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HomeMy WebLinkAboutAbestos Abatement - Miscellaneous - 273 OSGOOD STREET 10/5/2020 E & F ENVIRONMENTAL CERPOWOM Environmental/Demolition Contractors �,v�� Commercial/Industrial/Residential REc of�®��Pa Mkt September 24, 2020 Town of North Andover Health Department 120 Main Street North Andover, MA 01845 RE: 273 Osgood Street, North Andover, MA Dear Sir/Madam: Please be advised that we will be conducting an Asbestos Abatement at the above captioned address on October 5, 2020. 1 have attached a copy of the Notification filed with the MASS DEP for your records. Kindly contact us with any further questions or comments you may have. Very truly yours, Susan A. Pappalardo E & F Environmental Services, LLC /Enclosures 7 PUZZLE LANE, UNIT#2, NEWTON, NH 03858 (603)974-2503 FAX: (603)9742471 ---- -- �r; >µ« �-.'� ���;,fig -- -, -- .�� �- - ..,�.,. ___ �,._ I Massachusetts Department of Environmental Protection 100334464 BWP AQ 04 (ANF-001) Asbestos Project # Asbestos Notification Form (`"' Project Revision L n f- Project Cancellation A. Asbestos Abatement Description RECENEt) oc1 - 5 2020 1.Facility Location: TOWN OF NORTP N�VM RESIDENCE 273 OSGOOD STREET tiFl�,Ztl DEP Instructions 1.All a.Name of Facility b.Street Address sections of this form NORTH ANDOVER must be completed in MA 01845 0000000000 order to comply with c.City/Town d.State e.Zip Code f.Telephone MassDEP notification N/A N/A requirements of 310 CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title Department of Labor Worksite Location: EXTERIOR OF BUILDING Standards(DLS) i.Building Name,Wing,Floor,Room,etc. notification requirements of 453 2. Is the facility occupied? FV_a.Yes I`b.No CMR 6.12 3. Is this a fee exempt notification (city, town, district, municipal housing authority, state facility, or owner-occupied residential property of four units or less)? r a.Yes 1— b. No MassDEP Use Only 4.Blanket Permit Project Approval,if applicable: Date Received Approval ID# 5.Non-Traditional Asbestos Abatement Work Practice Approval, if applicable: Approval ID# 6. Asbestos Contractor: E&F ENVIRONMENTAL CORPORATION 300 BRICKSTONE SQ UNIT 252 a.Name b.Address ANDOVER MA 01810 6039742503 c.City/Town d.State e.Zip Code f.Telephone AC000971 h. Contract Type: r 1.Written r 2.Verbal g.DLS License# 7. GUILLERMO A MARGARIN FRIAS AS032500 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# 8 N/A a.Name of Project Monitor b.DLS Certification# 9 ASBESTOS NOTIFICATION LABORATORY AA00208 a.Name of Asbestos Analytical Lab b.DLS Certification# 10. 10/5/2020 10/6/2020 a.Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY) 7-4 N/A c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11. What type of project is this? (u a.Demolition f b.Renovation r` c. Repair F%W d. Other-Please Specify: REMOVAL Revised: 11/13/2013 Page 1 of 4 LlMassachusetts Department of Environmental Protection 100334464 BWP AQ 04 (ANF-001) Asbestos Project # Asbestos Notification Form f Project Revision r" Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): r' a.Glove Bag r b.Encapsulation r c. Enclosure r' d.Disposal Only r e.Cleanup r f.Full Containment For g.Other-Please Specify: POLY SURROUNDING STRUCTURE 13.Job is being conducted: r a. Indoors r b. Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 3000 1.Linear Feet(Lin.Ft.) 2.Square Feet(Sq.Ft.) b.Boiler,Breaching,Duct, c.Transite Pipe Tank Surface Coatings 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. d.Pipe Insulation e.Transite Shingles 1.Lin.Ft. 2.Sq. Ft. 1.Lin. Ft. 2.Sq.Ft. f Spray-On Fireproofing g.Transite Panels 3000 1.Lin.Ft. 2.Sq. Ft. 1.Lin. Ft. 2.Sq.Ft. It. Cloths,Woven Fabrics i.Other-Please Specify: 1.Lin.Ft. 2.Sq.Ft. j.Insulating Cement 1.Lin. Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. 15.Describe the decontamination system(s)to be used: POLY SURROUINDING STRUCTURE 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): ALL METHODS WILL COMPLY 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: a.Name of MassDEP Official b.Title of MassDEP Official c. Date of Authorization(MM/DD/YYYY) d.Waiver# e.Name of DLS Official f.Title of DLS Official g.Date of Authorization(MM/DD/YYYY) h.Waiver# 18. Do prevailing wage rates as per M.G.L.c. 149, § 26,27 or 27A—F apply to this r a.Yes Pr b.No project? Revised: 11/13/2011 Page 2 of 4 « /\ �\ � �G )y�� � � � . \\ �� �� \ � . . / \ �2 . . �: � � � � { \ � � . � \ \ \ . ( » ,�« � � : � � . %} �y. © . . " 5 -w ?a° �: [� � : w= : : . .