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2011-195 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110195 Date Issued: Friday, February 08, 2013 This is to certify that work requested to be done as shown by Permit Number P20110195 has been completed. Tax Map Number: 523400-226-019-0003-002-000-0000 Location: HONEYSUCKLE Rd Owner: JOHN & HELEN JO KELLY III Applicant: JOHN & HELEN JO KELLY III This structure may be occupied as a: Demolition 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, 6 Variance, or other issues and conditions as a result of approvals by the Director of Building& orcement Planning Board or Zoning Board of Appeals. Coa Enforcement TOWN OF QUEENSBURY r 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110195 Application Number: A20110195 Tax Map No: 523400-226-019-0003-002-000-0000 Permission is hereby granted to: JOHN&HELEN JO KELLY III For property located at: HONEYHOLLOW Ln 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. Tyke of Construction Value Owner Address: JOHN&HELEN JO KELLY III Demolition 75 MOUNTAIN CREEK Rd Total Value POUGHQUAG,NY 12570-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-195 demolition of cottage 7 $30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,May 12,2012 (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 dale.) Dated at the T rwn of een d yy May 12,2011 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement +.. � 4/ �OFFICE USE ONLY i TAX MAP NO. PERMIT NO. r I FEE PAID _!3 I Permission is hereby granted to the above named Applicant to demolish the building(s) MAY 0 9 2011 o described herein as set forth in the Application below. Director of Building&Codes Date i TOWN OF QUEENSBURY BUILDING&CODES APPLICATION FOR DEMOLITION PERMIT: Fill in applicable spaces and submit two(2) plot plans, drawn to scale,showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures on the property and indicate which are to be demolished. Indicate on the plot plan the location of all utilities. l APPLICANT/BUILDER: �i:��1, 1-1'borw'8Zi41Jf8-'1_,,jOWNER: ADDRESS: 1'7 G'Lj�s►,a �,,,cJ ��fi. , .�1��, 12�,;ADDRESS: A, PHONE NOS. , ) eel cry PHONE: PERSON RESPONSIBLE FOR WORK: y PHONE: LOCATION OF DEMOLITION: WHERE WILL DEMOLITION MATERIAL BE DISPOSED?•�•+w: / ,nr � � �i► � n /�,r �� ASBESTOS INFORMATIO • `� ✓ Is there any asbestos within a building to be demolished? YES NO ✓ If YES,our office needs the following information: I o Name of firm removing the asbestos: o License number of firm: ) o Indicate where the asbestos material will be disposed: :36,0, ME,j50.S - 5'� NOTE:A copy of Asbestos Removal Report must be filed with our office before demolition begins. STRUCTURE INFORMATION: ✓ Indicate which structure(s)will be demolished: RESIDENCE GARAGE BUSINESS i STORAGE BLDG. OTHER ✓ Size of structure: X I,ZZ5 �f ✓ Number of stories: ✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB GerL-5 ✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED 1 ✓ Structures(s): WILL BE REPLACED WILL NOT BE REPLACED V UTILITIES INFORMATION: ✓ Indicate utilities for this structure: GAS ELECTRIC d, PROPANE PUBLIC WATER ONSITE WELL-WATER PUMP PUBLIC SEWER kip Have you notified the Town Water Dept._for public water and public sewer disconnect? YES NO Have all utilitie been isconnected: YES NO � QUESTIONS? CALL 761-8256 OR EMAIL codes(aDaueensbury.net IGN TURE OF APPLICANT VISIT OUR WEBSITE FOR MORE INFORMATION www.gueensbury.net fz" T071711 Of Qtleensbto y - Coinncunitif Developnten.t Office - 742 Bay Road, Qtleensbtn•y, NY 12804 Framing / Firestopping Inspection Report Office No. (518) 761-8256 Date InpRection requ i Queensbury Building&Code Enforcement Arrive• am/ part: am/pm 742 Bay.Road, Queensbury, NY 12804 Inspector's Initials: NAME: PERMIT : —� LOCATION: n INSPECT ON: TYPE OF STRUCTURE: Y Framing N WA COMMENTS: _- Attic Access 220 x 30"minimum Jack Studs/Headers Bracing/Bridging Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly �v` 12"O.C. 10 C---.) 