BOTH-000676-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
QL Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000676-2016 Date Issued: Tuesday, October 18, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000676-2016
has been completed.
Tax Map Number: 227.17-1-17
Location: 34 GUNN LN
Owner: Jacqueline Wheeler
Applicant: Daniel McAvinny
This structure may be occupied as a: Demolition of 60 s.f. Storage Shed
Asbestos Report attached By Order of Town Board
Cross Ref. AV PZ-0181-2016 TOWN O'FFQQUEENSBUURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the
Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000676-2016
Tax Map No: 227.17-1-17
Permission is hereby granted to: Jacqueline Wheeler
For property located at: 34 GUNN 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
Type of Construction
Owner Name: Jacqueline Wheeler Demolition $0.00
Owner Address: 83 Old Coach RD Total Value $0.00
Diamond Point,NY 12824
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Demolition of 60 s.f.Storage Shed
Asbestos Report attached
Cross Ref. AV PZ-0181-2016
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,October 5,2017
(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 exp' tion/)date.)
Dated at the Town of ueensb 4ed s etcher 5,2016
SIGNED BY: Q for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee
SFP 2016
Provide 2 plot plans drawn to scale,showing lot boundaries with dimensions and ad)acent roads/streets. Show all existing structures
on property and Indicate which are to be demolished. Indicate the location of all utilities /
Date7Q �2L)) L Demolition Location �
Tax Map ID ���—�=J _ 1
APPLICANT ��.n1 Ji�_Y'�G_��r OWNER JJLC 9
Address _ Q _
Add r s
Phone _�j1LQ = aE 3Q Mdo _LL Ph e --------��5_= J(eJ-------
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: __� _ _____—_____Phone: _S� _/
I. Person Responsible for Work U�
2. Where will demolition material be disposed? AL
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 IF?Residence ___ Garage ___Business
_ Storage Bldg.___ Other
b) Size of Structure
c) Number of Stories 776 i" i
d) Foundation Type
e) Foundation
f) Structure(s)
7. Utilities Information
a) Indicate utilities for this structure —__ Gas _ _ Electric ___ Propane —_—Public Water ___Public Sewer
___On•site well water pump
a) Have you notified the Town Water Department for public ater and sewer disconnect? ---- Yes Kt-ho
b) Have all utilities been disconnected? ____Yes No
8. Signature
Print Name: _ y _nom_ _ _________ Date
Signature: ___ _ -----------------
Date
Town of Queensbury Building & Codes - Demolition Permit - December 2014
227.17-1-17 BOTH-000676-2016
Wheeler, Jackie
34 Gunn Lane
HANSON Demo of shed (asbestos report recvd)
GEOLOGIC & ENVIRONMENTAL CONSULTANTS
AN VLEET, LLC
September 15, 2016
Mr. David McAvimrey
McAvinney Builders
83 Care Free Lane j Cy Z!JI
Lake George,NY 12848
_ 9
RE: Pre-Demolition Asbestos Survey
34 Gunn Lane, Queensbury,NY
Dear Mr. McAvinney:
Hanson Van Vleet, LLC conducted an asbestos containing material (ACM) survey of the
residence at 34 Gunn Lane in the Town of Queensbury, Warren Country New York. HVV is
authorized by the New York State Department of Labor under license # 05-0220 to perform
asbestos inspections, sample collection and surveys. Samples of each type of suspected asbestos
containing material (SACM) were collected. All samples were collected by a NYSDOL licensed
Class D Inspector, in accordance with 12 NYCRR Part 56, (referred to as Industrial Code Rule
56) and 29 CFR Part 1910. The sampling was conducted on September 16, 2016. A copy of the
NYSDOL Asbestos license is attached to this letter.
Methods
Prior to initiating sampling, an on-site walk through inspection of the structure was performed in
accordance with Subpart 56-5(e) of 12 NYCRR Part 56. Building plans were not available for
review. Based on the site inspection, sampling of materials was performed to evaluate for
suspect asbestos containing materials (SACM). Bulk samples were collected following standard
sampling procedures. The samples were placed in double sealed sample bags and delivered by
Federal Express to EMSL Analytical for analysis under formal chain of custody procedures.
Friable type materials were analyzed by Polarized Light Microscopy (PLM) via the NY State
ELAP 198.1 method. Non-organically bound (NOB) materials were analyzed by PLM via NYS
method 198.6 NOB. If the NYS method 198.6 NOB was inconclusive, the NOB materials were
then analyzed by transient electron microscopy (TEM) via NYS method 198.4 NOB.
