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DEMO-000013-2017
TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: DEMO-000013-2017 Date Issued: Tuesday, October 10, 2017 This is to certify that work requested to be done as shown by Permit Number DEMO-000013-2017 has been completed. Tax Map Number: 227.17-1-50 Location: 119 SEELYE RD Owner: Michael Kajadsz, Susan Kaidas,Michael Kaidas Applicant: Michael Kaidas This structure may be occupied as a: Demolition Only of SFD 965 s.f.,Porch& Deck By Order of Town Board Asbestos Report Received TOWN OF QUEENSBURY Cross Ref.Z-AV-6-2017 scheduled for February 2017 ZBA review Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, 4t 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: DEMO-000013-2017 Tax Map No: 227.17-1-50 Permission is hereby granted to: Michael Kaidas For property located at: 119 SEELYE RD In the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance Tyne of Construction Owner Name: Michael Kajadsz Demolition-Residential $0.00 Owner Address: PO Box 268 Total Value $0.00 Cleverdale,NY 12820 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Demolition Only of SFD 965 s.f.,Porch&Deck Asbestos Report Received Cross Ref.Z-AV-6-2017 scheduled for February 2017 ZBA review $30.00 PERMIT FEE PAID-TIES PERMIT EXPIRES: Wednesday,January 31,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury beforethe exp' ation date.) Dated at the Town oWuesf ueensb ,2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Town of Queensbury Building & Codes Office Use Only Received + ==- = DEMOLITION PERMIT APPLICATION Permit #: ___________ NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee 1��v� `_; L - -_----- Provide 2 plot plans drawn to scale,showing lot boundaries with dimensions and adjacent roads /streets. Show all existing structures on property and indicate which are to be demolished. Indicate the location of all utilities Date �� Demolition Location Tax Map ID Z 27=1'7—1 ___ � GL�✓.�2t� APPLICANT /A�.f1 L � I�1QI-I's_----- __ _ OWNER ( f�Ll� _$_�t_S_A_r�_,�.4_1_YJA�S Address _ .,►.. ... ._...cr_ . — --- AddressO ,A L? G L !/ Phone ------------ Phone ---------- CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: _1g1L Q_'4 44/,0A S____________ Phone: ��`I�U 1. Person Responsible for Work 1411161-164"f& A 1,,OJ4 S 2. Where will demolition material be disposed? WA I 3. All buildings to be demolished require an Asbestos Surma LPt/ /� p G T 6 /fZ ^ A 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 77 6. Structure Information a) Indicate the structure(s)to be demolished _ _ Residence ___ Garage ___ Business ___ Storage Bldg. Other b) Size of Structure "Y&14- Y6' /3 c) Number of Stories 0 ffo d) Foundation Type 1 S e) Foundation Q 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 water and sewer disconnect? ____ Yes ____ No b) Have all utilities been disconnected? ' Yes ____ No /V411awA L 66f) VI ° p0�-- 3/ZLIZ 3 8. Signature Print Name: L /� � Date Signature: _ _________ Date - l __ Town of Queensbury Building & Codes • Demolition Permit - December 2014 112�Pr_ _ 227.17-1-49 DEMO-000013-2017 Kaidas, Michael & Susan OIPF=1ma Legend IRF=Imn Rod Found "`'P` 113 Seelye Road CIRF=Capped Iron Rod Found BMF=Bathey Marker Found SFD 965 s.f., Porch & Deck Lamp Utmp Post ilityPole Q[ = • =Well + PM=4OpOO=Stone Wall —moo-=Wood Fence -=Metal Farce Post 348.96' }��] 150.19' Sil Mx ins 4� Tie line i Q.7 12"k—'rrt537°36'42"E ns ation must be completed&inspected 123.14' O z 136'±Along Shore beginning demolitbn• 3 Tax 1:227.17-149 'O Area o_ t11W�fflCe to schedule an 40, 01 sq. ft. \ -- o+ a �Ontact 0. 3± acres yN� \ arcr t ® z e�amr \ _ t cw«ee I N78°27'30"E Bo.e B.v 19 40' In Of the site t0 any dernol�hon. (' # ro• \ 3 N�7, 1 t t v t3°,ck5��arc o° °gSS19, N 1 _--t Lake Doc ' a S88°08'30"W c,11-1kr ❑ - 14.35' George ad �Rr °�ra« (Q 333.73' SBe"50'54"W k` Dock See N Deed References. St ry Tax Farce/.227.17-149 Dock.x q rrJj1j(, Mahon J Jeerel ` Michael A Kajdasz (See Note 1J / Michael A.Kajtlasz Tax Parcel.227.17-1-50 "'9� Tie line SusanP.Ka1'dasz � Area SO-08-F6-4 Dated:May 19,1977 3 40,510± sq. ft. 102.76' Book 605,page 781 A.