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Home My WebLink AboutMiscellaneous - 180 Main Street00 0 N- fi n m (D rt BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext23 NORTH ANDOVER BOARD OF HEALTH FOOD ESTABLISHMENT UPDATE The Board of Health is presently in the process of updating their files, therefore, please answer the following questions and return to the North Andover Board of Health, 120 Main Street, North Andover, MA 01845 as soon as possible. Thank you for your time and cooperation in this matter. NAME OF ESTABLISHMENT Andover School of Montessori ADDRESS 180 Main Street, North Andover, MA 01845 TELEPHONE NUMBER ( 508) 688-1086 DAYS AND HOURS OF OPERATION m -f 8:15am - 5:30pm NUMBER OF FOOD HANDLING STAFF (INCLUDES DISHWASHERS, WAIT PEOPLE, COOKS, FOOD PREPARATION STAFF, SUPERVISORS/MANAGERS). o reacners NAME(S) OF CERTIFIED FOOD HANDLER(S), DATE CERTIFIED, AND SHIFT WORKED. NONE If you have any questions in reference to this update, please do not hesitate to call the Board of Health Office at 682-6483 ext. 23. C DEPARTMENT OF PUBLIC HEALTH/DEPARTMENT OF LABOR & INDUSTRIES F� NOTIFICATION OF DELEADING WORK All sections of this form must be completed in order to comply with the notification requirements of M.G.L.C. 111 S197 FILE NUMBER Lead Paint Inspector Date of Inspection Contractor performing project SenCam, Incorporated License # DC 000388 ATess of Project Building Name (if any) St.Michael's School Street Address 180 Main City North Andover Street Zip 01845 Floor Basement- First Floor - Apt. No. Deleading Method: (DRY SCRAPING) HEAT GUN ENCAPSULATION DEMOLITION (circle all that apply) POWER SANDING CAUSTICS REPLACEMENT OTHER If "Other" selected, please explai Check one: dwelling is Multi -family N /A School Start Date 5-8-93 single family N/A Completion Date 5-8-93 When will work be done: am 7:30 pm--!- 3 0 weekends? Yes Project Supervisor Name Patrick J. Sennott License # DC 000388 Property Owner Archdiocese of Boston Address 2121 Commonwealth Avenue City Brighton State MA Zip 02135 Telephone 617-254-0100 In case of emergency, contact what person:Patrtrick SennottSennott Phone: Area code required day 5 0 8- 6 8 3- 7 7 6 7 evening (OVER) 0034B/5 rev 11/16/89 In accordance with Chapter 773 of the Acts of 1987, Massachusetts General Laws C. 111 S197, 454 CMR 22.00 and 105 CMR 460.000, notice of the date and method(s) of removal or covering of paint, plaster, soil, or other accessible materials containing dangerous levels of lead, is to be provided to the following persons at least five days prior to the beginning of deleading. 1. Occupants of the dwelling unit 2. All other occupants of the residential premises, if any 3. Director, Childhood Lead Poisoning Prevention Program Department of Public Health, 305 South Street, Jamaica Plain, MA 02130 4. Lead Removal Program, Bureau of Technical Services Department of Labor and Industries, Division of Industrial Safety 100 Cambridge Street, Room 1101, Boston, MA 02202 5. Local Board of Health/Code Enforcement Agency 6. Massachusetts Historical Commision (if premises is listed on the State Register of Historic Places) The undersigned hereby states, under the penalties of perjury, that s/he has read and understood the Commonwealth of Massachusetts Deleading Regulations, 454 CMR 22.00, and Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000, and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. Date AA_r i i 28. 19c)l Signed: ga.l.� 1. Title: Operati s Manager _ Company: SenCam, Incorporated Office Use Only 0034B/6 rev 11/16/89 M J a 0 DEPARTMENT OF PUBLIC HEALTH/DEPARTMENT OF LABOR & INDUSTRIES NOTIFICATION OF DELEADING WORK (Y All sections of this form must be completed in order to comply wit 0 the notification requirements of M.G.L.C. 111 S197 FILE NUMBER Lead Paint Inspector South Shore Date of Inspection 5-23-91 Contractor performing project Patrick Sennott License #DC 000388 D/B/A- SenCam, Incorporated Address of Project Building Name Of any) St. Michael's Street Address 180 main -Street City North Andover School Zip 01845 Floor B, 1 , 2 - Apt. No. Deleading Method: DRY SCRAPING HEAT GUN ENCAPSULATION DEMOLITION (circle all that apply) POWER SANDING CAUSTICS j REPLACEMENT j OTHER If "Other" selected, please explai Check one: dwelling is Multi -family N/A single family N/a /A School Start Date 9/23/91 Completion Date 10/05/91 When will work be done: am 7:30 pm 3: 3 0 weekends? P o s s i b l e Project Supervisor Name Bill Callabrese License #SF 04742 Property Owner Archdiocese of Boston Address 2121 Commonwealth Avenue City Brighton State MA Zip 02135 Telephone 1-(617)-254-0100 In case of emergency, contact what person: Patrick J. Sennott Phone: Area code required day(508)-683-7767 evening (OVER) 0034B/5 rev 11/16/89 In accordance with Chapter 773 of the Acts of 1987, Massachusetts General Laws C. 111 S197, 454 CMR 22.00 and 105 CMR 460.000, notice of the date and method(s) of removal or covering of paint, plaster, soil, or other accessible materials containing dangerous levels of lead, is to be provided to the following persons at least five days prior to the beginning of deleading. 