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HomeMy WebLinkAbout0307 MAIN STREET (HYANNIS) - Health 367 Main Street Hyannis y. A.= 327 — 103 i I 09/1,4/2018 03:09PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/03 Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 p.978.348.1118 Q NO t.978.383.1097 www.ecoenvirotech.net rs;� -T: TRA.NSMITT,AL DOCUMENT +TO: FROM: Rhonda II COMPANY; DATE; Barnstable Board of Health 9/14/18 rAR: TOTAL NO,OF PAre's INCLUDING COVER: (508)790-6304 3 PT40NU NUMBER: sENI)ER's REFERENCE NUMBP.,R: RE: YOUR RCFERENCE NUMBEIL• 307 Main Street,Hyannis,MA Good Afternoon, Following please fired a revised copy of the DEP/DOS notification form for the asbestos abatement at 307 Main Street,Hyannis. Please contact Henry Moses (978) 423- 3999 or myself if you have any questions. Thanks so much, Rhonda 09/14/2018 03:09PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/03 • -K Massachusetts Department of Environmental Protection 100289345R2 BWP AQ 04 (ANF-001) Asbestos Project# j:..`;•,.':, .s>� Project Revision Notification - Project Revision A r—,, Project Cancellation A.Asbestos Abatement Description 1.Facility Location.: 307 MAIN STREET 307 MAIN STREET Instructions 1.All a.Name of Facility b.Street Address sections of this form BAR.NSTABIJ9 MA 02601 8026M072 must be completed in order to comply with th City/rown d.State e.Zip Code t Telephone MsssDEPnolfftcation LARRYDECKER 01A1NMREPRESENTATNE requirements of 310 CMR 7.15 and g.Fac ty Cone Person Name tt.Fecky Contact Person Title Department of Labor Worksite Location: THROUGHOUT Standards(DLS) i Bullding Name,wing,Roor,Room,etc, notificallon requirements of 463 2.Blanket Permit project Approval,if applicable: CMR 6.12 Approval I D# 3.Non-Traditional Asbestos Abatement Work Practice,Approval, MassDEP Use only if applicable: Approval Ip# Date Received 6125/2018 9/24/2018 a.Project Start Date(MWDDlYYYY) b.End Date(MMfDDNY Y) 6P-6A 8A-8P c.Work Hours-Monday Through Friday d.Worts Hours,Saturday&Sunday B. Other Project Revisions:' Note:Temporary storage of Asbestos containing waste material Is only allowed at the place of business of a DLS licensed Asbestos contractor or a transfer station that is permitted by MassDEP and - operated In compliance with Solid Waste Regulations 310 CMR 19.000 Note:Contractor must sign this form for DLS Page 1 of 2 notlflestion purposes Revised: 11/13/2013 09/14/2018 03:09PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/03 Massachusetts Department of Ezzvirontnenitai Protection 100289345R2 w G� BiWP.AQ 04 (ANF-001) Asbestos Project# ' Project Revision Notification rJ Project Revision Project Cancellation C. Cerd ication HENRY MOSES "I certify that I have personally 1.Name 2 Authorized Signature examined the foregoing and am PPESDENT familiar with the Information 3.PoWdoruTMe 4,Date(MM/DDIYYYY) contained In this document and 9784233999 e0a40M C,EWRO'TECHS,INC. all attachments and that,based on my inquiry of those 6 Telephone 6.Representing Individuals immediately 38 INTERVALE ROAD FITCHBURG responsible for obtaining the 7.Address e.Uty/Town information,I believe that the MA 01420 information is true,accurata,and 9.State 10.Zip Code complete.I am aware that there 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.o0 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 opplication or notification shall not be deemed valid unless payment of the applicable fee is made." ' P Revised 11/13/2013 Page 2 of 2 07 23/2018 02:33PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/03 Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 p.978.348.111 a f.978.383.1097 www.ecoenvirotech.net TR,A,N'SMITT.AL DOCUMBNT +TO: FROM: Rhonda COMPANY: DATE-1 Bamstable Board of Health 7/23/18 FAX: TOTAL NO.OF PAGES INCLUDING COVER: (508)790-6304 3 PHONE NUMBER SENDER'S REFERENCE NUMBER: RE. YOUR REFERENCE NUMBER; 307 Main Stteet,Hyannis,MA Good Aftemoon, Following please find a revised copy of the DEP/DOS notification form foz the asbestos abatement at 307 Main.Street, Hyannis. Please contact Henry Moses (978) 423- 3999 or myself if you have any questions. Thanks so much, Rhonda 07/23/2018 02:33PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/03 :• Massachusetts Depailmesat of Envirorvnental Protection --- -- -- BWP AQ 04 (ANF-001) t100289345Rl y '~' Project Revision on Notification Asbestos Project# i Project Revision C, Project Cancellation A. Asbestos Abatement Description 1.Facility Location: 307 MAIN STREET 307 MAW STREET Instructions 1.All a.Name of Facility In.Street Address sections of this form must be completed In BARNSTAB>� MA 02601 8028836072 order to comply with c CiVrown d,State e.Zip Code t Telephone MeeaDEP notification Y DECKER requirements of 310 LARROWNER REPRESENTATNIE CMR 7.15 and 9.Faculty Contact Person Name h.Facility Contact Person Thle Department of Labor Worksite Location: -MRDIJGHOl1T Standards(DLS) notification I.Building Name,Wing,Floor,Room,etc. requirements of a53 2_Blanket Pern*Project Approval,if applicable: CMR 6.12 Approval ID# 3-.Non-Traditional Asbestos Abatement Work Practice Approval, NlassDEP use Ordy if applicable; Approval ID tx Date Received &250018 9/17l2018 a.Project Start Date(MWl)I)P W) b.End Date(MM/DD/YYYY) 6P-5A aA 8P c Work Hours-Manday Through Friday d.Work Hours-Saturday&Sunday B. Other Project Revisions: Note:Temporary storage of Asbestos containing waste material is only allowed at the place of business of a DLS licensed Asbestos contractor or a transfer stedon That is permitted by Massl)EP and operated In compliance with Solid Waste Regulations 310 CMR 19.000 Note:Contractor must sign this form for DLS notifioation purposes Rovised: 11/13/2013 Page 1 of 2 07/23/2018 02:33PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/03 Massachusetts Department of Environmental protection 100289345R1 BWP AQ 04 ,ANF-001 Asbestos Project# project Revision Notification Project$e4 ioa r Project Cancellation C. Certification HENRY MOSES "I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PPf.SDENT familiar with the information 3 Pcabb nMde 4.Date(MM/DDNYYY) contained in this document and all attachments and that,based 9784233999 ECONOMC ENVIROTECHS,INC. on my inquiry of those 5.Telephone 6.Representing individuals Immediately 38INTERVALE ROAD FUC1 BURG responsible for obtaining the 7.Address 8.Cityrrown Information,I believe that the MA 01420 information is true,accurate,and 9 State 10.Zip Coda complete.I am aware that there are significant penalties for submitting false information, including possible fines and Imprlsohment.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 notificatior) shall not be deemed valid unless payment of the applicable fee Is made." Revised, 11/13/2013 Page 2 of 2 07/10/2018 11:37AM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 p.978.348.1118 f.978.383.1097 www.ecoenvi rotech.net TRANSMITTAL DOCUMENT +TO: FROM: Rhonda COMPANY: DATE: Barnstable Board of health 7/10/18 FAX: TOTAL NO.OF PAGES INCLUDING COVER: (508)790-6304 5 PHONE NUMBER: S£NDER5 REFERENCE NUMBER: RE: XOUR AEFI'RENCL•NUMBER: 307 Main Street,Hyannis,MA Good Afternoon, Following please find a copy of the DEP/DOS notification form fox the asbestos abatement at 307 Main Street,Hyannis. The project is an emergency scheduled for July 12, through July 19,2018. Please contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda 07/10/2018 11:37AM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts Department of Environmental Protection � O1 0290046 $wF AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Form ' Project Revision I'i Project Cancellation A.Asbestos,Abatement Description 1.Facility Location: .307 MAIN STREET 307 MAIN STREET Inetructlona 1.All a Name of Fadilty b.Street Address sections of this form BARNSTABLE MA 02601 8026836072 must be completed in d.State e.Zip Code L Telephone to comply with c.CitylTown MassDEP notification LARRY DECKER OWlr=RREPRESENTATIVE requirements of$10 9 Facility Contact Person Name h.Fact ty Contact Pelson Title CMR 7.15 and Department of Labor Worksite Location: DLUP6i'ER Standards(DLS) L Building Name,Wing,Floor,Room,etc. notification requirements of 453 2. Is the facility occupied?171 a.Yes C.b.No CMR 6.12 3.Is this a fee exempt notificeition (city,town,district,municipal housing authority,State facility,or owner-occupled residential property of four units or less)? r a.Yes R b.No MaeaDEP 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 sf 6.Asbestos Contractor: ECONOMIC ENVIROTECHS 38 INTERVALE ROAD a Name b.Address Fr U-BURG MA 01420 9784233999 a Cityflrown d.State e.Zip Code f.Telephone AC000459 ki.Contract Type:P.1.Written 171.2.Verbal g.DLS License# 7. HENRY MOSES AS031082 a.Name of COMractces On-She Supervisor/Foreman b.DLS Certification it 13 SUDESH MAN SINGH AM031998 a.Name of Project Monitor b.DLS Certification 0 9. ATC GROUP SERVICES INC AA000007 a.Name of Asbestos Analytical Lab b.DLS Certification ik 10' 7/19/2018 7112/2018 a.Project Start Date(MWDD/YYYY) b.End Data(MMIDDIYYYY) 6P-5A 8"P C.Work Hours-Monday Tluough Friday d.Work Hours•Saturday&Sunday 11.What type of project is this? r• a.Demolition rt b.Renovation r c,Repair ICI d.Other-Please Specify: DECONTAfv mKnoN i Page 1 of 4 Revised: 11/13/2013 07/10/2018 11:37AM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/05 Massachusetts Department of Envir0nmental Protection -100290046 _ Q O4 � �-001 Asbestos Project# BWP A ) Asbestos Notification Form 1"' Project Revision Project Cancellation A.Asbestos Abatement Description:(cont.) 12.Abatement procedures(check all that apply): a.Glove Bag F.-j b.Encapsulation !ei o.Enclosure 17 d.Disposal Only e.Cleanup (- f Full Containment r g.Other-Please Specify: 13.Job is being conducted: C;, a.Indoors WE: b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 1.Linear Feet(Lin.Ft.) 2.Square Feet(Sq.Ft) b.Boiler,Breaching,Duct, c.Transite Pipe . Tank Surface Coatings 1.Lin.FL 2.Sq.Ft. 1.Un.Ft. 2.Sq-Ft. d.Pipe Insulation e.Transite Shingles 1.Lin.Pt- 2.Sq.Ft- 1.Lin.R. 2-Sq.Ft. f.Spray-On Fireproofing g.Transite Panels 1.Lin.Ft 2.Sq.Ft 1.Lln.Ft. 2.Sq.Ft. h.Cloths,Woven fabrics i.Other-Please Specify: 1.Uri.Ft 2,Sq.Ft. j.Insulating Cement 1. loCYDS WINDOW DEBRIS Lin.Ft 2.Sq.Ft 1.Lln.Ft. 2.Sq.Ft 15.Describe the decontamination system(s)to be used: N/A 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CUR 6.14(2) (g): (2)6-MIL BAGS WETTED 17.For)�,xpergency Asbestos Operatioius,the MassDEP and DLS officials who evaluated the emergency: JEFFFINNEGAN ENVIRONMENTALANALYST a.Name of MassDEP Offcal b.Title of MassDEP Official 7/9/2018 SAW-18-231 c,Dew of Authorization(MMIDD/YYYY) d.Waiver 90 MEIISSA BUTTS ENARONMENTALANALYST e.Name of DLS Official f.Title of DLS OffirW 7/1012018 23036-2018 g.Date of Authorization(MM/DD/YYY`) h.Waiver 0 y to this a.Yes Pr b. No 18.Do prevailing wage rates as per M.G.L.c. 149,§26,27 or 27A—F app1 project? Revised: 11/13/2013 Page 2 of 4 07/10/2018 11:37AM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 '` :: •. Massachusetts Department of Environmental Protection 100 92 0�6 ~ BwP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification FormProject Revision r" Project Cancellation B.Facility Description ' 1.Current or prior use of facility: BANK 2.is the facility owner-ocoupied residential with 4 units or less?