HomeMy WebLinkAboutMiscellaneous - 20 BEECH STREET 4/30/2018 (2) / 20 BEECH STREET
J 2101033.0-0045-0000.0
� Safety Insurance
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
NORTH ANDOVER MA 01845 NORTH ANDOVER MA 01845
Re: Insured(s): MICHELLE TETREAULT
Property Address: 20 BEECH AVENUE, NORTH ANDOVER MA 01845
Policy Number: 0291529
Claim Number: BOS00036007
Date of Loss: 02-16-2013
Company: Safety Indemnity
Claim has been made involving loss, damage or destruction of the above-captioned property, which may either
exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass.
Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a
reference to the captioned insured, location, policy number. Date of loss and claim or file number.
Allan Leavitt,Adjuster 02/21/13
Safety Insurace Company
Homeowners Claims Unit
P.O. Box 55098
Boston, MA 02205-5098
Phone: (617)951-0600 x3213
Fax: (617)531-8891
00012.001
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ABATEMENT CONTROL SEMMES /NC.
ASBESTOS REMOVAL & MAINTENANCE
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s
May 27, 1999
NORTH ANDOVER BOARD OF HEALTH
146 MAIN ST.
NORTH ANDOVER, MA. 01845
DEAR SIR/MADAM
ENCLOSED PLEASE FIND A COPY OF NOTIFICATION SENT TO THE STATE FOR AN
ASBESTOS ABATEMENT PROJECT.
THE JOB WILL TAKE PLACE ON JUNE 10, 1999
LOCATION: 20 BEECH ST NORTH ANDOVER, MA.
ANY QUESTIONS CONCERNIG THIS MATTER SHOULD BE DIRECTED TO MY
ATTENTION.
SINCERLY,
✓V1I OF 1lCJRTH A„QOL l:i/
CHRIS CHRETIEN III fC
Y-ARD oc;�. Lr,i
PROJECT ESTIMATOR -
MAY 2 8 1999
2 INDUSTRIAL WAY • SALEM, NH 03079 NH (603) 898-9472 MA(888) 870-9292 • FAX (603) 898-1846
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L Facliky IOcadon:
. PAUL & . KRISTINA 'STEVENSON 20 BEECH AVE.
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1l�Tt��N� NORTH ANDOVER 01845 (978)725-5504
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1.
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bm NSA ayB�A�SIMfENT .y
2. is the faclay ocapiadt Yes W No
f►r.a.dao
aodkAM
taarrenww d310 3. Asbts=COntradw.
CMR 7.1f(AM naraip
x9&*wdMwk ABATEMENT CONTROL SERVICES, INC. 2 INDUSTRIAL WAY
SAM, •NH 03079 -a 603-898-9472 —_
of 1661M a"
tegwarAMofof453 AC000362. WRITTEN
CMR L12(lir dirt
Pw noe%~a All tkurw I Centrad 1Ype isvmwfi of ve/w -
taeM+r
a°i01" ie 4. C*Sft Projea Supervisor/FW=n:
rawamAlwee
~of Avi mtoo FRANK BALOGH ASI-0269
foraprW .. _.. ._.._. _ . auatoyfraaon•
�wwwewrrreNtat of
A� L Pm)M Monlwr:
I.O.ff.1W, W.410s7 NORTHEAST. ENVIREMENTAL AA/00153
3.TW f4rrn way be At�i --_-____. ...._ �ceroMradgn —
wM M Owwong Vw
U.S.MwMa r w"
►ra.ceM AgWay L Asbestos AnwydW Lab:
RAyora 1 Of rbsdoos s r►'gid SAME
664"116
aneolelorYtamration
i+�i+R 1�•
7. pmjea sport date 6/-1,Q/9%W date /10/9 gpecific work hours -Sun.)
L WtA type of Project is this, Awwo" "w O •w(Gori
9. Descrlbe the asbastos abatement procedures to be usa aa.'blew mow,
11sww arc air aYy attic(sglrn) �.
a.otrr.r -
10. Is the job being concluded X indoors ❑outdo0rst
PON
Total amount of each toe of Asbestus Containing Materials(ACM)to he handled on pipes or ducts(linear ft.)1-0 or other
°i,!T° surfaces(square R.) -0 to be removed,enclosed or encapsulated:
Lkmr Sawa tw , 1M_�l.+�.__ _�!».
