Loading...
HomeMy WebLinkAbout44678-Z TOWN OF SOUTHOLD FoI,��oa BUILDING DEPARTMENT y a TOWN CLERK'S OFFICE o • 4V SOUTHOLD, NY y�s1 �4 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44678 Date: 2/11/2020 Permission is hereby granted to: Olde Colonial Place LLC 45 Broidy Ln Southhampton, NY 11968 To: Demolish an existing building as applied for. At premises located at: 615 Pike St, Mattituck SCTM # 473889 Sec/Block/Lot# 140.-2-21 'Pursuant to application dated 1/27/2020 and approved by the Building Inspector. To expire on 8/12/2021. ` Fees: DEMOLI $683.50 Total: 683.50 Building Ins ,ector TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or•need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 ,y Survey Southoldtownny.gov PERMIT NO. -1 "1 g� Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate 2 Truss Identification Form Storm-Water Assessment Form U Contact: Approved ,20 Mail to: Disapproved a e 4 27),010 Phone. r -_- -_FvrnirptlQll _ —,20 _ V1 Building Inspector JAN 2 ] 2020 APPLICATION FOR BUILDING PERMIT Date 1 J z.z. � � , 202,0 INSTRUCTIONS A. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter,.a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or Regulations,for the construction of buildings,additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) 12 0- 5,yVtTj,)-4,L t'jy P7/17 T TT c 14y (Mailing address of applicant) "l le,A State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises QL Q IL co)o 0 W-f O/,� Z e c:. (As on the tax roll or latest deed) If applican is ac o on, signature of duly authorized officer (N e and title o corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on whi h proposed work'will be done: to House Number Street Hamlet County Tax Mapo. 000 Section 1 ff`� „Bloch ,; Lot a. Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy rz-r97-ol b. Intended use and occupancy 3. Nature of work(check which applicable): New Building .Addition Alteration Repair Removal Demolition Other Work 4- (Description) 4. Estimated Cost 2 J-) Fee (To be paid on filing this a plication) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. `y 7. Dimensions of existing structures, if any: Front Rear Depth Height ' Number of Stories Dimensions of same structure with alterations or additions: Front s Rear Depth {— Height Number of Stories { 8. Dimensions of entire new construction: Front Rear Depth Height f Number of Stories .: 1 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO—1 13. Will lot be re-graded? YES NO /Will excess fill be removed from premises? YES NO (JLjtc,_x LLC_ 14. Names of Owner of premises OLpa C-064 o4 L Address `!o j54Z,0L% L ai Phone No. Name of ArchitectAddress Phone No Name of Contractor-"moo 14 t4 CO fl-1-16 Address 1-u C,Z9 0"ns @,q TPhone No. fn 3 I- OCI 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO t" * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE IjEQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO rt/ * IF YES,D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO—I/"/ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OFSu�-Fo11L ) X404 r bio being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief, and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Q Lc" day of TO,n uayk 20�O Nota Public Z-SCHWAMB Si nature of Applicant Notary NOTARY PUBLIC,STATE OF NEW YO g pp Registration No.OIGA6274028 Qualified in Suffolk County Commission Expires Dec.24,20,Q0 OLDE COLONIAL PLACE LLC 45 BROIDY LANE SOUTHAMPTON, NY 11968 (613)287-1618, 283-2252 FAX Terra Tech Site Development Inc. 260 Cox Neck Road Mattituck, NY 11952 RE: 615 Pike Streef; Mattituck, NY--I 19-52 Dear John Conti, Let this