- �< y� « . ? � � � � § \ / ° � / � \ . v � � � » � � � \ \ \ � / \ ;�� \ � . � . � � � . � \ � � � � . � � ��/ . � ~ . . � � . ��± . � . � \ . . � \ � � \ \ \ - ` � \ i� � � � � � \ - � \ \ . . . � � . . � � � � \ . � . 7 . . . � � : i\° � l� . � � }° }\� � . . � � . �� � � � � �ƒ� � � . �� . . . \\ �� . � . � . » . ` \\� . �. � . � . � � �� \. . . � . � - � �° . � � 1& � C � . � � � . � � � . , � - . . y � . �. . � � . `\7 � . �/` � . \� � � }� � � . . . « . � � \§ . . � �7� �$ . \ � \} � < . � . \ � . }\ . 2 } � . \ � < � � 1 \� � � - � \ � � � 2 . » � . \\ . . » � } , . � \ . 2\ 1 \ . � � . . . }/ . . . � . . � ( : . � � � }: \\ � � � ��� } \ � . ;\ '�` \\ �< \/ . `71 Massachusetts Department of Environmental Protection 100334464 BWP AQ 04 (ANF-001) Asbestos Project # Asbestos Notification Form I— Project Revision F roject Cancellation B. Facility Description 1. Current or prior use of facility: RESIDENCE 2. Is the facility owner-occupied residential with 4 units or less? r a.Yes r b. No 3 BRYAN FOULDS 273 OSGOOD STREET a.Facility Owner Name b.Address NORTH ANDOVER MA 01845 0000000000 c.City/Town d.State e.Zip Code f.Telephone 4 N/A N/A a.Name of Facility Owner's On-Site Manager b.Address N/A MA 00000 0000000000 c.City/Town d.State e.Zip Code f.Telephone 5 N/A N/A a.Name of General Contractor b.Address N/A MA 00000 0000000000 c.City/Town d.State e.Zip Code f.Telephone STAR INSURANCE COMPANY g.Contractor's Worker's Compensation Insurer 0000000000 12/3/2020 h.Policy# i.Expiration Date(MM/DD/YYYY) 6. What is the size of this facility? 3000 2 a.Square Feet b.#of Floors Note:Temporary storage of Asbestos C. Asbestos Transportation & Disposal containing waste 1. Transporter of asbestos-containing waste material from site of generation: material is only allowed at the place F a. Directly to Landfill or r b. To Temporary Storage Location/Transfer Station of business of a DLS licensed Asbestos contractor or a transfer E&F ENVIRONMENTAL 300 BRICKSTONE SQUARE station that is c.Name of Transporter d.Address permitted by MassDEP and ANDOVER MA 01810 6039742503 operated in e.City/Town f.State g.Zip Code h.Telephone compliance with Solid Waste Regulations 310 CMR 19.000 2. If a temporary storage location/transfer station is used, list name of transporter of asbestos containing waste material from temporary storage location/transfer station to final disposal site: SERVICE TRANSPORT GROUP,INC. 301 OXFORD VALLEY RD,SUITE 803B a.Name of Transporter b.Address YARDLEY PA 19067 8779999559 c.City/Town d.State e.Zip Code f.Telephone Revised: 11/13/2013 Page 3 of 4 BWP AQ 04 (ANF-001) Asbestos Project # Asbestos Notification Form (` Project Revision Massachusetts Department of Environmental Protection 100334464 f Project Cancellation C.Asbestos Transportation& Disposal: (cont.) 3. Name and address of temporary storage location/transfer station for the asbestos containing waste material: N/A N/A a.Temporary Storage Location Name b.Address N/A MA 00000 0000000000 c.City/Town d.State e.Zip Code f.Telephone 4.Name and location of final disposal site(asbestos landfill): MINERVA LANDFILL N/A a.Final Disposal Site Name b.Final Disposal Site Owner Name 8955 MINERVA ROAD c.Address WAYNESBURG OH 44688 3308663435 d.City/Town e.State f.Zip Code g.Telephone Note:Contractor must sign this form for DLS notification purposes D. Certification FRANK BALOGH FRANK BALOGH "I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PRESIDENT 9/24/2020 familiar with the information contained in this document and 3.Position/Title 4.Date(MM/DD/YYYY) all attachments and that, based 6039742503 E&F ENVIRO on my inquiry of those 5.Telephone 6.Representing individuals immediately 300 BRICKSTONE SQUARE ANDOVER responsible for obtaining the 7.Address 8.City/Town information, I believe that the MA 01810 information is true, accurate, and complete. I am aware that there 9•State 10.Zip Code are significant penalties for submitting false information, including possible fines and imprisonment. The undersigned hereby states that I have read the Commonwealth of Massachusetts regulations governing asbestos abatement (453 CMR 6.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised: 11/13/2013 Pave 4 of 4