BOTH-000595-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
— Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000595-2016 Date Issued: Friday, June 30, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000595-2016
has been completed.
Tax Map Number: 227.17-1-17
Location: 34 GUNN LN
Owner: Jacqueline Wheeler
Applicant: Jacqueline Wheeler
This structure may be occupied as a: Demolition boathouse 256 sq.ft.
By Order of Town Board
TOWN OF QUEENSSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the4t
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the
Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
AdwAlk TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
ME Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000595-2016
Tax Map No: 227.17-1-17
Permission is hereby granted to: Jacqueline Wheeler
For property located at: 34 GUNN LN
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tvce of Construction
Owner Name: Jacqueline Wheeler Demolition $0.00
Owner Address: 83 Old Coach RD Total Value $0.00
Diamond Point,NY 12824
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Demolition boathouse 256 sq.ft.
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,October 5,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the exF(�/non ate.)
Dated at the Town of ucensb (/ e etcher 5,2016
SIGNED BY: .F' VVVVVV for the Town of Queensbury.
Director of Building&Code Enforcement
I own or wueensoury tsunaing be t oaes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit#: 4
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee —__3Q-L________--_
Provide 2 plot plans drawn to scale,showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures
on property and indicate which are to be demolished. Indicate the location of all utilities z /
Date C5LY( 90f4Demolition Location
-------- -----------
Tax Map ID 217,11_1_17_
APPLICANT __sR L%_ _ OWNNY� OWNER S_A�_ IL�t'l k)L'/ GIlrLC
Address ---------------------------- Address M ELD— Lo1CPY --
Phone ---------------------------- Phone --��J-- ��-�----/------- IVY
CONTACT PERSON FOR BUILDING fir CODES COMPLIANCE: C�11Q�_� �1,_—__r121____—_____Phone: ( _Ss /
i. Person Responsible for Work Av1w,4/` r7r/,,/)Lws
2. Where will demolition material be disposed? th t2;lm A/
3. All buildings to be demolished require an Asbestos Survey
4. AnV building substantially damaged by fire must obtain an Asbestos Removal Permit from the Department of Labor
5. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begin
a) Is there any asbestos In the building to be demolished _—Yes —k— No
b) If Yes,our office needs the following Information ____Yes No
Name of firm removing the asbestos
License number of firm
Indicate where the asbestos material will be disposed
6. Structure Information
a) Indicate the structure(s)to be demolished _-- Residence --- Garage --- Business
__—Storage Bldg. —)P— Other
b) Size of Structure rr
c) Number of Stories
d) Foundation Type WOO
e) Foundation UNL�
f) Structure(s) rludst:
7. Utilities Information
a) Indicate utilities for this structure__—Gas JW--Electric ___ Propane ___ Public Water ___ Public Sewer
___ On-site well water pump
a) Have you notified the Town Water Department for public water and sewer disconnect? —___ Yes ____ No DiAr
b) Have all utilities been disconnected? ____ Yes _4— No
S. Signature
Print Name: ---------------------------------------- Date
Signature: ---------------------------------------- Date ----------------
c
Citi vt.t.hr, I I c SEP Bois N rn --- - —
I �roi_ocIr � 1-.nviror�tri_r! t.CoNsutrAnn�s
�y
Y
September 15, 2016
Mr. David McAvinney
McAvinney Builders
83 Care Free Lane
Lake George, NY 1"2849
1.{L; �y 4'C.•.l'�CBY4GIiE.701t [',s l7CEC{lE u'14='t'F:y'
34 Gtow Laue, QneeasLm-y.,NY
Dear Mr. McAvinney:
Hanson Van Vleet, LLC conducted an asbestos containing material (ACM) survey of the
residence at 34 Gunn Lane in the Town of Queensbury, Warren Country New York. 14VV is
authorized by the New York State Department of Labor under license # 05-0220 to perform
asbestos inspections, sample collection and surveys. Samples of each type of suspected asbestos
containing material (SACM) were collected. All samples were collected by a NYSDOL licensed
Class D Inspector, in accordance with 12 NYCRR Part 56, (referred to as Industrial Code Rule
56) and 29 CFR Part 1910. The sampling was conducted on September 16, 2016. A copy of the
NYSDOL Asbestos license is attached to this letter.
Methods
Prior to initiating sampling, an on-site walls through inspection of the structure was performed in
accordance with Subpart 56-5(e) of 12 NYCRR Part 56. Building plans were not available for
review. Based on the site inspection, sampling of materials was performed to evaluate for
suspect asbestos coniainiag materials (SACM). Bulk samples were collected following siandard
sampling procedures. The samples were placed in double sealed sample bags and delivered by
Federal Express to EMSL Analytical for analysis under formal chain of custody procedures.
Friable type materials were analyzes( by Polarized Light Microscopy (PLM) via the NY State
ELAP 198.1 method. Non.organically bound (NOB) materials were analyzed by PLM via NYS.
method 198.6 NOB. If the NYS method 198.6 NOB was inconclusive, the NOB materials were
then analyzed by transient election microscopy (TENI) via NYS method 198.4 i>IOB.
Ingpectiou Results
The inspection of the properly revealed a one story residence, a wooden shed, and an elevated
boat house to be demolished.
The inspection of the residence revealed a one story, two bedroom, one bath, structure,
approximately 1070 square feet in size. The residence was of wood framed construction, on a
concrete block foundation with an asphalt shingled roof.
The exterior was wood sided. All exterior trim was wood. The windows were vinyl and/or wood
framed, with no window glazing.
Pre-Demolition Asbestosurve�•
34 Gunn Lurie
Queensbury,New York
September 30;2016
Page 2 oF4
The interior constI'uction consisted of Honlasote walls and ceilings in the kitchen, badnroom, and
bedrooms. Drywall ceilings and wooden flooring in the back room, anti vinyl floor tiles in the
bathroom. The basement consisted of concrete floors and concrete block walls.
