BOTH-000066-2016 TOWN OF QUEENSBURY
4W 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
— EW ommunity Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000066-2016 Date Issued: Monday, February 13, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000066-2016
has been completed.
Tax Map Number: 226.19-1-84
Location: 218 LAKE PKWY
Owner: Cathy Hodgkins,JOHN HODGKINS
Applicant: Witt Construction Inc.
This structure may be occupied as a: Demo,asbestos report received
Cross Ref. AV PZ-049-2015 and SP PZ-041-2015 By Order of Town Board
TOWNOFQUEENNSSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the ( r 4t
Variance,property owner of the responsibility for compliance with Site Plan, -`f/�)avjY
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 12804-5904 (518)761-8201
ddW
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000066-2016
Tax Map No; 226.19-1-84
Permission is hereby granted to: Cathy Hodgkins,JOHN HODGKINS,Witt Construction Inc.
For property located at: 218 LAKE PKWY
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
Owner Name: JOHN HODGKINS Demolition $0.00
Owner Address: 20 N Kings RD Total Value $0.00
Lake George,NY 12845
Contractor or Builder's Name 1 Address Electrical Inspection Agency
Witt Construction Inc.
563 N Broadway
Saratoga Springs,NY 12866
Plans&Specifications
Demo,asbestos report received
Cross Ref. AV PZ-049-2015 and SP PZ-041-2015
530.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,February 13,2017
(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 ofueensbu riday F b 016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
Permit �'�'��1"b` �►_� _
DEMOLITION PERMIT APPLICATION Perm -- ------
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee $LID.�_`�n_v_o_+tom
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 Demolition Location4 _ � �__„,�, J
Tax Map 1D 3!1_�L(�_�= r 201h
APPLICANT �J __ id _ OWNER &14J_L,fi (ALt_`,
Address �1 � ' � 1'_ { L �� __ Address ' ___--
� lY .CGC. srLC�n '
Phone _51�_`>,k Il ----------- Phone --------
CONTACT PER50N FOR BUILDING & CODES COMPLIANCE: _______________________________ Phone: ----------
1. Person Responsible for Work Joi YI f CA- Li5vbo fl Irf I Vec I
2. Where will demolition material be disposed?
1 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 -___ YesI�_ o
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 disposed
b. Structure Information
a) Indicate the structure(s) to be demolished _ Residence -_- Garage Business
-__ Storage Bldg, __- Other
b) Size of Structure
c) Number of Stories
d) Foundation Type
e) Foundation
f) Structure(s)
7. Utilities Information
a) Indicate utilities for this structure 1Gas ___ Electric -__ Propane ___ Public 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? _ Yes ____ No
8. Signature
5
Print Name: ��_`_= .� --------- Date --- - __-
Signature: } �; :. L .,L�_ j'j�. ,t^ Date --= _L ----
Town of Queensbury Building& Codes- Demolition Permit - December 2014
Town of Queensbury
Conununity De\c lnl7nient Office
742 Bay Road, Queensbury. NY 1_1804
Town of Queensbury Planning Board
RESOLUTION—Grant Site Plan Approval for Site Plan PZ-0041-2015
JOHN & CATHY HODGKINS
Tax Map ID: 226.19-1-84 /Property Address: 218 Lake Parkway/Zoning: WR
The applicant has submitted an application to the Planning Board for Site Plan approval pursuant to Article 9
of the Town zoning Ordinance for: Applicant proposes construction of a single family home of 2,927 sq. ft.
Project includes demolition of 1,081 sq. ft. footprint; project will include new storm water, new septic, new
plantings and grading on site. Project occurs within 50 ft. of 15% slopes and hard surfacing within 50 ft. of
shore. Project includes retaining an existing garage where only one is allowed and two are proposed.
Pursuant to Chapter 179-6-060 and 179-6-050 of the Zoning Ordinance work within 50 ft. of 15% slope and
hard surfacing within 50 ft. of the shoreline shall be subject to Planning Board review and approval.
