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DEMO-0155-2023 • Office Use Only DEMOLITION APPLICATION Permit#: —MO - a 155. 2e2� Permit Fee:$ 1 to Town of Quccnsbury Invoice#: 742 Bay Road,Queensbury,NY 12804 • P:518-761-8256 www.queensburv.net Flood Zone? Y © Reviewed By: Demolition Location: I .d. Tax Map ID #: **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? ID u f~iD CC �w v�- 2. Type of structure to be demolished: a. Residence d. Storage Building b. Garage e. Other: OlECEliVE11) c. Business 3. What type of utilities are connected to the structure: APR 12 2023 a. Gas f. Well-Water Pump TOWN OF QUEENSSURY b. Fuel Oil g. Public Sewer BUILDING& CODES c. Propane h. Other d. Electric i. None 58 e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes "`Q 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: 1 SIGNATURE: 7)/ '- DATE: Demolition Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): ety 45.1-c cAs Mailing Address, C/S/Z: 9 t c,,A.tyt.- A v A °SF. l 1ST Cell Phone: Land Line: S 14i 711 -00 9 Email: Sv S i e__?) ) (y la l 0 C mA- • Primary Owner(s): Name(s): P Mailing Address, Cf/S/Z: 2"l -7 Av,t- 12 13"G?, Cell Phone: Land Line: ' l es — 71 2 -9 (Li :Z Email: 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): is 4Y� Contractor Trade: Mailing Address, C/S/Z: 1`7 Av.- `STF tit,7 12$03 Cell Phone: Land Line: 5 10 719). -°1(Li Email: 1 **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: Cell Phone: S i 4; '7 5 -'7 _ Land Line: Email: ���a�(Ys-0(---117 r z7 e ��. c'_© •�. Demolition Application Revised June 2022 • • of. ` i . -z r- s E!u!E:nscorn GrTI INP �S Ire' —ai 1. !LDING & CODES DEPT. 0 FT1 !"1 518.832.9213 Reviewed Bv: C.,..)d FILE COPY Dated �, Ico ll t� I Pre-DBrholition , ' b�es os Survey ivy;,y )r . x 7 7 . r i + i�4,,,,. a ..., 1 L. vtiC 3`r ay'�'�r !. € s W .t. ^ r',i . • _ , s, T r s X, ..( .: , $ J ; Barn sI,' �, .� • : "4C2it#� .� h l"r][t 9 is 1 _,,,,,....A r•r a_ -'gym -x ttia *ak~� xe• ;.. t ' mt # 1'5',L`uzem •e Rd, ,. i7:.4, r.., `a.s �," "' �� '4 Queensbury NY 12804 ," "R - .° , •�"�Y4' ^'SE er+ 'h` �t. 3� x r�` W"�a,,v`• r'Wk'�.iS` ,1. , ' i ae;. 'J � t . iJ t ery , k. wa " �.� d i , +;r0 ' t. ram* t n-''' '4,i. 'f''s ''` ''F' 'f "• = 1 °F. R,� 'F"1 a •'i' t t *e � ` -r -" !S. r �� fit 1' , 1, t „t,.. ° " ` 10 i �' ' , ; .�11- ', 1' x+ " wr . a 4t"h , � • " / t i, r S f y r �`y' { } p �` ` ' r litty ti . f 'rt 4" , t 1-1 "hC'lr t# sj wt • , . i 1.;'t F f':1 t S at Z 3 gA N. ' . _ < .... o a 1V t ' '' ,'j,• • $• t r , . 'Kelly's�Raro 'Caf,.e4, ,t ;, • 1-' f � ,y, ,, , �,{ ' x { � , ,; : ,And Metpla ,' ' .}# • ' L r ♦ i A • A s : Slt s„i,t � k `±vsi C Ai, '} yS° ,1. L `, . ., h • , :_' �7-.' v.* s+��,,-, S 4. . .s-••,`F t •t..,,c *'.'• r K { f...4 "•t'e •1 .. $ � 4 �: , ., x , r---. . s "*._;._,,ti Luzerne�Rd - �pp Y < - a r e. Lfr ` "'.' 