BOTH-000506-2016 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-000506-2016 Date Issued: Monday, August 15, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000506-2016
has been completed.
Tax Map Number: 303.20-1-66
Location: I PARK AVE
Owner: Wilda MacKnight
Applicant: Wilda MacKnight
This structure may be occupied as a: Demo of remaining garage
Asbestos report received and attached 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.
= ~v I-OWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000506-2016
Tax Map No: 303.20-1-66
Permission is hereby granted to: Andrew MacKnight
For property located at: 1 PARK AVE
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
Tyne of Construction
Owner Name: Wilda MacKnight Demolition $0.00
Owner Address: 87 MEADOW DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Demo of remaining garage
Asbestos report received and attached
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 29,2017
(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 of eensb �ec]4t,2016
SIGNED BY: the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit#: j` = ,
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee
Provide 2 plot plans drawn to scale, showing lot boundaries with dimensions and adjacent roads 1 streets. Show all existing structures
on property and indicate which
are to be demolished. Indicate the location of all utilities
Date f 1_� '—_ Demolition Location _l _� �
Tax Map ID --------------
APPLICANT _ '�u_I `_ Ct r�j rr J /tl
�_ �7�_ _ OWNER --
Address — �_ _�7 c rc_— ---------- Address ---'---------------�_..___--_
Phone ------------ Phone --------------------------
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: phone:
I. Person Responsible for Work -
2. Where will demolition material be disposed?
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 __—_ 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 disposed
6. Structure Information
a) Indicate the structure(s)to be demolished _ Residence _ Garage ---Business
___ Storage Bldg. —_— Other
b) Size of Structure X
c) Number of Stories f
d) Foundation Type
e) Foundation c-
f) Structure(s) r-
7. Utilities Information
a) Indicate utilities for this structure ___ Gas ___ Electric ___ Propane —__ Public Water —__ Public Sewer
_,_ On-site well water pump ;� ('_1 I —
a) Have you notified the Town Water Department for public water and sewer disconnect? --_— Yes _=_ No
b) Have all utilities been disconnected? _�_Yes ____ No
B. Signature
Print Name: ---_--}�( [ d�`-- an _ h�+ Date -- -- --f�---
Signature: _________.,__..__ Date
Town of Queensbury Building&Codes - Demolition Permit - December 2014
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• �' MacKnight, Wilda 4
1 Park Avenue
Demo of remaining garage
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Silt fence to be installed as noted.
a i Installation must be cdmpleted &inspected
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g&to beginning demolition.
{ Phase contact this office to schedule an
in'pection of the site& or to any demolition.
P N!T Pd_(=�T F'i_.1N
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MICHAEL J. STEVENS licensed,Certified MCS Abestos
Material Inspector
P.Q. Box 2202
Glens Falls, Now York 12801
(518) 656.3270
MJF., 1rlcs�rsC�gmaiLersr1
303.2-0-1-66 BOTH-000506-20x6
MacKnight, Wit&
1 Park Avenue
Demo of remaining garage
To Whom It May Concem,
Please be advised that I 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 that,subject to any and all applicable states or
locals and regulations at the time of the enclosed test report,the property owner may proceed with remodeling or
demolition as the owner sees fit.
Thank you, —
Michael J. Stevens
License Number: 72900
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AmodSci New York
117 EAST 30TH ST.
AMERI VVl NEW YORK,NY 10016
TEL.:(212)879.8600•FAX:(212)679.3114
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PLM Bulk Asbestos Report
Michael I Stevens Date Received 07/28/15 AmeriSci Job# 215075312
Attn: Michael Stevens Date Examined 08/01/16 P.O.#
PO Box 2202 FLAP# 11480 Page 1 of 2
RE:I; 1 Park Ave.;'1 Park Ave.,Queensbury, NY
Glens Falls, NY 12801
Client No.l HGA Lab No. Asbestos Present Tota! %Asbestos
1 216075312-01 No NAD
Location: Roof Area West Side-Asphalt Shingle (by NYS ELAP 198.6)
by Bella J.Chemis
Analyst Description:Black,Homogeneous,Non-Fibrous,Bulk Material an 08/01/18
Asbestos Types:
other Material: Fibrous glass 1%, Non-ftrous 57.8%
2 216075312-02 No NAD
Location: Roof Area South End-Asphalt Shingle (by NYS EIRP 198.8)
by Bella J.Chemis
Analyst Description:Black,Homogeneous,Non-Fibrous,Bulk Material on 08l01l18
Asbestos Types:
Other Material: Fibrous glass 2 95, Non-fibrous 38.195
3 216075312-03 No NAD
Location: Roof Area North Side-Asphalt Shingle (by NYS ELAP 198.6)
by Sena J.Chemis
on 08/01/16
Analyst Description:Black,Homogeneous,Non-Fibrous,Bulk Material �
Asbestos Types:
Other Material: Fibrous glass 2%, Non-fibrous 39.8%
4 216075312-04 No NAD
Location: Pine Clap Board North End-Paint (EPA 400 PC)
by Bella J.Chemis
Analyst Description:OftWhite,Homogeneous,Non-Fibrous,Bulk Material on 08/01/16
Asbestos Types:
Other Material:Non-fibrous 53.7%
5 216075312-05 No NAD
Location: Pine Clap Board West End-Paint (by NYS ELAP 198.6)
by Bella J.Chemis
Analyst Description:Of Nhits,Homogeneous, on 08101/16
Fibrous,Bulk Material
Asbestos Types:
Other Malarial:Non-fibrous 63.7%
See Reporting notes on last page
AmeriSel Job* 210075312 Page 2 of 2
Client Mame:•Michael J.Stevens
PLM Bulk Asbestos Report
I; 1 Park Ave.; 1 Park Ave., Queensbury, NY
Client No.!HGA Lab No. Asbestos Present Total %Asbestos
6 216075312-06 t'ifo NAD
Location: Pine Clap Board East Side-Paint (by NYS FLAP 188.6)
by Bella J.Chends
on 08/01/16
Analyst Oem4ption:OfiWhite,Homogeneous,Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 51.8%
I
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Reporting Notes:
Analyzed by:Bella J.Chemis '
'NAQJNSD-no asbestos detected;NA=not analyzed;NAPS stop, F-V)=Sprayed On Flrepmft contsh M Vermiculite;
(SW%4=Surfachv IlAaterlal contali ft Vermiculite;PLM Bulk Asbestos Analysis by EPA WW4-82-Mo per 40 CFR M(NVLAP 200545-0},EtAP
PLM Method 188.1 for NY friable samples,which Includes the Identiflcatlon and quantltaflon of McWc lite or 198.6 for NOB samples or EPA 400 pt ct '
by EPA 8DWM4-82-020(NY ELAP Lab 11480);Note:PLM Is not coonsistentty reliable In ding asbestos In floor covedrigs and similar rwndrW to
organically bormd materials. NAD or Trace results by PLM are inconclusive,TEM Is awerilly the only method that can be used to datarmtne if thts
material can be cor>sidered or treated as non oontalnIng In NY State(also sea EPA AdWsory for floor tae.FR 69.146.38870.8/1/94)Naomi
Institute of Standards arid Technology Accreditation requirements mandate that tills report must not be reproduced a oW In fua WOW the approval of
the lab.TMs PLM report relates ONLY to the items tested.AIHA4 AP,LLC Lab 10102843,RI Cert AAI.-094.CT Cert PH-0188,Mass Cert AA000054,
R81r1ew6G END OF REPORT
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