2003-035 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256 .
BUILDING PERMIT
Permit Number: P20030035 Application Number: A20030035
I
Tax Map No: 523400-288-020-0001-020-000-0000
Permission is hereby granted to: GREAT ESCAPE THF,MF,PARK I,I, C
For property located at: 1172 State Rt. 9
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: GREAT ESCAPE THEME PARK L l
C/O PROPERTY TAX SERVICE CO Demolition
Total Value
2351 W NORTHWEST Hwy
DALLAS, TX 75220
Contractor or Builder's Name/Address Electrical Inspection Agency
GREAT ESCAPE,T14FME PARK
P.O. BOX 511
LAKE, GF,ORGF,_NY 128.45
Plans&Specifications
2003-035 DEMOLITION OF PART OF GHOST TOWN TO MAKE ROOM FOR COASTER RIDE AS
PER APPLICATION
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,February 11,2004
(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 of D:T
bu T esday,February 11,2003
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT b,,
Permit No.p�y
Instructions for completing the application Date:
Fee Paid: `` A
1. All applicable spaces are to be completed. rpnth�
2. Two plot plans are to be submitted, drawn to scale, showing: i Ly I� �
a. lot boundaries, with dimensions and adjacent roads and streets.
b. all existing structures, indicating which are to be removed. FF
a location of all utilities. R 0 7 2003
3. Fee submitted per current fee schedule. TOWN
BtJlLO� 1V®CS�JDR�
Owner of property: ��-n�¢} SGc_�� Property Location: UcLL �'r15 fsti
Mailing Address: �-1( 5/ Tax Map No. section , Zreck
Person responsible for work: 6jVc*A 'y ,P�r(` P &1 (2 J )Telephone No. � 2 ;fj Of V, �l
Mailing Address:
Where will demolition material be disposed of? (,IJCi e,L 4 7YaG 1 /j�
Is there any asbestos within building to be demolished? Yes 4 / No
If YES, name of firm removing asbestos from structure, license number, and where asbestos will be disposed of:
jcJ NAME OF FIRM LICENSE NUMBER
Ma na w e n1 /1 LA),'n o s5icee L Fo/' EJLVa
LOCATION WHERE ASBESTOS WI1ZL BE DISPOSED �a
A COPY OF ASBESTOS REMOVAL REPORT MUST BE FILED WITH THIS DEPARTMENT BEFORE DEMOLITION BEGINS.
The following building(s) located on property described above are to be removed:
Previous use of building (circle one): residence garage storage business ther f i,P,�
Have all utilities been disconnected? -as�J , electric S , propane , water
Size of building(s):
1. 4Z ft. by 16-/ ft. Location on property 6LIZ5-I -r6 0 yl
2. 1t. by ft. Location on property
3. Number of stories:
4. Foundation type (circle one): full cellar crawl space slab
Foundation will REMAIN BE REMOVED
5. Another structure WILL WILL NOT , replace this building=.
NOTES: r1_5 e K O .C�iI tL L
Signature of Applicant:
owner owner's agent,architec, contractor
TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT
Permit No:�. A _ )
Instructions for completing the application Date:
Fee Paid; n
1. All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to seale, shotwing:
a. lot boundaries, with dimensions and adjadent i4Md as streets.
b. all existing structures, indicating which are to be removed.
c. location of all utilities.
3. Fee submitted per current fee schedule.
Owner of property: Property Location: 1172 PT, T 621a .SP
Mailing Address: .&V 1 Tax Map No. section a ,-Block ;"i.' �O
Person responsible for work: FO AA I ,Py ry ( IJ ai V )Telephone No. 1172 15ea 4A, 3
Mailing Address' : .
Where will demolition material be disposed of? J)J e, AJO t7/lr C`l 70t c.I i�l
J ,
Is there any asbestos within building to be.demolished? Yes V; /. No
If YES, name of firm removing asbestos from structure, license number, and where asbestos will be disposed of:
ma a A M �7jl il i,,)I-M&
�1 e NAME OF FIRM ) 1 1 LICENSE NUMBER 1
�tr?can��Jwnf For) L�dujzfd VV
JLOCATION WHERE ASBESTOS WIDE BE DISPOSED /;1 F'Q d
A COPY OF ASBESTOS REMOVAL REPORT MUST BE FILED WITH THIS DEPARTMENT BEFORE DEMOLITION BEGINS.
