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DEMO-0217-2021 Office Use Only Permit#: t&&-ylo — b 2-%-- - 2021 DEMOLITION APPLICATION 11�� Permit Fee:$ 1 `Q gb "-- Invoice#: 15IQ k5 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury:net Flood Zone? Y Reviewed By: 12- r�cU�c10�rl�� Demolition Location: Tag Map ID#: 2B c f ,q__j_,n� **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** • DEMOLITION INFORMATION: 1. Where will demolition material be disposed? 2. Type of structure to be demolished: D E a. Residence d. Storage Building❑ APR 13 2021 b. Garage 91 e. Other: c. Business ❑ 7-0 OF QUEENS BUILDING& COpES 3. What type of utilities are'connected to the structure: a. Gas ❑ f. Well-Water Pump ❑ b. Fuel Oil ❑ g. Public Sewer❑ c. Propane ❑ h. Other d. Electric 10 L None❑ e. Public Water❑ 4. Have ALL utilities (water electri etc.) been disconnected? Yes t? No❑ ADDITIONAL INFORMATION: 1. Two inspections may be required: an inspection to determine that utilities areF 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 of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued. have read and agree to t�yh.�'e above: r PRINT NAME. SIGNATURE: DATE: Demolition Application Revised December 2020 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: ',., s I�Ot C'e- Mailing.Address, C/S/Z: ��. ZQ�.X'�av�, R-& Cell Phone ;$g Znd Line: 5711 Z f3 qe5- Email:5 tAa cawtw r�a�l-.� . • Primary Owner(s): Name(s): r r Mailing Address, C/S/Z: J G Cell Phone: Land Line: Email: ❑Check if all work will be performed by property owner only • Contractor: (List all additional contractors on the back of this form) 1 Contact Name(s): ,�,f014 M.o-t-eky � Contractor Trade:► e-64an-� &4 Cvrnh� /�'f' V'dab' 4 Qum"J-eJ,-�t- Mailing Address. C/ /Z:S �en-� PT� sDh �a-r�s N Z�39 Cell Ph9t qS-Land Line: �'/ ��7- �o g Z• Email:—}-p w,u�rpL�•�18(�,bve. Go rn **Workers' Comp documentation must be submitted with.this application** Contact Person for any questions regarding this project: P�tiC&.X\t Cell Phonet8 SS•$?aan�d Line: 5/? '7l3` ? Email: Y►aa�tJ2re.,1�w(Q.3��aLt�� r C.� Demolition Application Revised December 2020 Margaret Wallace, 12 Reardon Road,Queensbury,New York 12804 INTRODUCTION GENERAL INFORMATION ClearVU Inspections.was retained by Margaret Wallace, owner, to conduct a Limited Pre-Demolition Asbestos Survey. All methods and procedures employed in this survey were done in accordance with NYSDOL(New York State Department of Labor),OSHA(Occupational Safety and Health Administration),and USEPA(United States Environmental Protection Agency) regulations and protocol. The information contained in this report has been collected in accordance with existing regulations. If this document is to be utilized for bidding quotations, it cannot be held binding and must be field verified by those contractors submitting bids. PURPOSE The purpose of this survey was to identify, document, and measure specified asbestos-containing materials in this build- ing,which may be disturbed during renovation activities.Samples were collected of suspect accessible asbestos-contain- ing building materials.Should any materials be encountered that are not identified in this report,they should be as- sumed asbestos containing until a representative number of samples are collected to document these materials as non- asbestos containing. SCOPE OF SERVICES Provide a visual inspection of all accessible building components to determine the presence of suspect materials.The inspector physically assessed,quantified and conducted bulk sampling as required of suspect ACM (Asbestos Containing Materials)which were accessible or exposed.This report represents the locations and quantities of ACM (Asbestos Con- taining Materials) present as well as all sampled materials that tested negative for the presence of asbestos and their locations. Bulk sample analysis was performed by a participating New York State Department of Health Environmental Approval Program (NYSDOH-ELAP) certified laboratory. SAMPLING