Inspection Results
The inspection of the property revealed a one story residence, a wooden shed, and an elevated
boat house to be demolished.
The inspection of the residence revealed a one story, two bedroom, one bath, structure,
approximately 1070 square feet in size. The residence was of wood framed construction, on a
concrete block foundation with an asphalt shingled roof.
The exterior was wood sided. All exterior trim was wood. The windows were vinyl and/or wood
framed, with no window glazing.
Pre-Demolition Asbestos Survey
34 Gunn Lune
Queensbury,New York
September 30,2016
Page 2 oro
The interior construction consisted of Homasote walls and ceilings in the kitchen, bathroom, and
bedrooms. Drywall ceilings and wooden flooring in the back room, and vinyl floor tiles in the
bathroom. The basement consisted of concrete floors and concrete block walls.
Suspect ACM materials identified on the interior of the residential structure consisted of:
Drywall ceilings in the back room, vinyl floor tiles and associated mastic in the bathroom, and
flooring mastic remnants in the kitchen where flooring had been previously removed.
Suspect ACM materials identified on the exterior of the structure included: asphalt roof shingles
and tar paper underlayment.
Bulk samples at the residence were collected of 1) asphalt roof shingles, 2) tar paper
underlayment, 3) vinyl floor tiles, 4) floor tile mastic, 5) remnant flooring mastic, and 6) drywall.
The Inspection of the elevated boathouse and dock revealed an approximately 600 square foot
wooden framed structure with vinyl siding, aluminum framed non-glazed windows, and an
asphalt shingled roof, constructed on piers above the wooden dock. The interior of the boat
house consisted of wooden floors covered with sheet asphalt roofing with plastered seams.
Interior walls were unfinished with open wooden framing. The exterior of the boathouse and
dock included sheet asphalt rooting on the dock surface around the boat house, vinyl siding, and
an asphalt shingled roof with tar paper underlayment.
Suspect ACM materials identified at the boat house and dock included: sheet asphalt on floors,
plaster seams in flooring, asphalt shingled roof and tar paper underlayment.
Bulk samples at the boat hoose were collected of 1) sheet asphalt on floor, 2) plastered seams on
floors, 3) asphalt shingled roof, and 4) tar paper roofing underlayment.
A small grey shed was also to be demolished. The inspection of the grey shed revealed wooden
construction with wood framed windows and an asphalt shingled roof.
Bulk samples at the grey shed were collected of the 1) asphalt shingled roof, and 2) the tar paper
roofing underlayment.
Asbestos Containing Material Sampling Results
A minimum of three samples of each type of suspected ACM was collected. The samples and
results are summarized in Table 1 below. The Analytical results and chain of custody are
attached to this letter.
Pre-Demolition Asbestos Surrey
34 Gunn Lane
Queensbury.New York
September 30,2016
Page 3 of 4
Table 1
Asbestos Sampling Locations and Analytical Results
34 Gunn Lane Queensbury, NY
Sample Type of Material Location Approximate Result
No. Quantity
(square feet
S-IA Plaster Boat House Floor 20 ND
S-IB Plaster Boal House Floor 20 ND
S-IC Plaster Boat I-louse Floor 20 _ ND
S-2A Sheet Asphalt Boat House Floor Deck 800 ND
S-26 Slice(Asphalt Boat House Floor/Deck 800 ND
S-2C Sheet Asphalt Boal House Floor/Deck 800 N D
S-3A Tar Parer Underla yment Boat 1-louse Roof 400 ND
S-3B Tar Paper Underinyment Boat House Roof 400 ND
S-3C Tar Paper Underrla•ment Boat House Roof 400 ND
S-4A As halt Shingles Boal House Roof 400 ND
S-4B Asphalt Shingles Boal House Roof 400 ND
S-4C Asphalt Shingles Boat House Roof 400 ND
S-5A Tar Paper Underla ment Grey Shed Roof 100 ND
S-5B Tar Paper Underla rnent Grey Shed Roof 100 ND
S-5C Tar Paper Underla mens Grey Shed Roof 100 ND
S-6A Asphalt Shingles Grey Shed Roof 100 ND
S-613 Asphalt Shingles Grey Shed Roof 100 ND
S-6C Asphalt shingles Grey Shed Roof loo ND
S-7A 9"Vinyl Floor Tiles House Bathroom 80 ND
S-7B 9"Vinyl Floor Tiles House Bathroom 80 ND
S-7C 9"Vinyl Floor Tiles House Bathroom 80 ND
S-SA Floor Tile Mastic House Bothroom 80 ND
S-8B Floor Tile Mastic House Bathroom 80 ND
S-8C Floor Tile Mastic House Bathroom 80 ND
S-9A Mastic Remnants Kitchen Floor 100 ND
S-9B Mastic Remnants Kitchen Floor 100 ND
S-9C Mastic Remnants Kitchen Floor 100 ND
S-10A Drywall Ceiling Back Room 120 ND
S-10B Drywall Ceiling Back Room 120 ND
S-10C Drywall Ceiling Back Room 120 ND
S-1 IA As halt shingles House Roof 1000 ND
S-1 1B Asphalt Shingles House Roof 1000 ND
S-1 IC Asphalt Shingles House Roof 1000 ND
S-12A Tar Paper Underlameat House Roof 1000 ND
S-l2B Tar Pa er Underla�ment House Roof 1000 ND
S-l2C Tar Pa er Uoderlaymenl House Roof 1000 ND
Conclusions
Materials are considered asbestos containing if they contain I % or more of asbestos. No
asbestos containing materials were identified within the residential structure, boat house, or grey
shed at 34 Gums Lane, Town of Queensbury, Warren County, New York. No asbestos
abatement is required prior to demolition of the structure.
