2024-0499 fr
Office Use Only
DEMOLITION Permit#: OL ( U' kui q
Permit Fee:$ 60
Town of Queensbury AP L �-, E 1E " oice#: 41101iik4
742 Bay Road,Queensbury,NY 12804
SEP 16 2024i ': :::: / 6
TOWN OF QUEENSBURY
BUILDING& CODES
Demolition Location: 12 Se kr-c ni Lam, E'_ ax
Lave 0-000ge , H 127rL-I
**AN ASBESTOS REPORT IS REQUIRED WITH ALL
DEMOLITION APPLICATION SUBMISSIONS**
DEMOLITION INFORMATION:
1. Where will demolition material be disposed? /4-Q'C C1(11, i l Corp
2. Type of structure to be demolished: `J
a. Residence_ d. Storage Building
b. Garage e. Other: 1-0LIT 1,*j in
c. Business
3. What type of utilities are connected to the structure:
a. Gas d. Electric g. Public Sewer
b. Fuel Oil e. Public Water h. None
c. Propane f. Well-Water Pump i. Other:
4. Have ALL utilities (water, electric, etc.) been disconnected? Yes >e No
ADDITIONAL INFORMATION:
1. Two inspections are required: 1.) an inspection to determine that utilities are disconnected, and 2.) 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.
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: „An 1 S P1p1 k-I S
SIGNATURE: • — ��� • DATE: q I►CeI2_44
Demolition Application Revised May 2024
r
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): ��Q CIS ►P 1 k-(S
Mailing Address, C/S/Z: 2,0 1-11. ySwl!le Lane Lave rorcge 7 (L(-
Cell Phone: SOS 4)1 L I41 Land Line:
Email: SPCrG S1WA,n1O a maJ1 I = eery)
• Primary Owner(s):
Name(s): Oh f E WAN 11 e N t( RC I I V
Mailing Address, C/S/Z: 1 ry,bk rrt-C{in r1,1 f-e Pol Pbughcjuc g N V 1 Zc7t
Cell Phone: QII y [012_. crI LI' Land Line:
Email: j r I I Iy rc Q 9171a 1 . Corn
❑ 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): f'Bond Marie HOW(' J r / ilovVC- rnoc twice n CcnS-f'1'uCh�s�
Contractor Trade: Oava-F1m brnri I-+'f-on
Mailing Address, C/S/Z: I pS T I Kt '- e-Cif SO pH Ga jy 17,- (3 2.
Cell Phone: Z3g1 Land Line:
Email: IUWeViIrri—On a JCLt1&) edn
**Workers' Comp documentation must be submitted with this application**
Contact Person for any questions regarding this project: J(tniS 'p( pi k- S.
Cell Phone: (jp Land Line:
Email:3 1 CrC '1SnCCfl I D 0. (3r'nc I a ec_YY
Demolition Application Revised May 2024
. . I_ •
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J. lei & Orr:pally. IL.. - -,..----i- ,i Invoice
P.O.Box 800 i .
41-i-65,
h-,\
Valatie,NY 12184 - Orirr ‘r4=111
i. ---,now
olleirrA'"---- ----....m -
Phone# 518-392-6849 www.asbestoscom!4 yip
: ti. i -. chase ii,rder#
Fax# 518-392-5502 asbestoscompany 0,alio ." --":"1"1"/L '
"NH Bill To SEP:16 ll 2 O2 4 ;-Illinsi 2064
any,
I E21111111•111111 Invoice#
JPK Construction
TOBTILDOIFNG
AlbNY
UaEcEoNDsBEilmir-Fliwaril,.. 11111111111 FAX
•
-VSV 95
Terms 1Net 15
Project Location Bellewtuidith.Coitgies
talieCie,Nitr'
Description Amount
Demolition of building#1 with asbestos left in place per proposal#2055A 23,940.00
Demolition of building#2 with asbestos left in place per proposal#2056A 23,940.00
Demolition of building#3 with asbestos left in place per proposal#2059A 17,990.00
_ NY.Large Project Fee for building#4 2 000 00
Demolition of building#6 with asbestos left in place per PrOpOsal#2057A 23,850.00
Demolition of building#7 with asbestos left in place per proposal#2058A 23,850.00
Demolition of building#8/9 with asbestos left in place per proposal#2061A 32,730.00
Removal of asbestos containing Indteriajs.for!buildirig#10 per proposal#2.0.64 16,780.00
Demolition of building#11/12 with asbestos left in place per proposal#2062A 32,730.00
Removal of the asbestos roofing from the south boat slip 3,790.00
Removal of the asbestos roofing from the north boat slip 3,790.00
Previous Payments -65,210.00
10%Retainage -15,810.00
, .
, .
226.19-3-3 2024-0499
Kelly, Helen-Jo &John
12 Serenity Lane, Bldg 7
Demo of foundation only
..._.
.,.._-
,-
License#AC-99-0939 Total z4142,320.00//
Federal ID#14-1438766
..__ __-4-•7
T.J.Bell&Co.,Inc.accepts MasterCard/Visa/American Express • ,.-.)
i,.. -2
(, _--- I A/
T.J.Bell&Co.,Inc.is a NYS Certified Woman-Owned Business Enterprise. ------y 6 1' /2 i
t /I ei
.
