BOTH-000665-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
4 __ Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000665-2016 Date Issued: Tuesday, January 31, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000665-2016
has been completed.
Tax Map Number: 289.14-1-19
Location: 20 PIONEER PT
Owner: Renee Little,Robert Little
Applicant: Phinney Design Group
This structure may be occupied as a: Demolition Only of SFD 1305 s.f.
Asbestos Report pending By Order of Town Board
Cross Ref. AV PZ-31-2015 and SP 67-2015 or SP PZ-32-2015 TOWN OF QUEENSSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the �j4k--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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
QL Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000665-2016
Tax Map No: 289.14-1-19
Permission is hereby granted to: Renee Little,Robert Little
For property located at: 20 PIONEER PT
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: Renee Little Demolition-Commercial $0.00
Owner Address: 814 Fox Glen PL Total Value $0.00
Walnut Creek,CA 94598
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Demolition Only of SFD 1305 s.f.
Asbestos Report pending
Cross Ref. AV PZ-31-2015 and SP 67-2015 or SP PZ-32-2015
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,December 16,2017
(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 o ueensb j
rida , cc ber 16,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit#: jj+
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee 30+1n
d S PlS
Provide 2 plot plans drawn to scale,showing lot boundaries with dimensions and adjacent roads/streeys. Shof
tw allaexisting7—di structures
on property and Indicate which are to be demolished. Indicate the location of all utilities n
Date __ 29J ___ Demolition Location � P_o, P• NY
Tax Map ID _9_1 Y_/_/q
APPLICANT `PH-_N � ------ OWNER
yi3 �gz 1 I�V� �ZTtx
Address / �ycyvOrti r. ---- --- — ---------------
--- --- -------------
---- Address
----------- ---------
r°v'n ir..�rt�l C2.SZ3'� G� 9'/f98
------------ -------------
Phone ___5?m-S&L 7t Zo --x , r'-Z — Phone
------- ---------------------------
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: _ _"�`2T1MAO 4 Phone:
1. Person Responsible for Work 7e-
2.
e2. Where will demolition material be disposed? lq4(, L-JAC"t� G4cru-r
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 x, Residence ___ Garage ___ Business
Storage Bldg. --- other
b) Size of Structure 134>5 S.F.
c) Number of Stories j
d) Foundation Type &.uvc Cak C.FN -
e) Foundation
f) Structure(s) 7yq- V
7. Utilities Information
a) Indicate utilities for this structure___ Gases Electric x Propane ___ Public Water ___Public Sewer
2—c—On-site well water pump
a) Have you notified the Town Water Department for public water and sewer disconnect? ____ Yes 1G_ No
b) Have all utilities bqbn disconnected? ____Yes _ No
8. Signature
Print Name: _ _3AP�t �• _._M1 E'tf,�mav�_ 1yv Date ___ _ ? _
Signature: _ _ _________ Date
— --------------------- ----------------
() W
Town of Queensbury Building & Codes - Demolition Permit - December 2014
024
SPECTRVA PU.B((Phone)&*enedad y,NF 12301
(S18)348-8374(Phone)
Environmental Rsseciates. Inc. (518)346-4062(Pax)
'EECEEOlNO OON CLIENTS EXPEcrarjoNs Or EXCELLENCE' www4spectrum ean!
FILE COPY
ASBESTOS SURVEY/INSPECTION
FOR
RESIDENTIAL STRUCTURE - DEMO
20 PIONEER POINT
QUEENSBURY, NY 12804
TOWN OF QU N
BUILDING & OD `
Reviewed By: RUM PROJECT NO.: 16-338
Date:
OCTOBER 12, 2016
PREPARED FOR:
ROBERT AND RENEE LITTLE
814 FOX GLEN PLACE
WALNUT CREEK, CA 94598
Environmental Consulting&ManagetnentServices • Health&Safety Training • Laboratory Services
TABLE OF CONTENTS
SECTION I -INTRODUCTION
SECTION II -LIMITATIONS
SECTION III -ASBESTOS SAMPLING SUMMARY
ATTACHMENTS -TABLE 1-ASBESTOS SAMPLING RESULTS
-TABLE 2-ASBESTOS FINDINGS
-LOCATION MAPS
-LABORATORY REPORTS
-LICENSING AND CERTIFICATION
- 12 NYCRR PART 56-5.1
SECTION I-INTRODUCTION
On October 6, 2016, Spectrum Environmental Associates, Inc. (Spectrum) conducted a survey for
the presence of asbestos containing materials at the Residential Structure located at 20 Pioneer
Point in Queensbury,NY. Mr.Bruce Campbell Jr.(Asbestos Inspector#15-11979)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 of New York,New York(FLAP# 11480,
NVLAP#200546-0). 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.