�'. a_Yes Ri b.No 3 TD BANK 70 GRAY ROAD,MAILSTOP ME a.Facility Owner Name b.Address FALMOUTH MA 04105 6036578599 a Chyrrown d.State e.Zip Code is Telephone LARRY DECKS SAME 4,a.Name of Facility Owners on-She Manager b.Address SAME MA 04105 8026836072 G.City/Town d.Slate e.Zip Code t Telephone ECONOMIC BW RO TECH3,INC. 38 INIERVALE ROAD S.a.Name of General Contra= b.Address FnaeLIRG MA 01420 9783481118 c.City/Town d.State e.ZIP Code f.Telephone GREAT DMDE INSURANCE CO. g.Contractors Worker~a Compensation Insurer WCA2021669-12 6/1/2019 h.Policy# I.Expiration Date(MWDD/YYYY) 40000 2 6.What is the size of this facility? a.Square Feet b.9 of Floors Note:Temporary C. Asbestos Transportation&Disposal storage of Asbestos containing waste 1 Transporter of asbestos-containing waste Material from site of generation: material is only allowed at the place [" a.Directly to Landfill or l7 b.To Temport-y Storage Location/Trnsfer StatiOU of business of a DLS licensed Asbestos 38 INTERVALE ROAD contractor or a transfer ECONOMIC ENVIROTECHS,INC. stallon that is G Name of Transporter d.Address permitted by MA 01420- 9783481110 MasSDEP and FITCHBURG operated in e.CKy/rown f.state g.Zip Code K Telephone compliance with Solid Wavle 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/traU fer station to final disposal site: SERVICETRANSPORT GROUP 58 PYLES LANE a.Name of Transporter b.Address NEW CAsTLF EE 19720 3027181394 a city/Town d.State e.Zipe,Zip Cr f.Telephone Revise& 11/13/2013 Page 3 of 4 07/10/2018 11:37AM 9783831097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts DePartt7<1:ent of Environmental Protection 100Z90046 1BwP AQ 04 (ANF-001) Asbestos Project# `.' Asbestos Notification Form !" Project Revision Project Cancellation C.Asbestos Tramsportation&Disposal:(coot.) S.Name and address of temporary storage location/transfer station for the asbestos containing waste >Irtaterial: RORETRUCKING RECYCLEWISPOSAL 168 AIRPORT ROAD a.Temporary Storage I-acation Name b.Address FITCHBLIRG MA 01420 9783533192 C.Clty/fown d.State e.Zip Coda f.Telephone 4.Name and location of final disvosal site(asbestos landfill): MINER/AENTERPRISES INC. MNERVA ENTERPRISES INC. a.Final Disposal Site Name b.Final Disposal Site Owner Name 8955 MINEWAROAD c.Address WAYNESBURG CH 44688 3308063435 d.Cflyffown e.State f.Zip Code g.Telephone Note:Cordrador must eign this form for DLS notiftatlon purposes A. Cerdfication HENRY MOSES "I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PRIESDENr familiar with the Information g PositionrMe 4.Date(MM/DDM'YY) contained in this document and 9784233999 ECONOMIC ENVIRO TECHS.INC. all attachments and that,based on my inquiry of those 5.Telephone 6.Representing individuals immedlately 381NTERVALEROAD WChIBURG responsible for obtaining the 7.Address 8.Cityrrown Information,1 balleve that the • MA 01420 information is true,accurate,and 9 State 10.Zip Code complete.I am aware that there 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' I 04/16/2018 04:00PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 p.978.348.1118 L978.383.1097 www.ecoenvirotech.net TRANSMITTAL DOCUMENT +TO; `FROM: Rhonda COMPANY: DATE: Bamstable Board o£Health 4/10/18 FAX: TOTAL NO.OF RAGES INCLUDING COVER: (5,08) 790-6304 5 PHONE NUMBER: SENDER'S REFERENCE NUMBER: RE: YOUR REFERENCE NUMBER: 307 Main Street,Hyannis,MA. Good Afternoon, Following please find a copy of the DEP/DOS notification form for the asbestos abatement at 307]Main Street,HyaarAs. The project is scheduled for April 23,through June 29,2018. Please contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda I r 04/10/2018 04:00PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts Department of Environmental Protection 11p0278933 BWP AQ 04 (ANF-001 _ et :`�-;•.:• A,sbestos.Proj Asbestos Notification Form Project Revision project Cancellation A. Asbestos Abatement Description 1,Facility Location- 307 MAIN STREET 307 MAIN STREET Instructions 1.All a.Name of Facility b.Street Address sections of this form BARNSTABLE MA 02601 8026836072 must be Completed in order to comply with a Cib/Town d.State a Zlp Code f.Telephone MasaDEP notlflcation . IARRYDECKER OVJNERREPR)SENTATIVE requirements of 310 CMR 7.15 and g.Facility Contact Person Nerve f1 Facility Contact Person Title Department of Labor Wodcsite Location: THROUGHOUT Standards(DLS) i.Building Name,Wing,Floor,Room,Btr- notficatian requirements of 453 2, Is the facility occupied? PP,a Yes r 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)? 177 a.Yes 9- b.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 It Fong To: Commonwealth of Massachusetts 6.Asbestos Contractor. P.O.Box 4052 Boston,MA02211 ECONOMIC ENVIROTECHS 381NTERVALEROAD a.Name b.Address RTCHBURG MA 01420 9784233999 C Chy/T wn d.State e.Zip Code f.Telephone AC00045S h.Contract Type:17-;1.Written r 2.Verbal g,DLS License# 7 HENRY MOSES AS031082 a.Name of Contractor's On-Site Supervisor/Foremen b.DLS Certficaton# $ RAY BRESNAHAN AM9002W a.Name of Project Monitor b.DLS Certification# 9. ENVIRONMENTAL SANIPLINGANDTESTING LTD AA000132 a.Name of Asbestos AnalyorA Lab b.DLS Certification# 10, 4I23/2018 BY29/201 e a,Project Start Date(MM1DDr?YYY) b.End Date(MM/DD/YYYY) 7A-5P 7A�7 c.Work Hours-Monday Through Friday d.Work Hours-Saturday 8,Svndey 11.What type of project is this? r a.Demolition F b.Renovation r c,Repair r! d.Other-Please Specifyr Revised: 11/13/2013 Page 1 of 4 04/10/2018 04:00PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/05 Massachusetts t De artment of Envixoxunental Proection P 11000278933 _ BWP AQ 04 (ANF-001) Asbestos Project# Asbestos Norificatioxi Form r Project Revision (" Project Cancellation A.Asbestos Abatement Description:(coot.) 1Z.Abatement procedures(check all that apply): a.Glove Bag r b.Encapsulation '" c.Enclosure d,Disposal Only ri e.Cleanup r' f.Full Containment W. g.Other-Please Specify: RFDDANGERTAPE 13.Job is being conducted: r; a.Indoors r b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 750 1.Linear Feet(Lin.FL) 2.Square Feet(Sq.Ft) b.Boiler,Breaehiug,Duct, c.Tratasite Pipe Tank Surface Coatings 1.Lin.Ft Z.Sq.Ft 1.Un.Ft 2.Sq.Ft d.Pipe Insulation e.Transite Shingles 1.Uri.Ft. 2.Sq.Ft. 1.Lin.Ft. 2 Sq.Ft. f.Spray-On Fireproofing g.Transim Panels 1.Un,Ft 2.Sq.Ft 1.LIn.Ft, 2.Sq.Ft. h.Cloths,Woven fabrics i.Other-Please Specify: 1,Un.Ft 2.Sq.Ft j.Insulating Cement WINDOWS MO 1.Lin.Ft 2.Sq.Ft. 1.Un.FL 2.Sq.Ft 15.Describe the decontamination systems)to be used: WASH BUCKET 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): (2)6-MI-BAGS WETTED P and DLS officials who evaluated the emergency: 17.For Emergency Asbestos Operations,the MassD]✓ , a.Name of M865DEP Official b.Title of MassDEP Offic4al c.Date of Authorization(MMIDD/YYYY) d.Waiver# e.Name of DLS Ot71da1 f.Title of DLS Official g.Date R Authorization(MMJDDrnY`) h.Waiver# 18.Do prevailing wage rates as per M.G.L.c.149,§26,27 or 27A—F apply to this 1~ a.Yes 17 b. No project? Revised 11/13/2013 page 2 of 04/10/2018 04:00PM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 Massachusetts Department of Envirownental Protection 100278933 BWP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Form. r Project Revision r Project Cancellation 19.Facility Description 1.Current or prior use of facility: BANK 2. Is the facility owner-oompied residential with 4 units or less?1 a Yes Pi b.No 3.TD BANK 70 DRAY ROAD,MAILSTOP ME a.FaC91W Owner Name b.Address FALMOLrrH NE D4105 6MS78699 G,CltyrTown d.State e.Zip Code f.Telephone 4 LARRY DECKER SAME a.Neme of Facility Owner's On-Site Manager b.Address SAME NE 04105 B02WO072 c.Cilyfrown d.State s.Zip Code t Telephone s ECONOMIC 6NVIRO TECFS,INC- 38 WTERVALE ROAD a.Name of General Contnador b.Address FITCMURG MA 01420 9783481118 c.Clty/Town d.State e.Tap Code f.Telephone, (SAT DMDE INSURANCE CO. g.Contractors Worker's Compensation Insurer WCA2021669-10 B/1M2018 h.Policy# i.Expiration Pate(MMIDDIYYYY) 40000 2 6.What is the size of this facility? a.Square Feat b.#of Floors C.Asbestos Transportation &Disposal 1.Transporter of asbestos-containing waste material from site of generation' a,Directly to Landfill or Evil b.To Tcmporaxy Storage LocationMansfcr Station ECONOWCENAROTECHS,INC. 381NTBWVALE ROAD a Name of Transporter d.Address Note:Temporary FfrCF�URG MA 01420 9783481118 storage of Asbeetos containing waste e.CIVrrown f.State g.Zip Code h.Telephone material Is only allowed at the place of business of a DLS 2, If a temporary storage location/transfer station is used,list name of transporter of asbestos containing contractor Asbestos waste material from temporary storage location/transfer Station to final disposal site: contractor or a transfer station that Is 58 PYLES LANE permitted by SERVCETRANSPORTGROUP MessDEP and a.Name of Transporter b.Address operated in 3027781394 compliance with Solid NEW CASTLE Ct: 19720 Weate Regulations c City/Town d.State a.AP Code f.Telephone 310 CMR 19,000 Revised: 11/13/2013 Page 3 of 04,/10/2018 04:00PM 9783831097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts Department of Environmental Frotection 100278933 BWF A 04 ANF-,001) Q Q Asbestos Project# Asbestos Notification Form tr ProjectRevisioa Project Cancellation C.Asbestos xlransportatlion&Disposal:(coot.) 3.Name and address of temporary storage looatiotVtransfer station for the asbestos containing waste mateaial: RORETRUCIONG WCYCl.F_MSPOSAL 168 AIRPORT ROAD a.Temporary storage Location Name b.Address RTCHBURC, MA- 01420 9783533182 c.City/Town d,state e.Zip Code f,Telephone 4.Name and location of fugal disposal site(asbestos landfill): MQgERVASNTERPRISES INC. WERVAENTERPRISES wC. a.Final Disposal Site Name b.Final Disposal Site Owner Name M955 MINERVA ROAD c.Address WAYNESBURG CH 44688 3308663435 d.Cityrrown e.Slate f.ZJp Code g.Telephone D. Certification HENRY MOSES "i certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PFESDENIT famillar with the information 3 poeition/Troe 4.Data(MM/DD/YYYY) Note:convector must contained in this document and 9184233999 ECONOMIC ENVIROTECHS,INC. sign this Form for US all attachments and that,based notification purposes on my inquiry of those a Telephone 6.Representing individuals immediately 381NTERVALE ROAD FTfCHHURG responsible for obtaining the 7.Address 8.Cityrrown Information,I believe that the MA 01420 information is true,accurate,and s State 10.Tap Code complete.I am aware that there 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 Dapartmerd of Environmental Protection), and that I am aware that this permit application or notifiostion shall not be deemed valid unless payment of the applicable fee is made." I Revised: 11/13/2013 Page 4 of 4 03/06/2018 01:44PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnvlroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 p.978.348.1118 f.978.383.1097 www.ecoenvi rotecit.net TRANSMI'TT.A.L DOCUMENT TO: FROM: Rhonda COMPANY: DATE: Barnstable Board of Health 03/06/18 FAX.- TOTAL NO.OF PAGES INCLUDING COVER: (508)790-6304 5 PHONE NUIaEK SENDER'S REFERENCE NUMBER RE: YOUR REP1rRENCE NUMBER: 307 Main Street,Hyannis,M.A. Good Afternoon, Following please find a copy of the DEP/DOS notification form for the asbestos abatement at 307•Main Street,Hyannis. The project is an emergency scheduled for March 10,through March 12, 2018. Please contact HemT Moses (978) 423-3999 Or myself if you have'any questions. Thanks so much, .Rhonda 03/06/2018 01:44PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts Department of F-nvironmiental ProteCtiOn p I]00 3449 BWP A,Q 04 (ANk'-001) ,Asbestos Project 0 ' Asbestos Notification Form I- 1, Project Revision Project t mcellation A. Asbestos Abatement Description 1.Facility Location: 307 MAIN STREET 307 MAIN STREET Instructions 1.All a.Name of Facility b,Street Address sections of this form BARNSfABLE MA 02601 8026836072 must be completed In order to comply with c.CiVTOwn d,State e.Zip Code f.Telephone MassDEP notification CRY DECKER "ER REPRE5ENTATNE requirements of 310 CMR 7.15 and 9•Facility ContactPerson Name h.Facility Contact Person Title Department of Labor Worksite Location: 1ST FL HUMAN RESOURCESTRAINING OFFICE Standards(DLS) L Building Name,Wing,Floor,Room,etc. notification requirements of453 2. Is the facility occupied? W:a Yes Pub.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 i? b.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 Massachusetts 6.Asbestos Contractor: P.O.Box 4062 Boston,MA 02,211 ECONOMlCEN1AROTECHS 381NTERVALEROAD E.a Name Address FTTCHBURG MA 01420 9784233999 a Cityrrown d.State e,Zip Code f.Telephone AC000459 h.Contmet Type:F 1.Written 2.Verbal g.DLS License# 7. HENWMOSES AS031082 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification#R 8 RAY BRESNAHAN AM900294 a.Name of Project Monitor b.DLS Certification# 9. ENVIRONMENTALSMA"G AND TE5MG LTD AA000132 a,Name of Asbestos Analytical Lab b.DLS CertiAcation# 10. 3/10/201 A 3/12/201 B a,Project Start Date(MM/DDNYYY) b,End Date(MM/DDNYYY) 5P-2A 7A 7P c,work Hours-Monday Through Friday d.work Hours-Saturday&Sunday 11.Wbat type of,project i$this? I— a.Dcmolition R b.Renovation r' c.Repair r- d.Othcr-Please Specify; Revised:11/13/2013 Page 1 of 4 03/06/2018 01:44PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/05 Massachusetts Department of Envirownental Protection 100273449 t BWP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Foxlm r! Project Revision r'": Project Cancellation A.Asbestos Abatement)Description: (coot.) 12.Abatement procedures(check all that apply): r" a.Glove Bag r! b.Encapsulation PF, c.Enclosure r d.Disposal Only r e.Cleanup r f.Full Containment r, g.Other-Please Specify: F 13.Job is being conducted: V a.Indoors r" b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 0 300 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.Lln.FL 2 Sq.Ft , f.Spray-On Fireproofing g.Transite Panels 1,Lin.Ft 2.Sq.Ft 1.Lin,FL 2.Sq.Ft. h.Cloths,Woven Fabrics i.Other-Please Specify: 1.Lin.Ft 2.Sq.Ft j.Insulating Cement f1LE 300 1.Lin,Ft 2.Sq.Ft. 1,Lin.FL 2.Sq.Ft 15.Describe the decontamination system(s)to be used: 3 CHAMBER 16,Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g); (2)e-ML BAGS WETTED 17.For Emergency Asbestos Operations,the MassDSP and DLS officials who evaluated the emergency: .JEFF FINNEGAN ENVIRONMENTAL ANALYST a.Name of MassDEP Offical b.Title of MassDEP Official 3/6/2018 SAW-18-093 c.Date of Authorization(MM/DDr YYY) d.Waiver MpJSSA BUTTS ENVIRONMENTAL ANALYST e.Name of DLS Offidal f.Title of DLS Official 3►51201 a 21995-201 e g.Date of Authorization(MWDDIYYYY) h.VJeiver# 18.Do prevailing wage rates as per M.G.L.c. 149,§26,77 or 27A-F apply to this r a,Yes P b.No project' Revised:11/13/2013 Page 2 of 4 l . 03/06/2018 01:44PM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 Massachusetts Department of Environmental Protection a00273449 BWP AQ 04 `ANF^001) Asbestos Project 0 .Asbestos Notification Form L/ Project Revision F• Project Cancellation D.Facility Description BANK t ' 1.Current or prior use of facility: 2.Is the facility owner-occupied residential with 4 units or less? a.Yes W- b.No TD BANK 70 GRAY ROAD,MAILSTOP ME 3.a.Fadlity,Owner Name b.Address FALMOUTH K 04105 6036578699 c.City/Town d.State e.Zp Code f.Telephone 4. TARRY DECKER SAME a Name of Facility Owners On-Site Manager b.Address SAME ME 04105 8026836072 a City/Town d.State e.Zip Code f.Telephone 5 ECONOMIC B RRO TECH$,INC. 381NTERVALE ROAD a Name of General Contractor, b.Address FITCHBURG MA 01420 9783461118 a Cityrrown d.State e.Zip Code f.Telephone BERI4_EY 9SC ALTY UNDERWRITING MANAGERS g.Contractors Workers Corrlpensation Insurer WCA165205 3n7/zo18 h.Polley# i.Facpirstion Date(MMIDD/YYYY)40000 2 6.What is the size of this facility7 a.square Feet b.