Fwd:Invoice trom.1..J. bell& Company, Inc. Yage I or I ,
From:James Kelly<jpkconstruction@gmail.com>
To:JEK3rd@aol.com
Subject:Fwd:Invoice from T.J.Bell&Company,Inc.
Date:Wed,Jun 22,2011 10:13 pm
Attachments:Inv 2064 from T.J._Bell_C.pdf(66K)
Hi Johnny&Honey Jo,
Attached is the final T.J>Bell billing for the Beilewood cottage asbestos removal. !asked Dan`.if the.NYS Labor Dept.:ssues any
certificate;of.completion;_'he:said;they don't issue.any:paperwork on;the completed jobs .T:J:Bell s finalbilling is the fropf of
completion'and the inspections'along the way and the final Inspection by the State before the retaining fences were removed is
all that is required.
Hope all is well,talk soon,Jimmy
Begin forwarded message:
From:'T.J.Bell&Company,Inc"<ashestoscomnanyt®vahoo.cern>
Date:June 20,2011 11:08:51 AM EDT
To:jpkconstruc`Jenaemaiicom
Sitbject3 trivoice from T.J.Bell&Company,Inc.
Reply-To:'T.J.Bell&Company,Inc."<asbestoscompanyOvahoo.com> .
Dear Customer :
Your invoice is attached. Please remit payment at your earliest convenience.
Thank you for your business -we appreciate it very much.
Sincerely,
T.J. Bell &Company, Inc.
518-424-1582
To view your invoice
Open the attached PDF file. You must have Acrobat® Reader® installed to view the attachment.
(:0V NEtti$,.
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ENT)
Asbestos Project Notification
Project Reference Number: 25844694 Type: Initial Notification
Status: Notification Received Notification Received: 4/28/2011
Payment Status: Paid in full Number of amendments: 0
Notification Entered By: Jupiter
Environmental
Services, Inc.
Contractor Information
FEIN:061598172
Jupiter Environmental Services, Inc. Mailing Address
3 Lynn Court
Lincoln Park NJ 07035
Asbestos License Number:28543
Duly Authorized Representative
Annabel Pierce, Officer
Phone Number: 973-709-0200
E-mail Address: jupiteres@aol.com
Project Information
Project Start Date: 5/19/2011
Project End Date: 7/19/2011 •
Project Location County:Warren
Worker Compensation
Worker Compensation Policy#:
WC Exemption Certificate#:
Number of your employees you expect to be on project:
Will temporary workers be used?
If yes,name of temporary agency:
Project Location
yBuilding:Nan e:'Cottage_7,_'..' .. 3
Room or Location: entire structure
Bridge ID#:
Address Line 1: Bellewood Park cottages/Assembly point
Address Line 2:
City Town or Village: lake george
State: New York
Zip Code:
•
Building Information
Current Use: Other
Prior Use: Other
Approximate Year Built: 1940
Size(sq.ft): 1225
Is this fee exempt project?: NO
Reason:
Building Representative/Site Contact
Name: Jim Kelly
Phone Number: 518.253.7295
E-mail Address:
Cell Phone Number:
Phase Details
Phase# Phase Start Date Phase End Date Phase Location Phase Scope
Sub-Contractor Details
Name: Asbestos License Number:
Night/Weekend/Shift Work Details
07:00- 17:00 Mon.-Sat controlled demo of cottage#7 with ACM in place via excavator
Party for Whom Work is being Performed
First Name: Jim Last Name: Kelly
Organization:
Apt./Suite: Address Line 1: 241 Assembly point road
Address Line 2: City Town or Village: Queensbury
Province: State: NY
Zip Code: 12845 Country: United States
Contract Dollar Amount: $1.00
Variance Information
Procedures and Type of Equipment and Ventilation Systems Used
6,000 gal.water tanker used for wet of a controlled demo of existing cottage with ACM in place via excavator
Air Monitoring Firm
Name: Asbestos License Number:
Alpine Environmental Services, Inc. 29095
Laboratory Performing Analysis
Name: ELAP Registration Number:
Alpine Environmental Services 11740
Type of Asbestos Work
Pipe Related: No Siding: No
Clean up: No Vessel covering: No
Caulking/mastic: No Spray-on insulation: No
Roofing/flashing: No VAT: No
Demolition: Yes Demolition Ref#: 10A0593
Other-specify:
Waste Transporter
Name: Jupiter Environmental Services, Inc.
