DEMO-000068-2018 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-0201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: DEMO-000068-2017 Date Issued: Monday, March 6, 2017
This is to certify that work requested to be done as shown by Permit Number DEMO-000068-2017
has been completed.
Tax Map Number: 289.17-1-1.2
Location: 0 Birdsall RD
Owner: John Whalen
Applicant: George Ryan
This structure may be occupied as a: Demo of 4 structures(asbestos report
recv'd) By Order of Town Board
1.Cottage 2,000 sq. ft.;2.Cottage 2,000 sq. ft.;3.Tool Shed 2 ft.x 2 ft.;4. TOWN OF QUEENSBURY
Gazebo 8 ft.x 8 ft. Unsafe structures per 2/7/17 D.Hatin letter j4k--Issuance of this Certificate of Compliance DOES NOT relieve the Q
\
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.
Admik TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
1W Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: DEMO-000068-2017
Tax Map No: 289.17-1-1.2
Permission is hereby granted to: George Ryan
For property located at: 0 Birdsall 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
Owner Name: John Whalen Demolition-Residential $0.00
Owner Address: 794 State Route 149 Total Value $0.00
Lake George,NY 12845
Contractor or Builder's Name I Address Electrical Inspection Agency
George Ryan
955 State Route 149
Lake George,NY 12845
Plans&Specifications
Demolition of 4 structures
1.Cottage 2,000 sq.ft.-on slab
2.Cottage 2,000 sq.ft.-on slab
3.Tool Shet 2 ft.by 2 ft. -dirt
4.Gazebo 8 IL by 8 R -dirt
removal due to disrepair and structural collapse-Unsafe structures as per D.Hatin letter dated February 7,2017
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,February 28,2018
(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 o ueensb / / /Tues a ,F 28,2017
SIGNED BY: /VJ for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit #:
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee 3 0`'
Provide 2 plot plans drawn to scale,showing lot t o arks h f�f cj!' q� nt roads!streets. Show all existing structures
on property and Indicate which are to be demolis I &a h c l0 of i' i s
Date _ d_S� o !7_ FEB 2 8 3(� at tion -----1�%
-- ---
Tax Map ID _ o�g9 ��—� 11.2TOWN OF QUEENSBURY
---
COMMUNITY DEVELOPMENT] , l
APPLICANT �FAe6e_ 2YAN .-- OWNER __T�tin_fjAeZlen�jr.
------
Address �sr s+rr}s R+c !yy � _21-- g&.-
� L`EY_____
--1------------------------- Address 79
-- �2j.J�l�_
Phone `s 30_7— OSd —
--------- —
s�J— -- ---------------- Phone ----------------
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: ---- h________—_Phone: 3v7_D
I. Person Responsible for Work O Q6E
2. Where will demolition material be disposed? i flAm grAkm'D
3. All buildings to be demolished require an Asbestos Survey yes
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 —_:L 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 �(_ Resident —_— Garage --- Business
__— Storage Bldg. —X Other cF41e-bo
b) Size of Structure i, d pool f vw-c 3 %oa! S4 e,4 J Se,Le bo iC X 9'/
c) Number of Stories a _y
d) Foundation Type 1j / a G C o. S/w� �fla lSbed a zcbo n
e) Foundation (a
f) Structure(s) 4
7. Utilities Information
a) Indicate utilities for this structure--- Gas __— Electric --- Propane --- Public Water --- Public Sewer
--_On-site well water pump h r u elj6D 6F
a) Have you notified the Town Water Department for public water and sewer disconnect? _ --__ No
b) Have all utilities been disconnected? ___— Yes ----No
8. Signature
Print Name: A J4 -------------------- Date f
---------------
Signature: _ _ --------------------- Date
Town of Queensbury Building& Codes- Demolition Permit - December 2014
AmeriiSci Job#: 217023277
Client Name: Michael J. Stevens Page 4 of 4
PLM Bulk Asbestos Report
289-17-1-1-4; Birdsall RD; Birdsall Rd., Queensbury, New York
M
b [017 DNSBURYLOPMENT
289.17-1-1.2 DEMO 68-2017
George Ryan for John Whalen, Jr.
