DEMO-000498-2017 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-000498-2017 Date Issued: Wednesday, September 12, 2018
This is to certify that work requested to be done as shown by Permit Number DEMO-000498-2017
has been completed.
Tax Map Number: 302.7-1-24
Location: 2 GLENDALE DR
Owner: CKT Enterprises, LLC
Applicant: Starr Mowery
This structure may be occupied as a: Interior Demolition only
Asbestose Report Received By Order of Town Board
No exterior structural changes. TOWN OF QUEENSBURY
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: DEMO-000498-2017
Tax Map No: 302.7-1-24
Permission is hereby granted to: WJ Miner Construction
For property located at: 2 GLENDALE DR
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: CKT Enterprises,LLC Demolition-Residential $0.00
Owner Address: 11 Lafayette ST Total Value 50.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
WJ Miner Construction
24 Indiana AVE
Queensbury,NY 12804
Plans&Specifications
Interior Demolition only
Asbestose Report Received
No exterior structural changes.
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,September 10,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of ueensbrida e 12017
SIGNED BY: eA% for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
DEMOLITION APPLICATION Permit#: YM D R-C)o
Permit Fee:$
30
Irnn ((�ccn.btirr
Invoice:#:
742 Bay Road,Queensbury, NY 12804 _
P: 518-761-8256 www.queensbury.net '� w-7�
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Demolition Location: � ;t,,,,i_+a-� �'- . Tax Map ID
**AN ASBESTOS REPORT IS REQUIRED WITH ALL
DEMOLITION APPLICATION SUBMISSIONS**
CONTACT INFORMATION:
Okil
• Applicant:
Name(s): r--' VZ- nn C_—
Mailing Address, C/S/Z: j /,A f4-e 0(7
Cell Phone: ( Sc � ) :24 06 ` Land Line:
Email:
• Primary Owner(s):
Name(s): A.-yL9 r%&n 4 C k. IT
Mailing Address, C/S/Z:
Cell Phone: _(mac) U - Land Line: _( )
Email:
•
Contractor:
Business Name:
Contact Name(s):
Mailing Address, C/S/Z: h'>
Cell Phone: _(T/ P, Land Line: _(
Email: rz
Contact Person for Building & Code Compliance: (,a �� , � M ►.a.�
Cell Phone: _( • t b ) lGo - Land Line: _( )
Email:
Demolition Application Revised June 2017
DEMOLITION INFORMATION:
1. Where will demolition material be disposed? V.W 'Le_ 'Ple""Ve,
2. Type of structure to be dewK+s Ved:
a. Residence
b. Garage
c. Business
d. Storage Building
3. What type of utilities are connected to the structure:
a. Gas
b. Fuel it
c. Propane
d. Electric
e. Public Water
f. Well-Water Pump
g. Public Sewer
h. Other
i. None
4. Have ALL utilities been disconnected? Yes No
ADDITIONAL INFORMATION:
1. Two inspections may be required: an inspection to determine that utilities are disconnected, if
necessary, and a final inspection, after the structure is removed and the site is cleaned up and graded.
2. Twenty-four (24) hour notification is required for inspections.
Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has
been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a
permit has been issued.
I have read and agree to the above:
PRINT NAME: M NCr—
SIGNATURE: DATE: Ali )
Demolition Application Revised June 2017
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ASBESTOS RENOVATION SURVEY/INSPECTION
302.7-1-24 RC-000408-2017
FOR GIST Enterprises, LLC
2 Glendale ®rive
Interior ®em® (asbestos report recv`d)
BUILDING
2 GLENDALE DRIVE
QUEENSBURY, NY 12804
SPECTRUM PROJECT No.0 17-409
AUGUST 99 201'
t �lL
PREPARED FOR:
CKT VENTURES
11 LAFAYETTE STREET
QUEENSBURY, NY 12804
Environmental consulting&Management Services • Health&Wetr 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
-PHOTO ALBUM
-LOCATION MAPS
-LABORATORY REPORTS
-LICENSING AND CERTIFICATION
- 12 NYCRR PART 56-5.1
SECTION -INTRODUCTION
On August 7, 2017, Spectrum Environmental Associates, Inc. (Spectrum) conducted a survey for
the presence of asbestos containing materials at the building located at 2 Glendale Ave in
Queensbury, NY. Mr. Don Trischett and Mr. Ron Martin Jr (Asbestos Inspector#06-00655 and
89-00943 respectively) conducted this inspection following procedures and guidelines commonly
used and accepted by federal and state regulations. The objective of the survey was to identity 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-FLAP regulations.
