2011-178 4,011% TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110178 Date Issued: Tuesday, February 05, 2013
This is to certify that work requested to be done as shown by Permit Number P20110178
has been completed.
Tax Map Number: 523400-308-015-0001-037-000-0000
Location: 454 CORINTH Rd
Owner: NEW HOPE COMMUNITY CHURCH
Applicant: NEW HOPE COMMUNITY CHURCH
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
/1
Issuance of this Certificate of Compliance DOES NOT relieve the /
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110178 Date Issued: Tuesday, February 05, 2013
This is to certify that work requested to be done as shown by Permit Number P20110178
has been completed.
Tax Map Number: 523400-308-015-0001-037-000-0000
Location: 454 CORINTH Rd
Owner: NEW HOPE COMMUNITY CHURCH
Applicant: NEW HOPE COMMUNITY CHURCH
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the ¢
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)-761-8256
BUILDING PERMIT
Permit Number: P20110178 Application Number: A20110178
Tax Map No: 523400-308-015-0001-037-000-0000
Permission is hereby granted to: NEW HOPE COMMUNITY CHURCH
For property located at: 454 CORMTH Rd
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. T We of Construction Value
Owner Address: NEW HOPE COMMUNITY CHURL. Demolition
PO BOX 4270 Total Value
QUEENSBURY,NY'12804-0000
Contractor or Builders Name/Address Electrical_Inspection'Agency
Plans&Specifications
2011-178
demolition of residence
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 11,,2012-
(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 expiration date.)
Dated at the. n of Quee sl ury /�, V gEsday,May 11,2011
SIGNED BY w for the Town of Queensbury.
Director of Building&Code Enforcement
" ...................
eOFFICE USE ONLYT�ZW
AP NO. PERMIT NO. FEE PAID ' -
Permission is hereby granted to the above named Applicant to demolish the building(s) °1 described herein as set forth in the Application below. t '
Director of Building &Codes Date 0
r-
APPLICATION FOR DEMOLIk.TON PERMIT.
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads / streets. Show all existing structures
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities. 9 , ` f
APPLICANT/BUILDER;J, WILECGtus�e -trot OWNER: Mew 09y- Cc-IJe-LA
ADDRESS.-I'ICD ADDRESS:4c)U UUdrEe. g ,L C-6L-Ir-
SCaE.��ect�c�c c}Y lz3oiLr- C�vze�� gut ! t•��
PHONE NOS. i o - �4�= E(Xr 3 PHONE: -79 3-- 3i 2c� �_Oot-a LtLieag ES)
PERSON RESPONSIBLE FOR WORI4J e�t% �r;Ulktil t7o[JS�! PHONE: O 7 -2 3
LOCATION OF DEMOLITION:
U(.iTA�lO COJ�-tZ-`{ 1—J�,citD�i�.L:
WHERE WILL DEMOLITION MATERIAL BE DISPOSED?��-t 9 NKS IZp 5 20
ASBESTOS INFORMATION: ►-`C-
✓ Is there any asbestos within the building to be demolished? YES NO V
✓ If YES, our office needs the following information:
o Name of firm removing the ,asbestos:
o License number-of firm:
o Indidate where the asbestos material will be disposed:
NOTE: A copy of Asbestos Removal Repcilt must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structures) will be demolished: RESIDENCE V GA GE BUSINESS
✓ Size of structure: 36 X �o STORAGE BLDG, OTHER
✓ Number of stories: /
✓ Foundation type: FULL CELLAR �✓ CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLAC(':,:D WILL NOT BE REPLACED-7e-,
✓ Structures(s): WILL BE REPLX-'ED WILL NOT BE REPLACED V
UTILITIES INFORMATION: /
✓ Indicate utilities for this structure: .GAS ELECTRIC ✓ PROPANE
PUBLIC WATER J ONSITE VVELL-WATER PUMP PUBLIC SEWER
--;r Have you notified the Town Water Dept. for p blic water and public sewer disconnect? YES /NO
ave all utilities been disconnected: YESti NOH —
_
QUESTIONS 7 CALL 761.8256 OR EMAIL
codesogueensburv.net
6-9
VISIT OUR WEBSITE FOR,MORE INFORMATION
www.gueensburv.net
S GNA URE OF ICANT
Town of Queensbui iy • Community Development. Office • 742 Bay Road, Queensbury, NY 12804
Queensbury Building & Code Enforcement - Residfispection
Office No. (518)761-8256 Arrive: '.Z L'= a mDate Inspection request received: Inspectors Initi NAME: IS E.u) 14 C = CntA t�J�o `( C�v 9-c—LOCATION: f�t P,t>Pc C7 TYPE OF STRUCTURE:
nts•
Yes No NI
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off"posed/regulator 18 inches above grade
Interior privaa/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access,I s .ft:150 sq.ft.vents
Bathroom Fans if no window
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum Y2"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical;Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Se is System/Sewer Dept. Inspection Sticker 0 Q7
Site Plan /Variance required 1 ���L) QE
Flood Plain Certification, if required v
Okay to issue C/C or C 10 Temporary/Permanent C)U 1��
L:\Building&Codes Forms\Building&Codes\Inspection Forrns\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
s
h'
i
R.