5 O;�N co -GO O ��. O C co PROJECT NUMBER PREPARED FOR �=" �(D �3o 10069 Hayes Construction -.,-a- w m 5 297 Saratoga Rd �a °of SITE LOCATION South Glens Falls,South Glens Falls g - Barns 1 &2 • �_`D_0 o sc 5'�n0 Z70 • 15 Luzerne Road . PREPARED BY o o -'� 0 N QUEENSBURY, New York 12804 Ryan Wild fl CD• 18 Blackberry Lane 'CD'O. m 0 5 0 309.10-1-97 DEMO-0155-2023 Queensbury, New York 12804 Hayes & Hayes Group . 15 Luzerne Rd . Demolition of 2 storage buildings • Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 March 10,2022 Executive Summary Asbestos-Containing Material Field Survey • 15 Luzerne • • Two Barns for demolition 15 Luzerne Road •QUEENSBURY, New York, 12804 • I. SUMMARY OF FINDINGS On March 01, 2022, an asbestos-containing material (ACM)field survey was conducted at 15 Luzerne Road 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 Hayes Construction. 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 4 samples • were collected from 2 suspect homogenous materials. • Summary Table of Asbestos-Containing Materials ;Sam Ie=IDr•:. ,S ace Name°r=' .`Ma ', ._ . . .R.... . ...,R..._. .._ . ...� -". teual..�;•;;.,Analytical.'Result';r,>:=,';e?<Numerical'Result::,f'�.�.Mate�ial`Cat'egory.�::= ,:`;Friability- • • • No Asbestos Detected • 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.The original chain of custody &laboratory analytical reports are located in Appendix D of this report. • • • • • • • • • • Page2of8 Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 March 10,2022 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Hayes Construction 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. Return sampling is billed at$350, plus laboratory analysis fees. 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 FLAP 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 8 Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 March 10,2022 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, 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. 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 8 Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 March 10,2022 Appendix A: . ACM Homogenous Area Table Material ie ',=Space Name Section Name Friability Current Condition Result Quantity There are no homogenous materials for this project that are assumed or have tested positive containing asbestos • Page 5 of 8 Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 March 10,2022 Appendix B: Tested Negative Homogenous Material Table Ma eri t al Material' • I'.. <Materia a- S cep -Section•-:' Result -.::- j: 1, ;ry - Cate o - ?IVa" g._ ,;a m Miscellaneous 002 002-Concrete barn I Barn 1 Tested Negative by Lab(No Asbestos Detected) Surfacing 001 001-Electrical Wire barn 1 Barn 1 Tested Negative by Lab(No Asbestos Material Sheathing Detected) Surfacing 001 001-Electrical Wire barn 2 Barn 1 Tested Negative by Lab(No Asbestos Material Sheathing Detected) • • Page 6 of 8 • Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 March 10,2022 Appendix C: • All Suspect Materials Sampled ID NameSample Spac Section Material ' Analytical Regulatory Result Name Result 001A barn 1 • Barn 1 001-Electrical Wire 0% Tested Negative