The following building(s) located on property described above are to be removed:
Previous use of building (circle one): residence garage storage business tit eh r ' L i.
Have all utilities been disconnected? cras electric , propane , water
Size of building(s)-
ft. by ft. Location on property f?S_ I(jtv y't
2. $. by ft. Location on property
3. Number of stories:
4. Foundation type(circle one): full cellar crawl space sla ,/�
Foundation will REMAIN BE REMOVED I
5. Another structure WILL V`y WILL NOT replace this building.
NOTES: / (3 �, "r r � Tr Cl V Cc L i
Signature of Applicant:
owner/owner's agent,architeci,:contractor
Commercial Final Inspectio Re ort
Office No.: (518) 761-8256 Date Inspection re est cei d:
Queensbury Building&Code Enforcement Arrive: a p Depart: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initial
NAME: PERM GO 2,
LOCATION: DAT
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/.Roof Complete
Exterior Finish/Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in. /Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 s . ft.
All Doors 36 in.w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36 (w)x 44"(])/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator 18" Above Grade
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/z doors
> 10%> 1000 s . ft.
3/4 Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 s . ft.Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan,if required
Elevator Operation and Si is e/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Si na e
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond [Both sides] },.
Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides by 20' /Driveable Surface 20'wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C
L:\Building& Codes Forms\Building&Codes\Inspection Forms\C rcial Final Inspection Report.doc
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pni Depart`'' ` _ am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: ^-�PL� (_,�� an_v PERMIT#:
LOCATION: rZ INSPECT ON: —off
TYPE OF STRUCTURE:
Y N N/A l�
Framing COMNMNTS
Jack Studs/Headers -� />
Bracing/Bridging 'J�
Joist hangers ��-`------r
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C. G t ( lC Atkl-
Headroom 6 ft. 8 in.
Stairwells 36 in. or more v�
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '/z(w) 16 gauge (8) 16D nails each side 6 AL 6 U+L
Draft stopping 1,000 sq. ft.floor trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall
Fire separation 1,2,3 hour
Fire wall 2, 3,4 hour � �}
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side %inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H) .
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
Date 2/6/03
To: The Great Escape pec
P.o. Box 511 , Lake George , New York 12845
CC Person: Mr. Bob Culver
As Per Your Request For Demo Permit
From: C. R. Timms
3- Lincoln Street , Hudson Falls , New York 12839
YOUR DEMO PROJECT Non-Friable Asbestos Roof Removal
Project on the Tornado Building .
Necessary Notifications: E.P.A. N.Y.S. and all the necessary
Require Time.
All the Necessary Required Project Air Monitoring.
The Necessary Required Contractors Asbestos Removal License and
all workers doing the Asbestos Removal.
All Necessary Insurance
NOTE: the whole building was check for Asbestos Containing
Materials., and only the roof area contained Asbestos. After The removal of the roof
the waste becomes. C&D Material and can go to any C&D Landfill., Meeting all
Requirements for a Demo Project.
If you have any questions., You can call Me, C.R.Timms at the
following phone # 747-8839
UNrrED STATES EWRONMENTAL PROTECTION AGENCY-REGION 2
Division of Enforcement S Compliancy Assistance—Air Compliance Branch (DECA-ACB)
i 290 Broadway-21 Floor
Now York,NY 10007-1868 RECEIVED
1 NOTIFICATION OF DEMOLfT*N AND RENOVATION
2003 pera or roles os mar a e ecei o Ica Io
TOWN OF QUEENSBURY .
= ngina =Revised):
it. FACILITY INFORMATION Identify owner.removal contractor.an er operator)
-I"h�>r Gr�al' ESCLt•pe -Si X �lQ S
Address: l l 1 z
U1CexLSl1 N y 1280+
Contact:
-6bb Ct11Yl°r IS 142-35o 5"t 329,
Onurn vl(Dr) (-X-C-
ress: 'A -i Cf—ntyw � �P
City-. A•Ibar l' �J I22�1v
Contact
c.4 W-Ox ub►C. • 4i 45.3-043.3
Address:
IState: .