If you have any questions regarding this survey, please contact us at (518) 371-7940.
Pre-Demolition Asbestos Surra
34 Gunn Lane
Queensbury.New York
September 30.201 t,
Page 4 oro
Very truly yours,
ansot Van Vleet, LLC
James Gironda
NYSDOL Class D Inspector Certificate # 07-05263
CC: NYSDOL
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FIGURE 1; SITE LOCATION g 1 ANSON WATER8UPPLY I&
34 GUNN LANE rt
q 7ANVLEET, LLC ENVIRONMENTAL CONSULTANTS
@i
am EIVISL Analytical, Inc. EMSLOrcID: 031628241
Customer D: 11ANS22
' 307 West 381h Street Now York,NY 10018
I_
TeVFaz:(212)290-00511(212)290-0058 Customer P0:
hripAwrwv.EMSL.cae!nranhattanlaLLemsl.cai o Project ID:
Attention: James Gironde Phone: (518)371-7940
Hanson Van Vleet, LLC Fax: (518)371-5885
902 Route 146 Received Date: 09/19/2016 9:27 AM
Clifton Park, NY 12065 Analysis Date: 09/21/2016-09/23/2016
Collected Date: 09/16/2016
Project: 34 GUNN LANE,NY
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
SamplelD S-IA Description BOATHOUSE-PLASTER ON FLOOR
0316202,11-0001 Homogeneity Homogeneous
PLM NYS 190.1 Friable 09/21/2016 White 75.00%Ce Carbonate None Detected
25.00%Non-fibrous(other)
PLM NYS 190.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID SAS Description BOATHOUSE-PLASTER ON FLOOR
031628241.0002 Homogeneity Homogeneous
PLM NYS 198.1 Friable 09/2112016 White 68.00%Ca Carbonate None Detected
32.00%Non-fibrous(other)
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 190.4 NOB Not Analyzed
Sample ID SAC Description BOAT HOUSE-PLASTER ON FLOOR
031628241-0003 Homogeneity Homogeneous
PLM NYS 198.1 Friable 09/22/2016 While 34.00%Ce Carbonate None Detected
44.00%Nan-fibrous(other)
22.00%Quartz
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-2A Description BOAT HOUSE FLOOR/DECK-SHEET ASPHALT ROOFING
031628241-0004 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 190.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/232016 Black None 100.00%Other X1.00%Chrysotile
Sample ID S-28 Description BOAT HOUSE FLOOR/DECK-SHEET ASPHALT ROOFING
031628241-0005 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 092212016 Bleck 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/23/2016 Black 100.00%Other None Detected
Initial Report From:09/242016 07:09:55
ASB 198x 0000.1.711 Printed 924/2016 7:10:00AM Page 1 of 8
MSLAnalytic2al, Inc. LMSLOrder: 031628211
307 West 38th Street New York,NY 10018 Customer ID: HANS22
'r TeIfFax:(212)290-0051/(212)290-0058 Customer PO:
hill:%mvt EMSt rem!manhahnnlab,filr•m,l:ov, Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID S-2C Description BOAT HOUSE FLOOR/DECK-SHEET ASPHALT ROOFING
031628241.0006 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Black 100,00%Other None Detected
Sample ID S-3A ram Description BOAT HOUSE ROOF-UNDERLAYMENT
031628241-0007 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09122/2016 Black 100.00%Other Inconclusive:None Detected
Final residue mass 0%
TEM NYS 198A NOB 09/23/2016 Black 100.00%Other None Detected
Sample ID S-3B Description BOAT HOUSE ROOF-UNDERLAYMENT
031628241-0008 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 091222016 Black 100.00%Other Inconclusive:None Detected
Final residue mass<1%
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
Sample ID S-3C Description BOAT HOUSE ROOF-UNDERLAYMENT
031628241-0009 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09122/2016 Black 100.00%Other Inconclusive:None Detected
Final residue mass<1%
TEM NYS 198.4 NOB 092312016 Black 100.00%Other None Detected
Sample IS SAA Description BOAT HOUSE ROOF-ASPHALT SHINGLES
031628241-0010 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 092212016 Black 23.00%Glass 77.00%Other Inconclusive:None Detected
TEM NYS 190.4 NOB 0823/2016 Black 100.00%Other None Detected
Sample ID 5-48 Description BOAT HOUSE ROOF-ASPHALT SHINGLES
031626241.0011 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/222016 Black 24.80%Glass 7520%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Blade 100.00%Other None Detected
Initial Report From:091242016 07:09:56
