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DEMO-0168-2023 `•a i . 71. Office Use Only j DEMOLITION APPLICATION Permit#: p— O 1 (Qb•2o23 Permit Fee:$ l 1QD- Tavn of Queensbury Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.aueensbury.net Flood Zone? Y Reviewed B Demolition Location: It Tax Map ID **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS" DEMOLITION INFORMATION:1. Where will demolition material be disposed? V,)oske Mcancicue meA . �lr-vASV00c�- 2. Type of structure to be demolished: a. Residence ✓ d. Storage Building vl b. Garage e. Other: c. Business 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 ✓ i. None e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes ✓ No ADDITIONAL INFORMATION: 1. Two inspections are required: an inspection to determine that utilities are disconnected, 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. I have read and agree to the above: PRINT NAME: ' hn \_S SIGNATURE: DATE: Demolition Application Revised June 2022 i CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: r1 Name(s): e ^; c s rtu Lk\�c- 0-C Zo 'SA �S Mailing Address, C/S/Z: �A(o Ko�\c\ c'. ccLce C-ieriqe Cell Phone: .15a8- 5,99-1QQA Land Line: /A Email: 'Cr, ccyyn • Primary Owner(s): Name(s): c\oA S-k(,cetx W6c&-A Mailing Address, C/S/Z: 103 11i ox?\ar) c\ C cyccge\ NC au 51r0 Cell Phone: Sit CW Cffl- qMG Land Line: Email: SA(xcnu. w6 0 ca�nca�\ cc�W`n 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): --)oi-\n he 5�\. Gir(," Ct�s e,,�� I�yrvv� 1 ki�\�3c s Contractor Trade: Gle(\C-EQ� Cc'o-�Vo4c�'c Mailing Address, C/S/Z: _1i(� ci \crccxce . \Q9VA5 Cell Phone: 51%s- S. A-`1C�G�`l Land Line: Email: -cf. Ccm **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: 5-�cyy\') S Cell Phone: 1,5\9'S- 50,-`100A Land Line: Email: e '<nu coy o c r , corn Demolition Application Revised June 2022 j l L5 2 C E O V Blackberry Lane CLE ARVU n cle ry, 12804 learvuins ections.com INSPECTIONS APR 172023 ; 8.832.9213 TOWN OFOUEENSBURY BILE ���� BUDDING & CODES Pre-Demolition Asbestos Survey TOWN OF QUEENSBURY BUILDIN CODES DEPT. r..; Da r i f• t I e - o � gW rD � � 3 cn �' o% in I:A In PROJECT NUMBER PREPARED FOR m rn 10181 Stacey Wright N 3 O Surveyed Buildings: 11 Sperry Road 90 0 Garage, Northwest Shed, Northeast Queensbury, NY 12804 6 0cri Shed,Southeast Shed, House 0 00 PREPARED BY ! iI SITE LOCATION Ryan Wild N 11 Sperry Road 18 Blackberry Lane W Queensbury, New York 12804 TOWN OF QgSlgR6lgM, New York 12804 BUILDING DEPARTMENT Based on our limited examination,compliance with our comments shall not be construed as indicating the plans and specifications are in full compliance with the Building Codes of New York State. Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Executive Summary Asbestos-Containing Material Field Survey Single Family Dwelling with(4)Outbuildings Recently renovated home with marjor structural issues.Older sheds&garages on site. 11 Sperry Road ,Queensbury, New York, 12804 I. SUMMARY OF FINDINGS On November 25,2022,an asbestos-containing material (ACM)field survey was conducted at 11 Sperry Road located in Queensbury, New York(Site).The site was inspected to determine the presence of ACM in preparation for demolition.The ACM survey was performed at the request of Stacey Wright. 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 30 samples were collected from 10 suspect homogenous materials. Summary Table of Asbestos-Containing Materials Sample ID Space Name Numerical Result Material Category, Friability No Asbestos Detected. ***Electrical was on during the survey and electrical insulation was not sampled*** Following the introduction,a table of ACM grouped by homogeneous areas is included in Appendix A of this report.A table presenting those materials sampled which did not contain asbestos can be found in Appendix B of this report.A complete listing of all suspect materials sampled is provided in Appendix C of this report.A photographic log is provided in Appendix D of this report.The original chain of custody&laboratory analytical reports are located in Appendix F of this report. Page 2 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Stacey Wright to conduct a pre-demolition 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 building,which may be disturbed during renovation/demolition/rehabilitation activities.Samples were collected of suspect accessible asbestos-containing building materials.Should any materials be encountered that are not identified in this report,they should be assumed asbestos containing until a representative number of samples are collected to document