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HomeMy WebLinkAboutMiscellaneous - 53 HAROLD STREET 4/30/2018 (2) 53 HAROLD STREET . 210/009.0-0063-0000.0 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, Inc. at (617) 245-4403. Thank you, Frank Arsenault FLA/th 4 Railroad Avenue • Suite 304 • Wakefield, MA 01880 617-245-4403 r Commonwealth of Massachusetts Asbestos Notification Form— ANF-001 Asbestos Abatement Description 1. Facility location: Bernard Martino 5.,'.....HarQld...Road........................................ MiTAUCfpMlf Apma Adds North Andover, MA 01845 508-688-11138 t. All sections of this .................................................................................................... ....................................................... .........................._........._................_..._......._ loan must be compleled fJry/Tawn zip W* Terephae inadertocwolywith Basement theDepartment of _.......... . ..........................................................._....._....._................................................... __. .__...._ .� . Emkonmadal NbatlstlraorAsae/aaron9 buraWgrom,!velaµIoa roam hol#alon notification 2. Is the facility occupied? n Yes ❑No reQurements of 310 CMR 7.15 (ten workup days 3. Asbestos Contractor. prior notitiiauOn is repuwedolanyabatemant Asbestos Free, Inc. 4 Railroad Avenue proms:and the _..... ...... _ ..........__.._.................... . ....... .....__..........._ _ .__. .....___ Deputment of Labor AWN Address and kWuatrla Wakefield, MA 01880 245-4403 notilication requirement of 453 CMR 6.12 (fen Gry/TM ZlO W* NOW days p6ar notir"m is req #WoIAMV AC000133 written A�efantA►o/ecf ......l............................................................................................... ................................................................................................................................... aDafem A an thea pro a a laees►/ Car JU Tim W MVOWW) SgLw*• 4. On-Site Project Supervisor/Foreman: 2. SdxnkOripnalForm Paul Scott . . . ...... . .._.. ........_....................... SF07475 .................................................. To: _.. ._—....» _....... OY1Cerlliiatl00% Ceaaeeuwaltb of mawcMwelb 5. Project Monitor: Asshodes heyraee ►.0.I.120081 ......... . ........—.. Oestem.1AA02112• Nme QtlGrrtlatlon/ 0087 6. Asbestos Analytical Lab: 3. This form may be used lornatifyinpthe .Final Clearance Analysis........................ .....AA000Q$ ................................................... C... ... ...... US.Enviranorental gameNoWdion pJGnYOnron/ Region I asbestos dem IN 7. Project start date—DJ 93enddateJ?'3 9 specdicworkhours(Mon.-Fri.) 7-4 (Sat.Sun.) no renovation operations subCFR S b NESH. (10 8. What type of project is this? (circle one): aw waon rnaer G4)— lull a#rr(eVW) CFR Subpart K. FaQUO WUNOA 9• Describe the asbestos abatement procedures to be used (circle): gtwA4v enuasum emra+msdemup e+a4srd" disposdonly orrr(erpraln) Motll&" A r. Do 10. Is the job being conducted [3indoors p outdoors? -- 11. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.)-1-40 "other surfaces(square ft.) to be removed,enclosed or encapsulated: DaGdo Do linear/square feet boiksr,brsoW g,dart,&A wnkoe coatings..._/ Ow=1,solid core poe)nwAMon...... so egad or iryared pow pip#oul tion....140 insufetrg aermi................ .. spray-on kwoohg....................._J dokwY*iyarMOP.............. dogs,wow,&ics......:..............^/ los"board,W1 board............. o1h#r(piens#desaibe).................... 12. Describe the decontamination system(s)to be used: Change- room _ ....................................................................................................................................................................................................................._.._._ . ._. ........................................................................................................................................................................................................................................ 13. Describe the containorization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(8): All ACM to be doubled bagged in 6 mill. labelled asbestos removal baRs.�—� ................................................................ . ...... . . ........................................._.......................... .......................................................................................................................................................................................................................................... 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: ................. ................... ................................ .................. ................................. ... ...... ......................................................................................... al�ra�aal oird Aurr►afia�.................__.................................................... .iiti►er i. ............................._................_.................._. .... ....._ w,ntafuaarw nae .......................................... .......................................................................................................__— Balt aAuthalraran wdw/ 15. Do prevailing wage rates apply as per M.G.L.c.149,§26,27,or 27A-F to this project? p Yes 13 No Rev.6)92 WJ Facility Description 1. Current or prior use of facility: ........residential .__......»»....»..»»»..»._..»»_»..».. _.».»..».»».._.»_.»..........»..........._....»............».................»..» 2. Is the facility owner-occupied residential with 4 units or less? 0 Yes p No 3. Facility Owner: SAME Alame AUM Gb/Tan................»......»........»...».».......»........»....».......»......... ��.........»...».....»...»....._».... .ly»..........».....»..........».......».........._....... 4. Facility's Owner's On-Site Manager: ..................................................................................................... .................................................................................................................................... MAN Add= GO/Toon _ .........».»...»..... »...... »....»... _A­P*,�..»._..................._... .......... TN ._..............»....»...»»» .. » 5. General Contractor: Arm Adana Aetna Casulty and Surety ,0061C009i6i9g1 n 19./9,1 CoNadors Wonga camp.Mwni PD&YI Ab 6, What is the size of the facility? 94nn (sq ft)2(f of floors) Asbestos Transportation and Disposal 1. Transporter of asbestos-containing waste material from site to temporary storage site(f necessary)to final disposal site: ...... sb......esto�... .FLU......1m.0..................................... .....4....�ilx Avenue.......................................................................... .. Alyro AMW Wakefield, MA 01850 245-4403 .................................................................................................... ...................................................... ............................................................................ Cl/Am Ip mdr T000V 2. Transporter of asbestos-containing waste material from removaV temporary storage site to final disposal site: Recovery Express, Inc. 197 Portland Street ...»..............»....»..............»...».....»»».............................».. ................._............._.......................................................................... »»....»... Boston, MA 02114 523-7740 ..................................................................................................... .................................................................................................................................... Note:Transfer C<d/Tawn tip node Stations must 3. Refuse transfer station and owner(f applicable): comply with the Solid Waste Division regula- tions 310 CMR 18.00 Gb%.an...................................................................................... ��..»....................................... r�w�►................................._. ....». 4. Final Disposal Site: ».....T.urnkU....ea1ldfill._.......................................... waste...Maria.gament......................................................._...»_................ Loratlaa Meme am=Marne 90 Rochester Neck Roac ........................................................................................................................................................................................................................................... Aaldnss _ . Rochester, N.H. 03867. 1-800-847-5303 ..................................................................................................... ...................................................... .................. ........................................ ................. Gb/Town I,p oaoM TNipDorx � Certllicat/on The undersigned hereby states,under the penalties of perjury,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 his/her knowledge and belief. FrankArsenault.................................................`l.,/4 t,4�a, �„ .�� J. 1y.....7.....119Q................. PNMName Aatl�OrltedSlya�lun Glee Note:Contractor must sign this Supervisor Asbestos Free, Inc. 245-4403 form forDLl ............». »».....» .». ........»...................._......... R~�».». ..........................._.....»...._.. ........................». T »...».. Rusxionllltle �w notification - purposes 4 Railroad Avenue Wakefield, MA 01880 »». ....................»....... ...............».......»..........................».. »...»........ ........................».....................»....... Address WfITO n 1{0 orb Fee exempt(City,Town,district,'municipal housing authority,owner-occupied residential of four units or less)?M yes p no Sticker i(from front of form):