Pursuant to relevant sections of the Town of Queensbury Zoning Code-Chapter 179-9-080, the Planning
Board has determined that this proposal satisfies the requirements as stated in the Zoning Code;
As required by General Municipal Law Section 239-m the site plan application was referred to the Warren
County Planning Department for its recommendation;
The Planning Board opened a public hearing on the Site plan application on 1/26/2016 and continued the
public hearing to 1/26/2016 when it was closed,
The Planning Board has reviewed the application materials submitted by the applicant and all comments
made at the public hearing and submitted in writing through and including 1/26/2016;
The Planning Board determines that the application complies with the review considerations and standards
set forth in Article 9 of the Zoning Ordinance for Site Plan approval,
MOTION TO APPROVE SITE PLAN PZ-0041-2015 JOHN & CATHY HODGKINS. Introduced by
Paul Schonewolf who moved for its adoption, seconded by David Deeb:
Per the draft provided by staff conditioned upon the following conditions:
1) Waivers request granted:
2 Adherence to the items outlined in the follow-up letter sent with this resolution.
a) The limits of clearing will constitute a no-cut buffer zone, orange construction fencing shall
be installed around these areas and field verified by Community Development staff;
b) If applicable, the Sanitary Sewer connection plan must be submitted to the Wastewater
Department for its review, approval,permitting and inspection;
c) If curb cuts are being added or changed a driveway permit is required. A building permit will not be
issued until the approved driveway permit has been provided to the PIanning Office;
d) If application was referred to engineering then Engineering sign-off required prior to signature of
Zoning Administrator of the approved plans;
Phone: 518.761.8220 1 Fax: S18.74S•4437 1742 Bay Road, Queensbury, NY 12804 1 www.queensbui-y.net
e) If required,the applicant must submit a copy of the following to the Town:
a. The project NOI (Notice of Intent)for coverage under the current "NYSDEC SPDES General
Permit from Construction Activity" prior to the start of any site work.
b. The project NOT(Notice of Termination)upon completion of the project;
c. The applicant must maintain on their project site, for review by staff:
i. The approved final plans that have been stamped by the Town Zoning Administrator.
These plans must include the project SWPPP (Storm Water Pollution Prevention Plan)
when such a plan was prepared and approved;
ii. The project NOI and proof of coverage under the current NYSDEC SPDES General
Permit, or an individual SPDES permit issued for the project if required.
f) Final approved pians,in compliance with the Site Plan, must be submitted to the Community
Development Department before any fiuther review by the Zoning Administrator or Building and
Codes personnel;
g) The applicant must meet with Staff after approval and prior to issuance of Building Permit
and/or the beginning of any site work;
h) Subsequent issuance of further permits, including building permits is dependent on compliance with
this and all other conditions of this resolution;
i) As-built plans to certify that the site plan is developed according to the approved plans to be provided
prior to issuance of the certificate of occupancy.
j) Resolution to be placed on final plans in its entirety and legible.
Duly adopted this 26th day of January,2016, by the following vote:
AYES: Mr. Deeb, Mr. Schonewolf, Ms. White, Mr. Magowan, Mr. Ferone,Mr. Traver, Mr. Hunsinger
NOES: NONE
Phone: 5i8.761.82201 Fax: Si8.74S•4437 1742 Bay Road,Queensbury, NY 128041 www.queensbury.net
Town of Queensbury
Community [development Office
742 Bav Road. Queensbury, NY 12804
Town of Queensbury Planning Board
RESOLUTION -Planning Board Recommendation to Zoning Board of Appeals
Area Variance PZ-0049-2015 for John& Cathy Hodgkins
Tax Map ID: 226.19-1-84/Property Address: 218 Lake Parkway/Zoning: WR
The applicant has submitted an application for the following: Applicant proposes construction of a single family
home of 2,927 sq. ft. Project includes demolition of 1,081 sq. ft. footprint; project will include new storm
water, new septic, new plantings and grading on site. Project occurs within 50 ft. of 15% slopes and hard
surfacing within 50 ft, of shore. Project includes retaining an existing garage where only one is allowed and
two are proposed. Pursuant to Chapter 1796-060 and 179-6-050 of the Zoning Ordinance, work within 15%
slope and the hard surfacing within 50 feet of the shoreline shall be subject to Planning Board review and
approval. Variance: Relief requested for second garage. Planning Board shall provide a recommendation to
the Zoning Board of Appeals.