0 Birdsall Road
Demolition of 4 structures
Reporting Notes:
Analyzed by:Jared C.Clarke
'NAD/NSD=no asbestos detect NA=no nalyzed;NAPS=not analyzed/po dive stop,(SOF-V)=Sprayed On Fireproofing containing Vermiculite;
(SM-V)=Surfacing Material co
'cd
V iculite;PLM Bulk Asbestos Analysis by EPA 600/M4.82-020 per 40 CFR 763(NVLAP 200546-0), ELAP
PLM Method 198.1 for NY fdabl es,which includes the identification and quanfitation of vermiculite or 198.6 for NOB samples or EPA 400 pt ct
by EPA 600/M4-82-020(NY ELAP Lab 11480);Note:PLM is not consistently reliable in detecting asbestos in floor coverings and similar non-friable
organically bound materials. NAD or Trace results by PLM are Inconclusive.TEM Is currently the only method that can be used to determine if this
material can be considered or treated as non asbestos-containing in NY State(also see EPA Advisory for floor tile,FR 59,146,38970,8/1/94)National
Institute of Standards and Technology Accreditation requirements mandate that this report must not be reproduced except in full without the approval of
the Iab.This PLM report relates ONLY to the items tested.AIHA-LAP,LLC lab ID 102843,RI Cert AAL-094,CT Cert PH-0186. Mass Cert AA000054.
Reviewed By: END OF REPORT
ASBESTOS INSPECTION REPORT
PROJECT INFORMATION ABBREVIATIONS KEY
No)ect a: Pm)m Nmwe: Friability: Condition: Damage Potential:
IrerJ n-LL. 0,90 F-Friable I-lmut I-Cameo Po'caw
Dae lm liulldiog Name. NF-Non-Frkbk 2-Damaged.i Hlteamy Damaged 151 2-Noise Potentia
/ Accessibility 1-Demagm snrfecing Material s-Vgaalenememkt
12r)3 W LL I-EaailY Attnabk 4-Significemly Damaged SurGciog Maeriel 4-Ak E.InPme hal
Page a.. 5-D.Md5igniflcamy Damaged haw.Materia J-Water Pmeial
6-ACBM with PmemW for Damage 6-Other Enmomtemd Potmial
of �, C.V 'CNS 4-Gmcaxatbk 7-ACBM with PommW for Sigolficaa Damp 7-Aber Physical Pwcatia
SAMPLE IDENTIFICATION
Functional Homogeneous Areas Quantity Friability/ Condition Damage Bulk Comments
Space ID# Accessibili Potential Sam le#
rFI Floor y apo--t.
Wall
Ceiling
Other OeKr-U,, L 90 5q FT F l FW F;i fJ)n- L �LfiO'1/
1$ 3 Other �c -Cera i E - !ri le ` �prn-Z/n
1* Other r. / D S F 4 2 IV I L M400-zAxa
{ R Floor 13 q S L-� /-411:2 l L !LC
1 Wall
Ceiling
�F Other 6Uiq f cV - l 65• f11 B) L
�v mer or� oat.s Db S Cl> a12 r7/
t$ Other p I% q--y t}
'1.t/C7 Floor 61,,Tk 6 ='r / /• %2 17 r;, L ) / Z-e_
Wall
Ceiling
t� Other b&F rhaLlS h( CL
kkll Other �tTd- 2 !v Z C
# 1 other yr& ao r F lZprr ,w L e L e—
Floor
Wall
Ceiling /
Ft "b Other q( 1
-t:r-(It Other Ots 1x,72. (o S r ! ,N r
Other (ZvL9r- I
Floor !
Wall /
Ceiling /
Other o
Other /
Other
Floor
Wall
Ceiling
Other
Other
Other
AmeriSci Job#: 217023277
Client Name: Michael J. Stevens
Page 3 of 4
PLM Bulk Asbestos Report
289-17-1-1-4; Birdsall RD; Birdsall Rd., Queensbury, New York
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
#12 217023277-12 No NAD
Location: Kitchen-Floor-Vinyl Flooring (by NYS ELAP 198.6)
by Jared C.Clarke
Analyst Description: Grey, Homogeneous, Non-Fibrous, Bulk Material on 02/23/17
Asbestos Types:
Other Material: Non-fibrous 7.9%
#13 217023277-13 No NAD
Location: Outside Clapboard-Paint (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 62.7%
#14 217023277-14 No NAD
Location: Outside Clapboard-Paint (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 53.7%
#15 217023277-15 No NAD
Location: North Side Roof-Asphalt Shingle (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Fibrous glass 2%, Non-fibrous 20%
#16 217023277-16 No NAD
Location: West Side Roof-Asphalt Shingle (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Fibrous glass 2%, Non-fibrous 28.3%
See Reporting notes on last page
AmeriSci Job#: 217023277 Page 2 of 4
Client Name: Michael J. Stevens
PLM Bulk Asbestos Report
289-17-1-1-4; Birdsall RD; Birdsall Rd., Queensbury, New York
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
#6 217023277-06 No NAD
Location: Outside Clapboard-Paint (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 45%
#7 217023277-07 No NAD
Location: North Side Roof-Asphalt Shingle (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Fibrous glass 1 %, Non-fibrous 17.8%
#8 217023277-08 No NAD
Location: West Side Roof-Asphalt Shingle (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Fibrous glass 2%, Non-fibrous 34.6%
#9 217023277-09 No NAD
Location: Bathroom-Floor-Vinyl Flooring (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Blue, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 1.9%
#10 217023277-10 No NAD
Location: Bathroom-Floor-Vinyl Tile (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Blue, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 4.8%
#11 217023277-11 No NAD
Location: Kitchen-Floor-Vinyl Flooring (by NYS ELAP 198.6)
by Jared C. Clarke
on 02/23/17
Analyst Description: Green, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 5.3%
