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DEMO-0204-2023 Office Use Only DEMOLITION APPLICATION Permit#:DEMO-0204-2023 j Permit Fee: $165.00 Town of Queensbury Invoice#: 742 Bay Road,Queensbury,NY 12804 i P:518-761-8256 www.gueensbury.net Flood Zone? Y 'N Reviewed B Demolition Location: 18 Crooked Tree Dr. Lake George NY Tax Map ID #• 239.15-1-9 **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? Landfill - Hiram Hollow, Gansevoort 2. Type of structure a demolished: / % � ',.ti a. Residen d. Storage.Building b. Garage e. Other: Boat House c. Business F }"' 3. What type iliti1�1es are connected to the structure: c0 a. Gas f. Well-Water P a b. Fuel Oil g. Public Sewer c. Propan h. Othe d. Electric ✓ i. None -�� e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes V 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: Nicholas Denno- Northern Builders SIGNATURE: DATE: 04/25/2023 Demolition Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Northern Builders Mailing Address, C/S/Z: 33 Atwell Road Porter Corners NY 12859 Cell Phone: 518 796-6694 Land Line: 518 796-3774 Email: ndenno@northernbid.com • Primary Owner(s): Name(s): David Cohen & Michelle Kaplan - Mailing Address, C/S/Z: 18 Crooked Tree Dr Lake Geroge NY 12845 Cell Phone: 215 499-8827 Land Line: N/A Email: kaplancohen@gmail.com ❑ 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): Northern Builders Contractor Trade: General Contractor/Builder Mailing Address, C/S/Z: 33 Atwell Road Porter Corners NY 12859 - Cell Phone: 518 796-6694 Land Line: 518 796-3774 Email: ndenno@northernbld.com **Workers' Comp documentation must be submitted with this application** **WC COI is on file. Contact Person for any questions regarding this project: Nic Denno- Northern Builders Cell Phone: 518-796-6694 Land Line: 518-769-7334 Email: ndenno@northernbid.com Demolition Application Revised June 2022 �"( l ��y�P& /� M—� "n r'°`r' Map Pelerencc o�taa w•.m ou..y:w e.+.cA M1L+p or... r` w.•r P>br w:++aveJ,N w.er.,re.w.r�;e,n, 5y:Co;d:<r t McCormaea Dare:21 Pc:cher 1965 LAKE GEORGE \ Lne Crrw,.o+,-B-16•.r933' t`c,Y,K I,"J u-Z' •:� a>f a.72M a�.>,pe�- d,m ue.vo..w,< Deed Reference '•5 . u \'i TO A.ren TOWN OF QUEENSBUICY J� :e A.F, � Da:m 26 PeOwry 2016 5O0'.5350 Pax 283 7�3'_" < 'BUILDING & CODES EPT. Can , •� - Reviewed ("^�+v-�_•"`—-,_..._ (� 2. VV t 7R4 0 24.4 fl� >an o.ra..e ':.,;u •�— _�,, o- -- ��- b �('1�1J p P ILutPfr( k Longs Ayr of - --- Paf 4795136 Lomas r+P or ee P Q ew, Cree,ee front,LLC - — .1563/772 .. :ate:•- - a. - . i _ of a topoe3raphlc survey for David L. Cohen Michelle A. Kaplan 5rtuate in if -❑ Town of Queen5bur, County of Warren \�'�•.; ,_" - ° ° ,_ _ `- 5tate o New York Scale; 1° = 20 feet Date: 25 April 201 6 _> RCnacv: 10l,ovembcY 2017 aun / -i°J?e �'1•a3'ay^.v 4 pi i[ir�so a n>e:5rl--b-202r a 4, � aP r� S W C n-een v vi om~ r � ;r:rdC'✓.--:.a v,C(t.ZN7 vu:s_1_II,OId) 7 New York State Route 9L -- - - 239.15-1-9 DEMO-0204-2023 Cohen, David & Michelle Kaplan 18 Crooked Tree Ln Demolition of boathouse 111- H-FPi-CTliji`-1 EEF�V IEZI==—, L_-L_s Asbestos Survey Report = NYS Asbestos Inspector and Tester License#879661 LO ai Client Information: 0 Name: Nicholas Denno- Northern Builders r a s z i I Address: 18 Crooked Tree Drive, Lake George, NY m Phone: 518-796-6694. U. Time of Inspection: 103 � }VN OF QUEENBBURY I Date of Inspection: 5/1 2 s m Date of Report: 5/1I123'LDING & COD B DEPT, Reviewed PY, ai Date: • : Figure 1:Exterior View -J .l U Limited Full Asbestos Positive o Client Defined Areas: ❑Crawlspace ❑ 0 ❑Yes ❑No U ❑Basement ❑ ❑ ❑Yes El No ❑1 st Floor ❑ ❑ ❑Yes ❑No 02nd Floor ❑ ❑ ❑Yes El No El Attic El El ❑Yes ❑No m ❑xBoatHouse ❑ T li��N BF QUE`NSB ❑Yes ®No ©Laboratory Testing BUILDING & CODES DEP—Tes ®No 0 R,3viewed By: - z i Introduction: frQ, o The above named client has requested an asbestos survey at the subject property. n o N This inspection report identifies all associated locations to be tested,tested materials,laboratory results ° 0 and qty of tested materials when positively identified or assumed as asbestos. -C U Z The inspection report is strictly limited to visible and accessible areas requested to be inspected by the client only. It is the duty of the client and/or client's agents, contractors, remediation companies and m other third parties active in the identified work areas to contact Bald Eagle Inspection Services, LLC 0 and cease work immediately if any suspect material or unidentified material per this report is uncovered at any time. All unknown materials shall be assumed asbestos until proven otherwise. 