2011-197 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110197 Date Issued: Friday, February 08, 2013
This is to certify that work requested to be done as shown by Permit Number P20110197
has been completed.
Tax Map Number: 523400-226-019-0003-013-000-0000
Location: HONEYSUCKLE Ln
Owner: JOHN E KELLY III
Applicant: JOHN E KELLY III
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the,responsibility for compliance with Site Plan, Vv
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 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110197 Application Number: A20110197
Tax Map No: 523400-226-019-0003-013-000-0000
Permission is hereby granted to: JOHN E KELLY III
For property located at. . HONEYSUCKLE Ln
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. Tvne of Construction Value
Owner Address: JOHN E KELLY III
HELEN-JO R KELLY Demolition
75 MOUNTAIN CREEK Rd Total Value
POUGHQUAG,NY 12570-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-197
demolition of cottage 10/11
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,May 12,2012
(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 Queens ur;' �Th sda ,May 12,2011
SIGNED BY r 1 for the Town of Queensbury.
Director of Building&Code Enforcement
✓ F';Z
��'!� IE USE ONLY ____________ _cc
OFFIC % D. - -�- _�-
TAX MAP NO. PERMIT NO. FEE PAID
Permission is hereby granted to the above named Applicant to demolish the building(s) MAY 0 9 2011
- described herein as set forth in the Application below. ,
Director of Building&Codes Date ' T BUILDI O&CODES
_-------------___________---------_-----------__--------------___ __________
APPLICATION FOR DEMOLITION PERMIT:
Fill in applicable spaces and submit two(2) plot plans, drawn to scale,showing lot boundaries with
dimensions and adjacent roads/streets. Show all existing structures on the property and indicate which
are to be demolished. Indicate on the
-plot plan the location of all utilities. J
APPLICANT/BUILDER: °'p,L L11�U (t�Nal�nJfFl� �',1',,;OWNER:
ADDRESS: 1'7 -1) " �b..'.1 J/ ;'. ./2W,• ADDRESS: 4D an,
PHONE NOS. . )- Cd J4q,7-67cry PHONE: --I
PERSON RESPONSIBLE FOR WORK: y. , ,. PHONE:
LOCATION OF DEMOLITION: '
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? 3 w,i.1��-,nr����
ASBESTOS INFORMATION: Cl ='
✓ Is there any asbestos within e b ilding to be demolished? YES NO
✓ If YES, our office needs the following information:
o Name of firm removing the asbestos:
o License number of firm:o Indicate where the asbestos material will be disposed: .JC)yG-c Scr-1 P4tij
� E,`j!
NOTE: A copy of Asbestos Removal Report must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s)will be demolished: RESIDENCE GARAGE BUSINESS
STORAGE BLDG. OTHER"&A �S
✓ Size of structure: X r,Z�IS� U
✓ Number of stories:
✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED (/
✓ StructureS(s): WILL BE REPLACED WILL NOT BE REPLACED
UTILITIES INFORMATION:
✓ Indicate utilities for this Structure: GAS ELECTRIC PROPANE PUBLIC WATER
ONSITE WELL-WATER PUMP PUBLIC SEWER
KiN�•
Have you notified the Town Water Dept.for public water and public sewer disconnect? YES NO
Have all utilitie been isconnected: YES NO
o QUESTIONS? CALL 761-8256 OR EMAIL
codes(a)gueensbury.net
IGN TURF OF APPLICANT VISIT OUR WEBSITE FOR MORE INFORMATION
www.gueensbury.net
Tozmi of Queensbury - Conmuniity Developnien.t Office • 742 Bay Road, &eenski.ry, NY 12804
Framing / Firestopping_Inspection Report
Office No. (518)761-8256 Date Ins n requ i ed:
Queensbury Building &Code Enforcement Arrive: GY7 a m part: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: 4
NAME: --V 1 _\4 ERMIT t -19-
LOCATION: tJ- INSPECT ON: -
TYPE OF STRUCTURE: Ct)=JL 1 O I t 1
Framing Y N NIA COMMENTS:
Attic Access 22" x 30" minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers �vi tit`l�� opLt�
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C. .
