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Home My WebLink AboutMiscellaneous - 1600 OSGOOD STREET 4/30/2018 (98) /("oa 0961)v-P /�r/� - 1d7 20 rjc DEC-TAM CORPORATION 978.470.2860 Specialty Contractors fax 978.470.1017 RECEIVED APR 2 9 2013 TOWN OF NORTH ANDOVER HEALTHDEPARTMENT April 23, 2013 North Andover Board of Health 1600 Osgod Street Building 20, Suite 2-36 North Andover, MA 01845 RE: Dow Chemical, 60 Willow Street, North Andover, MA 01845(Main) Dear Sir or Madam: Please be advised that Dec-Tam Corporation will be performing an asbestos abatement projects at the above referenced locations. This work had been scheduled for May 8, 2013 thru May 8, 2013. All applicable local, state and federal agencies have been notified of this work. Please let me know if you have any questions. Sincerest regards, David Patti Sales Estimator DP/cam Enclosure Environmental Remediation Services - Surface Preparation - Facilities Services 50 Concord Street - North Reading, MA 01864 - www.dectam.com 0 solutions@dectam.com Commonwealth of Massachusetts _■ Asbestos Notification Form ANF-001 Decal Number APR 2 9 2013 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Important: When filling out A. Asbestos Abatement DescriP •tion forms on the computer,use 1. a. Is this facility fee exempt-city, town, district, municipal housing authority, owner-occupied only the tab key residence of four units or less?❑Yes ❑✓ No to move your cursor-do not b. Provide blanket decal number if applicable: use the return Blanket Decal Number key. 2. Facility Location: DOW CHEMICAL 60 WILLOW STREET a.Name of Facility b.Street Address NORTH ANDOVER MA 01845 9786891566 c.City/Town d.State e.Zip Code f.Telephone Number INSTRUCTIONS 3. Worksite Location: 1.Al sections of this MAIN form must be a.Building Name/Building Location b.Building# c.Wing d.Floor e.Room completed in order to comply with 4. Is the facility occupied? Q Yes ❑No DEP notification requirements of 310 CMR 7.15 5. Asbestos Contractor: and the Division of Occupational DEC-TAM CORPORATION 50 CONCORD STREET Safety(DOS) a.Name b.Address notification requirements of 453 NORTH READING 01864 1 19784702860 CMR 6.12 c.Ci /Town d.Zip Code e.Telephone Number AC000035 f.DOS License Number g. Contract Type: ✓❑Written ❑Verbal DAVID PATTI I ISAILES h.Facility Contact Person i.Contact Person's Title GEORGE A. PAGE AS071933 6' a.Name of On-Site Supervisor/Foreman b.Supervisor/Foreman DOS Certification Number URS AA000035 7' a.Name of Pra'ect Monitor b.Pro ect Monitor DOS Certification Number URS AA000035 8' a.Name of Asbestos Analytical Lab b.Asbestos Anallgical Lab DOS Certification Number —� 9 5/8/2013 1 151812013 a.Project Start Date mm/dd/ b.End Date mm/dd �0 7A-4P sN c.Work hours Mon-Fri. d.Work hours Sat-Sun. _0 10. a. What type of project is this? 0 ❑ Demolition 0 Renovation ❑ Repair ❑Other, please specify: b.Describe 11. a. Check abatement procedures: 0 ❑Glove bag ❑ Encapsulation 10 ❑ Enclosure ❑ Disposal only �LL ❑Cleanup Other, specify: CRITBAR/NEGAIR/DECON ❑ Full containment b.Describe —�z �Q 12. Is the job being conducted: ❑ Indoors? ❑Outdoors? anf001ap.doc•10/02 \ / Asbestos Notification Form•Page 1 of 3 Commonwealth of Massachusetts 100176159 Asbestos Notification Form ANF-001 Decal Number A. Asbestos Abatement Description (cont.) 13. Total amount of each type of Asbestos Containing Materials(ACM)to be removed, enclosed, or encs sulated: 10 300 a.Total pipes or ducts(linear ) o a other surTaces(square c.Boiler,breaching,duct,tank d.Insulating cement surface coatings Lin.ft. Sq.ft. LinL._.� Sq. e.Corrugated or layered paper i� f.Trowel/Sprayer coatings pipe insulation Lin.ft. Sq.ft. Lin.ft. Sq.ft. g.Spray-on fireproofing L___J r h.Transite board,wall board � 300 Lin.ft. Sq.ft. Lin. ( ft� ( q. i.Cloths,woven fabrics I j.Other,please specify: Lin S k.Thermal,solid core pipe insulation Lin.ft. Sq.ft. I.Specify 14. Describe the decontamination system(s)to be used: THREE STAGE 15. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): MATERIALS WILL BE WETTED AND PLACED IN DOUBLE BAGS AND LABELED FOR TRANSP 16. For Emergency Asbestos Operations, the DEP and DOS officials who evaluated the emergency: a._Naffieof DIEP Official b.Title c.Date(mm/dd/ )of Authorization d.DEP Waiver# e.Name of DOS Official t.DOS OfficialTitle g.Date(mmlddlyyyy)of Authorization h.DOS Waiver# �0 17. Do prevailing wage rates as per M.G.L. c. 149, §26,127 or 27A—F apply to this project? F1 Yes ✓[]No 10 B. Facility Description �N MANUFACTURING =0 1. Current or prior use of facility: �o 2. Is the facility owner-occupied residential with 4 units or less? ❑Yes 0 No DOW CHEMICAL 60 WILLOW STREET t- 3' a.Facility Owner Name b.Address .