0 TOWN OF QUEENSBURY BUILDING DEPARTMENT a Based on our limited examination,compliance CL with our comments shall not be construed as indicating the plans and specificaticns are in full compliance with the Building Codes of NEW yni:k 2tg te. 856 Knickerbocker Road,Schaghticoke,NY 12154,(518) 488-2538,info@baldeagle.biz Catalogue of Materials: Number Type Location Qty. Notes Results 1-01 Roof Underlayment ____ Roof,__ -_ _____N/A_ __.__NOB PLM -Inconclusive 1-01 Roof Underlayment- -_ Roof _ _N/A __NOB TEM___-___Not Detected - 1-02 __ Roof_Underlay_ment _ Roof _ __ _ _N/A _ NOB PLM Inconclusive 1-02 Roof Underlayment - Roof _- _ N/A - NOB TEM Not Detected 2-01 Side Wall Underlayment ____ Side Wall _ _-N/A NO PLM _ _Inconclusive_ 2-01 Side Wall Underlayment Side Wall - N/A NOB TEM Not Detected -- -- --- -- ------ -- - --- --------- -- --- -- - - --- ------ - - - - 2-02 Side Wall Underlayment- Side Wall_- N/A - NOB PLM Inconclusive ----------- ---- - 2-02 Side Wall Underlayment Side Wall N/A NOB TEM Not Detected - -- - ---- — - --- ----- ---- -: - - N 3-01 Cloth Wire_--- - -- _-_ _-_Elect- ri-cal--System---- N/A _ _NOB PLM-_Inconclusive _ 3-01 Cloth Wire Electrical System N/A _ NOB TEM Not Detected i 3-02 _ __ both Wire Electrical System _ _ N/A_ NOB PLM Inconclusive__ 6i 3-02 Cloth Wire Electrical System N/A NOB TEM Not Detected a 4-01 -Masonite - Ceiling _- N/A _ Scanning Not Detected r- 4-02 Masonite Ceiling N/A Scanning Not Detected Z t.. - ---- - -- -- - - - -- - - -- ---- - - -- - - - o. a� - - --- --- -- - - - -- - -- - ---- -- - -- - -- - -- --- - - J a 0 o L 0 0 I L .00 y L D m' L -- -_- _ 0 0 i a) N 0 i A) L Q_ U. 0 n 856 Knickerbocker Road,Schaghticoke,NY 12154,(518) 488-2538,info@baldeagle.biz Observations: Preface: The subject property was being inspected due to concerns for possible asbestos containing materials in the boat house.The client intends on demolishing the structure. Area of Concern: The boat house was observed to be a wood structure with slate shingle roofing situated on the lake. Partial demolition of all areas was started and observed to be incomplete. Exclusions: N This inspection strictly limited to visible and accessible areas requested to be inspected by the client only. Observations were limited where finishes covered wall, floor and ceiling assemblies. m Identification: a 0 Asbestos containing materials were not detected. z Any live electrical, plumbing and/or mechanical systems have been excluded. 0 Please find the preceding Catalogue of Materials for further information. m Sampling: a Total Samples . 14 ai Total Asbestos Positives 0 >_ 0 Conclusion and Recommendations: It is recommended that all asbestos containing materials be fully and professionally removed (remediated) by a NYS licensed remediation contractor under all recommended and required a) personal protective equipment, controlled air conditions and protocols as identified by a licensed °o asbestos project designer. If you do not have a licensed asbestos project designer you should discuss �j options with the NYS licensed remediation contractor. 00 Project Requirements: 1) One copy of this Asbestos Survey Report shall be kept onsite at all times during remediation. 2) Per NYS Code Rule 56, Subpart 5.1, paragraph (g) - Transmittal of Building/Structure Asbestos m Survey Information. a. One (1)copy of the results of the building/structure asbestos survey shall be immediately transmitted by the building/structure owner as follows: z i. One (1) copy of the completed asbestos survey shall be sent by the owner or their agent to the local government entity charged with issuing a permit for such o demolition, renovation, remodeling or repair work under applicable State or � local laws. in H. The completed asbestos survey for controlled demolition (as per Subpart 56- 11.5) or pre-demolition asbestos projects shall also be submitted to the o appropriate Asbestos Control Bureau district office. U iii. The completed asbestos survey shall be kept on the construction site with the z asbestos notification and variance, if required, throughout the duration of the asbestos project and any associated demolition, renovation, remodeling or o repair project. 