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 V2 w 16 gauge 8 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side h inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceilingfwall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
LABuilding&Codes Forma-OLDrBuildim&CodesMnspection FcmisWreming Firestopping Inspection ReporLdoc Revised January 7,2008
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1 Asbestos Project Notification
Project Reference Number: 25844600 Type: Amended Notification
Status: Notification Received Notification Received: 4/28/2011
Payment Status: Paid in full Number of amendments: 1
Notification Entered By: Jupiter
Environmental
Services, Inc.
Contractor Information
FEI N: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: 5/16/2011
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:
Pro"ect Location 10A
Building Name: Gotta '
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:
41 Building Information
Current Use: Other
Prior Use: Other
Approximate Year Built: 1940
Size(sq.ft): 1850
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:
Ni ht/Weekend/Shift Work Details
Mon.thru Saturday 07:00 to 17:00 controlled demo of cottages with ACM in place
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: Oueensbury
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 method of a controlled demo of existing cottages. Cat 330 excavator/PC
130 excavator and lined trailers.
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:
q
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: 5100
Non-friable linear feet: 0 Non-friable square feet: 2100
Fee
Total linear feet: 0.0
Total square feet: 7200.0
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#
�. TYPE OF NOTIFICATION (O=Original R= Revised C=Canceled): O
��. 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-L-ynn-Court- --.. ---- -- ----....._,_..._.. ------ -- - --
City: Lincoln Park State: NJ Zip: 07035
Contact: Pane Repic Tel: 973-709-0200
OTHER OPERATOR:
Address:
City: State: Zip:
Contact: Tel:
TYPE OF OPERATION (D=Demo, O=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 1, 2, 3, 6, 7, 8/9, 10/11
Address: Bellewood Park Cottages
i City: Lake George State: NY County: Warren
Site Location: Cottage 10/11
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 11 UNIT
3. Category Caiegory 11 ACM not removed
LnFt: Ln m:
Pipes
Surface Area Joint SgFt:5,100 Sq m:
compound.
Vol RACM Off Facility Compound CuFt: Cu m:
Vlll. SCHEDULED DATES ASBESTOS REMOVAL (mm/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
6� •
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
XII. WASTE TRANSPORTER#1
Name: Jupiter Environmental Services, Inc.
Address: 17 Warehouse Row
City: Albany State: NY Zip: 12205
---- _.-Contact Person:---Scott ---
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
i
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 ACCOMP SHED BY THIS PERSON WILL BE AVAILABLE FOR
INSPECTION DURING NORMAL BUSINESS URS. (Require -1 year after promulgation)
hiA'
Si a ure of Owner/Operator Date
XVIII.I CERTIFY THAT THE ABOVE INFORMATION IS R .
�:
(Signature f Owner/Operator) ate)
JES N141 (1/99) page 2 of 2
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I
Bellawood Park Cottages
November 2010 Assembly Point
Lake George,New York
Non-Asbestos Containing Materials Tested: Roofing shingles
Small Outbuilding:
Asbestos Material Found: Roll roofing and roofing/flashing 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, 94nch 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)453-0145 Fax: (518)453-0175
Bellewood Park Cottages
November 2010 Assembly-Point
Lake George,New York
i
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 the
Presumed Non-Asbsstos 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 roofingiflashing 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: Roofinglflashing cement
Presumed Asbestos Materials: joint compound, 94nch floor tile, sink coating,
linoleum under sink, window glazing compound, caulking at
i 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#819:
Presumed Asbestos Materials: Joint compound, 94nch floor tile, sink coating,
window glazing compound,caulking at siding joints, roll roofing,
and roofing/flashing 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
. o
Bellewood Park Cottages
November 2010 Assembly Point
Lake George,New York
Any suspect materials found during demolitionlrenovat on 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. Sulk.samples Were collected in accordance with USEPA ASI-IARA 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 an
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)i All samples were analyzed by EMSL Analytical (FLAP 11506:
Manhattan Lab).
