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Home My WebLink AboutMiscellaneous - 31 DUDLEY STREET 4/30/2018 31 DUDLEY STREET - 210/020.0-0001-•OOOO-O _ ................... Massachusetts Department of Environmental Protection '• Bureau of Waste Prevention—Air Quality } `hr nsmitial BWP AQ 04 Asbestos Removal Notification t , BWP AQ 06 Notification Prior to Construction or Demiitim .....................:.......... Facility Ip(if known) Permits for Asbestos 7. Describe the demolition/renovation procedures to be 8. Emergency Demolition/Renovation Asbestos flemu', . used: Operations State or local official who evaluated the emergency: Name Title Authority (Note:Demolition/Renovation Operations must comply with 310 CMR 7.09 t:)contrct emissions to prevent a Calznr,Qufhariz.fiov condition of air pollution.) (General Statement:If asbestos-containing material is unexpectedly found or damaged during a Demolition/Renovation operation,all responsible parties must comply with 310 CMR 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 removal n,)tification with the Department and/or a notice of a release/threat of release of a hazardous substance to the Department if applicable.) Certification certify that I have examined the above and that to the best of my knowledge it is true and complete.The.. signature below subjects the signer to the general statutes regarding a false and misleading statement(s). Asbestos Free, Inc., ' ............................... Print Name Authorized Signature Supervisor .................................... Q.S....E.]Cr„r".....Inc............................................................................ ....................................................... Position/rifle nepresenfing April 21, 1992 .............................................................................................. Date Rev.1/91 Page 4 of 4 ,Massachusetts Department of Environmental Protection :41686 ...............................: Bureau o1 Waste Prevention—Air Quality .Transmittal,! JRWP AQ 04 Asbestos Removal Notification BWP AQ 06 Notification Prior to Construction or Demolition ........... ................... t Facility ID(f known) Permits for Asbestos 11. Transporter of asbestos-containing waste material from 13. final Disposal Site removalAemporary storage site to final disposal site Meadowf ill Corp. Recovery Express, Inc. Name:....................................................................................................... -- --�- Rte 2 Box 68 Name ................................................................................................................ 197 Portland Street Address sheelAddress Bridgeport, W. VA. ............................................................................................................... Boston, MA 02114 —_ CIOVTown clry/loµa 304-842-2784 ................................................................................................................ 617-523-7740 Telephone Telephone 12. Refuse transfer station facility and owner(if applicable) (Note:Disposal of ACM must comply with the Solid Waste Divisions regulations 310 CMR 19.00.) ............................................................................................................ Name 14. Emergency Asbestos Removal Operations DEP official who evaluated the emergency: Address ..................................................................... .................................................................................. Name Clty/fown ............................................................................................................... .......................................................................................................... Title Telephone . ...................................................................................................... .................................................................................................I.............. Owners Name Authority .............. . .................................................................................. (Note:Transfer Stations must comply with the Solid DaleotAutho..r.it..ation....... Waste Division regulations 310 CMR 18.00.) 13 General Demolition/Renovation Description 1. Demolition/Renovation Contractor 4. Was the facility surveyed for the presence of asbestos containing material(ACM)? Yes O No Nanx If yes,who Conducted the Survey? -- ..........•— Address ............................................................................................................. Minx ........... -------.— CilJown ............................................................................................................... Tkpartmenl of labor and Indushies Cedilic3lion/ Telephone 5. If yes,who conducted the survey? 2. On-Site Supervisor ................................................................................................................ ............................................................................................................ Name Nanre ............................................................................................................... Lrparhneni o/labor and Industries Certiliralion/ 3. Identify the specific Worksite Location(s): 6. Demolition/Renovation Asbestos Removal ............................................................................................................ ................................................................................................................ ............................................................................................................ start nate End Dale ........................................................................................................... Rev.1/91 Page 3 of 4 ......... . . Massactnisetis Department of Envtronmentat Protection i :................................. Bill eau of Waste Prevention—Air Quality r Transmittal t UWP AQ 04 Asbestos Removal Notification r....� UWP AQ OG Notification Prior to Construction or Demolition facliry�lp�(if knov� Permits for Asbestos 2. On-Site Supervisor 7. Description of techniques used for estimation Tape Measure.------••------•------•------- - -----•-- F............ .... --- Nan)C SFO62Ti4 - --~- Drpartrnr-nt of Lata and Industries Certification 3. hygienist Testwell Cra' -------- ---- Nanr 4. Specific Worksite Locations(s)(i.e. Building name, 6. Asbestos Removal ncrrnbei,wing,floor,room, tunnel.}—May 135 1 G .................................................... basement srarlDale ......................................................... ............................................ . ....................................................................................... End We Ilours of Operation 5. Is the job being conducted indoors or outdoors? 6 daytime ❑ evening ❑ night indoors Days of Operation __...------------ K1 Mon.—Fri. ❑ Sat.—Sun. .. --- - -- - - (Note:Any changes in these dates must be reported to the appropriate regional of(ice. If a removal is postponed for 6. Estimated amount of Each type of ACM to be handled more than thirty(30)calendar days separate notification w: be required.) Linear/Square Feet boiler,breeching,duct, 9. Describe the asbestos removal procedures to be used. tank surface coatings / ❑ glove bag ❑ enclosure IN full containmer: .. ❑ encapsulation ❑ disppsal only - El P thermal,solid core pare insulation .9.0..................... L7 other-please describe ............................................................................................. corrugated or layered paper pipe insulation /............. 10. Transporter of asbestos-containing waste material from sit to temporary storage site(if necessary)to final disposal sig �.•- Asbestos Free, Inc. insulating cement • ........................................................................................ leer„ spray-on fireproofing / 4 Railroad Avenue ............................................................................ Address . trowel/sprayer coatings ..-.........�.............. Wakefield, MA 01880 .. . ...................................................................................... Ci4vTown cloths,woven fabric /............... 617-245-4403 ....................................................................................... Telephone transite board,wall board / ............................ other—please describe ..... / ... .................... 90 / Total in Linear Feet ............................ Total in Square Feel .......................... Page 2 Rev.1/91 .........................., .Massachusetts Department of Envlrenmental Protection 41686 Bureau of Waste Prevention—Air Quality Transmittal) PWP AQ 04 Asbestos Removal Notification ! bWP AQ 06 Notification Prior to Construction or Demolition 'Faciliry'o(rlkn.... Permits for Asbestos WE ...ftrDip Utronly................. Ll Applicability rerma No ""`"rd°"` Dernolili0rl/Renovatlon operations involving asbestos- renovation operations and demolition/renovation operations iReviewer ......... .-- rermnnnew, aue�ce containing Inalerial(ACM)and general Demolition/flenovation involving ACM is required under 310 CMR 7.09(2)and 310 Decision Date.................... operations are rhgulated by the Department of Environmental CMR 7.15(1)(b)twenty(20)days prior to any work being iality performed.The following information is required pursuant to Protection(DEP),Bureau of Waste Prevention—Air Qu Division,under Regulations 310 CMR 7.00,7.09 arid 7 15. 310 CMR 7.15. Notification to the REGIONAL OFFICE of general demolition/ General Project Description UE 1. Fncili!y Mary Silveira ............................................ 3. On-Site Manager ........................................................... . Nang 31 Dudley Street ............................................................................................................... ............................... ......................................................... Name, Address ................................................................................................................ North Andoverz...1KA...Olfi.4.5................................... Address ............................ 04,11 own 508-482-2299 ............................................................................................................... ........................................................................................................ Cif}/TOssrs Telephone ................................................................................................................ Telephone Size 2,400 ................................................. ........................................................... sage feel 4. General Contractor 2 ................................. .................................................. Number of floots Name Was the Facility built prior to 1980? M Yes O No --_-- AOdressV Residentail ...................................................................................................... -- — Current or Prior use of racilily CirylTown Is the Facility occupied? l Yes U No Telephone Is this Facility owner-Occupied Residential with 4 units or less? & Yes D No Does this project involve the removal and/or alteration of 2. Facility'?:vr.er Orly ttstfestos C3nla eavitN. ? Nand SAME app;i':d In 3110 CMR 7.00 and 7.157? ............... ............................................................................ Name O Yes 0 No ......................... .............................................................. If Yes,cor iplete Sections C arid D. Address ........................................................................................................... If No,complete Sections D and E. City/Town —.......................................:............................................................... Telephone ME WA Asbestos Re loval Description Wakefield, MA 01880 ..�___-_---_-------- 1. Asbestos Contractor _._.._..._. - C'n/Tnwn 617-245-4403 Asbestos...Free.z....Inc.:................................................ ----- -------- -- --- -- Telephone Name 4 Railroad Avenue..................................................... ACOOO133 - -- ....................................................... Drparlment of Labor and Industries License/ Addwess Page 1 of 4 Rei'.1.91 Dear Health Officer, Please find enclosed copy of the DEP notification that is verification of an asbestos removal being performed in your district. If you require any further information, of have any questions; please contact Asbestos Free Co at (617) 245--4403 Thank you, Frank Arsenault FLA/pp 13 New Salem St., Wakefield, MA 01880 617-245-11403