0�ISO E� Headroom 6 ft. 8 in. Stairwells 36 in. or more Exterior Deck Bracing Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 Y2 w 16 gauge 8 16D nails each side Draft stopping 1,000 sq. ft.floor trusses Anchor Bolts 6 ft. or less on center Ice and water shield 24 inches from wall Fire separation 1, 2, 3 hour Fire wall 2, 3, 4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side h inch or 518 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 6.7 sf above/below grade 5.0 sf grade LABuilding&Codes Forms-01.13113uirding&CodeslInspection FsrrnsTfarning Firestopping Inspection Report.doc Revised January 7,2008 C205S OV E•R LANE CV ta r\ ` oTy otvuo 1Nc, oT7.o Kw o,tu. 34e(a s=sf 3s z.-el xsl � � p a z.nlxst ° 0 i J � d' Puc P Q_ �✓ t 1°•?: `� �4 'J�FQ' � /3 [s � V!//4'Y.a;twc � o c as a I ;\ •p.. h f `J i :,ry a,�.r .. O W g5'Y MS' $ f 7!'"` cJ �4o,4CRE3 � o ''f•rw, a u•.Iwc L-______ _-____ -_ .�. 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O� Asbestos Project Notification Project Reference Number: 25844694 Type: Initial Notification Status: Notification Received Notification Received: 4/28/2011 Payment Status: Paid in full Number of amendments: 0 Notification Entered By: Jupiter Environmental Services, Inc. Contractor Information FEIN:061598172 Jupiter Environmental Services, Inc. Mailing Address 3 Lynn Court Lincoln Park NJ 07035 Asbestos License Number:28543 Duly Authorized Representative Annabel Pierce,Officer Phone Number: 973-709-0200 E-mail Address: iupiteres@aol.com Project Information Project Start Date: 5/19/2011 Project End Date: 7/19/2011 Project Location County: Warren Worker Compensation Worker Compensation Policy#: WC Exemption Certificate#: Number of your employees you expect to be on project: Will temporary workers be used? If Ves, name of temporary agency: Project Location U Luldin4 Name Cotta 5 Room or Location: entire structure Bridge ID#: Address Line 1: Bellewood Park cottages/Assembly point Address Line 2: City Town or Village: lake george State: New York Zip Code: Building Information Current Use: Other Prior Use: Other Approximate Year Built: 1940 Size(sq.ft)i 1225 Is this fee exempt project?: NO Reason: Building Representative/Site Contact Name: Jim Kelly Phone Number: 518.253.7295 E-mail Address: Cell Phone Number: Phase Details Phase# Phase Start Date Phase End Date Phase Location Phase scope Sub-Contractor Details Name: Asbestos License Number: Ni ht/Weekend/Shift Work Details 07:00- 17:00 Mon.-Sat controlled demo of cottage#7 with ACM in place via excavator Party for Whom Work is being Performed First Name: Jim Last Name: Kelly Organization: Apt./Suite: Address Line 1: 241 Assembly point road Address Line 2: City Town or Village: Queensbury Province: State: NY Zip Code: 12845 Country: United States Contract Dollar Amount: $1.00 Variance Information Procedures and Type of Equipment and Ventilation Systems Used 6,000 gal.water tanker used for wet of a controlled demo of existing cottage with ACM in place via excavator Air Monitoring Firm Name: Asbestos License Number: Alpine Environmental Services, Inc. 29095 Laboratory Performing Analysis Name: ELAP Registration Number: Alpine Environmental Services 11740 Type of Asbestos Work Pipe Related: No Siding: No Clean up: No Vessel covering: No Caulking/mastic: No Spray-on insulation: No Roofing/flashing: No VAT: No Demolition: Yes Demolition Ref#: 10A0593 Other-specify: J� Y Waste Transporter Name: Jupiter Environmental Services, Inc. NYS DEC or EPA Permit Number: NJ-494 Phone Number: 518.435.0700 Apt./Suite: Address Line 1: 17 Warehouse Row Address Line 2: City Town or Village: Albany Province: State: NY Zip Code: 12205 Country: United States Landfill Name: Senneca Meadows Phone Number: 315.539.5624 Apt./Suite: Address Line 1: 1786 Salcman road Address Line 2: City Town or Village: Waterloo Province: State: NY Zip Code: 13165 Country: United States Type and Amount of Asbestos Containing Material Friable linear feet: 0 Friable square feet: 3380 Non-friable linear feet: 0 Non-friable square feet: 1300 Fee Total linear feet: 0.0 Total square feet: 4680.0 Total Fee: 2000.0 Project Fee Schedule If the notification was submitted prior to 4/7/09,the actual project fee is one half of the amount shown on the fee schedule Linear Feet: Fee Square Feet: Fee 0-259 feet: $0 0- 159 feet: $0 260-429 feet: $200 160-259 feet: $200 430-824 feet: $400 260-499 feet: $400 825- 1649 feet: $1000 500-999 feet: $1000 1650 or more feet: $2000 1000 or more feet: $2000 Remarks EPA Notification of Demolition and Renovation Operator project# Postmark Date Received Notification# �. TYPE OF NOTIFICATION (0=Original R= Revised C= Canceled): 0 II. FACILITY INFORMATION (Identify owner, removal contractor and other operator) OWNER NAME: Jim Kelly Address: 241 Assembly Point City: Queensbury State: NJ Zip: 12845 Contact: Jim Kelly Tel: 518.253.7295 REMOVAL CONTRACTOR: Jupiter Environmental Services, Inc. ._. ......