HomeMy WebLinkAboutMiscellaneous - 1160 GREAT POND ROAD 11/30/2015 mmm All State Abatement Professionals,ssionals, inc.
4 Wilder Drive, Suite 12 866-565-ASAP
Plaistow, NH 03865 Fax: 603-378-0610
November 24, 2015 `A/
T VVIA
Town of North Andover
Health Department
1600 Osgood Street
Bldg 20; Unit 2035
North Andover,MA 01845
Phone#: (978) 688-9540
Fax #: (978) 688-8476
Re: Asbestos Abatement @ Brooks School, 1160 Great Pond Road
To whom it may concern:
All State Abatement Professionals, Inc. (ASAP) is scheduled to perform work for the
above referenced project on the following dates:
Start Date: 12/8/15
End Date: 12/8/15
All appropriate agencies have been notified for the above referenced project. If you have
any questions or need additional information, please do not hesitate to contact me.
Sincerely,
i
I�
J. Scott Curley
President
JSCJab
Enclosures
Asbestos ® Masonry Cleaning ® Selective Demolition ®Shot/Sand Blasting ® Mold Remediation
Commonwealth of Massachusetts -- --- --
Asbestos Notification Form ANF-001 10o2334a4
Asbestos Project#
( Project Revision
I— Project Cancellation
A. Asbestos Abatement Description
1.Facility Location:
BROOKS SCHOOL 1160 GREAT POND ROAD
Name of Facility Street Address
Instructions 1.All NORTH ANDOVER NIA 01845 9787256284
sections of this form City/Town State Zip Code Telephone
must be completed in NORMAND GRENIER FACILITIES
order to comply with
MassDEP notification Facility Contact Person Name Facility Contact Person Title
requirements of 310 Worksite Location_ FARMHOUSE BASEMENT
CMR 7.15 and
Department of Labor Building Name,Wing,Floor,Room,etc.
Standards(DLS) 2, Is the facility occupied? r-_Yes No
notification
requirements of 453
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)? F Yes r No
MassDEP Use Only
4.Blanket Permit Project Approval,if applicable:
Date Received Approval ID#
5.Non-Traditional Asbestos Abatement Work Practice Approval,
2.Submit Original if applicable: Approval ID#
Form To:
Commonwealth of 6.Asbestos Contractor:
Massachusetts ALL STATE ABATEMENT PROFESSIONALS 4WILDER DRIVE SUITE 12
P.O.Box 4062
Boston,MA 02211 Name Address
PLAISTOW NH 03865 6033780600
City/Town State Zip Code Telephone
AC000331 Contract Type: F Written F Verbal
DLS License#
7, JEFFREY CURLEY AS034502
Name of Contractor's On-Site Supervisor/Foreman DLS Certification#
8. Al SPECTRUM SERVICES AA000152
Name of Project Monitor DLS Certification#
9, Al SPECTRUM SERVICES AA000152
Name of Asbestos Analytical Lab DLS Certification#
10, 12/8/2015 1218/2015
Project Start Date(MM/DD/YYYY) End Date(MM/DD/YYYY)
7-3:30 NONE
Work Hours-Monday Through Friday Work Hours-Saturday&Sunday
1 1, What type of project is this'?
F Demolition F— Renovation Fv- Repair F_ Other-Please Specific:
Revised: 11/13/201 Page I of
Commonwealth of Massachusetts 1 00233484
Asbestos Notification Form ANF-001 Asbestos Project#
Project Revision
F" Project Cancellation
B. Facility Description
1.Current or prior use of facility: RESIDENCE
2.Is the facility owner-occupied residential\-vith 4 units or less? ( Yes f—./ No
3•BROOKS SCHOOL 1160 GREAT POND ROAD
Facility Owner Name Address
NORTH ANDOVER MA 01845 0000000000
City/Town State Zip Code Telephone
4,NORMAND GRENIER 1160 GREAT POND ROAD
Name of Facility Owner's On-Site Manager Address
NORTH ANDOVER MA 01845 9787256284
City/Town State Zip Code Telephone
j.ALL STATE ABATEMENT PROFESSIONAL 4 WILDER DRIVE,STE 12
Name of General Contractor Address
PLAISTOW NH 03865 6033780600
Note:Temporary
storage of Asbestos City/Town State Zip Code Telephone
containing waste FEDERAL INSURANCE COMPANY
material is only
allowed at the place Contractor's Workers Compensation Insurer
of business of a DLS 0044727722 3/22/2016
licensed Asbestos Policy# Expiration Date(MM/DD/YYYY)
contractor or a transfer
station that is 6.What is the size of this facility? 4500 2
permitted by
MassDEP and
operated in Square Feet #of Floors
compliance with Solid
Waste Regulations C. Asbestos Transportation & Disposal
310 CMR 19.000
1.Transporter of asbestos-containing waste material from site of generation:
F— Directly to Landfill or F To Temporary Storage Location/Transfer Station
ALLSTATE ABATEMENT PROFESSIONALS,INC. 4 WILDER DRIVE,STE 12
Name of Transporter Address
PLAISTOW Ni 03865 6033780600
City/Town State Zip Code Telephone
2. If a temporary storage location/transfer station is used,list name of transporter of asbestos containing
waste material fi•om temporary storage location/transfer station to final disposal site:
J.O.B./ROLLOFF,INC. 69 NORMAN STREET
Name of Transporter Address
EVERETT MA 02149 6173871495
City/Town State Zip Code Telephone
Note:Contractor must
sign this form for DLS Revised: 11/13/2013 Page 3 of 4