Suspect ACM materials identified on the interior of the residential structure consisted of:
Drywall ceilings in the back room, vinyl floor tiles and associated mastic in the batlu'oom, and
flooring mastic remnants in the kitchen where flooring had been previously removed.
Suspect ACM materials identified on the exterior of the structure included: asphalt roof shingles
and tar paper underlayment.
hulk simples at the resideince %Y('re, (:ollected of 1) nsphoh roof shro�,des, 2) tai' 173Yte1'
underlayment, 3) vinyl floor tiles, 111) floor tile mastic, 5) remnant flooring mastic, and 61) drywall.
The Inspection of the elevated boathouse and dock revealed an approximately 600 square foot
wooden framed structure, with vinyl siding, alunnnlUm framed non-glazed widows, and an
asphalt shingled roof, constructed on piers above the wooden dock. The interior of the boat
house consisted of wooded floors covered with sheet asphalt roofing with plastered seanns.
hnterior walls were unfinished with open wooden framing. The exterior of the boathouse and
dock included sheet asphalt roofing on the dock surface around the boat house, vinyl siding, and
an asphalt shingled roof with tar parer underlayment.
Suspect ACM materials identified at the boat house and dock included: sheet asphalt on floors,
plaster seams in flooring, asphalt shingled roof and tar paper underlayment.
Bulk samples at the boat house were collected of 1) sheet asphalt on floor, 2) plastered seams on
floors, 3) asphalt shingled roof, and 4) tar paper roofing underlaymeui.
A small grey shed was also to be demolished. The inspection of the grey shed revealed wooden
construction with wood framed windows and an asphalt shingled roof.
Bulk samples at the grey shed were collected of the 1) asphalt shingled roof, and 2.) the tar paper
roofing underlayment.
Asbestos Containrxrig I)�fAteKj aaalp liras result
A minimum of three samples of each type of suspected ACM was collected. The samples and
results are summarized in Table 1 below. The Analytical results and chain of custody are
attached to this letter.
Pre-Demolition Asbestos Curvo
34 Gunn Lane
Queensbury,New York
September 30,2016
Page 3 or,,t
Table 1
Asbestos Sampling Locations and Akialydeal Re.F.ulis
3A Gunn Lade Queensbury, NY
Sample Type orMnterial Location Approxhante Result
No. Quantity
(Square feet` _
S-IA Plaster _ _ _ Boat House Floor _20 ND
S-IB Plaster _ Boal House Floor 20 I ND
S-IC Plaster Boal(louse Floor I 20 ND
S-2A Sheet Asphalt I Bost I louse Floor/Deck I ^000 _ ND
5-23 Shect Asphalt I Boal House Floor/Deck 800 I ND
S-2C Sheet Asphalt Boat House Floor/Deck 800 _ NO
S-3A _ Tar PaperUnderlayment I Boat House Roof _I _doo ND _
S-3B Tar Paper Untlerlayment Boat I-tou5e Roof I 400 I ND
S-3C Tar Paper Underlayment I Boat House Roof 400 I ND
SAA � Asphalt Shingles ------� Boat I-louse Roof I 400 ND
SAB I Asphalt Shingles I Boat House Roof I 400 I ND
SAC Asphalt Shingles Boat House Roof -100 ND
S-5A _TmPaPaper Underlayment Grey Shell Roof I 100 ND _
S-5B I Tar Paper Underla rent Grey Shed Roof I 100 ND
S-5C Tar Paper Underlayment Grey Shed Roof 100 ND
S-6A Asphalt Shin les Grey Shed Roof 100 ND
S-6B Asphalt Shingles Grey Shell Roof 100 ND
S-6C Asphalt Shingles Grey Shed Roof 100 ND
S-7A 9"Vinyl Floor Tiles House Bathroom 80 ND
S-7B 9"Vinyl Floor Tiles House Bathroom 80 ND
S-'/C 9"Vinyl Floor Tiles Flouse Bathroom 80 ND
S-SA Floor Tile Mastic House Bathroom 80 ND
S-8B Floor Tile Mastic House Bathroom 80 ND
S-8C Floor Tile Mastic House Bathroom 80 ND
S-9A Mastic Remnants Kitchen Floor 100 ND
S-9B Mastic Remnants Kitchen Floor t00 ND
S-9C Mastic Remnants Kitchen Floor 100 ND
S-10A_ Drywall Ceiling Back Room 120 ND _
S-IOD Drywall Ceiling Back Room 120 ND
S-IOC Drywall Ceiling Back Room 120 ND
S-1 IA Asphalt Shingles House Roof 1000 ND
S-11B Asphalt Shingles Flouse Roof 1000 ND
S-1 IC Asphalt Shingles House Roof 1000 ND
S-12A _ Tar Paper Untlerlayment Nouse Roof 1000 ND
S-12B Tar Paper Underla•stent House Roof 1000 ND
S-12C Tar Paper Untlerlayment I House Roof 1000 ND
Conclusions
Materials are considered asbestos containing if they contain 1 % or more of asbestos. No
asbestos containing materials were identified within the residential structure, boat house, or grey
shed at 34 Gunn Lane, Town of Queensbury, Warren County, New York. No asbestos
abatement is required prior to demolition of the structure.
If you have any questions regarding this survey, please contact its at (518) 371-7940.
Pre Demolition Asbesios Survey
34 Gunn Lane .
Queensbury. New York
Seplember 30,2016
Page 4 of 4
Very truly yours,
Ijansol Van Vleet, LLC
i
C-
James Gironca
NYSDOL Class D Inspector Certificate# 07-05263
CC: NTTYSDOL
Ripley
Point
o' Middle) Bayfe I{.}itlsltili Buy
I V.L1 ii I� 1
Clwerdal0 1 y Sheldon ,
�tlj� Pointi
1
Sand f
s,
JirtU 1ni)ioclaturr3l
AssemA SII,`` I •i'
bly IF I
Point
ii 1
I
n li ? l
Harris
IIBay
1 i
�u
'\ r` Happy Family
(� l
,
\. Ishnds
!i
Bit; — ♦ - Ire
CM 1.