Contact I e:
= molt on = enova on
t'r1CVQ.tIIV. 15 ASBESTOS PRESENT7 n�
-°: Ye s
V. FACILITY DESCRIPTION(include building name,number and floor or room number):
BuildingName:
Tor 6Ady
—AUcTress:
Address:
i e: Countbity:
e Location:
Fcw n
u1 Ing ¢e: er. SqFt 9,o oors: Age in ears:
t 20
resen use: nor se:
OF ASBESTOS MATERIAL:
bulL Sam,plir'.5
VII.APPROXIMATE ZJF-RACM7=REMOVED AND NON-FRUGLE ASBESTOS MAI ERIAL THAT WILL NOT 13E PECIFY THE AMOUNT
OF ASBESTOS BELOW:
Non-friable Asbestos Material
not to be removed
RACM to be Removed Category I Category II
` Pipes-Linear Feetf
'Pipes-Linear ers
Surface krea-Square Feet
\` OL
Surface ,Area-Square Met ers
Volume RACM off 1--acility Component-Cubic Feet
volume RAuM o a01 I omponen -Cubic Meters
VIII. SCHEDULED DATES OF ASBESTOS REMOVAL: (MM/DD/YY) art: '2- (D 05 Completion:
IX.SCHEDULED DATES OF DEMOLITIOWRENOVATION: (MM/DD/YY) Start: Completion:
N0'tntCA-n0N OF DEMOLrROtr uND RENOVATION (continued)
r`SSk-J=ON OF RFNOVAT10N WORK, A,'YD Nffi[HOD(S)TO BE USED:
DESCRff'TTON OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO PREVENT EMISSIONS OF
�BESTOS AT THE DEMOLrnON AND RENOVATION SITE:
W'r",STE TRANS PORTER tt 1
C1LSiUn GW OrIG:
�Jc P.D. Spy �2 WLdOLJ SLISa.n �o4G�
Starr: 7�tu1 York- - Zip: tzo►�
rim t Person: - I Telcphone: .9 -�5i8 842-�84Z
WASTE TRANSPORTER##2
.ti�JI1C:
Adores _ • - -
1 lLy S Cate: Zip:.
Con ta, t PazarL Telephgne:
WASTE DISPOSAL SrM-
�Iarrie: C� r� rJx
Locasion: 100 ZOA-r - SrZeer, pCO:2T OF AZtSiNv -
city: A l" State: XICO yarn zip: 122.0 Z
rtlCphotie: y ,. -
-KN. . IF DEMOL17I1ON ORDERED BY A GOVERNMWr AGENCY,PLEASE MENTIFY THE AGENCY BELOW:
�i arilC: Tide
u ctiosi ty.
of onkx 0'q&f3Dfm- D=ordered to begin (2vgMlDWM
-OR EMERGENCY RENOVATIONS
Daic and hour of emergency(MNVDDIy-y):
')CSC ipticn of the Sudden,Unexpected Evan: ,
xplannHon of how the event caused unsafe co+sdidons or would cause equipment damage
or an LTrucasaable f-mancial burden:)