Conclusion
The following materials were found to be asbestos containing or presumed to be asbestos
containing materials at the gellewood Park Cottages located on Assembly Point in Lake George,
New York:
Building#1
t. Asbestos Material Location Substrate Quan Frlablli Condition
Joint com ound Thiou hout D all 3,370 sf Friable Dame, ed
Kitchen and Wood 108 Non-friable Damaged
y..' 9-inch floor file :Bath
Kitchen under Metal 5 sf Non friable Good
Sink
Linoleum East Center
Bedroom Carpet 9 sf Non-friable Damaged
Sink co tin Kitchen Sink Metal 8 sf Non-friable Good
Window glazing Exterior WoodlGlass 10 sf Non-friable Damaged
compound
Exterior at
Caulking at Siding Joints in Wood Wood 4 sf Non friable Good
Sidin
Caulking at Chimne Exterior WoodlBrick 1 sf Non-friable Damaged
Roll roofing,and Roof under
-' roofing/flashing Metal Wood 1,245 sf Non-friable Good
cement
Building#2
Asbestos Material Location Substrate Quant Friabil" Condition
Joint com ound THrou hout D all 3,370 sf Friable Dama ed
9-inch floor file Kltchen and Wood 108 Non-friable Damaged
Bath
Kitchen under
Sink,in and on MetallWood 8 sf Non-f fable Good
Linoleum Cabinet
East Center Carpet 9 sf Non-friable Damaged
Bedroom
Sink coatin Kitchen Sink Metal 8 sf Non-friable Good
Page 5
1146 Central Avenue Albany, New York 12205 Phone_(518)453-0146 Fax:(518)453-0175
1
Bellewood Pads cottages
November2010 Assembly Point
Lake George,New York
Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged
com ound
1=Xterior at
Caulking at Siding Joints in Wood Wood 4 sf Non-friable Good
Sidin
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimne
Roll roofing, and Roof under Wood 1,245 sf Non-friable Good
roofingiflashing :Metal
cement
Buildin #3 Frlabili Condition
Asbestos Material -- Location -Substrate. " Quan t
compound
Thtou hout D all 1,290 sf Friable Dama ed
Nltchen and Wood 68 sf Non-friable Damaged
9-inch floor file :Bath
Kitchen under Metal 5 sf Non-friable Good
Linoleum Sink
^x Sink coatin Kitchens Steel 16 sf Non-friable Good
-7 Window glazing Exterior Wood/Glass 14 sf Non-friable Damaged "
com ound
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non friable Good
Sidin
Roofing/Flashing Roof Roofing . 3 sf Non-friabie Good
Cement Shin le
_ Buildin 44
Asbestos Material Loocation Substrate Quanti FFriable Dama ed
li Condition
Joint com ound THrou hout D all 3,190 sf Fria
9-inch floor file • Bath Wood 42 sf Non-friable Dama ed
Kitchen under Metal 5 sf Non-friable Good
Linoleum : Sink
r Sink coatin Kitchen Metal 8 sf Non-friable Good
Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged
com ound
4 Exterior at
`F Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
-Sidin
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimne
Roll roofing,and Roof under
roofingiflashing Metal Wood" 1,160 sf Non-friable Good
1 cement
Buildin #5
Asbestos Material Location Substrate Quanti Friabiii Condition
Joint com ound Tlirou hout. D all 3,360 sf Friable Damaged
Kitchen and Wood 96 sf Non friable Damaged
9-inch floor file . Bath