�.,,•d1( �S Y
t} 7
ISIIP�lii,
/� f,r CO/�t``,,
/'IIVJVIV - NATER SUPPLY C
` >nN[� �� E NVIRONMENTAL 0014SULTANT
)/I C�tJNN L. S
,I i..�� /nl Ivu_tsr , I_t_u
ihr6;l.. ruler; 031620241 _
307 West 36th Street Nev!Yolk,NY 10018 r.11ICtl/ui01'III: I'IAPIS22
TeIfFa.:(212)290.0051/(212)290-0050 4ilCtointly 1'O:
Auonuon: James Gironde Phuna: (510)371-7940
Hanson Van Vleet, LLC rax: (510)371-5886
902 Route 146 17acr3ivetl Data: 09/19/2016 9:27 AM
Clifton Park, NY 12065 Analyeis Data: 09/21/2016-09/23/2016
Guilorterr!tlatn: 09/16/2016
-_t�rojert� 34 C7UNN LANE, NY
feet Ropoilvks. be11tot5 Aw lymis of HIM( llnaiDrval
Non-Asbaoiac
Anntyeed
'fast Uafxa Culo, Piilious Non-19bMuc sbe0los
SamplelU S-1A Description BOATHOUSE-PLASTER ON FLOOR
031628211-0001 _ Ilomosonek",_ Homogeneous_ _
PLM NYS i96:1 Frlable 0 9121/2 01 6 While 75.00%Ca Carbonate Mole Deiecied
25.00%Won-fibrous(other)
PLMMY:;'i98.g VCM -- - —_ Moianalyzed
PLM NYS 108.0 MOD -- NotAnalyzed
TSM HYS 190?NOB NotAnalyzed
aample ID 5-18 Uescl1ption BOAT HOUSE-PLASTER ON FLOOR
0316282/1-0002 1 101110901101i Homogeneous
PLM NYS 198:I Friable 09/27/2016 White 68.00%Ca Carbonate Norio Detected
32.00%Non-fibrous(other)
PLM NYS 198.6 VCM NotAnalyzed
PLM NYE 190.0 N98--_---�— — — NotAnalyzed
TEM MY8198.4 NOB _ - NotAnalyzed
Sample ID SAC Description BOATHOUSE-PLASTER ON FLOOR
031628241.OW3 Homogeneity Homogeneous
PLM NYS'198.1 Friable 09/22/2016 White 34.00%Ca Carbonate None Detected
44.00% Non-fibrous(other)
22.00%Quartz _
PLM M'S 198.6 VCM NotAnalyzed
PLM NYS 198.6 MOB NotAuelyzed
'fEM NYS 190.6 NOH Not Analyzed
Sample ID S-2A Description BOAT HOUSE FLOOR/DECK SHEET ASPHALT ROOFING
031628241-0004 Homogeneity Heterogeneous
PLM NYS 790.1 Friable NotAnalyzed
PLM NYO 17C.G VCM Not Mlslyzed
ALM MYS'I98.G MOB 09/22/2010 Bleck 100.00%Other Inconclusive:None Detected
TEM IJYS 100.6 NOU 09/23/2016 Black 140110 100.00%Other <'L00%Clnyaolilo
Sample 10 S-28 Description BOAT HOUSE FLOOR/DECK-SHEETASPHALT ROOFING
0316282,11-005 Homogeneity Heterogeneous _
PLM NYS 190.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM MYS 190.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM MYS 190.4 NOB 09/23/2016 Black 100.00%Other None[)elected
Imhal Report From 09/242016 07:09:56
0009.9.71 Printed 9/24/2016 7:10:OOAM Page 1 04 8
03'i G2G29i 1
I.
30/ Nest 39ih Street New`/ori;,MY 10018
Tel/Fax:(2 12)290-0051/(212)290-0058 ( i n u)'PO:
1 l�i2r rlU:
Cost i-klialy3lf; of Bulk WintorfD1
Nun-Ashestes
Anol;rzed
Tsai Date Color Fibrous Non-Fibrous, ASUnaioc
Sample ID S-2C Description BOAT HOUSE FLOOP./DECK-SHEET ASPHALT ROOFING
031628241.0006 Homogeneity Heterogeneous
PI.z1 MYS 198.1i Friable Not Analyzed
PI-P9 NYS'i98.6 VCM -_--- --- ---- NotAnalyzed
PLM M6198.6 MOB 09/222016 Black 100.00%Other Inconclusive:None Detecied
(HA NYS 100A NOH 09/23/2016 Black 100.00%Other None Detected
';amide ll) S-3A Uoscripilml BOAT HOUSE ROOF-UNDERLAYMENT
031628241-0007 Homogeneity Heterogeneous
P'LM NYS'198.i Friable ---^ Not.90aly ed --
PUPA NYS 190.6 VCM Not Analyzed
PLPB NYS 190.6 NON 0922/2016 Black '100.00%Other InconcineiBe:None Detected
Final residue mass<7%
TEM NYS 198A NOB 09/23/2016 Black 100.00%Ogler None Detected
Sample ID 5-36 Description BOAT I1OUSE ROOF-UNDERLAYMEIJT
031620241-0000 Homogeneity Heterogeneous
PLM NYS 198.1 Friable --- --- Not Analyzers
PLM NYS 190.6 VCM Not Analyzed