- 0.93± acres 107'±Along Shore Tax Parcel:22717-1-50 r // \ ' / The Middleton Family Inevoceble Trust, `o N Guy R.Middleton,Trustee To io J Michael Kaidas > 7± l Susan Kaidas Dated:October 19,2016 _ ___ _____ _ Book 5448,Page 158 (Se:Note 1) 157.02 Map References: _..,,�.. 214.75 S87"48'13"W \ 371.77' Map Of Lands Of BMF Gertrude C.McCoy a roe« /1 Harry Carpenter McCoy 'TOWN O F Q i Vi E.A. Dated:October 6,1972 �t By.LasRevised:June 7,1994 ,. �' ` MapCoulter r McCormack r Y Lands WF Of Map O/A Survey Made For C{ {� COP Robert 6 Janice Grilb 1 a Dated.September 15.1975 \chael A.Kajdastr t L•� 97&303 �.levie'A ed i,., \.i i YY y\.A mart For Ingress And Egmss In Common "......._...^--- ----• Over ExistingDrive,Then Along Extension Of Revised:August f0.1976 pryy9 p J 9 By:John B.Van Dusan +)atai e ( +/7 n 2)An Ea emenf To Usee to hlndCommonry,The Boathouse Map Of A Survey Made For '" -..p l Vin- Facilities._..Shall Run From That Portion Of The Guy R.Middleton Northedy Boundary....Being Described As being On Dated:November 7,1996 A Course S 88°08,30"W, 14.35'...,Said Easement Revised:November 18,1996 Shall Be 5 Feet in Width and Run To Each Dock...' By:Van Dusan 8 Staves ri Du.s h MY a e Yap of a Bvree7 made for - Steves Michael A. Kaidas S-1 Land Surveyors Susan Kaidas 189 Hawland Road Queenebuu. New York 18804 Tom of QaeeneburY, *amen CountJ, New York BFWt1 f r1-1 73064 818 798-8474 New York Us. No. 80198 Na I DATE DESCRIPTION owc.,,o.71 3' Tax Parcels:227.17-1-49 8 50 t E N V I R 0 N N E N T A L SERVICES November 17, 2016 Michael Kaidas Kaidas Properties, LLC 113 Seelye Road Cleverdale, NY 12820 Re: Asbestos Materials Removal Confirmation at: One Story Seasonal Residential Structure 119 Seelye Road Cleverdale, New York Michael, As requested, Brian Gould, NYSDOL Asbestos Project Monitor, visited the site at the above address on November 16th, 2016 for the purpose of verifying the removal of asbestos containing materials previously identified in the asbestos pre-demolition inspection performed in November 2016, Alpine Project Number#16-19979-A. The asbestos material identified during the pre-demolition inspection, namely: sink with asbestos sound deadener (undercoating), was observed to have been removed from the building. If Alpine Environmental Services can be of further assistance on this matter, please contact Craig Petreikis at our office at (518) 250-4047, ext. 313. Sincerely, Alpine Environmental Services, Inc. Brian Gould NYS Department of Labor Asbestos Project Monitor (#95-02582) From:Stevens,Andrew J. Sent: Friday, December 2,2016 8:38 AM To: 'mak45@roadrunner.com'; 'spkaidas@gmail.com' Subject:National Grid Demo Letter nationalgrid 300 Erie Boulevard West Syracuse New.York_13202 Date RE: Service Removal for Building Demolition. This letter is to confirm that,per your request,National Grid has confirmed electrical service and meters have been removed from 119 SEELEY RD QUEENSBURY NY 12804. The work was processed on work request#23146473. If you have any questions or need further assistance, please feel free to contact us at 800-260-0054. ....................... Sincerely, Customer Fulfillment nationalgrid This e-mail, and any attachments are strictly confidential and intended for the addressee(s) only. The content may also contain legal, professional or other privileged information. If you are not the intended recipient, please notify the sender immediately and then delete the e-mail and any attachments. You should not disclose, copy or take any action in reliance on this transmission. You may report the matter by contacting us via our UK Contacts Page or our US Contacts Page (accessed by clicking on the appropriate link) Please ensure you have adequate virus protection before you open or detach any documents from this