ID
9[ t ICJ..3 Y , S
i 441. � 1
85 1 g'0011 W
le
.166.8
c Ovo
. ,
0 tg ;l
.. t � •
��•','- VAR a W gF A.I1CL11SL0IAMO'lURVCMS.Of 14► � 1Tia
) us : `'t+�� •, vKIUYON-STATE-
fA�D-DmUM 7.a »li .
-s' � G MEM Yanr-STATE EDOCATfON urr.• .
1 Q ='ONLY-COPES:FROM,TIC ORMAL Of CAI ILMIAT .
� Rr IIARKC .uw AN:OmaNAL or1TNE LAND 41MTKYORI.
ve
J 'C(RTDTCi17KNS DKAG11E0 I1[11[OM9ai/Y IRA' ! 1
!.,_.•:`.-. .. TBAI S' RVEY-YUS PREPARED M ACCORDAMK Mm Ix
i DOSTND CODE-OF WACTCE i0i1•UMD SU11V[YOMS 4"0 _ -
y,-�.•:.::1.Ili ♦ By THE%NEM YORK STATE-ASWMMOM DV PWEt9iM.l
-` `- ` LX :SORVEY'ORS.SAKI CORMaTMS!MALL MW OIAS'
•■�� P
1.i. v e y® r s � i, 'TO TNE'PERSCN-FOR.1111d1.THE.SURVEY 13 MKPAI1f-0'AMO •.` ...
~ '+`• ON IDS BEHALF TO'LIE MILE COMPANY.CpMMUENMI <.
-AUNCY':AKDLEMDNO:NS7=7 M•L15,ED.HEREON.AIDTown -1
��-/ m THE A59DMEE5 aF n¢-IEIIDNC NsnTuna+' /,
ieensbury, New York 12804 y am'•
New York -Lie. No. 50135 •308.15-1-37&381126-1-41.1 &42.1
s P O 8oz,4024
Menectadr,NV 12301 -
$ (518)348-8374(Phone).
1-4
A ET1VlT'DTITt?4°l1tQT fTSSOC)Qtl,°S, lnc. (918)348 4082(Fax)
�EXCPBDINC OUR;CLIPNT$•EXPBCTATIONS OF_EXCELCENCP WWIY.4SpeCtrl/m.COm
ASBESTOS:SURVEY/INSPECTION
. F
- OR
454 :C ORIivTx ROAD
QUEENSBURY,'NEW:.PORK 128,04 . - - . .
SPECTRUM PROJECT NO.:
:
APiuL, S,:2011
- .Endronmental Seri*is'�Health&Safety Training Laboratory Services
TABLE OF CONTENTS
SECTION 11,
INTRODUCTION
SECTION II:- ;... LIMITATIONS..
SECTION III ASBESTOS-SAMPLING SUMMARY
: W. 7 : L
-ATTACHMENTS -` TABLE I'=ASBESTOS SAMPLING;RESULTS
-'TABLE 2 ASBESTOS"°FINDINGS,.' _
-LOCATION MAPS
-LABORATORY REPORTS
LICENSING.AN CERTIFICATION
- . ._ . "12 NYGRR PART 56=5.1 - •
•
SEC TIONI-INTRODUCTION
On April�15,2011; Spectrum Eriviroriinental As Inc: (Spectrum) conducted a-survey for
the presenc6 6f—,asbestos-.containing materials.at:the property ,located at 454. Corinth Road in
Queensbury, New Yorke. Mr David Crommie:(Asbestos Inspector#07=09607) conducted this
inspection.'following procedures-and guidelines„commonly used-:and accepted by federal and
state regulations The objective.o : e survey was to.-identify, the presence and approximate
locations and.quantities of suspect and/or confirmed asbestos containing.materials.
