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DEMO-0114-2021 Office Use Only DEMOLITION APPLICATION Permit#: _ f Permit Fee:$ b5 Town of Quce bury Invoice#: �J 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Flood Zone? Y N Reviewed By: Z0 byl '4 Demolition Location: Tax Map ID#: 23 7,43 a1-1sue **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? r-�ss 2. Type of structure to be demolished: �.) Residence d. Storage Building❑ E E Garage❑ e. Other: c. Business❑ MAR 16 2021 3. What type of utilities are connected to the structure: TOWN OF . QUEEIVSBURY a. Gas❑ f. Well-Water Pump❑ BUILDING&CODES b. Fuel Oil ❑ g. Public Sewer❑ c. Propane❑ h. Other d. Electric❑ i. None,' e. Public Water❑ 4. Have ALL utilities(water, electric,etc.) been disconnected? Yes K 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 (14) hour notification is required for inspections. 3. Workers' Comp insurance information is required to be submitted with this application. Declaration:I acknowledge that no structure(s)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a, permit has been issued. I have read'and agree to the above: PRINT NAME: 4.�FV,4-- .6 ✓Z/vn SIGNATURE: , DATE: 2A ' Demolition Application Revised December 2020 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): 20 AV layTav,/ Mailing Address, C/S/Z: 308 [-,g;,/&x /L6 Rloul wvo Cell Phone: �: 1// Email: t1uh ynGtvtile C"I • Primary Owners : Name(s): " H I rnc,v Mailing Address, C/S/Z: S,441y, t45 Cell Phone: Land Line: Email: `1"t A5 A60VJ, ❑Check if all work will be performed by property owner only • Contractor: (List all additional contractors on the back of this form) Contact Name(s): ?/4-7-2/cA SgOUD-eA L4- Contractor Trade:62cL4wgL& Mailing Address, C/S/Z: /Z.(x, L'U1L-c,1AW5 /Z6 Cell Phone: �adti�es�8=7E 3�l o Email: c��<ic��jvi.rcJ��c'��( **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: Cell Pho e: Email: e�7'16/✓nci;v :1 d7.I Gc 1 Demolition Application Revised December 2020 Qualcor, LLC Asbestos Survey Report Performed at: 20 Brayton Road, Queensbury, NY 12804 PREPARED FOR: TOWN OF QUEENSBURY BUILDING DEPARTMENT Don Bernard Based on our limited examination,compliance with our comments shall not be construed as indicating the plans and specifications are in full compliance with the Building Codes of PREPARED BY: New York State. Qualcor, LLC 241 Merrill Road Homer, NY 13077 March 31, 2019 10 NV Ned Re`1�e\ � -ate a FILE COPY i 4 March 31,2019 ATTN: Don Bernard Re: Pre-Demolition Asbestos Testing Conducted at: 20 Brayton Road,Queensbury, NY 12804 Dear Don: On March 21,2019,our inspector, Michael Guy,conducted an asbestos survey of the residential property located at 20 Brayton Road,Queensbury, NY 12804.The purpose of the survey was to identify potential asbestos containing materials(ACM's)prior to demolition. Qualcor, LLC visually inspected and then sampled for asbestos containing materials(ACM's). Asbestos containing materials(ACM's)'were identified by laboratory analysis. There was asbestos found in the vinyl flooring in the kitchen and adjoining dining room.(It is under the existing wood laminate flooring.) Additional details about the findings are provided in the report below.We have attached the Laboratory Analysis Report, Drawings,Sample Locations and Chain of Custody for your review and records. Please let me know if you have any questions. Sincerely, Michael T.Guy, President Qualcor, LLC Asbestos Introduction Building construction materials that contain asbestos are found in a variety of types and uses. Common types of ACMs(Asbestos Containing Materials)used in building construction include vinyl floor tile, linoleum flooring,mastic,ceiling