SECTIONII-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 CKT Ventures,its successors and/or assigns.
This report and its contents represent confidential information and should not be duplicated
without the expressed permission of the CKT Ventures its successors and/or assigns.
The building owner is CKT Ventures and may be reached at I I Lafayette Street in Queensbury,
NY.
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 1-ASBESTOS SAMPLING RESULTS
TABLE 2-ASEEST®S FINDINGS
PII®T®ALBUM
LOCATIONMAPS
LABORAToRYREPoRTS
LICENSING AND CERTIFICATION
NO'S INDUSTRIAL CODE MULE SECTION S6®5 I
TABLE 1 — ASBESTOS SAMPLING RESULTS
2 Glendale Drive
Spectrum Project# 17-409
Date Sampled: August 7, 2017
#
Sample Description Location/Area
PLM Results TEM Results
P P %Type) (%Type)
01 Ceiling textured spray on Ceiling 211 floor apartment 2B NAD NA
02 Ceiling textured spray on Ceiling 211 floor apartment 2B NAD NA
03 Ceiling textured spray on Ceiling 2nd floor apartment 213 NAD NA
04 Ceiling textured checker pattern Ceiling 2nd floor apartment 2B NAD NA
05 Ceiling textured checker pattern Ceiling 2nd floor apartment 2B NAD NA
06 Ceiling textured checker pattern Ceiling 2"d floor apartment 213 NAD NA
07 Sheetrock—white Ceiling 2nd floor apartment 2B NAD NA
08 Sheetrock—white Ceiling 2nd floor apartment 213 NAD NA
09 Sheetrock—yellow Ceiling 2nd floor apartment 213 NAD NA
10 Sheetrock—yellow Ceiling 21 floor apartment 2B NAD NA
11 Joint Compound Ceiling 2nd floor apartment 213 NAD NA
12 Joint Compound Ceiling 2nd floor apartment 213 NAD NA
13 Insulation backer Exterior wall 2nd floor apartment 213 NAD NAD
14 Insulation backer Exterior wall 2nd floor apartment 213 SAD NAD
15 Insulation backer Exterior wall 2"d floor apartment 213 NAD NAD
16 Wallboard backing—black coating Exterior wall 211d floor apartment 213 NAD NAD
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 I — ASBESTOS ,SAMPLING RESULTS
2 Glendale Drive
Spectrum Project# 17-409
Date Sampled: August 7, 2017
Sample# Description Location/Area PLM Results TEM Results
(/off e) (/o T e)
17 Wallboard backing—black coating Exterior wall 2nd floor apartment 213 NAD NAD
18 Roof felt Roof inside apartment 213 NAD NAD
19 Roof felt Roof inside apartment 2B NAD NAD
20 Shingles Roof inside apartment 213 NAD NAD
21 Shingles Roof inside apartment 2B NAD Chrysotile Trace
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
ABLE 2 - ASBESTOS FINDINGS
2 Glendale Drive
Spectrum Project# 17-409
Date Sampled: August 7, 2017
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 renovation of the 2nd floor apartment 2B.
• The sampling was limited to the request material(s) and location(s)by the client.
• The l St floor former store front area contained 9 x9 floor tile and black mastic is assumed
positive.No other materials were suspect.
• On the 1St floor the rear apartment I contains no suspect materials.
SF—square feet,LF—linear feet,ea—each
TABLE Z — ASBESTOS BINDINGS
2 Glendale Drive
Spectrum Project# 17-409
Date Sampled: August 7, 2017
Material Location/Area Estimated Quantity* Condition/Damaged
None of the materials tested were positive for asbestos according to USEPA and New York State Department of Labor-Industrial Code Rule 56
(NYS ICR 56
Floor the and mastics 19t floor former store front -T —720s Fair
*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.
