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HomeMy WebLinkAboutMiscellaneous - 40 LINCOLN STREET 4/30/2018 40 LINCOLN STREET 210/056.0-0021-0000.0 v t r - facJJJJy OescrJpt/oo , • I 1. C041111 ofNf �. 1.� ...».»..... ..»...»»......» ».»..».......................»..............................................».... 2. I6 the facility owner-occupied residential with/units or less? Yes Q No I Facility Owner: _ ........................ ..... ............................................................».......»».»...... ............... ...»»....»».....»»»...............»...... ......_........»�.»�r...............................».».................»..»»..»»»»»». 1 GO'/IAw l�to01 1et�prKrr 4. Facility's Owner's On-site Manager. A Gpr/lo>a Ar ooaY /e4pnarr L General Contractor: .. ........»».»»..»......».....»»».....»...».................................... .........................».................................................»....»..........»........»»».» MIN AMW ..............»........»».....»»»»....:...,..»..»»..»»»........»...»..»......... .............»........»»...».»»..»............. ............................»»».».» .............» GWiToea zoom TANW W 0,0, tea. a.S 1l/ s L)ce4c",i M.I e m.)j P ) r ) -- CWWACWS WWW Cane.UWW A7&Y/ LW-D" 6, What is the sin of the WOW 64 fl) (/Of floors) . Asbestos Tiasispodtation and Disposal 1. Transporter of asbestob-conlaining waste material from site to temporary storage site(if necessary)to final disposal site. �. .�... (: ...� f ............. ..........�t�.�...1..�...G. G�:C .....C = UJ. .....� . ......... ............. C ..i.. Wiles t 4pow TeNpaan 2. Transporter of asbestos-containing waste materia!from removal/tompora4;storage site to final dispose!sit.: .xac f` ........I.. ..... . . - .cx. .........5 . AUM . ..11.. .:....................... )o�..1.1. ...... .. ..........7.......... �? Note:Trans/er WON 1.......... Ifaoa T�evnarr��'. Stations must 3. Refuse transfer station and owner(if applicable): comply with IM Solid Waste Division nyula- �. »...»..........»......................».........................»».»..»»...». ...».»................».................................................................... ..»..._._...... tions 310 CMR 18.QO »...»..»...».»........ 4. FM Disposal Site �.n . »� ll.............. ........ ..........(YMC .lY !..hl ................ » » »h...... .................. 1`�. ,/ . '-. ............kb ......................... ...... fify/Taa f 4P am !•� `� i � � Cu'tlllcit/aa i The undersigned hereby eWec,under the penalties of perjury,that he/shd has read the Commonwealth of Massachusetts Reputations for the Removal,Containment or EncapcuWion of Asbestos,453 CMR 6.00 and 310 CMR 7.15,and that the information contained in this notification is true and correct to the best of hidher knowledge and belief. ps00 Note:Contractor C n must sirgn JW .rte 4� �!^ >;.',)..J�...».»....».»...»» L I�.�, _�� f Inc............. tow*Purposes 1lprwwyo tewr oar nDldiplioll , 'I Gfr/leNn I Fee exempt(City,Town,district,municipal housing authority,owner-occupied residential of four units or less)?�Ves p no Sticker/(from front of form): 6 cnmmouwealth of Massachusetts Notification form— - 9 j n. ,.� AsbAsbestos001_ , E_ Asbestos Abatement Description "" '" 1.' Faciligf loWoion: 'j�.............................._ .U...... .y ..... ......................e �. .... ,a..._.. AMM say - 16 S'3- C008 1. AN"ors oltha /1./c ` .� �.: 1• ...» ...�.J..I...(,.1..�:�.............. . �. .:��1��.»..Ll��..-..� lam must to completed Gpr/roeo 1po lunar noder to comply with .. ...».»»»»....._...............................». Ge DePeMsenl a .»............................ ...............»»............._............. Enrlrenrrwentel tt4rllrar�loaqua�gildlgOeamr,/,�soar,aaa... I ff�ea.dloa notilr:alion 2. Is ttte t cft oeoupied? 10e$ Q No rWeme S of 910 CMR 7.15 (In ira Uv dqs p01 COtItr1C10r: parnolidr�tiana � npurrd oler,�at►eterrwtf � poircp:aid tlr �.•• �� 06FU M M of Leave raw Aaan:s end h7duetrlee o..».».U�... of 4M CMft 6.12 (Mn CrO//oM zoo* ...... 6�e anys pro naif�c� m is w aar«rer � �.1. 1....�j. 0-fir c -��.�. .................................... . ................................................................... gAMW ewr►eree imm or m M+uraw�l w �0 4. 0044 Mid SupeniwrlForemart: L ' 2.SuW A 014M I'DIM. ._....»».»........ ?... ....�. .. ............»........�............r......».... To: •`�J»J�G�.�1.1�.....».��.�..�...�.». AUGiror+ralaia/ CeesMea,reellr e1 fweweaw.w 5. Project MOR40r: AeMetee fPre/tr •. . ►.0.1.120017 ....................................»......».............................................. ........................ ................................................................................___..»»»