See Reporting notes on last page
AmeriSci New York
117 EAST 30TH ST.
AMERI SCI NEW YORK, NY 10016
TEL:(212)679-8600•FAX:(212)679-3114
PLM Bulk Asbestos Report
Michael 1. Stevens Date Received 02/21/17 AmeriSci Job# 217023277
Attn: Michael Stevens Date Examined 02/23/17 P.O. #
PO Box 2202 ELAP# 11480 Page 1 of 4
RE:289-17-1-1-4; Birdsall RD; Birdsall Rd., Queensbury, New
Glens Falls, NY 12801 York
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
#1 217023277-01 No NAD
Location: Bathroom-Floor-Vinyl Flooring (by NYS ELAP 198.6)
by Jared C. Clarke
Analyst Description: Green, Homogeneous, Non-Fibrous,Bulk Material on 02/23/17
Asbestos Types:
Other Material: Non-fibrous 0.5%
#2 217023277-02 No NAD
Location: Bathroom-Floor-Vinyl Flooring (by NYS ELAP 198.6)
by Jared C. Clarke
Analyst Description: Green, Homogeneous, Non-Fibrous, Bulk Material on 02/23/17
Asbestos Types:
Other Material: Non-fibrous 2.7%
#3 217023277-03 No NAD
Location: Kitchen-Floor-Vinyl Floor Tile (by NYS ELAP 198.6)
by Jared C. Clarke
Analyst Description: Grey, Homogeneous, Non-Fibrous, Bulk Material on 02/23/17
Asbestos Types:
Other Material: Non-fibrous 3.3%
#4 217023277-04 No NAD
Location: Kitchen-Floor-Vinyl Floor Tile (by NYS ELAP 198.6)
by Jared C. Clarke
Analyst Description: Grey, Homogeneous, Non-Fibrous, Bulk Material on 02/23/17
Asbestos Types:
Other Material: Non-fibrous 0.6%
#5 217023277-05 No NAD
Location: Outside Clapboard-Paint (by NYS ELAP 198.6)
by Jared C. Clarke
Analyst Description: White,Homogeneous, Non-Fibrous, Bulk Material on 02/23/17
Asbestos Types:
Other Material: Non-fibrous 51.3%
See Reporting notes on last page
— — Please Reply To:
/040� AmeriSci New York
117 EAST 30TH ST.
AMERI SCI NEW YORK, NY 10016
TEL:(212)6758600•FAX:(212)679-3114
FACSIMILE TELECOPY TRANSMISSION
To: Michael Stevens From: Aleksandr Barengolts
Michael J.Stevens AmeriSci Job#: 217023277
Fax#: Subject: ELAP-PLM/TEM 5 day Results
Client Project: 289-17-1-124; Birdsall RD;
Email: tnikesoldcars@gmail.com Birdsall Rd.,Queensbury,New
York
Date: Thursday,February 23,2017 Number of Pages:
Time: 17:15:37 (includi cover sheet)
Comments:
CONFIDENTIALITY NOTICE: Unless otherwise indicated,the information contained in this communication is confidential information intended for use
of the individual named above. If the reader of this communication is not the intended recipient,you arc hereby notified that any dissemination,
distribution or copying of this communication is prohibited. If you have received this communication in error,please immediately notify the sender by
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MICHAEL J.$TEVENS licensed,CerfiBed NYS Abestos
Material Inspector
P.O. Box 2202
Glens Falls, New York 12801
(518) 6563270
MikeoldearsOgmail corn
To Whom It May Concern,
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, Zt
y / ---
Michael J. Stevens
License Number:72900
MJS keg
Enc.