PLM NYS 198.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Directed
Final residue mass<1%
TEM NYS 198.4 NO6 09/23/2016 Black 100.00%Other None Detected
Sample ID S3C .� Description BOAT HOUSE ROOF-UNDERLAYMENT
031626241-0009 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM MYS 190.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
Final residue mass<7%
TEM NYS 190.4 NON 09/23/2016 Black 100.00%Other None Detected
Sample lD S-4A Descnpiimi BOATHOUSE ROOF-ASPHALT SHINGLES
031628241-0010 Homogeneity Heterogeneous
PLM NYS 190.1 Friable Not Analyzed
PLM NYS 198.6 VCM Mot Analyzed
PLM NYS 193.6 NOB 09/22/2016 Black 23.00%Glass 77.00%Other Inconclusive:None Uatected
'I EM MYS 198.4 NOB 09123/2016 Black 100.00%Other None Detected
Sampiell) SAS Description BOAT HOUSE ROOF-ASPHALT SHINGLES
031620241-0011 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
FLM NY$ 198.6 VCM NotAnalyzed
FLM NYS'190.6 NOB 09122/2016 Black 24.80%Glass 75.20%Other Inconclusive:None Detected
TEM MYS 198A NOB 09/2312016 Black 100.00114.Other More Detected
Initial Report From:09242016 07:09:56
1.7i Printed 9/24/2016 7:10:OOAM Page 2 of 8
1
307 West 38ih Street iJew York,PIY 10018
Tel/Fax:(212)200.0051 I(212)290.0058 13i1tEob N3r I u:
•:r=61RL. l+m-,nluV t i. Project ll):
Tra;3t Re.poi i:Ashocios llnAysk of EMIR IUlatel•ial
Non-Asbostos
Analyzed
"i ssi Ume Color Fibrous Non-FNrouc Asbestos
Sample In SAC Uesciiptlou BOAT HOUSE ROOF-ASPHALT SHINGLES
031620241-0012 1lonlobenaky Heterogeneous
PLM NYS 198.1 Friable Not Annlyzed
111.1111 MYS 198.6 VCPA Moi Analyzed
PLM NYS 198.6 MOB 09/22/2016 Black 27.50%Glass 72.50%Other Inconclusive:None Detected
Trim'N.YS,198.:NON 09/23/2016 Black 100.00%Other Hone Ilelected
sanplo 11) S-5A •1c^cripdou GREY SHED ROOF-UNDERLAYNiENT
031628241-0013 llmsOgeucily Heterogeneous
PLPA MY6198A Friable _— - Notllnalyzed —
PLM N.YS 198.6 VOM Noi Annlyzed
PLPA NYS 190.8 MOO 09/22/2016 Black 100.00%Other luconcluslve:None Detected
Final residue mass<1%
Tt-'M NYS 198.4 NOD 09/23/2016 Black 100.00%Other Nona Detected
simple ID S-58 Description GREY SHED ROOF-UNDERLAYMENT
031628241-0014 1lomogeneity Heterogeneous
PLM NYS 190.1 Friable MoiAnalyzed
VLM NYS i98.6 VCM _ Not Analyzed
PLM NY$108.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
Final residuo mass<i%
TEM NYS 190.4 MOB 09/23/2016 Black 100.00%Other Norte Detected
Sample ID S-SC ne ctlPikul GREY SHED ROOF-UNDERIAYMENT _T
031626241-0015 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed _
PLM NYS 198.6 MOB 09/22/2016 Black 100.00%Other Inconclusive:Norse Detected
Final residue mass<t%
TEM PIYS 198.4 NOB 09123/2016 Black 100.00%Other None Detected
sample In SEA Doscrlprlon GREY SHED ROOF-ASPHALT SHINGLES
031628241-0016 1101,1000+1e1by Heterogeneous
PLM NYS 198A Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM PIYS 198.6 NOB 09/22/2016 Black 100.00%011ier Inconclusive:None Detected
TEM NY$ 198.4 NOD 09/23/2016 Black 100.00%Other None Detected
..a._...�...,_-._moo._. . ....-
Sample l0 5-68 Descrilllloll GREY SHED ROOF-ASPHALT SHINGLES
03/628241.0017 1lomogeuelLy Heterogeneous
PLM MYS 198.1 Friable NotAnnlyzed
PI.M NYS 198.6 VCM Not Analyzer/
PLM NYS 198.6 MOB 00/222016 Black 100.00%Other Inconclusive:None Detected
TCM NYS 198.A NOB 09/232016 Black 100.00%Other None Detected
initial Report From:09242016 07:09:56 J
nsr lac, 0nns-s.il Printed 9/24/2016 7:10.00AM Page 3 of 8
03
_ . iii: 1!FddS22 !