#of Floors C. Asbestos'Transportation&Disposal 1.Transporter of asbestos-containing waste material from site of generation: l:.. a.Directly to Landfill or 1 b.To Temporary Storage Location/Trar►sfer Station ECONOMIC EWRO TECHS,INC. 38 INTERVALE ROAD a Name of Transporter d.Address Note:Temporary FTPCIiBURG MA 01420 - 918348111g storage of Asbestos - - containing waste e.City/Town f.State g.Zip Code h.Telephone material is only allowed at the place of business of a DLS 2.If a twiporary storage location/transfer station is used,list name of transporter of asbestos containing licensed Asbestos waste material from temporary storage locatlon/transfer station to final disposal site: contractor or a transfer station that Is 68 PYLES LANE permitted by SERVICE TRANSPORT GROUP MessDEp and a.Name of Transporter b.Address operated in 19720 3027781394 eomplianee with Solid NEWCASTLE CE Waste Regulatlona G City/Town d.State a.Zip Code f.Telephone 310 CMR 19.000 Revisod:111IR2013 Page 3 of 4 03/06/2018 01:44PM 9783831097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts Department of Environnienta.i Protection 100273449 BWP A.Q 04 (ANFt-001) Asbestos Project# r Asbestos Notification Form Project Revision Project Cancellation C.Asbestos Transportatio,u&Disposal: (cont.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: RORETRUMNG RECYCLE901SPOM 159 AIRPORT ROAD a.Temporary storage Looa60n Name b.Address FrrCHBURG MA 01420 9783533192 o.Clty/rown d.State a Tip Code f,Telephone 4.Name and location of final disposal site(asbestos landfill): MINERVAENTE32PRISES INC. MINERVAENTERPRISIES INC. a.Final Disposal SMS Name b.Final Disposal Site Owner Name 8966 MINERVA ROAD c.Address WAYNESBURG CH 44688 33MG3435 d.Chyrrown a.State f,zip Code g.Telephone A. Certification HENRY MOSES I cartify that I have personally 1.Naine 2 Authorized signature examined the foregoing and am PRIE= T familiar with the Information 3 Poattion/Tftle 4,Date(MM/DD/YYYY) Note'Contractor must contained in this document and 9784233999 ECONOMIC e4VM TECHS,INC. sign this form for DLS all attachments and that,based noti9ea6on purposes on my inquiry of those 6.Telephone 6,RepreserNng Individuals immediately 3a INTERVALE ROAD FITCHBURG responsible for obtaining the 7.Address 8.Cityfrown information,I believe that the MA 01420 information is true,accurate,and S.State 10,Zip Code complete.I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment.The undersigned hereby states that 1 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 1 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 03/23./2018 10:40AM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/03 s Economic EnviroTechs, Inc. 38 lntervale Road m Fitchburg, MA 01420 MOW p.978.348.1118 !4� f.978.383.1097D www.ecoenvirotech.netM. �s �.w TR.&NSMITT.A.L DOCUMENT TO: FROM: Rhonda - t COMPANY: DATE: Bamstable Board of Heal& 03/23/18 FAX: TOTAL NO.OF PAGES INCLUDING COVER: (508)79M304 5 pi-tONE NUMBER: SEND IR'S REFERENCE NUM ER: RE; YOUR REFERENCE NUMBER: 307 Main Street,Hyannis,MA Good Afternoon) Following please find a:revised copy of the DEP/DOS notification foxxn for the asbestos abatement at 307 Main Street,Hyannis. Please contact Henry Moses (978) 423- 3999 or myself if you have any questions. Thanks so much, Rhonda 03/23/2018 10:40AM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/03 Massachusetts Department of Environmental Protection 1100273139R] ELect BWP AQ 04 (j ,AI`NF-DOS.) Asbestoss;Project# Pro Revision Notification � �"J Project Revision r' Project Cancellation A. Asbestos ,Abatement Description 1.Facility Location, 307 MAIN STREET 307 MAIN STREET Instructions 1.All a Name of Facility b.Street Address secdons of this form BAR14STABLE MA 02601 8026836072 must be completed in order to comply with c.city/Town d,State e.Zip Code f.Telephone MassDEP notification LARRY DECKER OWNER REPRESENTAIM requirements of 310 h.Facility act Person Title CMR 7,15 and g.FaciFty Contact Person Name �y Cont Department of Labor Worksite location: CQOSET standards(DLS) i.Buitdng Name,Wing,Floor,Room,eta notification requirements of 453 2.Blanket Permit Project Approval,if applicable: CMR 6.12 Approval ID# 3.Non-Traditional Asbestos Abatement Work Practice Approval, MassDEP use only if applicable: Approval ID# Date Received 2/26/2018 3222018 a.Project Start Date(MM/DD/YYYY) b.End Date(MMIDD/YYYY) 2.Submit Original 5P"2A 6P-2A Form To. C.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday commonwealth of Massachusotts P.O.Box4062 1B, Other Project Revisions: Boston,MA 02.2 Note.,Temporary storage of Asbestos containing waste material is only allowed at the plsea of business of a DLS licensed Asbestos contractor or a transfer station that is permitted by MassDEP and operated In compliance with Solid waste Regulations 310.CMR 19.000 Revised:11/13/2013 Pago 1 of 2 03/23/2018 10:40AM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/03 Massachusetts Department of Environmental Protection 100273139R1 L77. BWP AQ 04 (,NF-001) Asbestos Project# Project Revision Notification 17., Project Revision 17; Project Cancellation C. Certificaltion HENRY MOSES HENRY MOSES _ "I certify that I have personally 1.Name 2.Authorized Signature Notes Contractor muss examined the foregoing and am 91gn this form for DLS PR6SDEM 3/22/2018 notification purposes familiar with the informatlon 3.Positionmde 4,Date(MM/DDNYYI) contained in this document and all attachments and that,based 9784233989 ECONOMIC EMgROTECHS,INC. on my inquiry of those 6.Telephone 6.Representing Individuals immediately 38 INTERVALE ROAD FITCHBURG responsible for obtaining the 7.Address 8.Ciry/Town Information,1 believe that the MA 01420 information is true,accurate,and 9 State 10 Zip code complete.I am aware that there 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 7.16 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notiflcadon shall not be deemed valid unless payment of the applicable fee is made." Revised:11/13/2013 Page 2 of 2 05/14/2018 04:17PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnviroTechs, Inc, 38 Intervale Road Fitchburg, MA 01420 p.978.348.1118 f.978.383.1097 www.ecoenvirotech.net TR.A.NSMITTAL DOCUMENT +r0: FROM: Rhonda COMPANY: DATE: Barnstable Boaxd of Health 5/14/18 FAX: TOTAL NO.OF PAGES rNCLUDtNG COVERL (508) 790-6304 5 PHONE NUMBER: SENDER'S REFERENCE NUMBER: RE: YOUR REFERENCE NUMBER; 307 Main Street,Hyannis,MA Good Afternoon, Following please find a copy of the DEP/DOS notification form for the asbestos abatement at 307. Main Street,Hyannis. The project is an emergency scheduled for May 14, through May 16,2018. Please contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda 05/14/2018 04:17PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts Department of Environmental Protection 1100282182 BWP AQ 04 (ANF-001) Asbestos project G s .Asbestos Notification For r Project Revision Project CancellationCa+ .................... ..... r A.Asbestos Abatement Description ry') 1.Facility Location: rX 307 MAIN STREET 307 MAIN STREET � 1 Inatruationa 1.All a.Name of Fadrity b.Street Address sections of this form BA INSTABLE must be completed In MA 02601 B026836072 order to comply with c.Cityfrown d.State e.Zip Code E Telephone MassDEP notification LARRY DECKER OWNEtREPRESENTATIVE requirements of 310 CMR 7.15 and g.Facility Contact Person Name K Facility Conlact Parson Tide Department of Labor Wodcsite Location: NORTHWEST AREA ON SECOND FL Standards(DLS) i,fluliding Name,Wing,Floor,Room,eta notification requirements of 463 2. Is the facility occupied? CZ a.Yes r 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)? 1= a.Yes CZ b.No MassDEP use only 4.Blanket Pennit Project Approval,if applicable: Date Received Approval ID# S.Non-Traditional Asbestos Abatement Work Practice Approval, 2 Submit Original if applicable: Approval ID it Form To: Commonwealth of Maseachusettv. 6.Asbestos Contractor. P.O.Box 4062 Boston,MA 02211 ECONOMICENViROTECHS 381NTERVALE ROAD a.Name b.Address FITCHBURG MA 01420 978Q33999 c.Cityfrown d.State e.Zip Code f.Telephone AC000459 h.Contract Type_IV 1.Written 171,2.Verbal g.DLS Ucenee# 7. HENRYMOSES AS031082 a.Name of Contfactot's On-Site Superviaor/Foreman b.DLS Certification# RAY BRESNAHAN AMS00294 a.Name of Project Monitor b.DLS Certification# 9 FNVIRONMENTALSAMPLINGANDTESIING LTD AA000132 a.Name of Asbestos Analyllcal Lab b.DLS Certification# 10. 5/14/2018 511e12018 a.Project Start Date(MM/DD/YYYY) to End Date(MM/DDNYYY) 8P-2AM NIA c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11.What type of project is this? r a.Demolition Fl! b.Renovation I— c.Repair f-1 d.Other-Please Specify; Revised: 11/13/2013 Page 1 of 4 05/14/2018 04:17PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/05 ..pS1P1lR1>\.fW :. ...:��� Massachusetts Department of Environmental Protection �----? � ` 100282182 BWP AQ 04 (A NF-001) Asbestos Project# �! Asbestos Notification Form r ProjectRevision ev' C' project Cancellation A.Asbestos Abatement Description:(coat.) 12.Abatement procedures(check all that apply): r a.Glove Bag r- b.Encapsulation c.Enclosure r! d.Disposal Only r e.Cleanup C f.Full Conminmextt r!. g.Other-Please Specify: 13.Job is being conducted: W. a.Indoors r b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated! 0 400 1.Linear Feet(Lin.Ft) 2.Square Feel(Sq.Ft.) b.Boiler,Breaching,Duct, c.Transhe Pipe Tank Surface Coatings 1.Lin.Ft 2.Sq.Ft 1.Lin.Ft. 2.Sq.Ft d_Pipe Insulation e.Transite Shingles 1.Lire Ft 2.Sq.FL 1.Lin.Ft. 2.Sq.Ft f Spray-On Fireproofing g.Transire Panels 1.Lin Ft 2.Sq.Ft 1.Lin.Ft. 2.Sq.Ft b.Cloths,Woven fabrics i.Other-Please Specify: 1.LIR Ft 2.Sq.Ft j.Insulating Cement TU_E 400 I.UrL Ft 2.Sq.Ft. 1.Lin.Ft 2.Sq.Ft 15.Describe the decontamination systcm(s)to be used: 3CHAMBER 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): (2)SUL BAGS WETTED 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: JEFF FINNEGAN ENVIRONMENTALANALYST a.Name of MassDEP Official b.Ttie of MassDEP Official 5/14/2018 SAW-18177 c.pate of Authorization(MMOD/YYYY) d.Waiver# MEUSSA BUTTS ENVIRONMENTAL ANALYST a.Name of DLS Official f Title of DLS Offlclal 5/14/2018' 22645-2018 g.Date of Authorizatlon(MM/DDMNM h.Waiver# 18.Do prevailing wage rates as per M.G.L.o. 149,§26,27 or 27A F apply to this r a.Yes b. No project? Revised: 11/13/2013 Page 2 of 4 05/14/2018 04:17PM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 Massachusetts Department of Enviromnental Protection, 100282182 BWP AQ 04 (ANF-001) Asbestos Project# Asbestos n Notifica 'txo Fonn o'eet Revisio Pr rt ' C Project Caricellatiou B.Facility Description I.Current or prior use of facility: BANK 2. Is the facility owner-occupied residential with 4 units or less?r": a.Yes l! b.No 3 TD BANK 70 GRAY ROAD,MAILSTOP ME a.Facility Owner Name b.Address FALMOUTH MA 04105 6036578599 o:City/Town d.Slate e.Zip Code t Telephone 4.LARRY DECKER SAME a.Name of Fadllty Owner's On-Site Manager b.Address SAME MA 04105 8026836072 c.City/Town d.stet. e.zip Code t Telephone 5.ECONOMIC ENVIRO TECHS.INC. 38 INTERVALE ROAD a.Name of General Contractor b.Address FITCHBURG MA 01420 9783481118 c.Cityrrown d.State e.Zip Coda I.Telephone GREAT DIVIDE INSURANCE CO. g.Contractor's Worker's Compensation Insurer WCA2021669-10 611/2018 h.Policy# I.Ekpiratlon Date(MM/DD/YYYY) 6.What is the size of this facility? 40000 z a.Square Feet b.#of Floora C.Asbestos Transportation&Disposal, 1.Transporter of a6bestos-Containing waste material from site of generation; r a.Directly to Landfill or F7j b.To Temporary Storage Location/Transfer Station ECONOMIC ENVIROTECHS,INC. 38 INTERVALE ROAD c.Name of Transporter d.Address Note;Temporary storage of Asbestos FtTpHBURG MA 01420 978348 1118 containing waste e.Clty/lown f.State g.Zip Code h.Telephone material is only allowed at the place of twainesa of a DLS 2.If a temporary storage location/transfer station is used,list name of transporter of asbestos containing licensed Asbestos Contraotoro<a transfer waste materialtemporary�' ran from tem Storage locatioa/tsfer station to;Final disposal site: etstlon that is permitted by SERVICE TRfWSPORTGROUP 58 PYLES LANE MassDEP and a.Name of Transporter b.Address operated in compliance with Solid NEW CASTLE CE 19720 3027781394 Waste Regulations C.City/Town d.State e.Zip Code f.Telephone 310 CMR 19.000 Revised: 11/13/2013 Page 3 of"4 05/14/2018 04:17PM 9783831097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts Department of Environmental Protection BP AQ 04 (ANF-001 iooasi `s2 'W Asbestos Project# Asbestos Notification Ponn Project Revision. r Project Cancellation, C.Asbestos Transportation&Disposal:(court.) 