Spectrum 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 Spectrum 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. Spectrum accepts no responsibility for the content of
the building materials within areas or spaces that were unknown to us or not reasonably accessible.
Spectrum assumes no liability for any buildings that were not identified by the client that may fall
under state or federal regulations.
All quantities of ACM provided in this report are provided as required by law and are believed to
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.
This report has been compiled for the exclusive use of Robert & Renee Little, their successors
and/or assigns. This report and its contents represent confidential information and should not be
duplicated without the expressed permission of Robert & Renee Little their successors and/or
assigns.
The building owner is Robert&Renee Little and they may be reached at 814 Fox Glen Place in
Walnut Creek, CA.
SECTION III—ASBESTOS SAMPLING SUMMARY
The results of the sampling are provided in Table 1 (Asbestos Sampling Results) and the asbestos
findings are provided in Table 2 (Asbestos Findings) of the Attachments. The laboratory results
and sample location map(s) are also provided in the Attachments.
ATTACHMENTS
TABLE I -ASBESTOS SAMPLING RESULTS
TABLE 2-ASBESTOS FINDINGS
LOCATIONMAPS
LABORATORYREPORTS
LICENSING AND CERTIFICATION
NYS INDUSTRIAL CODE RULE SECTION 56-5.1
TABLE 1 — ASBESTOS SAMPLING RESULTS
20 Pioneer Point, Queensbury NY
Spectrum Project# 16-338
Date Sampled: October 6, 2016
Sample# Description Location/Area PLM Results TEM Results
/oType) /oType)
01 Window Glaze Area C Window NAD Anthophyllite Trace
02 Window Glaze Area F Window NAD Anthophyllite Trace
03 Mastic Under 9x9 C NAD Chrysotile Trace
04 Mastic Under 9x9 E NAD Chrysotile Trace
05 Floor Tile 9x9 Chrysotile 14.3% NA
06 Floor Tile 9x9 F NA/PS NA
07 Carpet Adhesive On 9x9 area E under carpet NAD NAD
08 Carpet Adhesive On 9x9 area C under carpet NAD NAD
09 Mortar Fireplace in Living Room NAD NA
10 Mortar Fireplace in Living Room NAD NA
11 Roof Vapor North Side Roof NAD NAD
12 Roof Vapor South Side Roof NAD NAD
13 Roofing North Side Roof NAD NAD
14 Roofing South Side Roof NAD NAD
15 Roof Tar Chimney Chrysotile 11.7% NA
16 Roof Tar Vent Pipe NAPS NA
Note: Asbestos containing materials are greater than 1%asbestos. Trace is considered less than 1%asbestos.
NAD-no asbestos detected,NA-not applicable,PS—Positive Stop,SF-square feet,LF—linear feet
TABLE 2 — ASBESTOS FINDINGS
20 Pioneer Point, Queensbury NY
Spectrum Project# 16-338
Date Sampled: October 6, 2016
Limitations:
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 State 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. Spectrum 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 included in this report for reference.
• 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.
• This survey is for the demolition of the house.
• Spectrum did not inspect any exterior area below grade. Foundation sealers,buried piping and
other items may exist below grade which may contain asbestos.
SF—square feet,LF—linear feet,ea—each
TABLE 2 — ASBESTOS FINDINGS
20 Pioneer Point, Queensbury NY
Spectrum Project# 16-338
Date Sampled October 6, 2016
Material Location/Area Estimated Quantity* Condition/Damaged
Floor Tile 9x9 Tile-Bedroom 1(D),Bedroom 2(F) 500 SF* Good
Roof Tar Chimney 2 SF* Good
* Quantities of identified ACM are estimates only and should be field verified prior to bid by the contractor or confirmed as part of an RFP or
design specification.
Please see the limitation listed above.
SF—square feet,LF—linear feet,ea—each
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LABORATORY REPORTS
7
AmeriSci New York
A117 ACR, S^, 117 EAST 30TH ST.
IV/L l� NEW YORK, NY 10016
TEL:(212)679-8600"FAX:(212)679-3114
PLM Bulk Asbestos Report
Spectrum Environmental Associates, Inc Date Received 10/07/16 AmeriSci Job# 216101786
Attn: Bill Massman Date Examined 10/10/16 P.O. #
P.O.Box 1024 ELAP# 11480 Page 1 of 4
RE: 16-338; 20 Pioneer Point, Demo.
