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DEMO-0597-2023 Office Use Only DEMOLITION APPLICATION Permit#: C7rDc( �- 20 Permit Fee: 1125 — Town of Quccnsbury Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.queensburv.net Flood Zone? Y N Reviewed By: Demolition Location: RI 7 1 5 f Rt Tax Map ID#: c' **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? L Gn ci i ) 1 2. Type of structure demolished: a. Residen d. Storage Building oca j b. Garage e. Other: ct' c. Business ®� i 9 0 Go G c 3. What type ties are connected to the structure: G° � a. Gas f. Well-Water P 0�� b. Fuel Oil_ g. Public Sewer .V c. Propan h. Otheta_ d. Electric i. None e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes No I I ADDITIONAL INFORMATION: 1. Two inspections are required: an inspection to determine that utilities are disconnected, 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 infcirmation 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: �VSS �en SIGNATURE: ! DATE: 9 43123 Demolition Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): S 5 ate.1 Mailing Address, C/S/Z: oZ Atm\ -C_ Art-- SGe-a-(Vjc ,c frfry,.5 51 .tire` /©? h6 Cell Phone: (s'I 0 i 9(, - 3 7/U Land Line: Email: r u S 5e /( 4 Aden a. yatioo . Cor+ • Primary Owner(s): Name(s): S4/KA- 4 , App -1- Mailing Address, C/S/Z: Cell Phone: Land Line: Email: ❑ Check if all work will be performed by property.owner only • Contractor: (List all additional contractors on the back of this form) Contact Name(s): *E-YY ? Contractor Trade: Z VQox1_ A..e , 4�� � �P v�v- c N"t 'Th((o Mailing Address, C/S/Z: l� Cell Phone: Land Line: Email: **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: /au e� Cell Phone: ( (&) 7N6 - 3 1 / L. Land Line: Email: r u S Se // - den Q' yat►oo . corp-. Demolition Application Revised June 2022 l • • t'r . `�-�'' •,.�. •..�: Forensic Engineers • Scientists Harlan-McGee of North America. Malta Ridge Professional Building 4000 Silver Beach Road • Malta, New York 12020 CERTIFICATION • This is to certify that the Asbestos Inspection Program for the former Sub Way Shop building located at 1471 State Route 9, Lake George, New York has been conducted in'accordance with the requirements of the -New York State Attorney General Asbestos Inspection Guidelines; the New York State Department of Labor, Asbestos Industrial Code Rule 56 (12NYCRR Part 56); and the requirements of the Building Code of New York. The data presented in this report is accurate to the best of my knowledge. I am a registered professional engineer licensed .by the New York State Education Department; a registered Asbestos Abatement 'Designer licensed by the New York State Department of Labor, and; have a minimum of thirty-five years of design and analysis work experience in building systems. I.am free from financial interests, which may conflict with the proper performance of my duties. 9, �T� ' August 18, 2023 ulest Tjailo P.E. Date Firm Name: Harlan-McGee of North America Address: 4000 Silver Beach Road Malta,New York 12020 Telephone: (518) 584-1300 _ � ys- Fax: (518) 584-1374 1� ;'_a`--' `_ 9 \ New York State License Number 059460 SEP 9 2023 I New York State Department of Labor AH 944)3601 I J New York State Department of Labor 64388 TOWN OF QUEENSEURY BUILDING E: LODES TOWN OF QUEENSBURY Professional Stamp: BUILDING DEPARTMENT Based on our limited examination,compliance with Our comments shall not he construed as indicating the plans and specifications are in ‘{ •full compliance with the Building Codes of ������ N w York State. ®`�1.4 () QUA neS ,e\nemi -2)0 Date. Phone: (518) 584.1300 Fax: (518)584-1374 Email: info@harlun•mcgce.com • . • EXECUTIVE SUMMARY • NARRATIVE • The abandoned building is located at 1471 State Route 9, .Lake George, New York. The owner is 1471 St Rt 9 LLC, 2 Moore Avenue, Saratoga Springs, New York. • The type of construction is that expected for older commercial structures. OBJECTIVE The objective of this inspection was to determine the presence of asbestiform minerals in suspect bulk samples. If these minerals are detected, they are identified and quantified. Identification is made as to which