3.Name and address of temporary storage location/transfer stations for the asbestos containing waste • ttlatetial: FIORE TRUCKING RECYCLE&DISPOSAL 158 AIRPORT ROAD a,Temporary Storage Location Name b.Address FITCHBURG MA 01420 9783533192 C.Cityfrown - d,State e.Zip Code t Telephone 4,Name and location of final disposal site(asbestos landfill): MINERVAFNTERPRISES ING MINERVAENTERPRISM INC. a.Final Disposal Site Name b.Final Disposal Site Owner Name 8955 MINERVA ROAD c.Address WAYNESBURG CH 44e8a 3308663436 d.Cltyfrown e.State f.Zip Code g.Telephone D. Certification HENRY MOSES ~I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PRESIDENT familiar with the information 3 Positionfrme 4.Date(MWDDNYYY) NaU;contractor must contained in this document and sign this form roc DLS all attachments and that,based 9784233999 EOONOMICEWROTECHS,INC. notification purposes on my inquiry of those 5.Telephone &Representing individuals Immediately 381NTERVAL.EROAD FITCHEURG responsible for obtaining the 7,Address S.City/rows information,I believe that the MA 01420 Information is true,accurate,and 9.Stare 10.ZIp Code complete.I am aware that there are significant peraltles 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 05/14/2018 03:31PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/03 i aR Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA, 01420 p.978.348.1118 f.978.383.1097 www.ecoenvirotech.net TRANSMITTAL DOCUMENT +TO: FROM: Rhonda COMPANY: DATE: Barnstable Board of Health 5/14/18 PAR; TOTAL NO,OF PAGES INCLUDING COVER: (509)790-6304 3 PHONE NUMBER: SENDER'S REFERENCE NUMBEIL• Rp; YOUR REFERENCE NUMBER, 307 Main Street,Hyannis,MA Good Afternoon, Following please find a revised copy of the DEP/DOS notification form for the asbestos abatement at 307 Main Street,Hyannis. Please contact Heaty Moses (978) 423- 3999 or tayself if you have any questions. Thanks so much, Rhonda 05/14/2018 03:31PM 9783831097 ECONOMIC EN11IRO TEC PAGE 02/03 Massachusetts Department of Environmental Protection „Y• r- 1100278933RI BWP AQ 04 (ANF-001) Asbestos project it Project Revision Notification rvr, Project Revision 1 ! Project Ganccllation -C Pw A.Asbestos Abatement Description •r: 1.Facility Location: 307 MAIN STREET 307 MAIN STREET Instructions 1.All a.Name of Facility b.Street Address sections of this form BARNSTABLE must be completed in MA 02601 8026fd36072 order to comply with c.City/Town d.State e. Code t Telephone MassDEP notlticatlon CRY DEO(ER OWNMREPRMeCATNE requirements of 310 CMR 7.15 and g.Facility Contact Person Name h.Fadlity Contact Person Title Department of Labor Worksite Location: THRC)UGHOUT Standards(DLS) noilfi.✓dtlon L Building Name,Wing,Floor,Room,etc requiremenn of 453 2.Blanket Permit Project Approval,if applicable: CMR6.12 Approval ID# 3.Non-Traditional Asbestos Abatement work practice Approval, MassDEP use Only if applicable: Approval I D# Date Recelved 4/23/2018 5/1442018 a Project Start Date(MMIDD/YYYY) b.End Date(MWDD/YYYY) 2.Submit Original 7A-5P 7A-5P FomlTo: c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday Commonwealth of massachusette BaBoxBaston,M MA 02211 A S. Other Project Revisions: Bo Note:Temporary storage of Asbestos conlaining waste material Is only allowed at the place of business of a DL S licensed Asbestos contractor or a transfer station that is permitted by MassDEP and operated In compliance with Solid Waste Regulations 310 CMR 10.000 1 Revised:11/13/2013 Page 1 of 05/14/2018 03:31PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/03 Massachusetts Department of Environmental Protection 100278933R1 --1 BNR AQ 04 (ANk'-001) Asbestos Project# .p:.... .... Project Revision Notification (r Project Revision P project Cancellation C. Ceirdfication HENRY M0898 NOW Contractor must .I coVy that I have personally 1.Name 2 Authorized Signature slgn Ihls form for DL8 examined the foregoing and am PRSSDENT. nottfloation purposes familiar with the information a.Poeidonn ft 4.Date(MMIDDIYri" contained in this document and 9784233999 ECONOMICENVIROTECHS,INC. all attachments and that,based on my Inquiry of those S•Telephone &Representing individuals immediately 38OJTERVA.EROAD RTC BURG responsible for obtaining the 7.Address 8.Cityrrown Information,I believe that the MA 0142D information is true,accurate,and g state 10,Zip Code complete.I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment.The undersigned hereby states that I have toad 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 l 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 2 of 2 06)'A/2018' 02:27PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 p.978.348.1118 f.978.383.1097 www.ecoenvirotech.net TRANSMITTAL DOCUMENT +TO: FROM: Rhonda COMPANY: AATL: Barnstable Board of Health 6/26/18 FAX: - TOTAL NO.OF PAGES INCLUDING COVER; (508)790-6304 5 PHONE NUMSER; SENDER'S REFERENCE.NUMt3ER: RE: YOUR REFERENCE NUMB 307 Main Street,Hyannis,MA Good Afternoon, Following please find a copy of the DEP/DOS notification fora for the asbestos abatement at 307 Main Street,Hyannis. The project is an emergency scheduled for June 25, through July 31,2018. Please contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda 06/A/2018 02:27PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts Department of Environmental,Protectiont.?100289345 � w BMT AQ 04 A; F-001) Asbestos Project# Asbestos Notification Form µF" r Project Revision 1 . Project Cancellation A. Asbestos Abatement Description 1.Facility Location: 3o7 MAIN STREET 307 MAIN STREET Instructions 1.All a.Name of Facility b.street Address sections of this Form BARNSTABLE MA 02601 8026836072 must be completed in order to comply with c.City/Town d.State e.Zip Code t Telephone MaasDEPnotlflcatlon LARRYDeMR OWNERREPRESENTA71VE requirements of 310 CMR 7.15 and g.Fac ft Contact Peraon Name h.Facility Contact Person Tide Department of Labor Worksite Location: THROUGHOUT Standards(DLS) I.Balding Name,Wing,Floor,Room,etc. nollflcallon requirements of 453 2_Is the facility occupied? Via.Yes rzi b.No CMR 8.12 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 We b.No MassDEP Use Only 4.Blanket Permit Project Approval,if applicable: Data Received Approval I D# S.Non-Traditional Asbestos Abatement Work Practice Approval, if applicable: Approval ID# 6.Asbestos Contractor. EOONOIuItC EWROTECHS 3a iNTERVALE ROAD 9,Name b.Address FITCHBURG MA 01420 97BQ33999 a ottyrrown d.State e.Zip Code f.Telephone AC000459 h.Contract Type:P11 1.Written I!2.verbal g.DLS Lioense# 7 HENRY MOSES A5031 W a.Name of Contracws On-Side Suparvisor/Foreman b-DLS Certification# 8 RAY BRESNAHAN AM900294 - a.Name of Project Monitor b-DLS Certification# 9 F-MJIRONMENTAL SAMPLJNGAND TESTING LTD AA000132 a.Name of Asbestos Analylleal Lab b.DLS Certification# 10. 8/2S/201 a 7131/2018 a.Project Start Date(MMIDDNYYY) b.End Pate(MM/DDNYYY) 6P-5A 8A-8 a work Hours-Monday Through Friday d.work Hours-Saturday&Sunday 11.What type of project is this? f— a.Demolition -1 b.Renovation rs c.Repair r i d.Other-Please Specify: Revised: 11/130013 Page 1 of4 06/2,6/2018 02:27PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/05 Massachusetts Department of Environmental Protection 0p289345 BWP A 04 ANF-001 Q Asbestos Project# r- Project Revision Asbestos Notification Fora 1" Project Cancellation A.Asbestos Abatement Description:(coat.) 12,Abatement procedures(check all that apply): (- a Glove Bag r b.Encapsulation [j c.Enclosure r d Disposal Only i e.Cleanup J- f.Full Containment F g.Other-Please Specify: RED DANGERTAQE 13.Job is being conducted: [:i a.Indoors Cv; b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 2250 1.Linear Feet(Lin.FL) 2.Square Feet(Sq.Ft) b_Boiler,Breaching,Duct, c.Transite Pipe Tank Surface Coatings 1.LIM Ft 2.Sq.Ft. 1.LIM R. 2.Sq.Ft d_Pipe Insulation e.Transits Shii files I.Lin.Ft 2.5q,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.Un.Ft 2 5q.Ft j.Insulating Cement WINDOWS 2250 1.Lin Ft 2.Sq.FL 1.Lin.Ft 2.Sq.Ft 15.Describe the decontamination system(s)to be used: WASHBUCIQ:T 16.Describe the cootainerization/disposal metbods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g); (2)WIL BAGS WETTED 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: i6T FINNEGAN ENVIRONMENTAL AWLYSt a.Name of MessDEP Officist b.Tole of MassPEP OWictal 6/25/2018 SAW-W231 a Date of Authorization(MMlDDNYYY) d.Waiver# MELISSA BUTTS ENVIRONMENTAL ANALYST m e.Name of DLS Official f.Title of DLS Official 612WO18 22961-2010 g.Date of Authorization(MM/DD/YYYY) h.WalveT S.Do prevailing wage rates as per M.G.L.c. 149,§26,27 or 27A—F apply to this Yes b. No projcct7 Revised:11/13/2013 Page 2 of 4 .06/26/2018 02:27PM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 Massachusetts DepaAment of Envirowmental Protection ^ --—'-----T 04 ANF-001 �100289345 BWP A M _ Q Asbestos Project# asbestos Notification Form l� Project Revision r Project Cancellation B.Facility Description 1.Current or prior use of facility: BANK 2,is the facility owner-occupied residential with 4 units or less? f' a.Yes W,b.No 3 TD BANK 70 GRAY ROAD,MAILSTOP ME a.Facility Owner Name b.Address FALMOUTH KE 04105 6036578599 c.City/Town d.State a.Zip Code f.Telephone 4.LARRYDECKER SANS a.Name of Facility Owners On-Site Manager b.Address SAME NE 04108 5026636072 C.CityfLown d.State e.Zip Code t Telephone ECONOMIC ENVIRO TECHS,INC. 38 INTERVALE ROAD S'a.Name of General Conbnsctor to.Address FTTCHBURG MA 01420 9783481118 C.City/rown d.State e.Zip Code f.Telephone GREAT DIVIDE INSURANCE CO. g.Contractoea Worker's Compensation Insurer WCA2021669-12 6IM019 In.Policy# i.Expiration Date(MM/DD/YYYY) 6.What is the size of this facility? 40000 2 a.Square Feet b.#of Floors Mots;Temporary sto*age of Asbestos C.Asbestos Transportation&Disposal containing wasim 1 Transporter of asbestos-containing waste material irons site of generation: material is only allowed at the place r a.Directly to LaadfUl or rv', b.To Temporary Storage Loeation/Tratasfer Station of business of a DLS licensed Asbestos contractor or a transfer ECONOMIC ENVIRO TECHS,ING 38 INTERVALE ROAD station that Is c.Name of Transporter d.Address permitted by MaesDEP and FrrCHBURG MA 01420 9783481118 operated in 6.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: SERVICETRANSPORT GROUP 68 PYLES LANE a.Name of Transporter D.Address NEW CASTLE [>= 19720 3027781394 C.Cityfrown d.State e.Zlp Code f.Telephone Revised: 11/13/2013 Page 3 of 4 .06/26/2018 02:27PM 9783831097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts Department of Environmental Protection 100289345 R:t. •::: SWP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Form r Project.Revision C. Project Cancellation C.Asbestos Transportation&Disposal: (cont-) 3..Name and address of temporary storage location/transfer station for the asbestos containitig waste material: FIORE TRUCKNG RECYCLE&DISPOSAL 168 AIRPORT ROAD a.Temporary Storage Location Name b.Address FITCHBURG MA 01420 9783533192 c.Cityrrown d.State e,Zp Code f.Telephone 4.Name and location of final disposal site(asbestos landfill): MUERVA ENTIEFFR1s1=S INC. MiNEWA,ENTERPRISES INC. a.Final Disposal She Name b.Final Disposal Site Owner Name B955 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 HENRY MOSES "I certify that I have personally 1.Name 2 Authorized Signature examined the foregoing and am PFESIDENT familiar with the information 3.PositionrMe 4.Date(MWDDNYYY) contained In this document and all attachments and that, based 9784233999 ECONOWCENVIROTECHS,INC. on my inquiry of those 5.Telephone 6.Representing individuals Immediately 38 KI-ERVALE ROAD FITCHBURG responsible for obtaining the 7,Address 8.City/rown information,I believe that the MA 01420 information is true,accurate,and 9 State 10.Zip Code complete.I am aware that t ere are significant penalties for submitting false information, including possible dines and imprisonment.The undersigned haraby 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 Departmeni 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 Crocker, Sharon From: Crocker, Sharon Sent: Monday, June 25, 2018 2:52 P To: HeathDeptMailbox Subject: FW: Asbestos Proje - 307 Main St., Hyannis - TD Bank FYI, Asbestos removal at 307 Main St Hyannis will be going on for next two weeks with the exception of July 4th. (See below) Sharon From: Finnegan, Jeffrey (DEP) [ma i Ito:jeffrey.finnegan@state.ma.us] >- Sent: Monday, June 25, 2018 2:21 PM To: Crocker, Sharon Cc: Coyle, Brenda; Baran, Cynthia (DEP) Subject: Asbestos Project - 307 Main St., Hyannis Sharon, Per our discussion, the TD Bank at 307 Main St in Hyannis is about to undergo a window replacement project. The window caulk was recently tested and determined to contain asbestos. As such, an asbestos abatement will remove the windows over the next few weeks. There are over 50 windows and the contractor expects to remove about 4 per day. The contractor plans to begin the work this evening, and will likely not work 4th of July week. Please keep me informed if there are any complaints or concerns. Jeffrey J. Finnegan I Environmental Analyst MassDEP I Bureau of Air and Waste I Southeast Regional Office 20 Riverside Drive, Lakeville, MA 02347 Phone (508) 946-2756 1 Fax(508) 947-6557 1 02/i3/2018 02:39PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnviroTechs, Inc. 38 Intervale Road Fitchburg, MA 01420 ', fxw4 p.978.348.1118 ,. f.978.383.1097 1—h www.ecoonvirotech.net r TRANSMITTAL DOCUMENT TO: FROM! Rhonda COMPANY: DATE Bawstable Board of Health 02/13/18 FAX: TOTAL NO.OF PAGES INCLUDING COVER: (508) 790-6304 5 PHONE NUMSSR SENDER'S REFERENCE NUMBER:R, YOUR REFERENGE NUMBER: 307 Main Street,liyannis,MA Good Afternoon, Following please find a copy of the DEP/DOS notification form for the asbestos abatement at 307 Mein Street,Hyannis. The project is scheduled for February 26,through March 31,2018. Please contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, ` Rhonda r 02/13/2018 02:39PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts Department of Environmental Protection 100273139 13WP A,Q 04 (A►.NF-001) Asbestos Project ,Asbestos Notification Form r.