•' 3el/Fax t301h90-00 1 (York,i90 tU010
Tei/Fax',(212)290-0051/(212)29U 0050 I h '� Irl. 1
-fest 12epoi is ohostor,Aintlysis of Bulk MatliFiai
Non-Acbostoc
Analyzed
TOM Date Color Minute 6101141lr'ruus Asbasios
Samplel0 S-6C Decrription GREY SHED ROOF-ASPHALT SHINGLES
031628211-0018 1lomoganoity Heterogeneous
PI-he NYS 100.1 Friable Not Analyzed
PLM MYS 190.6 VCM NotAnalyzed
PLM NYS 196.6 NOD 09/22/2016 Black 100.00%011ier Inconclusive:None Detected
'i EM NYS 190.,.NOR 09/23/2016 Black 100.00%Other Mone Detected
Semple it, S-7A Description BATHROOM-9"FLOOR TILES
031528241-0019 Homogeneity Heterogeneous
PLM MY81190:1 Friable -- _ --NotAnalyzed
111.M NY^u 190.5 VCM NotAnalyzed
I`l.re NYS•i08.6 00". 09/22/2016 Beige 100.00%Other Inconclusive:None Detected
TEM NYS 190.4 Nor, 09/23/2016 Beige 100.00% Other clone Deiected
Sample 10 5-78 Description BATHROOM-9"FLOOR TILES
031628241-0020 Homogeneity Heterogeneous
PLM NY3193.1 Friable — _ --- --- --- — NotAnalyzed ---_
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 198.6 NOD 09/22/2016 Beige 100.00%Other Inconclusive:Nolle Detected
TEM NYS 198.4 NOD 09/23/2018 Beige 100.00%Other None Detected
Sample ID S-7C Description BATHROOM-fl"FLOOR TILES
031628241-0021 Homogeneity Heterogeneous
PLM NYS 196.1 Friable NotAnalyzed
PLM NYS 198.6 VCM NotAnalyzed
PLM NYS 190.6 NOD 09/22/2016 Black/Beige 100.00%Other Inconclusive:None Detected
TEM NYS'198.4 NOD 09123/2016 Black/Beige 100.00%Other None Detected
3arnple iD S-BA Description BATHROOM-FLOOR TILE MASTIC
031628241-0022 Homogeneity Heterogeneous
PLM NYS 190.1 Friable NotAnalyzed
PLM NY$198.6 VCM NotAnalyzed
PLM NYS 198.6 NOD 09/22/2016 Brown 100.00%Other Inconclusive:None Detected
TCM NYS 198.4 NOD 09/23/2016 Brown 100.00%Other None Detected
Sample ID 5-80 Oesmiptinn BATHROOM FLOOR TILE MASTIC
031628241-0023 Homogeneity Heterogeneous
PLM MYS 190.1 Friable Not Analyzer)
PLM NYS 198.6 VCM NotAnalyzed
PLM MYS'190.6 NOD 09/22/2016 Brown/Black 100.00%Other Inconclusive:None Detected
TL•M MYS 190.4 NOR 09/23/2016 Brown/Blach 100.00%Other None Defected
Initial Repon From:09124/2016 07:09:56 1
l.SF. '193x 0p00-1.77 Printed 9/242016 710:00AM Page 4 of 8
. . - . OTI6'L82P1
. __ r,;i;;.o•I,trtl il,: .
307!Nest 3010 Slice,iJouv`/orl<,NY 10010 Uu4S22
l'w uul n !'I1:
lal/Faz:(2 12)290-0051!(212)290-0050
. PFgiPr,L IU:
iic?L l c(1urk:AJ)oSios Aii ilys,ila of Milk Whie l,11
floe:Asbecioa
Analyzed
'rest uaie Color Fibrous elon-14brous Asbestos
Sample lD S-8CDescription BATHROOM-FLOOR TILE MASTIC
031628241.0024 1lontogenalty Heterogeneous
PLM HYS 198.1 Friable ---_— NotAnalyzed
PI-M NYS'190.6 VCM Moi Analyzed
PI.M NYS 100.6 P1011 09/22/2016 Brown 100.00%Other Inconclusive:None Detected
YIiM MY:'190.4!09 09/23/2016 Brown 100.00%Other None Dolecied
tiamnlc 11• S-9A - - Du se.1plion KIl'CH01 FLOOR-MASTIC _
031620241-0025 Nomogencity Heterogeneous
PI.M NYS 198.1 Friaide -_ —---- _-- Moi Aomlyzed
PLM M"% 198.6 VCM -- Noihnalyzed .—
PI.M NYS 190.6 MOB 09/22/2016 Brown 100.00%Other Inconclusive:None Deiecied
'i cM NYS 190.1.NOV 09/23/2016 Brown None 100.00%Other 11.00% Chrysotile
Sample lD S-96 Description KITCHEN FLOOR-MASTIC
031628241.0026 Homogenaliy Heterogeneous
PLM MYS 190.1 Prlable Not Anolyzed
PLMNY'; 60.6 VCM NotAnelyzad i
PLM MYS 190.6 NOB 0912212016 Black 100.00%Other inconclusive:None Detected
TEM NYS 198.4 MOB 091232016 Black 100.00%Other None Detected
Sample ID S-9C Description_ KITCHEN FLOOR-MASTIC
031628241-0027 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM MYS 198.6 VCM Not Analyzed
PLM NYS 190.6 NOB 0 912 212 01 6 Black 100.00%Other Inconclusive:None Detester!
TEM MYS 196.4 MOB 0923/2016 Black 100.00%Other None Detected
Sample ID S-10A Description BACK ROOM DRYWALL CEILING
0316282460028 Homogeneity Homogeneous
PI.M MYS 196.1 Friable 09212016 Gray/Tan 5.00%Cellulose 65.00%Gypsum Mone Detected
8.00%Hair 22.00%Non-fibrous(other)
PLEA NYS 198.6 VCM NotAnalyzed
PLM NYS 190.6 NOB NotAnalyzed
TEM MYS 100.4 MOR Hat Analyzed
u^ample lD S-t 08 Descnirtion BACKROOM-DRYWALL CEILING
031628241-0020 Homogeneity Homogeneous
IILM MYS 190.1 Frlable 09/21/2016 Gray/Tan 4.00%Hair 6.00%Ca Carbonate None Detected
30.00%Non-Fibrous(other)
60.00%Ouariz _
PLM NYS 198.6 VCM —_-- --------_-- NotAnalyzed
PLM MYS 198.6 MOB NotAnalyzed
TEPA NYS 198A MOB Not Analyzed
initial Report From:0924/2016 07:09:56
.. S 10az 0000-'i.7', Pdnled 9/24/2016 710:00AM Page 5 of 8
1
I' 'I:iiUlllifll l: ��F+h�:+)L
Street
/ 307 West 38ihNew York,NY 10010 -" _ -- - --
c nsstoturr t'u:
v Tel/Fax:(212)290 90-000051/(212)290-0058
Y'eSS: Repo0;AshafAr)G Aiiaiyolu of HIM( Wbitut-In!