mineral and/or minerals are present from the Serpentine or Amphibole groups. These include Chiysotile, Amosite, Anthophylite, Crocidolite, Actinolite and Tremolite. • SITE INSPECTION and MATERIAL ANALYSIS • • Members of the staff of the Harlan-McGee of North America physically inspected each room or habitable space of the structure. Additionally, all accessible areas were inspected. Bulk samples of suspected insulation, mortar, wall/ceiling material, roofing and any other suspected asbestos laden material were collected. Bulk material samples were initially examined and grossly described. All remaining suspect material is then studied under plane-polarized light and orthoscopic illumination to determine refractive indices along specific crystallographic axes and antisotropism. These studies • involve immersing the sample in known refractive index liquids and qualitatively determining the mineral types by refractive index, morphology, signs of elongation, birefringence characteristics, and extinction angles. With this information, the mineral type is ascertained. A petrographic point counting technique is then applied to the sample under investigation to quantitatively outline a percent composition of mineral fiber in the matrix of the bulk sample. This counting involves representative sections of the entire material if it is homogeneous. If the entire material under study is heterogeneous, each stratum of the sample that can be isolated as a homogeneous section, is considered, and treated separately. • RESULTS OF ASBESTOS INSPECTION Members of the staff of Harlan-McGee of North America conducted the Asbestos Inspection. Material samples were collected by the inspector based on professional knowledge of building materials and known areas of usage for asbestos material. , It has been determined from both on-site inspection and laboratory analysis of the bulk samples taken during the inspection that asbestos material is not present. CONCLUSION • It has been determined from both on-site inspection and laboratory analysis of the bulk samples taken during the inspection that asbestos material is not present. Respectfully Submitted, 1 E►ne t J. Ga' or, P.E. August , 2023 EJG/gpv • . 'STATE,.6-rNEK-0160.EPAVANt-Or';i:46t'" - - • ERNEST J GAILOR CLASS(EXPIRES) eiN47-7117t D INSP(01124) „. 4*AI • CEng 9 4ro6ol ,EfeDMV :i42 5-563 . _ . - • • • ,. MUST BE CAR-10.;.421016...8,kSTOS,PROJECTS • tuff UI 1114111113 CI • • • • WE ARE YOUR DOL rito K Department STATE of Labor _ DIVISION OF SAFETY&HEALTH LICENSE AND CERTIFICATE UNIT, STATE OFFICE CAMPUS.BLDG. 12.'ALBANY,NY 12226 • ASBESTOS HANDLING LICENSE Harlan-McGee of North America Engineering, PLLC 4000 Silver Beach Road, Malta, NY, 12020 License Number: 64388 License Class: RESTRICTED • Date of Issue: 01/13/2023 Expiration Date: 01/31/2024 Duly Authorized Representative: Ernest Gailor 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 (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 any job involving asbestos or asbestos material. 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 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. g/Z///,-- Amy Phillips, Director For the Commissioner of tabor SH432'1221, NEW YORK STATE DEPARTMENT OF HEALTH • WADSWORTH CENTER • Expires 12:01 AM April 01, 2024 ..- "22 Issued April 01, 2023 • Aso, j CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE • • Issued in accordance with and pursuant to section 502 Public Health Law of New York State MS. TARA DANIELS NY Lab Id No: 10709 AD/RONDACKENVIRONMENTAL SERVICES INC 314 NORTH PEARL STREET • ALBANY, NY 12207 is hereby APPROVED as an Environmental Laboratory for the category ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE All approved subcategories and/or analytes are listed below• Miscellaneous Asbestos in Friable Material Item 198.1 of Manual EPA 600/M4/82/020 Asbestos in Non-Friable Material-PLM Item 198.6 of Manual(NOB by PLM) Asbestos in Non-Friable Material-TEM Item 198.4 of Manual Lead in Dust Wipes EPA 6010C Lead in Paint EPA G010C Sample Preparation Methods EPA 3050E • • • • • • • Serial No.: 67463 Property of the New York