4- 0 (y) m 0 o_ 856 Knickerbocker Road,Schaghticoke,NY 12154, (518) 488-2538,info@baldeagle.biz Observations Continued: 3) Per NYS Code Rule 56,Subpart 3.4, paragraph (a) - Notice and Record-keeping Requirements a. Every asbestos contractor and property owner shall maintain for at least thirty (30) years, a record of each asbestos project in which the asbestos contractor engages. Limitations: 1) Per NYS Code Rule 56, Subpart 5J, paragraph (j) - Unidentified and Unassessed Asbestos and shall be treated as follows: a. When any construction activity, such as demolition, remodeling, renovation or repair work, reveals PACM or suspect miscellaneous ACM that has not been identified by the N asbestos survey per this Part, or has not been identified by other inspections as per current OSHA or EPA requirements,all activities shall cease in the area where the PACM LO or suspect miscellaneous ACM is found and the Asbestos Control Bureau shall be notified by telephone by the building/structure owner or their representative, followed p with a written notice in accordance with the notification requirements of this Part. > Unassessed PACM or suspect miscellaneous ACM shall be treated and handled as Z ACM and assumed to be ACM, unless proven otherwise by standard EPA and OSHA accepted methods, including multi-layered systems sampling protocols; subsequent N analyses performed by a laboratory that meets the requirements of Section 56-4.2 of U this Part; and the analyses satisfies both NYS ELAP and federal requirements, including y multi-layered sample analyses, to document non-asbestos containing material. a b. Contact Bald Eagle Inspection Services, LLC ai 0 m a� m Y O O U y ^L^l W m ^L^`` rWr 1 rt- O Z I O The rest of this page was intentionally left blank. C o a 0 U Z U O O IL 4- 0 N U. • p o_ 856 Knickerbocker Road,Schaghticoke,NY 12154,(518) 488-2538,info@baldeagle.biz Definitions: Asbestos Containing Material (ACM) - An asbestos containing material-(ACM) is considered to be asbestos containing if at least one sample analyzed from any homogeneous area is proven to have asbestos present in a concentration that exceeds 1%by weight or identified as an untested presumed asbestos containing material (PACM). Asbestos Testing Methods - Per NYS Code Rule 56 tested material can be divided into three distinct categories, non-friable organically bond, other non-friable and friable materials. co N Non-Friable Organically Bound (NOB) Asbestos Material - Non-friable asbestos materials embedded in flexible-to-rigid asphalt or vinyl matrices, including but not limited to flooring materials, adhesives, "' mastics, asphalt shingles, roofing materials and caulks. a 0 Non-Friable-Any material that when dry, cannot be crumbled, pulverized, or reduced to powder by z hand pressure, and is not capable of being released into the air by hand pressure. m 0; L Friable - Any material that when dry, can be crumbled, pulverized, or reduced to powder by hand 0 pressure, or is capable of being released into the air by hand pressure. C(D a� Testing Protocols: Polarized light microscopy (PLM-Friable) NYS DOH 198.1 Methodology- If PLM method yields results 6 >1% asbestos based on initial sample weight then the sample is positive for asbestos containing material. If PLM method yields results <1% or no detection of asbestos then the sample is negative for 0 asbestos containing material. Friable materials that may be analyze with 198.1 include, but are not limited to, Ceiling Tiles without Cellulose, Gypsum Wallboard Joint Compounds, Wall and Ceiling 0 Plaster, Acoustical Ceiling and Wall Coatings, Sprayed Decorative Coatings (Texture Coats), Sprayed on Fireproofing, Asbestos Pipe