i VT. DESCRIPTION OF PROCEDURES TO BE.FOL.LOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS FOUND
OR PREVIOUSLY NONFR ABLE ASBESTOS MATERIAL BECOMES CRUMBLED,PULVERIZED,OR REDUCED TO
POWDER. We. MCAD"i 1 cL i—, l�ra,tl0r,
VI. ! CERTIFY THAT AN INDIVIDUAL TRAINED IN THE PROVISIONS OF THE THIS REGULATION (40 CAR PART 61.
r -
SUBPART Zvi)WILL BE ON-STIE DURING THE DEMOLITION OR RENOVATION AND EVIDENCE THAT THE RE
QUHUD 7RAIIING HAS BEEN ACCOMPLISHED BY THIS PERSON WILL BE AV FO SPECTION
DUPdNG NORMAL BUSINESS HOURS. (Requ4rd 1 year after Promulgao
(Siprianue of tor) (date)
T. 1 CERTIl:"Y THAT THE AB FO
OVE INRN ATION IS CORRECT. 03
(S i of CTvncr r) ( )
Figure 3. Notification of Dcrnolioon and Rcnovarion
02/07/2003 14:12 5187937237 GREAT ESCAPE PAGE 02
l
1a12 P.m RO-11 Off Dispatch Ticket Maintenanoo 2/07/20
Opened by,C9AABEA
966-2206 GRP;AT ESCAPE-OP.EN1 TOP C&D i
RTE 9 LAKE GEORGE NY. 12845
Ticket 203476 '
}.ntry date 02/06/2003 Time 15, 59: 09 Dispatch crate 2 0'7/2003 Time
Dump Site Driver code SCAST RCguested by E/R 30 1B RN�Ai)p Lv CPY -0 MIZ
-.odd type z o
Fquip code _ Poln•tC Map Coon j
Status Code Addltinal Comments exist jO7 tthis L•j.cke:t � 5eYvi i
Sv, Quar:tT-ty Special Description Svc Class �-Qb it R.Oute Seq#
300 1.00 30YD C&D--HAUL _ Haul Lrig f.
DTN 1.00 DISPOSAL PZR TON Disposal -
- 00 --
--�--.�+0 --
"Co — - —s
3�Exit F4dPrompt F6-r4etresh r'10-Account balance VII-Paymont hiator
F12-cance.1 F13-Additional 0Qruaenta FIB-Maintain driver/egU3.pment
Customor owned contain®r„ _
' 11
if
1
a
i
i
y
L�74��
`J STATE OF NEW YORK-DEPARTMENT OF LAB PR EMERGENCY NOTIFICATION REQUES-
�' DIVISION OF SAFETY AND HEALTH
. . .a ' ASBESTOS CONTROL BUREAU a. Date of Request b. Time of Da
State Office Campus
Building 12- Room .157
Albany, N.Y. 12240 . CD Name of Person Granting Request
AMENDED NOTIFICATION
a. ❑ Postponed ❑ Cancelled
b. New Start Date FEB 0 720 !THIN TWO WORKING DAYS OF
c. New End Date MERGENCY APPROVAL. you must s�
d. Submitted By ASBESTOS PROJECT NOT duplicate copies of this form with
1122t22_r!a_te fee to the As
BUILDING AND C� eau at the address shownbestos Co
Refer to Information Sheet or Code
Rule 56 for Time Deadlines
1. NAME AND ADDRESS OF CONTRACTOR 2. FEDERAL EMPLOYER IDENTIFICATION NO. 1 3. ASBESTOS LICENSE NO.
14-1804921 99-0720
MAGNUM ENVIRONMENTAL SERVICES, LLC 4. MAILING ADDRESS,(if different than listed in ITEM 1)
677 CENTRAL AVENUE
A_LFANY, NEW YORK 12206 5. NAME AND ADDRESS OF PARTY FOR WHOM THE PROJECT IS BEING PERFORME_
e Grno..# Escape-S,x1✓tags, I I�z 12o�.+t q , Qu{r,►-ti6b�.
. N Iz8
6.a. NAME AND TITLE OF DULY AUTHORIZED REPRESENTATIVE b. TELEPHONE NO.
HEATHER SOSINSKI (518 ) 453-0433
PROJECT INFORMATION
PROVIDEALL INFORMATION REQUESTED FOR THE BUILDING/SITEAT WHICH THE ASBESTOS PROJECT WILL BE CONDUCTED.
-7. ADDRESS(INCLUDE NAME OF BUILDING,ROOM NO.,CITY,TOWN,VILLAGE) 8. NAME OF BUILDING OWNER
1t�DYY1 0 ho5+—r6 un }�Yflt 1 1112 'gpu}C �'1 I (�utGnsbu�, Ny e Greer �c
9. COUNTY 10. CURRENT USE OF BUILDING 11. AGE OF BUILDING 12.TOTAL CONTRACT AMOUNT
Vocoj* + 20 yrs.