by Lab(No Asbestos •• Sheathing Detected) 001B barn 2 Barn 1 001-Electrical Wire 0% Tested Negative by Lab(No Asbestos Sheathing . Detected) 002A barn 1 Barn 1 ' 002-Concrete * 0% Tested Negative by Lab(No Asbestos Detected) 002B barn 1 Barn 1 002-Concrete 0% Tested Negative by Lab(N'o Asbestos Detected) • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Page 7 of 8 • Hayes Construction,15 Luzerne Road,QUEENSBURY,New York,12804 • March 10,2022 Appendix D: Chain of Custody&Laboratory Report • • • • • • • • Page 8 of 8 N 22D't . w ao N* 3 III liii 111111111. 11111 1111111 III III CIEARIU 903JL7 ►;►r:r;ati; Chain of Custody ClearVU Inspections 18 Blackberry Lane Protect: 10069 Queensbury,New York 12804 Site Location: 15 Luzeme 15 Luzeme Road EUROFINS CEI, INC . QUEENSBURY,New York 12804 • SAMPLES ACCEPTED Sampled By:Ryan Wild(ryan@ciearvuinspections.com) Reporting By: Ryan Wild(ryan@clearvuinspectitins.com) Purpose: Pre-Demolition Laboratory Notes Turn-Around Time Request ..-.-.. _ __r.. _ .. •-..c-ram.. - __�..___-__ ....a-__- - _J :Y.�.��t-^. -s. _TT�..i�-C'..'T— _n.._s Stop after first positive for each HM 3 Day Samples Sample ID Material Floor/Section Space ' Analysis NY ELAP 198.1 & 001A 001 -Electrical Wire Sheathing - Barn 1 barn 1 198.4 PLM&TEM where applicable NYELAP 198.1 & 001 B 001 -Electrical Wire Sheathing Barn 1 barn 2 198.4 PLM&TEM where applicable • NY ELAP 198.1 & • 002A 002-Concrete Barn 1 barn 1 198.4 PLM&TEM where.applicable NY ELAP 198.1 & 002E 002-Concrete ' ' Barn 1 barn 1 198.4 PLM&TEM • where applicable ClearVU Inspections-Chain of Custody For Hayes Construction 15 Luzeme-10069 1 of 2 4.L______-3(..1(2_2"' �ll(22 oPsi\ Date lime ( D:W ec d By D3J({/fl Time Received By Date Time . Received By Date lime 3131 2,2 2 Refinq ' d By Date Time Relinquished By Date Time Relinquished By Date Time Analysis By Date Time ClearVU Inspections-Chain of Custody For Hayes Construction 15 Luzeme-10069 2 of 2 tiffeurofins CEI March 9, 2022 ClearVU Inspections 18 Blackberry Lane Queensbury, NY 12804 • CLIENT PROJECT: 10069 LAB CODE: N220036 Dear Customer: Enclosed are asbestos analysis results for Asbestos Bulk samples received at our laboratory on March 4, 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 NIVIAAP TESTING NVLAP LAB CODE 101768.0 730 SE Maynard Road •Cary, NC 27511 •919.481.1413 tiff eurofins CEI ASBESTOS ANALYTICAL REPORT By: New York State ELAP Method Prepared for ClearVU Inspections CLIENT PROJECT: 10069 LAB CODE: N220036 TEST METHOD: NYS ELAP METHODS.198.1, 198.4 REPORT DATE: 03/09/22 TOTAL LAYERS ANALYZED: 4 #LAYERS>1%ASBESTOS: 0 730 SE Maynard Road • Cary, NC 27511 •919.481.1413 Asbestos Report. Summary tiff e u rof I f1 S By: NEW YORK STATE METHOD CEI PROJECT: 10069 LAB CODE: N220036 ASBESTOS BULK,NEW YORK STATE METHODS Client ID Lab ID :'s r Color ; Sample Description . 'Total Asbestos.%. 