tile,spray applied acoustical/decorative ceiling materials and fireproofing, plaster,wallboard and wallboard joint compound,pipe,duct,and boiler insulation,roofing and flashing and many other materials commonly used prior to 1978. Many asbestos containing building materials such as roofing,roofing tar,and adhesives were still commonly used after 1978. Materials containing greater than 1%asbestos by weight are considered ACMs and must be handled according to the Occupational Safety and Health Administration (OSHA)and the United States Environmental Protection Agency guidelines,as-well as State and Local regulations. Building Inspection and Bulk Sampling Collection On March 21,2019,our NY Licensed Asbestos Inspector,Michael Guy,visited the site to perform the asbestos sampling. The sampling was conducted in accordance with the requirements outlined in the NYSDOL asbestos standard (12 NYCRR Part 56). "Each area of the building was visually inspected to identify potential ACM. The inspector assessed each suspect material to determine whether it . represented a friable,non-friable,or non-friable organically bound (NOB)material. The materials were identified,quantified,and sampled for subsequent laboratory analysis. A total of Twelve(12)bulk samples were taken of suspected ACMs. These samples were sent to EMSL,490 Rowley Rd.,Depew,NY 14043(NYS ELAP#11606)and were analyzed via Polarized Light Microscopy(PLM)and/or Transmission Electron Microscopy(TEM)in accordance with NYS DOH procedures 198.1, 198.4,or 198.6. Summary and Limitations e This ACMI (Asbestos Containing Material Inspection)did identify asbestos containing materials via laboratory analysis. Only accessible materials were sampled and analyzed as part of this inspection. IF materials are disturbed as part of any renovation or repair work,which was not part of this inspection; the material should be assumed ACM and handled appropriately. ACM Inspection The findings of the inspection are summarized in the following table. Only materials found to contain asbestos are included. Representative samples collected from selected and readily accessible suspect ACM's were analyzed in the laboratory.. The laboratory results are included as an_attachment to this report. Sampling notes and field sketches are also included. (Asbestos containing materials were identified by laboratory analysis.) - m Findings Table ID Condition/Description Appearance %Asbestos Location Area(approx.) 1 Good/Vnyl Flooring Non-Friable,Brown 19%Chrysotile Floor,kitchen/dining room 200 SF PLEASE NOTE:The positive brown vinyl flooring is under the existing white/grey wood laminate flooring in the kitchen and dining room. Notes: 1. A vapor barrier,if found,under any flooring or siding,should be assumed positive.. 2. All non-fiberglass thermal system insulation is assumed positive (no insulation was visible or tested). This includes cold &hot domestic water,roof drains,and the heating loops. ACM may exist inside wall cavities,above all ceilings,etc. 3. The attached drawings/floor plans have been marked with the sample number,to indicate the location of where the building material samples were taken. Asbestos Bulk Sampling Analysis Report EMSLAnalytical, Inc. EMSL Order: 141901040 Customer ID: GLAN34 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax:(716)651-0030/(716)651-0394 Project ID: http:/Avww.EMSL.com/buffalolab@emsl.com Attention: Michael Guy Phone: (315)565-4964 Qualcor, LLC Fax: (315)471-8807 241 Merrill Road Received Date: 03/22/2019 8:55 AM Homer, NY 13077 Analysis bate: 03/26/2019 Collected Date: 03/21/2019 Project: 20 Brayton Rd.Queensbury, NY 12804 Test Report: Asbestos