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DEMO-0239-2021 Office Use Only DEMOLITION APPLICATION Permit#: bE"O D Z-�n•2jZl Permit Fee: Invoice#: b(o�1J 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net 'Flood Zone? Y N Reviewed By: Demolition Location: Tag Map ID#: 243 Sherman Ave. Queensbury, NY 12804 Tax Map ID 302.18-2-2.11 **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS" DEMOLITION INFORMATION: 1. Where will demolition material be disposed? Hiram Hollow Transfer Station 100 Washburn Rd. Gansevoort, NY 12831 2. Type of structure to be demolished: a. Residence X d. Storage Building❑ D E co Lut b. Garage ® e. Other: c. Business❑ APR 1 6 3. What type of utilities are connected to the structure: a. Gas f. Well-Water PumpTOWN�F GU,EIV�SUR\( DES b. Fuel Oil g. Public Sewer❑ c. Propane ❑ h. Other d. Electric © i. None ' Utilities marked were previously connected. e. Public Water® All utilities are currently disconnected 4. ,Have ALL utilities (water,electric, etc.) 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. 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 ury Building&Code Enforcement and Zoning Departments and a permit has been issued.. 1 have read and agree o the above: PRINT NAME: Larry ute - P si en O r - C Holdings, Inc. SIGNATURE: DATE: Demolition Applicatio Revised December 2020 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Larry Clute - President/Owner- DKC Holdings, Inc. Mailing Address, C/S/Z: 6 Holden Ave. Queensbury, NY 12804 Cell Phone: Land Line: 518-793-7277 Email: cluteenterprises@gmail.com • Primary Owner(s): Name(s): , Larry Clute - President/Owner - DKC Holdings, Inc. Mailing Address, C/S/Z: 6 Holden Ave. Queensbury, NY 12804 Cell Phone: Land Line: 518-793-7277 Email: cluteenterprises@gmail.com ✓❑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):Larry Clute - President/Owner- Clute Enterprises, Inc. Contractor Trade:General Contractor Mailing Address, C/S/Z: 6 Holden Ave. Queensbury, NY 12804 Cell Phone: Land Line: 518-793-7277 Email: cluteenterprises@gmail.com "Workers' Comp documentation must be submitted with this application" Contact Person for any questions regarding this project: Cell Phone: Land Line: 518-793-7277 Email: cluteenterprises@gmail.com Demolition Application Revised December2020 E�ll�l Uesm i i spend W8 Abs"iW P.O.Base 2202 itza�id�n �t,�m TOWN OF QUEENSBURY ��� BUILDING DEPARTMENT LIG Based on our limited examination,compliancewith our comments shall not be construed asindicating the plans and specifications are in full compliance with the Building Codes of New York State. QUEEEi ISBUR`('Po 111�om it May tdon�nt, GC�•D S Please be abed drat I boo Inspedad the property on tRte data indicated on the enclosed report and taken random samples as required, i bore sent the aampM to a Now York State approved IWMMtoiy tar reeling. Based upon my inspectlan combined srlth the laboratory teat results for the samples Wm ftm the subject pry Frrty,there were no aabeatos oontaining materials(AW s),iaund an ttta subject property or ideaftc!In the Sam- pies tested by the laboratory. Accordingly,it Is my understanding that,subjW to any and all appibabte ems w locals and r,eguMona at die Ems of the enclosed test rteport,the propmay awna+r may proosad whit remodeling or demolition as the owner saes fit. Y f Thank you, fnp Michael J.Stovene Licatm iVurribar:7291ao TOWN OF QUEENSSURY BUILDING & CODES DEPT. "FILE Copy Reviewed ye S Date: L4 P2-0 MJS keg 30VLS-2-2.11 DEMO-0239-2021. DKC Holdings 243 Sherman Ave Demolition of SFD & Garage Pre-Demolition Asbestos Building Survey 28 BAY PARKWAY LAKE GEORGE NY 12845 INTRODUCTION ON SEPTEMBER 7 OF 2020 LARRY CLUTE OF DC HOLDINGS IN QUEENSBURY NY 12804 retained: Michael J. Stevens to