An"initial`walkthrougli of the designated areas-.was conducted by ari experienced asbestos
inspector to observe and.record materials used in'the construcfion ofthe-building: The inspector
proceeded by assessing--,floors; walls; ceilings, surfacing-m aterials, thermal=systems'insulation,
roofing materials;and other miscellaneous materials with.the;potential to contain asbestos. From,
observations; the inspector prepared a isting of: materials that are suspected to'contain'
asbestos. :" .The -:inspector selected these materials.:for.: inclusion -in` the_ inspection through
professional "experience Nand.ian- understanding:of''the historical uses -of,asbestos. Generally
speaking,-.if. a .building material within 'a'structure 'could-''contain -the material was
. "included'in the inspection.. r,
Materials`"included ,in the `survey were; identified and ,recorded with".respect- to;'grouped
honiogeneous sampling':areas. ,_Representative -bulk."material samples were; collected from
locations.within•each'hoinogeneous�sampling area: Sampling information was recorded on"chain
of custody forms for.do,cumentation Samples were individually preserved within a container
. . and.transpgrted'to an�iiidependent laboratory for asbestos analysis:
Laboratory analysis. of: asbestos, samples. via ':`polarized,;Might microscopy (PLM):.and/or
trans mission"electron microscopy (TEM):.was conducted by AmeriSci,:of New York, New York ;
(ELAP# 11480,NVLAP#200546,-0). Sample,analysis was conducted as follows:
• "Friable"Asbestos Samples:PL1VI
• 'Non=Priable""Organically Bound(NOB)Asbestos Samples=PLM and, if.negative, TEM
for confirmation Ox.equired under NYSDOH=FLAP regulations -
SECTION:.4-LIMITATIONS :
'' !The.iriformatiori.provided in-this report was compiled from'f eld and laboratory:data obtained
`Oserationsoted arideordedeintnded t nthecondtduring,the„sitevisit.. ri ar iions'
that existed,at:the subject;site at the'tiine and date.that the observations were made.
Spectrurn.,l as not conducted its own analytical,. but has "utilized: an' independent--NYS-DOH
ELAPI approved laboratory to"-provide the "analytical results' contained`in this report. =All
--.discussions,-findings, and conclusions are based on information,that Spectrum received and:.:
.understood to be.factual:
Determinations 'of suspect asbestos,containing:materials within the building were subject to the.:
accessibility of individual areas:or,spaces: `-Spectrum.accepts no responsibility:for the content of
the::building'.materials within areas or spaces that were unknown .to us or .not reasonably ;
accessible: Spectrum'assumes .io_;liability for any buildings that were-not. dentified,by the client
that ihay,fall under-state'or-federal regulations.,
All : uantities;of ACM provided in,this report,are provided as:required,•by law.and are..believed�to '.
b`e.accurate . if-this,report' is to be',used for liidding-purposes;"field-verification.of quantities is_-:.
recommended by the abatement contractor-prior to bidding.
Conclusions and-re'commendations''provided:in, this.report pare based on the- assumption that.
iriaterials,identified are homogeneous throughout their application.
This report has been,compiled for,Alie exclusive use:of J:,Luke` Construction, its'successors
and/or assigns. This-report and its contents represent confidential-information and should not be
duplicated without,the expressed permission=of.the:J: Luke-.Construction,.its. successors and/
assigns..
The following limitation/conditions were noted'as,part of the survey
- "
The inspection was performed'in.accordance;with New.York StateIndustrial-Code Rule:5,6,
Section 5.1. It,is the responsibility of the owner;or'its'agent to:forward a'copy of this report
to the local government entity charged with issuing a permit for such:-demolition,renovation,
remodeling.or repair, work under;-applicable.State or:local laws ,as well as to the NYS
Department of Labor Asbestos Control:Btireau Spectrum -will not..send`.this xeport ao the'
NYSDOL .without written permission from its client due, to the sensitive..nature-of the
inforrriat on present in this report. A.copy_of 56-5.1 is.included in this report for,reference :
.Th"',building owner is New.Hope Church and-.may-.be reached at 454'_Corinth.Road, '
Ouee'nsl ury,New York or via-.the-construction agent J:Luke Construction Company,.LLC
located at 796-Burdeck Street in Schenectady;New York.12306.
SECTION III=ASBESTOS-SAMPLING SIIIVIMARY '
The :results of:the 'sampling are provided m Table 1 (Asbestos,Sainpling Results).-and 'the
asbestos- findings- are provided. in Table :2 '(Asbestos Findings) of the :Attachirients: The_ .
laboratory results and-sample:location..niap(s):are:also provided in the`Attachments.