—" Project Revision ' r Project Canceiiation A. Asbestos Abatement Description 1,Facility Location: 307 MAIN STREET 307 MAIN STREET Instructions 1.All a Name of Facility b.Street Address A sections of this form BARNSTASLE MA 02601 8026836072 must be completed in +—J order to comply with a Citylrown d.State e.Zip Code f,Telephone MassDEP notification LARRY DECKER ` OWNCRREPRE.SENTATIVE requirements of 310 h.Faaf Cord Person Title CMR 7,15 and g.Fealif Contact Person Name Department of Labor Worksite Location, CLOSET Standards(DLS) 1.Building Name,Wing,Floor,Room,etc notification requirements of453 2. Is the facility occupied? �/..2.Yes r-,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 Ma4sDEP Use Only 4.Blanket Permit Project Approval,if applicable: Date Received Approval ID# 5,Non-Traditional Asbestos Abatement Work Practice Approval, .r 2,Submit Original ifapplicable: ApprovallD# Form To: Commomvealth of Massachusetts 6.Asbestos Contractor: P.O.Box 4052 381NTERVALE ROAD Boston,MA02211 ECONOMIC ENVIROTECHs b.Address a.Name x FITCHBURG MA 01420 9784233999 C.City/Town d.State e.Zip Code f.Telephone AC000459 h.Contract Type:r 1.Written r-.2.Verbal g.DLS License# 7 1 FNRY MOSES AS031082 a Name of Contractors on-Site Supervisor[Foreman b.DLS Certification# RAY BRESNAHAN AM900294 I3 a Name of Project Monitor b.DLS Certificatlon# 9 ENVIRONMENTAL SAMPLING AND TESTING LTD AA000132 a.Name of Asbestos Analytical Lab b.DLS Certification# 10' 3/31/2018 yZ6/2018 a.Project Start Date(MMUDD/My) b,End Date(M►u!WNYYY) SP-2A SP-2A a Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11.What type of project is this? I— a Demolition 17 b.Renovation!I _• c.Repair I d.Other-Please Specify: Page 1 of 4 Revised:11/13/2013 02/113/2018 02:39PM . 9783831097 ECONOMIC ENVIRO TEC PAGE 03/05 Massachusetts Department of Environmental Protection 100273139 BWP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Form r Project Revision Project Cancellation A.Asbestos Abatemeut DescriP0073: (coot.) 12.Abatement procedures(check all that apply)- r a.Glove Bag r b.Encapsulation SY-1. .c.Enclosure d.Disposal Only r e.Cleanup f,Full Containment r' g.Other-Please Specify-, 13.Job is being conducted. FF. a.Indoors r b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 0 60 1.Linear Feet(Lin.Ft) 2.Square Feet(Sq.Ft) b.Boiler,Breaching,Duct, c.Transitc Pipe Tank Surface Coatings 1.Lin.FL 2-Sq.FL 1.Lin.Ft 2 Sq Ft 4.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.lain.FL + 2.Sq.Ft 1.Lin.FL 2•Sq.Ft h.Cloths,Woven Fabrics i.Other-Please Specify' 1.Un.Ft 2.Sq.Ft j.Insulating Cemont TILEONLY 60 1,Lin,Ft 2.Sq.Ft 1.Lin.Ft 2,Sq.Ft 15.Describe the decontamination system(s)to be used: 3 CHAMBER 16,Describe the containerization/disposal methods to comply with 310 CUR 7.15 and 453 CMR 6,14(2) W.- (2)&ML BAGS WEED 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency' a Name of MwsDEP Official b.Tide of MassDEP Official c,Date of Authorization(mWDDIYYYY) d.Waiver e,Name of DLS Official _ f,Title of DLS OEfidal g.Date of Authorization(MMIDDNYYY) 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 02/13/2018 02:39PM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 Massachusetts Department of Environmental Protection 100273139 $WP AQ 04 (A.NF-001) Asbestos Project# Asbestos Notification Form r'; Project Revision 1~ Project Cancellation B.fiaci)ity Description BANK ' 1.Current or prior use of facility; 2.Is the facility owner-occupied residential with 4 units or less? a.Yes 1 b.No TD BMK 70 GRAY ROAD,MAILSTOP ME 3 a.Facility owner Name b.Address FALMOUTH NE 04105 6036578599 C.Cityfrown d.State e.7Jp Code f.Telephone LARRY DECKER SAME - 4'a.Nsxne of Facility Ownees On-Site Manager b.Address SAME hE 04105 8026836072- e.City/rown d.State e.Zip Code t Telephone ECONOMIC ENVIRO TECKS,INC. 381NTERVALE ROAD 5 a.Name of General Contractor b,Address F17CHBURG MA 01420 9783481118 a City/rawn d.Sta et e.Mp Code f.Telephone BERKI-EY SPECIALTY UNDERWRITING MANAGERS g.Contrsao—es Worker's Compensation Insurer 327/201 a WCA165205 h.PoI1Cy# i.Expiration Date(MIN/DD/YYYY) 40000 2 6.What is the size of,this facility? a.square Feet b.#of Floors C.Asbestos Transportation &Disposal 1.Transporter of asbestos-containing waste material from site of generation, I.- a_Directly to Landfill or I? b.To Temporary Storage Location/Transfer Station ECONOMIC ENVIRO TE6H5,INC. 3a INTERVALE ROAD c.Name,of Transporter d.Address Note.Temporary fiTCl tBURG MA 01420 •97B3481118 storage of AsbesMa h.Tel hone containing waste e.Cibfrown f.State g,Zip Code eP material is only allowed at the plate of buslneas of a DLS 2.If a temporary storage location/transfer station is used,List flame of transporter of asbestos containing licensed Asbestos waste material from temporary storage tocation/transfer station to final disposal site: contractor gr a transfer station that le 58 PYL--S LANE permitted by S�RVICETRMI$PORTGROUP MassDEP and a.Name of Transporter b.Address operated in 19720 3027781394 compliance with Solid NEWCASTLE Waste Regulations o.CityRown d.State e.Zip Code f.Telephone 310 CMR 19-DOD Page 3 of 4 Revised;11/13/7-013 02/13/2018 02:39PM 9783831097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts Department of EnviirOnmental Protection 100273139 I Bw AQ 04 (A,NF-001) Asbestos Project# 4 Asbestos Notification porml r-, project Revision r.7" project Cancellation C.Asbestos Transportation&Disposal: (coat) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: FIORETRUCI4NG RI-C LESDISPOSAL 158 AIRPORT ROAD a Temporary Storage Lomtlon Name b.Address FITCFBURG MA 01420 9783533192 c.Cityfrown d.state e.Zip-Code zipCode f.Te{ephone 4.Name and location of£itaal disposal site(asbestos landfill): MNEWAENTERPwsESINC. MINERVAENTERPRISESINC. a Final Disposal Site Name b.Final Disposal Site Owner Name 805 MINERVA ROAD c.Address WAYNESBURG CH 44688 3308663435 d.cityrrown e.State f.Zip Code g.Telephona p. Celrtificati3OU HENRY MOSES "I certify that I have personally 1.Name 2,Authofted Signature examined the foregoing and am PRESKENT familiar with the information 3 PosltionM1116 4,Date(MMODNY" contained in this document and 6 MI CONOCEMAROTECHs,INC. Note-contractor must all attachments and that,based 978423399g Sign this s form for DLS S.Telephone 8,Representing notification purposes on my inquiry of those .Telep one ROAD Ff*Oi G individuals immediately responsible for obtaining the 7.Address 8.City/rows information,I believe that the MA 01420 information is true,accurate,and 9 State 1 o.Zip Code complete.I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment.The undersigned hereby states that 1 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 Jae is made." Rage 4 of 4 Revised:11/13/2,013 12/08/2016 04:51PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/03 Economic EnviroTochs, Inc. 38 intervals Road Fitchburg, MA 0420 p.978.3411.11 18. f.978.383.1097 www.ecoenvirotech.net TRANSMITTAL DOCUMENT FROM: TO: Rhonda COMFANX: DATE: Bammble Board of Health 12/09/16 FAX; "OT.0 NO.OF PAGES:NCLUDING COVER: (508)79M-"A 4 3 PROVE NUMBER: 5L:rNDER'5 REFERENCk NUMBER: YouR REFERENCE NUMBER: 307 Maid Street,Hyannis,MA Good Aftemomzx, Following please fum a ' ed Ca of the DEP/DOS notification form foz the asbestos abatemezlt t 307 Main Street,Hyannis. a project is rescheduled fort January 2, through January 6;2016. Please contact Hen;ty Moses (978)423-3999 opt myself if you have MY questions. 'l;hanks so pouch, Rhonda 12/08/2016 04:51PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02103 Massachusetts Department of EnviurOnmentai Protection 100255790R1 BWP A.Q 04 (ANC"-001) Asbestos jest# Project Revision Notification r; Project Revision Project Canceliation A.Asbestos Abatement Description l.Facility Location: . 307 MAIN STRFEJ 307 MAIN STREET Instructions 1.AN a.Name of Facility b.Street Address 9ectidns of this form t YANNIS MA 02601 6106063299 must be completed in d.state e.Zip Code f•Telaphone order to comply with c.ckylTovm TIVE MassDEP nOIAQabon HARRY GANDY �A requirements of 310 9 Faa1ity Cantos Parson Name h.Facility Contact Person Title CMR 7.15 and Department of Labor Worksite Location: CLOSET Standards(DLS) I,Building Name,Wing,Floor,Room,etc- nodcation requirements of 453 2.Blanket Permit Project Approval,if applicable: CMR e.12 Approval ID#. 3_Non-Traditional.Asbestos Abaternont Work Practice Approval, MamDEP Uft OFO ifapplicable: Approval ID# Data Received 1120017 1/012017 a.Prom Start Data(WWDDJYYYY) End Date(MMfbQIYYYI� 7A-5P NIA FSubmit prtginel d.We.rk Hours-Sa[urdaY&Sunday Fdtf1 To: c.Work Hours-Monday Through Friday i Commonwealth of Massachusetts P.O.Box4M R. Other Project Revisions: II Boston,MA 022t1 Note:Temporary storage of Asbegos containln9 Waste material is only allowed gkt the place of business of a bLS licensed Asbestos contractor or a tr2nsfar station that Is permitted by MassDEP and operated in Compliance with Solid. ' Waste Regulations 310 CMR 19.000 . Revised:11/13/2013 Page 1 of 2 12/08/2016 04:51PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03/03 Massachusetts Department of Environmental Protection 100255790R1 _ $WP AQ 04 (ANF-001) Asbestos Project# Project Revision Notification [r. Project Revision 17, Project Cancellation C. Cese dfitSdOn NEPIRY MOSES ,,I certify that I have personally t,Name 2.Authorized Signature Nate contractor must examined the foregoing and am PIRESEENT sign this form for DLS notrfrcation Pwpeses familiar with the information 3.Positiontie a.Date(MMIDDIYYM contained in this document and 9794233999 ECONOMIC ENMRDTECtiS�INC. all attachments and that,based on my inquiry of those 5•Temphone 6.Representing individuals immediately 381NTERVALEROAD FffCKBJFtt'' responsible for obtaining the 7.Address a.cityfroom information,I believe that the MA 01420 information is true,accurate,and 9.tote 10.tip Coda complete_I am aware that there are significant penalties for submitting false information, Including possible fines and imprisonment The undersigned hereby states that I have read the Commonwealth of Massachusett8 regulations governing asbestos abatement (453 CMR 8.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that 1 am aware that this permit application or notification shall not be deemed valid unless payment of the applicable flee Is made." Rented:11/13/2013 Page 2 of 2 11/30/2016 04:49PM 9783831097 ECONOMIC ENVIRO TEC PAGE 01/05 Economic EnviroTechs, Inc. 381ntervaie Road Fitchburg, MA 61429 p.978.348.1118 f.978.383.1097 www.ecoenvi rotech.net TRANSMITTAL DOCUMENT FROM: Phonda COMPAr Y: DATE: Bamstable Boatd of Health 11/30/16 FAX: TOTAL NO.OF PAGES INCLUDING COVER: - (508)790r6304 5 PHONE NUNBEK: SENDER'S REFERENCE NL-MBERo RE: YOUR REFERENCE NUM BE 307 Main Street,Hyannis,MA Good Afternoon, Following please find a copy of the DEP/DOS notification form foot the asbestos abatement at 307 Main Sueet, Hyannis. The project is scheduled for December 13,6-tough December 16,2016. Please contact Henty Moses (978)423-3999 or myself if you have any questions. Thanlo so much, Rhonda 11/30/2016 04:49PM 9783831097 ECONOMIC ENVIRO TEC PAGE 02/05 Massachusetts DeFartMent of Environmental PrOteCdOn 100255790 $WF AQ 04 (ANC'-001) Asbestos Project# Asbestos Notification Form r" oject Revision r, Project Caneellatlon A.Asbestos Abatement Description 1.Facility Location, 3W MAIN STREET 307 MAIN STRUT Instructions 1_All a.Name of Fatality b.Sheet Address sections of this form plYANNIS MA D2601 610BD63299 must be completed in order to comply with C.CilyRown d.State e.Zip Code f.Telephone MamDEPnotification HARRYCrANDY OW4mRs3RE.SEIVTATIVE= requirements of 310 h.Facility Co Person Ti>te CMR 7.15 and 9•Facility Contact Perron Name rcy med Department of Labor Worksitc.Location: CLOSET Standards(DLS) i,Building Name,Wing,Floor,Room,etc. notification requirements of 453 2. Is the facility occupied?F a.Yes C 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)? ri a.Ycs V b.No MassDEP Use only _ 4,Blanket Permit Project Approval,if applicable: Date Reoeived Approval ID# 5-Non-Traditional.Asbestos Abatement Work Practice Approval, 2.Submit Original if applicable: Approval 10# Form Toc commonwealth of Messachusett9 6.Asbestos ConbActor: P.B.Box4082 Boatnn,MA02211 ECONOMMIC9MROTECHS 35INTERVALI=ROAD a Narne b.Address A1CHBURG MA 01420 9794233999 t~CftylTown d.9tata e.Zip Code f.Telephone AC000459 h.Contract Type:W 1.Writtm r'2.Verbal 9,DLS License# 7,HENRYMOSES A5031082 9.Name of Contractor's On-Site Supervisor/Foreman b_DLS Certificstion# 8. SUCE.5H MAN SMH AM03190 a.Name of Project Monitor b.DLS Certification# 91 ATC GROUP SEFMCES INC AAo0DD07 a,Name of Asbestos Analytical Lab b.DLS Certifioatim# 10. , 12/1T D16 17Ji612016 a.PMdzt Start Data(MMIDI)NYYY) b.End Date(ML4 bbM'Y1) 7A-5P NIA c.work Hours Monday Through Friday d.Work Hours-Saturday&Sunday 11,What type of project is this? r a.Demolition.IF b.Renovation Ir c.Repair F.