....». Wee,ku U112• Naas ou c4mi adao d ODA 6. A W06 Anaytical lab: 3. This lam maybe �. !Q4>�.J�! .Q...t.n.ic•a�.l ............../�A...0.o 0ti..1...d..S�..... used for notityw�a en .. ............................... ..._.....� US 0WWM real Afeee QUGnkreoan/ f�uwction Agency man 5�15 �'� JJ D ( ) IOfism"WMQIsiortl 1. Projeclet�ltdale_J_J�enddate S �/�s eci(icworkhoure Mon.•Fri._�_(SaLSua.)�_ rerawt►an operations wDMa to NEStiAPS(10 CFR SuDpeA Id). & What type of project is thio? (circle one): arm Wfi mat mom oerrptAlibJ fat W"Vag" 9. DOW"OW"begoe abatement procedures to be used (circle): PON&V .rrns�n r�cawr�ea a.� raaesal� 10. Is the ob being conduded P'moors p ouWoois? fw� 11. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft-)-Z--w other wrface$($quare f.) to be removed,enclosed or encapsulated: &MI/sawn lest bode ,rAd,Ok ile ony ... hme.solid core pienuW . ...•• IOrr.. r nwleenr lrV aem ................ .. oan+Wted a r1*ndApsrpPs saint .. �iWer-ai brp►oabrw..................... IM460gw"no.............. � ebb,town Wks....................._J trmrrer board trail"d.............__J sir(pltw aimiO�J.................... 12. Dncriba the&contamination system(s)to be used: »C. can..*....0.(D..!�....................................._.......::...............................................................::::::..:__...:::...._......:::..:::: ::::. .- ................................................................................................. 13. Describe the containerization/disposal rpelhodc to comply with 310 CMR 7.15 and 453 CMR 6.142)(g): .CIL \UQ-...dh.. 9I.ed...i...)......6...�nA..t.(....o....��abb0�.� .....,. 14. For Emergency Asbestos Abatement Operations,the DEP and DLI otficials who evaluated the emergency: g ncY: .................................................. MIN as►taucw not _........»........._.._.. .ir:........ ........_.._...................................................._.._ airs ..iiaiiaoupfsw .......................... .................................... ........................................................................................................ ..._ ............................................. . ...................................... ......... ........................................................................................... .. �..»»....»,. WalAIIIISS" WAW/ I 15. Do prevailing wage rtes appy as per M.G.L.c.149.§26,27,or 27A•F to this project? [)Yes 00 lieu.� UZ FaCINY 1. C00eras or pfior use I sac _. .....»_ ............................................................................ .. .. ... ........ ...................... . 2. Ic the facility owner-occupied residential with 4 units or 666? ItIlY86 [3 NO 3. Facility Owner: ................... ......... ......a.f ................................................................................ . .... AIM ... ..................................... ...................&.... ...... . .. ................................................................. ..........�C:Ijr.. ............». U400 1^10M 4. f&c4tyli;Owner's On-SM Manager: .......... ........................ ........................................... ...............IL.................................................................... wn ......... ......................................... lokv 5. General contractor. . ................................................................................................ ............................................................................................ am Mass ..... ...........I............................. Cidilowi COMMWO Wawa cm.In"Of LWOW 6, What is the Sill Of the facility? 6q Of floors) Asbestos Traaspodation and Disposal I Transporter of a6be6lob-containing waste material from site to temporary storage site(if necessary)to final di6pgW Site: q -)... .. ............R a ................... . .............. New A5-R.Y.03................... Oak ZIP Quit 2. Transporter of asbestos-containing waste material from removal/temporary storage We to final disposal site: Y) e_'S50 V ..(. ). ... ... ..... ............... A"s l .............. .......................... . 7.7...I...ke...... Iipog, Note:Transfer CV/100 Stations must 3. Refuse transfer station and owner(it applicable): comp*with the Solid Waste .................................... Division repute- t ....... AMM lions 310 CMR 18.00 .......... .. ......... 6107M 4. Final DiSPMI Site. C5 ............... ----------A.... .............. ......... ...... . ... ..��..D..... dh. . . ....I.......... ...........k.66 .............................................................................. 6 ........ . AddMa V 4A, The undersigned hereby states,under the penalties of periury,that he/she has read the Commonwealth of Massachusetts Regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 7.15,and that the information contained in this notification is true and correct to the best of Wber knowledge and belief. Note:Contractor must sign this form tar DLI Awication ... .. .......... ....................... GbAwm If am Fee exempt(City,Town,district,municipal housing authority,owner-occupied residential of four units or less)? ,06 Q no Uckiif j(from front of form): Commonwealth of Massachusetts ©y (l Asbestos Notlficatlon Form — aNf-aoI F Asbestos Abatement Description 1, hclkty location: `� r�.�. ........�.n e o`«�.:......... t..�.....�.... --Li.••�......................................... . ....... �T111CftDMti ome s�� - 6 73- C50o8 1.Au sections of this A.iAh......... 1��. iA..... ......1.J...1....(.1.«�:�......I......... .l brm and be canpleted CrO" \ AD NoeNp" nadsr to comply with « r �I .T.. »««....................................................». ........»..... the DepeAmed of Mnralire•ealeMelaaeoo�a�lpaMor,�.wNp,•kor loam«.......»..».».»».....»...... Emkamwm el Praecum noui"ion 1 2, is the facility occupied? Was p No requion"of 310 CMR 1.15 (rr workino aqn 3. Asbestos Contractor: par nalQr�fian a npurdo/erryeberemerM �1 DepuUnd of Lebon Alar AM= _ Nut kwooles notilicriion requiemerrtl ..I„I�..l!~R...i»1�...y..l».. .... .�....... � .............. ......l...t.11:2.0................... ...... .. ...... of 453 CWi 6.12 (IMI Gpdroee 6 1paadr /wpnorr dJn par naifialial A rmvureaotA�rr . ,. . .... 0.0.....1....33.................................... ...1�.`� `�. e�........................................................................................ . . .... .. . . .... eba�ernenf pWea vAIfM qu / Caeorrs Too(e rap OU) MW Opo arm of squMeMrQ• 4. On-Sae Project Supervisor/Foreman: 2. S*M Oripintal Fam « .?�..t ».... »............ «.. ... .... �.«�s�............._«»..»_»»..».._ To: DUCe<rrWAM*4 CeMeeresiU d kumshustk 5. Project Monitor: Aebetee hearer F.U.coon ................................................................................................... ..... ................ ................................................................................ eeetettr MA 02112• Neon DIIGreIpIAn/ oor� 6, Asbutos WOW Lab: /� 3.This form maybe _ (� �1` �j Q616... used dor nctity►np the "� .a.��;�5?C.....O—A, 1�� .Q ..„cS,l'��@� ..............A a... ............ .................... . ...._» .._ US Envintwu Atenol DUGrIkilai/ Prowdion Apermy Region �; Sat.Sun. I of asbestos demolaw 7. Project fda daio JJ_q�end date s g3spocrfic work (Mon.-Fri.) (. ) newwabon opnat" CFRS b NE9t. (10 CFR W. 8.8. Wtype of project is this? (circle one): arno wn aper moryian a►ru/•W J Faa"uro.v 9. Dewibe tho asbestos et>atement procedures to be used (circle): Panay r rAzwo ruurwrafiard aNwup �� dlrpowlonl/ omrr(eryrilnJ uaeaea�I `�i10 011 10. Is the job being conducted indoors p outdoors? te.« OWN 70_-- ,� — 11. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.) or other DOW Do-- surfaces(square A.) to be removed,enclosed or encapsulated: kneadsquare bet boilr.W@ Aing,duct teat UAX catngs..._1 them al,wld core ppm m uboon...... c Uq*d w*WWpWppm XWJg wl... / awtetnp MW9................ .. a OarYYspeyer sprml�albrs�r bap.....................__,.J "&no.............. Able,wows Wks....................._J . oxwo bard,WI bard............._J alar(pMele akeaiDm)...................._J 12. Describe the decontamination systems)to be used: ........................................................................................................................................................._.....«»« 13. Describe the containeritation/ditposal othods to comply with 310 CMR 7.15 and 453 ChAR 6.14 2)(g): .�..�...1......1��.�'ni.....:�...l�Q... .1:.�.a......�....11n�..11....o.... .. . .... .... .... ....................................................:..:........ .......... .......... .................................................. 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: .................................................................................................... .. .................................. .. ............ . . . ........................................................ wfa asuorww raw Qir•WAi�rltaiaa �Igar�• IwleaaualGw nu rcalkba......on......................................................................... .w..ri................................................................. ...................w._....«_ ....... e r s 7A-F to this project? Yea o 15 Do prevailing wag ate apply as per M.G.L.c.149,§26,27,or 2 P 1 ❑ Q�►N Ileo.6192 t Dear Health Officer, Please find enclosed copy of the DEP notification that is verification of an asbestos removal being performed in your I district. If you require any further information, of have any questions; please contact Asbestos Free Co at (617) 245-4403 I Thank you, WAIFrank Arsenault FLA/pp 13 New Solem St., Woke field, MA 01880 617-245-4403