HomeMy WebLinkAboutAsbestos Abatement - Miscellaneous - 38 RUSSELL STREET 2/8/2022 E & F ENVIRONMENTAL 00 aV
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February 8, 2022 �,0-N-
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Town of North Andover
Health Department
120 Main Street
North Andover, MA 01845
RE: 38 Russell Street, North Andover, MA
Dear Sir/Madam:
Please be advised that we have filed a Notification with the MASS DEP regarding the
Asbestos Abatement at the above referenced property and have included a copy of it
with this letter. We will be at the property on February 21, 2022 to remove the Asbestos.
Kindly contact us with any questions or comments you may have.
Very truly yours,
Susan A. Pappalardo
Office Manager
/Enclosures
41 1 RIVER STREET, SECOND FLOOR, HAVERHILL, MA 01 832
PHONE: (603) 974-2503 FAX: (603) 974-2471
'0711
Massachusetts Department of Environmental Protection 100360126
BWP AQ 04 (ANF-001) Asbestos Project#
— � Asbestos Notification Form F_ Project Revision
f Project Cancellation
A. Asbestos Abatement Description
1.Facility Location:
RESIDENCE 38 RUSSELL STREET
Instructions 1.All a.Name of Facility b.Street Address
sections of this form NORTH ANDOVER
MA 01845 9783026432
must be completed in
order to comply with c.City/Town d.State e.Zip Code f.Telephone
MassDEP notification RICK GAGNON OWNER
requirements of 310
CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title
Department of Labor Worksite Location: BEDROOMS AND BATHROOM CLOSET
Standards(DLS)
notification i.Building Name,Wing,Floor,Room,etc.
requirements of 453 2. Is the facility occupied? r%_0 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)? FV a.Yes 7 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 411 RIVER STREET
a.Name b.Address
HAVERHILL MA 01832 6039742503
c.City/Town d.State e.Zip Code f.Telephone
AC000971 h. Contract Type: G% 1.Written r 2.Verbal
g.DLS License#
7. GUILLERMO A MARGARIN FRIAS II AS032500
a.Name of Contractors 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.
2/21/2022 2/23/2022
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?
r a.Demolition r b.Renovation r c.Repair r d.Other-Please Specify: REMOVAL
Revised: 11/13/2013 Page 1 of 4
`71 Massachusetts Department of Environmental Protection 100360126 j
BWP AQ 04 (ANF-001) Asbestos Project#
Asbestos Notification Form 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 r" c.Enclosure r- d.Disposal Only r' e.Cleanup
rr f.Full Containment r- g.Other-Please Specify:
13.Job is being conducted: rr a.Indoors r b.Outdoors
14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or
encapsulated:
0 900
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 CEIJNGTILE 900
1.Lin.Ft. 2.Sq.Ft 1.Lin.Ft. 2.Sq.Ft.
15.Describe the decontamination system(s)to be used:
FULL CONTAINMENT
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 r b.No
project?
Revised: 11/13/2013 Page 2 of 4
`71 Massachusetts Department of Environmental Protection 100360126
BWP AQ 04 (ANF-001) Asbestos Project#
Asbestos Notification Form F Project Revision
F Project Cancellation
B. Facility Description
1.Current or prior use of facility: RESIDENCE
2. Is the facility owner-occupied residential with 4 units or less? (✓ a.Yes r b.No
3.RICK GAGNON 38 RUSSELL STREET
a.Facility Owner Name b.Address
NORTH ANDOVER MA 01845 9783026432
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
S N/A N/A
a.Name of General Contractor b.Address
N/A MA 00000 0000000000
c.City(rown d.State e.Zip Code f.Telephone
STAR INSURANCE COMPANY
g.Contractor's Worker's Compensation Insurer
0000000000 12/4/2022
h.Policy# i.Expiration Date(MM/DD/YYYY)
6.What is the size of this facility? 1000 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 Wo b.To Temporary Storage Location/Transfer Station
of business of a DLS
licensed Asbestos
contractor or a transfer E&F ENVIRONMENTAL CORPORATION 411 RIVER STREET
station that is c.Name of Transporter d.Address
permitted by
MassDEP and HAVERHILL MA 01832 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:
EA LOGISTIC SERVICES,INC. 106 EGERTON ROAD
a.Name of Transporter b.Address
LANGHORNE PA 19047 2156170500
c.City/Town d.State e.Zip Code f.Telephone
Revised: 11/13/2013 Page 3 of 4
e
`71 Massachusetts Department of Environmental Protection 100360126
BWP AQ 04 (ANF-001) Asbestos Project#
Asbestos Notification Form f 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:
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 CH 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 2/8/2022
familiar with the information
contained in this document and 3.Position/fitle 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 411 RIVER STREET HAVERHILL
responsible for obtaining the 7.Address 8.City/Town
information,I believe that the MA 01832
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