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Home My WebLink AboutMiscellaneous - 11 SYLVAN TERRACE 2/5/2018 All State Abatement Professionals, inc. 4 Wilder Drive, Suite 12 866-565-ASN."I Plaistow, NH 03865 Fax: 603-378-0610 January 31, 2018 SECEIVFM zmB Town of North Andover 05 t405�k mkoovfR 10 I Health Department 6iPIMOA 1600 Osgood Street Bldg 20; Unit 2035 North Andover, MA 01845 Phone #: (978) 688-9540 Fax #: (978) 688-8476 Re: Asbestos Abatement(y), Residence - 11 Sylvan Terrace. To whom it may concern: All State Abatement Professionals, Inc. (ASAP) is scheduled to perform work for the above referenced project on the following dates: Start Date: 02/19/2018 End Date: 02/19/2018 All appropriate agencies have been notified for the above referenced project. If you have any questions or need additional information, please do not hesitate to contact me. Sincerely, J. Scott Curley President JSCJab Enclosures Asbestos -Masonry Cleaning d Selective Demolition o Shot/Sand Blasting • Mold Remediation °r"'r !�a k6;:�9C1, . iC: C iJck%idY'I -rt[ vc tl'r taCi.�,i6"'"f11,e4� w .;ifi 1O0280400 BP A 04 (ANF-001) _ Asbestos Project# Asbestos Notification kjorni Project Revision 1LI_ Pr(rIect Cancellation A. Asbestos Abatement Description 1.1^acility Location: RESIDENCE 11 SYLVAN TERRACE Instructions 1.All a.Name of Facility b.Street Address f sections of this form NORTH ANDOVER must be completed in MA 01845 0000000000 I order to comply with c.City/Town d.State e.Zip Code f.Telephone MassDEP notification HOPE DORAN HOMEOWNER requirements of 310 CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title Department of Lab:)r Worksite Location: WCHEN Standards(DLS) notification i.Building Name,Wing,Floor,Room,etc. requirements of 453 2. Is the facility occupied? l a.Yes b.No CMR 6.12 3. Is this a fee exempt notification (city, town, district, municipal housing authority, state facility, or owner-occupied residential property of four units or less)? 10 a. Yes I'_� b.No MassDEP Use Only 4.Blanket Permit Project Approval,if applicable: Date Received Approval ID# 5.Non-Traditional Asbestus Abatement Work Practice Approval, 2.Submit Original if applicable: Approval 10# Form commonwealth of Massachusetts G.Asbestos Contractor: P.O.Box 4062 Boston,MA 02211 ALL STATE ABATEMENT PROFESSIONALS 4 WILDER DRIVE STE 12 a,Name b.Address PLAISTOW W 03865 6033780600 c.City/Town d.State e.Zip Code f.Telephone AC000331 h.Contract Type: fwi 1. Written t_2,Verbal g.DLS License# 7 JOSEPH R CURL_EY AS900965 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# AIR TESTING SERVICES INC AA000124 8. a.Name of Project Monitor b.DLS Certification# AIR TESTING SERVICES INC AA000124 9. a.Name of Asbestos Analytical Lab b.DLS Certification# 10. 2/19/2018 2119/2018 a,Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY) 7:00-3;30 NONE c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11. What type of pr(Jcct is this? a.Demolition V b.12enovation l " c. Repair d. Other-Please Sllccif)': ; Pace l cal 4 RcN,ised: [1/13/2W3 Massachusetts Department of Environmental Protection 100280400 L71 BNNIP AQ 04 (ANF-001) -oject # Asbestos Pi Asbestos Notification Form Project Revision Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): a.Glove Bag b,Encapsulation i C. FACIOSLIN d.Disposal Only c.Cleanup 1.Full Containment f� g. Other-Please Specify: WETMETHODS 13.Job is being conducted: v a. Indoors F b. Outdoors 14 a,Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 0 2700 1.Linear Feet(Lin.FL) 2.Square Feet(Sq.Ft.) b.Boiler,Breaching, Duct, c.Transite Pipe Tank Surface Coatings 1.Lin.Ft, 2.Sq.Ft. 1.Lin.Ft. Z S%Ft. d.Pipe Insulation e.Transite Shingles 1,Lin,Ft, 2,Sq.Ft. 1.Lin,Ft. 2.Sq,Ft. f. Spray-On Fireproofing g.Transite Panels 1,Lin,Ft. Z Sq.Ft. 1,Lin.Ft, 2.Sq.Ft. h. Cloths, Woven Fabrics i.Other-Please Specify: 1.Lin,Ft, 2,Sq,Ft. Insulating Cement FLOORING 2700 1.Lin,Ft. 2.Sq.Ft. 1.Lin,Ft. 2.Sq.Ft. 15.Describe the decontamination system(s)to be used: PROVIDE AN ADEQUATE DECONTAMINATION SYSTEM. 