Schenectady, NY 12301
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
1 216101786-01 No NAD
1 Location: Area C Window-Window Glaze (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Grey,Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 61.5%
2 216101786-02 No NAD
1 Location: Area F Window-Window Glaze (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Grey, Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 22.5%
3 216101786-03 No NAD
2 Location: Under 9 X 9 C-Mastic (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Black, Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 11.7%
4 216101786-04 No NAD
2 Location: Under 9 X 9 E-Mastic (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 15%
5 216101786-05 Yes 14.3 %
2 Location: 9"X 9"D-Floor Tile (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Tan, Homogeneous,Non-Fibrous, Bulk Material
Asbestos Types: Chrysotile 14.3%
Other Material: Non-fibrous 35.7%
See Reporting notes on last page
AmeriSci Job#: 216101786
Client Name: Spectrum Environmental Associates, Inc. Page 2 of 4
PLM Bulk Asbestos Report
16-338; 20 Pioneer Point, Demo.
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
6 216101786-06 NAPS
2 Location: 9"X 9"F-Floor Tile
Analyst Description: Bulk Material
Asbestos Types:
Other Material:
7 216101786-07 No NAD
3 Location: On 9 X 9 Area E Under Carpet-Carpet Adhesive (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description:Yellow, Homogeneous,Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 44.1 %
8 216101786-08 No NAD
3 Location: On 9 X 9 Area C Under Carpet-Carpet Adhesive (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Yellow, Homogeneous,Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 42.8%
9 216101786-09 No NAD
4 Location: Fireplace In Living Room-Mortar (by NYS ELAP 198.1)
by Bo Sun
on 10/10/16
Analyst Description: Grey, Homogeneous,Non-Fibrous,Cementitious,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
10 216101786-10 No NAD
4 Location: Fireplace In Living Room-Mortar (by NYS ELAP 198.1)
by Bo Sun
on 10/10/16
Analyst Description: Grey,Homogeneous,Non-Fibrous,Cementitious,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
11 216101786-11 No NAD
5 Location: North Side Roof-Roof Vapor (by NYS ELAP 196.6)
by Bo Sun
on 10/10/16
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 3.5%
See Reporting notes on last page
AmeriSci Job#: 216101786
Client Name: Spectrum Environmental Associates, Inc. Page 3 of 4
PLM Bulk Asbestos Report
16-338; 20 Pioneer Point, Demo.
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
12 216101786-12 No NAD
5 Location: South Side Roof-Roof Vapor Po (by NYS ELAP 198.6)
by Be Sun
Analyst Description: Black, Homogeneous, Non-Fibrous,Bulk Material on 10/10/16
Asbestos Types:
Other Material: Non-fibrous 1.1 %
13 216101786-13 No NAD
6 Location: North Side Roof-Roofing (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Black, Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 54.2%
14 216101786-14 No NAD
6 Location: South Side Roof-Roofing (by NYS ELAP 198.6)
by Bo Sun
on 10/10/16
Analyst Description: Black, Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 50.5%
15 216101786-15 Yes 11.7 %
7 Location: Chimney-Roof Tar (by NYS ELAP 198.6)
by Bo Sun
on 10110/16
Analyst Description: Black,Homogeneous,Non-Fibrous, Bulk Material
Asbestos Types:Chrysofile 11.7%
Other Material: Non-fibrous 11.7%
16 216101786-16 NAPS
7 Location: Vent Pipe-Roof Tar
Analyst Description: Bulk Material
Asbestos Types:
Other Material:
See Reporting notes on last page
AmeriSci Job#: 216101786
Client Name: Spectrum Environmental Associates, Inc. Page 4 of 4
PLM Bulk Asbestos Report
16-338; 20 Pioneer Point, Demo.
Reporting Notes:
Analyzed by:Bo Sun
'NAD/NSD=no asbestos d tecled;NA=not analyzed;NAIPS=not analyzed/positive stop,(SOF-V)=Sprayed On Fireproofing containing Vermiculite;
(SM-V)=Surfacing Material containing Vermiculite;PLM Bulk Asbestos Analysis by EPA 600/M4-82.020 per 40 CFR 763(NVLAP 200546-0),ELAP
PLM Method 198.1 for NY friable samples,which includes the identification and quantitation 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
AmeriSci Job#: 216101786
Page 1 of 2
Client Name: Spectrum Environmental Associates, Inc.
Table I
Summary of Bulk Asbestos Analysis Results
16-338; 20 Pioneer Point, Demo.
