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DEMO-0162-2021 Office Use Only r DEMOLITION APPLICATION Permit#: D1IO2- 2) Permit Fee:$ 05 Town of Quecnsbury Invoice:#: 742 Bay Road,Queensbury, NY 12804 0: 51&761-8256 www.aueensbury.net Demolition Location: 39 Louise Lane Tax Map ID #: 289.6-1-17.6 **AN ASBESTOS -REPORT IS .REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS" CONTACT INFORMATION: o • Applicant: �z Name(s): Mary Sicard vo In Mailing Address, C/S/Z: 11 George St, Lake George, NY 12845 �o �•.� Cell Phone: (518) 7444888 Land Line: (518) 792-5963 nm ' Email: msicard@glensfallshosp.org aN v • Primary Owner(s): v C Name(s): Same as above -< Mailing Address, C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: ❑ Check if all work will be performed by homeowner only • Contractor: Workers' Comp documentation must be submitted.with this application Contact-Name(s): Charles Friedman Excavating Contractor Trade: Excavator Mailing Address, C/S/Z: 54 North St, Hudson Falls, NY 12839 Cell Phone:. (518)361-1748 Land Line: (518)747-9371 Email: cfriedmanexcavating.com **List all additional contractors on the next page 'Contact Person for Building&Code Compliance: Charles Friedman Cell Phone: (518)361-1748 Land Line: (518)747-9371 Email: cfriedmanexcavating.com DEMOLITION INFORMATION: 1. Where will demolition material be disposed?Waste Management, Gansevoort NY Demolition Application Revised January 2019 2. Type of structure to be demolished (check all that apply): b. Garage 1,L c. Businesi`- ! d. StorageDuyilatng ❑ e. Other ❑ (describe: ) 3. What type of utilities are connected to the structure (check all that apply): a. Gas ❑ b. Fuel Oil ❑ c. - Propane ❑ d. Electric ❑ e. Public Water ❑ f. Well-Water Pump ❑ g. Public Sewer ❑ h. Other i. None 4.' Have ALL utilities been disconnected? Yes N No ❑ ADDITIONAL INFORMATION: Two inspections may be required: an inspection to determine that utilities are disconnected, if necessary;;.an'd 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. I have read and agree to the above: PRINT NAME: Mar Sicard SIGNATURE: DATE: Demolition Application Revised January 2019 wSA maw .. F QUEENSEUR� .2.�, -�0w� Q D CAE VLF . INS � CDpES pEp�. pUILDS • �eviewe �y° MAR 2 6 2021 [)ate-. TOWN OF QUEENSBURY BUILDING&CODES t i! M�tt�a p� �til yolk8t� i **ad. I! titti s tl�asub " may,#are Wm no pr�t+dir�tlt•���► ttteA. t cne�P ��am or iot�t 1�N!t�q� dilttlS�iiiilA 1C11�' 11��' . ,._ colp, T0�0 QUEENSaURY gi)II.DING DEPARTMENT lianCe" 2021 minaUon,comp as Based on our limited ex not be consW� IDEVAO_0"'-- ts sha► fycations o 6 witl►our comet ans and s indicaUng the a with the wilding 289.E-1 • full C0c1 Sta e• 1Vla�ll NewY S7Card, Lot Of Ln %iA ms 39 L- ��' pemolition of SO , Pre-Demolition Asbestos Building Survey 39 LOUISE LANE LAKE GEORGE NY 12845 INTRODUCTION ON OCTOBER 10 OF 2020 MARY SICARD OF 11 GEORGE STREET IN LAKE GEORGE NY 12845 retained: Michael J. Stevens to preform an asbestos survey of the property located at 39 LOUISE LANE IN LAKE GEORGE NY 12845 this is a single family