METHODOLOGY During the visual inspection process,an inventory of suspect materials similar in appearance and composition was creat- ed and grouped into homogeneous sampling areas.A homogeneous area is defined as a surfacing,thermal or miscella- neous material that is uniform in texture, age,and appearance.A representative bulk sampling plan was created in ac- cordance with current USEPA(United States Environmental Protection Agency) requirements and guidelines. Bulk sam- ples were then collected of suspect ACM (Asbestos Containing Materials)to identify the presence of asbestos. There are a number of materials,which rarely contain asbestos and are not specifically addressed in this report.Such materials include but are not limited to,glass, rubber, cinderblock and mortar. LABORATORY METHODOLOGY The friable bulk samples were analyzed by Polarized Light Microscopy(EPA Interim Method:Appendix A to Subpart F 40CFR Part 763) at magnifications ranging from 10x to 400x,and New York State Department of Health ELAP Item Num- ber 198.1(Polarized Light Microscopy Methods for Identifying and Quantitating Asbestos in Bulk Samples).The estimat- ed phase abundances are provided in weight percent and are accurate to within 10 to 15 percent of the amount report- ed.These methods are sensitive to the detection of asbestos to less than one percent. All non-friable organically bound (vinyl flooring,caulking,etc.) bulk samples were analyzed by New York State Depart- ment of Health ELAP Item Number 198.4(Transmission Electron Microscopy Method for Identifying and Quantitating Asbestos in Non-Friable Organically Bound Bulk Samples). NOB samples were first reduced by the Gravimetric Matrix Re Page 2 of 7 Margaret Wallace, 12 Reardon Road,Queensbury,New York 12804 duction Method to determine if greater than one percent of material remained. If greater than one percent of the NOB material remained by weight,the sample was analyzed by Polarized Light Microscopy by New York State Department of Health ELAP Item Number 198.6 to determine if it contained greater than one percent asbestos. In accordance with New York State Department of Health regulations, Polarized Light Microscopy is not consistently reli- able in detecting asbestos in non-friable organically bound materials, and in cases of a negative result TEM analysis is performed.This method is sensitive to the detection of asbestos to less than one percent by weight.A material is con- sidered asbestos containing if it contains more than 1%asbestos. NYSDOL and USEPA regulations define asbestos containing material as containing greater than one percent(1%). Materi- als found to contain asbestos at concentrations of less than one percent(<1%) by weight are classified as containing trace amounts of asbestos. It should be noted,OSHA's definition of"asbestos containing" does not have a one percent (1%)cut-off,therefore,asbestos that is present in percentages less than one percent(<1%) continues to be covered by OSHA Construction Standard 29 CFR 1926.1101. HAYES MICROBIAL&EUROFIN CEI - LAB ID# 12048, COMPLETED THE ANALYSIS. WARRANTY The field and laboratory results reported are considered sufficient in detail and scope to determine the presence of ac- cessible and/or exposed asbestos-containing building materials.The findings contained within this report have been gathered in accordance with existing regulations and industry protocol. This survey and analytical methods have been used to provide the Town of New Hartford with information regarding the presence of suspect interior asbestos-containing building materials existing at the time of the inspection.This report is limited to the information available from the client at the time it was prepared. It is possible that conditions may exist which could not be identified within the scope of the survey or which were not apparent during the site visit. Page 3 of 7 Margaret Wallace, 12 Reardon Road,Queensbury,New York 12804 Executive Summary Asbestos-Containing Material