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BOTH-000227-2016 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: BOTH-000227-2016 Date Issued: Monday, April 24, 2017 This is to certify that work requested to be done as shown by Permit Number BOTH-000227-2016 has been completed. Tax Map Number: 308.6-1-58 Location: 39 WARREN LN Owner: ROBERT PARIS Applicant: ROBERT PARIS This structure may be occupied as a: Demo of 800 s.f. SFD due to fire Asbestos report recevied and attached to documents 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, 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. sm,wrno^nr, � TOWN OF QUEEN SBUR.Y 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 x Cotnt-nunity Development - Building & Godes (518) 761-82.56 BUILDING PERMIT Permit Number: BOTH-000227-20116 Tax Map No: 308.6-1-58 permission is hereby granted to: ROBERT PARIS For property located at: 39 WARREN 1 N 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 Tyrie of Construction Owner Name: ROBERT PARIS Demolition $0.00 Owner Address: 39 Warren 1:N Total"Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans& Specifications Demo of 800 s.f. SFD due to fire $ 30.00 PERMITFEE PAID -'THIS 13ERlV IT EXPIRES: Sunday,April 16, 2017 (Ifa 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 n:sbury, Tlr to April 21, 2016 SIGNED BY: for the Town of Queensbury. V, 114 Director of Building&Code Enforcement Town of Queensbury Building & Codes office use qnly Received DEMOLITION PERMIT APPLICATION Permit NO WORK MAY COMMENCE Imm I INTIL ISE Permit Fee _ _— a a �Co- RMIT I ISSUED Provide 2 plat pians 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 .w, y Crate _— _—__ ___ Demolition Location Tax Map ID "® fr ----- APPLICANT f -Coy-L5---=---�--------- OWNER — �—�.�_--____ _---------___ Address — ------ Address i7 — Phone Phone J �� _ _—_------- ✓ � ---__— __ CONTACT PERSON FOR BUILDING CODES COMPLIANCE: _____________ Phone' 1. Person Responsible for work . 2. Where will demolition material be disposed? a(' e' ).. � . r o n 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 De artment of Labor S. Asbestos Information: The Asbestos Removal Report must be filed with our offic,q before demolition begin a) Is there any asbestos In the building to be demolished —___ Yes __No b) if Yes,our office needs the following Information ____ Yes ___—No Name of firm removing the asbestos License number of firm Indicate where the asbestos material will be disposedAPR 0 2016 6. Structure Information a) Indicate the structure(s)to be demolished _ Residence Gajjq` qI g� �y II -- Storage Bldg. _rvOt ec �"I 6i 1 � i smoi° b) Size of Structure c) Number of Stories d) Foundation Type e) Foundation X r o f) StructureV Structure(s) a c - , 5k65 7. Utilities Information a) Indicate utilities for this structure --- Gas _. Electric __ Propane ___ Public Water Public 'Sewer On-site well water pump a) Have you notified the Town water Depart nt for public water and sewer disconnect? _—_— Yes ____No b) Have all utilities been disconnected? —_ Yes ____ No 8. Signature Print Name: % ? _ _ ------_,_---------------- Date I J_L Signature: .' - - ----- ----------- Date —__— Town of Queensbury Building& Codes- Demolition Permit - December 2014 . � .0 ; 308.6-1-58 BOTH'-0!00227-2016 C 39 Warren Dane � 20 1Paris, Robert . �o Demo of 899 s.f. dare f© fire f s � hI-DI _..