residence The BUILDING is located on 39 LOUISE LANE IN LAKE GEORGE NY 12845 The building is a SINGLE FAMILY structure of approximately 700 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, WOOD siding and a metal AND ASPHALT SHINGLE 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. i Michael J Stevens Licensed Asbestos Inspector PO Box 2202 Glens Falls, NY 12801 OCTOBER 19 2020 MIKE STEVENS RE: Pre-Demolition Asbestos Building Survey REPORT 39 LOUISE LANE LAKE GEORGE NY 12845 Dear MARY SICARD Please find the attached Pre-Demolition Asbestos Building Survey Report completed for the Property Located at: 39 LOUISE LANE LAKE GEORGE NY 12845 If you have any questions or require additional information, please feel free to contact: Mike Stevens @ 518-656-3270 Sincerely, Michael J. Stevens . J PRE-DEMOLITION ASBESTOS SURVEY 39 LOUISE LANE LAKE GEORGE NY 12845 Background Information: Buildings) Location: 39 LOUISE LANE LAKE GEORGE NY 12845 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 r Pre-Demolition Asbestos Building Survey 39 LOUISE LANE LAKE GEORGE NY 12845 OCTOBER 19 2020 LABORATORY RESULTS AmeriSci Now York AmEmscl 117 EAST30TH ST. NEW YORK,NY 10016 TEL:(212)679-8600"FAX(212)679.3114 PLIV'i Bulk Asbestos RepQrt Michael I Stevens Datea�a~elV�d Ali 00"t"Job# 220083666 Attn: Michael Stevens Dateviihonsid 1°814SI.20 P.O.°# PO Box 2202 ELAP:f0` _; r,_ 48q::,::;.. 1 Of 4 .: -_i-...... _.....' RE: 39 L06 39 ,D�JI:S LANE NY :Glens Falls, W 12801 Client No.!HGA Lab No. Asbestos Present Total %®Asbestos IA 220083666-01 No NAD i Location: Living Room Ceiling-Joint Compound (by NYS ELAP 198.1) by Bo Sun on 08/28/20 Analyst Description:White, Homogeneous,Non-Fibrous,Bulk Material Asbestos's Types: Other Material: Non fibrous 100% 2A 220083666-02 No NAD Location:.Living Room Walt-Joint Compound (by NYS ELAP 198.1) by So Sun on 08/28/20 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material y Asbestos Types: Other Material: Non-fibrous 100% 3A 220083666-03 NO NAD Location: Living Room Wall-Insulation (by NYS ELAP 198.6), by Bo Sun on 08/28/20 Analyst Description:BlacWYellow,Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 47.8 Comment: Submitted Sample Contained Tar(NOB) 4A f 220`083666-04 NA Location: Bedroom Wall-Compound"Insuilident Material Submitted For Preparation" Analyst Description:Bulk Material Asbestos Types: Other Material: See Reporting notes on last page --,,,AmeriSd Job#: 220083668 Page 2 of 4 Client Name: Michael J.Stevens PLM::.ltck.Asbq ►; Report �39 LOUISE. 9 LQUIS:-LAN;E-, NY C1194 No./HGA Lab No. A$bes#os P 0t TO- MI%Asbestos 5A 220083666-05 No ---- - NAD Location: Bathroom Floor-vinyl Flooring (by NYS FLAP 198.6) by Bo-Sun on 08ner20 Analyst Description:Grey,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material:.Nan fibrous 1.6% 6A 220083666-06 NA Location: Bedroom 2 Wail-Compound-insultident Material Submitted For Preparatbn" Analyst Descripdon:Bulk Material Asbestos Types: Other Material: - 7A '�' 220083666-07 No:. -- _._.. NAD . "" Location:-Kitchen Floor-Grout (t y NYS