transmission. National Grid pic and its affiliates do not accept any liability for viruses. An e-mail reply to this address may be subject to monitoring for operational reasons or lawful business practices. For the registered information on the UK operating companies within the National Grid group please use the attached link: http://www.nationaIgrid.comZcorporate/legal/`registeredoffices htm 227.17-1-49 DEMO-000013-2017 Kaidas, Michael & Susan 113 Seelye Road SFD 965 s.f., Porch & Deck ENVIRONMENTAL SERVICES REPORT OF PRE-DEMOLITION ASBESTOS INSPECTION Location of Inspection: 119 Seelye Rd.Cleverdale, NY Performed For: Kaidas Properties P.O. Box 268 Cleverdale NY, 12820 Date of Report: November 7,2016 Date(s)of Inspection: November 11, 2016 Project Number: 16-19979-A Material or G E E 0 W Area Inspected: Entire residence and boat house 'I ,t JAN Asbestos Materials: Residence: Sink Sound Deadener TO;TVN OF OUEENSSURY Boat House: BUILDING& CODES None Non-Asbestos Materials Tested: Linoleum, cove base mastic,Joint compound, drywall,wallboard, wallboard mastic, 2 x 4 ceiling the paper, roof vapor barriers&shingles, flashing tar, roiled roofing Inspection By: Alpine Environmental Services, Inc. 438 New Karner Rd. Albany NY, 12205 wwwAluir�� Inspector(s): Matthew Fiore Senior Industrial Hygienist NYSDOL Asbestos Inspector(Cert.#04-04675) 438 New Karner Road 9 Albany,New York 12205•Phone:(518)250-4047 November 2016 119 Seelye Rd. Cleverdale,New York Scope and Purpose This report is intended to document an asbestos inspection of the residence and boat house located at 119 Seelye Rd., Cleverdale, New York for the purpose of demolishing the structures. The inspection was performed on November 7,2016. "Asbestos containing materials", as defined by the United States Environmental Protection Agency (EPA), is any material containing greater than 1%by weight of asbestos. Friable samples(samples easily crushed/pulverized by hand pressure), were analyzed via Polarized Light Microscopy (PLM) and Non- Friable samples (samples not easily crushed/pulverized by hand pressure), were analyzed via Transmission Electron Microscopy (TEM) by EMSL Laboratory of New York, New York, a New York State Department of Health Approved Laboratory (FLAP#11506). As of April 2011 the NYS Department of Health requires that ceiling tiles be analyzed by TEM if they contain cellulose. Structure Descriptions Residence: The residential structure inspected was a one story wood structure built over a dirt crawl space. The interior walls and ceilings were wood. The floors were mostly wood with some linoleum flooring present. The windows had been previously removed. The electrical wire insulation was observed to be plastic coated. Only non-insulated pipes were observed in the crawl space. A gas space heater and a fire place were present for heating. The roof was asphalt shingle. Boat House: The boat house structure was 1 story bare wood structure built over a floating dock. No heating or water systems were present. The electrical wire insulation was observed to be plastic coated.The roof was asphalt shingle. Limitations Quantities, if any, listed in this report are estimated only and must be field verified by the owner or contractor. Results of Asbestos Inspection TABLE 1.Asbestos Containing Materials—119 Seelye Rd.,Cleverdale, NY Homogeneous Location Substrate Condition *Estimated Friable Sample# Area Quantity Sound Kitchen Metal Good 6 Sq ft No 08-01 Deadener Sink *Dimensions and Quantities are estimates only and should be field verified by the contractor. Page 2 of 3 438 New Karner Road•Albany,New York 12205 9 Phone:(518)250-4047 November 2016 119 Seelye Rd. Cleverdale,New York TABLE 2.Non-Asbestos Containing Materials— 119 Seelye Rd.,Cleverdale, NY Non-Asbestos Materials Locations Sample#'s Linoleum Kitchen And Bathroom 07-01, 07-02 Cove Base Mastic Bathroom 06-01, 06-02 Joint Compound Kitchen and Small Front Porch 01-01,01-02 Drywall Kitchen and Small