NYS DEC or EPA Permit Number: NJ-494
Phone Number: 518.435.0700
Apt./Suite:
Address Line 1: 17 Warehouse Row
Address Line 2:
City Town or Village: Albany
Province:
State: NY
Zip Code: 12205
Country: United States
Landfill
Name: Senneca Meadows
Phone Number: 315.539.5624
Apt./Suite:
Address Line 1: 1786 Salcman road
Address Line 2:
City Town or Village: Waterloo
Province:
State: NY
Zip Code: 13165
Country: United States
Type and Amount of Asbestos Containing Material
Friable linear feet: 0 Friable square feet: 3380
Non-friable linear feet: 0 Non-friable square feet: 1300
Fee
Total linear feet: 0.0
Total square feet: 4680.0
Total Fee: 2000.0
Project Fee Schedule
If the notification was submitted prior to 4/7/09,the actual project fee is one half of the amount shown on the fee
schedule
Linear Feet: Fee Square Feet: Fee
0-259 feet: $0 0- 159 feet: $0
260-429 feet: $200 160-259 feet: $200
430-824 feet: $400 260-499 feet: $400
825- 1649 feet: $1000 500-999 feet: $1000
1650 or more feet: $2000 1000 or more feet: $2000
Remarks
EPA Notification of Demolition and Renovation
Operator project# Postmark Date Received Notification#
I. TYPE OF NOTIFICATION (0=Original R= Revised C= Canceled): 0 •
II. FACILITY INFORMATION (Identify owner, removal contractor and other operator)
OWNER NAME: Jim Kelly
Address: 241 Assembly Point •
City: Queensbury State: NJ Zip: 12845
Contact: Jim Kelly Tel: 518.253.7295
REMOVAL CONTRACTOR: Jupiter Environmental Services, Inc.
--Address:-3 Lynn Court - -
City: Lincoln Park • • State: NJ Zip: 07035
Contact: Pane Repic Tel: 973-709-0200
OTHER OPERATOR:.
Address: •
• City: •State: Zip:.
Contact: Tel:
III. TYPE OF OPERATION (D=Demo, 0=•Ordered Demo, R=Renovation, E=Emer. Renovation): R
IV. IS ASBESTOS PRESENT? (Yes/No) Yes
V. FACILITY DESCRIPTION (Include building name, number and floor or room number)
Building.Name: Cottage 7 •
Address: Bellewood Park Cottages -
City: Lake George State: NY .County: Wan-en
•
Site Location: Cottage 7 .
Building Size: # of floors: 1 • Age in Years: 1940
Present Use: Vacant Prior Use: Cottage
VI. PROCEDURE, INCLUDING ANALYTICAL METHOD, IF APPROPRIATE, USED TO DETECT THE PRESENCE
OF ASBESTOS MATERIAL: •
Bulk Sampling . .
•
VII. APPROPRIATE AMOUNT OF Nonfriable Asbestos Indicate Unit of
ASBESTOS, INCLUDING: • • . Material Not to be Measurement Below
RACM Removed
1. Regulated ACM to be removed To Be
2. Category I ACM not removed Removed Cat I Cat II UNIT
3. Category II ACM not removed
Pipes • LnFt: Ln m:
Surface Area Joint SqFt:3,380 Sq m: '
compound _
Vol RACM Off Facility Compound - CuFt: Cu m:
VIII. SCHEDULED DATES ASBESTOS REMOVAL (mrn/dd/yy) Start: 05/16 /11 Complete: 05/30/11
IX. SCHEDULED DATES DEMO/RENOVATION (mm/dd/yy) Start: 05/16 /11. Complete: 05/30/11
JES N141 (1/99) page 1 of 2 Continued on page two
Notification of Demolition and Renovation (continued)
X. DESCRIPTION OF PLANNED DEMOLITION OR RENOVATION WORK,AND METHOD(S)TO BE USED:
6,000 gal water tanker on site with controlled demo with ACM in place via Excavator and placed into lined trailers.
XI. DESCRIPTION OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO PREVENT
EMISSIONS OF ASBESTOS AT THE DEMOLITION AND RENOVATION SITE:
Asbestos to be removed by wet methods in accordance to NYS Industrial code rule 56.11.5
XI I. WASTE TRANSPORTER#1
Name: Jupiter Environmental Services, Inc.
Address: 17 Warehouse Row •
City: Albany State: NY Zip: 12205 •
- -.....-Contact•Person: -Scott = -• - - .... - — Tel:--518,435.0700 . -..._.......
WASTE TRANSPORTER#2
Name:
Address:
City: State: Zip:
Contact Person: • Tel:
XIII. WASTE DISPOSAL SITE •
Name: Seneca Meadows •
Address: 1786 Salcman rd. •
City Waterloo State: NY Zip: 13165
•
Telephone: 315.539;5624 •
•
XIV. IF DEMOLITION ORDERED BY A GOVERNMENT AGENCY, PLEASE IDENTIFY THE AGENCY BELOW:
Name: . • Title:
Authority: .
. Date of Order(mm/dd/yy): Date Ordered to Begin (mm/dd/yy):
XV. FOR EMERGENCY RENOVATIONS . .
Date and Hour of Emergency(mm/dd/yy): •
•
Description of the Sudden, Unexpected Event: •
.
Explanation of how the event caused unsafe conditions or would cause equipment damage or an unreasonable
financial burden:
•
XVI. DESCRIPTION OF PROCEDURES TO BE FOLLOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS
FOUND OR PREVIOUSLY NONFRIABLE ASBESTOS MATERIAL BECOMES CRUMBLED, PULVERIZED, OR
REDUCED TO POWDER. If it crumbles, it will be contained and treated as friable.