ASB 198x 0609.1.71 Printed 9/24/2016 7:10:OOAM Page 2 0!8
BMSL Order: 03'1628241
307 West 38Ih Street New York,NY 10018 Customer ID: FIANS22
Te9Fax (212)290-0051/(212)290-0058 Customer P0:
flip corn/manhattnnid: Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID S-4C Description BOAT HOUSE ROOF-ASPHALT SHINGLES
031626241.0012 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NolAnalyzed
PLM NYS 198.6 VCM Not Anaiyzed
PLM NYS 198.6 NOB 09/22/2016 Black 27.50%Glass 72.50%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
Sample ID S-5A Description GREY SHED ROOF-UNDERLAYMENT -
031628241-0013 Homogeneity Heterogeneous
PLM NYE 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
Final residue mass<1%
TEM NYS 198.4 NOB 09123/2016 Black 100.00%Other None Detected
Sample IS S-513 Description GREY SHED ROOF-UNDERLAYMENT
031628241-0014 Homogeneity Heterogeneous
PLM NYS 190.1 Friable NolAnalyzed
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
Final residue mass<1%
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
SamplelD S-5C Description GREY SHED ROOF-UNDERLAYMENT
031628241-0015 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09=12016 Black 100.00%Other Inconclusive:None Detected
Final residue mass<1%
TEM NYS 198.4 NOB 09232016 Black 100.00%Other None Detected
Sample ID S-6A Description GREY SHED ROOF-ASPHALT SHINGLES
031626241.0016 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/23/2016 Black 100.00%Other None Detected
Sample IS S-613 Description GREY SHED ROOF-ASPHALT SHINGLES
031628241-0017 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYE 198A NOB 09/23/2016 Black 100.00%Other None Detected
Initial Report From:09/24/2016 07:09:56
ASD 198x_0009.1.71 Printed 924/2016 7:10:00AM Page 3 of 8
ENO_ Aui aIVtica1, Inc. EMSLOrder: 03162824'1 �—
307 West 30111 Street New York,NY 10018
Customer ID: FIANS22
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
Idle 11www.EIVISL core/rnanhatlanlab@emsl com Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Dale Color Fibrous Non-Fibrous Asbestos
Sample to S-6C Description GREY SHED ROOF-ASPHALT SHINGLES
031628241-0018 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09123/2016 Black 100.00%Other None Detected
Sample ID S-7A Description BATHROOM-W FLOOR TILES
031628241-0019 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Beige 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/2,312016 Beige 100.007.Other None Detected
Sample ID S-713 Description BATHROOM-9"FLOOR TILES
031628241-0020 Homogeneity Heterogeneous
PLM NYS 190.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Beige 100.00%Other inconclusive:None Detected
TEM NYS 198.4 NOB 0923/2016 Beige 100.00%Other None Detected
Sample ID S-7C Description BATHROOM-9"FLOOR TILES
031628241-0021 Homogeneity Heterogeneous
PLM NYS 196.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black/Beige 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/232016 Black/Beige 100.00%Other None Detected
Sample ID S-BA Description BATHROOM-FLOOR TILE MASTIC
031628241-0022 Homogeneity Heterogeneous
PLM NYS 196.1 Fdable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Brown 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Brown 100.00%Other None Detected
Sample ID S-813 Description BATHROOM-FLOOR TILE MASTIC
031628241.0023 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09222016 Brown/Black 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/23/2016 Brown/Black 100.00%Other None Detected
Initial Report From:09/24/2016 07:09:56
ASR 19ft 0069.1.71 Pdnled 9/2412016 7:10:00AM Page 4 of 8
MSL Analytical, Inc. EN(SLOrder; 031628241
Custolner ID: HANS22
307 West 381h Street New York,NY 10018
Customer P0:
TeuFax:(212)290-0051/(212)290-0050
hlp�1%vmm.EMSL.com/manhattanlab@emsl.corn Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Nan-Fibrous Asbestos
Sample ID S-8C Description BATHROOM-FLOOR TILE MASTIC
031628241.0024 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09122/2016 Brown 100.00%Other Inconclusive: None Detected
TEM NYS 198A NOB 09/23/2016 Brown 100.00%Other None Detected