Front Porch 02-01, 02-02 Wallboard Bathroom 03-01,03-02 Wallboard Mastic Bathroom 05-01,05-02 2 X 4 Ceiling Tile Paper Bathroom/Vanity Area 04-01,04-02 Roof Vapor Barriers Residence and Boat House Roofs 09-01,09-02 Shingles Residence and Boat House Roofs 10-01, 10-02 Flashing Tar Residence Roof 11-01, 11-02 Roiled Roofing Residence Roof 12-01, 12-02 Conclusion According to 12 NYCRR 56, the building owner (or owner's agent) is required to transmit this asbestos inspection report to any local government permit issuing agency (i.e. building department) for any demolition, renovation or remodeling. In addition, if this inspection is for the purposes of demolition, the building owner(or owner's agent) is also required to transmit this inspection report to the Asbestos Control Bureau, New York State Department of Labor. This inspection report is required to be displayed on site during all related construction work. Disturbance/Abatement of any asbestos containing materials, as well as air monitoring, must be performed by a NYS DOL licensed contractor, in accordance with state and federal regulations(NYS DOL ICR 56 and US EPA 40 CFR). If I can be of any further assistance to you on this matter, please contact me at (518) 250-4047 Ext 315. L4@ttF @A1 ineEnv.eo Sincerely, Alpine Environmental Services,Inc. Matthew Fiore (#04-04675) NYS Department of Labor Asbestos Inspector Enclosures:Sample Results,Alpine's Handling License, Inspector Certificates and EMSL ELAP Certificate Page 3 of 3 438 New Karner Road•Albany,New York 12205•Phone:(518)250-4047 EIUSL Analytical, Inc. EMSL Order. 031633586 307 West 38th Street New York,NY 10018 Customer ID: ALP150 Tel/Fax:(212)290-0051/(212)290-0058 Customer PO: 16 19979-A mM xtu :. SL.cu r r ionilai: soja fist.cum Project ID: Attention: Alpine Environmental Services Phone: (518)250-4047 438 New Kamer Road Fax: Albany, NY 12205 Received Date: 11/08/2016 10:31 AM Analysis Date: 11/10/2016- 11/11/2016 Collected Date: 11/07/2016 Project: 16-19979-A/119 SEELYE RD.CLEVERDALE, NY Test Report:Asbestos Analysis of Bulk Material Analyzed Non-Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample ID 01-01 Description FRONT PORCH CEILING-JOINT COMPOUND 031633586-0001 Homogeneity Homogeneous PLM NYS 198.1 Friable 11/1012016 White 55.00%Ca Carbonate None Detected 10.00%Mica Inseparable paint/coating layer included in analysis 35.00%Non-fibrous(other) PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 196.4 NOB Not Analyzed Sample ID 01-02 Description FRONT PORCH CEILING-JOINT COMPOUND 031533585-0002 Homogeneity Homogeneous PLM NYS 198.1 Friable 11/10/2016 White 65.00%Ca Carbonate None Detected 4.00%Mica 31.00%Non-fibrous(other) PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NDB Not Analyzed TEM NYS 198.4 NOB Not Analyzed Sample ID 02-01 Description FRONT PORCH CEILING-DRYWALL 031633566-0003 Homogeneity Homogeneous PLM NYS 198.1 Friable 11110/2016 Brown/Gray 15.0011/6 Cellulose 70.00%Gypsum None Detected 15.00%Non-fibrous(other) PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed Sample ID 02-02 Description FRONT PORCH CEILING-DRYWALL 031533586.0004 Homogeneity Homogeneous PLM NYS 198.1 Friable 1 111 012 01 6 Gray 6.00%Cellulose 70.00%Gypsum None Detected 24.00%Non-fibrous(other) PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB NotAnaiyzed Sample ID 03-01 Description BATHROOM-WALL BOARD 031633586.0005 Homogeneity Homogeneous PLM NYS 1198.1 Friable 11/10/2016 Brown 80.00%Cellulose 20.00%Nan-fibrous(other) None Detected PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB Not Analyzed TEM NYS 198.4 NOB Not Analyzed Initial Report From:11/11/2016 11:49:49 Printed 11/11/2016 11:49:50AM Page 1 of 3 EMSL Analytical, Inc. EMSL Order: 031633586 307 West 38th Street New York,NY 10018 Customer ID: ALP150 Tel/Fax:(212)290-00511(212)290-0058 Customer PO: 16-19979-A �. .EI'iSLcom/m,,hat;arlaG ernsi.ccr. Proect ID: Test Report:Asbestos Analysis of Bulk Material Analyzed