Field Survey Margaret Wallace 12 Reardon Rd Queensbury,New York 12804 I. SUMMARY OF FINDINGS On March 27, 2021, an asbestos-containing material (ACM)field survey was conducted at 12 Reardon Rd located in Queensbury, New York(Site).The site was inspected to determine the presence of ACM in preparation for renovation.The ACM survey was performed at the request of Margaret Wallace with Margaret Wallace. A summary of asbestos-containing materials is provided in the following table. However,this report should be read in its entirety,including detailed information that is contained in other sections and appendices.A total of 16 samples were collected from 8 suspect homogenous materials. Summary Table of Asbestos-Containing Materials ..._.._...... ___�-__ Material Material ID Material Category Regulatory Result Estimated Quanti- ty There are no homogenous materials for this project that are assumed or have tested positive contain- ing asbestos A table presenting all materials sampled which can be found in Appendix A of this report.A complete listing of all samples collected is provided in Appendix B of this report.A sample location diagram is provided in Appendix C of this report. Photographs of all positive materials are provided in Appendix D of this report.The original PLM laboratory analytical reports are located in Appendix E of this report. The Chain of Custody is provided in Appendix F of this report. Recommended response actions for those materials determined to be ACM are discussed in the Re- sponse Actions section of this report.Specific information regarding inaccessible areas or potential in- accessible materials can be found just below the Response Actions section of this report in the Inac- cessible Areas/Materials section. Page 4 of 7 Margaret Wallace, 12 Reardon Road,Queensbury,New York.12804 'Appendix A: ACM Homogenous Area Table Material Material Space Section. Friability Current Result Quantity Estimat- Category Name Name . I Condi- ed Quan- ition tity There are no homogenous materials for this project that are assumed or have tested positive contain- ing asbestos Appendix E: Sample Location Maps All Sample Locations for First Floor Garage A A A 3 4! ' CJ"y 6 3 : HouS lk Map ID Sample ID Section Space Name Material Lab Result Analytical Name Result Page 5 of 7 Margaret Wallace, 12 Reardon Road,Queens bu ,New York 12804 1 001A First Floor Exterior 001-Gas- Tested Nega- 0% Garage kets, Paper tive by Lab (No As- bestos De- tected) _._......_ 2 0016 First Floor Exterior 001-Gas- Tested Nega- 0% Garage kets, Paper tive by Lab (No As- bestos De- tected) 3 002A First Floor Garage 002-Cork Tested Nega- 0% Garage Wall Panel tive by Lab (No As- bestos De- tected) 4 002B First Floor Garage 002-Cork Tested Nega- 0% Garage Wall Panel tive by Lab (No As- bestos De- tected) 5 003A First Floor Exterior 003- Tested Nega- 0% Garage Sealant, tive by Lab Window (No As- Pane Glazing bestos De- tected) 6 003B First Floor Exterior 003- Tested Nega- 0% Garage Sealant, tive by Lab Window (No As- Pane Glazing bestos De- tected) 7 004A First Floor Exterior 004-Caulk, Tested Nega- 0% Garage Wall tive by Lab (No As- bestos De- tected) 7 004B First Floor Exterior 004-Caulk, Tested Nega- 0% Garage Wall tive by Lab (No As- bestos De- tected) 7 005A First Floor Exterior 005-Caulk, Tested Nega- 0% Garage Wall tive by Lab (No As- bestos De- tected) Page 6 of 7 Margaret Wallace, 12 Reardon Road,Queens bur ,New York 12804 7 005B First Floor Exterior 005-Caulk, Tested Nega- 0% Garage Wall tive by Lab (No As- bestos De- tected) --._____._......_.. -- 8 006A First Floor Garage 006- Rubber Tested Nega- 0% Garage tive by Lab (No As- bestos De- tected) .__.