Packing, Pipe Insulation, Duct Wrap, Fiberglass Insulation, Boiler 0 0 Insulation, Furnace Gaskets and House Wrap. U Co Polarized light microscopy (PLM-NOB) NYS DOH 198.6 Methodology-If PLM method yields results >1% I^ asbestos based on initial sample weight then the sample is positive for asbestos containing material. If � PLM method yields results <1% or no detection of asbestos then the sample must be reanalyzed by a 5 more sensitive test method such as Transmission Electron Microscopy (TEM). m L m Transmission Electron Microscopy (TEM) -TEM analysis is required by NYSDOH if the PLM-NOB result is negative or <1%. TEM is the superseding and final determining test method of result of presence of 0 asbestos. Z i 0 c Please note that some materials may require preparation for any testing protocol and shall be determined on an as needed basis by the lab. Additional samples may be required once sampledLn o materials are reviewed by the laboratory. a 0 Demolition - The wrecking or removal of any load-supporting structural,member of a building or U structure. Z U N Presumed Asbestos Containing Material (PACM) - All Thermal System Insulations and Surfacing o Materials found in buildings constructed no later than 1980. PACM is considered to be ACM unless °- proven otherwise by appropriate bulk sampling and laboratory analyses. NO Remodel-For purposes of this report and as per NYS Code Rule 56, remodel shall mean the same as o renovation. LO a� Renovation-The altering of an existing building/structure, or a portion of building/structure p CL 856 Knickerbocker Road,Schaghticoke,NY 12154,(518)488-2538,info@baldeagle.biz Definitions Continued: components or systems, including the stripping, removal or abatement of ACM from a building or structure. Operations in which load supporting structural,members are wrecked or taken out are demolitions. Repair (Asbestos) - Abatement, consisting of corrective action for a Minor Asbestos Project using required work practices to control fiber release from damaged ACM, PACM or asbestos material Repair - The replacement, overhaul, rebuilding, reconstructing or reconditioning of any'part of a N building/structure component or system with like or similar material or parts, due to damage or excessive wear. LO m Laboratory - The laboratory of record shall be Eastern Analytical Services, Inc. Located at 4 0 Westchester Plaza, Elmsford, NY 10523. The laboratory of record maintains and records an in-house >= quality control program and can be requested from the laboratory at the client's request. Z a� o: Sampling Requirements - All sampling quantities shall be conducted as per Asbestos Hazard 0 Emergency Response Act (AHERA) Subpart E,Section §763.86. O 1) Surfacing material. An accredited inspector shall collect,in a statistically random manner that y is representative of the homogeneous area, bulk samples from each homogeneous area of friable surfacing material that is not assumed to be ACM, and shall collect the samples as follows: : a. At least three bulk samples shall be collected from each homogeneous area that is 12 1,000 ft2 or less, except as provided in §763.87(c)(2). b. At least five bulk samples shall be collected from each homogeneous area that is greater than 1,000 ft2 but less than or equal to 5,000 ft2, except as provided in §763.87(c)(2). o c. At least seven bulk samples shall be collected from each homogeneous area that is U greater than 5,000 ft2, except as provided in §763.87(c)(2). Co 2) Thermal system insulation. N a. Except as provided in paragraphs (b) (2) through (4) of this section and §763.87(c), an 0 accredited inspector shall collect,in a randomly distributed manner,at least three bulk -0 samples from each homogeneous area of thermal system insulation that is not assumed m c to be ACM. b. Collect at least one bulk sample from each homogeneous area of patched thermal -C system insulation that is not assumed to be ACM if the patched section is less than 6 0 linear or square feet. z c. In a manner sufficient to determine whether the material is ACM or not ACM, collect o bulk samples(minimum 2),from each insulated mechanical system that is not assumed � to be ACM where cement or plaster is used on fittings such as tees, elbows, or valves, o except as provided under§763.87(c)(2). 