Non-Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample ID 03.02 Description BATHROOM-V%ALL BOARD 031633586-0006 Homogeneity Homogeneous PLM NYS 198.1 Friable 11110/2016 Brown 90.00%Cellulose 10.00% Non-fibrous(other) None Detected PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOS Not Anstyzed TEM NYS 198A NOB Not Analyzed Sample ID 04-01 Description FIBERGLASS CEILING TILE-PAPER 031633586-0007 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 White 100.00% Other Inconclusive:None Detected TEM NYS 198.4 NOB 11/1112016 White 100.00%Other None Detected Sample ID 04-02 Description FIBERGLASS CEILING TILE-PAPER 031633586-0008 Homogeneity Homogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 White 100.00%Other Inconclusive:None Detected TEM NYS 198.4 NOB 11/1112016 White 100.00%Other None Detected Initial Report From: 11/11/2016 11:49:49 Printed 1111112016 11:49:SOAM Page 2 of 3 EMSL Analytical, Inc. EMSL Order: 031633586 307 West 38th Street New York,NY 10018 Customer ID: ALP150 .low TeVFax:(212)280-0051 J(212)290-0058 Customer PO: 16-19979-A rill t,`SL.c t manhattaniaboemsi.com 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. RgD2rt Comments: Sample Receipt Date: I IIM016 Sample Receipt Time: 10:31 AM Analysis Completed Date: 11/10/2016 Analysis Completed Time: 3:07 AM Anaivst(s): Ghaly Hemaya PLM NYS 198.1 Friable(3) Yolanda Chow PLM NYS 198.1 Friable(3) j KametAlawawda PLM NYS 198.6 NOB(2) Gerald lannuzzJTEM NYS 198.4 NOB(2) Samples reviewed and approved by: James Hall,Laboratory Manager or OtherApproved Signatory NOB=Non Friable Organically Bound NIA=Not Applicable VCM=Vermiculite Containing Material -In New York State,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://www.wadsworth.orgitabeertJelapcenfformsiVermiculiWnterimGuidance RevO7O913.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 certfication,approval,or endorsement by NVLAP,NIST,or any agency of the federal government.This report may contain data that is not covered by the NVLAP accreditation. Samples srmtf d by EMSL AnstyUcal,dm..Naw Yak,NY NYS ELAP 11596 Initial Report From:11/11/2016 11:49:49 Printed 11/11/2016 11:49:50AM Page 3 of 3 rderIDf, 031633586 12,05 email: MalIF aAIj)iIwhI%x0III CHAIN OF CUSTODY Client: V11 iL T_nvirt-,immital .1,s4r% seci% P,�j. ("je\cr&jc. N Pro ie:t Nujj+L-r: 16-199"79-!\ Contact: NIIttlIC\\ Hore Sunil-fled By: Nlattlie\\ Fiore Phone: 518-2*;0-4047 Date Time Collected: H T2016 TurnIII-01.1ridTime: 72 lir P.O. NLIIIlbcr: a,nn ic Anal\ Maic 1-01 Front Porch CC)IIIII-I i faint N N's Stratified PLNI Stop at L-A1 COMPOLInd First Positive of-t)2 Fofilt f=ront Porch Ceiling NYS Stratified PIMCo;..P0LInd C)^-i)l from Porch Ceiling DTr %aH WS Stratified PTAI '�icth fit Fir..'( 02-02 Front Porch Ceiling Dry"all NYS Stratified PINI r0 Bathroom Wall Board Stratified IIIA71 Stop at , First Positive 2 1 Bathroom \VU111 Bozm-k 04-01 Fiberglass Ceiling -Idle Paper i NN'S Stratified IIIAI it First Positive ( 4-02 Fiberglass Ceilinif Tile Paper 1Y stratified Pl,.\I T C-), Disposition o1 Samples: Accept- Reject l"'Aplain r-TT- Comments: Ilv: Paae 1 1 rderID: '031633586 Alpine Environmrnr;31 Services,Inc. �� "31.63����- !C Pitons:(5 IS)250=4047 Albany,NY 12205 etnaii:MattF Alp' Env.com CHAIN OF CUSTODY Client_Alpine.Environmental Services. FrOjeet:. 119 Se41ve°Rd.Clexct ale.NY Projekt Nuri; 3,6=19979-A Contact: Matthew Fiore Sampled By: fatthc«1 lore Phone: 518-2504047 Date/Time ollected: 11/7/2016 Turnaround'Time: 72 hrP.O.Number ��'15I «Lo;amply: sample Sample ,44� No. No. Lctcatio l�fatariat I A lysis Rcsuits 01-01 Front Porch Ceiling Joint 'N'YS Stra ificd PLN1 Stop at Compound First Positive i 01-02 Front Porch Ceiling JointNYSStra '0ed PLMI 1 Compound .02-0:1 -rront:Parch Ceiling Drywall NYS Strat Iied PL14 I Stop at First Positive 02-02 Front Porch Ceiling Drywall NYS Strat feed PLIV1 03-01 Bathroom Wall Board j NYS Stratified 1 LM Stop at 1 I First Positive 03-02 � Bathroom Wal-I Board NYS'Strai `ed PU 04-01 1 Fiberglass Cciling Tile r Paper NYS Strat' ted PLM Stop at First Positive 04-02 Fiberglass Ceiling Tile ' Paper NYS Stratified PLivi j f � i C=) . Disposition of Sampies: Accept Reject Explain s� } Comments: c�- r— — .