001A N630 Cream Electrical Wire Sheathing No Asbestos Detected by 198.4 001E N631 Cream Electrical Wire Sheathing No Asbestos Detected by 198.4 002A N632 Gray Concrete No Asbestos Detected.0% 002E N633 Gray Concrete No Asbestos Detected.0% Page 1 of 1 • ASBESTOS BULK ANALYSIS ti~ e u rof i n S By:NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220036 18 Blackberry Lane Date Received: 03-04-22 Queensbury, NY 12804 Date Analyzed: 03-09-22 Date Reported: 03-09-22 Project: 10069 ASBESTOS BULK,NEW YORK STATE METHODS Client ID _ Layer Number :- Lab Description;;Category"Color• .'""i.:; ......r 001A Electrical Wire NOB Cream Initial Observations: N630 Sheathing Cellulose 10% Matrix 90% Method: Final Results: • Total Asbestos: No Asbestos Detected by 198.4 198.4 • None Detected 001B Electrical Wire NOB Cream Initial Observations: N631 Sheathing Cellulose 10% Matrix 90% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 • None Detected 002A Concrete Friable Gray Initial Observations: N632 Cellulose <1% Binder 60% Silicates 40% Method: Final Results: 198.1 No Asbestos Detectdital Asbestos: - No Asbestos Detected.0% • 002B Concrete Friable . Gray Initial Observations: N633 Cellulose <1% Binder 60% Silicates 40% Method: Final Results: • 198.1 No Asbestos Detectd'ebtal Asbestos: No Asbestos Detected.0% • Page 1 of 3 ; : eurofins • CEI 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 2 of 3 tiff eurofins 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): • S ' ac-198.1 ki4,7 Brunilda Gjoka 98.4 APPROVED Bl /44-.A'Gc Tianbao Bai, Ph.D.,CI Laboratory Director • NVLA • TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road•Cary. NC 27511 •919.481.1413 Page 3 of 3 . . . • .--,-.,4',-;''',`..S. i..;.-1,--•-•,.- -.Q.,-,:r....... New York State 4!Depaitnient of`L'elicii1-1,.. . . .•:,,,,, Division of Safety and Health, -,-'*'- '7' --:'-=',7•'",'""7- License and Certificate Unit 44 V2- --•;‘,- - • ,1,- _:,::, ,,,•,,, 5 State Campus Building 12 ...-t,5',,: v- ,:-...,e.,,. • A1banyHy.122 itic ,',/. .;', •,.. ,?.,,F1.▪... . •!-0 -4;--,. '1.,_. p" ASBESTOS HANDLING LICgNSE.-:, A'Y'' ,,,. .-:•.,-.. .:-, ,.,;-;..,•, . ,,., A-..' --,;,,,, .:,1,y, ,, Creative Spaces II LLC dba ClearVU'Ihspebtidhs ,,,F,!--,FILE NUMBER: LICENSE NUMBER:"z;2828900:4V"4'. 40 ."7..,, . , ,. ....4',.:-1 18-Black0errV kirie •‘'.*;::,-J .':;:-: •-•' LICENSE CLASS: RESTRICTED?v DATE OF'ISSUE: 01/28/2022 ,e ,:i'',T, •';':"7:-',.-„, , ..,v ,, .... •.,, ,',•,-,..,• ,EXPIRATION DATE 01/31/2023 Queenpb,uryNY 12804. „,.j.:: . . .,. . . . ,, ',z:--.:, ' „ici,• ...--'S' ,,•-,k . • :'?.`;:•:tfl,,L:,?.. : 71. .,, .. 0., i,, M 1.,:' " ,:l.l.'; •..: • , . . .....;r . :,-... i•--, ,•.: ,:••; . 1,-,,,:, -1 •',J' '•vi. ,,.;.. ::‹; :.';''.), 'f,-.'! 7..-•,•;•?. •,.• ,••: •.., , -.. ',-,, .r,.... ...:, v...,.. :V • ,q1 Duly Authorized Representative N14 .-. „ . , s ::.7- •.„•,• ...,„,• , .• • , - • ' -. :•.i' ' ''',W-1::, :f . i ',:..?,', '':,-,1' • • ' :':,..'• .••••;,1-`.