Analysis of Non-Friable Organically Bound Materials by PLM via the NY State ELAP 198.6 Method Matrix %Non-Asbestos Sample ID Description Appearance Material Fibers %Asbestos Types 3 Kit-Vinyl Floor Brown/Gray 81%Other None 19%Chrysotile 141901040-0003 Fibrous 19%Total Homogeneous 4 Kit-Vinyl Floor Positive Stop(Not Analyzed) 141901040-0004 5 Back Porch-Vinyl Floor Gray/White 100%Other None Inconclusive:No Asbestos Detected 141901040-0005 Non-Fibrous Homogeneous 6 Back Porch-Vinyl Floor Gray/White 100%Other None Inconclusive:No Asbestos Detected 141901040-0006 Non-Fibrous Homogeneous 7 Ext.Windows/Doors- White 100%Other None Inconclusive:No Asbestos Detected 141901040-0007 Caulk Non-Fibrous Homogeneous 8 Ext.Windows/Doors- White 100%Other None Inconclusive:No Asbestos Detected 141901040-0008 Caulk Non-Fibrous Homogeneous 9 Roof-Asphalt&Vapor Gray/Black 97.2%Other 2.8 Glass Inconclusive:No Asbestos Detected 141901040-0009 Barrier Fibrous Homogeneous 10 Roof-Asphalt&Vapor Gray/Black 97.1%Other 2.9 Glass Inconclusive:No Asbestos Detected 141901040-0010 Barrier Fibrous Homogeneous 11 Bathroom-Bathroom Gray/ran 100%Other None Inconclusive:No Asbestos Detected 141901040-0011 Non-Fibrous . Homogeneous 12 Bathroom-Bathroom Grayrran 100%Other None Inconclusive:No Asbestos Detected 141901040-0012 Non-Fibrous Homogeneous 'Polarized Light Microscopy(PLM)is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically bound materials. Quantitative Transmission Electron Microscopy is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos containing. The test results contained within this report meet the requirements of NELAC unless otherwise noted.EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported above and may not be reproduced, except infull,without written approval by EMSL.The above test report relates only to the items tested. EMSL bears no responsibility for sample collection activities or analytical method limitations.Samples received in good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:03/26/201910:50:41 ASS PLMNYNOB 0016 0001 Printed 3/27/2019 8:37:16AM Page 1 of 2 J EMSL Analytical, Inc. EMSL Order: 141901040 Customer ID: GLAN34 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax:(716)651-0030/(716)651-0394 Project ID: http:/Avww.EMSL.com/buffalolab@emsl.com Attention: Michael Guy Phone: (315)565-4964 Qualcor, LLC Fax: (315)471-8807 241 Merrill Road Received Date: 03/22/2019 8:55 AM Homer, NY 13077 Analysis Date: 03/26/2019 Collected Date: 03/21/2019 Project: 20 Brayton Rd.Queensbury, NY 12804 Test Report: Asbestos Analysis of Non-Friable Organically Bound Materials by PLM via the NY State ELAP 198.6 Method Matrix %Non-Asbestos Sample ID Description Appearance Material Fibers %Asbestos Types Analyst(s) Margo eurgio(9) Rhonda McGee, Laboratory Manager or other approved signatory 'Polarized Light Microscopy(PLM)is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically,bound materials. Quantitative Transmission Electron Microscopy is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos containing. The test results contained within this report meet the requirements of NELAC unless otherwise noted.EMSL maintains liability,limited to cost of analysis. This report relates only to the samples reported above and may not be reproduced, except infull,without written approval by EMSL.The above test report relates only to the items tested. EMSL bears no responsibility for sample collection activities or analytical method limitations.Samples received in good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:03/26/2019 10:50:41 ASB_PLMNYNOB 0016_0001 Printed 3/27/2019 8:37:16AM Page 2 of 2 EMSL Analytical, Inc. EMSL