•
XVII. I CERTIFY THAT AN INDIVIDUAL TRAINED IN THE PROVISIONS OF THIS REGULATION (40 CFR PART 61,
SUBPART M)WILL BE ON-SITE DURING THE DEMOLITION OR RENOVATION AND EVIDENCE THAT THE
REQUIRED TRAINING HAS BEEN ACCOMPLISHED BY THIS PERSON WILL BE AVAILABLE FOR
INSPECTION DURING NORMAL BUSINESS H 411URS. (Required 1 year after promulgation)
• l
("i� a 'e—o ner/Operator) (Date)
XVII I.I CERTIFY THAT THE ABOVE INFORMATION I'I CORRE T. •
Zg .2v((
•
• (Si. ature o er/Operator) (Dat )
JES N141 (1/99) page 2 of 2 •
• I
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November 2010 Bellewood Park Cottages
Assembly Point
Lake George,New York
Non-Asbestos Containing Materials Tested: Roofing shingles
Small Outbuilding:
Asbestos Material Found: Roll roofing and roofinglflashing cement
Non-Asbestos Containing Materials Tested: None
Tennis Court:
Asbestos Material Found: None
Non-Asbestos Containing Materials Tested: Asphalt
Building#1:
Asbestos Material Found: Linoleum(bedroom)
Presumed Asbestos Materials: joint compound, 9-inch floor tile, linoleum under
sink, sink coating,window glazing compound, caulking at siding
joints, caulking at chimney, roll roofing, and roofinglflashing
cement
Non-Asbestos Containing Materials Tested: Linoleum(kitchen floor)
Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar, •
hearth stone mortar, stone foundation mortar, concrete pier,
mastic to 9-inch floor tile, caulking at bath wall panels, adhesive
to bath wall panels,and carpet adhesive
Building#3:
Presumed Asbestos Materials: joint compound, 9-inch floor tile, sink coating,
window glazing compound, caulking at siding joints,
roofinglflashing cement
Non-Asbestos Containing Materials Tested: Linoleum under sink (kitchen), and
linoleum(bath)
Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar,
hearth stone mortar, stone foundation mortar, concrete pier,
mastic to 9-inch floor tile, caulking at bath wall panels, adhesive
to bath wall panels, carpet adhesive, textured paint and roofing
shingles
Building#4:
Presumed Asbestos Materials: joint compound, 9-inch floor tile, sink coating,
linoleum under sink, window glazing compound, caulking at
siding joints, caulking at chimney, roll roofing, and
roofing/flashing cement
Page 2
1146 Central Avenue Albany, New York 12205 Phone:(518)453-0146 Fax:(518)453-0175
Bellewood Park Cottages
November 2010 Assembly:Point
Lake George,New York
Non-Asbestos Containing Materials Tested: Linoleums (kitchen), vapor barrier
behind wood paneling, fiberboard ceiling panels, ceramic tile,
grout to ceramic tile, mortar to ceramic tile, and adhesive to
ceramic tile •
Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar,
hearth stone mortar, stone foundation mortar, mastic to 9-inch
floor tile, caulking at bath wall panels, adhesive to bath wall
• panels, carpet adhesive, and vapor barrier to fiberglass
insulation
•
Building#6:
Asbestos Material Found: 9-inch floor tile,and window caulking • - -
Presumed Asbestos Materials: joint compound, sink coating, linoleum under
• sink, window glazing compound, caulking at siding joints,
caulking at chimney,roll roofing,and roofing/flashing cement
Non-Asbestos Containing Materials Tested: Linoleum (kitchen), and fiberboard
ceiling panels
Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar,
hearth stone mortar, stone foundation mortar, mastic to 9-inch
floor tile, caulking at bath wall panels, adhesive to bath wall
panels, carpet adhesive, and vapor barrier to fiberglass
insulation
Building#7:
Asbestos Material Found: Roofing/flashing cement
Presumed Asbestos Materials: joint compound, 9-inch floor tile, sink coating,
linoleum under sink, window glazing compound, caulking at
siding joints,caulking at chimney,and roll roofing
• Non-Asbestos Containing Materials Tested: Linoleum(kitchen)
Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar,
•• hearth stone mortar, stone foundation mortar, mastic to 9-inch
floor tile, caulking at bath wall panels, adhesive to bath wall
panels, carpet adhesive, and vapor barrier to fiberglass
insulation
•
•
Building#18/9:
Presumed Asbestos Materials: Joint compound, 9-inch floor tile, sink coating,
window glazing compound,caulking at siding joints, roll roofing,
and roofinglflashing cement
Non-Asbestos Containing Materials Tested: Vapor barrier behind wood paneling
Page 3
1146 Central Avenue Albany,New York 12205 Phone:(518)453-0146 Fax: (518)453-0175
November2010 Bellewood Park Cottages
Assembly Point
Lake George,New York
Any suspect materials found during demolition/renovation activities that are not listed in this
report should be considered asbestos containing materials until tested and determined otherwise.