- d.Other-Flease Specify: Revised:11/13/2013 Page 1 of 11/30/2016 04:49PM 9783831097 ECONOMIC ENVIRO TEC PAGE 03105 Massachusetts Department of Environmental Protectian 1 b0255790 S'WP AQ 04.(A�Tk'�001} Asbestos Project� L Asbestos Notification Form Project Revision h, .Project Cancellation A.,Asbestos Abatement Description: (court) 12.Abatement procedures(check all that apply): r a.Glove l3ag r` b.Encapulation W! c.Enclosure F, d.Disposal Only r a Cleanup f Pull Containment r, g.other-Please Specify: 11.Job is being conducted F. a.Indoors r b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACNA)to be removed,enclosed,or eticapsulated: 60 1,f-inear t:eet Nn.Ft) 2.Square Fed(Sq.R.) b.Boiler,Breacbiing,Duct, c.Transite Pipe Wank Surface Coatings 1•Lin.FL 2 Sq.Ft 1.Lin.Ft 2,Sq.Ft d_Pipe Insulation C.Transite Shingles 1.Lin.Ft 2,Sq,FL 1.lin_Ft 2 Sq.FL f.Spray-On Fireproofing g.Transite Panels 1.Lin.Ft 2.Sq,FL 1,Lip.Ft 2.Sq.R. h.Cloths,Woven Fabrics 1.Other-Please Specify: 1.Un.FL 2 Sq.Ft j.In6ulatiog Cement TILE ONLY so 1.Lin.FL 2 Sq.Ft 1.Urt Ft 2.Sq.FL .15.Describe the decontamination system(s)to be used: 3GHAMSER 16.Describe the eontainerization/disposai methods to comply with 310 CMR 7.15 and 453 CMIZ (g): (2)6MtL BAGS 1NE7rED 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: a.Name of MgssDEP Offir el b.Title of f4a=05P Official a Date of Authorization(MM/DDIYYYY) I Waiver# e.Name of DLS Official f.Tide 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 ,a Yes b.No Project? Revised!11/13/2013 Page 2 of 4 11/30/2016 04:49PM 9783831097 ECONOMIC ENVIRO TEC PAGE 04/05 Massachusetts Department of Environmental Protection 100255790 BwP A o4: AvF-oarl Q ) Asbestos Project 4 Asbestos Notification Form r" Project Revision Project Cancellation B.Facility Description 1.Current or prior use of facility: BANK 2.Is the facility owner-occupied residential with 4 units or less?r a_Yes b_No 3 TD BANK 70 GRAY ROAD,MAILSTOP ME a Facility Owner Name b.Address FALMOUTH NE 04105 6036570599 C.Cityrrawn d.state e.Zip Coda f.Telephone 4.MARRY GANDY SAME 9.Name of Facility Ownees On-Site Manager b.Address SAME WE 04105 6108063299 a City1rown d.State e,Zip Code t Te*trone $ ECONOKC RURO TECHS,INC. _ 38 IN[MRVALE ROAD a Name of General Contractor b.Address Ff ViBURG MA 01453 978M1118 a Cityfrown d.state e.Zip Code f.Telephone BERKSKRE HATHAWAY GUARD g.Contractor's Worker's Compensation Insurer R2WC854881 120112016 h.Policy# i.Boration Date(MMA)DNYY11 "- b.What is the size of this facility? 40000 2 a.Square Feet b,#of Floors C.Asbestos-Transportation&Disposal 1.Transporter of asbestos-containing waste material from site of generation: a.Directly to Landfill or Fri b.To Temporary Storage Location/Transfer Station ECONOMIC Qd RO TBCHS,INC. 38 INTERVALE ROAD e.Name of Transporter d,Address NoM Temporary storage of Asbestt HTCBHURG MA 01420 U83491118 containing waste e.a1yrrawn f.State g.Zip Code h Telephone material Is only allowed at the place of business of a DLS 2.If a temporary storage location/transfer station is used,list name of transporter of asbestos containing licensed Asbestos contractoror a waste material from ttmlp°�storage location/transfer station to final disposal site: or Lansfu station that Is permitted by &SWCETRANSMUGROUP Sa PYLES LANE MessDEP and a.Name of Transporter b,Address gperated In compliance with Solid NEWCASTLE IF 19720 3027731394 Waste Regulations c 310 CMR 1 B.BDo Ciry/Taun d.State e.Zip Cede f.Telephone " • Revised;1111Y2013 Page 3 of 4 11/30/2016 04:49PM 9783631097 ECONOMIC ENVIRO TEC PAGE 05/05 Massachusetts Department of Environmetltal Protection 100255790 $VIP AQ 04.(AI,N -001) asbestos Project# Asbestos Notification Form 1-1. ]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 matctiial: FIORE TRUCKING RECYCLE&DIwOSAL 160 BENSON STREET a.Temporary Storage I-Pmtion Name b.Address FnUiBIM MA 01420 9783533192 a Cityrrawn d.State e.Zip Codt f.Telephone 4.Name and location of final disposal site(asbestos landfill). MINEFWAENTEVPRISESNC. MINERVAEN`rEFd3RkqESM. a.Finai Disci Site Name b.Final Disposal Site Owner Name 8955 MINERVA ROAD c,Addra69 WAYNESBURG CH 44688 3308%3435 d.Cityfrown e.State f.Zip Code g.Teephone D. Certification HEAIRY M05'ES °I certify that I have personally 1.Name 2.Authorized signature examined the foregoing and am PRESIDENT familiar with the information S.Posifion/Tille 4.Date(MMIDD"W) Note;Contactor must contained in this document and elan thle form for DLS all attachments and that,based 97842339g9 ECONOMICEPMRPT�BS,Ii+IC, notification purposes on my inquiry of those 5.Telephone 6.Representing individuals immediately 381NTERVALEROAD FITCHRM responsible for obtaining the • 7.Address 8.Citylfown Information,I believe that the MA 01420 information is true,aecurste,and 9 State 10.Zip Code complete.I am aware that there 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." Reviscd:11AV2013 Page 4 of 4 06/26/2012 15:56 9783831097 ECONOMIC ENUIRO TECH PAGE 01/03 5 ,y. . . ECONOMIC EWRo TECHS, INC. TRANSMITTAL DOCUMENT TO; FRO.V! Rhonda C;c7�IFAN v; Vnrr: Barnstable Board of Health 06/26/12 1.'Ax NUMBER: (508) 79C-63N TOTAL NO.OF PAGES INCLUDING COVER! 3 P'HONF.vUiVtRrit: SENDLR'S R%FERF.NC'E NUMBER: RED 307 Maim Street, Hyannis, YOLI,R REFF,.RENf,F.NUMR.T;R; To Whom It May Concern, Fallowing please find a revised copy of the DfiP/DOS noti.lication form for the asbestos removal at 307 Main Street. The pro)ect has been rescheduled for July 10, through July 11, 12. Please feel free to contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda } 38 Interval.e Road, Fitchburg, MA. 01420 Phone: (978) 348-1118 Fax. (978) 383-1097 L I 06/26/2012 15:56 9783831097 ECONOMIC ENUIRO TECH PAGE 02/03 Massachusetts Department of Environmental Protection - 1001491 � Bureau Of Waste prevention —Air Quality Decal Number".----Project Revision Notification I For Asbestos Notification ANF-001 and AQ 06 Important A. Facility When rtlling out Location forma on the t•--._,".".__._...,M.­- - 1,.,,--.__ computer,uss 1307 MAIN STREET `._,,,,�...�.,.,. key fah 1 one the Y .NamaoFFaCility —•",•"'"—,","."`—`^,.�--�^-�-., � to move,your cursor-do not 1307 MAIN STREET z.Street Addrass __... use the return _._._._........,,....._..-_. .,.�_— _...._......._._.......__�,,._ .,` kcy- HYANNIS _................... ...j _ — � 3,City -- L_•.,._.__.,—.__..,— , 4.State -- -- ....._.._._.. 5.Zp Cade 6.Telophone Number "'21— INSTRUCTIONS B. Project Cancelled 1. This form iS only available for ;—I Check here if this project is/was cancelled. online filing of project dale revisions. 2. Enter project decal number. C. Project Dates — 3. Validate that I -----'"----- the project ".— r...._— ....... ...__............ - a6/2712012 location is correct 1,Ori nal S[art o $!.-........... ale(mrNdd!._._....,.... ---_ _,.,._,—_,".. 2 t7rl for me entered i - .__•__.._._...,.._..._._......,.._._ _,_,,.,>�,—.FQd��>7e„ m/ decal. 3.Latest RevlsEd Stem Date(mrn/dd ""—•""""-- —"`-' I 4. Enter your new 4-Latest Fi2vieed End D2ta(mmldd/yyyy) project dates. S. Certify your notification, D. Revised Project Dates Submit date — Changes. 071111Z012 Start Date(mmlddlyyyy) -""""'--`-'� —'�^"� _ e 1S3d End Date + �"�-----•�-�• E. Other Project Revisions - i — i t ' i I I t k F. Revision History i .......... ................_...._................_........... I enf061)dm.doc•rev.215104 06/26/2012 15:56 9783831097 ECONOMIC ENUIRO TECH PAGE 03/03 'L Massachusetts Department of Environmental Protection) 10o14s10$ Bureau of Waste Prevention �����.�`~�• on—Air Quality �iag rvumbe�- -�--- ....: _ ro,ect Revision Notification For Asbestos Notification ANF-001 and AQ 06 G. CertiftatiOn The under8igned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 6.0()and 310 CMR 7.15,and that the Information contained in this notlfleation ig true and correct to the best of his/her knowledge and belie{. ,........__... ... .._ .._. ,HENRY MOSES......- - ._._....._.. ...................._......,......_........._.. I.....:...._ame........_._........-- _....-..... rizetl s' JPRESIDENT _..�i -.__ .. ------ -- u �.__4, �Qrlatur 2 _ _ Positianlrilte -� ECONO m/eg� MIC EN _—.. •, ----^-- VIRO TECHS, INC, L(878)348-1118 •--�---_.....—_._ 5. hone ---.....,,_....__..,_. 38 INTERVAI.E ROAD �- ^�! ""`� �_...._._.._..._. t FITCHBUW 7,City/TOwn �`...._ „�_.- --,� �0142p �.` — •i nnfoepdrn.doc-rev.2/$104 0W11/2012 10:16 9783831097 ECONOMIC ENUIRO TECH PAGE 01/03 . E LRoTECIRS,NOMIC INC. TRANSMITTAL. DOCUMENT To: FROM; Rhonda COMPANY: DATI,.: Barnstable Board of Health 07/11/12 r'xX NUMBER: TOTAL NO.Or,PAGES INCLUDING C0Vx,R; (508) 790-6304 3 1'HONF NUv1.TwIR; SENDER'S 1UTE-RENCF..NUM3ER: Hr: YOUR R.EFF..Rf(nICE NUMBER: 307 Main Street,Hyannis,MA To Whom It May Concern, Following please fiond a revised,copy of the DEP/DOS notification foam for the asbestos removal at 307 Maim Street. The project has been rescheduled.for July 17, through July 24, 2012. Please feel free to contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda 38 Intervale Road, Fitchburg, MA 01420 Phone: (978) 348-1118 Fax: (978) 383-1097 07/11/2012 10:16 9783831097 ECONOMIC ENUIRO TECH PAGE 02/03 Massachusetts Department of Environmental Protection 10014s108 Bureau of WaSte Prevention —Air Quality ❑ea!Number ' Project Revision Notifications I For Asbestos Notification ANF-001 and AQ 06 ImportantWhom filing A. Facility Location When filing out forms on the — -Y� ----computer,usA 4,L MAIN STREET _T�� i only the tab key 1.Name of Fatality — -^ -•• -•—_ —__ , to move your �,.._.._—_ .,,,.....— _. .........—.. , cursor-do not }307 MAIN STREET __............_,........ 2.5treclAtldreag _._......__..._.._—T.,.,,.,,.,.,, ---..._. use the return _._...... �.,......._...._...._._..-...... key. HYANNIS ) ----- ,,.,u�.----- •,.�( rr._.,.,.,....,.__.._..�,,,,,,..----...,.,,,.,,.z s..........._._..-.._.................. MA 11. 3.Clty ......._-._.._.-.. ........._.__....._...... �- - - --- -- ....... �i.i___-._.... ..i-. I_,,..,.....-. 5.Zip Code -...,,.,................................ „• t3.Telephone Numbar _----, .--- INSTRUCTION$ B. Project Cancelled 1. This form IS only available for i Check here if this project is/was cancelled. online filing of — pr0d date revisions. 2. Enter project decal number. C. Project Dates 3. vaildate that .............. ...........................the project i06/26/2012 f 06127/2012 ; — _.- ..__.._._.._.. ff ---- -- -----..—.. I..,.,..,,,M ocatlon is correct 1.Origins-Stara Date imMdd _—_..-.._,•„_,__—__, ,,, ' >�vxv.)..- z.odaJ;•I�I,Er,a I%�("m•d„gryy for the entered ;0 711 012 0 1 2 { ` decal. �------..^^,^,., 0711312012 3.Latest Revised StArt Date mm/dd! '-"•""'�-------• -- 4. Enter your naw ( `) 4,Latest Revised Entl Date{mm/ddlyyyy) pro01-0 dates, S. Certify your noti(lcaflon. D. Revised Project pates Submit date changes. —..,•^^.,..,....... ___,�,.�,.... ----„�.-°.°^ _-... 0 711 7120112 t 07/2412012 -_--- 1.RevlseC Start Date(mmlddlYYYY) 2.Revised End Date Date(mmlddlyyyy) E. Other Project Revisions - _ __._._..,,..,.,._,...._.-....._......�.._.._.— F. Revision History ........_._......................... {EDEP: 06/2612012 04:16;03 PM ;EDEP: 07/1012012 10:46:02 AM i I ..__........,...........,,...................................................—....-...............,..------ anF06pdrn.doc•rev.2/5/44 07/11/2012 10:16 9783831097 ECONOMIC ENUIRO TECH PAGE 03/03 M� Massachusetts Department 1 � of Environmental Protection 9Uo�as1D8 •_- ,,—_, Bureau of Waste Prevention—Air Quality °Lice, Yzaslir Project Revision Notification For Asbestos Notification ANF-001 and AQ 06 Certification The undersigned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 8,00 and 310 CMR 7.15,and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. _..... ............._....._._.._.................. ................._....._........ _.._.__.._.._.� ;HENRY MOSES . . .................................. ..................._.._.__......... ..,_ t. Name. A-ithorize 3lstnaiure--.. . PRESIDENT S _ _._ .._..,.._.._.._._................. _. 2. Posfilonllrlge 3. D e m/dtlJ """ ------_ 'ECONOMIC ENVIRO TECHS,INC. I(978y 348�1118 138 INTERVALE ROAD -i --- -— _.._........................ — ------ - !FITCHBURG ` a 0142 ----- ,.....�.....�i w...�.�_..��. _. 7. Cityltow n 9. zip Code ---^-"�.`--- - - anfp6pdrn.doe•rev.2/5/O4 JU /11/2012/WEIi 09:28 Ali C.O.M.M. Fire Dept FAX No, 508-760-2385 P. 001 CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Falmouth Road, Rte. 28 Emergency Number: Centerville,MA 02632-3117 9-1-1 Business:(508)790-2375 John M. Farrington Facsimile:(508)790-2385 Fire Prevention/Administration Chief of Department Facsimile: (508)957-8239 Dispatch Center FAX COMMUNICATION MESSAGE DATE: ( I�• TO: 1.Jt .