Order: 141901040 � y Customer ID: GLAN34 490 Rowley Road Depew,NY 14043 Customer PO: Phone/Fax:(716)651-0030/(716)651-0394 Project ID: http://www.EMSL.com/buffalolab@emsl.com Attention: Michael Guy Phone: (315)565-4964 Qualcor, LLC Fax: (315)471-8807 241 Merrill Road Received: 03/22/2019 8:55 AM Homer, NY 13077 Analysis Date: 03/25/2019 Collected: 03/21/2019 Project: 20 Brayton Rd.Queensbury, NY 12804 Test Report: Asbestos Analysis of Bulk Materials by PLM via the NY State ELAP 198.1 Method Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type 1-Drywall LR-Drywall,tape,Joint Brown/Gray 10% Cellulose 90%Non-fibrous(Other) None Detected 141901040-0001 Compound Fibrous Heterogeneous Paper and gypsum layers included in analysis. 1-Tape LR-Drywall,tape,Joint Tan 90% Cellulose 10%Non-fibrous(Other) None Detected 141901040-0001A Compound Fibrous Homogeneous 1-Joint Compound LR-Drywall,tape,Joint White 100%Non-fibrous(Other) None Detected 141901040-0001B Compound Non-Fibrous Homogeneous 2-Drywall LR-Drywall,tape,Joint Brown/Gray - 10% Cellulose 90%Non-fibrous(Other) None Detected 141901040-0002 Compound Fibrous Heterogeneous • Paper and gypsum layers included in analysis. 2-Tape LR-Drywall,tape,Joint Tan 90% Cellulose 10%Non-fibrous(Other) None Detected 141901040-0002A Compound Fibrous Homogeneous 2-Joint Compound LR-Drywall,tape,Joint White 100%Non-fibrous(Other) None Detected 141901040-0002B Compound Non-Fibrous Homogeneous /2"Analyst(s) G Tom Hanes(6) Rhonda McGee,Laboratory Manager or other approved signatory EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported 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. 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. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted.All samples examined for the presence of vermiculite. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:03/27/2019 08:37:05 ASB PLMPC 0006 0003 Printed 3/27/2019 8:37:29AM Page 1 of 1 EMSL Analytical, Inc. EMSLOrder: 141901040 Customer ID: GLAN34 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax: (716)651-0030/(716)651-0394 Project ID: http:/Avww.EMSL.com/buffalolab@emsl.com - Attention: Michael Guy Phone: (315)565-4964 Qualcor, LLC Fax: (315)471-8807 241 Merrill Road Received Date: 03/22/2019 08:55 AM Homer, NY 13077 Analysis Date: 03/26/2019 Collected Date: 03/21/2019 Project: 20 Brayton Rd.Queensbury, NY 12804 Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total Sample ID Description Appearance Material Fibers %Asbestos Types Asbestos 3 Kit-Vinyl Floor 141901040-0003 NotAnalyzed 4 Kit-Vinyl Floor 141901040-0004 NotAnalyzed 5 Back Porch-Vinyl Gray/White 100%Other None No Asbestos Detected None Detected 141901040-0005 Floor Non-Fibrous Homogeneous 6 Back Porch-Vinyl Gray/White 100%Other None No Asbestos Detected None Detected 141901040-0006 Floor Non-Fibrous Homogeneous 7 Ext.Windows/Doors- White 100%Other None No Asbestos Detected None Detected 141901040-0007 Caulk Non-Fibrous Homogeneous 8 Ext.Windows/Doors- White . 100%Other None No Asbestos Detected None Detected 141901040-0008 Caulk Non-Fibrous Homogeneous 9 Roof-Asphalt&Vapor Gray/Black 100%Other None No Asbestos Detected None Detected 141901040-0009 Barrier Fibrous Homogeneous 10 Roof-Asphalt&Vapor Gray/Black 100%Other None No Asbestos Detected None Detected 141901040-0010 Barrier Fibrous Homogeneous 11 Bathroom-Bathroom Graylran 100%Other None No Asbestos Detected None Detected 141901040-0011 Fibrous Homogeneous Analytical Sensitivity<1%Asbestos.This laboratory Is not responsible for%asbestos in total sample when the residue only is submitted far analysis.The above report relates only to the items