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2015-487 TOWN OF QUEENSBURY 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20150487-42377 Date Issued: Tuesday, January 16, 2018 This is to certify that work requested to be done as shown by Permit Number P20150487-42377 has been completed. Tax Map Number: 309.18-1-18.1 Location: 61 TWIN CHANNELS RD Owner: Leland Jarosz Applicant: Leland Jarosz This structure may be occupied as a: By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the lot property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 94411.114 Firm 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 CommunityDevelopment- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150487 Application Number: A20150487 Tax Map No: 523400-309-018-0001-018-001-0000 Permission is hereby granted to: LELAND E. JAROSZ For property located at: 61 TWIN CHANNELS 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 Value Owner Address: LELAND E. JAROSZ Demolition 357 OPALKA Rd FT. JOHNSON,NY 12070-0000 Total Value Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications BP 2015-487 Demolition of Single-Family Dwelling $30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, October 08,2016 (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 To of Q nsb .,/; r J , 3 ctober 08,2015 11, SIGNED BY ! for the Town of Queensbury. Director of Building&Code Enforcement u r � Town of QueensburyBuilding & es--' o' f qs'� only Rece ed DEMOLITION PERMIT APPLICA I OCT 0 8 2015er t J _,„A,,,,,-,-, NO WORK MAY COMMENCE UNTIL PERM! IS ` Perm t Fee T r.l.OF OUEENSBURY BUILDING& CODES Provide 2 plot plans drawn to scale,showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures on property and indicate which are to be demolished. Indicate the location of all utilities Date Jo -- 08 '.- Q.0/5 Demolition Location .1_—Cell / c/ t /ViV F C S Tax Map ID 365", í ? 1"/5" f A-1J, APPLICANT _ LE.6.Rdi.P__g_._ B SS S --__ OWNER 4 E 4.HNll E. Z-I?tt o s—z Address ___ 7__,11'14 /4 _P _ Address _.2... __c2_111f".. EL_RI. --- o 7 LT'c7it N, opt/ /1/.yt ao-.76... _,.Edi-rr_T'a bllvSaN__t41.2 0-70 Phone .!Y__ _./..125.9 Phone -57e 3 -j-O Q CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: b(}j/, Li}tr/it) Phone: /4 L- V'-6 6, 1. Person Responsible for Work 2. Where will demolition material be disposed? ill j .& HO L.J.dui 3. All buildings to be demolished require an Asbestos Survey 4. Any building substantially damaged by fire must obtain an Asbestos Removal Permit from the Department of Labor 5. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begin a) Is there any asbestos in the building to be demolished __ es ____ No b) If Yes,our office needs the following information _17Y_ es ____ No Name of firm removing the asbestos e w 1/0Z / w i&' aW5 cps 4,R i NG� License number of firm Indicate where the asbestos material will be disposed 14 i kA rr\ I#0 ir.o lAJ 6. Structure Information a) Indicate the structure(s)to be demolished __ 'R ! esidence ___ Garage ___ Business ___ Storage Bldg. ___ Other b) Size of Structure 30 X '26 _ c) Number of Stories / 1/ v d) Foundation Type C o Nck E, e 6,.);((repv,c .`,.