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DEMO-0062-2022 Office Use Only DEMOLITION APPLICATION Permit#: L&Mo — OO�2-' 292Z Permit Fee:$ U0FJ- Town of Queensbury Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-762-8256 www.gueensbury.net Flood Zone? Y N Reviewed By: Demolition Location: Tax Map ID#: -22-�jr j I1 7 -2-✓ 2- % 90 4fSN449ZY &�tl lP,, **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1) o � / 1. Where will demolition material be disposed? 2. Type of structure to be demolished: a. Residence d. Storage Building❑ b. Garage❑ e. Other: evFA) &4— yel6l O : c(Ip I ;(4 c. Business❑ 3. What type of utilities are connected to the structure: ID L a. Gas❑ f.Well-Water Pump❑ b. Fuel Oil ❑ g. Public Sewer❑ FEB 172022 c. Propane❑ h. Other TOWN OF QUEE d. Electric L None❑ BUILDING& COpESRY e. Public Water❑ 4. Have ALL utilities(water, electric,etc.)been disconnected? YesIN No❑ ADDITIONAL INFORMATION: 1. Two inspections may be required: an inspection to determine that utilities are disconnected, if necessary, and a final inspection, after the structure is removed and the site is cleaned up and graded. e Ih C4 1 fio S xuf vP W� �0 J &C4A I'0 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: ��L �/��/Vi� �✓ SIGNATURE: �i- /�� DATE: Demolition Application Revised December 2020 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): M. 10p, 3J r11/ �i/�iJl� Mailing Address, C/S/Z: Cell Phone: Land Line: cdt&ty-S plt)l- lk f � Email: s��Uj/T e4k ";/ • Primary Owner(s): y Name(s): o h,��''7 (;q,r&J i?J 11 Mailing Address, C/S/Z: �J �r - �,�.,r� 9 7 �4s�Pr�► ,�r11 Cell Phone: Land Line: � Email UZbc-1 l f70 re-6_W^ ❑Check if all work will be performed by property owner only • Contractor: (List all additional contractors on the back of this f rm) Contact Name(s): R0r fUIUI V bW -- /MALL 09;0/L14 /,5f1y Contractor Trade: o C/C- 0r'c- i f41f lid'&a,3 &CAAL ftt Mailing Address, C/S/Z: tVA t,kl, var Cl/fid rI 1�) V C6/�j 40&AY / /z � Cell Phone: Land Line: �ji �/� ��7 Email: b "Workers' Comp documentation must be submitted with this application" Contact Person for any questions regarding this project: Cell Phone: Land Line: Email: KAX IL g sthUj l� cPc� (P le,^'� CA, / r1lp r V `e CJ �- Demolition Application Revised December 2020 19 Blackberry Lane Queensbury, NY 12804 CLEARV ryan@clearvuinspections.com INSPECTIONS MAR 022022 518.832.9213 T BUILDING&EENSBURY CORES Pre-Demolition Asbes DFvey Based on our limited examination,compliance with our comments shall not be construed as indicating the plans and specifications are in FUE COPY full compliance with the Building Codes of New York State. • a. a PROJECT NUMBER PREPARED FOR 10062 Best Built Docks 17 Ash Drive SITE LOCATION Lake George,NY 12845 Robert Carbognin 197 Assembly Point Road PREPARED BY Queensbury, New York 12804 Ryan Wild 19 Blackberry Lane Queensbury, New York 12804 226.19-2-2 DEMO-0062-2022 TOWN OF QUEENSBURY Carbognin, Robert BUILDING & CODES PT. 197 Assembly Point Rd Reviewed Y.- Demolition of boathouse/sundeck Date: '� f Best Built Docks,197 Assembly Point Road,Queensbury,New York,12804 Executive Summary Asbestos-Containing Material Field Survey Robert Carbognin Boat House 197 Assembly Point Road Queensbury, New York, 12804 I. SUMMARY OF FINDINGS On February 18, 2022, an asbestos-containing material (ACM)field survey was conducted at 197 Assembly Point 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 Best Built Docks. 