`__._: ___ Reimquished By: Received By: , Date: +fie r Page 1 of 1 - {� t Of .; EMSL Analytical, Inc. EMSL Order: 031633520 307 West 38th Street New York,NY 10018 Customer ID: ALP150 Tel/Fax(212)290-00511(212)290-0058 Customer PO: Project ID: Attention: Matthew Fiore Phone: (518)250-4047 Alpine Environmental Services Fax: 438 New Kamer Road Received Date: 11/0812016 10:31 AM Albany, NY 12205 Analysis Date: 11/11/2016 Collected Date: 11/07/2016 Project: 16-19979-A/119 SEELYE RD.CLEVERDALE, NY Test Report:Asbestos Analysis of Bulk Material Analyzed Non-Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample ID 05-01 Description BATHROOM WALL BOARD-MASTIC 0316335240001 Homogeneity Heterogeneous PLM NYS 1981 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11111/2016 Yellow 100.00%Other inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Yellow 100.00%Other None Detected Sample ID 05-02 Description BATHROOM WALL BOARD-MASTIC ^. 031633520.0002 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Yellow 100.00%Other Inconclusive:None Detected TEM NYS 198.4 Nob 11H112018 Yellow 1011.001/b Other None Detected Sample ID 06-01 Description BATHROOM COVE BASE-MASTIC 031633520-0003 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/1112016 Yellow 100,00%Other Inconclusive:None Detected Final residue mass<1% TEM NYS 198.4 NOS 11/1112016 Yellow 100.00%Other None Detected Sample to 06-02 Description BATHROOM COVE BASE-MASTIC 0316335240004 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/1112016 Yellow 100,00% Other Inconclusive:None Detected TEM NYS 198A NOB 11/11/2016 Yellow 100.00%Other None Detected Sample ID 07-01 Description KITCHEN-LINOLEUM 031633520-0005 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11111/2016 Beige 100.00%Other Inconclusive:None Detected TEM NYS 198A NOB 11/11/2016 Beige 100.00% Other None Detected Initial Report From:11/11/2016 12:33:22 Printed 11/11/201612:33:23PM Page 1 of I EMSL Analytical, Inc. EMSL Order: 031633520 307 West 38th Street New York,NY 10018 Customer 10: ALP150 Tel/Fax(212)290-0051/(212)290-0058 Customer PO: rnanhattanlah@emsLcom Project 10: Test Report:Asbestos Analysis of Bulk Material Analyzed Non-Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample ID 07-02 Description BATHROOM-LINOLEUM 031633520.0006 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Beige 100.00% Other Inconclusive:None Detected TEM NYS 198.4 NOB 11111/2016 Beige 100.00% Other None Detected Sample ID 08-01 Description KITCHEN SINK-SOUND DEADENER 031633520-0007 Homogeneity g eity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Black None 98.70%Other 1.30% Chrysotile TEM NYS 198.4 NOB 11111/2016 Positive Stop(Not Analyzed) Sample ID 08-02 Description KITCHEN SINK-SOUND DEADENER 031633520-0008 Homogeneity PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Positive Stop(Not Analyzed) TEM NYS 198.4 NOB 11111/2016 Positive Stop(Not Analyzed) Sample ID 09-01 Description CAMP ROOF-VAPOR BARRIER 031633520.0009 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11111/2018 Black 100.00% Other Inconclusive:None Detected Final residue mass 0% TEM NYS 198.4 NOB 11/11/2016 Black 100.00% Other None Detected Sample ID 09-02 Description BOAT HOUSE ROOF-VAPOR BARRIER 031633520.0010 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Black 7.90%Glass 92.10%Other Inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Black 100.00% Other None Detected Sample ID 10-01 Description CAMP ROOF-SHINGLE 031633520.0011 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/1112016 Brown 1.60%Glass 98.40%Other Inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Brown 100.00%Other None Detected Initial Report From:11/11/2016 12:33:22 Printed 11/11/2016 12:33:23PM Page 