I The lst floor former store front area contained 9 x9 floor tile and black mastic is assumed positive. No other materials were suspect.
Please see the limitation listed above.
SF—square feet,LF—linear feet,ea—each
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LABORATORY REPORTS
Amer!Scl New br
117 EAST 30 T H ST.
AmERI SO NEW YORK, NY 10016
r TEL:(212)679-8600.FAX:(212)679-3114
PLM Bulk Asbestos Report
Spectrum Environmental Associates, Inc Date Received 08/08/17 AmeriSci Job# 217082207
Attn: Bill Massman Date Examined 08/08/17 P.O. #
P.O.Box 1024 ELAP# 11480 Page 1 of 4
RE: 17-409; 2 Glendale Ave., Queensbury; Apt. 213
Schenectady, NY 12301
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
1 217082207-01 No NAD
1 Location: Spray-On Texture Ceiling (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
2 217082207-02 NO NAD
1 Location: Spray-On Texture Ceiling (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
3 217082207-03 NO NAD
1 Location: Spray-On Texture Ceiling (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
4 217082207-04 No NAD
2 Location: Checker Pattern Texture Ceiling (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08108/17
Analyst Description: OffWhite, Homogeneous,Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose Trace, Non-fibrous 100%
5 217082207-05 No NAD
2 Location: Checker Pattern Texture Ceiling (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: OftWhite, Homogeneous,Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose Trace, Non-fibrous 100%
See Reporting notes on last page
Fitne'riSc.i Job Y:`: 2i7O82267
Page>of 4
Liieni Name: Spectrum E_nvironmenial;associates, ine:.
PLM Sulk Asbestos Report
17-409; 2 Glendale Ave., Queensbt,iry; Apt. 26
Client No. / HGA Lab No. Asbestos Present Total °fes Asbestos
6 217082207-06 NO NAD
2 Location: Checker Pattern Texture Ceiling (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: OflWhite, Homogeneous, Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose Trace, Non-fibrous 100%
7 217082207-07 NO DIAD
3 Location: White Sheetrock (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: White/Brown, Heterogeneous,Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose 30%, Non-fibrous 70%
8 217082207-08 NO NAD
3 Location: White Sheetrock (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: White/Brown, Heterogeneous,Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose 35%, Non-fibrous 65%
9 217082207-09 NO NAD
4 Location: Yellow Sheetrock (by NYS ELAP 198.1)
by Khaalid W. Perine
on 08/08/17
Analyst Description: White/Brown, Heterogeneous, Fibrous, Bulk Material
Asbestos Types:
Other Material: Cellulose 30%, Non-fibrous 70%
10 217082207-10 NO NAD
4 Location: Yellow Sheetrock (by NYS FLAP 198.1)
bV Khaalid W. Perine
on 08/08/17
Analyst Description: White/Brown, Heterogeneous, Fibrous,Bulk Material
Asbestos Types:
Other Material: Cellulose 25%, Non-fibrous 75%
11 217082207-11 No NAD
5 Location: Joint Comp. (by NYS ELAP 198.1)
by Khaalid W. Penne
on 08/08/17
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
See Reporting notes on last page
Ame���L 2'�'768220J
Rage 3uf�
. . QieniNume: Spectrum E-nvixnnmento|Associates, inc.