letter serve as our authorization for you to represent Olde Colonial Place LLC's facility at 615 Pike Street, Mattituck, NY to disconnect the services at this location (electric, water, gas, phone ,cable, etc.). We give you permission to obtain a demolition permit to demolish the house at this location. Edward Broid anaging Member`s Olde Colonial Place LLC On before me,the undersigned, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies),and that by his/her/their signature(s)on the instrument,the individual(s),or the person upon behalf of which the individual(s0 acted, executed the instrument. NANCY C HILBERT NOTARY PUBLIC-STATE OF NEW YORK r No.01H16068521 Qualified in Suffolk County (signature and office of individual taking acknowledgement) My Commission Expires 03-01-2022 BuildinjZ Department Application AUTHORIZATION (Where the Applicant is not the Owner) U Id e. C-9 10.) ,a..Q. P.-cu.2 Z.t-G I, residing at Ll S P20 A (Print property owner's name) (Mailing Address) Sc?oTN/4m)O-rO ii) 1V /)4&t do hereby authorizel errr� Tech 5,'7e- b.e✓mor rY yuJ ' (Agent) to apply on my behalf to the Southold Building Department. 1 (Owner's S' ature) (Date) /J c rz (Print Owner's Name) NANCY C HILBERT' NOTARY PUBLIC-STATE OF NEW YORK No.01H16066521 Cluelitied in Suffolk County My Commission Expires 03-01.2022 S 12/5/2019 OLDE COLONIAL PLACE LLC Service To: 45 BOIDY LA 615 PIKE ST SOUTHAMPTON,NY 11968 MATTITUCK,NY 11952 Customer Project#:900000103228 Dear OLDE COLONIAL PLACE LLC: This is to advise you that the PSEG-LI electric facilities at the above referenced location have been disconnected and removed off the building structure that is located on the property. Please note that there may still be PSEG LI facilities located within the property boundaries and that NYS law (NYCRR Part 753) requires all contractors to call for a utility locate (NY 811)prior to performing any ground excavation or regrade activity. The call to the 811 Call Center must be done at least 2 business days prior to the start of the work and confirmation of utility marks having been identified must be received from all the facility owners prior to any site work. You must also contact National Grid at 631-348-6150 to procure a letter of demolition associated with natural gas service, whether or not your home or business uses natural gas. If you have any questions regarding the above,please contact Building&Renovation Services at 1-844-341-6378 or via email at BRSLI@PSEG.com. Very truly yours, Carolyn Mackin—Manager Building&Renovation Services PSEG-LI f national ricl Janna-ry 22,.2020 Olde Colonial Place LLC 45 Broidy Ln Southampton, NY 11968 Email: bmaterialslOgmailagm National Grid WO#T102269951 —615 Pike St, Mattituck To Whom It May Concern: This letter is to advise you that the natural"gas-service line to the above location was physically disconnected on January 21, 2020. Please advise your contractor that care should be taken not to damage or remove the existing gas valve curb box.- This curb box will be used in the future by National Grid to reconnect the gas service line to this property. New York State law requires anyone planning underground excavation work to notify local utilities by making one call to atoll-free number to get your underground lines identified for you prior to doing any digging. This phone call needs to be made at least 2, but not more than 10 working days in advance of starting work, not including the day the call was made. The number to call is either the nationally sponsored"811", or the local number for NYC/LI area, 1-800-272-4480. Thi's. confirmation letter of a gas cut-off does not relieve the excavator of making this"811"call. If you have any further questions, kindly contact me at 631-348-6150. Respectfully, Christina M. Bonelli Sr..Supervisor, Central Processing Gas Customer Connections - I OLOR �'',' �.r.r,Lt TRIM L, _ tt 11 I i j ` I 140:2-21 4/12 ' I I � I � � _ i ! - ---- - --- - ----- -� ; I i _ 1 ! M. Bldg. r '" _ Ili -�--- � ""9a \ � ,�°" ' r� �.