2 of 4 EMSL Analytical, Inc. EMSL Order: 031633520 307 Wast 38th Street New York,NY 10016 Customer ID: ALPI50 TeWax:(212)290-0051/(212)290-0058 Customer PO: htitr:tl;tt;.Ei:3� r hattar,� oc, errsl.com Project ID: Test Report:Asbestos Analysis of Bulk Material Analyzed Non-Asbestos Test Date Color Fibrous Non-Fibrous Asbestos Sample 1D 10-02 Description BOAT HOUSE ROOF-SHINGLE 031633520-0012 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 188.6 NOS 11/11/2016 Brown <1.00%Glass 100.00%Other inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Brown 100.DO%Other None Detected Sample 1D 11-01 Description ROOF FLASHING-TAR 031633520.0013 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Black 100.00% Other Inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Black 100.00%Other None Detected Sample ID 11-02 Description ROOF FLASHING-TAR 0316335204)014 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOB 11/11/2016 Black 100.00%Other inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Black 100.00%Other None Detected Sample iD 12-01 Description CAMP ROOF-ROLLED ROOFING 031633520-0015 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOS 11/11/2016 Blade 100.00%Other Inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2016 Black 100.00% Other None Detected Sample ID 12-02 Description CAMP ROOF-ROLLED ROOFING 031633520-0016 Homogeneity Heterogeneous PLM NYS 198.1 Friable Not Analyzed PLM NYS 198.6 VCM Not Analyzed PLM NYS 198.6 NOS 11111/2016 Black 100.00%Other inconclusive:None Detected TEM NYS 198.4 NOB 11/11/2018 Blade 100.00%Other None Detected Initial Report From:11/11/2016 12;33:22 Printed 11/11/2016 12:33:23PM Page 3 of 4 EMSL Analytical, Inc.Inc EMSL Order: 031633520 307 Vlihst 38th Stnt+et New York,NY 10018 Customer ID: ALP150 IMP ! Wax(212)290.0051/(212)290-0058 Customer PO: .,. rttp:fNnvv.Ei<.4SL.ccm!mani7attanlab@emsl.ecm 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: 11/8/2016 Sample Receipt Time: 10:31 AM Analysis Completed Date: 11/11/2016 Analysis Completed Time: 4:57 AM Analyst(s): t Shahrakur Mahmud PLM NYS 198.6 NOB(15) Alicia Fo/gar TEM NYS 198.4 NOB(14) -- Samples reviewed and approved by: James Hall,Laboratory Manager or Other Approved Signatory NOB=Non Friable Organically Bound NIA=NotApplicacle VCM=Vermiculite Containing Material -In New York State,TEM is currently the only method that can be used to determine if NOB materials can be considered or treated as non-asbestos containing. AN samples examined for the presence of vermiculite when analyzed via NYS 198.1. -NYS Guidelines for Vermiculite containing samples are available at http://www.wadsworth.orgAabeart/etapcert/roffWVermiculitelnterimGuidance Rev070913.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 report may contain data that is not covered by the NVtAP accreditation. Samples anayzed by EMSL AroFy 4 Inc.New Yak NY NYS ELAP 11506 Initial Report From:11/11/2016 12:33:22 Printed 11/11/2016 12:33:23PM Page 4 of 4 rderlDt 031633520 / 2. Th6n.:(5,18)250=4047 438 New Kamer Rd. / A�bany,'NY 12205 - �•- email:iviattFaAlpineEriv.com CHAIN OF CUSTODY Client:Alpine Environmental Services Project:. 119 Scclvc Rd. Cleuerdale_NY Project Number: I6-19979-A Contact: Mathew Fiore Sampled By. Matthe«i Fiore Phone: 518-250-4047 Date/Time Collected: 11/7/2016 Tum- arattnd Urrte:72--hr R.O.Number. �_ -74 Log Sample Sample Sample 7 No. No. Location Material Analysis Results 05-01 Bathroom Wall Board Mastic Asbestos Stop at NYS Protocol First Positive 05-02 Batluootn W-611 Board ?Mastic Asbestos _ NYS Protocol- 06-01 Bathroom Cove Basc Mastic Asbestos, Stopat NYS Protocol First Positive 06-02 Bathroom Cove fuse Mastic Asbestos NYS Protocol Fitchen, - - -- Linoleum Asbest©a NYS-Protoeol, 07-02 'Bathrooin Linoleum Asbestos NYS Protocol 08-01 Kitchen Sink Sound Asbestos Stop at Deadener NYS Protocol First Positive �'OS,02 Kitchen'Sink Sound Asbestos Deadener NY&Protocol.