�W°*IIIA'OWW nw p n wnw i 1 i UIL e Ri , " _ Mte �m ' 0 — — • • ww�. w. w.w __m r Lj M i R m �m � a , MICHAEL J.STEVENS Licensed,Certified NYS Abestos, Material Inspector � RO. Box 2202. Glens.Fails,New York 12801 (5 t 8)656-3270 p� 0(0 a � fl`pa � � 2016 �Uf l c l "i pr .: IN2i c c l: To Whom It May Concern, Please be advised that II have inspected the property on the date indicated on the enclosed report and taken random samples as required. I have sent the samples to a New York State approved laboratory for testing. Based upon my Inspection combined with the laboratory test results for the samples taken from the subject prop- erty,there were no asbestos containing materials(ACM's),found on the subject property or identified In the sam- ples tested by the laboratory. Accordingly, it Is my understanding than subject to any and ail applicable states or locals and regulations at the time of the enclosed test report,the properly owner may proceed with remodeling or demolition as the owner sees fit. Thank you, Michael J. Stevens License Number:72900 MJS keg Enc. Please Reply To: Ameditl New York AMEm Sci 117 Esores NEW YORKK,,NY 1001616 TEL:(212)679.8800-FAX(212)67"114 FACSIMILE TELECOPY TRANSMISSION To: Michael Stevens From: Marik Paysakhov Michael J.Stevens AmerlSci Job#: 216041361 Fax#: Subject: EAP-PL,MMEM 5 day Results Clknt Project: 39; 39 Wanva UL,Queensbury, NY Email: mikesoldems@gmail.com Date: Friday,April 08,2016 Number of Pages: Time: 18:58:37 (Including cover shed) Comments: CONFIDENTIMM Nt WEL Untess ogwwise indicted,the infam ation contained In this communication Is ownfidadiat f nutation it ended for use of tic individual named above. If the reader of this communication b not the intanded rocipimt,you ares haft notified that any dissanination, disuftdem or copying of this communication b p rohibitc& If you have foccived this communication in error,please immediately no*dhe satda by t lcpleac and roma the odgind messa®o to the above aeldtm via the US Postai Savicc at our etepmae. Samples aft dispersed of in 60 days or enter ofterwiso hotructed by the protocol or special is udiona in wfsting. Thaah you. Carts;�ied Auatyais Set ke 24IX*wsA Dqp•7DaysA Week Competitive Pricer vtstt aer wets,tn-www.ame�l'adeoo Boston-Los Artpeles-Now York-Richmond _ �:�; .� _, �f � � �. w 1 � 'I 1 , � � � � � y � .� �.�_ �, ., y .-; � �.� � �^ � � .+ •i � � � i _ � � jai .� , .�SS � � J y .� _� � -: � �{ 1 1 s � i - i �' �'; M 'i ' _ ,� 1 �, -; i. 4 {. ' � ' 3 ., ,�� � ,�. � ♦j F� �' :iiir` I ..i:? i�t{ �'. 1 1 �t �w ��: ,y �:: ��� ..� � �„T �` ��.: ' 4 � F:-:. �j tt�� c' w� w�. t� �Itek�ti'�l�i o co IR 112W S5 well E a F e� m g rSCI AmedSCI New York AA117 EAST 30TH ST. MENEW YORK,NY 10016 TEL:(212)8794B680•FAX:(212)879-3114 PLM Bulk Asbestos Report I Michael I Stevens Deft Received 04/04/16 AmeNScl,lob# 216041361 Attn: Michael Stevens Date Exatftined 04/06/16 P.O.# i PO Boat 2202 ELAP# 11480 Page 1 of 2 j RE:39; 39 Warren Ln., Queensbury, NY Glens Falls, NY 12801 Client No./HGA Lab No. Asbestos Present Total %Asbestos #1 216041361-01 No NAD Location: Kitchen Ceiling-Calling Tile (by NYS ELAP 198.6) by Elie Babayeva Analyst Des dPdon:Grey,Homogeneous,Non-Fibrous,Bulk Material on 04/06116 Asbestos Types: Other Material: Nan-fibrous 43.1% #2 216041361-02 No NAD Location: Living Room wall-Sheefro& (by NYS ELAP 198.1) by Elie Babayeve Analyst Description:WhttalTan,Homogeneous,Fibrous,Bulk Materialon 04J06/1$ Asbestos Types: Other Material: Cellulase 26%, Non-fibrous 75% #3 216041361-03 No NAD Location: Bedroom i Wali-Sheetrock (by NYS ELAP 198.1) by Ella Babayeva Analyst Description:WhilelTen,Homogeneous,Fibrous,Bulk Material on 0410811$ Ash a min a Types: Other Material: Cellulase 20%, Non-fibrous 80% #4 216041361-04 No NAD Locution: Bedroom 2 Calling-Celong Tile (by NYS ELAP 198.6) by Ella Babayeva on 04/06/18 Analyst Description:Grey,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material:Non-fibrous 47.1% 218041361-05 No NAD Location: Bathroom Floor-Vinyl Flooring (by NYS ELAP 198.6) by Ella Babayeva MOW Description: Llght Green,Homogeneous,Non-Fibrous,Bulk Material on 04108/18 Asbestos Types: other Material: Non-fibrous 9.4 96 See Reportiing nates on last page AmedSci Job*. 216041361 Page 2 of 2 Client Name: Michael J.Stevens PLM Bulk Asbestos Report 39; 39 Warren Ln.,Queensbury,NY a ! , Client No.i HGA Lab No. Asbestos Present Total%Asbestos #6 216041361-06 No NAD Location: Mud Room wall-Sheetrock (by NYS FLAP 198.1) by Ella Babayeva on 04/06/16 Analyst Description:Offft teffan,Homogeneous,Fibrous,Bulk Metwisi Asbestos Types: Other Material:Cellulose 15%, Non-fibrous 85% #7 216041361-07 No NAD Location: Rear Roof Area-Admit Roofing (by NYS ELAP 198.8) by Ella Babayeva on 04108/16 Analyst Description:Black,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 5%, Non-fibrous 25.7% #8 216041361-08 No NAD iocatlon: South Side Roof-Asphalt Roofing (by NYS ELAP 198.6) by Ella Babayeva on 04108116 Analyst Description:Black,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 5%, Non fibrous 22.4% #9 216041361-09 No NAD Location: OffEce/Closet Floor.-VhV Flooring (by NYS ELAP 198.6) by Ella Babayeve on 04108116 Analyst Description:Green,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material:Non Obrous 3.4% Reporting Notes: Analysed by:Ella Babayeva 'NAD/NSD ano asbestos detected:NA snot analyzed;NAIP6919t aftVadlpositIve stop.PLM Bunk Asbestos Ans"s by EPA 6MM4-82-020 per 40 CFR 783(NVL.AP 2011548-0),FLAP PLM Method 198.1 for NY f labte samples.wtft Includes the Identlflcatlon and Quentifaboon of vemnicu lte or 198.8 for NOB samples or EPA 400 pt ct by EPA WWM4-e2-M(NY ELAP Lab 11480):Noie:PLM Is not consistently rellabte to detecting asbestos In floor coverings and slmNar non-Mable oWnlody bound matedals. NAD or Trace results by PLM are Inconclusive.TEM Is currently the only method that car be used to determ[ne If this material can be oonsldeted or treated as non asbestwoontsInIng In NY State(also see EPA Advisory for floor tile,FR 59,148,38970.8/1194)'Natiorrat Instltute of Standards and Technology Accreditation reWremerds mandate that We report must not be rewoducad except In fidl without the approval of the Iab.Ttds PLM report relates ONLY to rho Items tested.AIHA-LAP,LLC Lab ID 102843,RI Cert AAL-094.CT Cert PH-0186.Mass Cert AA000054. 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NWONUMrTIM 1111 r1 �R 1 � - t %,"1601 ! / MAW 1 New York State-A"arhnent of Labor Division of Safety and Health License and Cetificate Unit State Campus,Suliding 12 Albany,NY 12240 ASBESTOS HANDLING LICENSE Michael J Stevens FILE NUMBER: 13.72900 LICENSE NUMBER: 72900 PO Box 2202 LICENSE CLASS: RESTRICTED DATE OF ISSUE: 09/25/2015 Glens Falls,NY 12801 EXPIRATION DATE: 09/30/2016 Duly Authorized Representative—Michael Stevens: 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. LJ ftw� � Eileen M.Franko, Director SH ase(8/12) For the Commissioner of Labor as' 1WIVIOC I"' nrrfrl /r/r" r r rrr r all �� R�1r