Linoleum Kitchen under Metal 5 sf Non-friable Good
:_ Sink
Sink coatin Kitchen I Metal 6 sfI Non-friable Good
:J
Page 6
1146 Central Avenue Albany,New York 12205 Phone: (518)453-0146 Fax: (518)453-0175
Bellewood Paris Cottages
November 2010 Assembly Point
Lake George,New York
Window glazing Exterior Wood/Glass 11 sfi Non-friable Damaged
com ound
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
Sidin
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimne
Roil roofing,and Roof under
roofing/flashing Metal Wood 1,310 sf Non-triable Good
cement
Buildin #6
.. Asbestos.Material Location Substrate Quanti Friabil Condition
Joint com ound Throu hout D all 3,370 sf Friable Dama ed
f 9-inch floor file :.Bath Wood 46 sf, Non-friable Dama ed
Linoleum Kitchen under Metal 5 sf Non-friable Good
Sink
Sink coatin fGtchen Metal 5 sf Non-friable Good
Window
_ caulking/glazing Exterior Wood/Glass 10 sf Non-friable Damaged
com ound
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non friable Good
;Sldin
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged
Chimne
Roll roofing,and
.�; Roof under Wood 1,225 sf Non-friable Good
roofingiflashing Metal
Buildin #7
i Asbestos Material Location Substrate Quanti Friabili Condition
" Joint com ound Throu hout D all 3,380 sf Friable Damaged
!,
9-inch floor file Bath Wood 1 44 sf Non-friable Dama ad
Kitchen under Metal 5 sf Non-friable Good
Linoleum Sink
Sink coatin Kitchen Metal 8 sf Non-friable Good
Window glazing Exterior WoodlGlass 10 sf Non-friable Damaged
com ound
Exterior at
n� Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good
Sidin
Caulking at
erior Wood
Chimne
sf Non-friable Damaged
Roll roofing,and Roof under
roofing/flashing Metal Wood 1,225 sf Non-friable Good
I cement
1 Buildin #819
Asbestos Material Location Substrate Qua nti Friabili Condition
r..
!j Joint Compound Ttirou hout D all 5,100 sf Friable Dama ed
9-inch�fl7orfile Kitchens and Wood 202 sf Nonfriable Goo:Baths
Page 7
_I 146 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
_- Kitchen under Metal 5 sf Non-friable Good
Linoleum :Sink
j Sink coatin
Kitchens Steel 16 sf Non-friable Good
Window glazing Exterior Wood/Glass 12 sf Non-friable Damaged
corn ound
t:. Exterior at 10 sf Non4dable Good
Caulking at Siding Joints in Wood Wood
Sidin
Roll roofing,and Roof Wood 1850 sf Non-friable Good
roofingiflashing
cement
i
13uildin #10
trr
Asbestos Material Location SD s alle Q2 640 sf FFriable Damabed
Joint compound Throu hoot
Kitchen and Wood 97 sf Non-friable Damaged
9-inch floor file •Bath
Kitchen under Metal 5 sf Non-friable Good
Linoleum ;Sink
Sink coatis iratchen Metal 8 sf Non-friable Good
Window glazing Exterior Wood/Glass 8 sf Non-friable Damaged
com ound
Exterior at
Caulking at Siding Joints in Wood Wood 3 sf Non friable Good
;Sidin
Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged j
Chimne :
_ Roll roofing,and
roofing/flashing Roof Wood 965sf Non-friable Good
cement
Buildin #11112
r Asbestos Material Location Substrate Quanti Friabili Condition