Not-Asbastoa
Analyzed
Test Unto Cohn Fibrous Noll-Flbio0s Asbocios
Sample lb S-IOC Description BACKROOM DRYWALL CEILING
031628241-0030 1lomotlooelly Homogeneous
PLM NYS 190.7 Friable 09/22/2016 Brown 70.00%Cellulose 30.00%Non-fibrous(other) Nona Oelecied
PI.M NYS 190.6 VCM NotAnalyzed
PLM Ni'S 100.6 MOL' MotAnalyzed
Y11M NYS 190A MOD --- NotAnalyzed
^amptclP 5-11A naprdpilmt HOUSE ROOF-ASPHALTSHINGLES
031620241.0031 IlumogeneRy Heterogeneous
I'I.M NYS 196:1 Friable —_ NotAnalyzed
PLM NYS 196.6 VCM --- Hot Analyzed
PLM MYS 998.6 NOB 09/22/2016 Black 100.00%Other Inconclusive: Nona Uaiecied
TOM NYS'i 98.4 NOS 09/23/2016 Black 100.00%Other 0011e Daieciod
5ampiein S-11B lumclipiion HOUSE ROOF-ASPHALTSHINGLES
031628241-0032 1lonogenoliy Heterogeneous
PLM MYS 198.1 Friable Not Analyzed
PLM NYS 190.6 VCM NotAnalyzed
PLM NYS 190.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
'rOM NYS 190.4 NOB 09/23/2016 Black 100.00%Other None Detected
Sampla lD S-11C Description HOUSE ROOF ASPHALT SHINGLES
031626241-0033 Homogeneity Heterogeneous
PLM NYS 198.1 Friable NotAnalyzed
PLM NYS 190.6 VCM NotAnalyzed
PLI11 NYS 190.6 NOB 09/22/2016 Black 100.00%Other Inconclusive:None Detected
TEM NYS 198.d NOB 09/23/2016 Black 100.00% Other None Detected
Sample ID S-12A Description HOUSE ROOF-UNDERLAYMENT
031628241-0034 Homogeneity Heterogeneous
PLM NYS 108.1 Friable NotAnalyzed
PLM NYS 196.6 VCM NotAnalyzed
PLM MYS 196.6 NOB 09122/2016 Black 100.00%Other Inconclusive:None Detected
'i EM NYS 198.0,NOB 09/23/2016 Black 100.00%Other None Detected
Sampla lL` 5-128 Description I1OUSE ROOF-UI!DERLAYI4F.hlT
031628241-0035 Homogene8y Heterogeneous
FLM NYS 196.1 Friable NotAnalyzed
PI.M MYS 198.6 VCM Moi Analyzed
PLM MYS 100.6 MOB 09/22/2016 Black 100.00%Other Inconclusive:(lone Detected
Final residue Mass<1%
TEM MYS 190.4 NOB 09/23/2016 Black 100.00%Other None Detected
In10al Report From:09/24/2016 07:09:56
Air,_':9r+z 00u9-1.71 Printed 9/24/2016 7:10:OOAM Page 6 or 8
0.3 i62n7,;1
307 Wast 301h Street Newyork,My 10010
t%ilGioilu„'11 l: i ;-1PI;22
Tel/fa':(212)290-00511(212)290-0056 f u SY.1J111th1 {'lJ: J
.i''rlojar i BJ: _...
'1'Hr IL:;;it)icAi3bo8toBAnalysleoiNd1iMat(kdail
Non-Aauesios
Y.nalvzod
Cost Date 00101 111blous 1,1011-Flim 011e Asbestos
6emploln S-12C Description HOUSE ROOF-UNDERLAYMENT
031628271-0036 Iiombgeueky Heterogeneous
PLM NYS 190:1 Pitiable Not Analyzed
1>LM NYS-190.G NCM - -_ ---- --- — ----- — iiot Analyzed
PLPd NYS 190.6 NOB 09/22/2016 Black 100.00%Other Inconclusive: None Detected
'I EM Nl'S 190.:0 NOi; 09/232016 Black 100.00%Other 0.0,10 Detected
Inial Report From 0924/2016 07:09:56
::SF. 1L`8z OOOG-'Lil Primed 9/2412016 7:10:00AM Page 7 of
. ... i 0316282<L1
I
307 West 38th Slroet No•:York,HY 1001n �-•��• -. HF.NS2'I_
Tel/Fax:(212)290-0051/(2 12)290-0050 1 11 ..........
:• ill o/ all
't'<r,;i: f<e�Jortalt;imrios;!•In�,ItrFls crF{3u1i1: IUiateei�tl
The samples in this report were submitted to EMSL for analysis by Asbestos Analysis of Bulk Materials via NYS ELAP Approved Methods.The
reference number for these samples is the L"MSL Order ID above. Please use this reference number when calling about these samples.
12000rt C�inn7a�nis:
Sample Receipi Date: 9/19/2016 Sample Receipi Time: 9:27 AM
Analysis Completed(late: 9/21/2016 Analysis Completed Time: 4:52 PM
Deane Charles PLM NYS 190.1 Friable(4) Dean Liang PLM NYS 190.1 Friable(2)
Jon Williams PLM NYS 198.6 NOB(30) Nlolella INS TEM NYS 198.4 NOB(30)
Sat'rtplae reviewed and approved lby:
James Hall,Laboratory AAanager
or OtherApproved Signatory
NOB=Non Friable Organically Bound N/A=NotApplicable VCM=Vermiculite Containing Material
4n New York Slate,TEM is currently the only method that can be used to determine if NOB materials can be considered or treated as non-asbestos containing.
All samples examined for the presence of vermiculite when analyzed via NYS 198.1.
-NYS Guidelines for Vermiculite containing samples are available at hllp://www.wadsworth.org/IabcerUelapcerYforms/VermiculitelnterimGuldance_Rev070913.pdf EMSL
maintains liability limited to cost of analysis.This repel relates only to the samples reported above and may not be reproduced,except in full,without written approval by
EMSL.EMSL bears no responsibility for sample collection activities or analytical method limitations.Interpretation and use of test results are the responsibility of the client.
Samples were received In good condition unless otherwise noted.