preform an asbestos survey of the property located at 243 SHERMAN AVE QUEENSBURY NY 12804 this is a single family residence The BUILDING is located on 243 SHERMAN AVE QUEENSBURY NY 12804 The building is a single family structure of approximately 1700 square feet on a 96,600 square foot lot (construction date is approximately 19 00 according to warren County records). The residence consists of wood frame construction, vinyl siding and a metal roof The purpose of this survey was to complete a pre-demolition asbestos survey in accordance with Industrial Code Rule (ICR) 56. At the request of the client destructive sampling techniques( i.e. breaking through sheetrock walls, removing tiles, etc.) were utilized. The remainder of this report describes building inspection procedures, a summary of the results, conclusions and recommendations. A site plan and building specific sampling locations are depicted. Michael J. Stevens assumes no responsibilities for the implementation or enforcement of the procedures, work practices, engineering controls, or other asbestos-control methods recommended, required or mentioned in this document. PRE-DEMOLITION ASBESTOS SURVEY 243 SHERMAN AVE QUEENSBURY NY 12804 Background Information° - Building(s) Location: 243 SHERMAN AVE QUEENSBURY NY 12804 Party Performing Survey: Michael J. Stevens PO Box 2202, Glens Falls, NY 12801 Laboratory Used For Sample Analysis: Amerisci New york 117 East 301h Street New York, New York 10016 NYSDOH ELAP Laboratory ID # 11480 OWNERS INFO MIKE STEVENS PO BOX 2202 GLENS FALLS NY 12801 Michael J Stevens Licensed Asbestos Inspector P® Box 2202 Glens Falls, NY 12801 SEPTEMBER 26 2020 MIKE STEVENS RE: Pre-Demolition Asbestos Building Survey Report 243 Sherman ave QUEENSBURY NY 12304 Dear LARRY CLUTE Please find the attached Pre-Demolition Asbestos Building Survey Report completed for the Property Located at: 243 SHERMAN AVE QUEENSBURY NY 12804 If you have any questions or require additional information, please feel free to contact: Mike Stevens @ 518-656-3270 Sincerely, Michael J. Stevens Pre-Demolition Asbestos Building Survey 243 SHERMAN ANTE QUEENSBURY NY 12804 SEPTEMBER 26 2020 LABORATORY RESULTS Please Reply To: Ame Sce New York t 117 EAST 30TH ST. .AMERI CI NEW YORK, NY 10016 TEL:(212)679-8600•FAX:(212)679-3114 LABORATORY ELECTRONIC TRANSMITTAL To: Michael Stevens From: A Barengolts-Hitachi#542/Noran Michael J. Stevens AmeriSci.fob#: 220093111 Fax#: Subject: ELAP-PLM/TEM 5 day Results Client Project: 243; Sherman Ave; 243 Sherman Email: mikesoldcars@gmail.com Ave,NY Date: Thursday,September 24,2020 Number of Pages: Time: 19:01:31 (including cover sheet) Comments: NOTE:Attached report is to be considered preliminary until final review with accompanying analysis summary letter is issued. CONFIDENTIALITY NOTICE: Unless otherwise indicated,the information contained in this communication is confidential information intended for use of the individual named above. If the reader of this communication is not the intended recipient,you are hereby notified that any dissemination, distribution or copying of this communication is prohibited. If you have received this communication in error,please immediately notify the sender by telephone and return the original message to the above address via the US Postal Service at our expense. Samples are disposed of in 60 days or unless otherwise instructed by the protocol or special instructions in writing. Thank you. Certified Analyses Service 24 Flours A Day• 7 Days A Week Competitive Prices visit our web site-www.amerisel.com Boston•Los Angeles New York Richmond A6tf e r%Sc1 New York 117 EAST 30TH ST. AMEMSCI NEWYORK, NY 10016 TEL:(212)679-8600-FAX:(212)679-311.4 PL,M Bulk Asbestos Report Michael 3. Stevens Date Received 09/23/20 AmeriSci Job# 220093111 Attn: Michael Stevens Date Examined 09/24/20 P.C.