State D•partment of Health. Certificates are valid only at the address shown and must be conspicuously posted by the laboratory. Continued accreditation depends on the laboratory's successful ongoing participation in the Program. Con umers may verity a laboratory's accreditation status online at https://apps.health.ny.govlpubd.hlapplinks/wclelappublicwebl,by phone(518)485-5570 or by email to elap@health.ny.gov. Page 1 of 1 Adirotndac`k Environments ices,trtc AIHA-LAP,LLCAcc redited#100307 Experience is the solution NYSDOH#10709 314 North Pearl Street • Albany,New York 12207 Bulk Asbestos Report (800)848-4983 • (518)434-4546 • Fax(518)434-0891 Project: Harlan-McGee Associates,Inc. ProjLocation: Date Sampled: 8/10/2023 4000 Silverbeach Road - Date Received: 8/10/2023 Malta. NY 12020 PLM Analyzed: 8/14/2023 by-KTT Attu: Ernest Gailor TEAM Analyzed: 8/15/2023 by SPW Method References: NYSDOH ELAP 198.1/198.4/198.6 ReportDate:8/17/2023 WorkOrder• L a Non-asbestos - PLM TENT Result Lab Y Sample Identification Materials Fibers Asbestos of Residue Final ID e and Description Type (Percent and Type) (Percent and Type) PLM Result ELAP-198.4 Status r 001 A 1/Paper 1 Homogeneous, Paint No asbestos detected White,Non-Friable <1% No Asbestos Detected <1% Material Inconclusive** NAC 52.5 WL%Remaining PLMMethod: ELAP 198.E 001 B 1/Paper 1 Homogeneous, Ceiling Tile No asbestos detected Tan,Friable-Organically <1% No Asbestos Detected <1% Bound Inconclusive** NAC 41.6 Wt%Remaining PLMMethod: ELAP 198.6 002 A 2/Paper - Homogeneous, -Paint No asbestos detected White,Non-Friable <1% No Asbestos.Detected <1% Material Inconclusive** NAC 67.3 Wt%Remaining PLMMethod: ELAP 198.6 002 B 2/Paper 2 Homogeneous, Ceiling Tile No asbestos detected Tan,Friable-Organically <1% „No Asbestos Detected <y% Bound Inconclusive** NAC 40.6 wt'!-,Remaining PLMMethod: ELAP 198.6 Page 1 of 4 ReportDate:8/17/202 3 WorkOrder: L a Non-asbestos PLM TEM Result Lab Y Sample identification Materials Fibers Asbestos of Residue Final ID e and Description Type (Percent and Type) (Percent and Type) PLM Result ELAP-198A Status 003 3 A 3/Wall#1 1 ' Homogeneous, White, Friable <1% <1 NAC NAC PLMMethod: ELAP 198.6 004 4 A 4WaII#1 2 Homogeneous, White, Friable <1% <1 Material NAC NAC PLMMethod: ELAP 198.6 005 5 A 5/Roof#1 1 • Homogeneous, Tar/Roofing Black,Non-Friable <1% <1% Material NAC 0 Wt%Remaining PLMMethod: ELAP 198.6 006 6 A 8/Roof 1#1 2 Homogeneous, Tar/Roofing• Black,Non-Friable <1% <1% Material NAC NAC o 4Vt%Remaining PLMMethod: 'ELAP 198.6 007 7 A 7IWail#2 1 Homogeneous, W hite,Non-Friable <1% <1% Material NAC PLMMethod; ELAP 198.E 008 8 A 8/Wall#2 2 Homogeneous, White,Non-Friable - <1% No Asbestos Detected <1% Material NAC PLMMethod: ELAP 198.6 Page 2 of 4 . ReportDate:8/I7/202 3 WorkOrder: L a Non-asbestos PL�1 TEM Result Lab Y Sample Identification Materials Fibers Asbestos of Residue Final ID a and Description Type (Percent and Type) (Percent and Type) PLNI Result ELAP-I98.4 Status 009 A 9/Tile#2 1 Homogeneous, Floor Tile White,Non-Friable <1% <1% Material NAC NAC 0 Wt%Remaining PLMMethod: ELAP 198.6 010 A 10/Tile#2 2 Homogeneous, Floor Tile White,Non-Friable <1% • <1% Material NAC NAC 0 Wt%Remaining PLMMethod: ELAP 198.6 011 1 A 11/Ceiling#1 Homogeneous, White,Non-Friable <1% <1% Material NAC NAC 0 Wt%Remaining PLMMethod: ELAP 198.6 012 2 A 12/Ceiling.#2 Homogeneous, White,Non-Friable <1% <1%: Material NAC NAC 0 Wt%Remaining PLMMethod: ELAP 198.6: 013 3 A 13/Watt#3. 1 Homogeneous, Tan,Non-Friable <1% <1% Material NAC NAC PLMMethod: ELAP 198.6 014 4 A, 14Mlall#3 2 Homogeneous, • Tan,Non-Friable <1%. <1 cio Material NAC NAC PLMMethod: ELAP 198.6 P•isr 3 of 4 ReporiDate:8/17/2023 WorkOrder: a Non-asbestos PLN1 TEM Result Lab Y Sample Identification Materials Fibers Asbestos ID a and Description Type (Percent and Type) (Percent and Type) of Residue Final r PLA1 Result ELAP-198.4 Status 015 A 15/Glazing Metal#1 Homogeneous, Caulk White,Non-Friable <1% <1% Material NAC NAC • 0 14't%Remaining PLMMethod: ELAP 198.6 016 A 16/Glazina Metal#2 Homogeneous, Caulk White,Non-Friable <1% <1% Material NAC NAC 0 Wt"io Remaining