3) Bulk samples are not required to be collected from any homogeneous area where the 0 accredited inspector has determined that the thermal system insulation is fiberglass, foam glass, rubber, or other non-ACBM. Z 4) Miscellaneous material. U a. Ina manner sufficient to determine whether material is ACM or not ACM,an accredited o inspector shall collect bulk samples (minimum 2) from each homogeneous area of friable miscellaneous material that is not assumed to be ACM. 5) Non-friable suspected ACBM. ,— a. If any homogeneous area of non-friable suspected ACBM is not assumed to be ACM, p then an accredited inspector shall collect,in a manner sufficient to determine whether �O the material is ACM or not ACM, bulk samples (minimum 2) from the homogeneous a) area of non-friable suspected ACBM that is not assumed to be ACM. p o_ 856 Knickerbocker Road,Schaghticoke,NY 12154,(518) 488-2538,info@baldeagle.biz Maps and Layouts: 4-01(Ceiling) ce) N LO N U 0 Z � N U, L O 0 2-01 Y 2-02 �L ^W` W L n O O U 1-01(Roof) 00 N L Q) 5 00 C ^L' y_ 3-01 O 3-02 Z (Atjunction box I above on ceiling) O c N V7 U O U Z 4-02(Ceiling) U 1-02(Roof) N O L O O O: i3 o_ 856 Knickerbocker Road,Schaghticoke,NY 12154, (518) 488-2538,info@baldeagle.biz Figures: Figure 2:Interior Elevation Figure 3:Interior Attic Figure 4:Roof,1-02,1-02 Figure 5:Side Wall,2-01,2-02 N M LO t t - � Il Z 7 c U. N Figure 6:Electrical,3-01,3-02 Figure 7:Masonite,4-01,4-02 N Y Q J 'C r) H Y O O U 00 N L .j m L L O Z i The rest of this page was intentionally left blank. o c c m 0 a3 0 U Z i-' U ' N O MO 00 O O a. 856 Knickerbocker Road,Schaghticoke,NY 12154, (518) 488-2538,info@baldeagle.biz Chain of Custody: tom.+ r CHAIN OF CUSTODY CtGyc�c i 3s d Eae a Inspection Services,LLC v.Ru Ad,—w 15 Cr 6oked Trea Drive,LakeCro.;e aW�,a 655 K7&kerbocker Road uau:5/1/2023 N Schaohticoke,MY12154' rxtucsad 12 KR \ S F..1 &'Isson Federico sC..tu�aaC Stop at first Positive[SAFP) wS—[51B)4SE-2535 PLMcUseminimumI.tmeLhej when acasiiIL LO batd=_�leire pCgm Leoni sc+Gdrxstii�a 27 0 ad'ie�s-°nd v,Jason Federico f;eaer Z euuc 5/i/2023 4ca:1030AM U; i ua:,od gx. s�,cec�: N .Y Sample Location Sample Location Material Description Analysis Notes._ No. Mo. Requested i!-01 j Roof I Uadeflayrnent TEM SAFP_i-OLto 1-02_— _ _ 1--02 I Roof Underiayment I_'TEht 0 2-01. I _ side Wall UndL63yM"t _TEM j SAFP 2_-0_L_to 2-02 '2,-02 { side wan _Underlayrn=n_t { TEM I 3;-0i j ElctYrka3 Cloth Wire j TEht SAFP 3-0L to 3-02 ~ 3'-02 I Electrical -Cloth wire. I TEM - -- 41-01 _I Ce3in� _ wwrfte j PLM SAFP 4-0i to d-02 41-02 Celirg ' ht330nte l PLM ----- p I I i u 00 —�-- --;- -- �_ --1 — p I ! I 1 1 ! I o NO 0 • O� Z0fI U. 0_ 856 Knickerbocker Road,Schaghticoke,NY 12154,(518)488-2538,info@baideagle.biz Lab Reports: TAS BrtrhNa- 23i?2696 Easfen Anal, m p_1 o2 i ,Bulk Sample Results. RE: 18 Grooked.Tree Drive-Lake George CV Daft Collected: 05 01f2023 Client Paid Eaele hmec�on Senzces;LLC 856 RnirY erbocker'Road Collected Br-: Jason Federico Scha=hticoke NY l2i 54 N Date Received: 05.E 0412023 b Date rA.aaly zecl: 05108/2023 p "Analvzed By: George Htay >: Analy-ticalMethod: NYS-DOH 198.6 N U. .N'vT.A-P.Lab Code: 101646-0 NYS Lab No., 16851 N N Sammie ID Nenrber 1-01 1-02 2-01 2-02 Y O . J 13vQ NIllLOfl ; 'C Lab ID Number 2912842 2912843 2912844 2912S45 0 Sample Location Roof hoof Side Walls Side gall (D N O O Sample Description Underlr nnent Underlay went Underlaymeirt Underlaymenr U N (U Analytical Method NOB PIm NOB P-Im NOB P:m NOB Pim Cp Appearance ' Layered. -N`o No No Homogenous Yes .Yes Yes Fibrous Yes Yes Yes Yes p Color Black Black Black- Blacks Z I O N Asbestos °o Amosita ND ND -ND ND tN Content %Chrysotile ND N'D ND O %Other ND ND ND 0 U %Total Asbestos ND Inconclusive ND Inconclusive. NND Inconclusive ND Inconclusive Z U N Other %ormnic 9 6.7 97 2 97.6 97.6 0 MatEnal; CL Present %Carbonates 1-1 1.1 1.3 1.2 %Other Inorganic 2 2 1-7 1.1 12 O Fna.'i>A��u13e7uT6,x haQ Taan1.NaPutCmal�P.�uL al F�wc}i Fmi,cy."weilrie't:;.�.+�.-s���tt�.•_s��.n���.�:,..F.