The Town of Queensbury Zoning Ordinance, per Section 179-9-070 J 2 b. requires the Planning Board to
provide a written recommendation to the Zoning Board of Appeals for projects that require both Zoning Board
of Appeals & Planning Board approval;
The Planning Board has briefly reviewed and discussed this application, the relief request in the variance
application as well as the potential impacts of this project on the neighborhood and surrounding community,
and found that:
MOTION TO MAKE A RECOMMENDATION ON BEHALF OF THE PLANNING BOARD TO THE
ZONING BOARD OF APPEALS FOR AREA VARIANCE NO. PZ-0049-2015 JOHN &c CATHY
HODGKINS: Introduced by Paul Schonewolf who moved its adoption, seconded by Stephen Traver; and
a) The Planning Board, based on a limited review, has not identified any significant adverse impacts that
cannot be mitigated with current project proposal -
Duly adopted this 19th day of January, 2016 by the following vote:
AYES: Mr. Traver, Mr. Ferone, Mr. Magowan, Mr. Schonewolf, Ms. White, Mr. Hunsinger
NOES: NONE
ABSENT: Mr. Ford
Phone: 518.761.8220 1 Fax: 518.745.4437 1 742 Bay Road,Queensbury,NY 12804 1 www.queensbury.net
FtiLE. CQPY
L ANSON
GEOLOGIC & ENVIRONMENTAL CONSULTANTS
AN V'LEET, LLC'_'
FEB 1 ti ?Ut6
November 6, 201 J
Mr. John Hodgkins
20 King Road
Lake George,NY 12845
RE: Pre-Demolition Asbestos Survey
218 Lake Parkway
Town of Lake George,Warren County, NY
Dear Mr. Hodgkins:
Hanson Van Vleet, LLC conducted an asbestos containing material (ACM) survey of the
residential structure at 218 Lake Parkway, Tax ID: 226.19-1-84 in the Town of Lake George,
Warren County, New York (See Figure 1). HVV is authorized by the New York State
Department of Labor under license# 05-0220 to perform asbestos inspections, sample collection
and surveys. Samples of each type of suspected asbestos containing material (SACM) were
collected. All samples were collected by a NYSDOL licensed Class D Inspector, in accordance
with 12 NYCRR Part 56, (referred to as Industrial Code Rule 56) and 29 CFR fart 1910. The
sampling was conducted on October 21, 2015. A copy of the NYSDOL Asbestos license is
attached to this letter.
Methods
Prior to initiating sampling, an on-site walk through inspection of the house was performed in
accordance with Subpart 56-5(e) of 12 NYCRR Part 56. Building plans were not available for
review. Based on the site inspection, sampling of materials was performed to evaluate for
suspect asbestos containing materials(SACM). Bulk samples were collected following standard
sampling procedures. The samples were placed in sealed sample bags and delivered by Federal
Express to EMSL Analytical for analysis under formal chain of custody procedures. Friable type
materials were analyzed by Polarized Light Microscopy (PLM) via the NY State ELAP 198.1
method. Non-organically bound (NOB) materials were analyzed by PLM via NYS method
198.6 NOB. If the NYS method 198.6 NOB was inconclusive, the NOB materials were then
analyzed by transient electron microscopy(TEM) via NYS method 198.4 NOB.
Inspection Results
The inspection revealed a one story seasonal residential structure, approximately 1050 square
feet in size. The structure was of wood framed construction, on a concrete crawlspace
foundation,with an asphalt shingle roof.
The exterior was sided with wood clapboard and trim. The windows had been previously
removed by the homeowner.
902 Route 146 (518)371-7940
Clifton 'Park, New York 12065 Fax(518)371-5885
,
Pre-Demolition ACM Survey
218 Lake Parkway Lake George,NY
Page 2 of 2
The interior construction consisted of tongue and groove pine walls,wood floors and open wood
famed ceilings.
Suspect ACM materials identified on the exterior of the house included only asphalt roof
shingles. No suspect ACM materials were identified on the interior of the house.
Bulk samples were collected of the asphalt roof shingles.
Asbestos Containing Material Sampling Results
A minimum of three samples of each type of suspected ACM was collected. The samples and
results are summarized in Table 1 below. The Analytical results and chain of custody are
attached to this letter.
Table 1
Asbestos Sampling Locations and Analytical Results
218 Lake Parkway Lake George,NY
Sample No. Type of Material Location Approximate Quantity Result
(square feet
S-lA Asphalt Shingle Exterior-Roof NA ND
S-IB Asphalt Shingle Exterior-Roof NA ND
S-IC Asphalt Shine Exterior-Roof NA ND
Conclusions
Materials are considered asbestos containing if they contain 1 % or more of asbestos. No
asbestos containing materials were identified within the structure at 218 Lake Parkway Lake
George,NY. No asbestos abaiement is required prior to demolition of the structure.
If you have any questions regarding this survey,please contact us at(518)371-7940.