these materials as non-asbestos containing. LIMITATIONS&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 Containing 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.Buildings where power is connected, electrical wire sheathing could not and was not sampled. SAMPLING METHODOLOGY During the visual inspection process,an inventory of suspect materials similar in appearance and composition was created and grouped into homogeneous sampling areas.A homogeneous area is defined as a surfacing,thermal or miscellaneous material that is uniform in texture, age,and appearance.A representative bulk sampling plan was created in accordance with current USEPA(United States Environmental Protection Agency) requirements and guidelines. Bulk samples 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 metal,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 Number 198.1 (Polarized Light Microscopy Methods for Identifying and Quantitating Asbestos in Bulk Samples).The estimated phase abundances are provided in weight percent and are accurate to within 10 to 15 percent of the amount reported.These methods are sensitive to the detection of asbestos to less than one percent. Page 3 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 All non-friable organically bound(vinyl flooring,caulking,etc.) bulk samples were analyzed by New York State Department 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 Reduction 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 reliable 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 considered asbestos containing if it contains more than 1%asbestos. NYSDOL and USEPA regulations define asbestos containing material as containing greater than one percent(1%). Materials 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,OSHXs 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. Eurofins 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 accessible 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 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 4 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Appendix A: ACM Homogenous Area Table Material Id I Material I Space Name .Section Name I Friability I Current Condition I Result I Quantity There are no homogenous materials for this project that are assumed or have tested positive containing asbestos Page 5 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Appendix B: Tested Negative Homogenous Material Table 'Material _ Material Material Space Section Result Category Id Name Name Miscellaneous 001 001-Vinyl Flooring Foyer House Tested Negative by Lab (No Asbestos Detected) Miscellaneous 002 002-Gypsum Wallboard System Kitchen House Tested Negative by Lab (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) Miscellaneous 003 003-Ceiling Tile,Lay In Kitchen House Tested Negative by Lab (No Asbestos Detected) Miscellaneous 003 003-Ceiling Tile,Lay In Living House Tested Negative by Lab Room (No Asbestos Detected) Miscellaneous 004 004-Ceramic Tile with Grout Bathroom House Tested Negative by Lab (No Asbestos Detected) Miscellaneous 005 005-Caulk,Window Exterior House Tested Negative by Lab (No Asbestos Detected) Miscellaneous 006 006-Masonry Block(CMU) Exterior House Tested Negative by Lab (No Asbestos Detected) Miscellaneous 007 007-Masonry Block Mortar Exterior House Tested Negative by Lab (No Asbestos Detected) Miscellaneous 008 008-Masonry Block(CMU) Garage Garage Tested Negative by Lab (No Asbestos Detected) Miscellaneous 009 009-Masonry Block Mortar Garage Garage Tested Negative by Lab (No Asbestos Detected) Miscellaneous 010 010-Roofing,Composite Shingle roof Northwest Tested Negative by Lab Shed (No Asbestos Detected) Page 6 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Appendix C: All Suspect Materials Sampled Sample ID Space Section Material Analytical Regulatory Result Name Name Result 001A Foyer House Multi-layer Parent Material 001A- Foyer House 001-Vinyl Flooring 0% Tested Negative by Lab Flooring (No Asbestos Detected) 001A-Mastic Foyer House 001-Vinyl Flooring 0% Tested Negative by Lab (No Asbestos Detected) 001B Foyer House Multi-layer Parent Material 001E- Foyer House 001-Vinyl Flooring 0% Tested Negative by Lab Flooring (No Asbestos Detected) 001B-Mastic Foyer House 001-Vinyl Flooring 0% Tested Negative by Lab (No Asbestos Detected) 002A Kitchen House Multi-layer Parent Material 002A- Kitchen House 002-Gypsum Wallboard System 0% Tested Negative by Lab Compound (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) 002A-Tape Kitchen House 002-Gypsum Wallboard System 0% Tested Negative by Lab (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) 002A- Kitchen House 002-Gypsum Wallboard System 0% Tested Negative by Lab Wallboard (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) 002E Kitchen House Multi-layer Parent Material 002E- Kitchen House 002-Gypsum Wallboard System 0% Tested Negative by Lab Compound (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) 002E-Tape Kitchen House 002-Gypsum Wallboard System 0% Tested Negative by Lab (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) 002B- Kitchen House 002-Gypsum Wallboard System 0% Tested Negative by Lab Wallboard (Wallboard,Joint Tape,and Joint (No Asbestos Detected) Compound) 003A Living House 003-Ceiling Tile,Lay In 0% Tested Negative by Lab Room (No Asbestos Detected) 003B Kitchen House 003-Ceiling Tile,Lay In 0% Tested Negative by Lab (No Asbestos Detected) 004A Bathroom House Multi-layer Parent Material 004A-Grout Bathroom House 004-Ceramic Tile with Grout 0% Tested Negative by Lab (No Asbestos Detected) 004A-Mastic Bathroom House 004-Ceramic Tile with Grout 0% Tested Negative by Lab (No Asbestos Detected) 004A-Tile Bathroom House 004-Ceramic Tile with Grout 0% Tested Negative by Lab (No Asbestos Detected) 004E Bathroom House Multi-layer Parent Material 004B-Grout Bathroom House 004-Ceramic Tile with Grout 0% Tested Negative by Lab (No Asbestos Detected) 004B-Mastic Bathroom House 004-Ceramic Tile with Grout 0% Tested Negative by Lab (No Asbestos Detected) 004B-Tile Bathroom House 004-Ceramic Tile with Grout 0% Tested Negative by Lab (No Asbestos Detected) Page 7 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Sample ID Space Section Material Analytical Regulatory Result Name Name Result 005A Exterior House 005-Caulk,Window 0% Tested Negative by Lab (No Asbestos Detected) 005B Exterior House 005-Caulk,Window 0% Tested Negative by Lab (No Asbestos Detected) 006A Exterior House 006-Masonry Block(CMU) 0% Tested Negative by Lab (No Asbestos Detected) 006B Exterior House 006-Masonry Block(CMU) 0% Tested Negative by.Lab (No Asbestos Detected) 007A Exterior House 007-Masonry Block Mortar 0% Tested Negative by Lab (No Asbestos Detected) 007B Exterior House 007-Masonry Block Mortar 0% Tested Negative by Lab (No Asbestos Detected) 008A Garage Garage 008-Masonry Block(CMU) 0% Tested Negative by Lab (No Asbestos Detected) 008B Garage Garage 008-Masonry Block(CMU) 0% Tested Negative by Lab (No Asbestos Detected) 009A Garage Garage 009-Masonry Block Mortar 0% Tested Negative by Lab (No Asbestos Detected) 009E Garage Garage 009-Masonry Block Mortar 0% Tested Negative by Lab (No Asbestos Detected) 010A roof Northwest 010-Roofing,Composite Shingle 0% Tested Negative by Lab Shed (No Asbestos Detected) 010B roof Northwest 010-Roofing,Composite Shingle 0% Tested Negative by Lab Shed (No Asbestos Detected) Page 8 of 12 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Appendix • • Log All Location Photos J � � 11I' l HOUSE f' c NORTHWEST SHED �J GARAGE Page 9 of 11 rn Stacey Wright,11 Sperry Road,Queensbury,New York,12804 NORTHEAST SHED ��pp n� •� '€+��s,a� � 7 f SOUTHWEST SHED Page , 10 of 11 Stacey Wright,11 Sperry Road,Queensbury,New York,12804 Appendix E: Chain of Custody&Laboratory Report Page 11 of 11 �'��" o II 1 I l II II IIIII I II I IIlI 111!I I III • CtEaRVU BT8 E M U 11StitiitSS• Chain of Custody _v - tJi.+.` °d`k•:.':Ati;A?° .,t!t.. :.iv SLtC'.f".v.' .... ^v',:;i�-�v ClearVU Inspections Project: 10181 18 Blackberry Lane Queensbtuy,New York 12804 Site Location: 11 Sperry 11 Sperry Road Queensbury,New York 12804 EUROFINS CEI9 c5u%.i Sampled By:Ryan Wild(ryan@clearvuinspections.com) SAMPLES ACCEPTED Reporting By:Ryan Wild(ryan@clearvuinspecbons.com) W Purpose:Pre-Demolition Laboratory Notes Turn Around Time Request - - 'k�'.l.."if�.'�ES%5`• J:... ^5".•^:;'1` ..?4 , ... ',.;3:::'1: - _ - . ..G'ti.�. ..x,c Sri" ..:\S.Vk:!:.+•'X!:R�.. �iatSti:Cr:::. aY: i Stop after first positive for each HM 3 Day Samples Iva Sample Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 001A 001 -Vinyl Flooring House Foyer 198.4 PLM&TEM where applicable NY ELAP 198.1 & 00113 001 -Vinyl Flooring House Foyer 198.4 PLM&TEM where applicable 002-Gypsum Wallboard System(Wallboard, NY ELAP 198.1 & 002A Joint Tape,and Joint Compound) House Kitchen 198.4 PLM&TEM where applicable 002-Gypsum Wallboard System(Wallboard, NY ELAP 198.1 & 002B Joint Tape,and Joint Compound) House Kitchen 198.4 PLM&TEM where applicable NY ELAP 198.1 & 003A 003-Ceiling Tile,Lay In House Living Room 198.4 PLM&TEM where applicable ClearVU Inspections-Chain of Custody For Stacey Wright 11 Sperry-10181 1 of 3 Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 003B 003-Ceiling Tile,Lay In House Kitchen 198.4 PLM&TEM where applicable NY ELAP 198.1 & 004A 004-Ceramic Tile with Grout House Bathroom 198.4 PLM&TEM where applicable NY ELAP 198.1 & 004B 004-Ceramic Tile with Grout House Bathroom 198.4 PLM&TEM where applicable NY ELAP 198.1 & 005A 005-Caulk,Window House Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 005B 005-Caulk,Window House Exterior 198.4 PLM&TEM A0where applicable NYELAP 198.1 & 006A 006-Masonry Block(CMU) House Exterior 198.4 PLM&TEM where applicable NYELAP 198.1 & 006B 006-Masonry Block(CMU) House Exterior 198A PLM&TEM where applicable NYELAP 198.1 & 007A 007-Masonry Block Mortar House Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 007B 007-Masonry Block Mortar House Exterior 198A PLM&TEM where applicable NY ELAP 198.1 & 008A 008-Masonry Block(CMU) Garage Garage 198.4 PLM&TEM where applicable NY ELAP 198.1 & 008B 008-Masonry Block(CMU) Garage Garage 198A PLM&TEM where applicable NYELAP 198.1 & 009A 009-Masonry Block Mortar Garage Garage 198.4 PLM&TEM where applicable CiearVU Inspections-Chain of Custody For Stacey Wright 11 Sperry-10181 2 of 3 Sample ID Material Floor I Section Space Analysis NYELAP 198.1 & 009B 009-Masonry Block Mortar Garage Garage 198A PLM&TEM where applicable NYELAP 198.1 & 010A 010-Roofing,Composite Shingle Northwest Shed roof 198.4 PLM&TEM where applicable NYELAP 198.1 & 010B 010-Roofing,Composite Shingle Northwest Shed roof 198.4 PLM&TEM where applicable U —<7 11.25.22 15:00 Sampled By Date Time CS .:()D Received By Date Time Received By Date Time Received By Date Time �±Cr 11.25.22 17:30 Relinquished By Date lime Relinquished By Date Time Relinquished By Date Time Analysis By Date Time CIearVU Inspections-Chain of Custody For Stacey Wright 11 Sperry-10181 3of3 eurofins S' CEI December 2, 2022 ClearVU Inspections 18 Blackberry Lane Queensbury, NY 12804 CLIENT PROJECT: 10181 LAB CODE: N220339 Dear Customer: Enclosed are asbestos analysis results for Asbestos Bulk samples received at our laboratory on November 28, 2022. The samples were analyzed for asbestos using polarizing light microscopy (PLM) and / or transmission electron microscopy (TEM) by New York State ELAP approved methods. Sample results containing >1% asbestos are considered asbestos-containing materials (ACMs) per EPA regulatory requirements. The detection limit varies with the method chosen for the analysis. Eurofins CEI is accredited by the New York State Department of Health (NYSDOH) Environmental Laboratory Approval Program (ELAP), certificate#12048. Kind Regards, Tianbao Bai, Ph.D., CIH Laboratory Director NV(A TESTING --NVLAP LAB CODE-101768-0------- 730 SE Maynard Road - Cary, NC 27511 - 919.481.1413 aeurofins I CEI ASBESTOS ANALYTICAL REPORT By: New York State ELAP Method Prepared for ClearVU Inspections CLIENT PROJECT: 10181 LAB CODE: N220339 TEST METHOD: NYS ELAP METHODS 198.1, 198.4 REPORT DATE: 12/02/22 TOTAL LAYERS ANALYZED: 30 # LAYERS >1% ASBESTOS: 0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Asbestos Report Summary �•� e u rof i n s By: NEW YORK STATE METHOD C CEI PROJECT: 10181 LAB CODE: N220339 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Lab ID Color Sample Description Total Asbestos% 001A N5538A Beige Vinyl Flooring No Asbestos Detected by 198.4 ------------------- -------------------------- - - - ----------------- N5538B Yellow Mastic No Asbestos Detected by 198.4 001B N5539A Beige Vinyl Flooring No Asbestos Detected by 198.4 ------------------------------------- ---- --- - - ------ ------- --- N5539B Yellow Mastic No Asbestos Detected by 198.4 002A N5540A White Joint Compound No Asbestos Detected.0% ---- ------------------------------P-------- - - - ------------------ N5540B White Joint Tape No Asbestos Detected.0% N5540C White Gypsum Wallboard No Asbestos Detected.0% 002E N5541A White Joint Compound No Asbestos Detected.0% ----------------------------------P----------- ------------ ------ N5541 B White Joint Tape No Asbestos Detected.0% ----- - - ----- ----------------- -- --- --------- - - ---- -- ------ ----- N5541 C White Gypsum Wallboard No Asbestos Detected.0% 003A N5542 Beige,White Ceiling Tile No Asbestos Detected by 198.4 003B N5543 Beige,White Ceiling Tile No Asbestos Detected by 198.4 004A N5544A White Ceramic Tile No Asbestos Detected.0% - ------------ ----------------------- --- ------ - - ----------------- N5544B White Grout No Asbestos Detected.0% -- --- -- --------------------------- ------------ - ------------------ N5544C White Mastic No Asbestos Detected by 198.4 004B N5545A White Ceramic Tile