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 6 samples were collected from 3 suspect homogenous materials. Summary Table of Asbestos-Containing Materials Material Material Id Material Category Regulatory Result Friability Quantity There are no homogenous materials for this project that are assumed or have tested positive containing asbestos 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 cutoday&laboratory analytical reports are located in Appendix E of this report. Page 2 of 9 Best Built Docks,197 Assembly Point Road,Queensbury,New York,12804 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Best Built Docks 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 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 9 t Best Built Docks,197 Assembly Point 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(<I%) 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 9 Best Built Docks,197 Assembly Point 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 9 c , Best Built Docks,197 Assembly Point Road,Queensbury,New York,12804 Appendix B: Tested Negative Homogenous Material Table Material Material Material Space Result Category Id Name Miscellaneous 001 001-Adhesive Dock Tested Negative by Lab(No Asbestos Detected) Miscellaneous 003 003-Roofing Paper/Felt Dock Tested Negative by Lab(No Asbestos Detected) Miscellaneous 002 002-Roofing,Composite Dock Tested Negative by Lab(No Asbestos Shingle Detected) Page 6 of 9 Best Built Docks,197 Assembly Point Road,Queensbury,New York,12804 Appendix C: All Suspect Materials Sampled Sample Space Section Material Analytical Regulatory Result ID Name Name Result 001A Dock Unassigned 001-Adhesive 0% Tested Negative by Lab(No Asbestos Detected) 001B Dock Unassigned 001-Adhesive 0% Tested Negative by Lab(No Asbestos Detected) 002A Dock Unassigned 002-Roofing,Composite 0% Tested Negative by Lab(No Asbestos Shingle Detected) 002B Dock Unassigned 002-Roofing,Composite 0% Tested Negative by Lab(No Asbestos Shingle Detected) 003A Dock Unassigned 003-Roofing Paper/Felt 0% Tested Negative by Lab(No Asbestos Detected) 003B Dock Unassigned 003-Roofing Paper/Felt 0% Tested Negative by Lab(No Asbestos Detected) Page 7 of 9 Best Built Docks,197 Assembly Point Road,Queensbury,New York,12804 Appendix D: All Site Photos qa Robert Carbognin Robert Carbognin Page 8 of 9 Best Built Docks,197 Assembly Point Road,Queensbury,New York,12804 Appendix D: Chain of Custody&Laboratory Report Page 9 of 9 N220�2�1 CLEA�VU G U FAKW �,... ; Chain of Custody 6 ClearVU Inspections 18 Blackberry Lane � Project: 10062 Queensbury,New York 12804 Site Location: Robert Carbognin 197 Assembly Point Road 1Q � � `� :p�M,. ..� Queensbury,New York 12804 ° `� � " "''°$"`� k'` Sampled B Ryan Wild(ryan@clearvuinspecbons.com Reporting By: Ryan Wild (ryan@clearvuinspections.com) Purpose: Pre-Demolition Laboratory Notes Turn-Around Time Request Stop after first positive for each HM 5 Day Samples Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 001A 001 -Adhesive Unassigned Dock 198.4 PLM&TEM where applicable NY ELAP 198.1 & 001 B 001 -Adhesive Unassigned Dock 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002A 002-Roofing,Composite Shingle Unassigned Dock 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002B 