13. PROJECT DATE(S)-List 14. TYPE OF ASBESTOS WORK(CHECK 15. WILL WORK ON THE PROJECT BE COND CTED UNDER A VARIANCE? It
phased project dates in ALL WHICHAPPLY) yes,specify the type of variance:
REMARKS(Item 28) APPLICABLE VARIANCE-NO.: �nPlf "FPS
❑ Pipe Related ❑ INDIVIDUAL VARIANCE-PETITION NO.:
a. ACT AL STARTING DATE ❑ Sprayed on Insulation
Roofing/Flashing
Vessel Covering
❑ Siding 16. WILL SUBCONTRACTORS BE USED ON THE PROJECT? NO ❑ YES
b. PROJECTED ENDING DATE ❑ VAT
❑ Demolition If yes,please list name and federal employer identification number of E
Z,I 2-1 I03 ❑ Other(Specify) subcontractor in REMARKS(Item 28)on reverse of form.
17. ASBESTOS PROCEDURE(S)TO BE USED 18. TYPE OF ASBESTOS 19. AMOUNT OF ASBESTOS INVOLVED-CHECKALL APPLICABLE BOX(ES)
(CHECKALL WHICHAPPLY) MATERIAL LINEAR FEET SQUARE FEET
❑ Less than 260 ❑ Less than 160
( REMOVAL ❑ DEMOLITION (Specify) (Specify)
❑ ENCL05URE ❑ DISTURBANCE ❑ FRIABLE ❑ ($100) 260-429 ❑ ($100) 160-259
❑ ($200) 430-824 ❑ ($200) 260-499
❑ ENCAPSULATION ❑ HANDLING ❑ ($500) 825-1649 ❑ ($500) 500-999
❑ OTHER(Specify) ❑ ($1000) 1650 OR MORE �z ($1000y1� 10/�0%0'�OR MORE
NON-FRIABLE (f I C00.
(Specify) (Specify)
20. METHODS TO BE USED AT PROJECT SITE TO PREVENT ASBESTOS DISSEMINATION(INCLUDING TYPE OF EQUIPMENT AND VENTILATION SYSTEMS USE
WET METHODS, HEPA FILTRATION
21. 1 verify that the information specified on this notification is true and accurate and that the project will be conducted in compliance with the require-
ofm
)rj aa��3
a. Signature of the ractor or Duly Authorized Representative b. Date
PREPARE THIS APPLICATION IN TRIPLICATE AND SUBMIT:
c An original and one copy(with an ink signature on both copies)to the New York State Department of Labor,Division of Safety and Health,Asbes:.
Control Bureau, State Office Campus,Building 12-Room 157,Albany,NY 12240;retain one copy foryourrecords.
a• A check or money order,made payable to the Commissioner of Labor,for the fee due based on the project size as shown in item 19.
This notification must be submitted at least 10 days prior to the starting date of the asbestos project.
SH 483 (3-99)
AT PRC.ECT SITS 7C i REAr OR DISPOSE OF C.C,�,q -'-IIN ATED WAS;z V. IF APPl;C.13L-1
;-EPA FILTRaTICii
N:.%IE AND ADDRESS OF WASTE DISPOSAL SITE, IF ANY 2.1. NAP.1E AND ADDRESS OF WASTE HAULER.TRANSPORTER. IP A�j
rPorr CYF i W as�e flan erne r of c�sic rn ICJ Y
10p BoCa- SYPe f— {� p, aL-) 5 , SuSCtn wicl o"o QcctA
141b", N CW VICY-L J zwz.. Amslf_eaam, P.J y )2-D 10
25 METHOD(S)TO BE USED AT WASTE DISPOSAL SITE(IF APPLICABLE)
N/A
25 LIST ALL EQUIPMENT TO BE USED FOR THIS ASBESTOS PROJECT,e.g.NEGATIVE AIR FILTRATION UNITS,RESPIRATORS,WETTING DEVICES, HEPA
VACUUMS,ETC. DO NOT INCLUDE NON-ASBESTOS RELATED EQUIPMENT OR EXPENDABLE SUPPLIES. (ATTACH ADDITIONAL SHEETS IF NECESSA=
DESCRIPTION OF EQUIPMENT MANUFACTURER MODEL NUMBER QUANTITY
/2 RESPIRATORS NORTH 7700 24 1
LEI/DRY VACUUMS ARAMSCO 5
WNRT/DRY VACUUMS PULLMAN HOLT 7
NEGATIVE AIR EXHAUST UNITS ABATEvEW TECH 14
DECON TRAILERS AVENGER 2
27. LABORATORY ANALYSIS TO BE PERFORMED BY:
a. NAM E EM/•• leiss0c b. ELAP REGISTRATION NUMBER
28 REMARKS
02f05/2003 03:41 5184530443 _
MAG" M EW. SVC. PAGE H1
12/03/02 TUN 17:09 FAX 114 404 e110 YY30M/L a C lIIeei
3 Veo
FFP 0 72003
TOWN B�LD N�UEENSBU•
AND DpDER�
1TAT1OFN1W waft•0/1ARfMINTOFLAW
DIVISION OF SAFM AMD HEALTH