���,tm,:��n.ar nn-•xe rr� O L'uli.ity Csitd Tu Cci ffiAaa1J.S.T�Fi�.el S2nt L:,e lz Ua?1�11z CIcl t Clu,a Ft.,1,..Fl.l.valrt lj'WIAP'.A.V AF.'y r ft us C.ve-_et ilosF�ak,CzmdB:.Bi:ol Tu Cle;�T6tii0R Rmi.TdvlAr eiw,4iFvlmCtit�r9U2m"r.SlCch,r�a",..0 R_j..6-=A7oc.3sLw Tk�D Pcsl'} � TIz.aalaa:�wt.r-r:e aui�-clitez.!,n+y tm.l-'+�t�the lez.d zl�ta,lo�n in a as�fc anisiein+:tea hm.lA.i vrnn'iulit. AIHAiA+,ll.C)`:u f0@]}3 M�Cs{cl e?7C:71�.AA5.� ?J�.=%umt c'?.�i.S:uAAbl'u?2 6p,s.:cti�.t pOC-:I�u PHle1: ltiim ClFF I:+SA-0Ci Vavri�i7[1H1S�A^_,.?6:935 U U .856 Knickerbocker Road,Schaghticoke,NY 12154, (518)488-2538,info@baldeagle.biz £AS BalchNa. 2302M Pam 2 of Eastern Analytical Servicesi Inc. Bulb Sample Results RE: 1S Crooked Tree Drive-Lake George Date CoLected OSIOI 2023 Client Bald Eagle Inspection Sen-ice?,LLC N Collected By:-. Jason Federico S56 Knickerbocker Road Date Receii-ed: 05I04l2023 Schaghticoke NY I21�4 LO LO Date Analvmd; 0510302023 N Analyzed By: George Htay D Sisnatuie: - nal}tica114lethod: NYS-Di?H 198.6 Z NVIA P Lab Code: 101646-0 N NYS Lib No. 10,851 � O O Sample ID Number 3-01 3-02. N L.i�rNus-var � t3 J Lab ID Number 2912846 2912S47 N Samale Location Electrical Electrical N N O Sample Description Cloth[dire Cloth Fire 0 O L U cw H L., -Analytical Method NOB.Plm NOB"?�r O Appearance Layered '_Nro m Homogenous Yes Yes Fibrous Yes Yes Color Blacl: Black. 0 Z O Asbi-_-tos `;o Amosite ND" ND Content '/6 Chmotile ND ND 0 %Other ND" ND y %'Total Asbestos ND 'Inconclusive ND 'Inconclusive O U Z Other %Oreanic 64.S 61.1 CJ Materials N Present %Carbonates 32-7 36.6 0 CL %Other Inorganic 2.5 2.3 RnuSsA7 .1L-uT6cxD�T_. Fi4..fCa�t�Rq:,.1�il,F�,. +Fxucy.:"a6_ae F'rica nzllf�Llx at,�v_S.a:�I�na�rS c..�r�1-.•...c•�...a6,uC+.awx nrnl.ha-IN'Lrk1s r Lia><3n[.cildin Goa afAaal.0 76i.Rra[iSh.-eI:.[l�uv�l�lf�Clicla.i]onF,..lus Fi.Le�ctLnh'.7..iP,n.1..1_ynfuelL4c.�e,see `� Tlaefi,.�•F-Cm[6:ucl Tu Cl.aT}.x TiOB Ilnsa T�[al.4=�aa�4afciau r.^,.:-..�nr_.-.,�.i C[Ic 3.c ^..L FSaas�.lk.n ti's t.�7lm i!r itr�l 0 TF..a�al,.r rbn ml�,:c.as',_1iL z.:rev lm'�-^+^^'^tic Inc�mlanrs�z�axl in�u�'s a.Uaivc?�;>ya 4m 174 r .svlir � xIFLi:A�,11Cltiu 7p7}3 P1ukraa lDx;Ti...AA:.Lr'- 3'----4-�WC.N.AAp'u17_ L.,­S-UDW.Nu PHtk�. ?6W—DF.FN :_Y._C4 V---a A7:7[671i5 � (v U. CL 856 Knickerbocker Road,Schaghticoke,NY 12154,(518)488-2538,info@baldeagle.biz FASatchNa_ 30260 . Easfeaii alydcal Ser%ices, uc. Nee lof') Bulk raample'Resulis RE: 18 Crooked Tree Driie-take George Client Bald Eagle Inspection Sen-ices,LLC' M DateCoLecte8: 051OU2023 CN Collected BY. JasonFedetico $56I{nickerbockerRaad. Data Received: 05;U`?023 Schag$ticoke NY I215 Date p nal5•zed:: 45f09&23 N Analvzed By Fahrudin Ealic Signature: - -_ - Q Ana rdcal'MeALod: NYS-DOH 198-4 Z NVLAP Lab Code 10I646-0 NYS La1i No- 10951 O L O O Sample ID Number 141 1-02 2-01 2=02 O IzvLeN¢ube< ,c a 'L bID Number 2912S42 2912543 2912344 2912.945 tU Sample Location Roof Roof' Siae Wall. Side Wall O O L ' O Sample Description jJnderlay+np^t ilnderla}meat UnderL33meat Undeilayment se O L U w N L _4ni$•Eic4 Method NOB Tein NOB Tein NOB Tens %,—ogmr i O 70 Appearance Layered NI O No No No m Homogenous Yes Yes. Yes Yes 1=ibralls Yes Yes.. 'Yes sees Color Black Black :Black Black - t O Z O, 2-Sbertos %Amosite ND ND STD Ni) � Content °J°Chtvsotile ND VD ND ND_ O %Other ND ND NTD ND O %3'otal?asbestos. ND ND ND ND 0 U Z Other %Oreanic 96.7 97-2 97.6 0_6 U Mate iali O Present %Caiboaates 1-1 '1:1 1.3 1.2 O L CL °la Other Inorganic 2 1.7 1.1 1 2 NO r 'R-I a�pa.3-�7u na�n�cTmL Ryxst c,�mkii�m.r;,�,F she E.Q�cy.'wah.=What h�v.�?�Stra =®,�o�,ac,.���-sir Lo _mb��ee,��sa.d.'t�•r:a a�-c�C O f:u?ea'ti Cnitr]iu C,at OGAvtjm 75is R_�r713u[t;,efe[i�Mtic Clctia f]eim FuluS Fial,e.�elbal.7.?.P,r.Mlt�aey uT41J4 taa,.=� /'�' AIHA i.L�,ll.0 M..tUL"3i3 Ah:a�IsfcilFYfi Tea ..:R1 �'- �,••�+-EiL.t�•u AA U7Gn 6:,yd-i TiOFa t:u FH3.*1. CjcP T:..iA�A:� V aEAR t4 AL-1019T6 ` V QD U. O CL 856 Knickerbocker Road,Schaghticoke,NY 12154,(518)488-2538,info@baldeagle.biz £AS BatchNa. "302S7 Pate 2 of 2 Eastern Analwtical Ser-%ices,Inc. - Bulk Sample Results RE- 1S Crooked Tree Dri-.e.