ATTACHMENTS
TABLE I ASBESTOS SAMPLING RESULTS
TABLE 2=ASBESTOS FINDINGS': A.
LOCATIONMAPS ;
LABORATORFREPORTS
-!VGA AND 1 CER :: z
LICENS TIFICATION
1V--SINDUSTRIAL, -Ob RULE SECTION:56 5, 1
Table 1—.Asbestos Sampling Results
454 Corinth Road;
Qiieensbury New York.12804.
April 15,2011
Sample# Description Location/Area P oMtResults TEM Results;.
.01 Tar`Paper Roof NAD NAD
.02 _ Tar Paper. Roof: NAD. NAD
03 Shingle _ Roof . NAD NAD
40 Shingle -Roof `:: 'NAD NAD
50. Joint Compound. Throughout NAD NA
6 -Joint Compound - ` Throughout - NAD NA
07, Drywall Throughout _NAD NA.
08 Drywall . Throughout• NAD NA'
09 Mortar Basement wall/Garage .NAD NA
10 Mortar . ..•. Basement WalUGarage ; . . NAD: NA
11 CMU Basement Wall/Garage: NAD' NA
12. .';. CMU Basement Wall/Garage . NAD . NA' .
13 Window Glazing .: Garage- Anthophyllite<1_0.%
14 Window Glazing Garage NAD Anthophyllite<1:0%
15. Linoleum Bathroom NAD NAD
16 Linoleum Bathroom . NAD NAD:
17 Concrete Garage'Floo"r NAD ;NA
.18 Concrete` Garage Floor NAD
Note: Asbestos containing materials are greater than 1%'asbestos'. Trace is.considered less:than 19/6'asbestos..
NAD-:no;asbestos detected,NA-niot,applicablo;PS—,Positive,Stop, SF:-square feet,'LF.=linear feet
Table 2—Asbestos Findings
-454 Corinth Road
Queensbury,New York 12804
April 15;2011
Material Location/Area Estimated Quantity. Condition/Damaged
None Identified
— — —F`squar feet,LF feet;ea each
- . . _ S e: linear
LOCATIONMAP(Syl
LABO.RATORYREPORTS"
04/21/2011 13:30 2126793114 AMERISCI PAGE 02/06
117 EAST 30TH St.
TEL: 21 NEW YORK, NY 10016
�M q -Tns ( 2)679-860o•FAX:(212)679-3114
PLM Bulk Asbestos Report
Spectrum Environmental Associates, Inc Date Received 04/
Attn: Bill Massman 19/11Date Examined 04/211/11 AmeriSci.lob#
P,O,Box 1024110436Z3
FLAP# P.O.P � #
11480 Page 1 of 4
Schenectady, NY 12301 RE: 11.129; J.*Luke; 454 Corinth Rd.
Client No. l HGA
b No, Asbestos Present o
01 La Total /o Asbestos
01 211043623-01 No
Location: Tar Paper NAD
(by NYS ELAP 198.6)
Analyst Description: Black,Homogeneous, on Non-Fibrous, Bulk Material on Karol 04l21/1 Lu
Asbestos Types: 1
Other Material: Non-fibrous 3.3
02
01 211043623-02 No
Location: Tar Paper NAD
(by NYS ELAP 198.6)
by Karol H. Lu
Analyst Description: Black,Homogeneous, Non-Fibrous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 3.3%
03 211043623-03
No NAD
02 Location: Shingle
(by NYS ELAP 198.6)
by Karol H, Lu
Analyst Description:Black, Homogeneous, Non-Fibrous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 33.4%
04 211043623-04 No NAD
02 Location: Shingle (by NYS ELAP 198.6)
by Karol H.Lu
on 04/21/11
Analyst Description: Black, Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 19%
05 211043623-05 No NAD
03 Location: Joint Compound (by NYS ELAP 198.1)
by Karol H. Lu
on 04/21/11
Analyst Description: OffWhite,Homogeneous, Non-Fibrous, Bulk Material
Asbestos Types.