General
Asbestos Containing Material
"Asbestos containing materials", as defined by the United States Environmental Protection
Agency (EPA), is any material containing more than 1% asbestos as determined using the
method specified in Appendix E, Subpart E, 40 CFR Part 763, Section 1, Polarized Light
Microscopy. Bulk samples Were collected in accordance with USEPA ASHARA protocols for
number and types of samples. Materials easily crushed or pulverized by hand pressure are
considered friable. Materials:with a bituminous or resinous binder that are not easily crushed or
.. - • - pulverized by hand pressure are.considered.Non-friable Organically Bound (NOB). Friable and
non-friable materials, excluding organically bound materials were analyzed using Polarized Light
•
Microscopy (PLM). Non-Friable Organically Bound samples were analyzed using Transmission
Electron Microscopy (TEM), All samples were analyzed by EMSL Analytical (ELAP 11506:
Manhattan Lab).
Conclusion
The following materials were found to be asbestos containing or presumed to be asbestos
containing materials at the Bellewood Park Cottages located on Assembly Point in Lake George,
New York:
Building#1
11- , Asbestos Material Location Substrate Quantity Friability Condition
Joint compound Throughout Drywall • 3,370 sf Friable Damaged
.44
`.-== Kitchen and Wood 108 Non-friable Damaged
I 17 9-inch floor tile Bath- " Kitchen under Metal 5 sf Non friable Good '
Linoleum :Sink
East Center Carpet 9 sf Non-friable Damaged
Bedroom
•
*. Sink coating Kitchen Sink Metal 8 sf Non-friable Good
' Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged
compound
Exterior at
Caulking at Siding Joints in Wood Wood 4 sf Non friable Good
;J Siding
1 Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimney
Roll roofing,and Roof under
roofing/flashing Metal Wood 1,245 sf Non-friable Good
cement
Building#2
Asbestos Material Location Substrate Quantity Friability Condition
Joint compound Throughout Drywall 3,370 sf Friable Damaged
"' 9-inch floor tile KitcBanttand Wood 108 Non-friable Damaged
Kitchen under
Sink,in and on Metal/Wood 8 sf Non-friable Good
Linoleum Cabinet
East Center Carpet 9 sf • Non-friable Damaged
Bedroom
Sink coating Kitchen Sink Metal 8 sf Non-friable Good
1 Page 5
1146 Central Avenue Albany, New York 12205 Phone:(518)453-0146 Fax:(518)453-0175
_ 1
Bellewood Park Cottages
November 2010 Assembly Point
Lake George,New York
Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged
compound
Exterior at
Caulking at Siding Joints in Wood Wood 4 sf Non-friable Good
Siding
, Caulking at Exterior WoodlBrick 1 sf Non-friableNon-friable Damaged
Chimney
Roll roofing, and Roof under
roofing/•
Wood 1,245 sf Good
cement
Metal
Building#3
•--- Ast Mat - i - - Sutr Qity Fity i
Joint bes compoundos erial ThrLooughoutcaton Drywallbsate 1 uant,290 sf Friableriabil Condit Damagedon
Kitchen and Wood 68 sf Non-friable Damaged
9-inch floor tile -Bath
Linoleum Kitchen under Metal 5 sf Non-friable Good
Sink
} Sink coating Kitchens Steel 16 sf Non-friable Good
•
• Window glazing Exterior Wood/Glass 14 sf Non-friable Damaged
compound
ill
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non friable Good
Sidin•
Roofing/Flashing Roof Roofing 3 sf Non-friable Good
Cement Shingle
Building.#4 ,
Asbestos Material Location Substrate Quantity Friability Condition
Joint compound Throughout Drywall 3,190 sf Friable Damaged
9-inch floor tile Bath Wood 42 sf Non-friable Damaged
i Linoleum Kitchen under Metal 5 sf Non-friable Good
_ : Sink
_,r Sink coating Kitchen Metal 8 sf Non-friable Good
Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged
compound
4 Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
Siding
rt• Caulking at Chimney Exterior Wood/Brick 1 sf Non-friable Damaged
Roll roofing,and Roof under
roofing/flashingnt :Metal Wood 1,160 sf Non-friable Good
Building#5 ition
- •s Material Liocatlon Substrate Quantity Friability
Joint compol •u•hout Drywall 3,360 sf
- . �r-4t,.. .aged
9-inch floor tile • . _ -'on-frI b Damaged
°'. Metal ` 5 sf Non- Good
mmmi
Linoleum in
- rig Kitchen Metal 8 sf Non-friable Good
• Page 6
1146 Central Avenue Albany,New York 12205 Phone: (518)453-0146 Fax: (518)453-0175
i
• r November 2010 Bellewood Park Cottages
• Assembly Point
Lake George,New York
Vtfindow glazing Exterior Wood/Glass 11 sf Non-friabl- Damaged
compound
Exterior at
-. - - Siding Joints in Wood Wood sf Non-friable Good
Siding
Caulking at , • ; -•.!Brick 1 sf Non-friable Damaged
Chimne
Roll roofi • -- • Roof under
r••• • 'ashing Wood 1,310 s •i-ble Good
cement
Metal
•
Building#6
- . .. . . k.. Asbestos Material Location Substrate Quantity Friability Condition
Joint compound Throughout Drywall 3,370'sf - Friable Damaged .. - - -
.:.P, 9-inch floor the Bath Wood 46 sf Non-friable Damaged
Sink
Linoleum Kitchen under
(` Metal 5 sf Non-friable Good
Sink coating Kitchen Metal 5 sf Non-friable Good
Window
= Exterior Wood/Glass 10 sf Non-friable Damaged
caulking/glazing
i/
compound
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
Siding
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimney
°;; Roll roofing,and
s Roof under
_ roofing/flashing Metal Wood 1,225 sf Non-friable Good
cement
•
.•:'11 Building#7
Asbestos Material Location Substrate Quantity Friability Condition
r Joint compound Throughout Drywall 3,380 sf Friable Damaged
-'{1 9-inch floor the Bath Wood 44 sf Non-friable Damaged
/' Kitchen under Metal 5 sf Non-friable Good
Linoleum Sink
Sink coating Kitchen Metal 8 sf Non-friable Good
I'l. Window glazing •
Exterior Wood/Glass 10 sf Non-friable Damaged
1: compound Exterior at
• :13. Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
,•
Siding
:
:.:17:::::1
.'` Q Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
�!y Chimney
Roll roofing,and Roof under
.:1roofing/flashing .Metal Wood 1,225 sf Non-friable Good
;,.i cement
': } Building#/8/9
'{ Asbestos Material Location Substrate Quantity Friability Condition .