- 09=Q2 Camp Roof uapor. Asbestos Barrier NYS Protocol a' , cn �3 09-02 Boat House Roof Vapor AsbestosBarrier NYS Protocol 10-01 Camp;Roof Shingle r Asbestos: > 1\ �- rn YS'Protocol- Asbestos .. � 1d402 -Boat-House Roof shin9l4; NYS Protocol 3- 11-01 Roof Flashing Tari Asbestos Stop at NYS Protocol First Positive 11-02 Roof Flashing Tar Asbestos NCS Protocol Page 2 of 2 etc- ,. t- Paqe i O_` 2 I "J rile-, 1-7 s •0-3 163520 �b �2 PNonc-{5i8) 50=4047 =�2'�i���:: :3_6 3 3;:�:" :n 1CC5,I1fC: � J � 438?dew Kamer Rd. A"Nny,DIY 12205 email: NlattF@,AipineFiiv.com s 12-01 Camp Roof Rolled Asbestos 4 Stop at Roofing NO'S Protocol First Positive Roilcct. Asbestos i 12-02' Canzp.Raof Roofing NYS Protocol ' Disposition of Samples: Accept Reject Explain Comments: I Relinquished By: Received$y. Date: i ime: I 1 /(, /0.3/Air, a � � % CI oma' p •' r CIO Page 2 of 2 New York State—Department of Labor Division of Safety and Health License and Certificate Unit State Campus,Building 12 Albany,NY 12240 ASBESTOS HANDLING LICENSE Alpine Environmental Services, Inc. FILE NUMBER: 00-0320 LICENSE NUMBER: 29095 438 New Karver Road LICENSE CLASS: RESTRICTED DATE OF ISSUE: 06/22/2016 Albany, NY 12205 EXPIRATION DATE: 07/31/2017 Duly Authorized Representative—Craig Petreikis: 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 Sli'ATE OF NEW YORK• CEPARTMIENT OF LABOR ASBESTOS CERTIFICATE MATTHEW J FIORE CLASS(EXPIRES) C ATEC(03/17) 0 INSP(03/17) H PM (03/17) IL iviUST BE CARRIED ON ASBESTOS PROJECTS STATE OF-qEW YORK- EPARTWNT OF LABOR MOLD ASSESSOR MATTHEW FIORE ` EXPIRES: 01-18 k NEW YORK STATE DEPARTMENT OF HEALTH WADSWORTH CENTER Expires 12:01 AM April 01,2017 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. JAMES HALL NY Lab Id No: 99506 EMSL ANALYTICAL, INC 307 WEST 38TH STREET NEW YORK, NY 90098 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 Lead in Dust Wipes EPA 70008 Lead in Paint EPA 70008 Sample Preparation Methods EPA 3050B Serial No.: 54297 Property of the Now York State Department of Health. Certificates are valid only at the address shown,must be conspicuously posted,and are printed on secure paper. Continued accrvoitation deponds an successful ongoing participation in the Program. Consumers are urged to call(518)485-5570 to mrify the laboralWs accreditation status. ?age i of 1 pim - nrr- e ENVIRONMENTAL SERVICES November 17, 2016 Michael Kaidas Kaidas Properties, LLC 113 Seelye Road Cleverdale, NY 12820 Re: Asbestos Materials Removal Confirmation at: One Story Seasonal Residential Structure 119 Seelye Road Cleverdale, New York Michael, As requested, Brian Gould, NYSDOL Asbestos Project Monitor, visited the site at the above address on November 16th, 2016 for the purpose of verifying the removal of asbestos containing materials previously identified in the asbestos pre-demolition inspection performed in November 2016, Alpine Project Number#16-19979-A. The asbestos material identified during the pre-demolition inspection, namely: sink with asbestos sound deadener (undercoating), was observed to have been removed from the building. If Alpine Environmental Services can be of further assistance on this matter, please contact Craig Petreikis at our office at (518) 250-4047, ext. 313. Sincerely, Alpine Environmental Services, Inc. Brian Gould NYS Department of Labor Asbestos Project Monitor (#95-02582) z � From:Stevens,Andrew J. Sent: Friday, December 2,2016 8:38 AM To: 'mak45@road runner.com'; 'spkaidas@gmail.com' Subject: National Grid Demo Letter nationalgrid 300 Erie Boulevard West ......................................... Syracuse,New York.1.3.202 Date RE: Service Removal for Building Demolition. This letter is to confirm that,per your request,National Grid has confirmed electrical service and meters have been removed from 119 SEELEYRD QUEENSBURY NY 12804. The work was processed on work request#23146473. If you have any questions or need further assistance, please feel free to contact us at 800-260-0054. 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