Other Material: Non-fibrous 100%
See Reporting notes on last page
04/21/2011 .13:30 2126793114 AWRISCI PAGE 03/06
AmeriScl Job#. 211043623
Client Name: Spectrum Environmental Associates, Inc. Page 2 of 4
PLM Bulk ,Asbestos Report
11-129; J. Luke; 454 Corinth Rd,
Client No, ! HGA Lab No. Asbestos Present Total % Asbestos
06 211043623-06 No NAD
03 Location: Joint Compound (by NYS FLAP 198.1)
by Karol H.Lu
Analyst Description: OffWhite, Homogeneous, Non-Fibrous, Bulk Materiel on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 100%
07 211043623-07 No NAD
03 Location: Drywall (by NYS FLAP 198.1)
by Karol H. Lu
Analyst Description:White, Homogeneous, Fibrous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Cellulose 10%, Non4brous 90%
08 211043623-08 No NAD
03 Location: Drywall
(by NYS FLAP 198.1)
by Karol H, Lu
on 04/21/11
Analyst Description: White,,Homogeneous, Fibrous, Bulk Materiel
Asbestos Types:
Other Material: Cellulose 15%, Non-fibrous 85%
09 211043623-09 No NAD
04 Location: Mortar (by NYS FLAP 198.1)
by Karol H. Lu
Analyst Description: Gray,Homogeneous, Non-Fibrous, Cementitious, Bulk Material on 04/21 J11
Asbestos Types:
Other Material: Non-fibrous 100%
10 211043623-10 No NAD
04 Location: Mortar (by NYS FLAP 198.1)
by Karol H. Lu
Analyst Description: Grey, Homogeneous, Non-Fibrous,Cementitious,Bulk Material on 04121/11
Asbestos Types:
Other Material: Non-fibrous 100%
11 211043623-11 No NAD
04 Location: CMU (by NYS ELAP 198.1)
by Karol H. Lu
on 04/21/11
Analyst Description: Grey, Homogeneous, Non-Fibrous, Cementitious, Bulk Material
Asbestos Types:
Other Material: Non-fibrous 100%
See Reporting notes on last page
04/21/2011 13:30 2126793114 AMERISCI PAGE 04/06
AmeriSci Job#: 211043923
Client Name: Spectrum Environmental Associates, Inc. Page 3 of 4
PLM Bulk Asbestos Report
11-129; J. Luke; 454 Corinth Rd,
Client No. / HGA Lab No, Asbestos Present Total %Asbestos
12 211043623-12 No NAD
04 Location: CMU
(by NYS FLAP 198,1)
by Karol H.Lu
Analyst Description: Grey, Homogeneous, Non-Fibrous, Cementitlous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 100%
13 211043623-13 No NAD
05 Location: Window Glazing (by NYS BLAP 198,6)
by Karol H. Lu
Analyst Description: White, Homogeneous, Non-Flbrous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 5.8%
14 211043623-14 No NAD
05 Location: Window Glazing
(by NYS SLAP 198,6)
by Karol H. Lu
Analyst Description: White, Homogeneous, Non-Fibrous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 7.2%
15 211043623-15 No NAD
06 Location: Linoleum
(by NYS ELAP 198,6)
by Karol H. Lu
Analyst Description: Beige, Homogeneous. Non-Fibrous, Bulk Material on 04/21l11
Asbestos Types:
Other Material: Non-fibrous 18.2
16 211043623-16 No NAD
06 Location: Linoleum
(by NYS FLAP 196,6)
by Karol H. Lu
Analyst Description: Beige,Homogeneous, Non-Fibrous, Bulk Material on 04l21111
Asbestos Types:
Other Material: Non-fibrous 16.1 %
17 211043623-17 No NAD
07 Location: Concrete
(by NYS FLAP 198.1)
by Karol H. Lu
Analyst Description: Grey, Homogeneous, Non-Fibrous,Cementltlous, Bulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 100%
See Reporting notes on last page
04/21/2011 13:30 2126793114 AMERISCI PAGE 05/06
AMeriSci Job#: 211043623
Client Name: Spectrum Environmental Associates, Inc. Page 4 of 4
PLM Bulk Asbestos.Report
11-129; J. Luke; 454 Corinth Rd.