License and Certificate Unit
e1Juo1N1612,Room 16
STATE CAM/yf
ALeANT,N7 12140
ASBESTOS HANDLING LICENSE
LICINU N UMBtR; 99-0720
0A»oF 15Su1: 12/3/02
114MA Ion Art: 12/31/03
Comtracter: Hagm. 1vv1ro=wvta1 Socvices, LLC
Address: 677 Coatcki Avoue
Albany. NY 12206
Duly Authwrit"Representative: lienther SoelasiLl <
This license has boin issued lr, accordance with applicable provisions of Article 30 of the Labor Laws of
New York @tete.sad of the Now York Mate Codes. Rules sad Roplaum (i3 NYCRR Put 58). It is sobjed to
suspead w.or tevoatian ibr a(1) Believe violation d state,Worst or local laws with regard to the conduct cc on
sebiwtos project,er(2)dstwonstrated lack of responsibility In the conduct of any)ob iavolviar asbestos or sabesta
material.
This tioonee is valid only for the contractor named above end tkis license or a p1 of meet be prominently
displayed at the asbseioe prt�ict erarkBita. The lkeases veriflee that Illp raona eaiploblr the lloeases or+ as
a#Woo r*ct in Now York dtlte lave been issued to Asbastoe Certificate.approp"aW for type d work tlecy
perform,by ft New York Btate Deputment of Labor.
Re ard Cumlo, Director
iM17J(IOOe) FOR THE COMMISSIONER OF LABOR
.F
36 33
246 Canal Square
' TRVAf
P.O.Box 1024
Schenectady.AT 12301
,�'��1y��""�7nYY�'ental Ast9dates. . (5I8)346-6374(Phone)
Inc (518)346-4062(Pax)
'6weeding Our Clients Expectations of Excellence' � www,4spectrum.carn
December 24, 2002 8®
FER 0 7 2003
Mr.Robert Culver T BU L®N�q EFMSBURI�
Great Escape N�CODS
Po Box 611
Lake George,NIT 12845
RE: Great Escape Roof Sample
Dear Mr. Culver:
Spectrum Environmental Associates,Inc. (SEA) is pleased to submit this letter and the attached
documentation as our final report for the above referenced asbestos bulk sampling project. The
attached documentation includes; the bulk sampling Chain of Custody,laboratory results,
company license and individual certifications.
SEA was retained by Mr. Culver of the Great Escape to perform a roof asbestos inspection and
collect bulk samples of suspect asbestos containing materials (ACM) for analysis by an
independent New York State Department of Health(NYS-DOH) Environmental Laboratory
Approval Program(ELAP) approved laboratory.
This report is-for the exclusive use of the Great Escape, its employees, successors and/or assigns.
This report and its contents represent confidential information and should not be duplicated
without.the expressed permission of the Great Escape,its employees, successors and/or assigns.
SEA's inspector of record for this project is Mr. Charlie Capasso who performed the asbestos
inspection and bull:sampling on December 19,2002 in accordance with generally accepted
industry practices and applicable state and federal regulations including,but not limited to;NYS-
DOL Industrial Code Rule 56,USEPA—Title 40 CFR Part 763 "AHERA",USEPA Title 40 CFR
Part 61 "NESHAP" and OSHA—Title 29 CFR Part 1926.1101 "Construction Standard".
The scope of work was to sample the exterior window systems of the building for asbestos
containing materials(ACM) in the caulking and glazing. Our inspection revealed two types of
windows, one type on the ground floor and a second type for the remaining upper floors.Both the
caulking located between the windows and the building and the glazing located between the
window frames and the glass were tested.