h-•
41 Joint compound Throughout Drywall 5,100 sf Friable Damaged
. 9-inch floor tileKitchens and:Baths Wood 202 sf _Non-friable Good
li
Page 7
1146 Central Avenue Albany,New York 12205 Phone: (518)453-0146 Fax: (518)453-0175
r
Beilewood Park Cottages
November 2010 Assembly Point
Lake George,New York
Kitchen under Metal 5 sf Non-friable Good
Linoleum :Sink
Sink coatin• Kitchens Steel 16 sf Non-friable Good
Window glazing Exterior Wood/Glass 12 sf Non-friable Damaged
I compound •1
1 (`i. Caulking at Siding•
JoinExteriorts in W atood Wood 10 sf Non-friable Good
Sidin•
Roll roofing,and
roofing/flashing Roof Wood 1850 sf Non-friable Good
cement
•
- .- Building-#10 Condition
Asbestos Material Location Substrate Quantity
Friability
Joint compound Throughout Drywall 2,640 sf Friable Damaged
Kitchen and Wood 97 sf Non-friable Damaged
9-inch floor tile Bath
Kitchen under Metal 5 sf Non-friable Good
Linoleum Sink
Sink coating Kitchen Metal 8 sf Non-friable Good
Window glazing Exterior Wood/Glass 8 sf Non-friable Damaged
compound
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
;Siding
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimney
Roll roofing,and
roofing/flashing Roof Wood 965sf Non-friable Good
cement
Building#11112 Condition
(Q1\,:.;1,
AsbestosMaterialLocation Substrate Quantity FriabilityJoint compound Throughout Drywall • 5,100 sf Friable Damaged
% 9-inch floor tileKtchens
:Bathsand Wood 202 sf Non-friable Good
Kitchen under Metal 5 sf Non-friable Good
Linoleum : Sink
Sink coating Kitchens Steel 16 sf Non-friable Good
Window glazing Exterior Wood/Glass 12 sf Non-friable Damaged
compound
Exterior at
`^ Caulking at Siding Joints in Wood Wood 10 sf Non-friable Good
Siding
5 Roll roofing,and 'l
roofing/flashing i Roof Wood 1850 sf Non-friable Good
cement .
1 Tennis Court Friability Condition k
Asbestos Material Location I Substrate I Quantity
I None l
•
—
• Page 8
1146 Central'Avenue Albany,New York 12205 Phone: (518)453-0146 Fax:(518)453-0175
1 •
1I •
`----- --.._ _.... _ ._ ------ ---- •- - - — — -------- —
•
Bellewood Park Cottages
r • November2010 Assembly Point
Lake George,New York
Small Outbuilding Condition
Asbestos Material Location Substrate Quantity Friability
Roll-on Roofing
and Roof Wood 25 sq ft Non-friable Good
Roofing/flashing
Cement
Covered Boat Slips
Asbestos Material Location Substrate Quantity Friability Condition
North Slip Wood 312 sq ft Non-friable Good
Flat Roof
Roll-on Roofing South Slip
.. Wood 312 sq ft Non-friable Good
Flat Roof _
According to 12 NYCRR 56, the building owner (or owner's agent) is required to transmit this
asbestos inspection report to any local government permit issuing agency (i.e. building
department)for any demolition,renovation or remodeling.
In addition, if this inspection is for the purposes of demolition, the building owner (or owner's
agent) Is also required to transmit this inspection report to the Asbestos Control Bureau, New
York State Department of Labor.
This inspection report is required to be displayed on site during all related construction work.
Disturbance/Abatement of any asbestos containing materials, as well as air monitoring, must be
performed by a NYS DOL licensed contractor, In accordance with state and federal regulations
(NYS DOL ICR 56 and US EPA 40 CFR).