-Lake'George Client Bald Eagle h=ection Senices;LLC.Date Collected: 051D1t`2023 \. Collected By: Jason Federico '8561inica erboc-er RoadSch]a l ticoke:2,n 12154 Date Received.: 05,`04t2023 g � Date.-nah•zed: 05 09(2023 Qj Anahrze'd By Fahrudin La_lic_. � Sim-ture Analytical-Meihod: NY S-DOH 19S_4 Z NVL.A.P Lair Code: 101646-0 NYS Lab No_ 10851 N O: L O " O Sample ID,Ngxnber 3-01 3-02 ' N lz erNuab-a Y O J Lab ID Number 2912S46 2912547 N Sample Location Electrical- Electrical r) N O O Sample Description Cloth Wire Cloth Wire � O O L U 2-0 Analytical Methnd NOB rem NOS Tam _appearance Layered No Na D Homogenous Yes Fes m Fibrous Yes � Color Black Bla& L O Z O .-",sbztos %Amosite ND. ND C Content °!o Chiysotile ND ND a)t °'a Other ND ND ,,; 9'0 TotH 4sbeztos ND NLi U Z Other °fo 4rmnic 64.8 61.1 U Materials. N Present 4a_Carbonatez 32.7 36.6 O tL %Other Inorganic 2.5 .2.3 •ReuT.tfl._.�L 7u lh..c h�aT-.raL Fi�.rt Cmx k1�nil�s1.F_� Erticy.wS:.6oe^..'riern.1�.rrn"i.of _�...rt,m'.Suc�ka m�,a?a.�sL..,,,:.., �c�,x-,r.�L ttin a r;�.r O L',uutr Laird Tu C,ntdL A,ulrm i6E,R-.rt:tEw[h[Ie rin"W�tl'ela[I.;m Filua F,.l�se_it,r NNIAP,e Am•A 7uIarUS r--..,E /Y1 AQiA G.Y,U.Ctiu 1112 ? f11w�Cd..•1b-x:1ia A4i,-0?2 Y - ,..++:ry±iJ.\u A.4 fx�iQ12 G:,c i:t B[ti Ku PH=-t= td+i,e[7FF 11.,:A.7:.1 Veue.�r'70H ila Ai,.i(Y93ti \ r- U. i3 856 Knickerbocker Road,Schaghticoke,NY 12154,(518) 488-2538,info@baldeagle.biz Fps aalcniv®- 23 s Eastern ual�tical Sea •ices;Inc. �=e i of I Bulls Sample Results RE: 18 Crooked Tree Dr-;,e-Iake"George Date"Collected OSIOLr2423 Client: Bald Fa Inspection Sen-ices,LLC t 856 Knickerbocker Road N Collected By: Jason Federico Scha ticoke,Nz' I2154 \ Date Received: 0510 12023 LO Date Analyzed: 05j09t2023 _Anahtzed By: George Htav Analy tical Method: NYS-DOH L98.1 r AXTL4P Lab Code: 101646-0 Z N-fS_Lab No 10851 N O Sample ID_<rmaber 4 d 1 4-02 T—Y.N>?mtter O J Lab ID Number 2913636 2913637 Sample Location Ceilinz Ceiline N O Sanrple Description Masonite hlajonife" N O O L U Method of Quantification Scams Opdar 'Snw-rN.Omdon, in N :appearance Layered Yes Yes Homogenous NO No m Fibrous Yes Yes Color Brown Brov Samnle:Treatment Hcmopni-d_ Homogmized O Z I Asbestos %Amosite ND ND O Content D!b Chr;sotile ND. ND � Other ND ND N Tota_F Asbestos ND ND to 13 Other Fibrous %Fibrous Glans ND ND 0 mateiiaL- %Cellulose 6010 55.0 U Present 90 Other ND" ND Z %Unidentified ND. ND 4-: U O Non-Fibrous %Silicates- 10.0 10,0 O Material; °ro Carboinates. ND ND CL Present 0%Other ND ND Uniden"ed 30.0 "35.0 R—N Afp=3L-7u71ncfI mT..a PS.rfC�ncaLeRa:,.i=+�,1.F--,, ,cr.web:.tF'rirm.11_�ai.6��:�hd.av_TID..}i.�i>smi fi�.r.: 7.'rvtis�]!S Q Li.?ut�laitcl TuC�m fY.Lu.7,•m iF'���t!hutK,cicUc!Iti'i}eCl'etu brim Fsulua FnLc�r�t�ta.'l.xPm.Uv Alv y'uf fsUS Gnau=at loeR�ueCa 3e1}c17u Clum Tk6Al'.A-lam�Tet!�eTLo-kl.�attesi,ia,,O..0 i. .4i vyslzS Sensivr�.}e?i�.arW:e nndti�n aim tLawi,e�aenl A1HA id?,ll.CT:u.iDi,Y? i1L:.lc Gia,l nC}_:fia.aA?�7i2 54---•:i..-^-�'}i.iiu AAOtX:�i2 Cumr.'v�t BCEi 1:u PH•:e'_2 t:�ucnff r:..i.1:W 4'czn�t�t:H to AL-R:�3n r U Licenses: 0 CL 856 Knickerbocker Road,Schaghticoke,NY 12154,(518)488-2538,info@baldeagle.biz W_EY-ARE;.;`Y'OU,R-DOL Deparimeirt r of or DIvISION OF SAFETY&HEALTH LICENSE AND CERTIFICATE-UNIT,STATE!OFFICE CAMPUS.BLDG.12,ALBANY,NY 12226 t=" - ��� 1. ~u'', )':'}��1 a -j A`58ESTOS HANDLLN�G LICEfV.SE Bald Ea""le I s e Mori-'Se i`'��'' I' co j :-_ 9 .n,.P ct [yices';,LLC 1.' , 856 Knickerbocker.RoadSchaght_icoke,'NY,=1.2154 fi LO License Numli'er 29389_3=_ti I - - 'License'Class:-RESTRICT t`` j+ j _ Date of Issue:-03106/2023= ' :} Expiration-Date03/31/2024=t''.-f J ,1i! Z Duly Authorized Representative:'Jason-Federico_; This license has been issued in accordance with applicable proyisior1s..q Article;30 of the Labor Law of New'York State and of the New York State Codes,Rules and Regula'Uons(12,NYCRR'Part 56}!,t isaubject to` suspension orlrevocation fora(1)serious violation ofstate,federal or local (� laws with regard to the contluct of anasb6stos:pr6j&ct;6r•_(21'demonsliated lack,of responsibility in:the conduct of any job involving asbestos or asbestos material. This license is valid only:foi the''contractor named!atiove:and this license=ora photocopy:inust 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,appropriate for the type of work they pe'rfofm,by.the-New York State-Department_,of-Labor. j 0 70 .