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Home My WebLink AboutAsbestos Abatement Project - Miscellaneous - 335 WILLOW STREET 10/26/2020 DEC*TAM ENVIRONMENTAL SERVICES October 16, 2020 f{F.COVED 0c, 2 6 ZOZO North Andover Health Department OF NORTH ANppVER 120 Main St TD HAEgjH DEPARTMENT North Andover, MA 01845 Re: Bake'n Joy Commercial Building- 335 Willow Street— 1't Floor Cafe, Multi Media Room Dear Sir/Madam: Please be advised that Dec-Tam Corporation will be performing an asbestos abatement project at the above referenced location. This work has been scheduled for October 28, 2020. All applicable local, state and federal agencies have been notified of this work. Please let me know if you have any questions. Sincerest regards, Craig Starkman Sales Estimator CS/nap Enclosure 50 Concord Street,North Reading,MA 01864 - P:978.470,2860 F:978.470.1017 - www.dectam.com Massachusetts Department of Environmental Protection 1 100335569 BWP AQ 04 (ANF-001) L711Asbestos Notification Form Asbestos Project# r— Project Revision r-" Project Cancellation RECEN A. Asbestos Abatement Description 6 20N OCT 2 1.Facility Location: OF NpR1kA BAKE'N JOY FOODS 3351NILLOW STREET TO HEP►-1N pEPAR Instructions 1.All a.Name of Facility b.Street Address sections of this form NORTH ANDOVER MA 01845 9786821414 must be completed in order to comply with c.City/Town d.State e.Zip Code f.Telephone MassDEP notification TOM BRADLEY PROJECTMANAGER requirements of 310 CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title Department of Labor Worksite Location: FIRST FLOOR CAFE,MULTI MEDIA ROOM Standards(DLS) , notification i.BuildingName V\A Floor,Room,etc. �� requirements of 453 2. IS the facility occupied? r a.Yes 1✓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 W, 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# 5.Asbestos Contractor: DEC-TAM CORPORATION 50 CONCORD ST a.Name b.Address NORTH READING MA 01864 9784702860 c.City/Town d.State e.Zip Code f.Telephone AC000035 h.Contract Type: 1✓ 1.Written r—2.Verbal g.DLS License# 7. SCOTTAWRIGHT AS032177 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# 8 ENVIRONMENTAL HEALTH INC AA000044 a.Name of Project Monitor b.DLS Certification# 9 ENVIRONMENTAL HEALTH INC AA000044 a.Name of Asbestos Analytical Lab b.DLS Certification# 10. 10/28/2020 10/28/2020 a.Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY) 7AM-5PM N/A c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11. What type of project is this? r-` a.Demolition r b.Renovation r c.Repair r d.Other-Please Specify: Q4oing1y Revised: 11/13/2013 Pagel of 4 Massachusetts Department of Environmental Protection 100335569 ~' BWP AQ 04 (ANF-001) Asbestos Notification Form Asbestos Project# 't r Project Revision r Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): r a.Glove Bag r b.Encapsulation f c.Enclosure r d.Disposal Only r e.Cleanup W f.Full Containment r g.Other-Please Specify: 13.Job is being conducted: rV a. Indoors I— b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 50 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 1.Lin.Ft. 2.Sq.Ft 1.Lin.Ft. 2.Sq.Ft. h.Cloths,Woven Fabrics i.Other-Please Specify: 1.Lin.Ft. 2.Sq.Ft j.Insulating Cement SINKCOATING 50 1.Lin.Ft. 2.Sq.Ft 1.Lin.Ft. 2.Sq.Ft 15.Describe the decontamination system(s)to be used: THREE CHAMBERED 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): MATERIAL WILL BE WETTED,PLACED INTO LINED WASTE CONTAINERS AND SENT FOR DISPOSAL 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(MWDD/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 lW a.Yes r b.No project? Revised: 11/13/2013 Page 2 of 4 Massachusetts Department of Environmental Protection 003355 '9 BWP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Form � r— Project Revision t r Project Cancellation B. Facility Description 1.Current or prior use of facility: COMMERCIAL 2.Is the facility owner-occupied residential with 4 units or less?9 a.Yes r b.No 3 BAIE'N JOY FOODS 351 WILLOW STREET a.Facility Owner Name b.Address NORTH ANDOVER MA 01845 9786831414 c.City/Town d.State e.Zip Code f.Telephone 4 TOM BRADLEY 351 WILLOW STREET a.Name of Facility Owners On-Site Manager b.Address NORTH ANDOVER MA 01845 9786831414 c.City/Town d.State e.Zip Code f.Telephone 5.DEC-TAM CORPORATION 50 CONCORD STREET a.Name of General Contractor b.Address NORTH READING MA 01864 9784702860 c.City/Town d.State e.Zip Code f.Telephone STAR INSURANCE COMPANY g.Contractors Workers Compensation Insurer WC0871082 12/28/2020 h.Policy# i.Expiration Date(MM/DD/YYYY) 6.What is the size of this facility? 50000 1 a.Square Feet b.#of Floors Note:Temporary C. Asbestos Transportation & Disposal storage of Asbestos 1� P containing waste material is only 1.Transporter of asbestos-containing waste material from site of generation: allowed at the place r a.Directly to Landfill or io b.To Temporary Storage Location/Transfer Station of business of a DLS licensed Asbestos contractor or a transfer DEC-TAM CORPOARTION 50 CONCORD STREET station that is c.Name of Transporter d.Address permitted by MassDEP and NORTH READING MA 01864 9784702860 operated in compliance with Solid e.City/rown f.State g.Zip Code h.Telephone 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: REDTECH 173 PICI(ERING ST a.Name of Transporter b.Address PORTLAND CT 06480 8608944605 c.City/Town d.State e.Zip Code f.Telephone Revised: 11/13/2013 Page 3 of 4 Massachusetts Department of Environmental Protection 100335569 BWP AQ 04 (ANF-001) L17 -- Asbestos Project# Asbestos Notification Form J— Project Revision f Project Cancellation C.Asbestos Transportation&Disposal: (cont.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: DEC-TAM CORPORATION 50 CONCORD STREET a.Temporary Storage Location Name b.Address NORTH READING MA 01864 9784702860 c.City/Town T State e.Zip Code f.Telephone 4.Name and location of final disposal site(asbestos landfill): MINERVA LANDFILL BRUCE SULLIVAN a.Final Disposal Site Name b.Final Disposal Site Owner Name 9000 MINERVA ROAD c.Address WAYNESBURG CH 44688 3308663435 Note:Contractor must f. d.City/Town e.State Zip Code g.Telephone sign this form for DLS notification purposes D. Certification CRAIG STARI<MAN CRAIG STARI<MAN "I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am SALES 10/14/2020 familiar with the information contained in this document and 3.Position/Title 4.Date(MM/DD/YYYY) all attachments and that,based 9784702860 DEC-TAM CORPORATION on my inquiry of those 5.Telephone 6.Representing individuals immediately 5000NCORDST NORTH READING responsible for obtaining the 7.Address 8.Citylrown information, I believe that the MA 01864 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 Page 4 of 4