_..Address:..3..Lynrr Court---------- ------------------- -----._...----...--------------------- ._......---------- ------...- ------------- .._...._.- --------- City: Lincoln Park State: NJ Zip: 07035 Contact: Pane Repic Tel: 973-709-0200 OTHER OPERATOK Address: city: Zip: Contact: Tel: III. TYPE OF OPERATION (D=Demo, O Ordered Demo, R=Renovation, E= Emer. Renovation): R IV. IS ASBESTOS PRESENT? (Yes/No) Yes V. FACILITY DESCRIPTION (Include building name, number and floor or room number) Building.Name: Cottage 7 Address: Bellewood Park Cottages City: Lake George State: NY .,County: Warren Site Location: Cottage 7 Building Size: # of floors: 1 Age in Years: 1940 Present Use: Vacant Prior Use.: Cottage VI. PROCEDURE, INCLUDING ANALYTICAL METHOD, IF APPROPRIATE, USED TO DETECT THE PRESENCE OF ASBESTOS MATERIAL: Bulk Sampling VII. APPROPRIATE AMOUNT OF Nonfriable Asbestos Indicate Unit of ASBESTOS, INCLUDING: Material Not to be Measurement Below RACM Removed 1. Regulated ACM to be removed To Be 2. Category I ACM not removed Removed Cat I Cat II UNIT 3. Category 11 ACM not removed Pipes LnFt: Ln m: F Surface Area Joint SgFt:3,380 Sq m: compound Vol RACM Off Facility.Compound CuFt: Cu m: Vill. SCHEDULED DATES ASBESTOS REMOVAL (mm/dd/yy) Start: 05/16 /11 Complete: 05/30/11 IX. SCHEDULED DATES DEMO/RENOVATION (mm/dd/yy) Start: 05/16 /11. Complete: 05/30/11 JES N141 (1199) page 1 of 2 Continued on page two r.' Notification of Demolition and Renovation (continued) X. DESCRIPTION OF PLANNED DEMOLITION OR RENOVATION WORK,AND METHOD(S)TO BE USED: 6,000 gal water tanker on site with controlled demo with ACM in place via Excavator and placed into lined trailers. XI. DESCRIPTION OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO PREVENT EMISSIONS OF ASBESTOS AT THE DEMOLITION AND RENOVATION SITE: Asbestos to be removed by wet methods in accordance to NYS Industrial code rule 56.11.5 XII. WASTE TRANSPORTER#1 Name: Jupiter Environmental Services, Inc. Address: 17 Warehouse Row City: Albany State: NY Zip: 12205 Scott---- -_.._--._.. ---- - ..- - - - — -: ---...---._..._ _ Tel:--51-8:435:0700----._..- .... - WASTE TRANSPORTER#2 Name: Address: City: State: Zip: Contact Person: Tel: XIII. WASTE DISPOSAL SITE Name: Seneca Meadows Address: A786 Salcman rd. City Waterloo State: NY Zip: 13165 Telephone: 315.539:5624 XIV. IF DEMOLITION ORDERED BY A GOVERNMENT AGENCY, PLEASE IDENTIFY THE AGENCY BELOW: Name: Title: Authority: Date of Order(mm/dd/yy): Date Ordered to Begin (mm/dd/yy): XV. FOR EMERGENCY RENOVATIONS Date and Hour of Emergency(mm/dd/yy): Description of the Sudden, Unexpected Event: Explanation of how the event caused unsafe conditions or would cause equipment damage or an unreasonable financial burden: XVI. DESCRIPTION OF PROCEDURES TO BE FOLLOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS FOUND OR PREVIOUSLY NONFRIABLE ASBESTOS MATERIAL BECOMES CRUMBLED, PULVERIZED, OR REDUCED TO POWDER. If it crumbles, it will be contained and treated as friable. XVIi. 1 CERTIFY THAT AN INDIVIDUAL TRAINED IN THE PROVISIONS OF THIS REGULATION (40 CFR PART 61, SUBPART M)WILL BE ON-SITE DURING THE DEMOLITION OR RENOVATION AND EVIDENCE THAT THE REQUIRED TRAINING HAS BEEN ACCOMPLISHED BY THIS PERSON WILL BE AVAILABLE FOR INSPECTION DURING NORMAL BUSINESS H URS. (Required 1 year after promulgation) i na ner/O erator Date XVIII.I CERTIFY THAT-THE ABOVE INFORMATION I CORRE T. . f) (Si tafure o er/Operator) (Dat ) JES N141 (1/99) page 2 02 EJ aTi or aW,14e. p + 3 -BYyaxv/o.,Nc. ,wlo 'a'i J.rc•.erl�N� ! °an,Jr1 / -K 111 = �)r ,•�If I�W• �'•• �� h,a'�.r"^• .e4a1.L' iyw 1--.____ _ •.. -/` ,2� � \ .,.ww•r N MA,•, lcwN1\•r lnn( �('� 3 a t ,fia s. .'-deeel` a� I�;'k ��' Y.:YS%eJfP) � 2 s.\aaU\, 1Aur,• 1 --.0 - - - -¢ .w 4.+, w:er., �;..r�ai .',. /; - r- m �� - '•, � 'r_'JL••�ne+ - x, LL � Jr•Ml �"." 