rn.VA.2.31 1? (E:o4)5G2-S,i35 curtactCohayesmicrobial.com Fain,rr20.Hev.3,March?: :4.•7'_5 ChZein of Cuerod;