PLM Bulk Asbestos Report
17-409; 2G|enda|e Ave.. Queensbury; Apt. 213
Client No. / HGA Lab No. Asbestos Present Total % Asbestos
12 217082207-12 NO NAD
5 Location: Joint Comp. (by NYS ELAP198.1)
byKhaa|idVV. Pohno
on 08/08/17
Analyst Description: VVhiho, Homogoneoun, Non'Fibmun, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 1OU%
13 317083207-13 NO NAD
6 Location: Insulation Backing (by NYS ELAP198.0)
byKhuaUdVV. Pehn*
on 08/08/17
Analyst Description: B|aok/Bmwn, Homoganeouo,Non-Fibmun,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 1 %
14 217083207-14 No NAD
6 Location: Insulation Backing (by NYS ELAP19D.8)
byKhea|idVV Pohne
on 08/08/17
Analyst Description: 8|aoW8mwn. Homogeneous, Non'Fibmuu. Bulk Material
Asbestos Types:
Other Material: Non-fibrous 0.8%
15 217082207-15 NO NAD
8 Location: Insulation Backing (by NYS ELAP108.8)
byKhaa|idVV. Pohne
on 08/08/17
Analyst Description: B|auW8msn.Homogeneous, Non'Fibmuo.Bulk Material
Asbestos Types:
Other Material: Non-fibrous O.O%
16 217082207-10 No hJAC>
7 Location: Black Coating Wallboard Backing (by NYS ELAP188.8)
byKhaa|idVV. Pehno
on 08/08117
Analyst Description: 8/avWBmwn. Homogeneous,Non'Fihmun.Bulk Material
Asbestos Types:
Other Material: Non-fibrous O.7Y6
17 217082207-17 No NAD
7 Location: Black Coating Wallboard Backing (by NYS ELAP108.6)
byKhau|idVV Pehne
on 08/08/17
Analyst Description: Black/Brown, Homogeneous,Non-Fibrous,Bulk Material
Asbestos Types:
Other Material: Non-fibrous 0.0%
See Reporting notes nnlast page
AmehSo
~~ �ags�af�
CUent Wame: Specrum Envivonman1a/Asaooieies. !no.
PUPA ~—~-^^^ ~ l~~~~~^'t^~^^ Report
~
17-409� 2G|end2|e AVe.. Ougenobur�; Apt 2R
Client No. / HGA Lab No. Asbestos Present Total %Asbestos
18 217082207-18 NO NA[)
8 Location: Roof Felt (by NYS ELAP 198.0)
byKhaalidW. Perine
on 08/08/17
Analyst Description: 8laok, Homoganoouo, Non'F{bmus, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 1.V96
19 217082207-19 No PJA[)
8 Location: Roof Felt (by NYS ELAP108.8)
hyKhaa|idVV. Pahne
on 08/08/17
Analyst Description: B(aok, Homugmnooua, Non'Fibmus, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 0.7%
20 217082207-20 No N/\O
9 Location: Roof Shingle (by NYS ELAP198.8)
byKhaa|iUVV Pohno
on 08/08/17
Analyst Description: Black, Homogeneous, Non'Fibmua. Bulk Material
Asbestos Types:
Other Material: Non-fibrous 3.5%
21 217082207-21 No NAD
g Location: Roof Shingle (by NYS ELAP198.6)
byKhao|idVV. Perina
on 08/08/17
Analyst Description: 0uck, Homogenooun, Non'Fibmus.Bulk Material
Asbestos Types:
Other Material: Non-fibrous 3.7%
Reporting Notes:
Analyzed by:Khaalid W.Perine
*NAD/NSD=no asbestos detected/NA=not anal3jed;NA/PS=not analyzed1positive stop,(SOF-V) Sprayed On Fireproofing containing Vermiculite;
(SM-V)=Surfacing Material containing Vermiculilb;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,whichincludes 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/l/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 lab.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 orREPORT_
AmeriSci Job#: 217082207 Page I of 2
Client Name: Spectrum Environmental Associates, Inc.
Table I
Summary of Bulk Asbestos Analysis Results
17-409; 2 Glendale Ave., Queensbury; Apt. 28
Sample Heat Acid Insoluble
AmeriSci HG Weight Sensitive Soluble Non-Asbestos **Asbestos%by "Asbestos%by
Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS TEM
01 1 1 ---- ---- ---- NAD NA
Location: Spray-On Texture Ceiling
02 2 1 w — — ---- NAD NA
Location: Spray-On Texture Ceiling
03 3 1 ---- ---- ---- NAD NA
Location: Spray-On Texture Ceiling
04 4 2 ---- ---- -- NAD NA
Location: Checker Pattern Texture Ceiling
05 5 2 --- ---- ---- NAD NA
Location: Checker Pattern Texture Ceiling
06 6 2 ---- ---- ---- NAD NA
Location: Checker Pattern Texture Ceiling
07 7 3 -- ---- ---- ---- NAD NA
Location: White Sheetrock
08 8 3 ---- ---- --- NAD N,q
Location: White Sheetrock
09 9 4 ---- ---- ---- NAD IIIA
Location: Yellow Sheetrock
10 10 4 ---- ---- --- NAD NA
Location: Yellow Sheetrock
11 11 5 - ---- ---- ---- NAD NA
Location: Joint Comp.