002-Roofing,Composite Shingle Unassigned Dock 198.4 PLM&TEM where applicable NY ELAP 198.1 & 003A 003-Roofing Paper/Felt Unassigned Dock 198.4 PLM&TEM where applicable ClearVU Inspections-Chain of Custody For Best Built Docks Robert Carbognin-10062 r,r Sample ID Material Floor/Section Space �Aw 003E 003-Roofing Paper/Felt Unassigned Dock 2.18.22 2PM Sampled By Date . Time zl7 to-� Received By Date Time Received By Date Time Received By :Date Time 2.18.22 5PM -------Relinquished By Date Time Relinquished By Date Time Relinquished By e Time Analysis By Date Time ClearVU Inspections-Chain of Custody For Best Built Docks - Robert Carbognin-10062 eurofins CU February 28, 2022 ClearVU Inspections 18 Blackberry Lane Queensbury, NY 12804 CLIENT PROJECT: 10062 LAB CODE: N220027 Dear Customer: Enclosed are asbestos analysis results for Asbestos Bulk samples received at our laboratory on February 21, 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, rqvta TESTI N G NVLAP LAB CODE 101768-0 Tianbao Bai, Ph.D., CIH Laboratory Director INViA TESTING NVLAP-LAB-CODE 101768-0----- - 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 eurof ins CEI ASBESTOS ANALYTICAL REPORT By: New York State ELAP Method Prepared for ClearVU Inspections CLIENT PROJECT: 10062 LAB CODE: N220027 TEST METHOD: NYS ELAP METHODS 198.4 REPORT DATE: 02/28/22 TOTAL LAYERS ANALYZED: 6 # LAYERS >1% ASBESTOS: 0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 t , 00 Asbestos Report Summary e u rof i n s By: NEW YORK STATE METHOD I PROJECT: 10062 LAB CODE: N220027 ASBESTOS BULK, NEW YORK STATE METHODS Client ID' Lab ID Color Sample Description Total Asbestos % 001A N476 Black Adhesive No Asbestos Detected by 198.4 001 B N477 Black Adhesive No Asbestos Detected by 198.4 002A N478 Black, Blue Shingle No Asbestos Detected by 198.4 002E N479 Black, Black Shingle No Asbestos Detected by 198.4 003A N480 Black Roofing Paper/Felt No Asbestos Detected by 198.4 003B N481 Black Roofing Paper/Felt No Asbestos Detected by 198.4 Page 1 of 1 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD I Client: ClearVU Inspections Lab Code: N220027 18 Blackberry Lane Date Received: 02-21-22 Queensbury, NY 12804 Date Analyzed: 02-26-22 Date Reported: 02-28-22 Project: 10062 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 001A Adhesive NOB Black Initial Observations: N476 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 001 B Adhesive NOB Black Initial Observations: N477 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 002A Shingle NOB Black, Blue Initial Observations: N478 Fiberglass 20% Matrix 80% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 1 of 4 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CI Client: ClearVU Inspections Lab Code: N220027 18 Blackberry Lane Date Received: 02-21-22 Queensbury, NY 12804 Date Analyzed: 02-26-22 Date Reported: 02-28-22 Project: 10062 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 002B Shingle NOB Black, Initial Observations: N479 Black Fiberglass 20% Matrix 80% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 003A Roofing Paper/felt NOB Black Initial Observations: N480 Cellulose 80% Matrix 20% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 003B Roofing Paper/felt NOB Black Initial Observations: N481 Cellulose 80% Matrix 20% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 