# PO Box 2202 ELAP# 11480 Page 1 of 7 RE:243;, Sherman Ave; 243 Sherman Ave, NY Glens Falls, NY 12801 Client No. HGA Lab No. Asbestos Present Total % Asbestos 1 220093111-01 No NAD Location: Living Room I Kitchen I Dining Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: White/Grey,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 5%, Non-fibrous 46.5% 2 220093111-02 No NAD Location: Living Room/Kitchen/Dining Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description:White/Grey, Homogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 3%, Non-fibrous 47.5% 3 220093111-03 No NAD Location: Living Room/Kitchen/Dining Ceiling=Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description:White/Grey, Homogeneous,Fibrous,Bulk Material Asbestos.Types: Other Material: Fibrous glass 5%, Non-fibrous 42.6% 4 220093111-04 No NAD Location: Den&Utility Room Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description:White/Beige,Homogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 5%, Non-fibrous 39.5% . 5 220093111-05 No NAD Location: Den&Utility Room Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description:White/Beige, Homogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 5%, Non fibrous 39.2% See Reporting notes on last page AmeriScl Job#: 220093111 Page 2 of 7 Client Name: Michael J. Stevens PLM- Bulk Asbestos Report , 243; Sherman Ave; 243 Sherman Ave, NY Client No. I HGA Lab No. Asbestos Present Total % Asbestos 6 220093111-06 No NAD Location: Den&Utility Room Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: White/Beige, Homogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 7%, Non-fibrous 43.5% 7 220093111-07 No NAD Location: Bedroom 1 Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White, Homogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 8 220093111-08 No NAD Location: Bedroom 1 Wall&Ceiling-Compound (by NYS ELAP 198.1) ` by Valeriu Voicu on 09/24/20 Analyst Description: White,Homogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 9 220093111-09 No NAD Location: Bedroom 1 Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: White, Homogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 10 220093111-10 No NAD Location: Bedroom 2 Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White, Homogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 11 220093111-11 Nd NAD Location: Bedroom 2 Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:'White,Homogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% See Reporting notes on last page AmeriSci Job#: 220093111 Page 3 of 7 Client Name: Michael J.Stevens PLM Bulk Asbestos Report. 243; Sherman Ave; 243 Sherman Ave, NY Client No. I HGA flab No. Asbestos Present Total %Asbestos 12 220093111-12 No NAD Location: Bedroom 2 Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 13 220093111-13 No NAD Location: Bathroom Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White,Homogeneous, Non=Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 14 220093111-14 No NAD Location: Bathroom Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Volcu on 09/24/20 Analyst Description:White, Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 15 220093111-15 No NAD Location: Bathroom Wall&Ceiling-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White,Homogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 16 220093111-16 No NAD Location: Bath/Kitchen Floor-Vinyl Flooring (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Beige,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 100% 17 220093111-17 No NAD Location: Bath/Kitchen Floor-Vinyl Flooring (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Beige,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non fibrous 0.8% See Reporting notes on last page AmeriSci Job* 220093111 Page 4 of T Client Name: Michael J. Stevens PLIN Bulk Asbestos Report 243; Sherman Ave; 243 Sherman Ave, NY Client No. / HGA Lab No. Asbestos Present Total %Asbestos 18 220093111-18 No NAD Location: Bedroom 3 Walls-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White,Homogeneous, Non-Fibrous,Bulk Material Asbestos Types: - Other Material: Cellulose Trace, Non-fibrous 100% 19 220093111-19 No NAD Location: Bedroom 3 Walls-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: White,Homogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 20 220093111-20 No NAD Location: Bedroom 3 Walls-Compound (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 21 220093111-21 NO NAD Location: Bedroom Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description:White/Beige, Homogeneous,Fibrous, Bulk Material Asbestos Types: Other Material: Fibrous glass 3%, Non-fibrous 46.2% 22 220093111-22 No NAD Location: Bedroom Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description:White/Beige, Homogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 3%, Non-fibrous 45% 23 220093111-23 No NAD Location: Bedroom Ceiling-Ceiling Tile (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: White/Beige,Homogeneous,Fibrous, Bulk Material Asbestos Types: Other Material: Fibrous glass 10%, Non-fibrous 56% See Reporting notes on last page AmeriSci Job#: 2200931iI Page 5 of 7 Client Name: Michael J.Stevens PLM Bulk Asbestos Report 243; Sherman Ave; 243 Sherman Ave; NY Client No. 1 HGA Lab No. Asbestos Present Total %Asbestos 24 220093111-24 No NAD Location: Roof Shingle-Asphalt Shingles (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Green,Homogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 2%, Non-fibrous 19.8% 25 220093111-25 No NAD Location: Roof Shingle-Asphalt Shingles (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Green,Homogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 3%, Non-fibrous 26.1 % 26 . 220093111-26 No NAD _ Location: Roof Shingle Asphalt Shingles (by NYS ELAP 198.6) by Valeriu Voicu :. on 09/24/20 Analyst Description: Green,Homogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 2%, Non-fibrous 26% 27 220093111-27 No NAD Location: Garage Roof Shingle-Asphalt Shingle (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Black, Homogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 2%, Non-fibrous 13.5%. 28 - 220093111-28 No NAD Location: Garage Roof Shingle-Asphalt Shingle (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Black,Homogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 2%, Non-fibrous 22.8% 29 220093111-29 No NAD Location: Garage Roof Shingle-Asphalt Shingle (by NYS ELAP 198.6) by Valeriu Voicu on 09/24/20 Analyst Description: Black,Homogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 2%, Non-fibrous 17.6% See Reporting notes on last page ArneriSci Job#: 220093111 Page 6 of Client Name: Michael J.Stevens PLM Bulk-Asbestos Report 243; Sherman Ave; 243 Sherman Ave, NY . Client No. i HGA Lab No. Asbestos Present 'Total %Asbestos 30 2200931'11-30 No NAD Location: Foundation Cement-Cement (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: Grey/Beige,Homogeneous, Non-Fibrous,Cementitious,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 31 220003111-31 No NAD Location: Foundation Cement-Cement (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: Grey/Beige,Homogeneous, Non-Fibrous,Cementitious,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 32 220093111-32 No NAD Location: Foundation Cement-Cement (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: Grey/Beige, Homogeneous, Non-Fibrous;Cementitious,Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 33 220093111-33 No NAD Location: Garage Floor-Cement (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: Grey/Beige,Homogeneous, Non-Fibrous,Cementitious;Bulk Material Asbestos Types: Other Material: Cellulose Trace, Non-fibrous 100% 34 220093111-34 No NAD Location: Garage Floor-Cement (by NYS ELAP 198.1) by Valeriu Voicu on 09/24/20 Analyst Description: Grey/Beige, Homogeneous,Non-Fibrous,Cementitious,Bulk Material Asbestos Types: Other Materlal: Cellulose Trace, Non-fibrous 100% See Reporting notes on last page AmeriSci Job##: 220093111 Page 7 of 7 Client Name: Michael J. Stevens PLM Bulk Asbestos Report 243; Sherman Ave; 243 Sherman Ave, NY Reporting Notes: (1) This PLM job was analyzed using Olympus BH-2 Poi Scope S/N 229915 Analyzed by;Valedu Voicu °NAD/NSD=no asbestos detected;NA'--not analyzed;NAPS=not analyzed/positive stop,(SOF-V)=Sprayed On Fireproofing containing Vermiculite; (SM-V)=Surfacing Material containing Vermiculite;PLM Bulk Asbestos Analysis by Appd E to Subpt E,40 CFR 763(NVLAP 200546-0),ELAP PLM Method 198.1 for NY friable samples,which includes the identification and quantitation of vermiculite or ELAP 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 59,146,38970,8/1194)National Institute of Standards and Tec gy Accreditation requirements mandate that this report must not be reproduced except in full without the approval of the Iab.This PLM report relate LY to th items tested.AIHA-LAP,LLC Lab ID 102843,RI Cert AAL-094,CT Cert PH-0186,Mass Cert AA000054. Reviewed By: END OF REPORT AmeriSci Job#: 220093111 Page I of 3 Client Name: Michael J. Stevens TabOe I Summary of Baulk Asbestos Analysis Results 243; Sherman Ave; 243 Sherman Ave, NY Sample Heat Acid Insoluble. AmeriSci HIS Weight Sensitive Soluble Non-Asbestos ""Asbestos%by Asbestos%by Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS TEM 01 1 0.167 22.7 25.8 51.5 NAD NAD Location: Living Room/Kitchen/Dining Ceiling-Ceiling Tile 02 2 0.160 26.4 23.1 50.5 NAD NAD Location: Living Room/Kitchen/Dining Ceiling-Ceiling Tile 03 3 0.207 25.6 26.8 47.6 NAD NAD Location: Living Room I Kitchen I Dining Ceiling-Ceiling Tile 04 4 0.171 24.9 36.6 44.5 NAD NAD Location: Den&Utility Room Ceiling-Ceiling Tile 05 5 0.197 27.9 27.9 '44.2 NAD NAD Location: Den&Utility Room Ceiling-Ceiling Tile O6 6 0.192 24.7 24.8 50.5 NAD NAD Location: Den&Utility Room Ceiling-Ceiling Tile 07 7 — — --- --- NAD NA Location: Bedroom 1 Wall&Ceiling-Compound 08 8 ---- -- — --- NAD NA Location: Bedroom 1 Wall&Ceiling-Compound 09 9 --- --- — — NAD NA Location: Bedroom 1 Wall&Ceiling-Compound 10 10 ---- ---- -- -- NAD NA Location: Bedroom 2 Wall&Ceiling-Compound NAD NA Location: Bedroom 2 Wall&Ceiling-Compound 12 12 — — --- ---- NAD NA Location: Bedroom 2 Walt&Ceiling-Compound 13 13 -- -- --- — NAD NA Location: Bathroom Wall&Ceiling-Compound 14 14 — — --- — NAD NA Location: Bathroom Wall&Ceiling-Compound 15 15 -- --- --- ---- NAD NA Location: Bathroom Wall&Ceiling-Compound 16 16 0.143 59.8 39.7 0.5 NAD NAD Location: Bath/Kitchen Floor-Vinyl Flooring See Reporting notes on last page AmeriSci Job#: 220093111 Page 2 of 3 Client Name: Michael J. Stevens Table l Summary of Bulk Asbestos Analysis Results 243; Sherman Ave; 243 Sherman Ave,NY Sample Heat Acid Insoluble AmeriSci HG Weight Sensitive Soluble Pion-Asbestos °"Asbestos%by °*Asbestos%by Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLMIDS TEM 17 17 0.159 60.1 39.1 0.8 NAD NAD Location: Bath/Kitchen Floor-Vinyl Flooring 18 18 --- ---- --- --- NAD NA Location: Bedroom 3 Walls-Compound 19 19 - -- - - -- NAD NA Location: Bedroom 3 Walls-Compound 20 20 - -- -- - NAD NA Location: Bedroom 3 Walls-Compound 21 21 0.142 26.1 24.7 49.2 NAD NAD Location: Bedroom Ceiling-Ceiling Tile 22 22 0.188 22.5 29.5 48.0 NAD NAD Location: Bedroom Ceiling-Ceiling Tile 23 23 0.157 31.6 2.4 66.0 NAD NAD Location: Bedroom Ceiling-Ceiling Tile 24 24 0.312 25.4 52.8 21.8 NAD NAD Location: Roof Shingle-Asphalt Shingles 25 25 0.319 23.1 47.8 29.1 NAD NAD Location: Roof Shingle-Asphalt Shingles 26 26 0.287 16.0 56.1 28.0 NAD NAD Location: Roof Shingle-Asphalt Shingles 27 27. 