tested.This report may not be reproduced,except in full,without written approval by EMSLAnalytical,Inc.Samples received In good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:03/26/2019 03:32 PM Printed:03/27/2019 08:37 AM ASB_TEMMYNOB_0015_0001 Page 1 of 2 EMSL Analytical, Inc. EMSL Order: 141901040 Customer ID: GLAN34 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax: (716)651-0030/(716)651-0394 Project ID: http:/twww.EMSL.com/buffalolab@emsl.com Attention: Michael Guy Phone: (315)565-4964 Qualcor, LLC Fax: (315)471-8807 241 Merrill Road Received Date: 03/22/2019 08:55 AM Homer, NY 13077 Analysis Date: 03/26/2019 Collected Date: 03/21/2019 Project: 20 Brayton Rd.Queensbury, NY 12804 Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total Sample ID Description Appearance Material Fibers %Asbestos Types Asbestos 12 Bathroom-Bathroom Gray/Tan 100%Other None No Asbestos Detected None Detected 141901040-0012 Fibrous Homogeneous /2"Analyst(s) ' ` C' Mark Tale(8) Rhonda McGee,Laboratory Manager or other approved signatory Analytical Sensitivity<1%Asbestos.This laboratory is not responsible for%asbestos in total sample when the residue only is submitted for analysis.The above report relates only to the Items tested.This report may not be reproduced,except in full,without written approval by EMSLAnalytical,Inc.Samples received in good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:03/26/2019 03:32 PM Printed:03/27/2019 08:37 AM ASB_TEMNYNOB_0015_0001 Page 2 of 2 Photos,Chain of Custody, Field Notes OrderID: 141901040 490 Rowley Road Asbestos Bulk wilding Material .Chain of. Custody 1 Depew. NY 14043 EMSL Order Number(Lab use Only): EMSL ANALYTICAL.INC. (f 16)651-0030 - a t.t1M(J N*pe1.OP�nU.;16 riN4tH•N.J �-.�,�' (716)651-0394 Qualcor, LLC 116 EMSL-Bill to:E] Same ❑Different Company : If Bill to is Different note instructions in Comments— Street:241 Merrill Road Third Patsy Billing requires written authorization from third pasty City:Homer - State/Province:NY ZiplPostal Code:13077 Country:US i _....... . ......... ... - - .. . .. . Report To(Name):Michael Guy Telephone#:3153294271 t I Email Address: mike.qualcor@gmail.com Fax#: Purchase Order: Project Name/Number: _ Please Provide Results: Fax ✓ mail ail 1 U.S.State Samples Taken:NY CT Samples: ❑Commercial/Taxable ❑ Residential/Tax Exempt a Turnaround Time(TAT)Options*-Please Ch ck ❑3 Hour ❑6 Hour ❑24 Hour I ❑48 Hour I ❑ 72 Hour I Er 96 Hour„. I ❑ 1 Week ❑ 2 Week 'For TEM Air 3 hr through 6 hr.please call ahead to schedule,*There is a premium charge for 3 Hour TEM AHERA or EPA Level/1 TAT. You mil be asked.to start an authorization form for this service, Analysrs completed in accordance with EMSL's Terms and Conditions located in the Ana!ytical Price Guide PLM-Bulk(reporting limitl TEM-Bulk ❑PLM EPA 600/R-931116(<1%) PUEM EPA NOB-EPA 600/R-93/116 Section 2.5.5-1 ❑ PLM EPA NOB(<1%) W NY ELAP Method 198.4(TEM) Point Count ❑400(<0.25%)❑ 1000(<0A%) ❑ Chatfield Protocol(semi-quantitative) i Point Count w/Gravimetric❑400(<0.25%)❑ 1000(<0.1%) ❑TEM%-by Mass-EPA 600/R-93/116 Section 2.5.5.2 �j ❑AOSH 9002(<1%) El TEM Qualitative via Filtration Prep Technique ') [�NY ELAP Method 198.1 (friable in NY) _❑TEM Qualitative via Drop Mount Prep Technique VNY ELAP Method 198.6 NOB(non-friable-NY) Other _ { ❑ OSHA ID-191 Modified e.; ❑ Standard Addition Method Check For Positive Stop-Clearly identify Homogenous Group Date Sampled: Samplers Name: Samplers Signature: Sample# HA# Sample Location Q Material Description / 1 d5 I \ too() fl - Lt i• 00 Ir, VI4-,i 163r l . los�.� 00 Sr l/1qulf f=(60<'. oil 1 ! _0------- ---- - - - -- -- -- -— - — -_- - ---- -- ±0 f Client Sample#(s)_ - I .