According to the USEPA and the NYS=DOL, the definition of an ACM is a material with an
asbestos weight of one percent(1%) or more. Therefore, a material with less than one percent, or
a"trace", of asbestos can be treated as a non-asbestos containing material.
FQsbestos&Lead Consulting • Laboratory Services • Safety&Health 7haining • Site Rssessments
Mr.Robert Culver
December 24, 2002
The following table is a synopsis of the sampling performed and the laboratory results.
Field ID Sample Location Sample Result
E O1 Main roof 18.2 Chr sotile
E 02 Paper under wood shingles NAD
E 03 'Flashing near edge NAD
E®4 Shiu�les sl:inny roof front of building) 2.6 % Chr sotile
NAD=No Asbestos Detected
Scientific Laboratories,Inc. (SCI Lab) analyzed both friable and non-friable organically bound
(NOB)materials using Polarized Light Microscopy(PLM)in accordance with NYS-DOH
Environmental Laboratory Approval Program(ELAP)Method 198.1. Within the scope of this
method, all friable materials are analyzed using point counting to quantify the amount of asbestos
present. For NOB materials,the method incorporates mandatory matrix reduction techniques
including muffle furnace ashing and acid-treatment of the sample.
If an NOB material is determined to contain<1% asbestos by weight via PLM analysis,the
sample must by analyzed by NYS-DOH ELAP Method 198.4 (Transmission Electron Microscope
Method for Identifying and Quantitating Asbestos in Non-Friable Organically Bound Bulk
Samples). Method 198.4 is required in order to consider or treat NOB samples originating in
New York State as non-asbestos containing.
Should you have any questions concerning the collection and/or the analytical results presented in
this report,please do not hesitate to contact our office at(518) 346-6374.
Sincerely,
John C. Miller
Senior Project Manager.
Cc: file Reviewed:
Enclosure:
James A. Capasso II
VP Operations
2
%3,•26et2 iu; ,7 %126795392 SCILAB NYC PAGE 02/04
117 EAST 30TH STREET
a 1 LAB
NEW YORK,NY 10016
TEL: (212)679-860i1 4 FAX:(212)679-9392
PLM Bulk Asbestos Report
Spectrum Environmental Associates, Date Received 12/23/2002 SciLab Job No. 202122983
Inc. Date Examined 12/23/2002 P.O, # Massman
Attn: Bill Massman FLAP Number 11480 Page 2 of 2
P.O.Box '102 FEE: Great Escape
Schenectady, ICY 12301
Reporting Notes:
(1) PLM analysis of IV06 inert material
Analyzed by'Bella J. Chernis
`NAD/NSD=no asbestos detected; NA—not=analyzed; NA/Pg-not analyzed!positive stop; PLM Bulk
Asbestos Analysis by EPA 600/M4-82-020 per 40 CFR 763(NVLAP Lab#200546-0)and ELAP PLM Analysis
Prot000l 198.1 for Now York samples(NYSDOH BLAP Lab# 11480); Note:PLM is not consistently reliable In
,detecting asbestos in floor coverings and similar non-friable organically bound materials. TEM is currently the only
,method that can be used to determine if this material can be considered or treated as non-asbestos-contalninQ in
New York_State(also see EPA Advisory for floor tile, FR 59, 146,3a97o,6/1194). National Institute of Standards
and Technology Accreditation requirements mandate that this report must not be reproduced except in full without
;the approval of the laboratory, This PLM report relates ONLY to the items tested. AIHA#102843;VT Cert#
,AL016055
Reviewed By:
1.0:b/ 2126799392 SCILAB NYC PAGE 03/04
P.O.Box 1024
(W)346-6374(Pbeim)
,q �" tY�tt� '1 flssr�citxt�s, Iht�: (s:a)346-4062(&q
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f 2126799392 SCII_AB NYC PAGE 04/04
Iaunncar,,,,Y SCIENZIFIC"SORAr001", INC.