1. Occupants of the dwelling unit 2. All other occupants of the residential premises, if any 3. Director, Childhood Lead Poisoning Prevention Program Department of Public Health, 305 South Street, Jamaica Plain, MA 02130 4. Lead Removal Program, Bureau of Technical Services Department of Labor and Industries, Division of Industrial Safety 100 Cambridge Street, Room 1101, Boston, MA 02202 5. Local Board of Health/Code Enforcement Agency 6. Massachusetts Historical Commision (if premises is listed on the State Register of Historic Places) The undersigned hereby states, under the penalties of perjury, that s/he has read and understood the Commonwealth of Massachusetts Deleading Regulations, 454 CMR 22.00, and Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000, and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. Date September 13, 1991 Signed: Title: 0 erstio s Manacrer Company: Se.nOar«, Tncorporated Office Use Only 0034B/6 rev 11/16/89 September 23, 1991 North Andover Health Department 120 Main Street North Andover, Massachusetts 01845 Regarding: Lead Removal St. Michael's School 180 Main Street N. Andover, Massachusetts Dear Sir: On September 13, 1991, an original notification was sent to you of our intention to perform deleading work at St. Michael's School in North Andover. The job was to start on September 23, 1991 and the completion date was to be October 5, 1991. Due to circumstances beyond our control we are extending the start date to September 26, 1991. Please note the enclosed amended notification. Please do not hesitate to contact me if I can be of any further assistance on this matter. PJS/ch Sincerely, Patrick J. Sennott Operations Manager The Londonderry Professional Park Route 102, Londonderry, NH 03053 • Telephone: (603) 432-8373 The Professional Center 198 Mass. Ave., No. Andover, MA 01845 Telephone (508) 683-7767 • FAX: (508) 688-9998 DEPARTMENT OF PUBLIC HEALTH/DEPARTMENT OF LABOR & INDUSTRIES NOTIFICATION OF DELEADING WORK All sections of this form must be completed in order to comply with the notification requirements of M.G.L.C. 111 S197 FILE NUMBER Lead Paint Inspector South Shore Date of Inspection 5-23-91 Contractor performing project Patrick Sennott License #DC 000388 D/B/A- SenCam, Incorporated Address of Project Building Name (if any) St. Michael's Street Address 180 Main Street City North Andover School Zip 01845 Floor B, 1 , 2 _ Apt. No. Deleading Method: DRY SCRAPING HEAT GUN ENCAPSULATION DEMOLITION (circle all that apply) POWER SANDING CAUSTICS j REPLACEMENT j OTHER If "Other" selected, please explai Check one: dwelling is Multi -family N/A single family N /a /A School Start Date --9�1 4`k/ Completion Date 10/05/91 When will work be done: am -7 : 3 0 pm 3:30 weekends? Possible Project Supervisor Name Bill Callabrese License #SF 04742 Property Owner Archdiocese of Boston Address 2121 Commonwealth Avenue City_ Brighton State MA Zip 02135 Telephone 1-(617)-254-0100 In case of emergency, contact what person: Patrick J. Sennott Phone: Area code required day( 508 ) -683-7767 evening (OVER) Is 0034B/5 rev 11/16/89 In accordance with Chapter 773 of the Acts of 1987, Massachusetts General Laws C. 111 S197, 454 CMR 22.00 and 105 CMR 460.000, notice of the date and method(s) of removal or covering of paint, plaster, soil, or other accessible materials containing dangerous levels of lead, is to be provided to the following persons at least five days prior to the beginning of deleading. 1. Occupants of the dwelling unit 2. All other occupants of the residential premises, if any 3. Director, Childhood Lead Poisoning Prevention Program Department of Public Health, 305 South Street, Jamaica Plain, MA 02130 4. Lead Removal Program, Bureau of Technical Services Department of Labor and Industries, Division of Industrial Safety 100 Cambridge Street, Room 1101, Boston, MA 02202 5. Local Board of Health/Code Enforcement Agency 6. Massachusetts Historical Commision (if premises is listed on the State Register of Historic Places) The undersigned hereby states, under the penalties of perjury, that s/he has read and understood the Commonwealth of Massachusetts Deleading Regulations, 454 CMR 22.00. and Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000, and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. Date September 13, 1991 Signed'_-1�t�/� Title: Operstios Mana er Company: Sen' -'am, incorporated Office Use Only 0034B/6 rev 11/16/89