Et AP 198.1)• on 0812M Analyst Description:Grey,Homogeneous,Non-Fibrous,Cementifious,Bulk Material Asbestos Types: Other Material: Non-fibrous 100% 8A 2266666-08 No NAD Location: Foundation-Cement . (by NY$ELAP 198.1) by So Sun on 08/28/20 Analyst Description:Grey,Homogeneous,Non-Fibrous,Cementi0ous,Bulk Material Asbestos Types: Other Material: Non-fibrous 100% 9B _ 220083666-09 1VA Location: Living RoorrtWall-Compound"Insufficient Material Submitted For Preparation" K� Analyst Description:Bulk Material Asbestos Types: Other Material: See Reporting notes on last page Job A 220083008 Client Name: Michael J.Stevens Page 3 of 4 ksbes off.deport �3-0 L 0.1 E. 39 LOUIS NAIVE--, NY Client No. I HGA Lab No. Asbestos Present Total%Asbestos 10B 220083666-10 No NAD Location:°Kitchen Wall-Compound (by NYS FLAP 198.6) by So Sun on Anal*DescrFption:BlaoldBrown,Heterogeneous,Fibrous,Bulk Material 08l2Q/20 Asbestos Types: Other Material: Non-fibrous 16 rb Comment: Submitted Sample Appears To Be Tar Paper(NOB) 220083666-11 IVo N1 Location: Bath 2 Floor-Vinyl Flooring (by NYS FLAP 198.6) by.00 Sun .. on 08/Z81Z0 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Matertai: Non-fibrous 1.1 % h 12B 220063666-12 No NAD Lacatton: Bedroom 1 Calling-Compound (by NYS ELAP by So Sun on 08128(20 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Naterial: Non-fibrous 100% - .. �r wYr�Y 13B 220083666-13 No NM Location: Bedroom 2 Calling-Compound (by NYS ELAP 198.1) by Bo Sun an 08/28/20 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material!: Non-fibrous 100% ,. 148 . 290083666-14 No NAD Location: North Side Roof-Asphalt Shingle (by NYS FLAP 198.6)„ by So Sun on 0s128120 Analyst Description:Slack,Homogeneous,Non-Fibrous.Bulk Material Asbestos Types: - other Material: Non fibrous 28.7% See Reporting notes on last page - AmeriSci Job* 220083666 Page 4 of 4 Client Name: Michael J.Stevens ELM::.-U14 k Q port m LOUISE- 39 LOU`IS LADE.,, NY Client No.I HGA Lab No. Asbestos Present Total %Asbestos 15B 220083666-15 No NAD Location: Porch Roof-Asphalt Roofing (by NYS ELAP 198.6) by Bo Sun on 08/28/20 Analyst Description: Black,Homogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 39.2% Reporting Notes: (1) This PLM job was using_ p'hot Pot Scope S/N 954314 Analyzed by:Bo Sun 'NADINSD=no asbestos de ed;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 NOS samples or EPA 400 pt ct by EPA 600-M4-82-020(NY FLAP Lab 11480);Note:PLM is not consistently reliable in detecting asbestos In floor coverings and similar non4dable 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 59,146,38970,8/1/94)National Institute of Standards and Technology Accreditation requirements mandate that this report must not be reproduced except in full without the approval of the Iab.This PLM report relates ONLY tot items tested.AIHA-LAP,LLC Lab ID 102843,RI Cart AAL-W,CT Cart:PH-0186,Mass Cart AA000054. c Reviewed By END OF REPORT AmedScl Now York 117 EAST 30TH ST. AdERI SCI NEW YORK,NY 10016 TEL:(212)679-BSW•FAX(212)879.3114 PLM bulk Asbestos Report T , Nilftei 3. swam Date SmWed j- . AW041400 220OM66 ABM: Michael Stevem Daft-E amiftV 10/18/20 P.O. PO BoxZ2Q2 9t,AP; 9 of 4 39`ibulls UWE NY .Glens Fails, NY 1280i. Ci!"t nd HGA Lab No. Asbestos Present Total%Asbestos 220083666-01 No NAD Location: Living Room Ceiling-Joint Compound (by NYS FLAP 198.1) by Bo Sun on 081 e= AnaVd Descrtpilon:Write,Homogeneous,Non-Fibrous,Bulk Material Asbestos 7 : ..Gtltier Material:Non-fibrous 100% - 17B =0083666.02 No NAD . Loaaftm•Living Room Well-Joint Compound (by NYS SLAP 198.1) by Bo Sun on 08V28J20 AnoWd Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Oilier Material: Nan-fibrous 100% 11 8B. 220Q8366643 No NAD Locadon:'Living Room Wall-lnsutadon (by NYS SLAP 198.6), by Bo sun on 081=0 Analyet Description:Bla*Yellow,Heterogeneous,Non-Fibrous,Buk Material Asbeataa 7�s: Other Matorkh Non-fibrous 47.8 4!i . •• Comment: submitted Sample Contained Tar(NOS) 22Q�83666-04 NA Location: Bedroom Well-Compound"insufficient Materiel Submitted For PreperafloM Analyst Description:Bulk Material . _ _ AebestQs 7yitea: Other Materlet: See Reporting notes on lest page :"_'_"„ Amerl8d,fob#: 22MUOS Client N6me: MICM91 J.Stevens Page 2 of 4 .-PLU-Sulk A as Report 39L.OU SE. 340 LOUIS LANE' NY Client No.I.M" Lab No. Albasioe Pmea fB 220083666-05 . AbWAD r Lmilon: Bethwom Flow-Vinyl Fiawng Mr Nye MAP'WA). by So Sun 01r'08/28i20 Ant1l*UaNWO*n:Grey,Homogeneous,Non-Fibrous,Bulk MatedsI Aabe33o3 TM m: Other Mstertal:.Note fibrous 1.6% 21B 22008366646 NA LOCaftn: t3edreom 2 Wall•Compound-Insuf dant mat um 9ubrrdrod For Preparation" Am"Description:Bulk MaWftl Asbe3tQ3 Tmgm: �iwt Mstertal: 228 -•r 220083666-07 NO ~M- NAD Locations•Mogen FtOor-erw ft fiii 9LAP 100.1). • 6y_BoSurt Anatlyst Dam0ption:Grey,Homogeneous,NonAbrM,C:ementltious,Bulk Material on 08J200 Asbestos Types: Other Material:Non abws 100% i23B 22666466-08 No NAD Location: Foundation-Cement : (by NYS ELAP 188.1) by Ba Sun an 08128/20 Anatilst Description:Grey,Homogeneous,Non-Fibrous,Cementifious,Bulk Materiel �Types• .. Other Material: Non-fibrous 100% 24B 22008366"9 ' ' 14A Lc=i6n: LIvMg Rod n.'" air-ompGound'Insualcient Matetlat 3ubn*tad For preparation" Anal"t DQsa0dan:Bulk MatwW A$bestaa Typos: Other Matarhd: See Reporting notes an last page .;�MOW Job#• 22008MIS POP 3 of 4 CUent Name: Michael J.91eans .p ` l e as Report NY V' 4N 2..• r Client ado.!HGA Lab No. Asbsstos Present Tolal%Asbestos 2`5:B 220083666-10 No NAD L0Ml0n::Kitctren Well-Compound (by NYS FLAP 198.8) by Bo Sun on MOM Ana"Descrlpdm:BIacWBIOM,Heterogeneous,Fibrous,Bulk Material Asbestos Types: Ogrir Material: Non-fibrous 16% Comment; Submitted Semple Appears To Be Tar Paper,(NOS) Zf B 220083666-11 No. NAD Location: math 2 Rioor-Vinyl Fiooring (by NYS ELAN 198.6) by so sari on 08/Z8/x0 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbestos Types: Me Materiai: Non4bous 1.1% r 27B 2200SUM12 No NAD Uwallon: Bedroom 1 Calling-Compound (by NYS FLAP 198.1); by Bo Sun •on 08128/20 Analyst Description:White,Homogeneous,Non-Fibrous,Bulk Material Asbs>atw Types: Cthar Materiel: Non-fibrous 100% " 28B 220083666-13 No NAD Location:'Bedroom 2 CeHing-Wmpound (by NYS FLAP 198.1) by 180 Sun on 08/28120 Analyst Description:White,Homogeneous,Non-Fibmus.Bulk Materiel Asbe=tvs Types• 0111wMateriak Non fibrous 100IDA 29B 220003666.14 No MAD Location: North Side Roof-Asphaft Shingle (by NYS FLAP 188,6)•• by Bo Sun Analyst Descaiptlon:Black,Homogeneous,Non-Fibrous,Bulk Material on 08128120 na ; Asbestos Types: .. -- • outer Matedd: Nonfibrous 28.7 Sera Reporting notes an test page AfieriScl Job#: =0083666 Client Name: Michael J.Stevens Page 4 of 4 : Ist ► R.Aport 39 4 5 39Louis Mgt, NY Client No. /HGA Lab No. Asbestos Present Total %Asbestos 220083666-15 No NAD Location: Porch Roof-Asphalt Roofing (by NYS ELAP 198.6) by So Sun Analyst Qescription:Black,Homogeneous,Non-Fibrous,Bulk Material on 08/28/20 Asbestos Types: Other Material: Non-fibrous 39.2% Reporting Notes: (1) This PLM job was Pot Scope SIN 954314 Analyzed by:So Sun •NACf/NSO=no asbestos d d;NA=not analyzed;NAPS--not dnalyzed/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 200646-0),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-M4-82-024(NY ELAP Lab 11480);Note:PLM Is not consistently reliable in detecting asbestos to floor coverings and similar nondriable 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 asbastos-containing In NY State(also see EPA Advisory for floor tile,FR 59,148,38970.8/1/94)National Institute of Standards and Technology Accreditation requirements mandate that this report must not be reproduced except in full without the approval of the iab.This PLM reort relates ONLY to items tested.AIHA-LAP,LLC Lab 10102843,RI Cart AAL-094,CT Cart PH-0188,Mass Cart AA000064. c Reviewed By. NO OF REPORT err [ t cFill • / - NOWME MEN e. lit W—i iii���ii Poll Vol Of a.x + o, s >' r •J V f t �• III 1 �� �,, �• t ' :'a r / � �� r w,w,`:•. � �_.,,r._ � _ • fit' . 3.•- _ ,.,.-.•_r. JL 1 00 jf 00.8 1 j 1 ` • , 1 t Mir &A" - r rr r tJ5 r t �F� MUTT, ' t a will !'�j � rej Pill ( fIrt,r. NOR� Ar ieriSci Job M. 220083666 Page 2 of 2 Client Name: Michael J.Stevens Table i Arabs Results 39 LO'UISE 339 L.©'TIS LANE}, NY 7 s .:lid: Insoluble erlSci HG• Wblght Sentiltive Soluble Non-Asbestos **Asbestos%by *•Asbestos%by mple a GIieM Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS TEM , 4 • d yzed by:Gabriella Morozov ;Date Analyzed a/29/2020 M 49-ck l�91�— )omn UtaUve Analysis(Semi/Fu ;Bulk Asbestos Analysis by Appd E to Subpt E,40 CFR 763 or NYSDOH ELAP 198.1 for New York friable samples or NYSDOH FLAP 198.E for New York NOB pies;TEM(Semi/Full)by EPA 6dd/R 93/116(or NYWOH ELAP 198.4;for New York samplesr NAD=no asbestos detected during a quantitative analysis;NA=not analyzed;trace=<1%;(SOF-V)_ S On Fireproofing containing Vermiculite;(SM-V)=Surfacing Material containing Vermiculite;Quantitallon for beginning weights of<0.1 grams should be considered as qualitative only;Qualitative Ar ysis: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 foi qualitative analysesr NVLAP(PLM)200546-0,NYSDOH ELAP Lab 11480.AIHA4 AP,LLC(PLM)Lab