Sample Heat Acid Insoluble
AmeriSel HG Weight Sensitive Soluble Non-Asbestos "`Asbestos%by "Asbestos%b
Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic°% PLM/DS TEM y
01 1 1 0.299 3.7 34.8 61.4 NAD Anthophyllite Trace
Location: Area Window-Window Glaze
02 2 1 0.240 6.3 71.3 22.4 NAD Anthophyllite Trace
Location: Area Window-Window Glaze
03 3 2 0.145 84.8 3.4 11.6 NAD Chrysotile Trace
Location: Under 9 X 9 C-Mastic
04 4 2 0.233 81.1 3.9 14.9 NAD Chrysotile Trace
Location: Under 9 X 9 E-Mastic
05 5 2 0.230 24.8 25.2 35.7 Chrysotile 14.3 NA
Location: 9"X 9"D-Floor Tile
O6 6 2 0.188 26.6 21.3 52.1 NAPS NA
Location: 9"X 9"F-Floor Tile
07 7 3 0.270 48.1 7.8 44.1 NAD NAD
Location: On 9 X 9 Area E Under Carpet-Carpet Adhesive
O8 8 3 0.299 46.8 10.4 42.8 NAD NAD
Location: On 9 X 9 Area C Under Carpet-Carpet Adhesive
09 9 4 - -- ---- - NAD NA
Location: Fireplace In Living Room-Mortar
10 10 4 --- --- -- ---- NAD NA
Location: Fireplace In Living Room-Mortar
11 11 5 0.257 96.1 0.4 3.5 NAD NAD
Location: North Side Roof-Roof Vapor
12 12 5 0.282 87.9 11.0 1.1 NAD NAD
Location; South Side Roof-Roof Vapor
13 13 6 0.299 43.5 2.3 54.2 NAD NAD
Location: North Side Roof-Roofing
14 14 6 0.279 45.5 3.9 50.5 NAD NAD
Location: South Side Roof-Roofing
15 15 7 0.290 56.9 19.7 11.7 Chrysotile 11.7 NA
Location: Chimney-Roof Tar
16 16 7 0.310 51.6 25.5 22.9 NAPS NA
Location: Vent Pipe-Roof Tar
See Reporting notes on last page
AmeriSci Job#: 216101786 Page 2 of 2
Client Name: Spectrum Environmental Associates, Inc.
Table I
Summary of Bulk Asbestos Analysis Results
16-338; 20 Pioneer Point, Demo.
Sample Heat Acid Insoluble
AmeriSel HG Weight Sensitive Soluble Non-Asbestos "Asbestos%b
sample Client Sample# Area (gram) Organic% Inorganic% Inorganic% y '"Asbestos%by
PLM/DS TEM
Analyzed by:Marik Peysakhov ;Date Analyzed 10/11/2016
"Quantitative Analysis(Semi/Full);Bulk Asbestos Analysis-PLM by EPA 600IM4.82-020 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 Bulk 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;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,AIHA-IAP,LLC(PLM)Lab IO 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.solls and other heterogenous materials).
Reviewed By:
3 P°•ffivx7°24
SPECTRUA
E Schenectad y,AT 72301
Environmental Hssociates, Inc, (81p8)346-6374(Phone)
•excECDING CLR Cl/PNTS rx,rcr,""',,"C.,eELLE.VCr- ' (518)346-4062(Pax)
mtnv.4spectrum.com
BULK SAMPLING CHAIN� F CUSTODY (Rw.ma mow)
PROJECT INFORMATION
P,rylectq� uildin Nenw:
Mntriv Analysis Requested Turnaround
Date Sem m: cation:
)0' ) Bulk ❑ Paint qrPLM-SLAP 198.1 %�T -ELAP 198.4 ❑ RUSH ❑ 24 Hour
Pegep I Of iar. .0
't M Imo•LI - ❑ Soil ❑ Wipe PLM-ELAP 198.6 ❑ ❑ TL Hour _S
SAMPLE IDENTIFICATION
Sample ID# I Group#:* Materiel Semple Location Condition/Comment
,elo iR Aye
I )�
rS7•� i �Qi o
.5 (CDS 911 q ,
' 7 L (-Q-L', �Q)l 4c .}
cl, 621
L in
T ooh v r N :4`i Sjc)C�
S' G N
is CYN7
S 'd 3
�
Unless otM1erwix stated please analyze each group to first(t')positive result I
[mments: •112 1 6 10
01786 I .
CHAIN OF CUSTODY
Relinquished By Date Time ceived By Da Time
Method of Submittal
M 1
Environmental Consulting & Management Services Health k Safety Training Laheratory Services
LICENSING AND CERTIFICATION
L
P 0, 1094
SPESPECTRUM (818)348-837(Phan)
EnOrenmental Rssacrates, Inc. r318) .4 pettry room
'EBeteoi,Yo OUR CtieNr9 ERYCCrarims of Excew.YCt' WWW.49(lPdrLM,COnt
State of New York — Department of Labor
Asbestos Certification
•,iniEOf 'ICr: '��iRK. DEPAGTME:d10FUfi���'
BRUCE W CAMPBELL JR
CLASS(EXPIRES)
CATEC(05117) DINSP(05)17)
�* H PM (05117)
FAUST BE CAR.RIEP OH ASBESTOS PROTECTS
IF FOUND RETURN TO:
�n EYES am NYSDOL - LLC UNIT
HAIR SRO ROOM ISIA SUILDINO 12
s$ SOT 6' 00" STATE OFFICE CAMPUS
ALEANY NY 12240
Bry
Oo
0
State of New York — Department of Labor
Colles Certification
A Asbestos Handler
B Restricted Handler - Allied Trades
C Air Sampling Teclu�ician ---
_ -.--.__._---_ .--.-Ins ector
E Management Planner------
-E - —operations and Maintenance
G Supervisor
}-)
Project-Monitor ---- 1
Pro)--'ect Designer J
---� - - ----- --
EnvironmentalConsulting& 41(inagementServices • Health &•.5'afetl,'1'raining • laboratorrS'ervices
New York State—Department of Labor
Division of Safety and Heafth
License and Certificate Unit
State Campus,Building 12
Albany,NY 12240
ASBESTOS HANDLING LICENSE
Spectrum Environmental Associates, Inc FILE NUMBER: 99-0129
LICENSE NUMBER: 29081
P.O. Box 1024 LICENSE CLASS: RESTRICTED
DATE OF ISSUE: 02/25/2016
Schenectady, NY 12301 EXPIRATION DATE: 02/28/2017
Duly Authorized Representative—William L Massmann:
This license has been issued in accordance with 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 project,or(2)demonstrated lack of
responsibility in the conduct of any job involving asbestos or asbestos material.
This license is valid only for the contractor named above and this license or a photocopy must be prominently displayed at the
asbestos project worksite. This license verifies that all persons employed by the licensee on an asbestos project in New York
State have been issued an Asbestos Certificate,appropriate for the type of work they perform,by the New York State
Department of Labor.
Eileen M.Franko, Director
SH 432(8/12) For the Commissioner of Labor
NEW YORK STATE DEPARTMENT OF HEALTH
WADSWORTH CENTER
1 ':NK Expires 12:01 AM April 01,2017
Ott ,Q Issued April 01, 2016
CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE
Issued in accordance with and pursuant to section 502 Public Health Law of New York State
MR. PAUL J. MUCHA NY Lab Id No: 11460
AMERICA SCIENCE TEAM NEW YORK INC
117 EAST 30TH ST
NEW YORK, NY 10016
is hereby APPROVED as an Environmental Laboratory for the category
ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE
All approved subcategories and/or analytes are listed below:
Miscellaneous
Asbestos in Friable Material Item 198.1 of Manual
EPA 600/M4/82/020
Asbestos in Non-Friable Material-PLM Item 198.6 of Manual(NOB by PLM)
Asbestos in Non-Friable Material-TEM Item 198.4 of Manual
Serial No.: 54287
Property of the New York State Department of Health. Certificates are valid only at the address
shown,must be conspicuously posted,and are pnnied on secure paper. Continued amnidltatlon depends
on successful ongoing participation in the Program. Consumers are urged to call(518)485-5570 to
verity the laboratorys accreditation status.
Page 1 of 1
NYS INDUSTRIAL CODE RULE SECTION 56-5. 1
SUBPART 56-5
PHASE IA: ASBESTOS SURVEY PLANNING AND DESIGN
56-5.1 Asbestos Survey Requirements for Building/Structure Demolition,
Renovation, Remodeling and Repair
(a) Asbestos Survey Required. An owner or an owner's agent, except the owner
of one and two-family dwellings who contracts for, but does not direct or control
the work, shall cause to be conducted, an asbestos survey completed by a
licensed asbestos contractor using inspectors certified in compliance with
Section 56-3.2(d), to determine whether or not the building or structure, or
portion(s) thereof to be demolished, renovated, remodeled, or have repair work,
contains ACM, PACM or asbestos material. This asbestos survey shall be
completed and submitted as indicated in Subdivision (g) of this Section, prior to
commencing work. All such asbestos surveys shall be conducted in
conformance with the requirements of Subdivision (e) of this Section.