Very truly yours,
sonjt—
es
Vleet,LLC
WJ Gironda
NYSDOL Class D Inspector Certificate#07-05263
CC: NYSDOL
� � A�alyioal, Inc. EMSL Order. 041531751
Gustomerld: HAAIS22
200 Route 130 North,Cinnaminson,NJ 08077
Phone/Fax: (800)220-36751(856)786-5974 CustamerPO:
htto11vwAt,.EMSL,comm cinnasblabQEMSL.com ProjeetlD:
Attn: Jaynes Gironda Phone: (518)371-7940
Hanson Ilan Vleet, LLC Fax: (518)371-5885
902 Route 146 Received: 10/23/15 9:25 AM
Clifton Park, MY 12065 Analysis Date: 10130/2015
Collected: 1012112015
Project: 218 Lake Pkwy _
Test Report:Ashestos Analysis of Bulk Material
Analyzed Non Asbestos
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID SAA Description Roof-Sh`.r.S'e
041531751-0001 Homogeneity Homogenea:s
PLM NYS 196.1 Friable Not Analyzed
......... .
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 10/29/2095 Black Inconclusive:None Detected
TEM NYS 198.4 NOS 1013012015 Black None Detected
Sample ID S-113 Description Roof-Shingle
041531751-0002 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 10129/2015 Blade Inconclusive:None[]elected
TEM NYS 196,4 NOB 10130/2015 Black Atone Detected
Sample ID SAC Description Roof-Shingle
041531751-0003 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOS 10/29/2015 Black Inconclusive:None Detected
TI=M NYS 198.4 NOB 10/30/2015 Black None Detected
Analyst(s)
exts Kum
Jul/ Patel
Ted Young Benjamin Ellis,Laboratory Manager
or other approved signatory
NOB=Non Friable Organically Bound NIA=Not Applicable VCM=Vermiculite Containing Material
-in New York State,TEM is currently the only method that can be used to determine if NCS materials can be considered or treated as non-asbestos containing.
All samples examined for the presence of vermiculite when analyzed via NYS 198.1.
-NYS Guidelines for Vermiculite containing samples are available at htt :/Amwl.wadsu,mrth.or it rtlela rerUformsNemiimliteirtte6mGui nee Rev070913. f
IF_M5L maintains liability limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced,except in full,without written approval by EMSL.
EMSL bears no responsibility for sample collection activities or analytical method limitations. interpretation and use of test results are the responsibility of the client.Samples were
received in good condition unless otherwise noted.
This report must not be used by the diem to claim product certification,approval,or endorsement by NVLAP,NIST,or any agency of the federal government.This report may contain
data that is not covered by the NVLAP accreditation.
Samples analyzed by EMSL Analytical,Inc.Cinnaminson,NJ NYS ELAS 101372.PA ID#66-00367
Initial'Report From 10/30/2015 09:25:21
Test Report 198VCM-7.30.0 Printed:1013012015 9:25:21 AM THIS IS THE LAST PAGE OF THE REPORT. Page 1
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SITE LOCATION MAP FIG-1 H ANSON WATER SUPPLY a
218 LAKE PARKWAY -- _ _.
ENVIRONMENTAL GON$UITQNT3
302
LAKE GEORGE, NEW YORKvANVLEET, ��c
ROUTE 146 CLIFTON PARK,NEWYORK 125 (518)371-7940 FAX(518)371-5365
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tipw York State—Department of Labor
Division of Safety and Health,
License and Certificate Unit
State C.�rnpus',BAding 12';
Albany,NY 12240
ASBESTOS HANDLING LICENSE
y
Hanson Van Vleet, LLC FILE NUMBER: 05-0220.,
LICENSE NUMBER' 28463
902 Route 146 LICENSE CLASS: RESTRICTED
DATE OF ISSUE: 03/09%2015
Clifton Park, NY 12065 1 EXPIRATION DATE: 03/31/2016
Duty Authorized Representative 'D Kirby Vanvleet:
This license has been issued in accordaf cd iyith 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 prosect,or(2)demonstrated lack of
responsibility ifs the conduct of any job,involving asbestos or asbestos nbAterial.
This license is valid only for tl a contractor named above and this license ora photocopy must be promineritly displayed'at the
asbestos pLcject worksite. This license verities that all�persons employed by the licensee on an asbestos project in New Ybrk
State have been issued an Asbestos Certificate,appzropriate for the,type of work thiry perform,by the New York State
Department of Labor.
Eileen M.Franko, Director
SH 432(8/12) For the Commissioner of Labor
1