�i����- "C/ � I I �� r. 4- ,i Extension Extension f (� i Extension oundation I 1 c¢ Both « s + Dinette Porch��' � 1 j� �) t'�Qi y ry. B ement ;? 1 Floors �" K. Porch ��. Ext. 11Valls ; ct; Interior F_.inish Breezeway 7 Xi"7 ` S- /2 Fire Place V. Heat I= 25. + DR. Garvge Type Roof ; , Rooms ist Floor �-n, L, i; � - J Patio Recreation Room l Rooms 2nd Floor FIN. B 0. B. I Dormer !Driveway Total ; !,r� ! 1z�a �MUl� l� s / 3 Ig IL TOWN OF SOUT OLD PROPERTY REC®R®j OWNER - STREET ; VILLAGE DIST.1 SUB. _ LOT JJ act, l..,l: '.f -/ -r��' �Jil,� "..�� -r,�.r'_ rte' " FORMER {OWNER N,)',� ,L ACR. /�'J" �- l 11L�Q.YI 1Y f'.' °GYiftl L\/I�f\G f�` CCS ✓'✓i" I 1y 3 ` t 1 tee. sift. ; f ' ���i Y v C CA/dr) 4 S. W TYPE OF BUILDING RES. SEAS. VL. FARM I COMPv'%. CSB, MICS. Mkt. Value LAND i IMP. TOTAL DATE REMARKS 0 C11"'2' s -?/a 4 blF �o P7 7 a � 4 c 6)0 _ /6 3 7 V 13 5.zo 1 911FIY-f J--feL 1300 4fOO O - S-3 O 0 le ok(i- RDt' ) ? E CG// U_�C dr J CCLp6S.._3£1sd"� 54/0,(? ce co1-/,:g,,97vo trlsCv�y� d .. ,jY-0.,, x7,ref--- _ 30(7 0 acv 0 3 / t Acis--L 1,2101 1,9'q = >VG men t nuc I IZ/1( Ii Ef r F AGE BUILDING CONDITION �iiP- 36M4 &14-ta-brIs , NEW i NORMAL j BELOW ABOVE FARM Acre Vdlue Per Vclue Acre 4 Tillable I FRONTAGE ON WATER Woou[and FRONTAGE ON ROAD C, Meadowland f � DEPTH House Plot BULKHEAD Total DOCK �- i i i RED IT ED en4i:ronmental solutions February 7,2020 Mr.John Conti RE: Asbestos Survey 615 Pike Street Mattituck, NY Dear Mr.Conti: On February 5, 2020, Accredited Environmental Solutions performed an asbestos survey at the property located at the above referenced location. Potential Asbestos Containing Materials (PACM) were sampled by New York State licensed asbestos inspector Mark Vascak,license#14-18574.All bulk samples were analyzed by New York State certified laboratory EMSL Analytical, Inc,ELAP#11469. Asbestos is defined by Part 56 of Title 12 of the Official Compilation of Codes, Rules and Regulations of the State of New York (Cited as 12 NYCRR Part 56): Any material containing greater than one percent(1%) of asbestos, is known as Asbestos Material (AM). The attached EMSL laboratory results indicate that the specific sampled materials do not contain asbestos. At this time the premises to be demolished is free of asbestos containing materials (ACM) and therefore petition the Dept of Buildings to issue a demolition permit. Please let me know if you have any questions or need additional information. Sincerely, OF NEW A, ROS y0 61 Steven Rosenbaum m N O Accredited Environmental Solutions ; � Q ZFO • : . ... ... ::. ._:.... .' v .. . . ` �� moo• 121���1, ��� FEB 1 1 2020 gseEsros 'W Enc: EMSL laboratory results Asbestos certification 156 Shore Road, Port Washington, NY 11050 Phone 516-944-5323 Fax 516 -908-5323 Email: info@optonline. net New-York State' 'x,Department:of L borz.-, Division ofSafetypnd Health ',. License andiectiicate Unit ` 't x State Cam pus;Buildi g 12 f «>f Albany* NY.12240 '. �^"���y.:r;-�s�^-._ �-•. r ^� ASBESTOS HANDLING LICENSE,�-,� w Jj�t• % .�,�Y ~'`4'i.`.�yy�,•�ry yHA'.?* /4.F \}}}`'''S `l-� .+" Y HpM14"h..f' , A.... s„^t>r..+-c. -•wr .w..w•v,,.-..