(b) Exemptions To Asbestos Survey Requirements: The asbestos survey
required by this Subdivision (a) of this Section shall not be required for the
following classes of buildings or structures:
(1) an agricultural building;
(2) buildings or structures for which original construction commenced on or
after January 1, 1974;
(3) A structure certified in writing to be structurally unsound by a licensed
Professional Engineer, Registered Architect, Building Inspector, Fire
Inspector or other official of competent jurisdiction. (See Section 56-11.5)
(c) Building/Structure Demolition. If a building/structure asbestos survey is not
required or performed per Subdivision (b) of this Section, and the
building/structure is certified to be unsound or slated for contracted demolition,
the building/structure shall be assumed to contain asbestos, and shall be
demolished per this Part, unless the building/structure is adequately certified to
be free of asbestos containing material. Acceptable documentation for
certification shall be a previous thorough building/structure asbestos survey,
abatement records or other documentation acceptable to the Commissioner or
his or her representative.
(d) Responsibility To Comply. No exemption to the requirement to conduct an
asbestos survey shall exempt any person, asbestos contractor, property owner
or business entity from the inspection or asbestos survey requirements of EPA,
OSHA, and any other applicable section of this Part.
12 NYCRR 56 Subpart 5, Page 41
(e) Building/Structure Asbestos Survey Requirements. The asbestos survey
shall include a thorough inspection for and identification of all PACM, suspect
miscellaneous ACM, or asbestos material throughout the building/structure or
portion thereof to be demolished, renovated, remodeled, or to have repair work.
The required inspection shall be performed by a certified asbestos inspector,
and, at a minimum, shall include identification of PACM, suspect miscellaneous
ACM or asbestos material by all of the following methods:
(1) The review of building/structure plans and records, if available, for
references to asbestos, ACM, PACM, suspect miscellaneous ACM or
asbestos material used in construction, renovation or repair; and
(2) A visual inspection for PACM and suspect miscellaneous ACM throughout
the building/structure or portion thereof to be demolished, renovated,
remodeled, or repaired. For the purpose of this Part, all PACM and
suspect miscellaneous ACM visually assessed shall be treated and
handled as ACM and shall be assumed to be ACM, unless bulk sampling
is conducted as per this Section, standard EPA and OSHA accepted
methods, including multi-layered systems sampling protocols; the
subsequent analyses are performed by a laboratory that meets the
requirements of Section 56-4.2 of this Part; and the analyses satisfies both
ELAP and federal requirements, including multi-layered sample analyses,
to document non-asbestos containing material.
(f) Building/Structure Asbestos Survey Information.
(1) The asbestos survey shall, at a minimum, identify and assess with due
diligence, the locations, quantities, friability and conditions of all types of
installations at the affected portion of the building/structure relative to the
ACM, suspect miscellaneous ACM, PACM or asbestos material contained
therein. The following list is not inclusive of all types of ACMs, it only
summarizes typical ACMs. The certified asbestos inspector is responsible
for identification and assessment of all types ACM, PACM, suspect
miscellaneous ACM and asbestos material within the affected portion of
the building/structure:
(i) PACM
(a) Surfacing Treatments:
(1) Fireproofing;
(2) Acoustical Plaster;
(3) Finish Plasters; and
(4) Skim Coats of Joint Compound.
12 NYCRR 56 Subpart 5, Page 42
(b) Thermal System Insulation:
(1) Equipment Insulation;
(2) Boiler, Breeching, Duct, or Tank Insulation, Cement or
Mortar Used for Boilers and Refractory Brick;
(3) Piping and Fitting Insulations including but not limited
to, Wrapped Paper, Aircell, Millboard, Rope, Cork,
Preformed Plaster, Job Molded Plaster and coverings
over fibrous glass insulation.
(ii) SUSPECT MISCELLANEOUS ACM
(a) Roofing and Siding Miscellaneous Materials:
(1) Insulation Board;
(2) Vapor Barriers;
(3) Coatings;
(4) Non-Metallic or Non-Wood Roof Decking;
(5) Felts;
(6) Cementitious Board (Transite);
(7) Flashing;
(8) Shingles; and
(9) Galbestos.