- -- Total#of Samples: — Relinquished(Client): Date: Z l Time: Received(Lab): _ _ Date: — Time: _ Comments/Special Instructions: 4-1 d ; AA c� qh Page 1 of pages AR-L 2 CU19 17 _ �Paqe 1 Of 2 � it II OrderID: 141901040 490 Rowley Road Asbestos Bulk Building Material y Chain of Custody Depew, NY 14043 EMSL Order Number(Lab use Only): EMSL ANALYTICAL.INC. (716)651-0030 �O( (716)651-0394 I� Additional Pages of the Chain of Custody are only necessary if needed for additional sample information Sample# HA# Sample Location 4 Material Description I I 1 �a�(-•�'fon�ti� �SR° his-G�.��� -�' �trftl v� I I! II i is i� li i RI I � Ij I . I ' i I it � 1 I I I � t , i I II Jj1 IJ I � i `CommentslSpecialInstructions: pJ 614 �. � q Page of Z pages MAR 2 2 2019 Paqe 2 Of 2 C - New-Yorrk State FI.Department.of.L_aboe - = - Division oflSafety and Health,r f" = , License and Cerkicat6,0nitf,' State Cam_pus,'Building12 l _ k, Albany,NY 12240 _ 1' ASBESTOS HANDLING LICENSE Qualcor-LimitedLiability Company i 4 FILE NUMBER: 14-75388 `'LICENSE NUMBER:' 75388 - - 241 Merrill Rd. _';3*' r' LICENSE CLASS: RESTRICTED.- I DATE OF ISSUE: 04/11/2018 Homer,-NY 13077 1r _ f"�7�c=.�' EXPIRATION}DATE: 04/30/201 b �, � - I;� t' i'��',i'., `.t_'v'''' ,._"'\.:•y L�:��,�.w 1_;�.:--:'a°�''., '�J '1'--�J'''t S'r�j .- - rL 1 1, JJ ri`1+ .o j Dul Authorized Re resentativel='Michael'Gu � }I i 1. �l a Ilr11a':r•,~i�;_ ,' i . � -- -- I i ., r, } ` ;:it I F. 4 !•� - 1i } :.;�,�.i� : , , J s. ..I.;, This license has been issued in aceordancewith'applicable provisions of Artic1e:30�'of the Lahor Law of New York'State-and of the New York State,Codes,Rules and Regulations:(I12 NYCRR Pait'S6): It is-;subject to suspension or revocation'for a(1) ,! , r 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'as6estos or asbesfos`material: �,•- ' This license is:valid only for the contractor nat Q*6`6ve and"thislicense or d-I 66op_y-must.be_promineritly displayed at the asbestos project worksite. This'license verifies thafall•persons-employed:by.the licensee on an-asbestos,project in New York State have been:issued an Asbestos Certificate,-approp_riate fo'r the type.bf-wo_rk they perform,by the New York State Department of Labor. Eileen M.Franko, Director SH 432(8/12) - For the Commissioner of Labor STATE OF NEW YORK - DEPARTMENT OF LABOR ' ASBESTOS EERTIFICATE MICHA.EL--T'L-_OUY CLRSS(EXPIRES) cn D,. ,-INSP( ll,/19) CERTa lataeaa - DMUff 734390620 j MUST BE CARRIED ONASBESTOS PROJECTS 1111111111711�INIIIIIA : � . Qualcqr, LLC Asbestos Handlers License#-75388 Asbestos Building Inspector License#-10-14948 In C/O: Don Bernard RE:Asbestos Removal at: 20 Brayton Rd., Queensbury, NY 12804 To Whom It May Concern, We conducted a pre-demolition asbestos survey for the owner, Don Bernard, on the residential property located at 20 Brayton Rd., Queensbury, NY 12804, on March 21, 2019. Asbestos was found at the property and identified by laboratory analysis to be in the kitchen/dining room flooring. At the request of the homeowner,we returned on March 11, 2021 to determine if the asbestos had been removed.All the flooring in the kitchen/dining room had been removed. All asbestos that we identified through our original testing and in our report was removed from the property and was no longer present. The owner told us he removed it and took it to a dump that accepts ACM. Please keep this letter with the original inspection report for your records and let us know if you have any questions or concerns. Michael Guy, President Qualcor, LLC 239.8-1-15 315-329-4271 20 Brayton Rd «C EMO-011¢2021 20 Brayton Rd Demolition of SFD DECEQVE MAR 16 2021 TOWN OF QUEENSBURY BUILDING& CODES