No Asbestos Detected.0% ----------------------- --------------------- - - ------ ---------- - N5545B White Grout No Asbestos Detected.0% -- ------------------------------------------ - - - ------------------ N5545C White Mastic No Asbestos Detected by 198.4 Page 1 of 2 Asbestos Report Summary ®� e u rof i n s ' By: NEW YORK STATE METHOD 1 CE! PROJECT: 10181 LAB CODE: N220339 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Lab ID Color Sample Description Total Asbestos 005A N5546 White Window Caulking No Asbestos Detected by 198.4 005B N5547 White Window Caulking No Asbestos Detected by 198.4 006A N5548 Red,Gray Masonry Block No Asbestos Detected.0% 006B N5549 Red,Gray Masonry Block No Asbestos Detected.0% 007A N5550 Red, Gray Masonry Block Mortar No Asbestos Detected.0% 007B N5551 Red, Gray Masonry Block Mortar No Asbestos Detected.0% 008A N5552 Red,Gray Masonry Block No Asbestos Detected.0% 008B N5553 Red,Gray Masonry Block No Asbestos Detected.0% 009A N5554 Red,Gray Masonry Block Mortar No Asbestos Detected.0% 009B N5555 Red, Gray Masonry Block Mortar No Asbestos Detected.0% 010A N5556 Black,White Shingle No Asbestos Detected by 198.4 010E N5557 Black,White Shingle No Asbestos Detected by 198.4 Page 2 of 2 ASBESTOS BULK ANALYSIS e u rof i n s l By: NEW YORK STATE METHOD ! CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 001A 1 NOB Beige Initial Observations: N5538A Vinyl Flooring Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected N5538B 2 NOB Yellow Initial Observations: Mastic Cellulose <1% Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 001E 1 NOB Beige Initial Observations: N5539A Vinyl Flooring Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 1 of 11 ASBESTOS BULK ANALYSIS lie u rof i n s I By: NEW YORK STATE METHOD i CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color ---- -- -- - ----- - - -- ------ ------------- ----- ----- -- N5539B 2 NOB Yellow Initial Observations: Mastic Cellulose <1% Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 002A 1 Friable White Initial Observations: N5540A Joint Compound Binder 60% Calc Carb 40% Method: Final Results: 198.1 No Asbestos Detect(Tobtal Asbestos: No Asbestos Detected.0% N5540B- 2 Friable White - - Initial Observations: Joint Tape Cellulose 100% Method: Final Results: 198.1 No Asbestos Detect(Tbtal Asbestos: No Asbestos Detected.0% --- - - Friable White - -N5540C 3 Initial Observations: Gypsum Cellulose 15% Gypsum 85% Wallboard Method: Final Results: 198.1 No Asbestos Detect6fttal Asbestos: No Asbestos Detected.0% Page 2 of 11 ASBESTOS BULK ANALYSIS e u rof i n s I By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 002B 1 Friable White Initial Observations: N5541A Joint Compound Binder 60% Calc Carb 40% Method: Final Results: 198.1 No Asbestos Detect(Ebtal Asbestos: No Asbestos Detected.0% N5541 B 2 Friable White Initial Observations Joint Tape Cellulose 100% Method: Final Results: 198.1 No Asbestos Detect(Tibtal Asbestos: No Asbestos Detected.0% -N5541C 3 Friable White Initial Observations: Gypsum Cellulose 15% Gypsum 85% Wallboard Method: Final Results: 198.1 No Asbestos Detect6TcOtal Asbestos: No Asbestos Detected.0% 003A Ceiling Tile NOB Beige, Initial Observations: N5542 White Cellulose 60% Matrix 20% Fiberglass 15% Mineral Wool 5% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 3 of 11 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD I CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 003B Ceiling Tile NOB Beige, Initial Observations: N5543 White Cellulose 60% Matrix 20% Fiberglass 15% Mineral Wool 5% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 004A 1 Friable White Initial Observations: N5544A Ceramic Tile Silicates 70% Binder 30% Method: Final Results: 198.1 No Asbestos Detect(Tcbtal Asbestos: No Asbestos Detected.0% N5544B 2 Friable White Initial Observations: Grout Binder 80% Calc Carb 20% Method: Final Results: 198.1 No Asbestos DetectETibtal Asbestos: No Asbestos Detected.0% Page 4 of 11 ASBESTOS BULK ANALYSIS tiff e u rof i n s I By: NEW YORK STATE METHOD CE0 Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color N5544C 3 NOB White Initial Observations: Mastic Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 004B 1 Friable White Initial Observations: N5545A Ceramic Tile Silicates 70% Binder 30% Method: Final Results: 198.1 No Asbestos DetectETibtal Asbestos: No Asbestos Detected.0% N5545B 2 Friable White Initial Observations: Grout Binder 80% Calc Carb 20% Method: Final Results: 198.1 No Asbestos Detect67obtal Asbestos: No Asbestos Detected.0% -N5545C 3 NOB White Initial Observations: Mastic Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 5 of 11 ASBESTOS BULK ANALYSIS ®� e u r®fins By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 005A Window Caulking NOB White Initial Observations: N5546 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 005B Window Caulking NOB White Initial Observations: N5547 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 006A Masonry Block Friable Red, Gray Initial Observations: N5548 Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos Detectd'(btal Asbestos: No Asbestos Detected.0% Page 6 of 11 ASBESTOS BULK ANALYSIS e u rof i n s l By: NEW YORK STATE METHOD 1 CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Clierit ID Layer Number , Lab ID Lab Description Category Color 006B Masonry Block Friable Red,Gray Initial Observations: N5549 Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos Detectd'ebtal Asbestos: No Asbestos Detected.0% 007A Masonry Block Friable 'Red,Gray Initial Observations: N5550 Mortar Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos DetectETcbtal Asbestos: No Asbestos Detected.0% 007B Masonry Block Friable Red, Gray Initial Observations: N5551 Mortar Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos DetectET(Otal Asbestos: No Asbestos Detected.0% Page 7 of 11 ASBESTOS BULK ANALYSIS e u rof i n s I By: NEW YORK STATE METHOD I CEI Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID ` Layer Number Lab ID Lab Description " Category Color 008A Masonry Block Friable Red,Gray Initial Observations: N5552 Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos Detectd6tal Asbestos: No Asbestos Detected.0% 008B Masonry Block Friable Red,Gray Initial Observations: N5553 Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos Detectd'ibtal Asbestos: No Asbestos Detected.0% 009A Masonry Block Friable Red,Gray Initial Observations: N5554 Mortar Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos DetectET(btal Asbestos: No Asbestos Detected.0% Page 8 of 11 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CE6 Client: ClearVU Inspections Lab Code: N220339 18 Blackberry Lane Date Received: 11-28-22 Queensbury, NY 12804 Date Analyzed: 12-02-22 Date Reported: 12-02-22 Project: 10181 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number- Lab ID Lab Description ',Category Color 009B Masonry Block Friable Red,Gray Initial Observations: N5555 Mortar Silicates 70% Binder 30% Paint <1% Method: Final Results: 198.1 No Asbestos Detect(Tcbtal Asbestos: No Asbestos Detected.0% 010A Shingle NOB Black, Initial Observations: N5556 White Cellulose 55% Matrix 45% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 010B Shingle NOB Black, Initial Observations: N5557 White Cellulose 55% Matrix 45% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 9 of 11 eurof ins ICEI LEGEND Non-Anth = Non-Asbestiform Anthophyllite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate NOB = Non-Friable Organically Bound SM-V = Surfacing Material Containing Vermiculite GLOSSARY OF TERMS Inconclusive- No Asbestos Detected PLM is not consistently reliable in detecting asbestos in floor coverings and other NOB materials. Currently, quantitative TEM must be used to determine if this material can be considered or treated as non-asbestos containing. Inconclusive-CR Conflicting Results: Sample yielded 1% or less asbestos as determined by gravimetric reduction and TEM analysis but had protruding fibers identified as asbestos during preliminary examination -further sampling and analysis needed. Inconclusive-Trace (type of asbestos)detected at 1% or less Asbestos identified at 1% or less by the 198.6 method, and 0 asbestos points out of 400 (or more) nonempty points were counted. Further testing by TEM using NYS 198.4 method is required. Trace asbestos detected at less than 1% For methods 198.1 and 198.8, NYSDOH defines trace as samples where 0 asbestos points out of 400 (or more) nonempty points were counted, but did contain asbestos positively identified by PLM. Trace asbestos detected at less than 1% For method 198.4 NYSDOH defines trace as asbestos detected at 1% or less. REGULATORY LIMIT: > 1% by weight 730 SE Maynard Road • Cary, NC 27511 - 919.481.1413 Page 10 of 11 tiff eur®fins CEI DISCLAIMERS: Reported asbestos content verifiable only as the percentage of asbestos in residue submitted to laboratory. Samples with inconclusive results must not be interpreted as being non-ACM. This report relates only to the samples tested or analyzed and may not be reproduced, except in full, without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. Interpretation of the analytical results is