This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP.NIST,or any agency of the federal government.This report may
contain data that is not covered by the NVLAP accreditation.
Samples analyzed by EMSLAnaMlral.Inc.ale:v Yak.W WS ELM 11508
Initial Report From:09/24/2016 07:09:56
7:S3_tl08::_OVO^-7.71 Printed 9/24/2018 7:10:00AM Page 3 of 0
OrderlD: 0315262.51
LIVE,. OIckn ivt1111Iu I ;C It 11 nr!nfv) n t ,I(la
_—.
f'U7 ,1 lull f!d I l '>�1iln I I l lu �'l,li
('om{rely.f!a11son V; V!eat LLC e Bill 1
Sti-eat:902 POLILe 1411 _. i '(I t'ady f3illin.l".(p wliflorl rI,jiln m -'Iulon from third im,ly
Co_rmtry,L 15
J1aa::i5i nut; I:,,; '1^31'170;0
10it
I;cir )rJar:
FIO(Ct 1.'�il lel is 'lulllll.:Jh.
U.S.St.d. :: I• pIY 1 ':-ual I, ;,. nut n ntl:_Ut I malupt
I ' IA {.:111(( - ::h �inn•'i � i, I'
6(1(ll �
[.I I 1 1 A t Ir I 1'i) LJ r I :'i AP P4(`Ui d l i .1
1 '1111(:sol,llll I I 1Uu 1 '(1: ^.)i � 't000( ),IV.) I I ( h aiiiultl (Moll Gol( '1111 :I I::I Iill ltlll)
Glint( oum`9C 1• 'Ao i..tll L!'100 IU.:i'a OV).lits`, D�A U 1r1/R O II
LI NIn;;H^00"1. (.'I`/,)
rWI NY FLAP Ivlothwi eCe 1 (lrloble.111 NYI L,( f[i:d Clu 1111 J11:'¢yl t Ili Uli i;lu�utl (^I) I.:,: II ui1J,
NY I:LAI'Nc hod 7('jit.6 h!013(nun tri lt)le_;.I•;)
0 ()SHA ID 91 Modifiod l a
[j Standard Addltott Method -
�]Check rm.positive Stop C(¢¢rl ldenllfi }{rnno ensu¢GtrUji 1_i)<Ito Smnpt¢d:���' �•)�_,i_- _ _ _.
Samplers h1mno: ll�a 'ies GIroncict
Sam{Slors + `" p ers SiOnntaro: ` �Yti_
Salnt)le k HA fi I Sample Locado» —� Material Dascri;_tloll
t C 6 t
� t
1.11
Rclinquishrd ((ka.nt): 11' --- DIt. ' ��� I•I _. ' 1t
1 ime
_('ommrntsl5�let utl 6 .auctions:
OrclerID: '031628241
`ko;
1" Iulb!"' Mo 1".;
LI,ISL MIALYYIfnt INf.
Addilionall"agas(;!'I;tc-. Ch:?h I ni GUS(t)dV,'?l() Old"I
Saunpial€ HA 41 Lull;!flollial—1)(Isc,iptim-o,
41
J_
j
J-1
It
Will,
OrJerID: '031628241
1 J [ I'liAli' l VAJ.0
I, urderN(I I II bf�I,(Lab usu udy):
ACIAVI;hum PI IONI�: (212)290-00,51
Halition Van Moot 1A.0
lf,qc,:t .1shill--D nuh n1
Strout:902 RQUIO 1116
Rolloi 1'10 JarnesOwnda T
Ex Mail all
v mp!
'Stato SaullL_Nal�(Atv 1' iiii
ITRY Mrl(�bi�lahtlalr[�Tx rxe
7-*ri L�i�v-Tv
I Plena Chock
Tr J-11 9611oul t -1
i, ltoMI-111 . .. ... j,
IIIA 1
;O(W
"I'lil 4f�l 1"llo .1i, I 1p) I I A 1. ......
LI Njp;j!!min ]II'i"Ah.,I'LlY • ilit !!iO�- .�:Il i lf 1
Nly MAI 1161110 Ill NY) )Wilitild`� `1, !0:
liy t�y aArj tLIS11�1?d It6,3�� Ujilon-M
_ L 13
El.0,07YA 10-1.91 WJ.Mod
Standard Addition Method
Chuck For Positive Stop GIO"irly idnntify Fiume annus C-roun] Dal()
n el sampim a 131gliaturcl:
'Itura:
,ffirripIask, Giro 61�
Samplag HA Saml)[a Location Motorial Description
It
.1 d
I( it tik At
-7 If
it
polill(Ilw4led(Glie Date:
_
GtrA
l"'welved(Lal
I a-1 _1111m:
ramments cl I It rimtions:
9 1)1/1/(,
Yk IL
Of a r" . If,
OrderID: 031628241
o I i I(fit jq IfikAici I'd
f. haiii o1 Custody
EMU. Order Nuirlber(Loh Uso Only): New York, NY I O(i i,
&
(212) 290-00-fib
A(Mition-ii I of tilt., Uplin of Custody ang only
I I owasaly if ll ecied for additior),11 val 111)to 111fol Illadoo
MatorIA D 1 0 1,
HA 11
6'--4
is 1)
ii
c P
If I i
JA
It
1-1-61,wl -flaw
SP I t de- oV s..