-I-&YL 4)i�' .10(S-16 e) Foundation is)it jac �o o( ,e, , t* � ,)-1')(� W;it Gac Pr,ct��[� CD'Si rs f) Structure(s) ©m e 57-tAd-(4-L 7. Utilities Information a) Indicate utilities for this structure ___ Gas _ ectric ___ Propane _ ublic Water ___ Public Sewer ___ On-site well water pump a) Have you notified the Town Water Department for public water and sewer disconnect? __ _ Yes ____No b) Have all utilities been disconnected? __&s ____No i o/o i /a c/6- 8. Signature Print Name: ___Z.. ..4....4,01_12__ ___4-7/it iL `z... Date 1d—G 2 -- aa r S Signature: ___44,30.4__6_ ,,_ Date /0 -04i jazczyc Town of Queensbury Building& Codes - Demolition Permit- December 2014 Town of Queensbury Building &Code Enforcement Office No. (518)761-8256 Demolition Inspection Report Inspection request received: 6 19 j x* Name: Inspected on: Location: n C.Vrc-"nek Arrive: a. p. Permit No.: r-,7,> b'}- �ouS e� Inspector's Initials: Comments and/or diagram Y N N/A Gas Shut-off Water Shut-off Electric Disconnected Asbestos Removed/Documentation Property Cleaned Up and Graded Okay to Issue Certificate of Compliance Demolition Inspection_112012 Lehland Jarosz BP 2015-487 61 Twin Channels Road Demolition of SFD r 4.1 . -'G ,v- 777,,,,' _ ^, , '))1 „"l ' T'`' 1 yam' } , ��\ . /y.�j¢ \\:‘...4-4.y, `_ Z.` ttom�' [ `'FAL -'+ a^..... _ fir.. Y ..� < _ .7 a 1 a 'e^ZwT b. 1 s ' sJ� � • ,¢ 1." x... z- ,.. :c {5m Y • _ y -r�Sc n f 77"ti. ' -1,-•,4, `c' 1 h-,e.,-.4, y z,> Ac} ,. v 01 -.' !it -111 :".• .''. a \' , _tc 14 ! T - :nilI l `"�4 T 4�4: .,..„111.4.-..i. R _ - ` • ".:-" w - ., , ': "� A •E �a TP�0 �i ,., M BSc•.Ir a .a� , , .-,,a .., ';IV ,c,-{,ce, 3, I t •'Ti7 .a--.,-t,•:-.—yr ,... }..:i�• .-1 i < x'W '''' 4 a f .. e s •.-4 • _ - , _Y . e ,fit-tot. .•s``t. ..: # -' ''' .-a , , . , • � Yse�C..t, ':' :.uek. A ..-:i..u•+T.'a BUILDING & C% : BIS-I'. 1 Twin Channels Road Reviewed By: -'� 6 Date: o,5�c House scheduled to be demolished during the week of October 12, 2015 by Fred Smith. The concrete foundation will remain through the winter season year 2015—2016. Spring Year 2016 the foundation will be removed. Mr.Jarosz will be applying for Planning Board and Zoning Board approvals in the future;to rebuild. Mr.Jarsoz will contact the Town of Queensbury Water Dept.on Friday, October 9, 2015 to turn water off. Electrical is off -by National Grid. /,dli/3 TOWN OF QUEENSBURY BUILDING DEPARTMENT 4 r'��� Based on our limited examination,compliance FILE CiO PY with our comments shall not be construed as indicating the plans and specifications are In /d f Pi.S full compliance with the Building Codes of New York State. l W 1 f06/ad13.• G f %w IAl ctMM�J> s s�n f•Rdfgi y OP /$ /�� µ L 3 0 9rt lg —/ —1F, C .< t TOWN OF fUEEIS�= RV 1+dgS,I 'Td t "p mo4..15 av BUILDING&CODES :a il 1 k4NDS 0 4 c;<" ' 1-'0,f/ " ._ -</iiii:( P.,9 L"Ni tfo u5 , itgiA6K 4.4 30 r i . 1 a q 1 i 1 Alpine Environmental Services, Inc:ifer 438 New Karner Road LALBANY, NY 12205 US (518) 250-4047 �� 0 8 20151IIç1( ie 1 Info@AlpineEnv.com www.AlpineEnv.com TOWN OF QUEENSBURY ENVIRONMENTAL SERVICES BUILDING&CODES BILL TO Leland Jarosz 61 Twin Channels Road Queensbury, NY 12804 INVOICE# DATE TOTAL DU: DUE DATE TERMS ENCLOSED 15-17977-A 09/30/2015 $0.00 10/30/2015 Net 30 ACTIVITY QTY RATE AMOUNT Asbestos Inspection (Paid in full Check#1214) 1 1,900.00 1,900.00 Project Location: PAYMENT 1,900.00 BALANCE DUE $0.00 Thank you for your business. Visa, MasterCard, AMEX, and Discover accepted. At the discretion of Alpine Environmental, all overdue invoices are subject to collection, court costs, and interest (1.5% per month). nipirae ENVIRONMENTAL SERVICES REPORT OF ASBESTOS INSPECTION r11014 , i u • Location of Inspection: 61 Twin Channels Road Queensbury, NY Building Owner: Leland E. Jarosz Alpine Project#: 15-17977-A Material or Area Inspected: Entire Building Asbestos Material Tested or Assumed: Window Glazing Non-Asbestos Containing Materials Tested: Texture Coating, Joint Compound, Drywall, 12"x12" Ceiling Tiles, Ceiling Tile Adhesive, Floor Mastic, Electric Wire(Cloth),Exterior Wall