Sample ID S-9A Description KITCHEN FLOOR-MASTIC
031628241-0025 Homogeneity Heterogeneous
PLM NYS 196.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Brown 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Brown None 100.00%Other <1.00%Chrysotile
Sample ID S-98 Description KITCHEN FLOOR-MASTIC
031628247-0026 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
SamplelD S-9C Description KITCHEN FLOOR-MASTIC
031628241-0027 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Bleck 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/232016 Black 100.00%Other None Detected
Sample ID S-10A Description BACKROOM-DRYWALL CEILING
031628241-0028 Homogeneity Homogeneous
PLM NYS 198.1 Friable 09/212016 Gray/Tan 5.00%Cellulose 65.00%Gypsum None Detected
8.00%Hair 22.00%Non-fibrous(other)
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 196.6 NOB NotAnalyzed
TEM NYS 198.4 NOB NotAnalyzed
SamplelD S-108 Description BACKROOM-DRYWALL CEILING .,-,.�.._.. -
031628241-0029 Homogeneity Homogeneous
PLM NYS 198.1 Friable 09/21/2016 Gray/Tan 4.00%Hair 6.00%Ca Carbonate None Detected
30.00%Ni(other)
60.00%Quartz
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 198.6 NOB NotAnalyzed
TEM NYS 198.4 NOB NotAnalyzed
( Initial Report From:0924/2016 07:09:56
ASB 198x_0009.1.71 Printed 9/24/2016 7:10:OOAM Page 5 of 8
EMSL An aly-dc. al, Inc. CMSI-Order: 03162824'1 —
Custorner ID: HANS22
307 West 381h Street New York,NY 10018
Tel/Fax:(212)290-00511(212)290-0058 Customer P0:
htlp:IMww EMSt.coin I nianhaltanlab@ernsl.rom Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
SamplelD S-10C Description BACKROOM-DRYWALL CEILING
031628241.0030 Homogeneity Homogeneous
PLM NYS 198.1 Friable 09/22/2016 Brown 70.00%Cellulose 30.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB NotAnalyzed
TEM NYS 198.4 NOB NotAnalyzed
SamplelD SAIA Description HOUSE ROOF-ASPHALT SHINGLES
037628241-0031 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
SamplelD 8-11B Description HOUSE ROOF-ASPHALT SHINGLES
031628241-0032 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
SamplelD S-11C Description HOUSE ROOF-ASPHALT SHINGLES
031628241-0033 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 0912212016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/23/2016 Black 100.00%Other None Detected
SamplelD S-12A Description HOUSE ROOF-UNOERLAYMENT
031628241-0034 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 0912212016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198A NOB 09/23/2016 Black 100.00%Other None Detected
SamplelD S-12B Description HOUSE ROOF-UNDERLAYMENT
031628241-0035 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
Final residue mess-1%
TEM NYS 198A NOB 0912312016 Black 100.00%Other None Detected
Initial Report From 09/24/2016 07:09:56
ASH 1917x 0000-1.71 Printed 9/24/2016 7:10:OOAM Page 6 of 8
EMSL Analytical, Inc, ---- ENISLOrder: 031628241 -- -
Customer ID: HANS22
307 West 38th Street New York.NY 10018
Customer P0:
TeUFax:(212)290-00511(212)290-0058
h1tpJhv,rv.EMS1..com 1 manlmtlaniabaemstc0111 Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
SamplelD S-12C Description HOUSE ROOF-UNDERLAYMENT
031628241-0036 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NolArlalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 198.6 NOB 09/2212016 Black 180.00%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 09/2312016 Black 100.00%Other None Detected
Initial Report From:09/24/2016 07:09:56
ASB 19Ux 0009-1.71 Printed 9/24/2016 7:10:00AM Page 7 of 8
EMSL Analytical, Inc. EMSLOrder: 03/628241
,I...^ 307 West 381h Street New York,NY 10018
Customer ID: HANS22
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
hNR//www.EMSLcom/manhailanlab�Aemsl coni Project ID:
Test Report:Asbestos Analysis of Bulk Material
The samples in this report were submitted to EMSL for analysis by Asbestos Analysis of Bulk Materials via NYS ELAP Approved Methods.The
reference number for these samples is the EMSL Order ID above. Please use this reference number when calling about these samples.