Client No, / HGA Lab No. Asbestos Present Total %Asbestos
18 211043623-18 No
07 Location: Concrete NAD
(by NYS ELAP 19t3.1)
by Karol H.Lu
Analyst Description,, Grey, Homogeneous, Non-Fibrous,Cementitious, Sulk Material on 04/21/11
Asbestos Types:
Other Material: Non-fibrous 100%
Reporting Notes:
Analyzed by: Karol H,Lu
'NAD/NSD=no asbestos detected; NA=not analyzed; NAPS=not analyzed/posittve stop; PLM Bulk Asbestos Analysls by EPA 600/M4-82-020 per 40
CFR 783(NVLAP Lab Code 200546-0),ELAP PLM Method 198.1 for NY friable samples or 198.6 for NOB samples(NY ELAP Lab ID11480);
Note:PLM is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically bound materials. NAD or trace results
by PLM are Inconclusive,TEM is currently the only method that can be used to determine if this material can be considered or treated as non
asbestos-containing in NY State(also see EPA Advisory for floor tlla,FR 69.146,38970,8/1/94).National Institute of Standards and Technology
Accreditation requirements mandate that this report must nol be reproduced except in full wlthout the approval of the lab,This PLM report relates ONLY
to the items tested.AIHA Lab#102843,
Reviewed By: END OF REPORT
AmedSci Job#: 211043623 Page 1 of 2 m
Client Name: Spectrum Environmental Associates, Inc. p
N
Table 1 W
Summary of Bulk Asbestos Analysis ResultsCD
11-129; J. Luke; 454 Corinth Rd_
Sample Heat Acid Insoluble F
AmeriSci HG Weight Sensitive Soluble Non-Asbestos "Asbestos%by "'Asbestos%by 00
Sample# Cilent Sample# Area (gram) Organic% Inorganic% Inorganic% PLMOS TEM
01 01 01 0.182 96.2 0.5 3.3
NAD NAD
Location: Tar Paper N
N
02 02 01 0.304 95.4 1.3 3.3 NAD NAD m
Location: Tar Paper iO
D3 03 02 0.745 43.5 23.1 33.4 NAD NAD A
Location: Shingle
04 D4 02 0.652 48.8 32.2 19.0 NAD NAD
Location: Shingle
05 05 03 — — —
NA
Location: Joint Compound NAD
06 06 03 — — — — NAD NA
Location: Joint Compound
07 07 03 — — — MAD NA
Location: Drywall I>
08 08 03 — — — — NAD NA M
Location: Drywall CO
09 09 04 0-- — — — NAD NA H
Location: Mortar
10 10 04 — — — — NAD NA
Location: Mortar
11 11 04 — — — — NAD NA
Location; CMU
12 12 04 — — — — HAD NA
Location: CMU
13 13 05 0.463 9.9 94.2 5.6
NAD Anihaphyllite<1.0
Location: Window Glazing
14 14 D5 0.333 8.7 84.1 7.0
NAD Anthophyllile<1.0
Location: Window Glazing
15 15 06 0.242 44.6 37.2 18.2 NAD NAD
Location: Linoleum
1>
-16 16 06 0.266 43.0 40.9 16.1 NAD MAD IMTI
Location: Linoleum
m
See Reporting notes on last page Ili
m
W
AmeriSci Job* 211043623 Page 2 Of 2 m
Client Name: Spectrum Environmental Associates, Inc. ?
N
Table
Summary of Bulk Asbestos Analysis Results c
11-129; J. Luke; 454 Corinth Rd. H
cn
Sample Heat Acid Insoluble
AmeriSci HG Weight Sensitive Soluble Non-Asbestos —As bestos%by —Asbestos%by m
Sample# Client Sample# Area (gram) Organic /a Inorganic% inorganic% PLMJDS TEM
17 '17 07 — — NAO NA
-
Location: Concrete F,
N
18 18 07 — — — — RIAD NA
Location: Concrete Lo
N
A
I>
M
m
H
co
0
H
Analyzed by:Roman Peysakhov ;Date Analyzed 4/23/2011
"Quantitative Analysis(SemilFuIt);Bulk Asbesto's AnalysJs-PLM by EPA 600/M4-82-020 per 40 CFR or ELAP 198.1 for New York friable samples or ELAP 198.6 for New York NOB samples;TEM
(Semi/Full)by EPA 6001R-93/116(not covered by NVLAP Bulk accreditation);or ELAP 198.4 for New York samples,HAD=no asbestos detected during a quantitative analysis;NA=not analyzed;Trace=
<1%:Quantitatlon for beginning weights of<0.1 grams should be considered as qualftatn+e only;Qualitative Analysis:Asbestos analysis results of"Present'or"NVA=No Visible Asbestos"represents
results for Qualitative PLM or TEM Analysis only(no accreditation coverage available from any regulatory agency for qualitative analyses); AIHA Lab#102843,NVLAP Lab Code 200546-0,NYSDOH
FLAP LAB ID 114a0.