Vapor Barrier, Roof Vapor Barrier,Asphalt Shingles Date of Inspection: September 25, 2015 Inspection Performed By: Alpine Environmental Services, Inc. 438 New Karner Road Albany, New York 12205 Phone (518)250-4047 Inspector(s): Benjamin Natale NYS Department of Labor Certified Asbestos Inspector September 2015 61 Twin Channels Road,Queensbury,NY 1.0 Asbestos Inspection: 1.1 Scope and Purpose This report is intended to document the pre-demolition asbestos inspection of the of the house located at 61 Twin Channels Road, Queensbury, New York. "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). 1.2 Description The building dimensions are approximately 20'x30'. The structure was erected half on grade and the other half is an unfinished basement. The building was two stories,framed of wood. No pipe insulation was observed. Piping consisted of steel and PVC. A hole was dug at the exterior foundation reveling no vapor barrier was present. An exterior vapor barrier was observed between cedar shakes and wood framing. The roof was constructed of asphalt shingles and a single vapor barrier. Interior walls were composed of drywall and joint compound. Electrical wires including metal clad, vinyl, and cloth sheathed were all observed. Exterior window glazing was found to be present. No window caulking was observed. 1.3 Limitation There were no limitations at the time of inspection. 1.4 Results of Inspection Bulk samples were collected throughout the interior and exterior of the building. Samples were collected as prescribed by US EPA ASHARA protocols for the numbers and types of samples. See the sample results section for all samples collected and the results of analysis. 1.5 Conclusion and Recommendations The following asbestos containing materials were found at 61 Twin Channels Road: Table 1: Asbestos Containing Materials Tested or Assumed: Homogeneous Location Substrate& Approx. Friability Condition Material Accessibility Quantity Window Glazing 11 5F (02 01) Exterior Wood —22 Non-Friable Good Windows Please note these quantities are only estimates and the user should field verify all quantities. Page 2 438 New Karner Road Albany,New York 12205 Phone:(518)250-4047 September 2015 61 Twin Channels Road,Queensbury,NY The following materials were sampled by Alpine Environmental Services and determined not to contain asbestos: Table 2: Non-Asbestos Containing Materials Tested: Non-Asbestos Locations Sample#'s Material Texture Coating Second Floor 06-01,06-02,06-03 Joint Compound Throughout Interior 07-01,07-02 Drywall Throughout Interior 08-01,08-02 Electric wire(Cloth) Throughout Interior 09-01,09-02 12 inch Ceiling Tiles Throughout Interior 03-01, 03-02 Ceiling Tile Adhesive Throughout Interior 04-01, 04-01 floor mastic First Floor 05-01, 05-02 Vapor Barrier Exterior Walls 10-02 Vapor Barrier Roof 10-01 Asphalt Shingles Roof 01-01, 01-02 Any materials not sampled during this inspection should be considered suspect unless sampled and determined to be non-asbestos. All asbestos containing materials must be abated prior to the demolition/renovation of any part of the structure unless performed under a variance issued by the NYS Department of Labor. Disturbance/Abatement of any asbestos containing materials, as well as necessary 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)250-4047. Sincerely, Alpine Environmental Services,Inc. Benjamin Natale, NYS Dept.of Labor Asbestos Inspector Enclosures: Results, NYSDOL Handling License(s), NYSDOL Handling Certificate(s), NYSDOH ELAP License(s) Page 3 438 New Karner Road Albany,New York 12205 Phone:(518)250-4047