Report Comments:
Sample Receipt Date: 9/19/2016 Sample Receipt Time: 9:27 AM
Analysis Completed Date: 9/21/2016 Analysis Completed Time: 4:52 PM
AnalVst(s):
Deers Char/es PLM NYS 188.1 Friable(4) Dean Liang PLM NYS 198.1 Friable(2)
Jon 4lhlliams PLM NYS 108.6 NOB(30) wolella Bis TEM NYS 198.4 NOB(30)
Samples reviewed and approved by:
James Hall,Laboratory Manager
or Other Approved Signatory
NOB=Non Friable Organically Bound N/A=Not Applicable VCM=Vermiculite Containing Material
-In New York Slate,TEM Is currently the only method that can be used to determine if NOB materials can be considered or treated as non-asbestos containing.
All samples examined for the presence of vermiculite when analyzed via NYS 198.1.
-NYS Guidelines for Vermiculite containing samples are available at http://n .Wadsworth.org/labmrUelapwrVforms/VefmiculiteintedmGuidanc4 RevO7O9l 3.pdf EMSL
maintains liability limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced,except in full,without written approval by
EMSL.EMSL bears no responsibility for sample collection activities or analytical method limitations.Interpretation and use of test results are the responsibility of the client,
Samples were received in good condition unless otherwise noted.
This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST,or any agency of the federal government.This raped may
contain data that is not covered by the NVLAP accreditation.
sr.ples S,Wymd by EMSLAnelylica,Inc.New Y.1k.NY We ELAP 11$00
Initial Report From:09124/201607:09:56
ASB 198x 0009-7.77 Printed 9/24/2016 7:10:00AM Page:8 of 8
Order2D: 0316207.41AL Asbestos Bulk Building Material sol west 38111 strer:l
Chain of Custody New York, NY 10018
EMSL Order Number (Lab use Only} Ptic r:e:(212)290-0051
EMSL ANALYTICAL.INe. ---
i. r..o—...vaueo—.� (2.12)290-0058
EMSL-Bill to:Ej Same ❑Different
Company:Hanson Van Vleet LLC Ilean.isDneN,mnole instrudions incornmenls--
Street 902 Route 146 Ei d Parly Billet rer vires Indten aulhonzatfon from third pally__-_—
._. .-. .__. - r --
City,Clifton Park State/Province:NY Zip/Postal Code:92065 Country us -
Report To(Name):James Gironde Telephone#:5183717940
Emall Address Jyironda a hansonvanvleel.com Fax#: 5183717940 Purchase Order:
Project Name/Number:34 Gunn Lane Please Provide Results: QFax ✓ mall all
U.S.State Samples Taken:NY CT Samples:�CommerciaUTaxable Lj Residential/Tax Exem t
Turnaround Time TAT O tions"-Please Check
❑3 Hour ❑6 Hour ❑24 Hour ❑48 Hour El72 Hour ❑ 96 Hour K 1 Week ❑ 2 Week
'For TEA:!Air 3 hr through 6 hr,please cell ahead In schedule.'Thero is a premium charge tori Hour TEhI AHERA or EPA Level It TAT. You will be asked to sign
au aufhorizalien loon for this somice. Analysis wmplefod in accordance with EWL's Terms and Conddlons bca,edin the Ana1lical Price.Guide-