(b) Other Miscellaneous Materials:
(1) Dust and Debris;
(2) Floor Tile;
(3) Cove Base;
(4) Floor Leveler Compound;
(5) Ceiling Tile;
(6) Vermiculite Insulation;
12 NYCRR 56 Subpart 5, Page 43
(7) Gaskets, Seals, Sealants (including for condensate
control);
(8) Vibration Isolators;
(9) Laboratory Tables and Hoods;
(10) Chalkboards;
(11) Pipe Penetration Packing or Other Firestopping
Materials;
(12) Cementitious Pipe (Transite);
(13) Cementitious Board (Transite);
(14) Electrical Wire Insulation;
(15) Fire Curtains;
(16) Fire Blankets;
(17) Fire Doors;
(18) Brakes and Clutches;
(19) Mastics, Adhesives and Glues;
(20) Caulks;
(21) Sheet Flooring (Linoleum);
(22) Wallpaper;
(23) Drywall;
(24) Plasterboard;
(25) Spackling/Joint Compound;
(26) Textured Paint;
(27) Grout;
(28) Glazing Compound;
(29) Terrazzo; and
(30) Boiler Rope.
12 NYCRR 56 Subpart 5, Page 44
(2) All ACM, PACM, suspect miscellaneous ACM, or asbestos material
reported under Paragraph (1) of this Subdivision shall include the location
of the materials, an estimate of the quantities, types, friability and
condition of the identified materials to be treated and handled as ACM.
For the purpose of this Part, all PACM and suspect miscellaneous ACM
visually assessed shall be treated and handled as ACM and shall be
assumed to be ACM, unless bulk sampling is conducted as per this
Section, standard EPA and OSHA accepted methods, including multi-
layered systems sampling protocols; the subsequent analyses are
performed by a laboratory that meets the requirements of Section 56-4.2
of this Part; and the analyses satisfies both ELAP and federal
requirements, including multi-layered sample analyses, to document non-
asbestos containing material.
(3) The building/structure asbestos survey shall also include the
building/structure name, address, the building/structure owner's name and
address, the name and address of the owner's agent, the name of the firm
performing the asbestos survey and a copy of the firm's current asbestos
handling license, the names of the certified inspector(s) performing the
survey and a copy of the current asbestos handling certificate for each
inspector utilized, the dates of the asbestos survey, a listing of
homogeneous areas identifying which ones are ACM, all laboratory
analyses reports for bulk samples collected, and copies of the appropriate
certifications for the laboratory used for analysis of samples taken during
the asbestos survey.
(g) Transmittal of Building/Structure Asbestos Survey Information. One (1)
copy of the results of the building/structure asbestos survey shall be immediately
transmitted by the building/structure owner as follows:
(1) One (1) copy of the completed asbestos survey shall be sent by the owner
or their agent to the local government entity charged with issuing a permit
for such demolition, renovation, remodeling or repair work under
applicable State or local laws.
(2) The completed asbestos survey for controlled demolition (as per Subpart
56-11.5) or pre-demolition asbestos projects shall also be submitted to the
appropriate Asbestos Control Bureau district office.
(3) The completed asbestos survey shall be kept on the construction site with
the asbestos notification and variance, if required, throughout the duration
of the asbestos project and any associated demolition, renovation,
remodeling or repair project.
(h) Removal Required. If the building/structure asbestos survey finds that the
portion of the building/structure to be demolished, renovated, remodeled, or have
repair work contains ACM, PACM, suspect miscellaneous ACM assumed to be
12 NYCRR 56 Subpart 5, Page 45
ACM, or asbestos material, which is impacted by the work, the owner or the
owner's agent shall conduct, or cause to have conducted, asbestos removal
performed by a licensed asbestos abatement contractor in conformance with all
standards set forth in this Part. All ACM, PACM, suspect miscellaneous ACM
assumed to be ACM, or asbestos material impacted by the demolition,
renovation, remodeling or repair project shall be removed as per this Part, prior
to access or disturbance by other uncertified trades or personnel. No demolition,
renovation, remodeling or repair work shall be commenced by any owner or the
owner's agent prior to the completion of the asbestos abatement in accordance
with the notification requirements of this Part. For multi-phased work, the access
restriction for uncertified trades or personnel applies to each intermediate portion
of the entire project. Upon completion of the intermediate portion of the asbestos
project, other trades or personnel may access that portion of the work site. For
demolition projects that are exempt from asbestos survey requirements due to
being structurally unsound, the demolition is considered an asbestos project and
shall proceed as per Section 56-11.5.
(1) All building/structure owners and asbestos abatement contractors on a
demolition, renovation, remodeling, or repair project, which includes work
covered by this Part, shall inform all trades on the work site about PACM,
ACM, asbestos material and suspect miscellaneous ACM assumed to be
ACM at the work site.