RAVI-Y
- ij�
'Commentsk3pacial instructions:
i (ice j.o /Ca
VV
CLASS(EXPIRES)
1) INSP( f 1/16)
rf-vy V Ue ii L ia'0,. •�iL'l1iL';:l"Ii'.t
Division of Safety and Health
License and Certificate Unit
Stale Campus,Building 12
Albany,MY 12240
A a2Ek;T,C)8 iAWIJILIWT LICUN,,=
I Janson Van Meet, LLG DILE NUMBER: 05-0220
LICENSE NUMBER: 28463
902 Route 146 LICENSE CLASS: RES'tf;ICTED
DATE OF ISSUE: 03/24/2016
Clifion Dark, NY '12065 EXPIRATION DATE: 03/31/7,01'7
L
LtulyAuthorized Representative D i<irby'Vanvleet:
This license has been issued in accordance with applicable provisions of Article 30 of the Labor Law of New York State,and of
the New York State Codes,Rules and Regulations(12 NYCRR Part 56). It is subject to suspension or revocation for a(1)
serious violation of state, federal or local laws with regard to the conduct of all asbestos project,or(2)demonstrated lack of
responsibility,in the conduct of any job involving asbestos or asbestos material
This license is valid only forlhe contractor named above and this license or a photocopy Durst be prominently displayed at the
asbestos project worksite. This license verifies that all persons employed by the licensee on an asbestos project in New York
State have been issued an Asbestos Certificate,apjiropriatn for the type of work they perform,by(lie.New York State
Department of Labor.
Eileen A Franke, Director
SH 432(8/12) For the Commissioner of Labor
TOWN OF QUEENSB RY, j
TOWN OF QUF-,EN BURY
BUILDING & CODES ��I��".
- � 1/2
I��VI��Jl/ea:l � °�°
8 red on our limited exal iin-tiol�s corn liance r -
our comments shai! not be construed as Gunn Lane � --
u, -atincg the Maris and specification: are in Date: -
I':' ompliance with the Building Codes of �.
New York State. `
� o
Well
Mean High Water: 320.20' Mjomees douse
Lands N/F Of
Marianne Cattablani, et. al.
-14161236 I
Ad,{o'nee Lack ; r` (
1 ° ed x"
F _ 3/4 IPF. ,N. . r �_ - Right-Of-Way
1 q, , "
r sl8 i For Ingress And Egress
un
S820,5,1 s38„E - 't i I I ` ;` �,� `3/4^IPF
t/ 2 f f ' To°4 — ,tt 2.a' n-To
VERR
IF
Elevation=319.6' 3 Shed 174.98' 23.12�:
Lake f I t rt t = €ui•�.! Canopy e y E-!I2° PF
I t'1 i j stied / / CIF z
Tie Line t
N0°11 `.34"W 3 /
. '' " ` [ story - ( -w• �
102.64` (i ( Area or Wood-Frame
1101± Along Shore r(l I e6uwas house
330-•-'1 �
LANDS N/F OF
_ _
f: ! ` F ...-. --- _ ..=.. 33 - INWALD ENTERPRISES,LLC -
Dock s
_ - I '" � a� 34881252
`� _ _ x plrG LSrlve
�ne1M — �^ 't !�5dted In Corru ted
mnry Wa(k Slate Palo Metal P� i
Deck _ wood \ i 1 Area
I aooux ,Y -07.3`' sq
i
r d 4i+ acres
'60ck
- t '
227.17-1-17 BOTH 595-2016
Wheeler
Jacqueline -- 1 Rkeio� -
- ,ae�► i Ralrood Spike Fn
fire
4 Gunn Lane tt,,,; Riau 1; I
1 __r. ` u. Pole NO 24-2
Demolition Boathouse ��, 3o to _ 1 , _
3�* r ? I Eley: 329.88
DockPERMIT P
l f a I HAVE PwR�C`�t�LY fit! ",
�' r ='!t €.
C \ . 761 / i ~.r - ,. \ L`. o I art {)IN,jT ! E €T � C r� E. !;�€ l l .H—
Ght� lad °"48 - ( POSH
} CTS ! 3rI ,1. 1t; ;''.4)
On Douldor
Cr,
18 W. _
----- ~`i r - - _
,
Covered,pock
- LANDS W OF
Map References:
INWALD ENTERPRISES, LLC -
Froin Corner
Map Of A Survey Of A
33801213
Parcel Of Land At LEGEND
Cleveniate On Lake George
Made For A.Q`��' C - QCIRF: :CAPPED IRON ROD FOUND
Lee J. Yanney G7 �`tt STF� 01PF=IRON PIPE FOUND
Dated.August 15, 1952 Deed Reference: `` F� Ci� _UT1LlTYPOLE
By. John B. Van Dusen �r - -
y Barbara.Y. Haraden l
c Q .-SEPT
JC.TANK CQVER
Map Of A Portion Of The Lands Of ToFENGE C1NE
Ray 8 Jean
Nelson Robert H. Yanney t+ Vertica Datum NGVD29 x -WIRE FENCE UNE"
Dated:
May 23, 1980 Dated.April 16, 1993 E`,j,3; sat35 �, i_ -
y F J t
Revised:August 20, 1980 Book 881, Page,168 to N0 S Contour Interval :1 Fvbtx-.LAMPPOST
Date =March
23, :2016
Scale t"=2Q'
VVAMomjWAWvnat(OKA nMiOAwanr cSurvey- made or:`-.-
.C'”'►` �► _ .. Map of a Topographic
- VIP or « .
�,� � - Final ZBA Approved Plans _
owr Dora nta+me oacwu ar ttq�nivcr
� µ or,mVW 1
steveS xxs,wLacowotoasaioeera,cnazaorrts. Area aoriance PZ-0181 016
, . , t> rr Jackie - Wheeler
' itaseuactxazrarMnwaooRawoewtmme line
aacaae Wheeler -
�rmwarraRxsr�,eNeoa�,towarrwraeto,ta
La iad Su�ve'vox'
sir t oF, .
cnttweowrommeoo uer cwaautona New York
Queensbury, New York 12804 f%' ` QTMC "°� ' °".AND Town of Queensbury, War-ren bounty, Wheeler C2999
5 69 Haviland Road Quee y, DWG.NO, I G024
O DATE DESCRIPTION l
(5 18 792-•8474 New:Yor k.Lie. No. 5.0135.
f
Tax Parcel:227.17-1-17 - _