• ,:i' . . ?...,-.I..5.,,,34.zz5 R.:1 r.,,It•nt, ' Iti this'ficense'..has been issued in aCCOliiencewithqipPlicable.ProVisiorisofAitfelelki•of the Labor Law of New YerloSiateirl of- the New.York State Codes,Rules'aiitilRegulationS,(12 NYCRR Pare56):-It is,SUblect to suOnsion or revocation for a(1) serious violation of State,federal or igeel laws WItlit-egard to the conducttofatiestos project,or(2)demotiiirateillack-of ,...... , responsibility in the conduct of any jobl,involving,asbesto4 or asbestos material?,:-,t, ..,;,..1., . ,,,.:,., -- „t;:a. ;',:i: .. -''.i--':.::-,..,.---.---",---';',-2.:::,-.:*;,-1,.;!&,.',.. --.1.;,:•-•!.',.;.7,---`:'.'.. .. ,..... ..!:;0...,s7:. ..... 14•6' .,'L,: ...?),'.'14 , 1'-'1 • ',::'-`• ,,..,7..f.,;z:. . ThiSli,cense isw,a.l.id onlyfor the contractor named na.Med•aboVe and-tfits:lidense ciiliholoCopy mustbeiominently displayefat t„he asbestos project wor1csitef...,:rhiSlicense verifies that,all:persons empley,,crbkthe licensee on ati-asbestsq-Proje:ctin,NeWYerk • State have been issued an Asbestos Certificate,appfnpriate:f4 thl,tipet.ot work they perform,by theNew York State . . -:. -.--r. .... ...--• Department of Labor ,.,7...); • • '''•:ir... ''i- .,,,,-:',;4;"'" ?,-,. -,-.--..,-, „,,,.,:-.,'' ''',',-,,,, • • .„,.72-.v.. . ',..*„ ..-' .:1---- , -4:;,,, 49' _,'-''. %., ,-.:„..›, • ''1', „ ' 4-- ..•!::. '''',`,-*,:-'1i,,,T,.-,..., • _.,-,,,:tz:V..-.;',',',,,,,,,z,,%2,,,,,,,, -‘,:c.,:y, ••,-(•,• :1••;:,i i-- -"..=4"iatf" ,';-.•07.L,7•wN:',V4W‘o'-' .4' "-q.'s ,::',, ?4'' „..?.:: ,,,0‘..,,, ,.:'.,, •,.-,,,: ;' . „:.,, :••• 1$4 •• 9.z, ,,,,t,.. • '- . '-':::Z=,.-,. 'C: .)" •:i '')„.i' ';' -it,r. '''. ..--. Y.',: -. --'-' ,...,,,,r. _.. •.,,, '''.;-,. ..//.../te , '-- , ....... ..,.-i . ... Amy Phillips,Director SH 432(8/12) • For the Commissioner of Labor • . . - . . • . . . . . • • • . . • • • r STATE'S EI YORI DEtrAI ICFraBOR Iff:��' fir. %' e:4 -S„ ..�:3".ti cY!a,i`isxu.3M1 .18996a, 'i' :<t";MUSfBE'.CARRIED:ONTMBESTO PRdJECYS 3\ W. I _ C3 GK7' '�xs aas • 1110S RYAN WILD Real Estate Inspector %at License#16000085839 Blackberry Ln,Oueensbury 518 832 9213 CLEARVU ryan@clearvulnspectfons.com www.clearvulnspectlons.com • INSPECTIONS _N YORK-':De ailment : -- -: ATE OF.. '. of eath = ANDREW M.CUOMO= -- HOWARD A.ZUCKER,M.D.,3.D. a.ISA,7 PINO,M.A.;3.1);=-F Governor .- •. • — -Commissioner •-' -,-,-.;_• Executive Deputy Commissioner '. • _._:=_. .. - LAB.ID:.12048 ;_.. _• . April01,2021. == - DR:TIANBAO BAI _,-, - EUROFINS CEI_ = - - _ _ ` INC_ _ = _ __ '730SE:MAYNARDBOAD = Certificte_Expiation Date NC 27511 =,;_ • April 2022  -_ _-: Dear Dr.Bali-- ..: - .Enclosed are certlficate(s)-of approval issued to your environmental laboratory for the current permit-year.The = 2. _- _certifloate(s)supersedes)any previously ones)and is(are)in effect through.the expiiatioRdaterlisted. - "Pleasercarefully-examine-the.certificate(s)to insure that the categories,subcategories,anaiytes;�andmethods • = _ - .:rr• ..for which your laborafory 1s approved.are correct.In addition,verify that your laboratory's name,address,lead '-_ -_ __ • --" technical director,and identification number accurate. =:- •: - =; - -L- - u Prsuant to NYCRRSubpart 55-2.2,original certificates must be posted conspicuously In the laboratory and - copies shall be made available to any client of the laboratory upon request - :. __-- : °Pursuant to NYCRR Subpart 55-2.6,any misrepresentation of the fields of accreditation(category-method=_. - -.