If Alpine Environmental Services can be of further assistance on this matter,please contact our
office at(518)453-0146.
•
Sincerely,
Alpine Environmental Services,Inc. '
•
Brian Gould
NYS Dept.of Labor Asbestos Inspector
Enclosures: Results, NYSDOL Handling License(s), NYSDOL Handling Certificate(s), NYSDOH
ELAP License(s)
I - Page 9
1146 Central Avenue Albany,New York 12205 Phone:(518)453-0146 Fax (518)453-0175
`A ak=zrw-rx..:k.^.t.S'a.-Z.Va '•E-;Liip'"s..cir.
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' :,'''',: #;i` .ulkyt 4`' ,f) a�'"��• ".ta',,R.k, ',,.'3 :: ,µ:. q' ,, - •r � �i Vic. C ,r
�;. - '.4'i% .�A. �� ^r. ,4 :' ,,� w 1y1t �.,Yjlfir ,__J��`•.. w�,��;,��'_ !c.:-r ��''x.,� A'''% ..-.4:: rA,, :,'F . '4.3—`,y 'e"tis.,:%^,ahl,( �r fir-.% /;i. ..` . } t?.r x 5 �i`s"� :.��.�.,.._"'����."" .r.•: fi:::wct� �. .,�. a.. xl y;..' � � .� '.,r ...;` .� �' kk+ ,,. ".v J_ .T3 c •se isr ai'd onf;,fort 1e contractor na tt' ibaite.andsth'ls' ieense o' `"hon,•.� must`
asbef �! �`��. `y� � �;...__�_.._._. X.ec�` �;1 �� .A .Copy bg;�?'mi tly displaye21,•at.tb.
s proect,wcOslayrfInglitoOse verifies that a•If ereons.emploxed; the'licensee on:at5tnab}est s j' t,ley�v Yq k.
State.li e b.eei s ved'an A. estos Certificate;:app:oprlt}t orilje,thiebo48.,tk-they perform :by.thy ew.Y� ate "-4 . •
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TrTTet
• �;Maureen A.Cox,Director .
SH 432(4-07) FOR THE COMMISSIONER OF LABOR
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DIVISION OF SOLID& HAZARDOUS MATERIALS
Ala PART 364
WASTE TRANSPORTER PERMIT NO. NJ-494
alma
IOW Pursuant to Article 27,Titles 3 and 15 of the Environmental Consorvation Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
JUPITER ENVIRONMENTAL SERVICES, INC. 0 NEW
3 LYNN COURT ■ RENEWAL
LINCOLN PARK, NJ 07035 0 MODIFICATION
CONTACT NAME: ANNABEL PIERCE EFFECTIVE DATE: 08/31/2010
COUNTY: OUT OF STATE EXPIRATION DATE: 08/30/2011
TELEPHONE NO: (973)709-0200 US EPA ID NUMBER:
•
AUTHORIZED WASTE TYPES BY DESTINATION FACILITY:
The Permittee is Authorized to Transport the.Following Waste Type(s)to the Destination Facility listed:
Destination Facility Location Waste Type(s)
Mill Seat SLF Bergen,NY Non-Hazardous Industrial/Commercial
Asbestos ,
Petroleum Contaminated Soil
Sludge from Sewage or Water Supply Treatment Plant
MINERVA ENTERPRISES INC WAYNESBURG,OH Asbestos
Seneca Meadows LF Waterloo,NY Non-Hazardous Industrial/Commercial
Asbestos
NOTE: By acceptance of this permit, the permitteel agrees that the permit is contingent upon strict compliance with
the.Environmental Conservation Law, all applicable regulations, and the General Conditions printed on the back of
this page.
ADDRESS: New York State Department of Environmental Conservation
Division of Solid & Hazardous Materials-Waste Transporter Program
625 Broadway,9th Floor
Albany,NY 12233-7253
// �r, Date: rP / = l ��
AUTHORIZED SIGNATURE: 1=`��7.� �' E
•
1'44,U £`, PAGE 1 OF 2
This permit is not valid ttti ii the
effective date listedo le Permit
I I
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DIVISION OF SOLID &HAZARDOUS MATERIALS
PART 364
Obi/ WASTE TRANSPORTER PERMIT NO. NJ-494
Pursuant to Artide 27,Titles 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
JUPITER ENVIRONMENTAL SERVICES, INC, 0 NEW
3 LYNN COURT • RENEWAL
LINCOLN PARK, NJ 07035 ❑MODIFICATION.
CONTACT NAME: ANNABEL PIERCE EFFECTIVE DATE: 08/31/2010
COUNTY: OUT OF STATE EXPIRATION DATE: 08/30/2011
TELEPHONE NO: (973)709-0200 US EPA ID NUMBER:
AUTHORIZED VEHICLES:
The Permittee is Authorized to Operate the Following Vehicles to Transport Waste:
•
(Vehicles enclosed in<>'s are authorized to haul Residential Raw Sewage and/or Septage only)
13(Thirteen) Permitted Vehicle(s)
NJ TBW61 D
NJ TFX82W
NJ THC73Z
NJ THC74Z •
NJ THC75Z
NJ THD16A
NJ THD26A
NJ THD40C •
NJ THD41C
• NY 13554PB
NY 69111JS
NY 70814JU
NY AV78646
End of List
•
•
PAGE 2 OF 2
TOWN OF QUEENSBURY
Community Development Office
�" � 742 Bay Road, Queensbury, NY 12804-5902
March 25, 2011
Daniel Bell, Vice President
T.J. Bell and Company, Inc.