✓-� v`t•�'C t�`� �,i1 Afccredited Leadlnspection, Inc. ' _ =FILE NUMBER:08Y�3632�6 �- LICENSE NUMBER5`%B X26: - 1156 Shore Road'6 r LICENSE CLASS: FULL\, ' `�' C0 t, i DATE OF ISSUE: 03/28/20419 /'Port 1N hingtonn, NYA410501-°' g air,,�� XPIRATI,. DATE: 03/31'/2020 y. > _ Jnr s*y t ®uAuthorize dStev nsehbaum:ly Repret,(" [/y .0 az:4• „ .'f� •"�� p�P'C 'i+.".:... '�'s'y idE+{�, -. fx a1., „1, f 4 !I`{ Fid II 7••rl� !"o•,..''"sof . .��. '°di -8i r' •:" r;# ;'� hxv",. This hcenseph s been issued in accordanc nth,, heabl rbuzsLons o Erricle,30'I pf the Labor Law of New Y r aState and o r �r aaP.F - L_P -�— p t�fwt z 1 aft: C �r `. This New;ZYrk*State Codes,RulesaIegutatis2rN 'CR�Part5;6).'`It issubject to suspension or revoca on for a(1) seridons vio'latio o state,federal ,,loc �1 a�V's th r„e�ard-totheno� duet ofyan>ashestos prdj;ect,or(2)demo nstrated,lackioi a� t� � j { : respons bility in th conduct of anyjgb mvolvi g�alet 's oxsl�estos pial. f u r� . k� �.�;�'�,,»�` } �x;:•�+t�� ,fir. •w ,�'.��.--�-_.:� � r� `�1 r,��' qty, , This"license is:vand only for tlx contractor narned.; bo. a an tT�> .leense o :2 photeopymuster"eminently displayed at the asbesto project w,orksite),This Qqj se veri+i`ites that�ll��er--sons-empl�y d��.lZy,,he licensee on an-ashes o project in New York State have een";is Med an Asbestos Certificate';appropriate dor t etypellofW`,,oxk they perform,by thel�tew York.State Department of Laor. T11 VA �,� f�t ��[j` -."4,' '''T..,+.,»,_ *"''w'•'MF%'` ..�+{ < °rte dro- Y�� t;. >� A�'.{r:i �'"'_� '':n...r--.... _ �•`�y'"fir^"'^'" �2'., a�� t''`�. +.-y err f f'. �i �..."-':-'d--.��—Vim,-r.3".�"X:e-.s +f •7{� i i',r^ • �a..,:,y//���,��rrr '^r I� P.*hj+'�•.� � vy � �� �=t �.S lYhri'�'a f' Y~ Eileen M.Franko, Director SH 432(8/12) "i For the Commissioner of Labor EMSL Analytical, Inc. EMSL Order: 062002634 Customer ID: ACCR63 528 Mineola Avenue Carle Place,NY 11514 Customer PO: Tel/Fax:(516)997-7251/(516)997-7528 Project ID: http://www.EMSL.com/carleplacelab@emsl.com Attention: Steven Rosenbaum Phone: (516)944-5323 Accredited Lead Inspection, Inc. Fax: (516)908-5323 156 Shore Road Received Date: 02/05/2020 3:23 PM Port Washington, NY 11050 Analysis Date: 02/06/2020 Collected Date: 02/05/2020 Project: John Conti,615 Pike st, Mattituck, NY Test Report: Asbestos Analysis of Non-Friable Organically Bound Materials by PLM via the NY State FLAP 198.6 Method Matrix %Non-Asbestos Sample ID Description Appearance Material Fibers %Asbestos Types 17 2 FL Front Left Rm Center Gray/White 100%Other <1 Wollastonite Inconclusive:No Asbestos Detected 062002634-0017 Window-Window Non-Fibrous Glazing Homogeneous 18 1 FL Center Rm(Dining Gray/White 100%Other <1 Wollastonite Inconclusive:No Asbestos Detected 062002634-0018 Rm)1 st Window from Non-Fibrous Right-Window Glazing Heterogeneous Analyst(s) Omatie Ramrattan-Scarallo Daniel Clarke,Asbestos Laboratory Manager (2) or other approved signatory 'Polarized Light Microscopy(PLM)is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically bound materials. Quantitative Transmission Electron Microscopy is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos containing. The test results contained within this report meet the requirements of NELAC unless otherwise noted.EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported above and may not be reproduced, except infull,without written approval by EMSL.The above test report relates only to the items tested. EMSL bears no responsibility for sample collection activities or analytical method limitations.Samples received in good condition unless otherwise noted. Samples analyzed by EMSL Analytical,Inc.Carle Place,NY NYS ELAP 11469 Initial report from:02/06/2020 15:45:54 ASB PLA4NYN0B 0016 0001 Printed 2/6/2020 3:45:57PM Page 1 of 1 EMSL