Warning Note:PLM limitation,only TEM will resolve fibers<0.25 micrometers in diameter.TEM bulk analysis is representative of the fine grained matrix material and may not be representative of
non-uniformly dispersed debris forwhich PLM evaluation Is recommended(i.e.soils and other heterogenous materials).
m
Reviewed By:
m
w
m
w
04/21/2011 13:30 2126793114 AMERISCI PAGE 06/06
sSPECTRVAf 211 0 4 3 6 2 3 Scbenecladl,NY 12301
(818)346-6374(Phone)
Environmentar associates, Inc. (618)346-4062(Fox)
A •ExerEvivc DUR CLIFNTs EXPGCrarms OF&CELLENCE• imm4spedrum.com
BULK SAMPLING CHAIN OF CUSTODY Rave -ng
PROJECT INFORMATION
Pmjcct0: rm)cct"mne Matrix Asbestos Analysis Lend Analysis Turnaround
(r-t24 Lk!«
1hre$n led: BuildingMmp:
w_ 1 V s Bulk ® PLM—IELAP 198.1 ❑ AAS—Air ❑ RUSH
Page tl 1anm lgnmr.
l of ( �`t•D�. 1 fi Paint ® PLM—ELAP 198.6 ❑ AA5—Painl -24 Flour
commcmi: Unles!Olhenclmanted ennly:c each�ron0 In I°pnalrive rc:ult. ❑ 72 Hour
❑ Soil TF_M—ELAP 199.4 ❑ AAS—Dust/Wipc
❑ Wipe 0 Othcr ❑ Other Otllcr
SAMPLE IDENTIFICATION
Lab ID#f Ficld ID 4 Group#1 Material Floor or $ompic Location
Building
Gl C1 /
r!Z ti r,
D
Sze-
all
CT 03 s114- G .'If
Ol �
L4.
Of �✓
�r �VI�r
(2
r3
ILl
oC �: erlG
I 07cw�c-
1X Con e-w
C RAIN OF CUSTODY
Relinquislied By Datc Time Received By Dam Timc Method of Submittal
y �q 1\03
1
111
Environmental Consulting&management Services • Health&safety Training - Laboratory Services
LICENSING A1VD.CERTIFICATION
L `tVEW f STATE DEI'A�tTMEt�IT,OFtLAB OR
DIVISION OF SAF.ETYIAND EiEAL H ;
40 � � LICENSE AND CER7IFICATEUNITt; �
I t STATE CAMPUS BUILDING 12
v s r rf
ALBANY NY 12240�
�' `�.` 2'1s d'' ,.•*' �r ,f._:a'.7,y,Y..t_ .a �,, �.4y°�uf A" g- ;"r � 4
r s /
- l ASBESTOS HANDLING LICENSE-
S S
h F� �
SpectrumEnvlrcnmentalAssoclates, Inc t `, j FILE NUMBCR
xt t �K 1fr ,3t7 ..f:` o. f z„✓�V ..s.j `r s r-: e
;& A 3; LICENSE NUfJIBER:` 208'1 tlx
P.O. 1336x 1024 LICENSE CLASS: RESTRICTED-
�z :.DATE OF ISSUE: OV31
Schnec,t�rJy, N`/ u123 EXPIRATIO,V DATE. 02/28/2012 `k
n t
„ / c
s'fi zn
'ilk ,b'G # rz"'_> >,.1 t• -y -
G'3 i '� �s� i 3' '�':. €:�� .% r�'""„ r ,^1 ♦ �.�+a� 1 F r,—.- a�.�_. a S` s `s
�} I V
t
'a"T yH.• 4
gs ..
ugl
Duly.Authori d�§Rfzpresentativel,-`1VVilliamiL Massmann:.-�'l,;'.',\\. ���.n j: : a
A , t
hUlit1bt ,
;.:'f� �� *�€� .��{
ghis Iteens ;has Luen issued m accgrdance,w�th applicable.-proi+tsions o)= frticle` 0,of the La or Law of New�'orl4,State and of
the New Yorlc5St§tekCodes, Rulesa d=Regulatt }s.(12:N SCRR'Part 55)"It�sSuliject to suspension or revocationfor a(1)
seriot�violation of state, federal or localavvs with:regardtothe conduct,oan aestos projeNdt,or(2)demonrated lack of F{:
re�pons�brlity to t,1e conduct of any-}ob�nvolvmg�s'aestos or asbesfds m'006al t f I v y
ts"= i'�> 'w. t,+ f s .c"'•3✓' '`rem, -, s t`� ��•-�;;ex �..