12 12 5 ---- ---- --- NAD NA
Location: Joint Comp.
13 13 6 0.105 98.1 1.0 1.0 NAD NAD
Location: Insulation Backing
14 14 6 0.118 97.5 1.7 0.8 NAD NAD
Location: Insulation Backing
15 15 6 0.157 98.7 0.6 0.6 NAD NAD
Location: Insulation Backing
16 16 7 0.145 98.6 0.7 0.7 NAD NAD
Location: Black Coating Wallboard Backing
See Reporting notes on lost page
AmeriSci Job#: 217082207 Page 2 of 2
Client Name: Spectrum Environmental Associates, Inc.
Table E
Summary of Bulk Asbest®s Analysis Results
17-409; 2 Glendale Ave., Queensbury; Apt. 213
Sample Heat Acid Insoluble
AmeriSci HG Weight Sensitive Soluble Mon-Asbestos ^^Asbestos%by `"Asbestos%by
Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% eLMIDS
VERA
17 17 7 0.157 98.7 0.6 0.6 NAD NAD
Location: Black Coating Wallboard Backing
18 18 8 0.272 97.8 0.4 1.8 NAD NAD
Location: Roof Felt
19 19 8 0.142 97.2 2.1 0.7 NAD NAD
Location: Roof Felt
20 20 9 0.229 94.8 1.7 3.5 NAD NAD
Location: Roof Shingle
21 21 9 0,244 95.1 1.2 3.6 NAD Chrysotile Trace
Location: Roof Shingle
Analyzed by:Karol H,Lu �---- ;Date Analyzed 8/9/2017
"Quantitative Analysis(Semi/Full);Bulk Asbestos Analysis-PLM by EPA 600/M4-82-020 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-LAP,LLC(PLM)Lab ID 102843.
Warning Note:PLM limitation,only TEM will resolve fibers<0.25 micrometers in diameter.TIrM bulk analysis is representative of the fine grained matrix material artd may not be representative of
non-uniformly dispersed debris for which PLM evaluation is recommended(i.e.soils and other heterogenous materials).
Reviewed By:
�
SPECTRVM �Cr�er�eer��a�>&T/near
E (598)346-6374(phoney
R Enrimnrmental Rssedates. Inc. (S&8),?46-406z(ram.
'EXCEEDING OUR CLIENTS EXPECTBTIONS Of EXCELLUCE'
BULK SAMPLING CHAIN C V STODV (Rev. P.1'7P.I�18V.��jmt'd'lB7IQDl1t.C'cDtltti;
03/07/2014)
PROJECT INFORMATION
Project fl:' 1 6 Bu ng Name: �tt Matrix Analysis Requested Turnaround
!�0 e 61
Date Sampled: AreaiLocation:
-? / Bulk Paint PLM-ELAP 198.1 TI-,M-ELAP 198.4 ® RUSH 24 Hour
4) JqA v
page tt a o f. Investigator � Soil ® Wipe PLM-ELAP 198.6 ® _ ® 72 Hour
6 �
SAMPLE IDENTIFICATION
Sample ID#: Group#:* Material I Sample Location Condition/Comment
� t i
13 L3 I
� I
G z-
3 e
*Unless otherwise st ed lease analyze each group to first(1")positive result.
Comments:
207
CHAIN OF CUSTODY _
Relinquishe Date Timeeceived By Patel Time Method of Submittal
II
Ill �.i
Environmental Consulting Management Services HeaaHA & g at'etV Fll'01ming 0 L&&ordnt0FV Services
171 60.hitt§0244;
S SPECTRV rt)3e tm� ,4 f 230,
R 346-63, (Phoffe/
Environmental Rssvdateso Inca (yrs)346-4®62(Fmy1
'EXCF.EUIN6 OUR CLIENTS EXPECTBTIONS OF EXCELLE'NCE' L'vGUn'a1.4-��jmrAatdnaattII.e'P)orP
BULK SAMPLING CHAIN OF CUSTODY (Rev ,,,/0712014)
PROJECT INFORMATION g _
Project N: ' sail gG�e. CI �� 1bIlatrix Analysis Requested Turnaround
_—•--
a
Date Sampled r ArWL-ocation: Paint
-
/ *Bulk ® 1 aint �pPLM—ELAP 198.1 CEM—ELAP 198.4 I2US11 24 Hour
Page u Z 0f •Z Investigator: Soil Wipe PLM—ELAP 198.6 92 Hour ® -�
SANIPLE IDENTIFICATION
Sample lD 4: Group!l: Material Sample Location Condition/Comment
R
Unless otherwise stated please analyze each group to first(1")positive result.