Analytical, Inc. EMSL Order: 062002634 y Customer ID: ACCR63 528 Mineola Avenue Carle Place,NY 11514 Customer PO: Phone/Fax:(516)997-7251/(516)997-7528 Project ID: ,M http://www.EMSL.com/carieplacelab@emsl.com Attention: Steven Rosenbaum Phone: (516)944-5323 Accredited Lead Inspection, Inc. Fax: (516)908-5323 156 Shore Road Received: 02/05/2020 3:23 PM Port Washington, NY 11050 Analysis Date: 02/06/2020 Collected: 02/05/2020 Project: John Conti, 615 Pike st, Mattituck, NY Test Report: Asbestos Analysis of Bulk Materials by PLM via the NY State ELAP 198.1 Method Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type 1 3 FL Front Rm Left Wall Brown/Gray 1% Cellulose 15%Ca Carbonate None Detected 062002634-0001 -Sheetrock Fibrous 80%Gypsum Heterogeneous 4%Non-fibrous(Other) 2 3 FL Front Rm Left Wall White 80%Ca Carbonate None Detected 062002634-0002 -Joint Compound Non-Fibrous 4%Mica Heterogeneous 16%Non-fibrous(Other) 3 2-3 FL Stairway Left Gray/Tan 60%Quartz None Detected 062002634-0003 Wall-Plaster Top Coat Non-Fibrous 15%Ca Carbonate Heterogeneous 25%Non-fibrous(Other) 4 2-3 FL Stairway Left Gray/Tan 60%Quartz None Detected 062002634-0004 Wall-Plaster Bottom Non-Fibrous 15%Ca Carbonate Coat Heterogeneous 25%Non-fibrous(Other) 5 2 FL Front Left Rm Gray/Tan 65%Quartz None Detected 062002634-0005 Right Wall-Plaster Top Non-Fibrous 15%Ca Carbonate Coat Heterogeneous 20%Non-fibrous(Other) 6 2 FL Front Left Rm Gray/Tan 60%Quartz None Detected 062002634-0006 Right Wall-Plaster Non-Fibrous 15%Ca Carbonate Bottom Coat Heterogeneous 25%Non-fibrous(Other) 7 2 FL Hallway Left Wall Gray <1% Cellulose 12%Ca Carbonate None Detected 062002634-0007 -Sheetrock Fibrous 80%Gypsum Heterogeneous 8%Non-fibrous(Other) 8 2 FL Hallway Left Wall White 80%Ca Carbonate None Detected 062002634-0008 -Joint Compound Non-Fibrous 5%Mica Homogeneous 15%Non-fibrous(Other) 9 1 FI Middle Rm(Dining Red 70%Quartz None Detected 062002634-0009 Room)Front Wall- Non-Fibrous 15%Ca Carbonate Plaster Top Coat Heterogeneous 15%Non-fibrous(Other) 10 1 FI Middle Rm(Dining Gray/Tan <1% Synthetic 50%Quartz None Detected 062002634-0010 Room)Front Wall- Non-Fibrous 15%Ca Carbonate Plaster Bottom Coat Heterogeneous 35%Non-fibrous(Other) EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported and may not be reproduced,except in full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted.All samples examined for the presence of vermiculite. Samples analyzed by EMSL Analytical,Inc.Carle Place,NY NYS ELAP 11469 Initial report from:02/06/202015:45:54 ASS F"LMAC'0006 0003 Printed 2/6/2020 3:46:OOPM Page 1 of 3 EMSL Analytical, Inc. EMSL Order: 062002634 y Customer ID: ACCR63 528 Mineola Avenue Carle Place,NY 11514 Customer PO: Phone/Fax:(516)997-7251/(516)997-7528 Project ID: ,M http://www.EMSL.com/carleplacelab@emsl.com Attention: Steven Rosenbaum Phone: (516)944-5323 Accredited Lead Inspection, Inc. Fax: (516)908-5323 156 Shore Road Received: 02/05/2020 3:23 PM Port Washington, NY 11050 Analysis Date: 02/06/2020 Collected: 02/05/2020 Project: John Conti,615 Pike st, Mattituck, NY Test Report: Asbestos Analysis of Bulk Materials by PLM via the NY State ELAP 198.1 Method Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type 13 1 FL Kitchen Floor- Gray 55%Quartz None Detected 062002634-0013 Floor Tile Grout Non-Fibrous 15%Ca Carbonate Heterogeneous 30%Non-fibrous(Other) 14 1 FL Bath Floor Front- Gray 60%Quartz None Detected 062002634.0014 Floor Tile Grout Non-Fibrous 15%Ca Carbonate Heterogeneous 25%Non-fibrous(Other) 15 1 FL Bath Right Wall @ White 45%Quartz None Detected 062002634-0015 Left-Wall Tile Grout Non-Fibrous 15%Ca Carbonate