__.._. _ —_____ _ ___ __ 9 006B First Floor Garage 006-.Rubber Tested Nega- 0% Garage tive by Lab (No As- bestos De- tected) 9 007A First Floor Roof 007- Roof- Tested Nega- 0% Garage ing Mem- five by Lab brane (No As- bestos De- tected) 10 007B First Floor Roof 007-Roof- Tested Nega- 0% Garage ing Mem- tive by Lab brane (No As- bestos De- tected) 10 009A First Floor Roof 009-Fiber- Tested Nega- 0% Garage board tive by Lab (No As- bestos De- tected) 9 009B First Floor Roof 009- Fiber- Tested Nega- 0% Garage board tive by Lab (No As- bestos De- tected) Page 7 of 7 II h CLEARUU : : DL550T _ IXS7Et110NS Chain of Custody ClearVU Inspections _. .. .. . . . . . _.. .. . :..... .... ... .:.... . .. .._. 19 Blackberry Lane � Project: 10018 Site Location: 12 Reardon Queensbury,New York 12804 12 Reardon Rd Queensbury,New York 12804 Sampled By: Ryan Wild(ryan@clearvuinspections.com) Purpose: NESHAP Compliance,(Pre-Renovation/Pre-Demolition) Laboratory Notes Turn-Around Time Request Stop after first positive for each HM 5 Day .Samples. Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 001A 001 -Gaskets, Paper First Floor Garage Exterior 198.4 PLM&TEM . where applicable NY ELAP 198.1 & 001 B 001 -.Gaskets,Paper. First Floor Garage Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002A 002-Cork Wall Panel First Floor Garage Garage 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002B 002-Cork Wall Panel First Floor Garage Garage 198.4,PLM&TEM where applicable NY ELAP 198.1 & 003A 003-Sealant,Window Pane Glazing First Floor Garage . Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 003B 003-Sealant,Window Pane Glazing First Floor Garage Exterior 198.4 PLM&TEM where applicable ClearVU Inspections-Chain of Custody For Margaret Wallace 12 Reardon-10018 1 of 3 NY ELAP 198.1 & _ 004A 004-Caulk,Wall First Floor Garage Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 004B 004-Caulk,Wall First Floor Garage Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 005A .005-Caulk,Wall First Floor Garage Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 005B 005-Caulk,Wall First Floor Garage Exterior 198.4 PLM&TEM. where applicable NY ELAP 198.1 & 006A 006-Rubber First Floor Garage Garage 198.4 PLM&TEM where applicable . NYE LAP 198.1 & 006B 006-Rubber First Floor Garage Garage 198.4 PLM&TEM where applicable NYELAP 198.1 & 007A 007-Roofing Membrane First Floor Garage Roo_ f 198.4 PLM&TEM where applicable NY ELAP 198.1 & 007B 007-Roofing Membrane First Floor Garage Roof 198.4 PLM&TEM where applicable NY ELAP 1,98.1 & 009A 009-Fiberboard First Floor Garage Roof 198.4 PLM&TEM where applicable NY ELAP 198.1 & 009E 009-Fiberboard First Floor Garage Roof 198.4 PLM&TEM where applicable ClearVU Inspections-Chain of Custody For Margaret Wallace 12 Reardon-10018 2 of 3 L1 Y 09�6 3/27/2021 12PM Sampled By Date Time Received By Date Time Received By Date Time Received By Date Time 3/29/21 2PM Relinquished By Date Time Relinquished By Date Time Relinquished By Date Time Analysis By Date Time ClearVU Inspections-Chain of Custody For Margaret Wallace 12 Reardon-10018 3 of 3 HAYES MICROBIAL CONSULTING - #21010669 Analysis Report prepared for We would like to thank you for trusting Hayes Microbial,for your analytical needs! We received 16 samples by FedEx in good condition for this project on March 30th,.2021. ClearVu Inspections The results in this analysis pertain only to this job,collected on the stated date,and should not be used in the interpretation of any other job.This report may not be duplicated,except in full,without the written 18 Blackberry Lane consent of Hayes Microbial Consulting, LLC.. Queensbury, NY 12804 Phone: (618) 832-9213 This laboratory bears no responsibility for sample collection activities,analytical method limitations,or your use of the test results. Interpretation and use of test results are your responsibility.Any reference to health effects or interpretation of mold levels is strictly the opinion of Hayes Microbial. In no event,shall Hayes Microbial or any of its employees be liable for lost profits or any special, incidental,or consequential damages arising out of the use of these test results. 