ID 102843. W 3ming 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 n -uniformly dispersed debris for which PLM 93igivation is recomme (i.e.soils and other heterogenous materials). Reviewed By eriSci Job P. 220083666 Page 1 of 2 Client Name: Michael J.Stevens _ Table I ,w S�rr rraily rot Bt fk best6a Ain..blysls Results 39 LOUISE 39 LOU.IS LANE,1, N :Sasltpie tie8t Abld, Insoluble ' AmerlSci HG tNeigtit Sensitive soluble Non Asbestos '*Asbestos%by Asbestos%by Sample# Client Sample# Area. (gram) Organic% Inorganic W, Inorganic% PL AIDS TEM 01 1A -- -- — NAD NA Location: Living Room Ceiling-Joint Compound 02 2A -- --- ---- -- NAD NA Location: living Room Wall-Joint Compound 03 3A 0244. 49.4 2.7 47.8 NAD NAD Location: Living Room Wall-Insulation 04 4A -- -- — — NA NA Location: Bedroom Walt-Compound"Insufficient Material Submitted For Preparation" 05 5A 0.229 49.6 49.5 1.6 NAD NAD Location: Bathroom Floor-Vinyl Flooring 06 6A --- -- --- — NA NA Location: Bedroom 2 Wall-Compound"insufficient Material Submitted For Preparation" 07 7A — _ — NAD NA Location: Kitchen Floor-Grout 08 8A -- — --- NAD NA Location: Foundation-Cement 09 9B -- --. —. -- NA NA Location: Living Room Wall-Compound"insufficient Material Submitted For Preparation" 10 10B 0.147 76.5 7.6 16.0 NAD NAD Location: Kitchen Wait-Compound 11 118 0.175 48.9 50.0 1.1 NAD NAD Location: Bath 2 Floor-Vinyl Flooring 12 128 --- -- -- — NAD NA Location: Bedroom 1 Ceiling-Compound 13 138 -- ---- --- --- NAD NA Lmtion: Bedroom 2 Ceiling-Compound 14 14B 0.508 54.3 17.0 28.7 NAD NAD Location: North Side Roof-Asphalt Shingle 15 15B 0.343 48.3 12.6 39.2 NAD NAD Location: Porch Roof-Asphalt Roofing So Reporting notes on last page fr N N.•j'Y tiI rr c 4V wK,..• ...,w Y'YH YLR r K N= -`+1 R`�L ].1tA )FOi .d r 6• rx A#.Nr ♦ f•.•h N'YT� IYRrY♦twl ilY----- YVY.YL L-• yl ty RKiP1 YMi V1f 1{x'11 1/'yrriµ R•'wFi 114•K YY %R Y k.]Y fly j•1 M<}N V" "• �• - � '+` wwr rwrnN uA'.Wn( �Y •H Y.+{YK'N irJi•YNM�t !rw'7F, <{r fAyYr} >♦}IVL YYa Yr r ),•Yw l/f rY% Y'r ;<-aY ar'w n r / V.q w 1Na:Nrf)v•itW rrHY.r%.Y µµriff►♦l ltH Lila • �•a yyTT..Y•YM!•:.x r sl r YrYM a/;'VLH r4 Y.w V JR -L'a rMN { NTIV/r RRIM'•Irirxf wr Yµ AN NSik YLLW1Il�r Mi♦1%�}JIIL' ` Ar}i1Rlr YR YR Ywr +r>•/ rV 1•xw/K rY♦ +• }... 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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 OCTOBER 10 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 39 LOUISE LANE LAKE GEORGE NY 12845 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 UPDATED NOTES OCTOBER 18 20 20 STRUCTURE IS A SINGLE STORY BUILDING ROOF METAL AND ASPHALT SHINGLE WITH NO UNDERLAYMENT WINDOWS ARE VINYL REPLACEMENT NO CHALKING MAN DOORS ARE WOOD NO GLAZING FOR THE GLASS INSULATION IS BARE FIBERGLASS NO VAPER BARRIER HEAT IS ELECTRIC NO WRAPPED DUCTWORK AGE OF STRUCTURE POSTED AT 1950 ALL DRAIN AND WATER PIPES ARE PLASTIC OR COPPER NO FOUNDATION OR BASEMENT SIDING IS WOOD WITH NO UNDERLAYMENT WINDOWS ARE ALUMINUM •i?, '•.�'L t.:^,r"rf.;4rr: i.l.. 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