17 EAST 30TH STREET i . B 1, NEW YORK,NY 1 D016
TEL: (212)U79-8600•FAX:(212)679.9392
,PLM Bulk Asbestos Report
Spectrum Environmental Associates, Date Received 12/23/2002 SciLab Job No. 202122983
Iric, Date Examined 12/23/2002 P,O. # Massman
Attn: Bill Massman ELAP Number 11480 Page 1 of 2
P.O.Box 1024 RE: Great Escape-
Schenectady, NY 12301
Client No.I HGA Lab No. Asbestos Present Total % Asbestos
E1 202122983-01 Yes 18.2 %
Location:Main Roof
Description, Black, Homogeneous',Roofing Material
Asbestos Types:Chrysotile 18.2%
Other Material: Non-fibrous V.2%
C2 202122963-02 No NAD t
Location,Paper Under Wood Shingles
Descripflon: Black, Homogeneous, Roofing Material
Asbestos Types;
Other Material: Non-fibrous $.9%
t
E3 202122983-03 Na NAD
Location:Near Edge
Description: Black, Homogeneous, Roofing Material
Asbestos Types:
Other Material: Non-fibrous 1.4%
1
E4 202122983-04 Yes 9.8
Location:Shingle (skinny roof front of bidg)
Description: Black, Homogeneous, Roofing Material
Asbestos Types: Ohrysotile 9.8%
Other Material: Non-fibrous 9.8%
Seir ab Joel#: 202122983 Page I of 1
Client ANamc: Spec(rum Environmental Associates,Inc!.
�
W
Table I �.
Summary Of Btdk. Asbestas Analysis Results
Great Escape ;
SciLa€r Client HG Sample Heat Acid Insotable
Sample sample# Area Vireigbt Sensitim Satuhle Noa-Asbestoos MM Asbestos %by °" Asbestos To by ',2
# Location (gram) Organic% Inorganic % lnarganic % PLIVVW TE I lo
01 El 0.39 53.33 5.13 23.34 Chrysotile L8.2- NA LD
Main Roof tJ
02 E2 0.277 95.31 0.72 317 MAD Chrysotile Trace
Paper Under Wood Shingles
03 E3 0.773 80-08 18.50 1.42 NAD NAD-
Near Edge
04 E4 0.392 79.85 0.51 9.814 Chrysotile 9.8 JVA
Shingle(skinny roof front of bid;)
(n
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r
- D
n
�naly�edby:Aornan Peysakbov ;1)atc Analyzed 12/23102
Quantitative Analysis(5enti/Fu11);Bulk Asbestos nalysis-PLyl by E.PA 6We'M48Z-020 per 40 CFR(NVLAP LaW2,60546-0);TEM(Semi/Full)by EPA 60Mt-931116(not covered by NVLAP Bulk accmditation);
or FLAP 198.11198-4 forNew Y ork samples(NYSDO1l BLAP817480);NL AD=rto ash'eslos[Ietectetl duria g a quanlira live ana lysis;NA=not aoalp M;Trace=<1:5;Quantitation for beginning weights of<0.1 gram
should Ix considered as qualitative®]y;Qualitative Analysis:Asbestos analysis results of"Present"or'NVA=No Visible Asbestos'reptesents results for Quabhfive PLII or'IEtvl Analysis only(no accreditation
coverage available from any regulatory agency for qualitative analyses); AIRA LaIC[12843.
Warning Note:PLI1 limitation,only IEhi win resolve fibers<0--?S micmmelcrs in dinmeier.rEld bulk analysis is nepresentalive of Ike fine grained matrix matmai and pray not he representatire of non-uniformly
dispersed debri,for which PLbI evaluation is recommcuded(i.e.soils and other heterogencus materials). 0
D
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Reviewed By-,_ m
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2 0 a 2 21:30 2.126799392 SCILAB NYC PAGE 03/03
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STATE OF NEW YORK-DEPARTMENT OF LABOR
DIVISION OF 5AFETY AND HEALTH,
License and Certificate Unit
BUILDING 12, Room 161
STATE CAMPUS
XCE 510 ALBANY, NY 12240
ASBESTOS HANDLING LICENSE
LICENSE NUMBER: 99-0129
DATE OF ISSUE: 2/26/0 2-
EXPIRATION DATE: 2/28/03
Contractor: Spectrum Environmental Associates , Inc .
Address: P . O . Box 1024
Schenectady, NY 12301 .
Duly Authorized Representative: John B . VanD enburgh III
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. The licensee 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.
Richard Cucolo, Director
S11 432 (10-00) FOR THE COMMISSIONER OF LABOR