the sole responsibility of the customer. Samples were received in acceptable condition unless otherwise noted. This report may not be used by the client to claim product endorsement by NVLAP, NYSDOH or any other agency of the U.S. Government. Information provided by customer includes customer sample ID, location, volume and area as well as date and time of sampling. ANALYST(S): S4-�'q tee e- 98.1 Partima Poudel AEFarya- 198.4 APPROVED B) Tianbao Bai, Ph.D., Cl Laboratory Director 0 HV(A TESTING -NVLAP--LAB CODE-101768-0----- 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 11 of 11 ` N,ew York State—Department=of.Labor,, x Division of-Safety and Health License and Ceitifcate,Uhiti ,f l� S , State Campus,'Build'ing 12 3 Albany,.NY._12.240 ✓ `.1 ` -a ASBESTOS HANDLING LICENSE-,, f Creative_Spaces II, L-LC dba ClearVU Insk cece tions a 'FILE NUMBER: LICENSE NUMBER_, 282890'f 18-Blackberry Lane LICENSE CLASS: RESTRICTED- DATE OF ISSUE: 01/28/2022 ';y ! ;Queensbu�ry�NY 12804. r $ >� ` ( � EXPIRATION;DATE: 01/39%2023 - ....,!I .l .,:eL„f_�..� — �3�7'°� _ ��._ � ��•�)F 'j~� �a }� }f it �i, D610uthorized,Representative 'Ryan'Wild :icy !• ,� sT: �';".• ";-..., j.-�',}, 1 . '`.�'-µP� ,� Y P3,, This license l as been issued in accoi'dhncelw>th�applicalile=provisions;of_=Article 5#Wthe Labor Law of New York=�Sfa`te and of,, t E .r.' ; - the New York-State:Codes,Rules and Regulations(12 NYCRRPart 56) Itis.§ubject to suspension or revocationifor a(1) � ',l s' '� ytFf f ? ! r t senous violation of state,federal or local laws witliregard-to the conduct of ansasbestos project,or(2)demonstrate'd.lackof y ,, �� �� }i .y, airnro a ? :•—., res onsibili inthe,o d t aft. xs'ffi."t,,' ' l p ty on uc of any job,involving;asbestos or asbes`tos`matenak ._• i'� !�-s, This licehse is'valid only,for thecontractor named:above and='thisrlicense or-a, ',dopy must b6� m nently displayed'at1the asbestos project�w_.orksite This.license verifies thatjall;per�sons�empioyedby the lic�see on an=asbestos:proj6ct in New York State have b'eeifassued an Asbestos Certificat`e;•appiopriate for the,ty�e of work tliey perform,by the`New YokkjState` Department of L'abor. . 1 f ti i ! ✓ ` �,� j' �f/ r'�„`a. �M` }.f✓'/�. `A' 'tfP is Amy Phillips,Director SH 432(8/12) For the Commissioner of Labor STATE OF NEW Ydkk DEPARTMENT OF LABOR; 3 -ASBESTOS'CERWICATE; F„ s Y� RYAWP=INII D ; C.ATEC(05/23)1.,0:-IN5P,,,(05/ H,PM' (05/23)'I PD t'. �.. -CFRTW 21;- -428 DMu#-T736996.18 t MUST BE CARRIED ON ASBE_STOS:PROJECTS P ' nnuun mi m�ma�,i mom; it 1 1 1 111 l 1.111111111 IP I III IF FOUND RETURN TO:' .EYES BRO NYSDOL - L&C UNIT G� a HAIR BRO, ROOM 161A BUILDING 12 HGT 6' 03" STATE OFFICE CAMPUS _o AT:iiaNv NY 12240 D c •- al�Estate Inspect License #16000onni Blackberry CLEAR y U -• p • INSPECT 1 O N S - NEW YORK STATE DEPARTMENT OF_HEALTH - WADSWORTH CENTER Expires 12:01 AM-April701, 2623 Issued April 01, 2022= CERTIFICATE OF APPROVAL FOR LABORATORY-SERVICE Issued in accordance with and pursuant to-section 502 Public Health Law of New York State DR. TIANBAO BAI= _ - NY Lab Id No: 12048-- - EUROFINS CEI, INC. - 730 SE MAYNARD ROAD _ = _- CARY, NC 2751-9 is hereby APPROVED as an'Environmental Laboratory in conformance with the National-Environmental Laboratory Accreditation Conference Standards(2016) for the category _ ENVIRONMENTAL ANALYSES POTABLE WATER - All approved analytes are listed-below. Miscellaneous -- Asbestos _ EPA 100.2 Serial No.: 64945 Property of the New York State Department of Health.-Certificates are valid only at the address shown,must be conspicuously posted,and are printed on secure paper. Continued accreditation depends _ -on successful ongoing participation in the Program. Consumers-are urged to call(518)485-5570 to _ y,z verify the laboratory s accreditation status. Page 1 of 1 NEW YORICSTATEDEVAktMENT OW HEALTH WADSWORTN*CENTER 01 AM fth'101 0234-. expirek02: ... -Issued.A IiI 6i,2022 P CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE Issued In a=rdiihce with and pursuant to section 502 PLibliq HOalth Law of Now York-Stath DR.'TIANBAO ff' NY Lab Id No:12048.--. EUROFINS CEI,INQ­ 730-SE MAYNARD ROAD -CARP,, NC 276ff A FY .1s.-herebyAPPROVED'as an:-Environmontal1oboiatory.br the category- ENVIRONMENTAL ANAE YSE9SOL1D AND-HAZARDOUS WASTE-- All approved subcategoriesrgnd(bj�_-,enaiytlqs are listed below. Alsbellaheous Asbest6s lin'Friable Material.- J 'Item 198.1 of Manual -.EPA COO/M4/82/020 Mbegtds Ifi-Non-FrIable Materfal-PILM �-Item of Whual(W3 by PLM)= Asbastos-In Non-FrWble Material-TEM Item 198.4 of Manual Asbeiffis=-Veffniculite-Contain—iiig Mitedal item 198.8 of Manual Serial No.