Comments Q �� 7 ® 8 2 2 ® 7
CHAIN OF CUSTODY
elinquished By Date fime Deceived By to Time Method of Submittal
? 7 :V/ l/ I
lIl
Environmental Consulting &- Raanaffememe Services Reaalth & Sart'etV Frealaain g - lLaborarkoa•rV Services
LICENSING AND CER TIFICATION
i
A 0.Box 1024
V C!1 P11 PCbdli 43123014
i/A
't-" it�7v1::=;i�,r7P^t72:ri:.t�lei
°FXCEEDI O OVP. CL1EXTS FTP£CTi17'1O.I'S OF EXCELLENCE'
,�t'n't0, o 1�my, V 0.1.'lt: - .I %(JctCll:l:1�)ii P:3.l abo1:'
STATE OF NEVV`ORE:-GEPAKTA,1r'H T OF LOOP
k,1E5TC1`CERTIFICATE
DONALD S T RISCWETI
CLASS(EXPIRES)
CATEC(07/17) D INSP(071'I7)
"r- H PM (07117)
i%,fUST'DIE CARRIED:=1141 ASBESTOS ROJECTS
WHIM r 1101 H ua
iI�i I Ilii I l iI Ml ll��l�i l 11 lii
IF FOUND RETURN TO:
=_m EYES GRN NYSDOL - L&C UNIT
M HAIR GRy ROOM 161A BUILDING 12
n
�$ HGT 5' 10" STATE OFFICE C4AMPUS
`='c ALBANY NY 122-0
m
ry
'"w o
s1 411✓ of i Te � 1. 01 -, - :i1e���1.1•i�a en-t of Lobo1.
Codes Certification
A Asbestos Handler
B Restricted Handler - Allied Trades
C ' Air Sam lin Technician
D Inspector
P Management Plaimer
F Operations and Maintenance
G Supervisor j
�j Project Monitor
T , Project Designer
Eli14ro'(1I11011tal cons11%f ng A-t11111111,�G'II1B711 sL'7'1'%CE'S 1-fB(1%ftl S,S'lihofy Trainhig Labot'll!`01'}1 Sol,viCC'S
t 1t Ii.L;011:W211
r� SPEC- TRVA
S�i�z���tut�y items'723Gt
(518�346-63YIi(Pholm-�
,ihilirU'Titmel la cis soclOies. lm,% x518,1346-400(twx)
'EXCEEDIii'C VDR VLimrs EXPECTATiOA's OF EXCELLEXCE' wiew.4spei;im,-t.evm
State of New York`-" Dep Fi.t` men-t of Lab or
Asbegtos Certification
TkTE 0i_NJCY YORK-DEPARTMENT OF LAGrJR
a,SGE:ST0 5 CKT1FICATE
RONALD MARTIN JR
CLASS(EXPIRES)
C ATEC(10117) D INSP(IO/17)
G SI.JPR(10/17) H PM (10/171
tnJ[T BE CARIED JFK X'SIBE TODS PROJECT
- IIIIIIIIHIHlillilli Nillil
IF FOUND RETURN TO:
EYES BRO NYSDOL - L&C UNIT
N HAIR BRO ROOM 161A BUILDING 12
®a HGT 6' 00" STATE OFFICE CAMPUS
o ALBANY NY 12240
�M
fd
.O
State of Ne�,v - orfi--- Department of Labor
Codes Certification
A Asbestos Handler
B Restricted Handler - Allied Trades
C Air Sampling Technician
D Inspector
E Management Planner
F Operations and Maintenance
G Supervisor
H Project Monitor
I Project Designer
Environmental Consulting c&management Services - Health&Safety Training • laboralor•yServices
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
Spectrum Environmental Associates, Inc FILE NUMBER: 99-0129
LICENSE NUMBER: 29081
P.O. Box 1024 LICENSE CLASS: RESTRICTED
DATE OF ISSUE: 01/26/2017
Schenectady,NY 12301 EXPIRATION DATE: 02/28/2018
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.FTM D, I3YstztoT
SH 432(8/12) For the Commissioner of Labor
-NEW YORE. STATE DEPARTMENT OF WEAN`€'
WADSWORTH CENTER
Expires 12:01 ASH April 01, 2018
A Issued April 01, 2017
6 '
CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE
Issued in accordance with and pursuant to section 502 Public Wealth Law of New York State
MR. PAUL J. MUCHA NY Lab Id No: 11480
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 6001M4182/020
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.: 56034
Orouerty of the New York State Department of Health. Certificates are valid only at the address
snovm.must be conspicuously posted,and are printed on secure paper. Continued accreditation depends
on sucressrui ongoing participation in the Program. Consumers are urged to call(518)485-5570 to
ve•-'y the laborarorys accreditation status
Page 1 Of 1
