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HomeMy WebLinkAboutMiscellaneous - 73 RIVERVIEW STREET 7/10/1989 ' �� ILBERT REA JOB ` 44 Rea St vosc op NO. ANDOVER, MA 01845 Phone 68249804 «^L»»mrsoa' o^rc CHECKED BY oms oo«Ls_________. iX � 3 t r 1 J 3 s 1 � F r . 1 f i E I i 1 X 3 I� B a 3 1 1 f � q�w ve 1l 2 04 SA A !o,� ;f X15, FP9 Uep cotivifla k„ ,�' ., �� �� � t� 'Y;��'�M '`�Ship l• �"r ,�t._1 �j 11 TO C �' ApwoVW6 w 9'.-='vc �=-"sf-,=- ,wa;�3���5'."�-"��-a"Y'-� 'x-rc •..,2�.z r' - rl r•..r M.'ti-...fir<. a'.v-' w-✓--v r�..,Tir°,.,,R- wi +�`or-�_o.:.rs ,3_;�4� � ,..,�c��-- '� � •Y.`l'��v v�-,r _ -G._—+�; I '�'_4.=. '�-`�� -,-5 Cv'��'cf.��---��Y - -p era' 6 �' � -�� ..,y=• _"Yr, C_�._ '� - - 3"_. •` +ate° ORION Ra::a ._ -x�a.r'-� Ei� �. .�� _ .3,,ix�^.,.-�Er'� �... ��.t�„r��F • -... �,�c_��... _ `�,_ ��,.�' t. �r.. .�.rc'���`l _.--r- T. r�`-..," c:..u` '. 09/25/2013 10: 31 FAX 19787412012 A&ASErRVICE;S 14002/002 Department of Public Health &Department of Labor E - Nq'rI ICATION OFD LEADING WORK \ If All uestions of this form must be completed in order to comply with the notification requirements of M.G.L.C.111197, 454 CMR 22.00 and 105 CMR 460.000,as most recently amended Contractor purlbrnaing project Chris ZOrzy license# DC000440 P,xp,Date 6/7/2014 Loud taint Inspector Berl Misah Date of Inspection 9/23113 Lleenac#1/R3984 Exp.Date A121gk]ES8 OF P "t'' 5trect Address 75 Riverview Strut Apt.Number City North Andover,MA 7.!p 018455 Property Owner John Tor'torelli Add,., 73 Riverview Street, No. Andover, MA 'lelephonc,Number 978-500-5096 Deleading Method:[a Wet/Dry Scraping ❑Meat Gun l]Liquid Encapsulant ©Demolition I]Cmustloa Q Reph,cemcnt QCovering EJ Other T "Other"selected,please explain Check one: Dwelling is multi-family Single-family„ ntlhor� Start Date 10!712013 Completion Date 10/8/2013 When will worlt be done: AM X PM x (Specify times on site) Weekends? Project Supervisor Name Willie Woods License#DS3534 Exp.Date (6113 Woriccr'v C:omptnsation Policy Number 0243MSI6 Carrier Traveler`s In envc of emergency contact Chris Zvrzy I'cl.if_(979 ) 741-0424 (Contractor's Representative) Drk,J,RADING CO1V`I'RACTOR The undemigned hereby states,under the pains and penaltle_g of perjury,that he/she has read and understood the Commonwealth of Ma,vauchusetty Dolo,uling Regul:rtiona,4;54 CMR 22.00,and the Leitd Poixoning Prevention end Control Regubatiom,105 CM 11460.000,And that the information contained in this notification is true and correct to the best of his er knowledge and belief. Date Signed Company Name Address Telephone Number OVER-1r