HomeMy WebLinkAboutMiscellaneous - 260 BRADFORD STREET 4/30/2018 (3)0
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Dear Health Of f ic6r:
Please -find i`,eficlosed
a copy of the DEP noti�icdtio'n
that� is verifi6at ion of an
asbestos removal being performed.
1-n your district`-�'If you
require any further Infoi ,mation*
or have any,que6ti6ns; please
Free''Itic.
contact Asbestos,,,,
at (617) 245�4403.'-�-
Thank you,";-,.
Frank Arsenau
Sup ery isoir,?::*""
IY
FA:lc
Enclosure
-rd
'A
617-245-4403
13 New Solern St., Wokefield,'WA 0188
07
'-flar DEP11181F Only .........
I P IMM No .........................
Received Dale ..........
Review e ...... * ..... — ----------
Pelmh 0 Appr. 0 Denied i
Decigion Dale ....................
PrM ec on
Massachusetts Department of Environmental
waste Prevention — Air Quality
Bureau of
BWP AQ 04 Asbestos Remova I Notification'
BWP AQ 06 NO I tification Prior to Construction
or DerpolitiOrl
Permits for Asbestos
Applic8 wilitt,
Demoliliorl/nonovation operations involVilig asbc'1(1r'
containing material (AGM) and general Deniolition/lIcnovation
operations are regulated by the Department of Environmental
Protection (DEP), Bureau of Waste Prevention —Air ouality
Division, under Pe6iiWicins 3 . 10 CMR 7,00, 7.09 and 7 `15.
-1 E06NAL OFFICE of general demolitiont
Notification to the.8
scription
EFG—eneral. P'
.'rojeci Be
I Facility
Maureen and.," .................
........... 15
483 Massachusetts, Avenue ......................
...............................................
018 5
Northt�Andbijek' ,�'MA.. . 4 ...................... ; .............
........ ...... .........
61ry*1,*T*o ... W*n
508-794-3�90 ............. ..........................................................
Size
2 00
.,4 .................
...............
........... .............. M ......................................
............ - A ".., -
JVUMherojjjMs'--v,,PiZ!Q I I
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Was the Facility,bUlit prior to 1980? Clyes 0 No
Residiifift-`al:
Is the FacilitY,Occupied?..� Yes 0 No
Is this Facility Owner: -Occupied Residential with 4 units or less?
. ON Yes 0 NO
2. Facility Owner
SAME
......................
.. ...................... ....................................
Address
.............................
ri�lTow,
............... 6 .............. .............. ..........
Telephone
1
Transmittal I Q'i
..................................
Facility ID (if known)
renovation operations and do molition/renovat ion operations
involving ACM Is required under 310 CMR 7.09 (2) and 310
CMR 7.15 (1) (b) twenty (20) days prior to any work being
performed. The.following information Is required pursuant to
rW1jt(A
310 CMR
rAshe;t6i,`ReM0va1 Description
Asbestos contractof
.... lur . . .................... ................
Narne
!�qUx.9.4.d .. Ame.nue ....................................................
Address
j
Z.,
WWI
3. On-SIteManagd5_,,
....................... ..................................
............
Nan i �Al
................................. ......
Addresit14;V_. 'j"-,
................. ............................... ............. ............ ................
.............. ....... ........................................... ........................ I
Telephone %;
4. 'Gineir�l Contractor
d
-----------------
)w
Address
Willorm
Telep�on�
Does this PtOlOct involve the remov3I and/or alteration of
any Asbestos Containing Material (ACM) as defined and
applied In 310,CMR,7.00.and 7.157?
J
0 yet
0 NojR,�:
It Yes, compl.ete'Sections C and D.
if No, compje%S.e_ctions,D and E.
4 14
x
W ak e f i e Ld�, 1�1 �01 8
PVTO
6 17 — 2 4 5 7: jA4 0 _3 --
Telephone
AC000133'
&partment of Labv ind Indl,10tes License
. � P 614
ami
"k
F
7
Rev. 1/91
as^h.sen"�_nA"ar#rnnr9# nf C#tu1rnnrnan#aLPrnfj3H1nn -
. . . . . . . . .
Massachusetts Department of Environmental Protection
.................... . ...
Bureau of Waste Prevention — Air Quality
':
........ .......
Transmitta A `4
BWP AQ 04 Asbestos Removal Notification
Februar t�"A 1,992
y
13WP AQ 06 Notification Prior to Construction ouDemblition
L .......... ID (ff kno'wn)
Fackw ... ""
Permits for Asbestos,.".
_44
..4 P
Describe the demolition/renovation procedures to be 8.
Emergency Demolition/Renovation Asbestos ROMOV31
7.
Operations
used:
State or local.off IcIal who evaluated the
emergency:
. ..... . . . ......... .
................................ ............... .. ..................
........................... .................. . ........ . . ......
o
.......................... ..........................................................
Auftfily
(Note: Demolition/Renovation Operations must comply
with 310 CM R 7.09 to control emissions to prevent a Date ofAytho&allon
condition of air
(General Statement: If asbestos -containing material is unexpectedly found or damaged during a Demolition/Renovation
operation, all responsible parties must complY with 310 CIVIR 7.00, 7.09, 7.15 and Chapter 21 E of the General Laws of the
Commonwealth. This would include but would not be limited to filing an asbestos remova! notification with the Department
and/or a notice of a release/threat of release of a hazardous substance to the Department if applicable.)
F _Ceiritfflciddh)��
V
I certify that I �ha�e:biimlned the above and that to the
best of my knowiiiijiIt is true and complete. The
signature belc*i�bji6 the signer to the general statutes.
e 'd' nt(s).;'
regarding a fals an tmlsleading staterne
t
Asbesto
.................................... ... ........
Asbestos Zte-a
. . . . . . . . . . I . 4.14
.................................................
. . . . . . . . .
T,
Februar t�"A 1,992
y
........................ .............................................................
Date
A"
.7!u
o
-44
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