Joint corn ound Thlrou hout D all 5,100 sf Friable Dama ed i
` 1 Kitchens and Wood 202 sf Non-friable Good
A 9-inch floor the :Baths
t' Good
Kitchen under Non-
Metal 5 sf liable
1. Linoleum Sink
Sink coatis Kitchens Steel 16 sf Non-friable Good
Window glazing Exterior Wood/Glass 12 sf Non-friable Damaged 1
com ound
Exterior at
Caulking at Siding Joints in Wood Wood 10 sf Non-friable Good
Sidin
Roll roofing,and roofing/flashin Roof Wood 1850 sf Non-friable Good
g ;
cement
Tennis Court
Asbestos Material Location Substrate Quan i Friabili Condition `
None
—` Page 8
i 1146 Central'Avenue Albany,New York 12205 Phone:(518)453-0146 Fax: (518)453-0175
Bellewood Park Cottages
November Assembly Point
r
Lake George.New York
Small Qutbulldin
Asbestos Material Location Substrate Quanti Friabil Condition
Roll-on Roofing
and Roof Wood 25 sq ft Non-friable Good
Roofingfflashing
Cement
Covered Boat Sli s I
Asbestos MaterialrN
tion Substrate Qua n ' Friabil' Condition
Slip Wood 312 sq ft Non-friable Good
Roof
Roll-on Roofing SlipWood 312 sq ft Non-friable Good
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, NYSD.OL Handling License(s), NYSDOL Handling Certificate(s), NYSDOH
ELAP License(s)
Page 9
1146 Central Avenue Albany,New York 12205 Phone: (518)453-0146 Fax:(618)463-0175
�NW Y,6.kWSTATE ':e, ARTI I►EN i QB L" F O,R
DIVISION OF A ETYANDrtHEF�L'rl �f# r
LICENSE'ARy C8�2�'t;fiIC1��I I NITr' 4, "n
STATE CAMPUS 6 IL LNG 12 4 rz*l,tf2. 7xa
pr AFL A �Yrz 12240
P� SBESTOS HANDLING E.ICEI S ,v s -AINIT
kW
Jupiter Fnirironrpental Servlc 5r l;ne , f , t" � ;FILE NUMBER :001,14
. 4 � iCENSE' UMBER ° i
C N ' 54<3
3 Lyimrit'otrt � ��1�` LICENSE CLASS FU +,..
! < 5 .f'(? '
_ DATE 0F�ISSUE: 02/1,7��t 1
7
Llncgln larTt1 070 ° � ;`'`r` G EXPIRATICSt ,DATE .02/2�/ ?OrL 't
¢¢ , ,..
�,`,,"wv +,� .� s I. i rA --� ' y.r n� I s • + .'!tlgx �2`r•tiih
n
�c a5 3t }
i L AW Y"4 F: rntM•Y< Mcaai�.i\d" :,7,� \ i °` .N�`+cr' �'� .C
Z�.?yYtf" 3 t 4 S _ •t ttat I'y l�,'$(7" v,2 S."£.i.��i 1• R ,} ..:! !) �. �.S Cf ... C.
in
t3771.
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s s� � • ,•r,ii t ,G2 -`c °ter.i 1V •'1�1 7�rj 1 v,.J`= `# t '� �u
-..; 4�1.:ilt• ,':'•�`.I'`�E f;
s •,�}iar afr � k.
ti,. 0 !� t l �k` `uT x l,lr4!)t �'f r��Ga u.fw f, aa aa�1 t ! .-. t gY. ..
' h>s tc^as �h t�rep issued m ac. o, nc$Iuithiclilziclvis�b�i of=E � ,offh�L or Law of Neworklate a d.o .
w 3
Nei Ygxlzi�Stato,Codes Rules��i�n'r.,"�dtRegulat�d 1�N` �'RR Pait`:51G) l s�s i'�ect to su4 , nsion or revocation Aor a(1):i'
�*•,. u,y.44'x 4 L -� V $�dl' , �, fi a.:: i•W': .ft', fl I
sek�ioit>v�o at�an otate,fe.ieral". t� val lamst tJ�e c itd c{v,a}}{p1es'to prodor(2)democateko }
r �rFs*bti t ���th nduct of an valvin s1— .. " or asb & t aa1 �,' bW
y u = s'ri` t�°ar Yrti r? h j x� tr
10 ti" ..',.y `4' ���{{��T '4(.r •y)".: `.. .. �
This#hcv' s IC�aa oilyifar tie contractor nad�[ Vie andithi�liense o` aphofb&onysnust b ..
tnI tl des la ® a
asb.E q,, fro ecty��+ % ,si 1� Chi e i�se verifies that alTf er�ans mployed Fi.'thedicer see on ati stiest rod i,Nervy Ya k.