•analyte)_forwhich your laboratory is approved may result in denial,suspension,or revocation of your__= : certification: Any use of the Environmental Laboratory Approval Program(ELAP)or National Environmental __ __ _- Laboratory Accreditation.Program(NELAP)name,reference to=the laboratory's approval status,and/or using". _ - - the NELAP logo in any catalogs,advertising,,business solicitations,.proposals,quotations,laboratory_analytical"-. ::reports;or other materials must include the laboratory's ECAP identificationInumber and distinguish between - -= - =._ •testing for which.the laboratory:is approved and testing for which-the laboratory is not approved _-; — • 41f you have any questions,please contact us at the Environmental Laboratory Approval Program,Wadsworth". Center,New York State_Department of Health;Empire State Plaza,:Albany NY,12237;by phone at(518)- - : ___:. 485-5570;by facsimile at(518)485-5568;,and;by emailAt elapi@healthm.gov. _ _-_ •_-_=_ Sincerely, .., Victoria Pretti • _: _ =_ = _= - - Directoi and QAOfficer _ -_ -= „ - = -_ Environmental-LaboratoryApprovafPrOgram " , • • --- _-- Empre State Preza,CerningTower,Albany,NY 122371health.ny.gov:. "=Y - ' _ , NEW YORK`,'STATEdDEPARTMENT,OF HEALTH: a �.WADSINORTH'CENTER' :01`AM'Qp�i f01 :2022;� ' ::.' :,; Issued l01 r: =CERTIFICATE,OF'APPROVALFOR'LABORATORY:;SERVICE_,;_ Issued In accordancewith and ursuant to.•section 502-Public` ea aw'of New o e<'..p -- .,'L YrkStet DR:_TIAN8A0 8AI' •• NYLab-ld;No1204 - ' .'EUROF,INS CE!,NC. :;t'- • 1 ' 730?SEMAYNA`RD.ROAD •R N 27511: • - .`,%T,. -' '>'.:is'herebyAPPROVED-as an Envirotiinental;Labdrafory.in conformanceewiththe';. ''.;.'. ar a onal Environmental:Lab'oratoryAccreditation?Conference Standards;2016 for:the categ o ".' `;';;- =::,`.- ,;,.: •7 ENVIRONMENTA"L A'NALYSES POTABLE::WATER:c,'` >`' ..':•= Il:approvedanal arerlisted�lielow'. ,. : • • Miscellaneous - - - _ EPA.100.2. • • • • t ' , er I No S la 3 - r is -•'address•i; e ie vatld�onl'at Ilia"De' 'oRHealUil:CeNfi'P i' a 1, ,,Ym,,,. artmeiil ra ro th Netiv le Y - 'y, Perh! P - b _ I onde•,end� n� ed'ac red ted n n s ed' �eeure' s r.-Contlnu c Ic`e' I st 'and�are� dnl on s ,'i''�ifi - s `mu "cons us ed, P St'bb 0 hown,, P Pe f P - P Y•Po 4 :ri� e`."'is -t Consumers re u t 9 4a5S570to':' - ,',�. �-�.on su�ce�sfulongofng�paNclpaQon I ;Ih.P!oe m. rg -, ( ) , ' ved tt,eli•rato s'acaedllavdri.taele..' r>:' N N,,, rrA9G •.Pa e1 f -.. 9 : NEW_PORK STATE DEPARTMENT:,OF HEALTH =-- ___ ._ -_" — WADSWORTH CENTER . _ •. - :. 2 22_ .A -. •A�-__._ - , .-Issuad April001 _ t�-•:. C-E- RTIFICATE OF APPROVAL FOR LABORATORY SERVICE,=_-., -_-_- -=_ =_ - Issued in accordance with and pursuant to section 502.Fubllc Health Law of New York-State = r=-_ Y • • •DR.TIANBAO BAI=-__'=--- _ •• NY Lab Id No:12048.:,, • - - • _=_ EUROFINS CEI,INC.