-!A4946 Property of-the New York State b P"rimentbfHeal—OL-CertMeaWsCr6Vafld6ffyatthe'addrOSS= sham.must be.conspldwusly posted, secure posted; are printed an paper. Continued accreditation depends successful.ongoing-pa-EWpa n In the Proqram.�tinsuffiers are urged to"L(518"-85-WMW. vqdfy 048100ratorys at_. r"tup. of SITE LOCATION MAP Not to Scale Lands Now or Formerly of ZONINGREQWREMENT5.- Zoned ................................... Waterfront Residential LotSize................................2acre Minimum Lot Width. ........ 190 Minimum Setbacks Front..............................30' Side................................25' Rear................................30' (Zoning data is shown for informational purpose only. It is the responsibility of the Owner/Builder to verify all zoningrequirementand setbacks) Silt fence to be installed as noted. Installation must be completed & lrgx)cted to beginning demolition. Please contact this office to schedule an inspection of the site gdz to any demolition. 3rdct aFrA%IL 1. Boundary information shown hereon was compiled from an actual field survey conducted on March 27,, 2023. 2. North orientation and beaning base perMap Reference 1. 3. Warren County taxparcel 316.9-1-8. 1. 4. The location of underground .improvements or encroachments, d any exist or as shown hereon, are not certified. There may be other underground utilities, the existence of which are unknown. Size and location of all underground utilities must be verified by the appropriate authorities. The Underground Facilities Protective Organization must be notified prior to conducting test botIngs, excavation and construction. 5. This survey was prepared without the benefit of an up to date abstract of title. 6. Field data capture tookplace with an accumulated snow cover of8" to 2: Every effort has been made to prepare a complete plotting of the conditions 7. Reproduction or copying of this document may be a violation ofcopyright law unless permission of the author and/ or copyrightholderis obtained 8. A copy of this document without a proper application of the surveyors embossed seal should be assumed to be an unauthorized copy. 9. Property corner monuments were not placed as apart of this survey unless otherwise noted. 10. The edge of water shown per actual field location at the time of the field survey. The area is subject to the change due to natural causes of the edge of water. DEEDREFERENCE.- 1. Conveyance to Stacey Wright & Timothy Wright by deed dated November 30, 2022, filed m the Warden County Clerks Office on December 9, 2022in Book 6729 of Deeds atpage 100 MAPREFERENCES.- 1. Map entitled 'Map of a Surveymade forMarria Parker; prepared by Van Dusen & Ste ves, dated last revised August23, 2018, filed m the Warren County Clerks Office on August 26,2018. "ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK AND OPINION." Ma2Nail Found N8400258"E 2900' Lands Now or Formerly of yNancy P. Humane IPF Book 970 Page 276 316.5-1-7 Edge of Woods //\�=-7 1 ! �� �,\ 1 + 1 It' I ` \ ` \ \ \ \\ \ / ! ,' �� .' / CIRF \ \ (\� / t \� \ \ \ + + 1 1 \ 1 \ \ �> �, / , �/ (vds) i, , i� LEGEND \ ��lI\\ \\\\,-\ \ , v \ PROPERTYLINE I,% - - ADIOINERSPROPER7YLINE \ ar, a+r OVERHEAD WIRE \ \ Co.) V77L17YPOLE @o IRONPIPEFOUND (IPF) \ @a CAPPEDIRONRODFOUND (QRF) \ O CORNER w g S87.2821 "E 9674' `���\+\��►,\\ii\\++`��,`���\\`�i�\\I���\�`��it`\\'\��\o �� . „E 1403 147t N78 \\\\ \\ U cover Woods \ �. 10 '-Wood Framed House i \\ \`\\ (to be removed) \\``�\ \\ \�\\ porch I \ \\ \\ \\\\\ \ \\\\ \\\\ \`\` \`\ \\;• '= Area =/�.31 Acrest `1I \`\�-193.7 (toberemotied) \�\\\\\,\ n S \�\ .So Arote 10 de \ \ \\ \\ \\\ \\\\ \\\\ \\\ \t \\ IMo° It 252 +Along Shore \\ \\\\\ Carport ! N1900236"W 1 249.24'(tieline) I\\\\\\�\\\\ \\\ \\\\\\\ \\ �; ���� �z��- 0 30 60 90 KRISTIN M. DARRAH DATE REVISIONS RECORD/DESCRIPTION 050803 Lands Now or Formerly of Valen tin o & Curtis Book 6604 Page 140 316.5-1-6 / Lands Now or Formerly of Christopher Thomas & Anne Evans r r I r r I I I DRAFTER 1 UNAUTHORIZED ALTERATION OR ADDITION TO THIS DOCUMENT IS A VIOLATION OF SECTION 7209 SUBDIVISION 2 OF THE NEW YORK STATE EDUCATION LAW. ® 2023 Darrah Land Surveying, PLLC APPROVED.•KMD DRAFTED.- RJT CHECKED.- KMD PRO1.. NO.- 23093 SCALE: 1 "--30' DATE: 0313012023 Book 6206 Page 1 316.5-1-5 Map of a Boundary & Topograhpic Survey Lands Now or Formerly of Stacev Wrioht & Tim othv Wrizht TOWNOFQVEENSBURY N WARRENCOUNTY, NEW YORK Darrah Land Surveying, PLLC 59 Lake Avenue, Lake Luzerne, New York 12846 Voice: (918) 798-4692 or (518) 654-9416 23053-11 1 SHEET 1 OF 1 PROJNO.23053--1