PLM-Bulk(reporting limit) TEM-Bulk
❑PLM EPA 6001R-93/116(<1%) ❑TEM EPA NOB.-EPA 600/R-93/116 Section 2.5.5.1
❑PLM EPA NOB(<I%) 9 NY ELAP Method 198.4 (TEM)
Point Count ❑400(<0.25%)❑ 1000(<0.1%) ❑Chatfield Protocol(semi-quantitative)
Point Count w/Gravimetric❑400(<0.25%)❑ 100,0(<0-1%) ❑TEM%by Mass-EPA 600/R-931116 Section 2.5.5.2
❑ NIOSH 9002(0%) ❑TEM Qualitative via Filtration Prep Technique
Is❑ NY ELAP Method 198.1 (friable in NY) ❑TEM Qualitative via Drop Mount Prep Technique
0 NY ELAP Method 198.6 NOB(non-friable-NY) Other
❑ OSHA ID-191 Modified 4Grou
E3 Standard Addition Method
XCheck For Positive Stop-ClearlyIdentifyHomogenousDate Samted:9/ /16 Samplers Name:JanleS Gironda mplers Signature: fl
jr—
Sample# HA# Sample Location Material Description
it It II it it „
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Client Sample it(s): rj - �j' .. _ Total ft of Sample JL
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Relinquished(Client): / _ -_ Dale
Received(Lab): - f�a. Dnte_ '.I�T: ___._.. .... _-Time: _�_✓'J_ t _-.-----
Comments/Seclat h ructions: )
Il lr:nv;iu:b,n Nn ETI OOP
OrderiD: 031628241
,asbestos Bull( Building Material soy West,3811) strool
Chain of Custody New York. NY 10018
E_M_SL Order Number(Lab Use Orly): PHONE:
EM9L ANALYi1CAt.INC. - (212)290.0051
-. \ " 1
Z.-<� i_ - ( ( (212)290•0058
Additional Pages of the Chain of Custody are only necessary if needed for additional sample information
Sample 0 HA# Sample Location Material Discription y 7 ,
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'Comments/Special instructions:
In«o���:m���ITeLINca
I
Page of pages
DrderlD: 031626241 307 West 38111 Street ,
Asbestos Bulk Building Material
Chain of Custody New York, NY 10018
EMSL Order Number(Lab use Only): PHONE:(212)290.0051
EMS ANALVtICAL INC.
u—ro •.� .•5. FAX: (212)290.0058
Hanson Van Vleet LLC EMSIIL-Bill to:0 Same [3 Different
Company: Bill to Is Different nolo Insaucdons In Comments-'
street:902 Route 146 I ThirdPari allltn re uires vrdtion oultlodzation from third art
Cit :Cy lifton Park __ St_a_telProvince`NY _ Zip/Postal Code:12065 Country:US
Report To(Name):James Gironda Tele hone#:5183717940 _
Email Address: J9ironda@hansonvanvleet.com Fax#: 5183717940 _ purchase Order:
Project Name/Number:34 Gunn Lane Please Provide Results: ✓ax mall ail
U.S.State Samples Taken:NY CT Samples:LL11 Commercial/Taxable ❑ResidentialRax Exempt
TuTharound Time ATOptions*•-Please Check
❑3 Hour ❑ 6 Hour I U 24 Hour 48 Hour ❑ 72 Hour ❑ 96 Hour Q i Week ❑ 2 Week
'For TEM Air 3 hr through 6 hr,pleaso call ahead to schedule.'Tham is a prornium charge W3 Hour TEM AHERA or EPA Laval//TAT. Youlvhlbeaskedtostgn
an authorization form for this service. Analysis completed in accordance with EMSL's•Terms and Conditions located In the Anal /cat Price Guide.