2 of 4 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 3 of 4 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): �/MM A(A Kamila Reichert- 198.4 APPROVED By Tianbao Bai, Ph.D., CI Laboratory Director m V A TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 4 of 4 STATE OF NEW YORK-DEPARTMENT OF LABOR v ASBESTOS CERTIFICATE t �'(' RYAN.P=WILD -CLASS(EXPIRES) CATEC(05/22).D INSP(05/22),_; X' H PM (05/22).. CERTt .2i-014 8 D MV�3-173 69 A618," MUST BE CARRIED ON ASBESTOS PROJECTS 11111111�11111I�IIIIIIf f III---------------- IF FOUND RETURN. TO, EYES BRO NYSDOL - L&C UNIT —;3 HAIR BRO ROOM 161A BUILDING'12 a HGT 6' 03" STATE OFFICE CAMPUS' y o n ALBANY NY 12240 .; ..p..:.r �.. '-. e.1 9 N EAR I N S P E C T I O N S New York State 'Department,of.Laboe`- . 1 Division of Safety and Health; G i-' License and Ceftificate.U`nit, 1 a: State Campus;Building 12# Albany,_NY,12240 ' y _.. �, '--: ::,��-.__,_--_ - -_ �--�:-:~-�._ � t_,-=-='tee ;':s• ASBESTOS HANDLING LICENSE- , „—�_-�• N. Creative_Spaces-ll, LLC dba ClearVU ln_spections 4 FILE NUMBER: .� s LICENSE NUMBER: ~282890_r s �. . ,1r8;Blackberry Lane ::, ;?<,`s` : LICENSE CLASS: RESTRICTED DATE OF ISSUE: 01/28/2022 r Queensbury,, NY 12804 r- = x ' ':"K.., EXPIRATI,ON!DATE: 01/31%2023 }' ( �'�! r ,E� 'J (4 {�' s •�'•' �' ---��1�;;•e;�'{ti1�4;.r..'�`�' ��7�-�'' r{�T t 1t' 'i 9 ti ,t i tt i If 'r�' �. F 'ysy.'•?'r'.�dl:_� �: .'.d.t L:T� 1 'R�.�`�: i ,! .,_:—_`� `..m...e'°y1 II .} 1 t t.I —_i, D ly Authorized Representative.) Ryan Wild': I � �."_ „�- --�`4} } �� _�` 'f• ry, `?� �.� ',:' - a,- "^� �-�i4'�>s �r! ��-iiiFa�'•. r�#r 1 _ lfi !g `fr l�'�`�"• "'i�x i:�.�.°.:•t,'I:.r1�;+F�St}e;r Ssr�S�t'i This'license has been issued in acc ordanceGwith;;'i pphcable pros 9i6r" `6fArticl6 'of the Labor Law of New York:State and of thee New York±State.Codes,Rules and'Regu�atio 5 s;(l@12,NYCRR Part'36): It is subject to suspension or revocatlon'for a(1) �� t serious violation of state,federal or local laws withArega d-ito{the conduct'of an,asliestos'pro�ect,or(2)demonstratedlack ofr z responsibility in the conduct of any job)'involvmg�tasbesfos or asbestos material This,license in valid only+for the contractor named"above and this,;license or-'a'; 6t4cop_y..must.be prominently displayed.'at the asbestos project wgrksite. This`-lieepse verifies that-allpersons-employed by the licensee on ari asbestos project:in New York State have beeeissued an', sbestos Certificate,appropnate forilie type4of-work-they perform,by the'New York State Department of Labor. Amy Phillips,Director SH 432(8/12) For the Commissioner of Labor - _ -- -- -naIF ffift, A[►[Qt> W ktii..CUOMO;:-:-,;: . ..- ::_ HOtA►ARDA._ E[ti M,Q.�3.Q,.. _IF:35A3rPIQ :M.A:. .F :: rrlmissiorter _ _ fzecutivo t3eputy Corrlr rter= - LAB-ID:.12048 AptiI01,:_2021 ... DR.-TIANBAO BAI-__- EUROFINS=CEI; INC. -- :730 SE=MAYNARD-ROAD - - Certificate-Expiration Date- - CARY =NG' 27511 -- =. . A.nI 01- 022 Dear Dr. Bait_ _Enclosed are certificates)of:approval Issued to your environmental laboratory for the current permit-year.The _ce0100te(s).supersede(s)anjr previouslyissued one(i)and�s(are)in effect through=the expiratior€W—listed. _- -Please=carefully examine the certificates)to insurethe=thatcategories,subcategories,analytes;=and=methods _ for which your-laborato_ -_is a roved are=correct.In addition,veri. that our