q t, {. j't!F r'' f .... ,,•r �,. 2. .t. .._ a^ q6-,
5 1 ? �4 lid
r✓�. "'t�} �,. �..b Y 7;'!i ,A_/ •`�"'' ..+ 'h:� A"r S �„ f mod• 7 j .
i h�sNltc et�se�s uaonly fa, th, contractor na�ned;aUove and tl�iis�tcense or a phofocopy,.must be prominently dtsplayeci at#tlie
asbestos pr�olect��,n}tkstte t jfi license verifizs that all�pzrsons employed;by�rthe licensee on arr-asbestos_projectin New Y H
State Hie$eemttssRed a ;A3bestos Certificate,ap.prop►iate for.hetypeµof woxk they perform;by the7ew York State : , Y;r
Dpai trnept ofLY£ __ �_ ,� r \ f ;a
m,
f
� zr 42
�,`« __ �3 •-_ .rU fir`
• r
" ~ "r Maureen A. Cox, Director
SH 432(4-07) FOR THE COMMISSIONER OF LABOR
STATE OF NEW YORE(-.DEPARTMENT OF LABOR
ASBESTOS_ CERTIFICATE
DAVID RQM IE
I CLi4SS(EXPIRESI,
_t C �EEC(07/11)..D{I SP(07/11)
M`(07/11)-a
f
I Nf OF
*ET0"607
MUST BE CARRIED ON ASBESTOS PROJECTS
II I II;III IIIIIIII IIII I II I•II I IIILII I II LIII
IF FOUND, RETURN TO:
EYES BRO NYS'D, = L&C UNIT
HAIR BRO ROOM 161A-BUILDING 12
HGT 6' 001 STATE OFFICE CAMPUS
ALBANY NY 12240
NEW YORK STATE DEPARTMENT OF HEALTH
WADSWORTH-CENTER
Expires 12:01 AM April 01, 2012
Issued April 01, 2011
CERTIFICATE OF APPROVAL FOR LABORATORY-SERVICE
Issued in accordance with and pursuant to section 502 Public Health Law of New York State
MR. PAUL MUCHA NY Lab Id No: 11480
AMERICA SCIENCE TEAM NEW YORK INC EPA Lab Code:NY01376
117 EAST 30TH ST
NEW YORK, NY 10016
is hereby APPROVED as an Environmental Laboratory for the category
ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE
All approved subcategories and/or analyies are listed below:
Miscellaneous
.Asbestos in Friable Material EPA 600/M4/82/020
Item 198.1 of Manital
Asbestos in Non-Friable Material-PLM Item 198.6 of Manual(NOB by PLM)
Asbestos in•Non-F1lable Material-TEM ITEM 198.4 OF MANUAL
I
Soria) No.::44322'
Proper y.01he New York Slate Department of Health. Certificates are valid only at the address
shown,must be conspicuously postec,and are printed on secure paper. ConUnued.accreditatlon'depands
on successful ongding pa'rtioipation"in the Program. Consumers are urged to call(518)485-5570 to
verffy the,1 6oratorls.accrediiatlon status.
Page 1 of 1
national, rid
4 0 Sylv3n Rd
Waltham NIA 02451
April 1,2011
Its 5crvoG:Removal fUr:l3ui1cliriD.zmolition.
To wham,it.ma:y concern.
This.letter-is tc,Ponfirm that,por your request,National (.frid has con',irmed el&t ical.
seivicc and DuJors have been removed from 454 Coiinth Rd,,Oitmisbury,NY. '17hc
work was processed on w.qrk rcqu;;st.l0698g4-S and the meter"2845 z9:96. If you l ays
py queki ns,or need furthei assistance,�Iease f�l i'rtrc o contact me at(508-) 3$7-4` 5,
imerely,A
a'
Daniel Nonnil
Customer Order Fulfillment!
national
Date: 04124J2011
Fitft i4mes 0e Williamson
n,ationaf -rid
Supervisor
Upstate CVstotrt Driver,Consti ucti=
Xatio ad Grid
RE Cor;frrmation Memo / WR# 10698944
Fer'your request this written c ommuh6eatlBn.confifts that on:Sept.23,20, 09,Mrloral Grid
rehired the Natural Cues servi'ce is 464 Corinth tad Queensbury,NY.
Should you require any further inforrnatlon pleas;ocritarvt our CuStorner Care Representative
at 315452.7 4&
Attn: Don Hughes,