P A4t tom Ansa aaraipr — ,_ �+f .d*d ire pi's MWINN.0 ,-10 �--_
�M.
Catrupsrry w lrywwt AWW Pr+#bwYlrw' _—. !vwdemp Cnunt _.
�►ay'e�hrpr0olhp Tiw.ri4Wpv►cnrenyt �._
CafK WPM fabw Tions"&"-4 wad 006v
12. Describe tine dKwitatNnatlon systems)to be used:
+w GLOVEBAG PROCEDURE
13. Describe tfre containerization/disposal methods to comply with 310 011k 7.15 and 453 CMR 6.14(2)(9):
ALL CONTAINERIZATION,DISPOP A_L WILL COMPLY WITH.—___......_
310 cmr 7_5 ,and .4N_gm
14. For Emergency Asbestos Abatement Operations,the DEP and DU Officials who evaluated the emergency:
AWrtr dAP At�1r+W
Tmi
AM dAWV1&~
n -
L Current or prw use of ww.. ,
RESIDENTIAL
2. U the tsdlity owner•oca+pied resider"With 4 units or Nw? X Ya No
J
3. FadJityOvwbgr 20 BEECH AVE . `
PAUL & KRISTINA STEVENSON
MOM 01845 (978)725-5504
NORT. ANDOVER Al Takphar
C#YITAW '
4, Faditft,Ownef's Ort-su Manager
Address .
L GaWd CorMraalw: ,
N/A Addresr ,
AWW
• �aa� Tdr�har
CA ?a va afA Gror
Caavacserbr Nw*m Can%;Nwr
L what is tie sine d the fadllty'al•!Q(sqf*2 (i floors)
IsdestasT�►osl�r�odoioadQ/sArsal
1. Transpartrr Of�n�
vwsoe amteriai(tom sloe to temporary swrape sia of necessary)to&W disposal slat
ABATEMENT CONTROL SERVICES, INC. 2 INDUSTRIAL WAY
"wm 03079 603-898-9472
SALEM j Nilzip Tsar
�Ar� avda
2. Trampadw of assbesoes•oorrt�&*vraft nWAd&hom reowval/wmpora.►swrage sine to Anal dlsposal site:
SAME -�►•
Ad co
... cede Tsaga�ar
Not+e.•Tnnsfar 3. RdM transfer station and owner of awkwe): .
Sra6wr neat Ad~
catmfy no aw M+ms
Slid Waste Teles r
Division repWr lav avde .
Darn 310 LTtR G4'/Ta
1400
4. PdW DlspoW SRe. WASTE MGMT OF NH
,TURNKEY LANDFILL
Locaaon Maar
90 ROCHESTER NECK RD
Ad~ 03067 6Q3-332-2386
ROCHESTER, NH ` zoco* rd�n«r
t+ �IoI at of Massachusetts Regulation
' The undusigned hereby stapes,under the penalties d perjwy,that he/ has read the Commonweal o*na+�In
for the Remor�l,Corrtalnment or B=pSufatiM of Asbe`sws,4S3 CMR 6.00 and 310 CMR 7.15,and that Me infonr►ation
this notification is true and correct to the best of Ns/her Wwwledge and belief.
5/27/99
FRANK BALOGH
A ENT CONTROL SERVICES, INC. 603-898-9472,
Nom:contractor President TdrAhar
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tffAa grmso SALEM] NH 03079
for DU 2pSTRIAL WAY
so�tl/iatriao �aa*
. �
' Fee exempt(Gly.Town,district.munidpal housing suti'�a'KY.°WAa`O00Y�resfda�d tar units a lm)? X Ya V No
Sticker 0 c front of harm):
/address T Title of File
Page of
Date File Open: Date file closed:
Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes
action Document/ document/
Num. Action Department
Board of Appeals — Board of Health — Planning Board — Conservation Commission — Building Departrnen.t
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