16,Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CIVIR 6.14(2) (g): DOUBLE 6 MIL POLY 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated tile emergency: a,Narne of MassDEP Official b.Title of Wa—ssDFP Official c.Date of Authorization(MM/DDNYYY) d.Waiver# e,Name of DLS Official f.Title of DLS Official g,Date of Authorization(MM/DDNYYY) h.Waiver# 18. Do prevailing wage rates as per N4.G,1- c. 1X19, :16, 27 or 27.E-1'" npp 1Y lo this a. Yes V b,No project? Revised: 11/13/2013 Page 2 of 4 Massachusetts Department of Environmental Protection _- 100280400 BWP AQ 04 (ANF-001) Asbestos Project It Asbestos Notification Form i'roject Revision Project Cancellation B. Facility Description I.Current or prior use of facility: RESIDENCE 2. is the,facility owner-occupied residential with 4 units or less? f . a.Yes f.., b.No HOPE:DORAN 11 SYLVAN TERRACE a.Facility Owner Name b.Address NORTH ANDOVER MA 01845 0000000000 c.City/Town d.State e.Zip Code f.Telephone 4.JOSEPH CURLEY 4 WILDER DRIVE,STE 12 a.Narne of Facility Owner's On-Site Manager b.Address PLAISTOW Ni 03865 6033780600 c.Cityfl'own d.State e.Zip Code f.Telephone 5. ALL STATE ABATEMENT PROFESSIONAL 4 WILDER DRIVE,STE 12 a.Name of General Contractor b.Address PLAISTOW NH 03865 6033780600 c.City/Town d.State e.Zip Code f.Telephone STATE NATIONAL INSURANCE CO. g.Contractor's Worker's Compensation Insurer NFA086759000 3/22/2018 h,Policy# i.Expiration Date(MM/DD/YYYY) 1300 2 G. What is the size of this facility? a.Square Feet b.#of Floors C. Asbestos Transportation & Disposal 1 Transporter of asbestos-containing waste material from site of generation: i" a. Directly to Landfill or f4i b.To Temporary Storage Location/Transfer Station ALLSTATE ABATEMENT PROFESSIONALS,INC 4 WILDER DRIVE,STE 12 c.Name of Transporter d.Address Note:Temporary storage of Asbestos PLAISTOW NH 03865 6033780600 containing waste e.City/Town f.State g.Zip Code h.Telephone material is only allowed at the place of business of a DLS 2. 1f a temporary Storage location/transfer Station is used,Ilst name of transporter of asbestos containing licensed Asbestos waste material from temporary storage location/transfer Station to filial disposal site: contractor or a transfer station that is permitted by J.O.BlROLLOFF,INC. 69 NORMAN STREET MassDEP and a.Name of Transporter b.Address operated in compliance with Solid EVERETT MA 02149 0000000000 Waste Regulations c.City/Town d.State e.Zip Code f.Telephone 310 CMR 19.000 it Page 3 of 4 Revised: 11/13/2013 MassachUsetts Department of Environmental Protection 100280400 BWP AQ 04 (ANF-001) Asbestos Project # Asbestos Notification Form Project Revision Pro J ect Cancellation C. Asbestos Transportation & Disposal: (runt.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: ALL STATE ABATEMENT PROFESSIONAL 4 WILDER DRIVE a.Temporary Storage Location Name b.Address PLAISTOW N-1 03865 6033780600 St-,',, a.7in rade f.Telephone 4.Name and location of final disposal site(asbestos landfill): TURNKEY LANDFILL WASTE MANAGEMENT OF NH a.Final Disposal Site Name b.Final Disposal site Owner Name 97 ROCHESTER NECK ROAD c,Address ROCHESTER NH 03839 0000000000 d,City/Town e.State FZIP Code g,Telephone D. Certification JOSEPH CURLEY JOSEPH CURLEY "I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PRESIDENT 1131/2018 familiar with the information 3.Position/Title 4.Date(MM/DDfYYYY) Note:Contractor must contained in this document and 6033780600 ASAP,INC sign this form for DLS all attachments and that, based notification purposes on my inquiry of those 5.Telephone 6.Representing individuals immediately 4 WILDER DRIVE,STE 12 PLAISOW responsible for obtaining the 7.Address 8.City/Town information,I believe that the NH 03865 information is true, accurate, and 9,State 10,Zip Code complete. I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment. The undersigned hereby states that I have read the Commonwealth of Massachusetts regulations governing asbestos abatement (453 CMR 6.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made," Revised: 11/13/2013 Page 4 ol'4