P.O. Box 800
Valatie, NY 12184
RE: Buildings One, Two, Three, Six, Seven, Eight, Nine, Eleven, and Twelve
Dear Dan:
This letter will reference that I did inspect the cottages located off Lake Parkway in the Town of Queensbury
for demolition.
An inspection of the buildings revealed that several of the buildings are showing signs of structural collapse
and severe damage from water, ice and snow.
As this would put the workers at risk who would be removing roofing materials and flooring materials, it is my
strong suggestion that the buildings be totally demolished, as allowed under the New York State Labor Law,
to avoid any worker injury that could occur during the removal of asbestos.
I trust this will answer all your concerns. If not, please don't hesitate to contact me.
Sincerely,
TOWN OF QUEENSBURY
David Hatin, Director
Building and Code Enforcement
DH/mg
"Home of Natural Beauty ... A Good Place to Live "
Jupitcr
17 Warehouse Row,Albany NY 12205
Tel: (518) 435-0700 Fax: (518)435-0702
4" info@Jupiteres.com
Environmental Services, Inc.
www.jupiteres.com
NOTIFICATION TO OCCUPANTS
ASBESTOS REMOVAL PROJECT
Location: Cottage# 7-Bellewood Park Cottages Bay Parkway, Assembly Point
Asbestos Material: Controlled Demo with ACM in place
Approx. 3,380 sq. ft. of joint compound
Approx. 44 sq. ft. 9x9 tile
Approx. 5 sq. ft. of linoleum
Approx. 8 sq ft sink coating
Approx. 10 sq. ft window glazing
Approx. 3 sq. ft. caulking at siding
Approx. 1 sq. ft. caulking at Chimney
Approx. 1,225 sq. ft. of Roofing Material
Date: 5/ 16/11 —5/31/11
Contractor: Jupiter Environmental Services
License No: 00-1142
Air Monitor: Alpine Environmental Services, Inc
Address: 1146 Central Ave Albany,NY 12205
Laboratory: Alpine Environmental Services, Inc
Address: 1146 Central Ave Albany,NY 12205
12NYCRR56-1,8(e)
• IvIAY/12/2011/THU 01 : 19 AM JUPITER ALBANY FAX No. 5184350702 P.. 001/001
c
L
Juptter 17 Warehouse Row,Albany, NY 12205
Tel:(618)435-0700 Fax: (518)435-0702
Environmental Services, Inc.. info@Juplteres.com
• May 12,2011 www.jupiteres.com
Attention.
• 1) NYS D.O.L.—Jason Pensabene—Sr.Industrial Hygienist—518.485.8054 •
2) Administration office for Emergency dispatch at Warren County Sheriff.—518.7432519
3) North Queensbury Building &Codes Department—Dave Hatin--Director-518.745.4437
4) North Queensbury/Lake George Fire House—Chief Jeff Baertschi—518.656.3008
. . 5)_ .North.Queensbuty_llescue.Squad-518.655.9525
To Whom It May Concern:
My name is Scott Latza and I work for Jupiter Environmental services,Inc..We are a demolition/asbestos
abatement contractor hired by TJ.Bell&company,inc.for the owner John Kelly at 241 Assembly point rd.
Queensbury,NY 12845 to demo the existing Bellewood Park Cottages at the end of Assembly Point road on Bay
Parkway next to Crossover Lane—Honeysuckle Lane.
Dig safely has been called and the Pre demolition Ticket No.is-05091-008-012.The Demolition Ticket No.is—
05091-008-013.Water/Sewer has been contacted and I was informed there is no conflict.i talked with Laura King
on May 8th at 10:55 am.
' The Demolition permits have been submitted to the code and compliance department and have been approved.
The permits Numbers are as follows;P20110191,P20110192,P20110193,P20110194,P20110195,P20110196, •
and P20110197 •
•
We will be mobilizing Monday May 16th 2011 and will be doing some final set up prior commencing the razing of
Cottages;1,2,3,6,7,8/9,and 10/11.We have brought in a 6,000 gal Water tanker for the duration of the
demolition for dust control and wet methods.
•
This will be an active Asbestos Abatement project until further Notice. Please make all
Emergency response personnel aware. •
The onsite contacts are as follows;
Jupiter Environmental Services, Inc. -Project Manager—Scott Latza-Cell,(518)810.2847
Jupiter Environmental Services, Inc. —Site Super.—Shaun Boles-—Cell(518)844.9270
If you have any questions please do not hesitate to contact me
Kind regards,
Scott Latza
•
Jupiter Environmental Services,Inc
518.435.0700 office
518.435.0702 fax
518.810.2847 mobile
scott@jupiteres.com
Ft.
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