NYS INDUSTRIAL CODE RULE ►SECTION 56-501
SUBPART 56-5
PRASE IA.- ASBESTOS SURVEY PLANNING AND DESIGN
56-6.9 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, PALM 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, ACID, 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
FLAP 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) Rooting 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;
(3) 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, PAJCM' suspect OligC8l[GDeDUs ACM. or asbestos nOat6h@i
reported Under Paragraph /1\ Of this Subdivision shall include the location
of the rnotaria|s, an estimate of the qu8Dtities, typee, 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 @smaooed shall be treated and handled as ACM and shall be
oo8unOed to be ACM. WO|emo bulk sampling is conducted GS per this
Section, standard EPA and OSHA accepted methods, including multi-
layered systems sampling protocols; the subsequent analyses are
performed by 8 laboratory that meets the requirements of Section 58-4.2
of this Part; and the analyses satisfies both ELAp and federal
requinamnentS, including multi-layered sample an8|yeem, to document non-
asbestos containing material.
(3) The building/structure asbestos Sun/ay shall also include the
building/structure name, address, the building/structure owner's name and
address, the name and address ofthe owner's agent, the name 0fthe firm
performing the asbestos aUrVaV and 8 Copy of the firm's current asbestos
handling license, the n8Oleg of the Certified inspector(s) performing the
survey and @ CODy of the CUrnaOt asbestos handling certificate for each
inspector utilized, the dates of the asbestos SUn/ey. a listing of
homogeneous areas identifying which ones are ACM, all laboratory
analyses reports for bulk samples collected, and copies ofthe 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\
COpV of the results of the building/structure @SbaotoS survey oh@|| be immediately
transmitted by the building/structure owner as follows:
(i) One /1\ copy ofthe completed asbestos survey shall besent bVthe owner
ortheir agent to the |OoGl government entity charged with issuing @ permit
for such demolition, [8DOV@tiOn' remodeling Or repair VYO[k under
@pD|iC@b|S State or local lGvvG.
(2) The completed asbestos survey for controlled demolition (as per Subpart
58-11.5\ O[ pre-demolition asbestos projects Sh8|| @|s0beGUh0OittedLO1hG
appropriate Asbestos COOtn}| 0Uro8U district office.
/3\ The completed asbestos survey shall be kept on the construction site with
the asbestos notification and vG[i@noe, if required, throughout the duration
of the asbestos project and any associated denno|ition, renovetion,
remodeling Orrepair project.
/h\ Removal Required- If the building/structure asbestos survey finds that the
portion of the building/structure to be derno|i8hed, ren0vated, remode|ed, or have
repair work contains ACM, P/\CM, suspect miscellaneous ACM aS8V[ned to be
12NYCRR58 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, PALM, 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 PALM,
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 PALM 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 56-4.2 of this Part; and the analyses satisfies both NYS FLAP and
federal requirements, including multi-layered sample analyses, to document non-
asbestos containing material.
12 NYCRR 56 Subpart 5, Page 46