10018 12 Reardon Rd Queensbury, New York 12804 Collected: March 27,2021 - Received.: March 30 2021 Reported: April 6, �021 . Steve Hayes,BSMT(ASCP) Laboratory Director Hayes Microbial Consulting,LLC. O'D srq.,� i3p Connecticut Department ; AG PAOZ� •o(Pu6lic Heath EPA Laboratory ID: VA01419 Lab ID: #188863 DPH License: #PH-0198 Hayes Microbial Consulting,LLC. 3005 East Boundary Terrace,Suite F. Midlothian,VA.23112 (804)562-3435 contact@hayesmicrobial.com Page:1 of 5 Ryan Wild 10018 ##2101066-9 ClearVu Inspections 12 Reardon Rd _ 18 Blackberry Lane Queensbury, New York 12804 Queensbury,NY 12804 Asbestos 198:4 (518)832-9213 Subcontracted 1: Eurofin CEI-Lab ID#12048 ----------�---- ---- I Organic Acid F Acid._. - # i _ Sample I Material Description _Weight i Material°i° 11,Soluble*�. Insoluble°i ! �bestos°i _ J 1 001A-001-Gaskets,Paper First Floor Garage Exterior Bulk Material/Silver/... None Detected 2 001 B-001-Gaskets,Paper First Floor Garage Exterior Bulk Material/Silver/... None Detected 5 003A-003-Sealant,Window Pane Glazing First Floor Garage Exterior Bulk Material/Gray/... None Detected 6. 00313-003-Sealant,Window Pane Glazing First Floor Garage Exterior Bulk Material/Gray/... None Detected 7 004A-004-Caulk,Wall First Floor Garage Exterior Bulk Material/Black/... -None Detected 9'" 004B-004-Caulk,Wall First Floor Garage Exterior Bulk Material/Black/... None Detected 9 005A-004-Caulk,Wall First Floor Garage Exterior Bulk Material/Clear/... None Detected 10 005B-004-Caulk,Wall First-Floor Garage Exterior Bulk Material/Clear/... None Detected Collected:Mar 27,2021 Received:Mar 30,2021 Reported:Apr 6,2021 Project Analyst:�_ —"..r ,.� ?�'i"�c71 `',.i; � s Y------�..__- —�i 1Date:':; -;,, f Reviewed B :' ', Date r :% Renaldo Drakes;HAYE & . i f 04x-06 "2021 ? Darien Williams, G� ",' i(04 06-2021 I MICROBIAL CONSULTING 3005 East Boundary errace, uite F.Midlothian,VA.23112 (804)562-3435 contact@hayesmicrobial.com Page:2 of 5 Ryan wild 10018 #'21010669 ClearVu Inspections 12 Reardon Rd - 18 Blackberry Lane Queensbury,New York 12804 Queensbury,NY 12804 Asbestos 198.4 (518)832-9213 Subcontracted 1: Eurofin CEI-Lab ID#12048 ( � Organic 1 ,. . ° I Sample Material Description. ;Weight rial°io So ub a% Insoluble°i° Asbestos Mate .1-1 006A-006-Rubber First Floor Garage Bulk Material/Black None Detected 12 006B-006-Rubber First Floor Garage Bulk Material/Black None Detected 13 007A-007-Roofing Membrane First Floor Garage Roof Roof Membrane/Bla... None Detected 13 007A-007-Roofing Membrane First Floor Garage Roof Mastic/Clear None Detected `14 007E-007-Roofing Membrane First Floor Garage Roof Roofing/Black None Detected } 14 007B-007-Roofing Membrane First Floor Garage Roof Mastic/Clear None Detected" I Collected:Mar 27,2021 Received:Mar 30,2021 Reported:Apr 6,2021 HProject Analyst: i Date: (Reviewed By: ' Date: 04 06 ',+? '.`_., SI G, ram.-.-.,.-_._.....—�� AY E S Renaldo Drakes, `" ,r-202. Darien Williams, r' I104:=06.-2021 MICROBIAL CONSULTING --� '"_ t . a<z.wo , Y 3005 East Boundary errace, uite F. Midlothian,VA.23112 (804) 562-3435 contact@hayesmicrobial.com Page:3 of 5 Ryan Wild 10018 #2101066-9 ClearVu Inspections 12 Reardon Rd 18 Blackberry Lane Queensbury, New York 12804 Queensbury,NY 12804 Asbestos 198:1 (518)832-9213 Subcontracted 1: Eurofin CEI-Lab ID#12048 j— Sample —! Material Description ^-� Non-Asbestos Fibers Asbestos Fibers �7 3 002A-002-Cork Wall Panel First Floor Garage(Garage) Friable/Brown None Detected 4 .� 002B-002-Cork Wall Panel First Floor Garage(Garage) Friable/Brown None Detected 15 009A-009-Fiberboard First Floor Garage Roof Friable/Brown None Detected . 