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L,u+• " QII'1::•tlNL?4.NIN1'��rL ��/�••�� AIMC-0OM• -- Bellawood Park Cottages November 2010 Assembly Point Lake George,New York Non-Asbestos Containing Materials Tested: Roofing shingles Small Outbuilding: Asbestos Material Found: Roll roofing and roofingtfiashing cement Non-Asbestos Containing Materials Tested: None Tennis Court: Asbestos Material Found: None Non-Asbestos Containing Materials Tested: Asphalt Building#I: Asbestos Material Found: Linoleum(bedroom) Presumed Asbestos Materials: joint compound, 9-inch floor tile, linoleum under sink, sink coating,window glazing compound, caulking at siding joints, caulking at chimney, roll roofing, and roofingtfiashing cement Non-Asbestos Containing Materials Tested: Linoleum(kitchen floor) Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar, hearth stone mortar, stone foundation mortar, concrete pier, mastic to 9-inch floor tile, caulking at bath wall panels, adhesive to bath wall panels,and carpet adhesive Building#3: Presumed Asbestos Materials: joint compound, 9-inch floor tile, sink coating, window glazing compound, caulking at siding joints, roofing(fiashing cement Non-Asbestos Containing Materials Tested: Linoleum under sink (kitchen), and linoleum(bath) Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar, hearth stone mortar, stone foundation mortar, concrete pier, mastic to 9-inch floor tile, caulking at bath wall panels, adhesive to bath wall panels, carpet adhesive, textured paint and roofing shingles Building#4: Presumed Asbestos Materials: joint compound, 94nch floor tile, sink coating, linoleum under sink, window glazing compound, caulking at siding joints, caulking at chimney, roll roofing, and roofingiflashing cement - Page 2 1146 Central Avenue Albany,New York 12205 Phone: (518)453-0145 Fax:(518)453-0175 Bellewood Park Cottages November 2010 Assembly.-Point Lake George,New York Non-Asbestos Containing Materials Tested: Linoleums (kitchen), vapor barrier behind wood paneling, fiberboard ceiling panels, ceramic tile, grout to ceramic tile, mortar to ceramic tile, and adhesive to ceramic the Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar, hearth stone mortar, stone foundation mortar, mastic to 9-inch floor tile, caulking at bath wall panels, adhesive to bath wall panels, carpet adhesive, and vapor barrier to fiberglass insulation Building#6: Asbestos Material Found: 9-inch floor tile,and window�caul mg - - - - -- - Presumed Asbestos Materials: joint compound, sink coating, linoleum under sink, window glazing compound, caulking at siding joints, caulking at chimney,roll roofing,and roofing/flashing cement Non-Asbestos Containing Materials Tested: Linoleum (kitchen), and fiberboard ceiling panels Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar, hearth stone mortar, stone foundation mortar, mastic to 9-inch floor tile, caulking at bath wall panels, adhesive to bath wall panels, carpet adhesive, and vapor barrier to fiberglass insulation Building R: Asbestos Material Found: Roofing/flashing cement Presumed Asbestos Materials: joint Compound, 94nch floor tile, sink coating, linoleum under sink, window glazing compound, caulking at siding joints,caulking at chimney,and roll roofing Non-Asbestos Containing Materials Tested: Linoleum(kitchen) Presumed Non-Asbestos Containing Materials: Drywall, fireplace brick mortar, hearth stone mortar, stone foundation mortar, mastic to 9-inch floor tile, caulking at bath wall panels, adhesive to bath wall panels, carpet adhesive, and vapor barrier to fiberglass insulation Building#819: Presumed Asbestos Materials: Joint compound, 94nch floor tile, sink coating, window glazing compound, caulking at siding joints, roll roofing, and roofinglfiashing cement Non-Asbestos Containing Materials Tested: Vapor barrier behind wood paneling Page 3 1146 Central Avenue Albany,New York 12205 Phone:(518)458-0146 Fax: (518)453-0175 I i Bellewood Park cottages November 2010 Assembly Point Lake George,New York Any suspect materials found during demolitionlrenovation activities that are not listed in this report should be considered asbestos containing materials until tested and determined otherwise. General Asbestos Containing Material "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 i 