0.501 19.6 64.9 15.5 NAD NAD Location: Garage Roof Shingle-Asphalt Shingle 28 28 0.418 18.9 56.4 24.8 NAD NAD Location: Garage Roof Shingle-Asphalt Shingle 29 29 0.305 21.0 59.4 19.6 NAD NAD Location: Garage Roof Shingle-Asphalt Shingle 30 30 --- - --- -- NAD NA Location: Foundation Cement-Cement 31 31 --- - - ---- NAD NA Location: Foundation Cement-Cement 32 32 --- - - -- NAD NA Location: Foundation Cement-Cement See Reporting notes on last page AmeriSci Job#: 220093111 Page 3 of 3 Client Name: Michael J. Stevens TaNe 8 Summary of Bulk Asbestos Analysis Results 243; Sherman Ave; 243 Sherman Ave, NY Sample Beat Acid Insoluble AmerlScl HG Weight Sensitive Soluble Non-Asbestos *Asbestos%by **Asbestos%by Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/®S TEM 33 33 -- — — -- NAD NA Location: Garage Floor-Cement 34 34 — ---- -- — NAD NA Location: Garage Floor-Cement Analyzed by:A Barengolts-Hitachl#542/Noran ;�Datealyzed 9/24/2020 *'Quantitative Analysis(Semi/Full);Bulk Asb A LM by WE to Subpt E,40 CFR 763 or NYSDOH ELAP 198.1 for New York friable samples or NYSDOH ELAP 198.6 for New York NOB ' samples;TEM(Semi/Full)by EPA 600/R-93/116(or NYSDOH ELA 8.4;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.TEM bulk analysis is representative of the fine grained matrix material and may not be representative of non-uniformly dispersed defiris for which PLM eval ation is recommended(i.e.soils and other heterogenous materials). Reviewed By: li�ellaw - i t�*Al • Mr.111�MIF�lf� "" . Alw ��Y.6�IRT�.RT.�lli�li�4LUlwPFCtY�Ii y � o t, �p � s' RR �2Ve�� ' f�C2Y+'► ''� / Ir i ,a4. i o c . +1 i �. 'l(� j�S�i � l2•`Z.Ir1 �'�l'J /� c./L---•• AiN LIM o 2C L. art s A- L �a r Iju e S a a !�'!'em>R tee an 0m* Jl;t�f�LN�iO®0 v � x- �►.:. - iOki - _� omw— ow 1 r t . Pre-Demolition Asbestos Building Survey 243 SHERMAN AVE QUEENSBURY NY 12804 Summary Of Results A material is considered by the EPA to be Asbestos-containing if at least one sample collected from the homogenous area shows asbestos present in an amount greater than 1%. Based on review of the Laboratory results, none of the submitted friable and non-friable ACM samples analyzed contain asbestos. Survey Building Inspection Procedure Mr. Michael J. Stevens, a New York State Certified Inspector Certification #72900) conducted an asbestos survey of the building(s) on SEPTEMBER 17 2020 which included both the interior and exterior portions of the BUILDING Mr. Stevens visually inspected the residence for suspect asbestos containing materials (ACMs). The roof of the residence was accessed with a ladder. Methodologies used were generally consistent with USEPA publications: "Guidance for Controlling Asbestos Containing Materials in Buildings" (June 1985) and "Asbestos in Buildings: Simplified Sampling Scheme for Friable Surfacing Materials" (dated October 1985). The documents were used for their asbestos survey concepts, such as identifying homogenous materials, quantifying materials, and evaluating friability(potential to crumble with hand pressure) and condition (good, damaged or significantly damaged). Over 3,000 products are currently known to contain asbestos.Although no comprehensive list of ACMs exists, Mr. Stevens utilized the USEPA's " Sample List of Suspect Asbestos-Containing Materials" as a general guide to identify and document