` _ •• - _ _4.__ ,__ .. : . _ :._.730 SEMAYNAR!).ROAD= .` �r-_-- •:_CARP,NC 2751'1-=i ._ --- -:_. : = _ • • • -•• =n=.Is'herebyAPPROVED as an EnvironmentaFLatioratory for the category., - __- _=__ - --— - ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE- =. • :.:. _ --" - .- -- • =-All approved subcategories-and/or_arialytes_aere listed below:':_: _ • • Miscellaneous -- Asbestos In.Friable Material_ - Item 198.1 of Manual- - • - - -.._ .. _ _PA 800/M4/821020 -'' Asbestos In Non-Friable Material-PLM - Item 198.6 of Manual(NOB by PLM) _:=i _ _ - --_ Asbestos In'Non-Friable Material-TEM Item 198.4 of Manual - ' Asbestos-Vermlcullte-Cantalnlng Material Item 198.8 of Manual `_-._ - • Serial No::-.632971 _- - = Propertyo(:the New York State Department-ortilealth.Certificates are valid only at the'address" `- - ,. - _- -=-'_-.shown:must be Conspicuously posted,and are printed on secure-paper.Continued accreditation depends• _•_ -==•__- -- :.-on successful ongoing par8oipatIon In the Program:Consumers are urged to call(518)485S57ato'_,- -� •—_-_-:� _ _ r verify the laboratoys accredttatlon status. -_ • Page,1 of 1. . —.. • --' - __=NEW YORK STATE.DEPARTMENT_OF HEALTH;•• ==. • ... - WADSWORTHCENTER L_:: — ___ Expires 12:01 AM April 01,-2022-:_.- << 1 :Issued April 01,2021 — :. r 'bC -. -CERTIFICATE-OF=APPROVAL FOR LABORATORY SERVICE _ __ _ . _- - -• Issued in accordance with and pursuant to section 502 Pubff5Health-Law of New Yoih State -. .-DR.T/ANBAO BAI __-- '='T. _• ; :1 .NYLab Id No:12048 _ •__-_ - - EUROFINS CEl,1NC.= • =.730 SE MAYNARD.ROAD__ -_ CARP,NC 27511-:_-.'' . • .. . • _ - ._: - - _ _-_ = _= .: . _ _ •:Is'hbrebyAPPROVED•as an Environmental:Latior=atory for the-category, - -" _ __ _ `__ ENVIRONMENTAL ANALYSES:AIR:AND:EMISSIONS ._ ' , _ -• All approved subcategories endlor_analytes;are listed below:..-• _ oT _- • Miscellaneous - _ - _ -=- - - • Astitistos`_ - -._ =- 40 CFR 763-APX A No:In __.. - - • Flbera -=- -. • •- .'.-. NICSH 7400 A RULES' .- _ • • • • Serial No::6329$•=-.,_. ___ •• --. •__ Property_otthe New York State Hoeft of He Certificatis me valid oNy et the address:- s -- ._ showji 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(51814855510 to ,. • _ -, :_ - • - __- verify the laboratoiya accreditation status. - -_ - _ Page.I of 1. _- _ - Parcel ID : 309.10-1-97 '''' V . . . ,-1 . „, Al , ' .: . ;' i ' 1 :. ._ COLUP�i�1�` i{ '' .. > ' w,r a 'sa t s• S7 x s°sg' '$ fA 1 To.' I n V ~ ipv - ,,..,,,,. b.tiVirl,';'''',i'...4:4 f v f• • yc; by T-1 ,. - . \ � -Yak u:, . •. •i4• I +tom f �1� -, +ayxx _ 'E h �, t i ti '! 4 3 I t ,} Z s, " 1 1' NE�Ix iiYE 3F n i3 ,40 Ilia . 5 - _,t' �� ors to *t to $.: *„. i ' r a - April 11, 2023 ECEOWEL) 1:2,256, 0 75 150 300 ft r 1 , i I APR 12 2023 0 20 40 80 m TOWN OF - I- CAL 1=1=t'�SBUf�Y BUILDING& CODES NYS ITS GIS Program Office,Westchester County GIS • Map Produced by Queensbury GIS. Map is for General Reference Purposes Only