(i) Bidding. Bids may be advertised and contracts awarded for demolition,
remodeling, renovation, or repair work, but no work on the current intermediate
portion of the project shall commence on the demolition, renovation, remodeling
or repair work by any owner or agent prior to completion of all necessary
asbestos abatement work for the current intermediate portion of the entire
project, in conformance with all standards set forth in this Part.
Q) Unidentified and Unassessed Asbestos. When any construction activity, such
as demolition, remodeling, renovation or repair work, reveals PACM or suspect
miscellaneous ACM that has not been identified by the asbestos survey per this
Part, or has not been identified by other inspections as per current OSHA or EPA
requirements, all activities shall cease in the area where the PACM or suspect
miscellaneous ACM is found and the Asbestos Control Bureau shall be notified
by telephone by the building/structure owner or their representative, followed with
a written notice in accordance with the notification requirements of this Part.
Unassessed PACM or suspect miscellaneous ACM shall be treated and handled
as ACM and assumed to be ACM, unless proven otherwise by standard EPA and
OSHA accepted methods, including multi-layered systems sampling protocols;
subsequent analyses performed by a laboratory that meets the requirements of
Section 564.2 of this Part; and the analyses satisfies both NYS ELAP and
federal requirements, including multi-layered sample analyses, to document non-
asbestos containing material.
12 NYCRR 56 Subpart 5, Page 46
ENVIR0NMENTAL SERVICES �L�...; Flu D
L�
November 30, 2016 TOW,; ,',I ENSBURY
Bti::.'."`•'� :,ODES
Robert & Renee Little
814 Fox Glen Place
Walnut Creek, CA 94598
Re: Asbestos Removal Confirmation at 20 Pioneer Point, Queensbury, New York
Robert & Renee:
Alpine is in contract with Robert & Renee Little to provide asbestos air monitoring &
project monitor visual inspection services for the asbestos abatement at the captioned
location. The asbestos material identified in the asbestos pre-demolition inspection
report, prepared by Spectrum Environmental Associates, Inc., has been removed.
This letter is meant to fulfill the requirements of NYS Department of Labor Industrial
Code Rule 56 5.1 (h) which states:
"No demolition, renovation, remodeling or repair work shall be commenced by
any owner or the owner's agent prior to the completion of the asbestos
abatement in accordance with the notification requirements of this Part."
Do not hesitate to contact me with any questions at (518) 250-4047 ext. 307.
Sincerely,
Alpine Environmental Services, Inc.
Michael Balzano, F��E COPY
Field Operations Manager
438 New Karver Road •Albany, New York 12205 • Phone: (518)250-4047 • Fax:(518)250-4353•email
craigp@alpineenv.com
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EXISTING CONCRETE STAIRS AND REMOVE EXISTING CONCRETE / /// REMOVE EXISTING STRUCTURE, INCLUDING // / 2.EXACT SIZES AND LOCATION OF WALLS TO BE DEMOLISHED TO BE DETERMINED BY
PATH TO REMAIN STAIRS IN THLIR ENTIRETY / / / BUT NOT LIMITED TO:ROOFS,CEILINGS, '- �/ y\� / CONTRACTOR AND COORDINATED,WITH NEW CI 11ONSTRUCTION. REFER-TO , .
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% \{ ,/ Q.: r
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DEBRIS FROM ENTERING THE EXISTING HEATING AND COALING SYSTEM DURWG
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BARRIERS PRIOR TO INSTALLATION. -,
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�.� REMOVE EXISTING CHIMNEY IN � v '\" l � - 1. �,.0, '
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ITS ENTIRETY ` ; 6.COORDINATE WITH OWNER REMOVAL AND STORAGE OF ALL ECZUIPMENT : `� f� '", .`C=�
REMOVE EXISTING DOCK IN �'i �y -7"-
FURNISHINGS AND ELECTRICAL OR PLUMBING FIXTURES. REMOVE AND STQRE,AS F�1
ITS ENTIRETY ` ' - 1 �/► ! c°�c�'c o : c4 _
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OF PROPANE TANKS - _(D too r O" �' r_l
EXISTING TREES TO REMAIN. 7 �
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��/�� '?'. j.. 7.UTILITIES RENDERED USELESS BY THE DEMOLITION SHALL BE.REMOVED TO ITS POINT E-9 C"0 F- "`"`
PROVIDE PROTECTION TO ROOT r �_ _ - >-M O G:0o (4 (.w
OF SUPPLY.CAP UTILITIES RENDERED OBSOLETE BELOW FLOOR LEVEL,=ABOVE'CEILING," of U a CM
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