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 l non-liable 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 (FLAP 11506: Manhattan Lab). Conclusion The following materials were found to be asbestos containing or presumed to be asbestos containing materials at the Bellewood Park Cottages located on Assembly Point in Lake George, New York: Building#1 4= Asbestos Material Location Substrate Quan" Friabili Condition Joint com ound Thou hout D all 3,370 sf Friable Dama ed '? Kitchen and 9-inch floor tile Bath Wood 108 Non-friable Damaged Kitchen under Metal 5 sf Non friable Good Linoleum :Sink East Center Carpet 9 sf Non-friable Damaged + Bedroom Sink coatin Ktchen Sink Metal 8 sf Non-friable Good = Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged com and Exterior at Caulking at Siding Joints in Wood Wood 4 sf Non friable Good Sidin Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged Chimney Roll roofing,and Roof under Wood 1,245 sf Non-friable Good -- roofing/flashing °Metal cement Buildin #2 • Asbestos Material Location Substrate Quan Friabil' Condition Joint compound Throughout D all 3,370 sf Friable Dama ed "< 9-inch floor file Kitchen and Wood 108 Non-friable Damaged Bath Kitchen under 5inlf,in and on MetaIANood 8 sf Non-friable Good Linoleum Cabinet East Center Carpet 9 sf Non-friable Damaged Bedroom Sink coatin Kitchen Sink Metal 8 sf Non-fiiable Good i Page 5 1146 Central Avenue Albany, New York 12205 Phone:(518)453-0146 Fax:(518)453-0175 i Beliewood Park Cottages November 2010 Assembly Point Lake George,New York Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged com ound Exterior at Caulking at Siding Joints in Wood Wood 4 sf Non-friable Good Sidin ':- Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged Chimne all roofing,and Roof under Wood 1,245 sf Non-friable Good roofing/flashing :Metal cement Buildln #3 Friabil{ Condition Asbestos Material - Location - Substrate _ Quanta Jointcom ound Thtou hoot D all 1,290sf Friable Dama ed Kitchen and Wood 68 sf Non-friable Damaged 9-inch floor tile Bath Linoleum Kitchen under Metal 5 sf Non-friable Good Sink Sink coatin Kitchens Steel 16 sf Non-friable Good Window glazing Exterior Wood/Glass 14 sf Non-friable Damaged com ound Exterior at Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good Sidin Roofing/Flashing Roof Roofing 3 sf Non-friable Good Cement Shin le , Buildin 44 abili Condition ' Asbestos Material QOcation Substrate Quanta Fri Joint com ound Throucinout D all 3,190 sf Friable Dama ed 9-inch floor He Bath Wood 42 sf Non-friable Dama ed Ktohen under Metal 5 sf Non-friable Good i Linoleum : Sink r Sink coatin Kitchen Metal 8 sf Non-friable Good Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged corn ound Exterior at Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good Sidin Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged Chimne Roll roofing,and Roof under roofing/flashing Wood 1,160 sf Non-friable Good 1 cement Metal Buildin #5 Asbestos Material l.iocatlon Substrate Quanta Friabiti Condition Joint com ound Throu hoot D all 3,360 sf Friable Dama ed Kitchen and Wood 96 sf Non-friable Damaged 9-inch floor file Bath Linoleum Kitchen under Metal 5 sf Non-friable Good Sink Sink coatin Kitchen Metal 8 sf Non-friable Good Page 6 1146 Central Avenue Albany,New York 12205 Phone: (518)453-0146 Fax: (518)453-0175 Bellewood Park Cottages November 2010 Assembly Point Lake George,New York Window glazing Exterior Wood/Glass 11 sf Non-friable Damaged com ound Exterior at Caulking at Siding Joints in Wood , Wood 3 sf Non-friable Good :Sidin Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged Chimne Roll roofing,and Roof under roofing/flashing Metal Wood 1,310 sf Non-friable Good cement Bulldin 6 .. AsdIng# .Material Location Substrate Quanti Friabil Condition Joint compound Ttrou hoot D all 3,370 sf Friable Dama ed 9-inch floor file : Bath Wood 46 sf Non-friable Dama ed Linoleum Kitchen under Metal 5 sf Non-friable Good Sink Sink coatin Kitchen I Metal 5 sf Non-friable Good Window caulking/glazing Exterior Wood/Glass 10 sf Non-friable Damaged bt compound Ektedor at Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good 'Sidin Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged Chimne Roll roofing,and .z., Roof under wood 1,225 sf Non-friable Good roofing/flashing Metal cement .,1 Buildin #7 1 Asbestos Material Location Substrate Quantity Friabili Condition Joint compound THrou hoot D all 3,380 sf . Friable Dama ed j 9-inch floor file Bath Wood 44 sf Non-friable Dama ed 6s, Kitchen under Linoleum Metal 5 sf Non-friab{e Good Sink + Sink coatin Kitchen Metal 8 sf Non-friable Good Window glazing Exterior Wood/Glass 10 sf Non-friable Damaged com ound �s Exterior at Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good iSidin �i Caulking at Chimne Exterior WoodBrick 1 sf Non-friable Damage Roll roofing,and Roof under r roofing/flashing .Metal Wood 1,225 sf Non-friable Good ,;. cement U. Bulldln 0819 'r:•r .'� Asbestos Material Location Substrate Quanti Friabili Conditi on Joint com ound Throu hout I Drvwall 1 5,100 sf Friable Dama ed 'j 9-inch floor He Kitchens ant ths Wood 202 sf Non friable Good Ba :y Page 7 1146 Central Avenue Albany,New York 12205 Phone: (518)453-0146 Fax: (518)453-D175 Bellewood Paris Cottages November 2010 Assembly Point Lake George,New York Kitchen under Metal 5 sf Non-friable Good Linoleum :Sink I lr� Sink coatin KitchensSteel 16 sf Non-friable Good Window glazing Exterior Wood/Glass 12 sf Non-friable Damaged com ound Exterior at 10 sf Non-friable Good 2. Caulking at Siding Joints in Wood Wood Sidin Roll roofing,and Roof Wood 1850 sf Non-liable Good roofing/flashing cement i Buildin #10 i Asbestos Material Location Substrate! QuQ sf FFriable Damabed Joint com ound Throu hout Kitchen and Wood 97 sf Non-friable Damaged 9-inch floor tile :Bath Kitchen under Metal 5 sf Non-friable Good Linoleum Sink Sink coatin kGtchen Metal 8 sf Non-friable Good Window glazing Exterior Wood!Glass 8 sf Non-friable Damaged com ound Exterior at Caulking at Siding Joints in Wood Wood 3 sf Non-friable Good Sidin Caulking at Exterior Wood/Brick 1 sf Non-friable Damaged j Chimne Roll roofing,and Wood 965sf Non-friable Good roofinglflashing Roof cement Buildin #11112- Asbestos Material Location Substrate Quanti Friabili Condition Joint com ound 7t rou bout D all 5.100 sf Friable Dama ed !% Kitchens and Wood 202 sf Non friable Good �. 94nch floor the 'Baths Kitchen under Metal 5 sf Non-friable Good k Linoleum : Sink Sink coatin Kitchens Steel 16 sf Non-friable Good Window glazing Exterior Wood/Glass 12 sf Non-friable Damaged com ound Exterior at Caulking at Siding Joints in Wood Wood 10 sf Non-friable Good . 'Sidin •4. Roll roofing,and Wood 1850 sf Non4dable Good roofingl8ashing i Roof cement Tennis Court Asbestos Material I LOCation Substrate Quan ' Friabili Condition None —' Page 8 i 1146 Centrai'Avenue Albany, New York 12205 Phone: (518)453-0146 Fax: (518)453-0175 I II Sellewood Park Cottages r November 2010 Assembly Point Lake George.New York Small Outbuildin Asbestos Material Location Substrate Quanti Friabil Condition Roll-on Roofing and Roof Wood 25 ft Non-friable Good Roofing/flashingsq Cement Covered Boat Sll s Asbestos Material Location Substrate Quart ' Friabil, Condition I North Slip Wood 312 sq ft Non-friable Good Roll-on Roofing Flat RoofSouth Slip Wood 312 sq ft Non-friable Good Flat Roof .._ . According to 12 NYCRR 56, the building owner (or owner's agent) is required to transmit this asbestos inspection repott to any local government permit issuing agency (i.e. building department)for any demolition,renovation or remodeling. In addition, if this inspection Is for the purposes of demolition, the building owner (or owner's agent) is also required to transmit this inspection report to the Asbestos Control Bureau, New York State Department of Labor. This inspection report is required to be displayed on site during all related construction work. Disturbance/Abatement of any asbestos containing materials, as well as 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(618)453-0146. I Sincerely, Alpine Environmental Services,Inc. {r �1.•!1!, r.1.1 i Brian Gould NYS Dept.of Labor Asbestos Inspector Enclosures: Results, NYSD:OL Handling License(s), NYSDOL Handling Certificate(s), NYSDOH ELAP License(s) Page 9 Il 1146 Central Avenue Albany,New York 12205 Phone:(518)453-0146 Fax:(518)453-0175 I N al E11` Y4QRKSTATEDEP4RI F ENS VAl ,R �' �s`DAyIS10N OF A ETY ANQ i LTgji gs tIt3ENSE A[�D G6 �1IC 'fE'lNil 3 ? $� STATE CAMPUS$DUI �NG 12 l �nt s t ti AL6 I �yNY ► Y 1224(i ss n � `i s A�.> SBESTOS HANDLING LIC08 F 5 F S34 a' S Jupiter EnViron.t ental SeNldos�(c ��"� r ' , f f=1 NUMBER �0 9c,142 r { a t s.,7 3r{ r 5„ '£, _.. tr jd'� ` i*�u +. �. ,+ai 4.0-�3 br t ' L iCEN NUMBER 2 543 � 3 Lynn ,ourt ^rr.r i LICENSE.CLASS. DkTE OF,ISSUE: 02L.1 rT11 3 3, Lin,cpinr ,Yl��lj 0705 �,, t` EXPIRATLON�DATE .02/2$� O�Z .s , l id y° ,�:1 tyYc� + 41R it, Ma �� 1 x a�:o^ 1 ` t )' f'�, �a. a �r 'S \'rj" ;z.. ,',r 4`kta2q.� �. L t•t� �!1 t"s3 �sy VIA S bzj 1 1 ; a4 1 aJ i °f77 ra l tl �Zi th f j �'+ , 4�i ' .r+r �' c�l� r+ ty R i � -/ �;ry,•' �.'�ct�� k� �.is �A bIy.A}4thctz�ci Represetitafive� .;Annabesl� rerc _.', 4 7 .1 <t� 34 n.k, rs y.i .�^,�+ ii : t j9 sue..! '<` °.c• Y! ,jlt .-=dr{ 'y�y,'vt. „ axe . A, Ss f�i 'tom( �$ �f •, t(Il'J''•.. t tt j y�Y` a-`� � a+o- k. tt�� pry :sta a`"� hls �r^t7sg>has �sen issued.to ae c�` ar�eeiwsth 111 1`c t" att abtt of= t!eje ta'of fhe Lq}"bk Law 6f.,New or0 :. � y + •t,�11.,_— ` a"?4 e.Ne YcllGkr�Sta Codes,Rules! ,'c egglatsdll ° 1'�N GRR Pat `Y h ts1 -ct to sus"ns' n or revocalt-1 n se to >vtdaho otate,fe.ieral. al yavl stj rrctq�tlte c nd ct,of t 'esto�fi pro�e..t,or(2)demofrate uko tfis r ottssbtl to tt stonduct of an t v•Ivtn` sasCQs or asbe _ ii jt • +Z S` � raFYl h i 4 iS � i L t �t r'• ,.Y r VR < �^9 �• �-!;s .} ij'�y�' r t"qy This lrc�` se t�, a[�ci on y far the contractor nak cl bogie an`'thls 6yi erase.D elrf.O Copy must b ? rat fitly.dtsp a at El e as be. ps pro�eqt ego�sit6ll—ht�]�ecnse verifies that tl ersons emplo�ed;fi. the•hcertsee on ai£�sbest0s profs art ev✓York. Stag l+ ve bee04 alaed an Awt estos Certificate, . .opt at`�o tie t e,o o -they per form,by t)x ew Yolk ate Dep art aiop�t.of TtBryr vY` .j", a�� .,P` AJ Rmn y j" <? y, s. r�" 1�� #; xAf:r" .•1j0 b8 "`6t `xF s,, cn ;� a 1 ua K. •r ftf sip .. aerRd»• S`s ��•�'-, x F. Maureen A.Cox,Director : . . ... .. TOR THE COMMISSIONER OF LABOR NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DIVISION OF SOLID.&HAZARDOUS MATERIALS PART 364 WASTE TRANSPORTER PERMIT NO. NJ-494 Pursuant to Article 27,Tiiles 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364 PERMIT ISSUED TO: PERMIT TYPE: JUPITER ENVIRONMENTAL SERVICES, INC. 0 NEW 3 LYNN COURT m RENEWAL LINCOLN PARK, NJ 07035 Ei MODIFICATION CONTACT NAME: ANNABEL PIERCE' EFFECTIVE DATE: - 08/31/2010 COUNTY: OUT OF STATE EXPIRATION DATE, 08/30/2011 TELEPHONE NO: (973)7Q9-0200. US EPA ID NUMBER: AUTHORIZED WASTE TYPES BY DESTINATION FACILITY' The Permittee is Authorized to,Transpor0he:Following Waste Types)to the Destination Facility listed Destination Facility Location Waste Type(s) Mill Seat SLF Berpn,NY Non-Hazardous Industrial/Commercial Asbestos Petroleum Contaminated Soil Sludge,fr9m Sewage or.Water Supply Treatment Plant .............. MINERVA ENTERPRISES INC. WAYNESBURG.,OH Asbestos Seneca Meadows LF Waterloo,NY Nion-Hazardous Industrial/ComMiarcial Asbestos NOTE: By acceptance of this permit,the permittee agrees that the permit is:contingent upon strict compliance with the,Environmental Conservation Law, all applicable regulations, and the General Conditions printed on the back of this page, ADDRESS: New York State Department of Environmental Conservation Division of Solid & Hb.zardbus Materials-Waste Transporter Program 625 Broadway, 9th Floor Albany,NY 12233=7258 AUTHORIZED.SIGNATURE: Date: F N E PAGE 1 OF 2 OTIC This perInit is not 'Valid until the '9ff0Ct1V0 date listed on the permit NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DIVISION OF SOLID&HAZARDOUS MATERIALS AM WASTE 364 gamma Pursuant TRANSPORTER PERMIT NO. NJ--494 Pursuant to Article 27,Titles 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364 PERMIT ISSUED TO: PERMIT TYPE: JUPITER ENVIRONMENTAL SERVICES, INC. ❑ NEW 3 LYNN COURT ■ RENEWAL LINCOLN PARK, NJ 07035 ❑MODIFICATION CONTACT NAME: ANNABEL PIERCE EFFECTIVE DATE: 08/31/2010 COUNTY. OUT OF STATE EXPIRATION DATE: 08/30/2011 TELEPHONE NO: (973)709-0200 US EPA ID NUMBER: AUTHORIZED VEHICLES: The Permittee is Authorized to Operate the Following Vehicles to Transport Waste: (Vehicles enclosed in—'s are authorized to haul Residential Raw Sewage and/or Septage only) 13(Thirteen)Permitted Vehicle(s) NJ TBW61 D NJ TFX82W NJ THC73Z NJ THC74Z NJ THC75Z NJ THD16A NJ THD26A NJ THD40C NJ THD41C NY 13554PB NY 69111JS NY 70814JU NY AV78646 End of List PAGE 2 OF 2 TOWN OF QUEENSEURY Community Development Office 742 Bay Road, Queensbury, NY 12804-5902 March 25, 2011 Daniel Bell, Vice President T.J. Bell and Company, Inc. P.O. Box 800 Valatie, NY 12184 RE: Buildings One, Two, Three, Six, Seven, Eight, Nine, Eleven, and Twelve Dear Dan: This letter will reference that I did inspect the cottages located off Lake Parkway in the Town of Queensbury for demolition. An inspection of the buildings revealed that several of the buildings are showing signs of structural collapse and severe damage from water, ice and snow. As this would put the workers at risk who would be removing roofing materials and flooring materials, it is my strong suggestion that the buildings be totally demolished, as allowed under the New York State Labor Law, to avoid any worker injury that could occur during the removal of asbestos. I trust this will answer all your concerns. If not, please don't hesitate to contact me. Sincerely, TOWN OF QUEENSBURY David Hatin, Director Building and Code Enforcement DH/mg "Home of Natural Beauty ... A Good Place to Live " 17 Warehouse Row,Albany NY 12205 Jupitep Tel: (518) 435-0700 Fax: (518)435-0702 Environmental Services, Inc. infogJupiteres.com www.jupiteres.com NOTIFICATION TO OCCUPANTS ASBESTOS REMOVAL PROJECT Location: Cottage#7-Bellewood Park Cottages Bay Parkway, Assembly Point Asbestos Material: Controlled Demo with ACM in place Approx. 3,380 sq. ft. of joint compound Approx. 44 sq. ft. 9x9 tile Approx. 5 sq. ft. of linoleum Approx. 8 sq ft sink coating Approx. 10 sq. ft window glazing Approx. 3 sq. ft. caulking at siding Approx. 1 sq. ft. caulking at Chimney Approx. 1,225 sq. ft. of Roofing Material Date: 5/ 16/11 —5/31/11 Contractor: Jupiter Environmental Services License No: 00-1142 Air Monitor: Alpine Environmental Services, Inc Address: 1146 Central Ave Albany,NY 12205 Laboratory: Alpine Environmental Services, Inc Address: 1146 Central Ave Albany,NY 12205 12NYCRR56-1,8(e) MAY/12/2011/THU 01 : 19 AM JUPITER ALPANY FAX No. 5184350702 P. 001/001 J dte.r imp 17 Warehouse Row,Albany, NY 12205 Tel:(518)435-0700 Fax: (518)�F35-D702 Environmental Services, Inc. infoQJuplteres.corn May 12,2011 www.jupiteres.com Attention: 1) NYS D.O.L.-Jason Pensabene-Sr.Industrial Hygienist-518.485,8054 2) Administration office for Emergency dispatch at Warren County Sheriff.-528.743_2519, 3) North Queensbury Building&Codes Department-'Dave Hatin-Director-518.745.4437 4) North QueensbugfLake George Fire House-Chief Jeff.Saerischi-618.656.3008 5)_ :North.Queensbur�_Rescue.Squad r 51.8..65.6.9525 To Whom It May Concern: My name is Scott Latza and I work for Jupiter Environmental services,Inc..We are a demolition/asbestos abatement contractor hired by Ti.Hell&company,inc.forthe ownerJohn'Kelly at 241 Assembly point.rd. Queensbury,NY 12845 to.demo the.existing Bellewood Park Cottages at the end of Assembly Point road on Bay Parkway next to.Crossover Lane-Honeysuckle Lane. Dig safely has been called and the Pre demolition Ticket No.is-05091-00"12.The Demolition Ticket No.is- 05091-008-013.-Water/Sewer has.been contacted and I was informed there is no conflict.l taiked.with Laura King on May Su'at 10:55 am. The:Demolition permits have,been submitted to the code and compliance department and have been approved. The permits Numbers areas follows,P20110191,PZ040192,P20110193,P20110194,P20110195,P20120196, and1220110197 We will be mobilizing Monday May.le 2011 and will be doing some final set up prior commencing the razing of Cottages;1,2,3,.6,7,8/9,and 10/11.We have brought in a 6,000 gal Water tanker for the duration of the demolition for dust control and wet methods. This will be an-active Asbestos Abatement project until further Notice.Please make all Emergency response personnel aware. r The,onsite contacts are as follows: Jupiter Environmental Services, Inc. -Project Manager-Scott T-at=-Ceu(518)810.2847 Jupiter Environmental Services, Inc. -Site Super.-Shaun Soles -Cell(5.18)'844.9270 if you have any questions please do not hesitate to contact me Kind regards, Scott Wtza Jupiter Environmental Services,tnc -518.435,0700 office 518.435.0702 fax 518.810.2847 mobile scott@)uplteres.com