Heterogeneous 40%Non-fibrous(Other) 16 1 FI Front Bath Right White 50%Quartz None Detected 062002634-0016 Wall @ Right-Wall Tile Non-Fibrous 15%Ca Carbonate Grout Heterogeneous 35%Non-fibrous(Other) 19 1 FL Front Hall Left Gray <1% Glass 15%Ca Carbonate None Detected 062002634-0019 Wall-Sheetrock Fibrous 60%Gypsum Heterogeneous 25%Non-fibrous(Other) 20 1 FL Front Hall Left White 2%Cellulose 70%Ca Carbonate None Detected 062002634-0020 Wall-Joint compound Non-Fibrous 3%Mica Homogeneous 25%Non-fibrous(Other) 21 1 FL Center Rm(Din Brown 2% Cellulose 46%Quartz None Detected 062002634-0021 Rm)Fireplace-Mortar Non-Fibrous 30%Ca Carbonate Homogeneous 15%Gypsum 7%Non-fibrous(Other) 22 Basement Left Wall- Gray/White 2% Cellulose 40%Quartz None Detected 062002634-0022 Mortar Non-Fibrous 28%Ca Carbonate Heterogeneous 30%Gypsum 0%Non-fibrous(Other) 23 1 FI Center Rm(Din Red 3% Cellulose 30%Quartz None Detected 062002634-0023 Rm)Fireplace-Plaster Non-Fibrous 47%Ca Carbonate Top Coat Homogeneous 20%Gypsum 0%Non-fibrous(Other) 24 1 FI Center Rm(Din Brown 2%Cellulose 45%Quartz None Detected 062002634-0024 Rm)Fireplace-Plaster Non-Fibrous 1% Hair 48%Ca Carbonate Bottom Coat Homogeneous 3%Mica 1%Non-fibrous(Other) EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported and may not be reproduced,except in full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted.All samples examined for the presence of vermiculite. Samples analyzed by EMSL Analytical,Inc.Cade Place,NY NYS ELAP 11469 Initial report from:02/06/202015:45:54 ASB POOP C 0006 0003 Printed 2/6/2020 3:46:0013M Page 2 of 3 EMSL Analytical, Inc. EMSL Order: 062002634 Customer ID: ACCR63 528 Mineola Avenue Carle Place,NY 11514 Customer PO: Phone/Fax:(516)997-7251/(516)997-7528 Project ID: http://www.EMSL.Gom/carleplacelab@emsl.com Attention: Steven Rosenbaum Phone: (516)944-5323 Accredited Lead Inspection, Inc. Fax: (516)908-5323 156 Shore Road Received: 02/05/2020 3:23 PM Port Washington, NY 11050 Analysis Date: 02/06/2020 Collected: 02/05/2020 Project: John Conti,615 Pike st, Mattituck, NY Test Report: Asbestos Analysis of Bulk Materials by PLM via the NY State ELAP 198.1 Method Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type 25 1 FI Center Rm(Din Red 38%Quartz None Detected 062002634-0025 Rm)Right Wall-Plaster Non-Fibrous 42%Ca Carbonate Top Coat Homogeneous 20%Gypsum 0%Non-fibrous(Other) 26 1 FI Center Rm(Din Gray 2% Cellulose 34%Quartz None Detected 062002634-0026 Rm)Right Wall-Plaster Non-Fibrous 2% Hair 47%Ca Carbonate Bottom Coat Homogeneous 12%Gypsum 3%Mica 0%Non-fibrous(Other) Analyst(s) Erick Rosa(15) Daniel Clarke,Asbestos Laboratory Manager Omatie Ramrattan-Scarallo or other approved signatory (7) EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported and may not be reproduced,except in full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted.All samples examined for the presence of vermiculite. Samples analyzed by EMSL Analytical,Inc.Carle Place,NY NYS ELAP 11469 Initial report from:02/06/2020 15:45:54 ASB PLMPC 0006 0003 Printed 2/6/2020 3:46:OOPM Page 3 of 3 EMSL Analytical, Inc. EMSL Order: 062002634 Customer ID: ACCR63 528 Mineola Avenue Carle Place,NY 11514 Customer PO: Tel/Fax:(516)997-7251 /(516)997-7528 Project ID: .M http://www.EMSL.com/carleplacelab@emsl.com Attention: Steven Rosenbaum Phone: (516)944-5323 Accredited Lead Inspection, Inc. Fax: (516)908-5323 156 Shore Road Received Date: 02/05/2020 03:23 PM Port Washington, NY 11050 Analysis Date: 02/06/2020 Collected Date: 02/05/2020 Project: John Conti,615 Pike st, Mattituck, NY Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total Sample ID