Stag 1lka�e l eer, a Iced an A;,f�estos,Certificate,appropt tat of let ie o they Pei form;by th ew 1'q k ate;
Depariviopt of Ttb�r ;�a
7- A�
Pk—
�c ' �a��Gr. _ tiJ`� .e' s �� •�
!N wt
°ram o-ct Fri �i ,' :s
S`a
i kf s 5
'd SA 1-`�:s'
x
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
PART 364
WASTE:TRANSPORTER PERMIT NO. N-44%4
Pursuant to Article 27,Titles 3 and 15 of the Environmental consieriatioh Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
JUPITER ENVIRONMENTAL SERVICES, INC, El NEW
3 LYNN COURT E RENEWAL
LINCOLN PARK., NJ 07035 El MODIFICATION
CONTACT NAME: ANNABEL PIERCE EFFECTIVE DATE: 08/3112010
COUNTY: OUT OF STATE EXPIRATION DATE: 0813012011
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 Types)
Mill Seat SLF Bergen NY Non-Hazardous industrial/Commercial
-Asbestos
Petroleum Contaminated Soil
Sludge,ft9m 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 permittee agrees that the permit
t 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 Envir6nmental Conservation
Division of Solid &.Hazardous Materials-Waste Transporter Program
625 Broadway, 9th Floor
Albany,NY 12,233-7253
AUTHORIZED SIGNATURE: ' (° rif +�f Gate: ! l ? fL
PAGE I OF 2
NOTICE
This Permit is not valid until the
efff,'CtiVe date'listed on the permit
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DIVISION OF SOLID & HAZARDOUS MATERIALS
_ PART 364
WASTE TRANSPORTER PERMIT NO. NJ.-494
Pursuant to Artide 27,Tities 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
JUPITER ENVIRONMENTAL SERVICES, INC. ❑ 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: 08/3012011
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
NJTHC74Z
NJ THC75Z
NJ THD16A
NJ THD26A
NJTHD40C
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 "
MAY/12/2011/THU 01 : 19 AM JUPITER ALBANY FAX No. 5184350702 P/. 001//001
inpiteir
17 Warehouse Row,Albany, NY 12205
Tel:(6-18)435-0700 Fax: (518)435-0702
Environmental Services, Inc. info@Juplteres.com
May 12,2011 www.jupiteres.com
Attention;
1) NYSD.O.L.—Jason'Pensabene—Sr.Industrial Hygienist-518.485,8054
2) Administration office for Emergency dispatch at Warren County Sheriff.—518.743.2519
3) North Queensbury Building&Codes Department -Dave Hatin—Director-518.745.4437
4) North Queensbury/Lake George Fire House—Chief Jeff Baertschi—618.656.3008
5)_ .North.Queensbury_Rescue.Squad i.-51.8..65.6.952.5
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 T.J.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 1auta king
on May EP 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,PZ0110192,P20110193,P20110194,P20110195,:P20110196,
and P20110197
We will be mobilizing Monday May le 2011 and will be doing some final set up prior commencing the razing of
Cottages;i,2,3,6,7,8/%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 on.active Asbestos Abatement project until further Notice.Please make all
Emergency response personnel aware. r
The onsite contacts are as follows;
Jupiter Environmental Services, Inc. =Project Mapager—Scott Latza-CeU(518)810.2847
Jupiter Environmental Services, Inc. —Site Super..—Shaun Doles-—Cell(518)844.9270
If you have any questions please do not hesitate to contact me
Kind regards,
Scott Latza
Jupiter Environmental Services,tnc-
518.435.0700 office
518.435.0702 fax
518.810.2847 mobile
scott@jupiteres.com
Jupiter 17 Warehouse Row,Albany NY 12205
Tel: (518) 435-0700 Fax: (518)435-0702
Environmental Services, Inc. info@Jupiteres.com
www.jupiteres.com
NOTIFICATION TO OCCUPANTS
ASBESTOS REMOVAL PROJECT
Location: Cottage# 11/12 -Bellewood Park Cottages Bay Parkway, Assembly Point
Asbestos Material: Controlled Demo with ACM in place
Approx. 5,100 sq.ft. of joint compound
Approx. 202 sq. ft. 9x9 tile
Approx. 5 sq. ft. of linoleum
Approx. 16 sq ft sink coating
Approx. 12 sq. ft window glazing
Approx. 10 sq. ft. caulking at siding
Approx. 0 sq. ft. caulking at Chimney
Approx. 1,850 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)