laboratory's name,_ad_di_ess,lead - -- _ -= -technleal director,and identification.number.;are.accurate. y === _.,.Pursuant to NYCRR=Subpart 55-2.2,original certificates must be posted conspicuously in the1aboratory 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)-for which 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 NEW logo in:any.catalogs,advertising,_business solicitations,-proposals,quotations,laboratory analytical - _ - - r -- repoi#s;or other materials must inolride the laboratory's ELAP identification:number'ard distinguish'between =_ testing for which.the.laborato-.is a and d testing for which the laboratoryno t.n-ot approved. - - - - -ifyoa have any questions,please contact us=at the Environmental Laboratory Approval Program,Wadsworth Center,New York State_Department of Health,Empire.State Plaza,:AlbanyrNY,12237;by phone at(518) -_ 48.5=5570;by facsimile-4t.(518)485-5568;and-.by email-at elap@health.ny.gov. _ ..Sincerely,: : Victoria Pretti - - - - -_=- Director`and QA,O..Mcer = -- - Environmental-L- boralo A rov r ro yam:_:_ ' - = -- - . - _ _ - - - - _=----:-FEnIft State Plaza,CorNn*TQi W,Albany,NY 12237 jheaIth.ny.god::.: = NEW YORK STATE DEPARTMENT OF HEALTH WADSWORTH CENTER Expires 12:01 AM April 01, 2022 -Issued April 01, 2021 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 CARP, NC 27511 - 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.: 63296 - ."� .. rye• 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 verify the laboratory's accreditation status. Page 1 of 1 NEW_YORK STATE:DEPARTMENT:OF HEALTH — - - - - - - - - WADSWORTH CENTER Expires.12:01'AMApril._01T2022_- - Issued April 01,20fl=_-::_ =_ -'_-=CERTIFICATE_OF APPROVAL FOR LABORATORY SERVICE_ - - - Issued In accordance with and pursuant to section 502-Pu61167 Health'Law of New York st6te =_ `DR. TIANBAO WA =_ NY Lab/d No:1204 =: ___ ._:": .:.... .. -- EUROF/NS CEl, INC:- = - ==-_ - _ — - -_ - - SEMAYNARD:ROAD ==- :_. CARY,NC "27519 -- _ _serebyAPPROVED as an Environmental=Catioiatory for the category ENVIRONMENTAL ANALYSES=SOLIDA_°ND HAZARDOUS-WASTE =-=Al!approved subcategories=and/orarralytes_ace listed below.° =-Miscellaneous — Asbestos-in:Fdable Material_ Item 198.1 of Manual- - EPA600/M4/82/020 = - — Astiestos in:Non-Friable Material-PLM Item=198.6 of Manual(NOB by PLMff= - — —- =- Asbestos in'Non-Fdable Matedal-TEM Item 198A of Manual - Asbestos-Vermiculite-Contalning Material Item 198.8 of Manual _- Serial _ Property oldie New York State Departriient of Health.Certificates are valid only at thwaddress - =-shown nust be consplcriously posted,and are QiinteiYoriwcure-paper. Continued accredita_dod deLends successful ongoing participation In the Program.-Consuriiars are urged to call(518)485-5570-_to_ verify the-laboratorys accredithildr status. NEW-PORK STATE DEPARTMENT OF HEALTH:: : - _ WADSWORTH CENTER Expires 12:01 AM April 01,=2022:__ Issued-April 01, 2021 _ - - CERTIFICATE_OF APPROVAL FOR LABORATORY SERVICE - _ -:_ _- -. Issued In accordance with and pursuant to section 502_pu611c Health`Law of New Yorh.Sfete - =_ -_ =DR. TIANBAO BAI=_=_-__====-= :. - "" � :_ ____=-_ ===�- .NYLab Id No:12048.=._ -------_-:- . EUROFINS CEI, INC:-- -_730 SE:MAYNAR _ROAD _ __:CARY, NC -27549 ereby APPROVED as an Environmenfal.L.