�Q NORTH ANDOVER 101845 978-689-1566 0 c.Ci /Town d.Zip Code e.Telephone Number area code and extension �LL 4 KENNETH TWINING SAME AS ABOVE (aName of�FacilityOOwner's On-Site Manager b.On-Site Manager Address L��! �Q c.City/Town d.Zip Code e.Telephone Number(area code and extension) anf001ap.doc•10/02 Asbestos Notification Form-Page 2 of 3 Commonwealth of Massachusetts 100176159 Asbestos Notification Form ANF-001 Decal Number B. Facility Description (cont.) 5. a.Name of General Contractor b.Address c.Ci [Town d.Zip Code e.Telephone Number area code and extension GREAT DIVIDE INS.CO JWCA153726610 1 112/28/2013 f.Contractor's Worker's Comp.Insurer g.Policy Number h.Exp.Date(mm/dd/y 6. What is the size of this facility? 200001�� a.Square Feet b.Number of floors C. Asbestos Transportation and Disposal 1. Transporter of asbestos-containing material from site to temporary storage site (if necessary): Note:Transfer a.Name of Transporter1 b.Address Stations must I I comply with the c.City/Town d.Zip Code e.Telephone Number Solid Waste Division 2. Transporter of asbestos-containing waste material from removal/temporary site to final disposal site: Regulations 310 CMR 19.000 SERVICE TRANSPORT 158 PYLES LANE a.Name of Transporter b.Address NEW CASTLE,DE 18779999559 c.Ci /Town d.Zip Code e.Telephone Number 3. a.Refuse Transfer Station and Owner b.Address I ]1 I( c.C' /Town d.Zip Code e.Telephone Number 4. IMINERVA ENTERPRISES INC a.Final Disposal Site Location Name b.Final Disposal Site Location Owner's Name 9000 MINERVA ROAD I IWAYNESBURG c.Final Dis osal Site Address d.Ci [Town OH 44688 ®� e.State f.Zip Code g.Telephone Number �o D. Certification N The undersigned hereby states, under the DAVID PATTI �� David Patti 0 penalties of perjury,that he/she has read the a.Name b.Authorized Si nature �o Commonwealth of Massachusetts regulations SALES 1412312013 for the Removal,Containment or �r c.Position/Title d.Datemm/ddJyyw) Encapsulation of Asbestos,453 CMR 6.00 and 8784702860 �� DEC-TAM � 310 CMR 7.15, and that the information Contained in this notification is true and correct e.Tele hone Number f.Representing o to the best of his/her knowledge and belief. 150 CONCORD STREET o Q.Address _ U. NORTH READING 101864 2 h.City/Town I.Zip Code � �Q an P• oc 10/02 Asbestos Notification Form•Page 3 of 3 � f Ngery•� O4t.�LCD Abe f�O L A, CA NORTH ANDOVER BUILDING DEPARTMENT °R�rEo �5 1600 Osgood Street North Andover Tel: 978-688-9545 Fax: 978688-9542 .BUSMSSFO"FOR TOWN CLERK DATE: NAME: , o- ADDRESS; act r TYPE OF BUSINESS.: ��i . BUILDING LAYOUT PROVIDED: S NO A.VAFLA�7 k`'AE [ 1`Ei`r S1 ACES: ZONING BY LAAW USAGE: S NO MI DING INSPECTOR SIGNATUPIE 13USMSS FORM FORTOWN CLERK 1 2.40 Home Occupation(1989132) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary to the use-of the building for liidng ptuposes. Home occupations shall 'include,-but not'limited to the following uses; personal services such as furnished by an artist or instructor, but not occupation involved with-motor vehicle repairs, beauty,parlors, animal kennels, or the conduct of retail business,or the manufacturing of goods,which impacts the residential nature of the neighborhood. 4. For use of a dwelling in any residential district or multi-hmily district for a home occupation, the following conditions shall apply: a. Not more than a total of three (3) people may be employed in the home occupation, one of whom shall be i-he=owner of thd home occupation and residing in said divelling., b. The use is carried on strictly within the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customary with residential buildings, - d. Not more than-twenty-five (25) percent of the existing gross floor area of;the dwelling unit. so used, not to exceed one thousand (1000) square feet, is devoted to'such use. In connectionwith such use,there is to be kept no stock in trade, commodities or products which occupy space bevond these limits; e. There will be,no display of goods or wares visible from the street; f The building or premises occupied shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use Mtbm the neighborhood; g. Any such building shall include no features of desi&p_not customary in buildings for residential use. signature Dgo