suspect ACMs within the building, In addition, in some cases, Mr. Stevens utilized their experience and the knowledge obtained through training courses to identify suspect ACMs. Mr. Stevens inspected all spaces of the building, including storage rooms, utility rooms, and crawl spaces. During the survey, the inspector classified each suspect ACM as one of three types: 1) surfacing material applied by spray or trowel, 2) thermal insulation on pipes, tanks, boilers and related features, 3) miscellaneous not classified as surfacing material or thermal system insulation. The inspector touched all assumed or suspected materials on all surfaces, including walls, ceilings, structural members, and mechanical equipment, to determine their friability, or the extent to which the material, when dry, may be crumbled, pulverized, or reduced to powder by hand pressure. In addition, the.inspector assessed the condition of each suspect ACM and classified the material as either 1) good 2) damaged 3) significantly damaged. A suspect ACM is considered in good condition if there are no visible signs of.damage, is considered damaged if the material contains less than 25% localized damage or less than 10%'distributed damage and is considered significantly damaged if the material contains greater than 25% localized damage or greater than 10% distributed damage. It should be noted that in accordance with the Occupational Safety and Health Administration (OSHA),Asbestos Construction Standard 29 CFR 1926.1101, any thermal insulation, surfacing materials, floor tiles, roofing felts and shingles found in buildings constructed no later than January 1, 1981 are presumed ACMS To arrive at a preliminary evaluation of ACM, Mr. Stevens considered the following in its assessment: 1) location of the ACM; 2) condition of the material, such as damage and severity of damage; 3) accessibility to building occupants; 4) the potential for disturbance; 5) known or suspected causes of damage; and 6) preventative measures that might eliminate the likelihood of future damage. Pre-Demolition Asbestos Building Survey 243 SHERMAN AVE QUEENSBURY NY 12804 Conclusions & Recommendations Conclusions Based on the completion of the survey, No regulated asbestos materials (>1%) were identified at the site based on materials sampled. Recommendations Based on the results of this survey, Mike Stevens has the following recommendations at this time. Prior to any demolition activities, a copy of the asbestos survey should be provided to the demolition contractor and local asbestos control board. Maintain a copy of this asbestos survey with the property. If un-assessed suspect ACM is identified during demolition activities, retain an asbestos building inspector to sample the material(s). One copy of the asbestos survey report should be immediately transmitted by the building owner as follows: 1) One copy of this report must be immediately transmitted by the building owner, or their agent, to the local government entity charged with issuing a permit for such demolition, renovation, remodeling or repair work under.applicable NY Stat laws. 2) The completed asbestos survey for controlled demolition (as per Subpart 56-11.5) or pre-demolition asbestos projects shall also be submitted to the NEW YORK STATE DEPARTMENT OF LABOR r f � I r Y R�:']'R R4.i Iaa K�l■L'rrY Yc'Y w R.-Yt K N! R1 KKr R.Or rr 'R+a4.■■ttr Rl \ST/MY.r■rk4r RrjR'.�'rNR'K)i lf.Ytr R ■Y•MXAi!{Ifyf�f7C-�y7y_>•. ; , .li 1lRYry KeL11w WILY:.<YK t)R Y L 1 R Lrtr (4w,KY.rrY\rr NV/fYa RYYi 6Rr rKarifY'i.Rif YCR RRR■<.fL-Y if.i {:tgRFYCK>tUY R6K nr<PMRJrT R RhFa's MwY •rK k.Rr' )L>'Y if% f Y:Y': Nfa KKr w■YrNR rKK6 r ccll'Y Rr•■.r ............ . .. ...■Y..... 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