— atory_for tha category ENVIRONMENTAL ANALYSES .EMISSIONS - - ----- 17 _ ---All approved subcategories andLor_ana/yfes are listed below: Miscellaneous Asbestos _ = 40 CFR-763 APX A No.III -- _. Fibers;.-= - =.:: :'- NIOSH 7400 A RULES- -= V. Serial Nod:._63298:1'..::- Property=otthe New York State Depaitment dMealth.-Ca[lificates are valld only at the address __shdwri,-must lte cansp[cuhusly posted,and are�IrIntedon=secure paper. Continued accreditatlott depends _ __o successhil bngoing:pcipa . tail(518)4857 tont ga go venfy theaborator/s accredilatioiistatus —— - - - -- _. __Pagel of 1-, LAKE GEORGE PARK COMMISSION FILE REVIEW Date: November 06, 2018 Town: Queensbury Owner: Assembly Point Realty L L C Parcel M 226.19-2-2 Facility: Private Lakefront Old M 8-9-11 Account#: 3260 Lakefront: 82.00 Adjusted: Linear Ft: 0.00 Assoc. Slips: 0 Address: 197 Assembly Point Road Review of this file indicates that the total number of structures approved on this lakefront is: 1 Dock(s) 1 Mooring(s) Notes: # D or length width shape boat closed articul permit or reg# supersedes M house or open ating? 1 D 35.00 29.00 U Y O F. 5234-22-09 503 1 M 0.00 0.00 1 F. 5234-44-18 ErEDVE D - FEB 18 2022. TOWN OF QUEENSBURY BUILDING&r CODES 226.19-2-2 DEMO-0062-2022 Carbognin, Robert 197 Assembly Point Rd Demolition of boathouse/sundeck This review is based on a review of fee records and dock&mooring registrations and permits. The sketches,drawings and surveys associated with this FILE REVIEW have been compiled from Lake George Park Commission records of docks and moorings at the subject property for the purpose of describing the size,shape and,location of all docks and location and swing of all moorings authorized at the property. This compilation is for the convenience of the Commission and the homeowner,and does not include the complete,original authorization of each structure,which may include limits not represented by the graphic representations attached to this REVIEW. Each structure should have a full document associated with it's original placement and copies of these documents are available on request. In the cases of docks,an Existing Wharf Registration(1981),a permit,or consent order should be associated with each structure. Single moorings were not required to be documented or permitted prior to 1988 so information on the location of moorings pre-dating 1988 may not be on record. Registration of moorings has been required since 1988 so that all"grandfathered"moorings are listed,whether a location is known or not. These"grandfathered"moorings must have been placed legally in the first instance and comply with offshore limits and property boundary limits in effect at the time of placement. � I ?a X R Stolle o ; ' G 2GG.59 13'± 3'iot' to IS 0A "—� i open-sided sundeckl —' —j1?3" 3f 3'un-canopied ! boatcover �� boatlift 1 13' top OF c-o_iiin5 , f i et° w°lis I Csai 2> a --.. Z ttv I Pt t Sur(°cE Dock '+J f Schedule A 'Page 5 of 5 t t Permit#5234-28-18 RECEIVED 6948 Hydraulic Lift MAY 0 .92018 e 48"0 High 108.0 Wide S tAKE GtUhuL I'r.ot�•..�... ...• -.1 Part Number: 1024.761 t r (113 A i v, 20 10 0 2 22 w �s� •�� :S'j �g 4 C5 "1 A 1 13 B 2¢ ParLsiist A a 7TEU 45T'Ef 2mU'Mf msm DFSCFWSM 1 1 1Qk,7d84 Boltattt Bi'eant Pant 103.0-4;;Ooo#tydrauic 2 1 10>117551 BDH4m Beam Resr 108.0 -503o Rydistffic Parts List"o, a 1 iP7J7622 n!RSods2xd11iigtt2 t-fi000Hydrade. 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