16 009B-009-Fiberboard First Floor Garage Roof Friable/Brown None Detected r Go I I ected:Mar 27,2021 Received:Mar30,2021 Reported:Apr6,2021 H AY E S Project Analyst' 1i� Dater i Reviewed By: '" !I Date: Renaldo Drakes. - _ °Darien Williams, o j llllfl 04 06=2021 j i e !04-06-2021 j MICROBIAL CONSULTING _ �' " L 3005 East Boundary errace, uite F. Midlothian,VA.23112 (804) 562-3435 contact@hayesmicrobial.com Page:4 of 5 Ryan wild 10018 #21010669 ClearVu Inspections 12 Reardon Rd 18 Blackberry Lane Queensbury,New York 12804 Queensbury,NY 12804 Asbestos Analysis Informatioln (518) 832-9213 Subcontracted 1: Eurofin CEI-Lab ID#12048 Analysis Details All samples were received in acceptable condition unless otherwise noted on the report.This report must not be used by the client to claim product certification, approval,or endorsement by AIHA,MIST,NVLAP,NY ELAP,or any agency.The results relate only to the items tested.Hayes Microbial Consulting reserves the right to dispose of all samples after a period of 60 days in compliance with state and federal guidelines. PLM Analysis All Polarized Light Microscopy(PLM) results include an inherent uncertainty of measurement associated with estimating percentages by PLM. Materials with interfering matrix,low asbestos content,or small fiber size may require additional analysis via TEM Analysis. TEM Analysis Analysis by TEM is capable of providing positive identification of asbestos type(s)and semi-quantitation of asbestos content. Definitions 'None Detected'-Below the detected reporting limit of 1%unless point counting is performed,then the detected reporting limit is.25%. New York ELAP Per NY ELAP198.6(NOB),TEM is the only reliable method to declare an NOB material as Non-Asbestos Containing. Any NY ELAP samples that are subcontracted to another laboratory will display the name and ELAP Lab Identification number in the report page heading of those samples.The original report provided to Hayes Microbial Consulting is available upon request. HAYED MICROBIAL CONSULTING 3005 East Boundary Terrace;Suite F.Midlothian,VA.23112 (804)562-3435 contact@hayesmicrobial.com Page: 5 of 5 .I env Y Qrk,gtate vepartment or;raeaiL#a:c ea nncace.or asnesre)s auaecy.a raanutg This Corm iS.tY e i? ciat.TiCR3'Cj Cif succcC SM 1_61t166i' b#-3`ttica'.Yoram BiaFe.accnrlited asl�estas.�fety tmi3�i4 rou e. C ertiticate: 'T�.G ~F:. - ' Y Tr acne p 0 rrc' 'ti1Y i3vrtct. iif';ilUkor-.V6hit lcs FDI(DN.,l .,ID)t' Minlo=of Trainee ' I }. l .. . . . Signature of TraitiLe ! Teleplibne-Nlumber Date-of Birth' ` Address,, (Street orPZ}'I3c�s) c i=' j .r• (Ciivl �',_ (Stotc) (ZiL Code) :;t: i r Qt1SCb com„ Tr iii� ��p - `Provider's,Na111e TelcphoneNumber- Ambient-Environmental;,lhc: Address' irtgtcsttvent = - 'Cburse__. :- . lbany, New York 12203 - . 518-4 2-97t04. _[ octiric�n. . Zip`Cade 'tiY.S'DOIJ asi nns' :C Oc Urse Tide': ,:^r� :is _ o"' Ey t +-: ,�_• ETiR'i'nitixl. Q'Refresaer. EJ UG)H Equivalency- >Q - _ .lattt.�.rrUdl.f.3.IGt L4r. rerev., Training-Language: Engiitili= `Othci nL_ Dates of TI aiiting From: t certify that-the-dsbestos saferi_training cgiir-i'6it�e'ufi;thc�ab6%'e date coniplied,,iWtli both IU i�Y'C I�Pi Pail ?3 and ll;:w3is.cortsisteni witli':the,cunicdltdh and,itnthiciois apprcive!by the NUu'.1YO k State'D.cpartment o#` Health,aud'the traiiice ri cciying.this cLi i Scate;ci3it3pleted ilre;traitiit course a3ici successfully passed thc-exa3n_ination. lraitnang Darector?• f` .,ir: : .l• , -, F ' t~. �,f , +•� V p±+ ('Prin{;) �:''.(Signatum 1DE 3F I)1)H-283 (lU%tl;} 0"ot"ll7nforin-i'tie+.'i' ' #.){)TT:F:qu3�ralei3cy i�ri�tlIt},NYSDOH.ry�?re�entuiiveutily New York State-:Department-of16bor;.:,, :. .. Division of Safety and Health. License and Certificate,Unit' State Campus,-Building 12 Albany,.NY 12240 ASBESTOS HANDLING LICENSE:; .. Creative.Spaces II, LLC dba ClearVU Inspections FILE NUMBER: 21-282890 LICENSE NUMBER: `282890 18 Blackberry Lane LICENSE CLASS: RESTRICTED:.,.: DATE OF ISSUE: 01/26/2021 Queensbury,; NY 12804• EXPIRATION DATE: 01/31/2-022 Duly Authorized.Representative:7 Ryan Wild: This license'-has been issued in accordance with applicable provisions.of Artic1e.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 fora(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 joli 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..Jhis-license verifies that all persons employed by the licensee on an asbestos.prcject 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. WOO Eileen M.Franko, Director SH 432(8/12) For the Commissioner of Labor