PLMMethod; ELAP 198:6 017 A 17/Glazing Wood#1 Homogeneous, Caulk No asbestos detected White,Non-Friable <1% No Asbestos Detected <1% Material Inconclusive** NAC • 6.4 Wt%Remaining PLMMethod: ELAP 198.6 018 A 18/Glazing Wood#2 Homogeneous, Caulk No asbestos detected White,Non-Friable <1% No Asbestos Detected <1% Material Inconclusive** NAC 7.1 Wt%Remaining PLMMethod: ELAP 198.6 ACNI:Asbestos Containing Material NAC:Non-Asbestos Containing Materiale+w.CaLe.) Approved by: **A negative result for an NOB sample is considered inconclusive.The following NYS ELAP Tara Daniels disclaimer applies:"PLM is not consistently reliable in detecting asbestos in floor coverings and Laboratory Director • similar NOB materials. Before this material can be considered or treated as non-asbestos containing, confirmation must be made using transmission electron microscopy(TEM)". • Page 4 of 4 rjon- - 2023 nationaigrid 300 Erie Boulevard West Syracuse,New York 13202 September 19, 2023 RUSSELL FADEN RE: Service Removal for Building Demolition. RUSSELL FADEN, This letter is to confirm that, per your request,National Grid has confirmed electrical service and meters have been removed from 1471 STATE ROUTE 9 LAKE GEORGE, NY. The work was processed on work order#30831656 and meter#57719853 has been removed. If you have any questions or need further assistance, please feel free to contact me at 315-468-7513. Sincerely, Mary Landers Customer Fulfillment nationaigrid D *�:y� • nationa6 rid September 5, 2023 • Via Email: russellfaden(a)yahoo.com Re: National Grid GSR #: 30831654 Service Address: 1471 State Route 9, Lake George This letter is to advise you that the natural gas service line to the above location was physically disconnected on September 1, 2023. The service was retired 8'W of the property line, therefore, there is no live gas to the building as of September 1, 2023. If you feel that the location where the service was terminated (as stated above) will interfere with your planned excavation, please contact us immediately and do not start excavation. New York State law requires anyone planning underground excavation work to notify local utilities by calling "811", or 800-962-7962. This confirmation letter of disconnect does not relieve the excavator of making this"811"call. Respectfully, DedeMedoot bil Debi Melsom J/ 1 Gas Connections UNY SEP 19 a ,; Phone: (518) 603-4015 � ,1� Email: debra.melsom@.nationalgrid.com cU040;NCoo*� �‘( 1125 Broadway,Albany,NY 12204 2 , — 5 s EXISTING TREES TO BE CLEARED AND GRUBBED STREAM DI UR NCF AREA EXISTING LIGHT POLES TO BE REMOVED EXISTING ASPHALT DRIVEWAY IN DOT RIGHT OF VED AND EXISTING DRIVEWAY, BUILDING, DISPOSED OF AT A LICENSED WASTE FACILITY CONCRETE AND OTHER DEBRIS TO WAY TO HE REMOVED AND DISPOSED OF AT A BE REMOVED AND DISPOSED OF AT LICENSED WASTE FACILITY A LICENSED WASTE FACILITY EXISTING CONCRETE CURBING TO BE REMOVED AND DISPOSED OF AT A i �.� LICENSED WASTE FACILITY f' TO BE REMOVED . EXISTING CONCRETE SIDEWALK IN DOT ROW 1 `; t f 7. r✓ : f , ti / , ! ' ! , , f sallow ma co OF av __.. _... _ — , i _ EXISTING CONCRETE HEADWALL TO BE f' f f . � `�' t, Ji � .. � f - _ �`` REMOVED AND DISPOSED tar. � UL yy s , / v i �8w 3 Z W f ! f ., F , y{ X , W —EXISTING .... ;. _ � }SAS MAIN , ,. EXISTING WATER • w - - _ SERVICE Ld , i + 34- rr Vx ■ /� y 0 1�.,.._1�i - :.., S �. ■ ■_Y ■ ■ III ■ ■ ■ �` , J ! } _� �! !, CONCRETE SIDEWALK DOT R.O.W. TO REMAIN _ F CL 41V `y ,!,_ EXISTING DRAINAGE MANHOLE n :t TING 38" PIPE , a AND CONNECTING TO BE REMOVED ,. EXISTING LIGHT POSE TOREMAIN f EXISTING 18" CMP PIPE TO BE REMOVED EXISTING CONCRETE CURBING TO BE "`...,,y r .,,". - / .✓ .Fi / ,;i REMOVED WASTE FACILITY LINE {TYP.) OVE D AND DISPOSED OF AT A ' ` ' - / J. ; ,! > J/,;, • LICENSED EXISTING TREES TO ICE CLEARED AND GRUBBED (TYP) PROPOSED TI�EELI'�E EXISTING TREE - f`! EXISTING ASPHALT DRIVEWAY IN DOT RIGHT OF WAY TO BE REMOVED AND DISPOSED OF AT A LICENSED EXISTING 18" CMP TO BE REMOVED ! ; f EXISTING OVERHEAD UTILITY LINE MEAMDIMIRBANCES DISTURBED STREAM AREA Si � 88 f %_ w3 f L� ! 1 111 1 ! mill - 2a 40 80 SCALE. 1 "=2Q' ci s dr U°IleQF F EXISTING CATCH BASIN (r(P>)