AmeriSci Job#: 217023277
Client Name: Michael J. Stevens
Page 1 of 2
Table I
Summary of Bulk Asbestos Analysis Results
289-17-1-1-4; Birdsall RD; Birdsall Rd., Queensbury, New York
Sample Heat Acid Insoluble
Sample# p He gram) Organic
Sensitive Soluble o Non-Asbestos Asbestos%by "Asbestos%by
Client Sam le# Area Or anic /, Inorganic / Inorganic / PLM/DS TEM
01 #1 0.211 18.0 81.5 0.5 NAD NAD
Location: Bathroom-Floor-Vinyl Flooring
02 #2 0.188 18.1 79.3 2.7 NAD NAD
Location: Bathroom-Floor-Vinyl Flooring
03 #3 0.150 28.7 68.0 3.3 NAD NAD
Location: Kitchen-Floor-Vinyl Floor Tile
04 #4 0.161 28.6 70.8 0.6 NAD NAD
Location: Kitchen-Floor-Vinyl Floor Tile
05 #5 0.076 36.8 11.8 51.3 NAD NAD
Location: Outside Clapboard-Paint
06 #6 0.100 36.0 19.0 45.0 NAD NAD
Location: Outside Clapboard-Paint
07 #7 0.239 25.1 56.1 18.8 NAD NAD
Location: North Side Roof-Asphalt Shingle
08 #8 0.279 20.1 43.4 36.6 NAD NAD
Location: West Side Roof-Asphalt Shingle
09 #9 0.160 29.4 68.8 1.9 NAD NAD
Location: Bathroom-Floor-Vinyl Flooring
10 #10 0.189 28.6 66.7 4.8 NAD NAD
Location: Bathroom-Floor-Vinyl Tile
11 #11 0.226 19.9 74.8 5.3 NAD NAD
Location: Kitchen-Floor-Vinyl Flooring
12 #12 0.126 30.2 61.9 7.9 NAD NAD
Location: Kitchen-Floor-Vinyl Flooring
13 #13 0.102 35.3 2.0 62.7 NAD NAD
Location: Outside Clapboard-Paint
14 #14 0.067 37.3 9.0 53.7 NAD NAD
Location: Outside Clapboard-Paint
15 #15 0.295 26.1 51.9 22.0 NAD NAD
Location: North Side Roof-Asphalt Shingle
16 #16 0.267 22.5 47.2 30.3 NAD NAD
Location: West Side Roof-Asphalt Shingle
lee Reporting notes on last page
AmeriSci Job* 217023277
Client Name: Michael J. Stevens Page 2 of 2
Table 1
Summary of Bulk Asbestos Analysis Results
289-17-1-1-4; Birdsall RD; Birdsall Rd., Queensbury, New York
AmeriSci Sample Heat Acid Insoluble
HG Weight Sensitive Soluble Non-Asbestos
Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS /O by ..Asbestos%by
TEM
Analyzed by:Aleksendr Barengolts ;Date Analyzed 2/23/2017
"Quantitative Analysis(Semi/Full);Bulk A stos Analysis- by EPA 600/M4-82-020 per 40 CFR or ELAP 198.1 for New York friable samples or ELAP 198.6 for New York NOB samples;TEM
(Semi/Full)by EPA 600/R-93/116(not covered by NVLAP accreditation)or ELAP 198.4;for New York samples;NAD=no asbestos detected during a quantitative analysis; NA=not analyzed;Trace=
<1%;(SOF-V)=Sprayed On Fireproofing containing Vermiculite;(SM-V)=Surfacing Material containing Vermiculite;Ouanfltation for beginning weights of<0.1 grams should be considered as qualitative
only;Qualitative Analysis:Asbestos analysis results of"Present"or"NVA=No Visible Asbestos"represents results for Qualitative PLM or TEM Analysis only(no accreditation coverage available from any
regulatory agency for qualitative analyses):NVLAP(PLM)200546-0,NYSDOH ELAP Lab 11480,AIHA-LAP, LLC(PLM)Lab ID 102843.
Warning Note:PLM limitation,only TEM will resolve fibers<0.25 micrometers in diameter.TEM bulk analysis is representative of the fine grained matrix material and may not be representative of
non-uniformly dispersed debris for which PLM evaluation is recommended(i.e.soils and other heterogenous materials).
Reviewed By: