DEMO-0255-2023 Office Use Only
DEMOLITION APPLICATION Permit#:. ''N10 - 02t5- 2-026
Permit Fee:$ tarD
Town of Queens 6ury
Invoice# k 2.6
742 Bay Road,Queensbury,NY 12804
P:518-761=8256 www.gueensbury.net Flood Zone? Y (N ) Reviewed By: _
Demolition Location: 8 East Avenue, Queensbury, NY 12804 Tax Map ID #• 309.9-2-26
**AN ASBESTOS REPORT IS REQUIRED WITH ALL
DEMOLITION APPLICATION SUBMISSIONS**
DEMOLITION INFORMATION:
1. Where will demolition material be disposed? Local C&D landfill (Casella dumpsters)
2. Type of structure tn he demolished:
r
a. Residen d. Storage Building
b. Garage e. Other:
1�_ ,
c. Business �.,�
�. G)
3. What type ilities are connected to the structure: n
a. Gas LJ f. Well Water P a
b. Fuel Oil g. Public Sewer l _L
c. Propan h. Othe A/ �ePt:e SystcN►
R
d. Electric i. None
e. Public Water
4. Have ALL utilities (water, electric, etc.) been disconnected? Yes No
ADDITIONAL INFORMATION:
1. Two inspections are required: an inspection to determine that utilities are
disconnected, and a final inspection after the structure is removed and the site is
cleaned up and graded.
2. Twenty-four(24) hour notification is required for inspections.
3. Workers' Comp insurance information is required to be submitted with this application.
Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has
been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a
permit has been issued.
I have read and agree to the above:
PRINT NAME: Joshua Hala//�
SIGNATURE: 44C DATE: 5/5/23
Demolition Application Revised June 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Showcase Homes of Malta (Joshua Hala)
Mailing Address, C/S/Z: 2651 Route 9, Malta, NY 12020 j
Cell Phone: 518-223-5045 Land Line: 518-580-1305
Email: joshhala@shohomes.com
• Primary Owner(s):
Name(s): JoAnn Gregory
Mailing Address, C/S/Z: 8 East Avenue, Queensbury, NY 12804
Cell Phone: 518-225-5276 Land Line:
Email:
❑ Check if all work will be performed by property owner only
• Contractor: (List all additional contractors on the back of this form)
Contact Name(s): Showcase Homes of Malta (Joshua Hala)
Contractor Trade: Retailer
Mailing Address, C/S/Z: 2651 Route 9, Malta, NY 12020
Cell Phone: 518-223-5045 Land Line: 518-580-1305
Email: joshhala@shohomes.com
"Workers' Comp documentation must be submitted with this application"
Contact Person for any questions regarding this project: Joshua Hala or Adam Hala
Cell Phone: 518-223-5045 Land Line: 518-580-1365
Email: joshhala@shohomes.com
Demolition Application Revised June 2022
TOWN OF UEENSBURY T,
BUILDING &
Reviewed B��
Date,
ASBESTOS
SURVEY/INSPECT107%
N
For the Dwelling Located at;
8 East Ave, Queensbury, New York 12
� 804
FIatley Read, Inc.
P.O. Box 104
Schuylerville, NY 12871
(518) 577-5681
Asbestos Handling � P y .
License Number: 199443
Date of Site Visit: March 6,2023
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
F?aspd on our limited examination,compliance
with our comments shall not be construed as
indicat.ig the plans and specifications are in
full compliance with the Building Codes of
INew York State.
G09.9-2-26 DE
regOrY,Jo q aO'Oz55-z023
8 Fast Ave mes
Demolition Of Inn &
manufactured home
J
SECTION I-INTRODUCTION
On March 6,2023, Flatley Read, Inc. conducted a survey for the presence of asbestos
containing materials at the building located at 8 East Ave, Queensbury,New York Michael
Jenison (Asbestos Inspector#608027371) conducted this inspection following procedures and
guidelines commonly used and accepted by federal and state regulations. The objective of the
survey was to identify the presence and approximate locations and quantities of suspect and/or
confirmed asbestos containing materials.
An initial walkthrough of the designated areas was conducted by an experienced asbestos
inspector to observe and record materials used in the construction of the building. The inspector
proceeded by assessing floors, walls, ceilings, surfacing materials, thermal systems insulation,
roofing materials and other miscellaneous materials with the potential to contain asbestos. From
observations, the inspector prepared a listing of building materials that are suspected to contain
asbestos. The inspector selected these materials for inclusion in the inspection through
professional experience and an understanding of the historical uses of asbestos. Generally
speaking, if a building material within a structure could contain asbestos,the material was
included in the inspection.
Materials included in the survey were identified and recorded with respect to grouped
homogeneous sampling areas. Representative bulk material samples were collected from
locations within each homogeneous sampling area. Sampling information was recorded on chain
of custody forms for documentation. Samples were individually preserved within a container
and transported to an independent laboratory for asbestos analysis.
Laboratory analysis of asbestos samples via polarized light microscopy (PLM) and/or
transmission electron microscopy(TEM) was conducted by AmeriSci New York, 117 East 301h
Street,New York,NY 10016 (ELAP# 11480). Sample analysis was conducted as follows:
• "Friable"Asbestos Samples—PLM
• "Non-Friable"Organically Bound(NOB)Asbestos Samples—PLM and, if negative, TEM
for confirmation as required under NYSDOH-ELAP regulations.
SECTION II-LIMITATIONS
The information provided in this report was compiled from field and laboratory data obtained
during the site visit. Observations noted and recorded are intended to represent the conditions
that existed at the subject site at the time and date that the observations were made.
Flatley Read has not conducted its own analytical but has utilized an independent NYS-DOH
ELAP approved laboratory to provide the analytical results contained in this report. All.
discussions,findings, and conclusions are based on information that Flatley Read received and
understood to be factual.
Determinations of suspect asbestos containing materials within the building were subject to the
accessibility of individual areas or spaces. Flatley Read accepts no responsibility for the content
of the building materials within areas or spaces that were unknown tolus or not reasonably
accessible. Flatley Read assumes no liability for any buildings that were not identified by the
client that may fall under state or federal regulations. i
All quantities of ACM provided in this report are provided as required by law and are believed to
I.
be accurate. If this report is to be used for bidding purposes, field verification of quantities is
recommended by the abatement contractor prior to bidding.
Conclusions and recommendations provided in this report are based on the assumption that
materials identified are homogeneous throughout their application. Sample sites were determined
using information provided by the Client.
This report has been compiled for the exclusive use of the property owner, successors, and/or
assigns. This report and its contents represent confidential information and should not be
duplicated without the express permission of the homeowner, successors, and/or assigns. This
report should only be reproduced in its entirety and all the appropriate information provided.
The following limitation/conditions were noted as part of the survey:
• OSHA requires that an employer not expose its workers above the PEL and therefore.specific
training,work practices and/or respiratory protection may need to be a consideration when
handling materials that are less than one percent.
• The inspection was performed in accordance with New York Statle Industrial Code Rule 56
Section 5.1. It is the responsibility of the owner or its agent to forward a copy of this report
to the local government entity charged with issuing a permit for such demolition,renovation,
remodeling or repair work under applicable State or local laws as well as to the NYS
Department of Labor Asbestos Control Bureau. Flatley Read will not send this report to the
NYSDOL without written permission from its client due to the sensitive nature of the
information present in this report.
• A copy of 56-5.1 is available upon request.
• This report reflects the conditions found at the date and time of the inspection(s). Conditions
of the area and materials may change due to external events, forces or influences. Re-
inspection of the area may be required prior to the start of any work if an extended period of
time has passed or if disturbances have occurred.
• All asbestos locations on drawings are approximate. All quantities are estimated and must be
field verified prior to use as part of a bidding document. Materials may extend or be hidden
behind or within other materials or structural.members. Any contractor or other user of this
report is required to physically confirm the quantities and verify measurements of materials
to be removed, to be bid for removal, or for any other purpose. Contractors are responsible
to physically visit the site and confirm all quantities for bidding purposes.
• Flatley Read did not inspect any exterior area below grade. Foundation sealers,buried piping
and other items may exist below grade which may contain asbestos.
v
SECTION III—ASBHESTOS SAMPLING S UMMAR Y
The results of the sampling are provided in Table 1 (Asbestos Sampling Results) and the
asbestos findings provided in Table 2 (Asbestos Findings). The laboratory results and sample
location map(s) are also provided in the following Attachments.
Table 1 —Asbestos Sampling Results
- e
M-lt' - ATE --::�Resiilts<-_:..-�-;
'rrs' -
EIM.R su s�-��� -
fl-`
- - - �ati" 'Are` _^Loc oii/ a:.:
Descc `ti`'n: -
a;,.
z "-
1 A,B Yellow Rolled Flooring Bathroom 1 Floor NAD NAD
2 A,B Tan/White Rolled Flooring Laundry Floor NAD NAD
3 A,B White/Brown Ceiling Board Ceiling All Except Addition NAD N/A
4 A,B Tan/White Wall Board Ceiling Addition,All Walls NAD N/A
5 A,B White Sheetrock Tape Ceiling Addition,All Walls NAD N/A
6 A,B White Sheetrock Joint Compound Ceiling Addition,All Walls NAD N/A
7 A,B Light Brown Rolled Flooring Bathroom 2 Floor NAD NAD
Table 2-Asbestos Findings
Norte of the materials-tested-were-positive for-asbestos-as-defined-by-the-USEP-A and-New Y-ork-State_Department-of_Labor_—Industrial-Co-de—
Rule(NYS ICR 56).
J
AmeriSci New York
117 EAST 30TH ST.
AMERI Scl NEW YORK,NY 10016
TEL:(212)679-8600• FAX:(212)679-3114
PLM Bulk Asbestos Report
Flatley Read, Inc. Date Received 03/08/23 AmeriSci Job# 223031642
Attn: Michelle DeGarmo Date Examined 03/10/23 P.O. #
P.O. Box 104 ELAP# 11480 Page 1 Of 3
RE:BEA - RTSC; 8 East Ave, Queensbury, New York
Shuylerville, NY 12871
Client No. / HGA Lab No. Asbestos Present Total %Asbestos
1 A 223031642-01 No NAD
1 Location:Bath 1 Floor-Yellow Rolled Flooring (by NYS ELAP 198.6)
by Valeriu Voicu
on 03/10/23
Analyst Description:Beige, Homogeneous,Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 24.2%
113 223031642-02 No NAD
1 Location:Bath 1 Floor-Yellow Rolled Flooring (by NYS ELAP 198.6)
by Valeriu Voicu
on 03/10/23
Analyst Description:Beige, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 23.6%
2A 223031642-03 No NAD
2 Location:Laundry Floor-Tan/White Rolled Flooring (by NYS ELAP 198.6)
by Valeriu Voicu
on 03/10/23
Analyst Description:Tan,Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 1.5%
213 223031642-04 No NAD
2 Location:Laundry Floor=Tan/White Rolled Flooring (by NYS ELAP 198.6)
by Valeriu Voicu
on 03/10/23
Analyst Description:Tan,Homogeneous,Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 1.5%
3A 223031642-05 No NAD
3 Location:Ceiling All Except Addition-White/Brown Ceiling Board (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst-Description:Brown/White, Heterogeneous, Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose 12%, Fibrous glass 1%, Non-fibrous 87%
See Reporting notes on last page
AmeriSci Job#: 223031642 Page 2 of 3
Client Name:Flatley Read, Inc.
PLM Bulk Asbestos Report
8EA-RTSC; 8 East Ave, Queensbury, New,York.'
i
Client No./ HGA Lab No. Asbestos Present Total %Asbestos
313 223031642-06 No NAD
3 Location:Ceiling All Except Addition-White/Brown Ceiling Board (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:Brown/White,Heterogeneous, Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose 15%, Fibrous glass 1%, Non-fibrous 84%
4A 223031642-07 No NAD
4 _ Location:Ceiling Addition,All Walls-Tan/White Wall Board (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:Brown/White, Heterogeneous, Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose 20%, Non-fibrous 80%
i
413 223031642-08 No NAD
4 Location:Ceiling Addition,All Walls-Tan/White Wall Board (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:Brown/White, Heterogeneous, Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose 10%, Non-fibrous 90%
5A 223031642-09 No NAD
5 Location:Ceiling Addition,All Walls-White SR Tape (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:White,Heterogeneous, Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose 5%, Non-fibrous 95%
513 223031642-10 No NAD .
5 Location:Ceiling Addition,All Walls-White SR Tape (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:White, Heterogeneous, Fibrous,Bulk Material
Asbestos Types:'
Other Material: Cellulose 7%, Non-fibrous 93%
6A 223031642-11 No NAD
. 6 Location:Ceiling Addition,All Walls-White SR Joint Comp (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:White, Homogeneous,Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose Trace, Non-fibrous 100%
See Reporting notes on last page
AmeriSci Job#: 223031642 Page 3 of 3
Client Name:Flatley Read, Inc.
PLM Bulk Asbestos Report
8EA- RTSQ 8 East Ave, Queensbury, New York
Client No. / HGA Lab No. Asbestos Present Total %Asbestos
613 223031642-12 No NAD
6 Location:Ceiling Addition,All Walls-White SR Joint Comp (by NYS ELAP 198.1)
by Valeriu Voicu
on 03/10/23
Analyst Description:White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose Trace, Non-fibrous 100%
7A 223031642-13 No NAD
7 Location:Bath 2 Floor-Lt Brown Rolled Flooring (by NYS ELAP 198.6)
by Valeriu Voicu
on 03/10/23
Analyst Description:Lt.Brown, Homogeneous,Fibrous, Bulk Material
Asbestos Types:
Other Material: Fibrous glass 3%, Non-fibrous 11.8%
713 223031642-14 No NAD
7 Location:Bath 2 Floor_Lt Brown Rolled Flooring (by NYS ELAP 198.6)
by Valeriu Voicu
on 03/10/23
Analyst Description:Lt.Brown, Homogeneous, Fibrous, Bulk Material
Asbestos Types:
Other Material: Fibrous glass 5%, Non-fibrous 10.4%
Reporting Notes:
Analyzed by:Valeriu Voicu• Reviewed by:Marik Peysakhov
Date:3/10/2023 �f
*NAD/NSD=no asbestos detected;NA=not analyzed;NA/PS=not analyzed/positive stop,(SOF-V)=Sprayed On Fireproofing containing Vermiculite;
(SM-V)=Surfacing Material containing Vermiculite;PLM Bulk Asbestos Analysis using Olympus,Model BH-2 Pol Scope,Microscope,Serial#:229915,by
Appd E to Subpt E,40 CFR 763 quantified by either CVES or 400 pt ct as noted for each analysis(NVLAP 200546-0),ELAP PLM Method 198.1 for NY
friable samples,which includes the identification and quantitation of vermiculite,or ELAP 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.RI Cert AAL-094,CT Cert PH-0186,Mass Cert AA000054,NJ Lab ID #NY031.
END OF REPORT
AmeriSci Job#: 223031642 Page 1 Of 2
Client Name: Flatley Read, Inc.
Table•I
Summary of Bulk Asbestos Analysis Results
8EA- RTSC; 8 East Ave, Queensbuly New York
Sample Heat Acid Insoluble
AmeriSci HG Weight Sensitive Soluble Non-Asbestos '*Asbestos%by "Asbestos%by
Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS TEM
01 1A 1 0.175 64.2 11.6 24.2 NAD NAD
Location: Bath 1 Floor-Yellow Rolled Flooring
02 1 B 1 0.151 63.5 13.0 23.6 NAD NAD
Location: Bath 1 Floor-Yellow Rolled Flooring
03 2A 2 0.132 79.2 19.3 1.5 NAD NAD
Location: Laundry Floor-Tan/White Rolled Flooring
04 2B 2 0.125 79.7 18.8 1.5 NAD NAD
Location: Laundry Floor-Tan/White Rolled Flooring
05 3A 3 — — — — NAD NA
Location: Ceiling All Except Addition-White/Brown Ceiling Board
O6 3B 3 — — — — NAD NA
Location: Ceiling All Except Addition-White/Brown Ceiling Board
07 4A 4 — — — — NAD NA
Location: Ceiling Addition,All Walls-Tan/White Wall Board
08 4B 4 -- — — — NAD NA
Location: Ceiling Addition,All Walls-Tan/White Wall Board
09 5A 5 — — — — NAD NA
Location: Ceiling Addition,All Walls-White SR Tape
10 5B 5 — — — — NAD NA'
_ Location: Ceiling Addition,All Walls-White SR Tape
11 6A 6 — — — — NAD --NA
Location: Ceiling Addition,All Walls-White SR Joint Comp
12 6B 6 — — — — NAD NA
Location: Ceiling Addition,All Walls-White SR Joint Comp
13 7A 7 0.191 66.4 18.8 14.8 NAD NAD
Location: Bath 2 Floor-Lt Brown Rolled Flooring
14 7B - 7 0.202 66.3 18.3 15.4 NAD NAD
Location: Bath 2 Floor-Lt Brown Rolled Flooring .
See Reporting notes on last page
AmeriSci Job#: 223031642 Page 2 of 2
Client Name: Flatley Read, Inc.
Table I
Summary of Bulk Asbestos Analysis Results
8EA- RTSC; 8 East Ave, Queensbury, New York
Sample Heat Acid Insoluble
AmeriSci HG Weight Sensitive Soluble Non-Asbestos "Asbestos%by "Asbestos%by
Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS TEM
Analyzed by:Marik Peysakhov /G Reviewed by:Marik Peysakhov Date:3/10/2023 Zf �f
"Quantitative Analysis(Semi/Full);Bulk Asbestos Analysis-PLM by Appd E to Subpt E,40 CFR 763 or NYSDOH ELAP 198.1 for New York friable samples or NYSDOH ELAP 198.6 for New York NOB samples;
TEM(Semi/Full)by EPA 600/R-93/116(or NYSDOH ELAP 198.4;for New York samples).Analysis using Hitachi,Model H7000-Noran 7 System,Microscope,Serial#:747-05-06.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;Quantitation 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,NJ Lab ID #NY031.
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).
Relinquished By: Date/Time: C BULK CHAIN OF CUSTODY
ReceivYORK
ed By: t,:L(�nd l Date/Time: AMERI SCl 117nEAST 30TERISCI H STREET
�— NEW YORK,NY 10016
Relinquished By: Date/Time: TOLL FREE:(800)706-5227
PHONE:(212)679-8600
Date/Time: FAX:(212)679-9392
Received B WwW.AMERisci.coM
ompany: Flatley Read Inc. Project:
Street Address:12 Spring St, Ste 102 Pr9j Mgr,.-'' Proj#:
city: Schuylerville State:NY zip:12871 Proj Add'r",ess: . ee Pro'State:New York
Phone:518-577-5681 Cell: 518-430-7788 nalysis` ❑PLM; QPositive Stop; aTEM Y ELAP PLM/TEM w/NOB Prep.
Fax Results? Y❑ Fax#: ASTM.Ddit Microvac VVi e ; OQualitative; NY ELAP 198.8 Vermiculite
Email-Results? YD✓ Email: info@flatleyread.com urnaround Time: 5 day Material Type: 21 Bulk ❑Dust Water
Results to:Michelle DeGarmo rampled,,-.By:_ C Date Sampled:
peciallnstructions or Comments:
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Cl �'' �54ry DATE OF ISSUE: 03/17/2022
Q` �S6h'li,Jerville 'NY 12871� °tr ;w ;�'t�:'� EXPIRATION,DATE: 04/34%2023 {,
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his icense<lias U:een issued in accgrcance;withap licai'1,`a>prouisonsf�ofhA�ti'c1ey .Q;'bf the Labor Law of New Yprk Stae'`and of At
Elie I�jew X;oi Atkte4Codes,Rules' dk�egulatigns.;12 NYCRR Part 56): It is;su sect to suspension or revoca4ibn fora(1)
seous violation A,�tate,federal or locallalvs witl>i ega d to.the eoudu4ct of an.asbestoSiproaeet,or(2)demonstrated;lackQf {
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-onsibili in the"Qconduct of an'=r ob'in olviag a5liesfos'or•asbestos,%4tefla7:
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This,f cense is5vval�d only for the contractor,n�aTrizc abbye arid-tliis license oz aphotocopy-must.be;rpr`Om neatly displayed'at�the
asbestos pro ect Worksite�AThis-lieense verifies th4, persons employ(Py the licensee on�an asbesto project in=Nei York
State hareUeenssed an:4bestos Certificate;'apprqq1riate foi-the tpeof vi�ork-they perform,by theNew Yo"rk Stater
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Department of.L"bor. ,ge
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Amy Phillips,Director
SH 432(8/12) For the Commissioner of Labor