HomeMy WebLinkAboutAsbestos Abatement - Ace Hardware - Miscellaneous - 50 PETERS STREET 5/9/2023 E & F ENVIRONMENT
Environmental/Demolition Contractors
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April 27, 2023
North Andover Health Department
120 Main Street
North Andover, MA 01845
Please be advised that we will be conducting an Asbestos Abatement
at the above captioned address beginning on May 6, 2023. 1 have
attached a copy of the Notification filed with the MA DEP for your
records.
Kindly contact us with further questions or comments you may have.
Very truly yours,
Susan A. Pappalydo
E & F Environmental Corporation
/Enclosures
18 AYERS VILLAGE ROAD, BUILDING 1 , UNIT 5
METHUEN, MA 01844
(603)974-2503 FAX: (603)974-2471
Massachusetts Department of Environmental Protection - -
- BWP A 04 ANF-001 100384885
Q � Asbestos Project#
Asbestos Notification Form
r Project Revision
n, r Project Cancellation
A. Asbestos Abatement Description MAC �'� ovEa
TORN OSHDEPAR MENT
1.Facility Location:
HARDWARE STORE 50 PETERS STREET
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: EXiERIORSIDING
Standards(DLS)
notification i.Building Name,Wing,Floor,Room,etc.
requirements of 453 2. Is the facility occupied? r a.Yes f—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 r 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: r 1.Written r 2.Verbal
g.DLS License#
7 GUILLERMO A MARGARIN FRIAS II 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.
5/6/2023 5/12/2023
a.Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY)
7-4 7-4
c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday
11. What type of project is this?
I— a.Demolition r b.Renovation r c. Repair I✓ d. Other-Please Specify: REMOVAL
Revised: 11/13/2013 Page 1 of 4
'1
Massachusetts Department of Environmental Protection 100384885
- 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
r f.Full Containment rI g.Other-Please Specify: POLY SURROUNDING STRUCTURE
13.Job is being conducted: r a. Indoors rr b. Outdoors
14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or
encapsulated:
0 2800
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 TRANSITE SIDING 2800
1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft.
15.Describe the decontamination system(s)to be used:
POLY SURROUNDING 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 W b.No
project?
Revised: 11/13/2013 Page 2 of 4
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`71
Massachusetts Department of Environmental Protection 100384885
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: HARDWARE STORE
2. Is the facility owner-occupied residential with 4 units or less? r a.Yes W b. No
3 NORTH ANDOVER VENTURE LIMITED PARTNERSHIP 990 WASHINGTON STREET,SUITE 212
a.Facility Owner Name b.Address
DEDHAM MA 02026 0000000000
c.City/Town d.State e.Zip Code f.Telephone
4 N/A N/A
a.Name of Facility Owners 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
WA MA 00000 0000000000
c.City/Town d.State e.Zip Code f.Telephone
STAR INSURANCE
g.Contractor's Worker's Compensation Insurer
0000000000 12/4/2023
h.Policy# i.Expiration Date(MM/DD/YYYY)
6.What is the size of this facility? 17125 1
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 I'" 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 CORPORATION 18 AYERS VILLAGE RD.,BLDG 1,#5
station that is c. Name of Transporter d.Address
permitted by
MassDEP and METHUEN MA 01844 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
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`71
Massachusetts Department of Environmental Protection - --
BWP AQ 04 (ANF-001) 100384885
Asbestos Project #
Asbestos Notification Form
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.Citylrown 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 4/21/2023
familiar with the information
contained in this document and 3.Position/TiUe 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 18 AYERS VILLAGE RD.,BLDG 1,#5 METHUEN
responsible for obtaining the 7.Address 8.City/Town
information, I believe that the MA 01844
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 Paee 4 of 4