-. 00 Amy Phillips;Director For the Commissioner-of Labor—,) 00 i Ln m c L a) L I z° STATE OF NEW YORK DEPARTMENT OF LABOR - ASBESTOS CERTIFICATE i O a) JASON J FEDERICO,It o CLASS(EXPIRES) a i0a D INSP(12/24) z w MUST BE CARRIED ON ASBESTOS PROJECTS 0 tY unnru uun�Nu,l'Itu L0 a) U. CLIENT ATTESTATION: O CL 856 Knickerbocker Road,Schaghticoke,NY 12154, (518) 488-2538,info@baldeagle.biz I/We have read, understand and agree with all the above terms, conditions, and statements evident by signing the Asbestos Service Agreement and the use of this Asbestos Report to seek and secure a qualified contractor for the remediation of the conditions observed and described in this report. I agree to furnish the chosen Abatement Contractor with a copy of this report. I/We understand that there may be asbestos in hidden and confined areas of the structure which are not identified in this report. The inspection report is strictly limited to visible and accessible areas requested to be inspected by the client only. It is the duty of the client and/or client's agents, contractors, remediation companies and other third parties active in the.identified work areas to contact Bald Eagle Inspection Services,LLC and cease work immediately if any suspect material or unidentified material per this report is uncovered at any time. All unknown materials shall be assumed asbestos until proven otherwise. I understand that any disagreement and or required clarification of the above terms, conditions, and statements shall be sent to the Asbestos Inspector of record in writing for immediate attention. N ABATEMENT WORKER SUPERVISOR ATTESTATION: `O I understand that.per NYS Code Rule 56,an Asbestos Report must be furnished by the client and reviewed by.myself prior to remediation work, therefore, I have read, understand, and agree with the above terms, conditions, and 0 statements evident by the use of this Asbestos Report and certify that this asbestos project was/will be performed in >.: compliance with all NYS and regulatory requirements.All remediation contractors and workers are properly licensed. 7- The inspection report is st(ctly,limited to visible and accessible areas requested to be inspected by the client only. It is the duty of the client and/or client's agents, contractors, remediation companies and other third parties active in .the identified work areas to contact Bald Eagle Inspection Services, LLC and cease work immediately if any suspect aa) material or unidentified material per this report is uncovered at any time. All unknown materials shall be assumed G asbestos until proven otherwise.I understand that any disagreement and/or required clarification of the above terms, conditions,and statements shall be sent to the Asbestos Inspector of record in writing for immediate attention. ai 0 Copyright Statement: o aD The wording and formatting of this report is protected by 2023 copyright law (C). All wording and formatting of this report is property of Bald Eagle Inspection Services, LLC. Plagiarism of any wording or formatting of this report is taken seriously and is not acceptable without the expressed written consent o of Bald Eagle Inspection Services, LLC. Written content and formatting is considered intellectual U property of Bald Eagle Inspection Services, LLC. Any use of this intellectual property must be properly 00 cited as "property of Bald Eagle Inspection Services. LLC - (518) 488-2538" ALL RIGHTS RESERVED. N ^L` W .? m Jason J Federico, President Bald Eagle Inspection Service, LLC i Certified Professional Inspector O NYS Home Inspector License#1600007491 Z NYS Mold Assessor License#00742 NYS Asbestos Inspector and Tester#879661 0 FHA 203(k)Consultant ID#P1885 C NAMRI Professional#415946 O InterNACHI Professional#15120411 0 IAC2 Professional#04-6656 H Professional Estimator O O U Z U N O CL The rest of this page was intentionally left blank. 0 �O r— a� U. a o_ 856 Knickerbocker Road,Schaghticoke,NY 12154, (518) 488-2538,info@baldeagle.biz