PLM-Bulk freportlna limit) TEM-Bulk
❑PLM EPA 600/R-93/116(<I%) ❑TEM EPA NOB-EPA 6001R-93/116 Section 2.5.5.1
❑PLM EPA N08(<1%) NY ELAP Method 198.4(TEM)
Point Count ❑400(<0.25%)❑ 1000(40.1°!a) _ ❑_Chalfield Protocol(semi-quantitative)
Point Count w/Gravimetric❑400(40.25%)❑ 1000_(<0.1%) ❑TEM%by Mass-EPA 600/R-93/116 Section 2.5.5_.2
j-NIOSH 9002•(-116)_ ❑TEM Qualitative via Filtration Prep Technique - —
9 NY FLAP Method 198.1 (friable In NY) -ff TEM 6-88 alive via Drop Mount Prep Technique
W NY ELAP Method 198.6 NOB(non-friable•NY) Other
❑ OSHA ID-191 Modified ❑
❑ Standard Addition Melhod
W.Check For Positive Stop-Clearly Identify Homogenous Group Date Sam led:9) /1 6
Samplers i4ame:James Girdnda Samplers Signature:We
Sample# HA# Sample Location Material Descri tion f"•1
r �IGr) ON '�nvr
•77 - z
it
S1L "
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Client Sam le# s : C7 I �,,I�� Total#of Samples: G
----- - —
Relinquished(Client): Date: I�I_l Time: im/
Received(Lab): I r•1�1� Data: I Time: `2 [
CommentsfSpectall ructions:
19--
II Inwntl.,5iva n:n E;.1
NOD
OrderID: 031628241 30%West 38th Street
Asbestos Bulk Building Material
41 Chain of Custody New York, NY 10018
CMC
EMSL Order Number(Lab Use Onty): PHONE: (212)290-0051
L HNALYTICAL INC. E ___ _-_I
u.��. .. FAX: (212)290-0058
Additional Pages of the Chain of Custody are only necessaryff needed for additional sample information
Sample 1t HA rr Sam to location Matorial D scri lion
4
S- l b i? (4 ry NN��-- S r r
s' C (1 it rr fr
S / (p r
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'Comments/Special Instructions:
UMM11Jumm mn RM NCe
Page -7—„or�„^,pages �/(/�,[,L, ��/� 6 71•Z -!
uhi is
JAMES _I GIRONDA
CLASS(EXPIRES)
D INSP(1 '1/16)
MUST BE CARRIED ON ASBESTOS PROJECJS
New York State—Department of Labor
Division of Safety and Health
License and Certificate Unit
State Campus,Bullding 12
Albany,NY 12240
ASBESTOS HANDLING LICENSE
Manson Van Vleet, LLC FILE NUMBER: 05-0220
LICENSE NUMBER: 28463
902 Route 146 LICENSE CLASS: RESTRICTED
DATE OF ISSUE: 03/24/2016
Clifton Park, NY 12065 EXPIRATION DATE: 03/31/2017
Duly Authorized Representative—D Kirby Vanvleet:
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,Rales and Regulations(1.2 NYCRR Part 56). It is subject t6 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 th*y perform,by the New York State
Department of Labor.
Eileen M.Franko, Director
SH 432(11/12) For the Commissioner of Labor
/ 1 227.17- 147 B®TIB-000676-2016
Wheelelr, Jackie
34 Gunn Lane
s~"R syh' Demo ofshed (asbestos report recvd)
i _ q 'ROP•,1 6S
S r •,,v �
� FOP 2'��2'D � �•f" :i - I 1/2"
9
IPF
-. / -
EAVE TRENCH
3 _ PROF.4"PVC SDR-35 s l
mOUTLET FROM EAVE TRENCH Lands N/F.'f Gunn Lane " �
:L~:^vnir;Q Ad -7,511 traf r ar nne Cattabia'pi, et. at. TOWN OF QUEENSBURY
I7 Water': 320.20°,.' INSTALL EROS%ON CONTROL 9416/236: BUI!_DING DEPARTMENT I
g BLANKETS%N5NU�4LEE6FTER Well
TOPSO%L%NG&SEEDING, Based on our limited e;<srnin.
with our comme safion,complian 'e I tO N QUEENSBURY
PROP.LAKE WATER SUPPLY, NORTH.AMERICAN GREEN nts shalt nn', be construed s
5�5UN OR EQUAL djol is Nouse. indicating the plans and secifrcations are 'n
PROVIDE 5'FROST PROTECT%ON e PRbP,1®®®GAL full compliance with the wilding Co es of /~ ``B IL NG & Co ES EPT.
PROP,SILT FENCE ° r "1 F�sECASTC®NC, VewYork State. I
if I PUMP STATION �'
REINFORCED W®F%LTRE ki t 1 ' vi wed B
SILT SOS F ROP.12a®GAL
(`yPYCAL ON LAKES%DF) 1PET�CA�P�®6aC,
- ! te.':
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PROP,VEGETATED +1 i SEPT%C SANK I _
i
DETENTION AREA ; s2 s :• PROP,4i'PVC -
1 SDF=35 HOUSE��WER ; _ ;Shed' "
Ad�otner's Dock `4 g/�5�PSR M%P�SL®P j N •, x fight-Of-Way
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FOR COLD WEATHER
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REINFORCED
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FOR COLD WEATHER
o9cr
INFILTRATION -- — —__— — __
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+f,
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--- -- _ --Drama 1983�p. -1$&11 Kr PROP.PERMEABLE
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