Description Appearance Material Fibers %Asbestos Tvpes Asbestos 11 1 FI Middle Rm(Dining Brown/White/Green 100%Other None No Asbestos Detected None 062002634-0011 Room)Floor @ Non-Fibrous Detected Fireplace-12x12 Self Heterogeneous Adhesive Floor Tile 12 Basement Floor- Brown/White/Green 100%Other None No Asbestos Detected None 062002634-0012 12x12 Self Adhesive Non-Fibrous Detected Floor Tile Heterogeneous 17 2 FL Front Left Rm Gray/White 100%Other None <1%Anthophyllite <1% 062002634-0017 Center Window- Non-Fibrous Window Glazing Homogeneous 18 1 FL Center Rm Gray/White 100%Other None No Asbestos Detected None 062002634-0016 (Dining Rm)1st Non-Fibrous Detected Window from Right- Heterogeneous Window Glazing 27 2 FI Front Wall @ Black 100%Other None No Asbestos Detected None 062002634-0027 Center-Siding Felt Fibrous Detected Homogeneous 28 2 FI Front Wall @ Black 100%Other None No Asbestos Detected None 062002634-0028 Center-Siding Felt Fibrous Detected Homogeneous 29 2 FI Roof @ Front Black 100%Other None No Asbestos Detected None 062002634-0029 Center-Roofing Felt Fibrous Detected Homogeneous 30 2 FI Roof @ Front Gray/Black/Green 100%Other None No Asbestos Detected None 062002634-0030 Center-Roofing Fibrous Detected Shingle Heterogeneous 31 2 FI Right Roof Center Black 100%Other None No Asbestos Detected None 062002634-0031 -Roofing Felt Fibrous Detected Homogeneous Analytical Sensitivity<1%Asbestos.This laboratory is not responsible for%asbestos in total sample when the residue only is submitted for analysts.The above report relates only to the Items tested.This report may not be reproduced,except in full,without written approval by EMSL Analytical,Inc.Samples received in good condition unless otherwise noted. Samples analyzed by EMSL Analytical,Inc.Cade Place,NY NYS ELAP 11469 Initial report from:02/06/2020 03:45 PM Printed:02/06/2020 03:46 PM ASB—TEMNYNOB_0015 4901 Page 1 of 2 EMSL Analytical, Inc. EMSL Order: 062002634 Customer ID: ACCR63 528 Mineola Avenue Carle Place, NY 11514 Customer PO: Tel/Fax: (516)997-7251 /(516)997-7528 Project ID: M http://www.EMSL.com/carleplacelab@emsl.com Attention: Steven Rosenbaum Phone: (516)944-5323 Accredited Lead Inspection, Inc. Fax: (516)908-5323 156 Shore Road Received Date: 02/05/2020 03:23 PM Port Washington, NY 11050 Analysis Date: 02/06/2020 Collected Date: 02/05/2020 Project: John Conti,615 Pike st, Mattituck, NY Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total Sample ID Description Appearance Material Fibers %Asbestos Types Asbestos 32 2 FI Right Roof Center Gray/Black/Green 100%Other None No Asbestos Detected None 062002634-0032 -Roofing Shingle Fibrous Detected Heterogeneous Analyst(s) Rosemary Ortega(10) Daniel Clarke,Asbestos Laboratory Manager or other Approved Signatory Analytical Sensitivity<1%Asbestos.This laboratory Is not responsible for%asbestos In total sample when the residue only Is submitted for analysis.The above report relates only to the Items tested.This report may not be reproduced,except in full,without written approval by EMSL Analytical,Inc.Samples received in good condition unless otherwise noted. Samples analyzed by EMSL Analytical,Inc.Carle Place,NY NYS ELAP 11469 Initial report from:02/06/2020 03:45 PM Printed:02/06/2020 03:46 PM ASS—TEAINYIVOB-0016 0001 Page 2 of 2 IF FOUND .RBTURN TO: STATE OF.NEW YORK:DEPARTMFNTOF LABOR =n EYES GRN NYSDOL - LAC UNIT ASBESTOS CEUMCATE "' r"i s+ HAIR BRO ROOM,161A BUILDING 1.2 ---^-� nneenn pt� rA _8 HGT 6' 00" STATE OFFICE CAMPUS' 1Y1ARK J-VASCAK AT.uANv NY 12240 CLASS(EXPIRES) =:N C ATEC(04120), D INSP(04/24) i MUST BE CARRIED ON ASBESTOS PROJECTS � pe�tuta©o�guti�rs