�� l Y! PHONE: ATTN: FROM: r WE ARE SENDING{ ) PAGES, INCLUDING THIS COVER SHEET. PLEASE CALL(508)790-2375 IF YOU DO NOT RECEIVE THE TOTAL NUMBER OF PAGES. CONMENTIALITY NOTICE: This fax transmission may contain confidential information belonging to the sender and such information is legally privileged an(is Intended only for the use of the individual or entity named above. Any copying,disclosure, distribution or dissemination of this information or the taking of any action based on the contents of this communication is strictly prohibited. If you have received this transmission In error, please notify us immediately by telephone and return the original transmission to us by mail or delivery at our address above. We shail cover the cost of retum mail_ Thank your �'A j +v JU /11/2012/WED 09:29 AM C.0.M.M. Fire Dept FAX No. 508-i60-2385 P. 002 MM DD YYYY NFIRS -1 ❑Delete 01920 U 1 07 1 1 071 1 2012 12 112-0001884 I 000 ❑pTange ljdgjC MID ,A, stata* Ineldent Pete * Station Incident Number * exposura * ❑No Activity Chaak e'.is box to Indite chat .oak... ra the k thi.ii ..c,dmt i.pro Li an tp.91141ug Firs Cens118 TYdeC B Location* �aadula en s Indicate _Lion a^Ale.m.tly.1.utien 1,'i wtian°. only for N1141AW fins, ®Street address 330 " IWEST FAY RD ❑Intersection[-]in front Of Numbet/Hilepost Prefix street or FS hwa s Y street Type suffix I I ❑Rear of l� JOSTERVILLE I MA 02655 Apt./suite/Ream❑ndjacant to city state 21p Coda ❑Directions , Croce street or directions. as applicable Incident Type * Midns,ght is 0000 YF� �, 1 Data & Times E2 Shift & Alarms Qr 3 Oil or other eomhustible li ;Q Check bcxea if Month LOCal Qp=ioa Day Year Hr Min Sec Y?eident 3 e dates are tho same as Alarn ALARM al—ways sequSred 17 4 I I na`°' I Coin 3 Aid Given or Received* Alarm 11: 0 I hift or Alarm DistrictI 20, KatooA ARRIVAL. required, unlass canee:e4 Cr did not arriVs ]. ❑AIIltual aid received I � I ❑ ElArrival* ' 07 07 2012 20:17:16 E3 2 AutOmatxC aid reCQ. Their F'[lIn Their 3 [:]Mutual aid given State CONTROLLED Optional, Except for wildland fires Special Studies 4 ❑Autonatic aid given ' I ❑controlled u " I ^ 11__ I Lo_el opcioa 5 ❑Other aid given Their LAST UNIT CLEME, required except for wildland fires Incidont Number Last Unit N ®None 07 07 2012 22:20.16 st"Y Top St°offal ❑ Cieargd u U �� Study value ri Actions Taken* G1 Resources* G2 Estimated Dollar L0S$e8 & Valuee ❑ Check n 1E an Apparatus or bin box and skip this section LOSSES: R°quire4 ;Or all. fixes if known. Optional IOY nor tIY68. 73 Provide manpower Personnel torn is used. Ncrfte I Apparatus Parsormo:L Qza rt 000 000 pYlna[y Action Taken (11 � y � � 1 ❑ I �' '75 Supprses�an $I(Provide equipment I contents i 000 000 ❑ Additional Action Taken (2: EMS PRE-INCIDENT VA'Lt7E: optional, �( y g I Other 1 OOD3J 1 00051 $1 00�0 lJ 82 lNoti£ other agencies. Property. 000 i 000 Additional Action Taken (97 ❑ Check bCX li resource counts Include ald received rezoirces. Contents $I 000 , 000 ❑ Completed Modules g1lfcasualt"EINone A3 Hazardous Materials Release j Mixed Use Property ❑Fire-2 Deaths Injuries N []None Not Mixed 10 Asaenbly use ❑Structuxe-3 Fire U I I j ❑Natural Gas: ,low 1enk, 20 RdUCtition use ElCivil Fine cas.-4 sarviro L1 civil ❑Propane gas: �i Yn. c..c :..sn k­220 emu: 33 Medical use Fire 8esv. Cas.-5 civillanl____y,�� 3 Gasoline', a.aiai.ty.i t,,ak of portable aanteimx 40 Residential use 51 Row of stores ❑EMS-6 H2 4 Li it 1 lnkmiav.a is>emt oortbl..tas.p. �tector a 53 Enclosed male ❑HazbMt-7 Required for confined sires. 5 ❑Diesel fuel/fuel oil:_mai.sv.1 teak_pastanl. 58 Bus. & Residential Wildland Fire-8 solvents; n 1❑beteator alorted occupants 6 ❑Household l t ovefof[ioe spill,eleanny oolp 59 Office use Q ApparatLs-9 7 ❑Motor oil: fbem.hti-a:yart.Ll.aent.i— 60 Industrial use FX1Personnal-10 2❑nat4ctok+did not alert them 8 ❑p yt: 63 Military use pint a>a�:otaL'aq a as g.3loaa &5 Far use ❑ILC9tln-11 uEl Vnkavwa o ❑other: aP` -A Ramat.ations xegaixed u spill,66°aL., 00 Cthar mixod use m P1*aae o It the Xasuae fay J Property Use* structures 341❑clinic,clinie type Jnfirmagy 539 L,J Household goods,sales,repairs 342❑nootos/dentist office 579 ❑motor vehicle/boat sales/repair 131 ❑Church, place of worehip 361❑Prison or jail, not juvenile 5-71 ❑Gat or servica station 161 ❑Rsstaurant or cafeteria 419❑I-or 2-fami1 y dwpiling 599 Business office 162 (]Bar/Tavern or nightclub 429❑Xulti-family dwelling 615 ❑Electric generating plant -3- 'E1Vm1 Zf Ira id�r arteri - ... ❑ _�..-..-._-._4-._-_.-4�9_ Rooming boardinq�iouee _•-•-_-•6-1•�'❑_Ltiboratoiy/science.lab •---,-•--.. _ _ 215 ❑89.gY: school or junior high 449❑commercial hptol or mtel 70Q ❑Manufacturing plant 241 ❑College, adult education 459❑Residential, board and care 819 C.Livestock/poultry storage(bara) 311 ❑care facility £or the aged 464❑Dormitory/barraoka 882 ❑Nall-residential parking garage 331 ❑Hospital 519 Q POOd and beverage sales 8 91 ❑'Warehouse Outside 936[]vacant lot 981 ❑const:r4ctj,pc, site 124 ❑Playground or Dark 938 ❑Graded/aaze for plot of land 984 ❑ Industrial plant yard 655 ❑Cxope or orchard 946[]Lake, river, stream 669 >rorest timberland Leokug and enter a property Use cede only if ❑ (timberland) 951Railroad right Of way you have NOT cheered a Pzoporty use.1`ox: 807 ❑Outdoor storage area 960 Other street ❑ Property use 89$ 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway 931 ❑Open land or field 962 ❑Residential street/drivsway (Dock, marioa, pier, wharf I NFIRS-1 Revision 0,3 11 99 f.'T CONM Flre """ 01920 07/07/� 2 12- 001884 JUVI li 2012AED 09: 29 ANY C.0.M.M. Fire Dept FAX No, 508-i 60-238F P. 003 Erl Porson/Entity Involved lBartor_ & Gray Mariners Club 1508 - 737 - 6222 Local Cptlon ausiness name ;if applicable) Area Code phone Number U [Wi.1.Uam [HeiserCr,ac u ❑-Same ddreTMs sox if i k_ms„ lore. IPira= Name MY Last Name 8 am4 adtlYeBa 88 S :ix incident location. T'rien skip the three 1-0 Ste hen DR u duplicate address Number prefix Street Or)lighway. street Type linen. YP Su!!Sx CHATRAD4 Pcst Orfica ROY Apt.(Suite/T140n C_ty u 02633 State zip code ©More people involved? Cheek this box and attaAh supplwwntai. v*4%$ (AIIRS-16) as necessary K2 owner El Same as Person %ZolvadP Rhen chock this box and skip be rest OZ this section, u u Local option Business name )if Applicable) Dre& Code Phono Afuober u I I � u Check this box 1! uY„Ns„ Mre. E"irst Name P¢ Last Name surf LJ same inc �ddident los as u u The"sk1 location, Then skip the three I� duplicate address Vumbar Prefix Street or ffighway street Typo suffix lines. { I ' f Posr Office Box Apt./suita/noon City State 21G Code L Remarks Local Opticn Caller Name : BPD Caller Phone : PLT OIC : ELORIDGE Pats. : 0 AGR : NINone lmotte ; 2012/07/07 20:17:16 - 304 AT EVENT MANNING IS 3 emmobile ; 2012/07/07 20:21:43 -- 321 AT EVENT MANNING IS 1 lmotte 2012/07/07 20:47:29 - (RB) - 328 AT EVENT MANNING IS 1 _motte 2012/07/07 20:49:30 - 322 AT EVENT MANNING IS 2 -motte 2012/07/07 20:12:54 FUEL SPILI, IN THE WATER lmotte ; 2012/07i07 2C:16:46 PH TO BOB SALMONNE 506-280-0412-LARGE AREA AT TOWN BOCK, TRYING TO FIGURE WHICH BOAT/TO 321-TRY CALLING HARBORMASTER lmotte ; 2012/07/07 20:18:52 304-INVESTIGATING A STRONG ODOR lmotte ; 2072/07/07 20:25:2C PH TO DAN MORN/HARBORMASTER-GAVE REPORT FROM 304 BELOW -AS LONG AS $OAT WAS FOUND AND LEAK HAS-'STOPPED-,"NOT "RESPONDING. .. .. _... .. ._. . ..... ..: .... ....... ...... _.. .. L Authorization [8260 IELDRIDGE, BYRON L. IICAPT _j IShi€t Comm 1 071 LL17J 1 2012 Officer in charge ID _ signature position orrank Assignment month nay Year - " loxie® 16260 I ELDRIDGE, BYRON L. 1CAPT 18hi€t Comm 1 L 1 U 2012 aame - Position or rank Assignment NentY. Day Year as officer Nembar making report ID Signatire ire cparga. cots. Fire 01920 01/07/2M 12-0001964 JUL/11/2012/WED 09:30 Alf C.0.M.M. Fire Dept FAX No. 508-760-238F P. 004 mull uu S t i I 1 01920 U � 2012 �2� 12-0001884 000 complete FDIC * stata* Inowent Date * station Incidant Nuabar * � alma * N8rrati'v0 Narrative: Caller Dame : BPD Calle;- Phone : PLT OIC : ELDRIDGE PaLts. : 0 AGR : N16one lmotte ; 2012/07/07 20:17:16 - 304 AT EVENT MANNING IS 3 emmobile ; 2012/07/07 20:21:43 - 321 AT EVENT MA_'VNING IS 1 lmotte ; 2012/07/07 20:47:29 - (RB) - 328 AT EVENT MANNING IS 1 lmotte ; 2012/07/07 20: 49:30 - 322 AT EVENT MANNING IS 2 lmotte ; 2012/07/07 20:12:54 FUEL SPILL IN THE WATER lmotte ; 2012/03/07 20:16:46 PH TO BOB SALMOINNE 508-280-0412-LARGE AREA AT TOWN DOCK, TRYING TO FIGURE WHICH BOAT/TO 321-TRY CALLING HARBORMASTER -motte ; 2012/07/07 20:18:52 304-INVESTIGATING A STRONG ODOR lmotte ; 2012/07/07 20:25:20 PH TO DAN HORN/HARBORMASTER-GAVE REPORT FROM 304 BELOW -AS LONG AS BOAT WAS FOUND AND LEAK HAS STOPPED, NOT RESPONDING lmotte ; 2012/07/07 20:25:41 304-FOUND THE BOAT, STOPPED THE LEAK, LARGE DIESEL SPILL lmotte ; 2012/07/07 20:36:33 PH CAPT ELDRIDGE-AROUND 10 GALS, MADE ALL NOTIFICATIONS, ALSO NEED SOMEONE TO BRING A SPILL DRUM THAT WILL SOAK OIL IN WATER lrlotte ; 2012/07/07 20:37:23 STA 1 COV-LEHANE lmotte ; 2012/07/07 20:39:35 PH TO DONNA MIOR"Ot-420-3149-BOH--10 MIN ETA lmotte 2012/07/07 20:43: 40 - ....Rg--T0--WGG-MARI-NE-8A1'FrT•Y--G. V 9R-T--1-4 R-2-T —(•USC-G— - lmotte ; 2012/07/07 20:49:35 PH TO NRC-GAVE ABOVE, REPORT NUMBED. 1017028 lmotte ; 2012/07/07 21:07:23 PH JOLIE/MOEP-NEED TO SPEAK TO SOMEONE DIRECTLY ON SCENE. GAVE HER CAPT ELDRIDGE CELL # lmotte ; 2012/07/07 21-31:1.0 PH TO KEN GAULT -NAUTICUS MARINE (PER CAPT ELDRIDGE)-GAVE SITUATION, THANKED ME FOR ADVISING HIM. COMM Fire 01920 07/07/2 M 12-0001884 JUL/11/2012AED 09:30 Ali C.0.M.M. Fire Dept FAX 11o, 508-760-2385 P. 005 MM DE) YYYY u u L 7 uJ late OL920 MA 7 7 2012 � 2 ` I 12-CC01884 000 Naz�tiva b'DID ,k 3LatQ , InCi4Ant DdtB * Station Incident Number .k ExposurQ Narrative: lmotte 2012/C7/07 21:46:33 PH CAPT ELDRIDGE-NEED THE HAZ MAT TRAILER W/317 HERE (STILL WAITING FOR THE CG) -motte 2012/07/07 21:47:20 STA. 3 COV-GELI1\AS lmotte 2012/0' /07 21:53:08 OH CAPT SAC CG WAS ON SCENE lmotte 2012/07/07 21:58:16 321-NOT GCING TO NEEb THE TRAILER NOW/To 317 lmotte 2012/0/07 22:20:12 REP FOR CG ON LOC, ADV BOAT OWNER OF PROCEDURES TO FOLLOW TOM AM, UNITS CLR Responded in 321(1% with 304 (3) to the Town Landing, 330 W. Bay Rd., Ost., For a possible fuel spi,l.l. in the water. Upon arrival of 304, strong odor of fuel in air and sheen on water in area of town landi,r�g, 304 found the Capt, of the vessel Reliance, Bill Neiser, who reports the spill is coming from the vessel he is operating. Mr. Neiser believs it is a hydraulic leak and -s stopped at this time. The vessel is docked at Nauticus Marina. Upon arrival, went onto the vessel w=th the Boat Capt. and observed a reddish fluid in the bildge area, this smells like diesel fuel and not hydraulic fluid. The Capt. had removed the bildge pump, and was trying to find the source of the leak. The spill is in the bildge area and approx. 10' L x 18" W x 4" D. Requested all agencies be :notified. The vessel is a 44' Hinckley Cabin Cruiser. Fuel capacity is 500 Gallons of diesel. The vessel is leased by Barton and Gray Mariners Club, 27 Front St., Exeter, NH 03833, 617-728-3555. Torn. Barton, Johnathan Jenkins-VP. The principal owner is Atlantic Nautical LLC, 10 Weybosset St. , Providence, RI 02903. Harbor Master did not respond. Requested 322 with spill kits to respond to scene. TOB BCH Rep. Donna Mixandi, on location and advised of the situation. Coast Guard Rep. enroute, eta 1 hour. Spoke to MDEP Rep. Julie Hutchinson by phone and advised her of situation, she will respond in the am to assess the situation. NRC notified by dispatch. Took photos of bildge area and fuel gauge sending unit that leaked. Capt. Neiser used absorbant pads to soak up remaining spill in bildge area. Upon arrival QLU_CQ._R_ep_ atty-Officer-GallowAy,_.-it _Wa.s_sfete.rmi_aed._that..pnob.ably.._iess than. . ..�0-ga-l-�otx�--trad-sxtil.l��l-iT[tzs�il�z3�ar'�anzY"�srr.��"a�cU�,-i�'Ca�tS�w�f-er�PU-G'alrtiay �-- - - - advised the Captain to notify their Insurance Cc. and also a Spill Clean-up Contractor to be onsite in the am to clean up any product still cr, the water and clean and remove all spill product from the bildge area. The Captain will secure the vessel for the night and make sure no further hazard exsists. Used approx. two packages of pads from spill containers from station 1, asked Captain tc have clean-up contractor` ;replace the pads. Ret. to Qtrs. 07/07/2012 23: 32:45 beldridge COMM Fire 01920 07/07/2012 12-0001884 JUL/11/2012/WEII 09:30 AM C.C.M.M. Fire Dept FAX llo. 508-i 60-2385 P. 006 CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT 1875 ROUTE 28 CENTERVILLE, MA 02632 (508)790-23751FAX#(508)790-2385 OILIHAZARDOUS MATERIAL RELEASE FORM F.A.# LOCATION: ADDRESS OF RELEASE: t a ba DATE OF RELEASE: 7 - j_?- PRODUCT REI..EASED: fuse L Pf'IrL ESTIMATED QUANTITY: -4 I a .-flj A CORRECTIVE ACTION TAKEN BY ESPONSIBLE PARTY: Peirooc, b 1LL NOTIFICATIONS: FIRE DEPARTMENT: YESO NO( ) DATE; ('Z_ TIME: '2-a 11 NATIONAL RESPONSE CENTER YES( NO( ) DA E: '7•,,7,-I-Z TIME: l o° DEPT> OF ENVIRONMENTAL PROTECTION YES(, NO( ) DATE: TIME:_ jO_7 OIL SPILL COORDINATOR: YES( ) NO`k) DATE: ------TIME: W-- TOWN BOARD OF HEALTH: YES(X) NO( ) DATE: -Z=j-Q�_TIME: TOWN HARBORMASTER: YES(k) NO( ) DATE. --"?wf�TIME: •7-egito OTHER AGENCIES: COMMENTS: Ef!LE UE3) Zit u— -Valt- 6Ek6QO c d LOAT�ef_ 4- 5rLte.LG L-L htoH tu. r api WAD _ I� s REPORTED BY: DATE: ­7 ' - 1 . COPY-FIRE DEPARTMENT COPY-D.E.P. COPY-BOARD OF HEALTH C-O-MM FORM il58 07/10/2012 10:22 9783831097 ECONOMIC ENUIRO TECH PAGE 01/03 ECONOMIC EWRo TECHs, nuc. TR-A,NSMITTAL DOCUMENT "C7 FROM: Rhonda COMPANY; DATE: Barnstable Board of Health 07110/12 FAX NUMBER: TOTAL NO,or-PAGES INCLUDING COVER: (508)794-6304 3 13.UUNr.ni.lMntA; SENDER'S REFERENCENUMBER: RE; YOUR REFERENCE NUMBER: 307 Main Street,Hyannis,MA. To Whom.It May Concern, Following please find a revised copy of the DEP/DOS notification form for the asbestos removal. at 307 Main Street. The project has been. extended through July 13, 12, Please feel free to contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda 38 Inten ale Road, Fitchburg, MA 01420 Phone: (978) 348-111.8 Fax: (978) 383-1097 07/10/2012 10:22 9783831097 ECONOMIC ENUIRO TECH PAGE 02/03 Massachusetts Department of Environmental Protection100149108 I Bureau of Waste Prevention—Air Quality Decal Number i Project Revision Notification .................. For Asbestos Notification ANF-001 and AQ 06 imortant When 1`10 g out A. Facility Location farmson the -- --__._._,_..... ._........................................................ ..w -..,.,...., ..w-..........._....,.,,,, .__. .,.,._.,-..„ M-...-.........._.........._...._._................................ computer,use i 307 MAIN STREET E only the tab key 1.Name of Faculty to mor your !307 NIM STREET Cursor-do not --._...- _._._._......_._._....................... ---..........._......................_.._,,.,._..W,......_,_ . .._ .�.........,....,......__......_...._.......•....._.... ----' use the return ?•Street Address _ key, HYAPINIS MA E ._............__.._.......... - --- -- ................__.._.._..._...---- ----------3 3.City 4•State �.Tp Gode _..........._...__...............................__.._..._._..._._._._..._........._._._............ r 6.Telephone Number INSTRUCTIONS B. Project Cancelled 1. This form is _ only evai for online filingg of -- " �Check here if this project Is/was cancelled. o ` project dale revisions. 2. Enter project decal number. C. project Dates 3. Validate that ..------------•---.................... . .........................---------- r------- the project ,06/2812012 t06/2712012 I location Is correct 1.Original.Sfart Date(mmlddlyyyy) __._.__._... 2;Sri inal, ntl Da,t��mmldtll�+yy�+� — -- _....................._._._................ ........, , ......._..11 for the entered ZT/1012012 !0711112012 decal. 4.Latest Revised End Date(mnVddJ ,.—_•_--•___-_----•___.......__........---_.._.—.�__.__.__�. ,___..-.._._.,.�...,......�,,..................�,,,-..,.-. )...... ..... ... 3.Latest Revi a Slarl Date(mmJddlyyyy) 4. Enter your new project dales. 5. Certify your _.... notification. D. Revised Project Dates - - Submit date changes. r-..., ,m.-,,•..N.,.. ,.w,,,......... ......... .............. ..... ...__._.._._.—_�.—, I0 711 312 0 1 2 1,Revised Stem Date(mmld6yyyy) 2.Revised End Date Data(mnVddlyyyy) E. Other Project Revisions 1 I 1 I 1 F. Revision History ...._._...........................-- -------__��_ M ,� .��. � •._.................... ._...._.. -...-=..._....r !EDEP:06/261201204:16:03 PM anf06pdm,dac-rev.215104 07/10/2012 10:22 9783831097 ECONOMIC ENUIRO TECH PAGE 03/03 L11Massachusetts Department of Environmental Protection ,10o7491a8 Bureau of Waste Prevention —Air Quality DeCel Number — --------- Project Revision Notification 1 For Asbestos Notification ANF-001 and AQ 06 G. Certification The undersigned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos,483 CMR 6.00 and 310 CMR 7,15, and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. :HENRY MOSES 1. Name.. . Authorized S..�gvatut�—---—..__...... .. ;PRESIDENT 2, PositionM le �.{'..D e..(mmfddlvWY) 'ECONOMIC ENVIRO TECH$,INC. 978 34$1118 4. R.prese!i irq— _•__._._ a. Telephone_..._..Re _._.._. r `38 INTERVALE ROAD 6, Address _......... ...... ......... .._... ...,..........,., ...............__---.. FITCHBURG 01$20 7. City/Town B. Zip Code anfO6pdm.doc-rev,215M4 06/13/2012 14:55 9783831097 ECONOMIC ENUIRO TECH PAGE 01/04 ELCONOMIC Ro TECHS,if TRANSMITTAL DOCUMENT I'0: FROM: Rhonda. COMPANY: DATE: Barnstable Board of Health 06/13/12 FAX Nt iMBER: TUyAL NO.OF PAGES INCLUDING COVER: (508) 790-6304 4 PHONE N1,TM3ER: SPNi>f:.R'S.Nftl T;RISNCL NUMBER; RE: Y01.1X k1:FER_ENCE NUMBER; 307 Main Street,Hyannis,MA To Whorn It May Concern, Following please find a copy of the DEP/DOS notification form for the asbestos removal at 307 Main Street. The project has been scheduled for June 26, through June 27, 12. Please feel free to contact Henry Moses (978) 423-3999 or myself if you have any questions. Thanks so much, Rhonda &41 CID —A €n .��,fey Ye•r^'pA ' 1 : ti 38 Intervale Road, Fitchburg, MA 01420 Phone: (978) 348.1118 Fax: (978) 383-1097 06/13/2012 14:55 9783831097 ECONOMIC ENUIRO TECH PAGE 02/04 Commonwealth of Massachusetts 100149108 Asbestos N �� r otification Form ANF-001 Decal Number ------ Important: A. Asbestos Abatement Description when fining out formp to the 1. a. Is this f icilit fee exempt city,town, district, municipal housing authority,owner-occupied computer,use Y p - ty_� p only the tab key residence of four units or less? [_]Yes r Na _•�_ ____ __ to move your cur80r-00 not b.Provide blanket decal number if applicable: . --• -----r--�w--�--.••••—_—___...,_-. use the return Blanket Decal Number key. 2. Facility Lontion: u1Wil'.H.F 1i'^Y ..w �t ^ ; 1 MA 307 MAIN STREET 307 IN STREET Name of Faclllt -- — ^�' lHyannisMA [92WI C.CltyfTown d.State e.Zip Code L Telephone Number --_......._._..__.. INSTRUCTIONS 3. Worksite Location' 307 MAIN STREET ,__-._._.....__..... ._...... 1.All sections of this __. ! M y W �ASEMENT� form must be a.Building Name/Bullding Location b,Building C.Wing d.Floor e.Rpprn completed In order to Comply wltl 4. Is the facility occupied? J;! Yes t.J No DEP notlticat:on requirements of 310 cvla 7.15 5. Asbestos Contractor: and the Division ECONOMIC ENVIRO Tl:CHS of occupational ; 38 IN7'ERVALE ROAD Safely(DOS) a_Narne _ . .. .. .-. b.Address notlfication FITCHBURG „•,..•_.I �014219784233999 _ ..ww•,_..,.--- requirements of 453 I .,,. _..--••-------.-..._...._ CIVIL 0.12 c.Clty/Town _._...........__..............d,Zip Code_...... e.Telephone Number F.A0000459 g. Contract Type: O✓ Written Verbal DES—LiGEn62 Number ,KEVIN MELLEN a ty ntact Person t.Gontect Persons Title HENRY MOSES - --- - AS0310132 — - . ......- _ n M __ 9.Name of On-SKe Su ervlsoNForemen rAMO""'"0_S(: - - n"'•',._. p b.5�rvisor orrsmen pOS CertlflcaUon - NUmt�2r 7: SUDESH SINGH .,,,,._ _,.,. J M031998 _.—.__.,...� a Name ai Pr_oject Monitor _ 1"'Project Mo.n for D05 Certification Number .ATI ASSOCIATES AA000007 -- -I ,-� a.Name of Asbestos Anaiytical,Lab b,,, sb stos Analvticai Lab DES Ce �f^M. P��. _ 0,.. Iiq. _ --- �"` j0 612 612 0 1 2 I0612712012 _ — on um er 9 Project a_Project Start Date�mmlddlyyyyl ._._._ b,Didd Date mmldd y8A-4P - N c.Work hours Mon-f?'rl. c7 Work hours Sei-Sun. T wV o 10. a.What type of project is this? Demolition ✓ Renovation r 4 Repair i -- .... ...— �._,Other,please specify-. b. Describe - 11. a.Check abatement procedures: ° I Glove bag i Encapsulation o Enclosure !,.,f Disposal only Cleanup Other,specify: i Full containment b.Describe z �Q 12. Is the job being Conducted: L�j Indoors? F i Outdoors? ■ anf001 ap,doc•10V02 APbestos Notification Form•Page 1 of 3 i 06/13/2012 14:55 9783831097 ECONOMIC ENUIRO TECH PAGE 03/04 ! Commonwealth of Massachusetts 1L L0014910i3 Asbestos Notification Form ANF-001 Deca'f�tu� AR Asbestos Abatement Description (cont) 13. Total amount of each type of Asbestos Containing Materials(ACM)to be removed, enclosed,or encapsulated: '0 1432 a.Total pipes or d-uots TIFF&R)'" *K'76 a'f o'er su aea square C.Boiler.breaching,duct,tank ` {{ ?..-- d.Insulatingcement 1...W�..•� surface coatings Lln. »" Sq.fl. -� Lin.ft. sq.ft. e.Corrugated or layered paper E= ("�E pipe ineulatgn Lin,ft, 5q;ft f..TraweVSprayar coatings Lln�1.... .. _ W. Sq.ft. g.Spray-on fireproofing h.Transite board,well board Lin.ft. i.Cloths,woven fabrics I' - j,Other,please specify: ! ��1 432 Lin,ft, ,.. ..— — .,....w Lin.ft, ----,,,, K.Thermal,5oliCl pare pipe VAT,MASTIC Insulatlon LT'n.'f`t.___ ;;:_ I.Spactry 14. Describe the decontamination system(s)to be used; j3 CHAMBER 15. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR _........- - _..--- ---- -._.............._._..............,,.,.,- ---------- (2)B-MIL BAGS WETTED ; 15, For Emergency Asbestos Cperations, the DEP and DOS officials who evaluated the emergency: LDate(mrnldd�yyyyj„a�Autnarizalion d,DEPWalver# e.Name of DOS 5f_FGgl D OfficialTitle --- —--- ---- ............._......__...................,..,.. �....., IL EEMMOMM= g.Date(mm/ddlyyyy)of Authorization h.DOS Walver# N �0 17. Do prevailing wage rates as per M.O,�.c. 149,§26,27 or 27A—F apply to this project? Yes F No B. Facility Description 0 1. Current or prior use of facility; rANIC 2. Is the facility owner-occupied residential with 4 units or less? []Yes r�) No 3. 'TD BANK �.„.„._...�_.- ---_ --------_.1 GRAY RM, MAILSTOP ME100.18 r a.Facility Owner Name .— rn M b,Addressgnomon it�IR♦rlr�� �FAI MOUTH I04105I o s Cit R-awn d.Zfp Code e.Telephone Number(area code and extension) LL 4. !KEVIN MECCI N F--- I a.Name at Facility Owner's C}n-Site Manager__ b.On-Sit@ Manager Address ff 1 4 C.City/rown d.Zip Code a.Telephone Nurnt5er(area code and extension) anf001 ap.doc•10f02 Aahestog Nattficaaon Form•Pa @ 2f 06/13/2012 14:55 9783831097 ECONOMIC ENUIRO TECH PAGE 04/04 Commonwealth of Massachusetts 100149/08 - Asbestos Notification Form ANF-001 oeoel Number B. Facility Description (cont.) ;ECONOMIC ENVIRO TECHS,INC. 38 INTERVAL f; ROAD a.Name of General Contractor b Address - aFITCHBURG 01420 , �� {97$ 348.1118 c;CltyrTown.._.._....._.................... d.Zip Gode•••.••,•„ e,T®I�hona Number(area cod®and extension) __.._.. Z URICW-AMERICAN INSURANCE_ GROUP ___ 6z--zue410$P1021_ T 2 t92/z12101 f6otacr's Worker's Comp.Insurer Policy Number n - -— EzA Dat@ j mjdtliyyyy) G. What is the size of this facility? ...-.---.__—........ �.__-.__-� --- a.Square Feet b,Number of floors C. Asbestos Transportation and Disposal 1. Transporter of asbestos-containing materiel from site to temporary storage site(if necessary): ERVICE TRANSPORT E.S....._ GROUP 58 PYRES LANE a Name of Trans ortEr Note;Transfer —=.-.,,. ..V....�----------,-- b,Address,�,__�_... s must ;NEW CASTLE __._........,.,....,., Station m #19720 � �$77)999.9559 1 comply with the ,,, �-- ----.................. C.CRYfTowR Solid Waste d•ZIP Code e•Telephone Number Reguun 2. Transporter of asbestos-containing waste material from removalttem ora site to final disposal site: Regulations 316 P ry A CMR 19,000 a.Name of Transporter _.__.._... b°Address - . c.-CltylTown _ d.Zip Code _ e.Telephone Number 3. SAME a.Refuse Transfer Station and Owner b,_Address a.Cit !Town d.2i Code --- w.,......... ----•---•r,.,....,....w,.,..._ _...__ e —..-----•.............,-,.M,.,.. 4. MINERVA ENTERPRISES INC 1 ,Telephone Number - -- �� a.Final Disposal Site Location Name b.Final Disposal Site Location Owner's -M,., --.. .. N RVA ROAD .. .. . --- i900D MI E IWAYNE;SBURG r c.Final Disposal Site Address d.cityfrown e.state _.M - �M f,2fp Code � .n. u. W �O D. Certification The undersigned hereby states, under the HENRY MOSES penalties of perjury, that he/she has read the r a•Name b,Authorized Slynature ... Commonwealth of Massachus® p�� Its regulations PRESIDEN for the Removal,containment or T - - - �-� L__,....,. r Position/ride Encapsulation of Asbestos,453 CMR 6.00 and e. d,Data mmldd l - 31t} M 7, �(978)3d8-1118 G R 15, and that the information contained in this notification is true and correct e.Telephone Number f-Representing__ ° to the best of his/her knowledge and belief. [8 INTERVALE ROAp �- -Address „ � u. FITCHBYRG 01424 _ Z h.Qyltown L Zip Code =g anf001 ap.doc-10102 A , sbestos Notification Form•Page 3 of 3� f t w' COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENERGY& ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PRO SOUTHEAST REGIONAL OFFICE 20 RIVERSIDE, DRIVE, LAKEVILLE, MA 02347 608.946- DEVAL L.PATRICK UN A.BOWLES Governor Secretary TIMOTHY P.MURRAY ` '� _.2-u , ARLEEN O'DONNELL Lieutenant Governor Commissioner URGENT LEGAL MATTER:PROMPT ACTION NECESSARY August 27,2007 Mr. Craig Ashworth,President RE: BARNSTABLE-BWSC E.B.Norris&Son,Inc. Residential Dwelling PO Box 486 307 Main Street,i9sterviRe r} yowNis Hyannisport,MA 02647-0486 RTN#4-20719 NOTICE OF RESPONSIBILITY M.G.L. c.21E,310 CMR 40.0000 ATTENTION:Mr.Ashworth On August 21, 2007 at 10:33 am the Department of Environmental Protection ("MassDEP") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property which requires one or more response actions. During the removal of a 750-gallon gasoline Underground Storage Tank(UST),soil headspace measurements in excess of 100 parts-per-million were encountered. This condition poses a 72-Hour Notification Condition as per 310 CMR 40.0313 (2). The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency'Plan (the "MCP"), 310 CMR 40.0000,require the performance of response actions to prevent harm to health, safety,public welfare and the environment which may result from this release and/or threat of release_and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice,'of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. MassDEP has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. MassDEP also has reason to believe that you(as used in . this letter, "you" refers to E.B. Norris &.Son, Inc.) are a Potentially Responsible Party (a "PRP") with liability under M.G.L. c.21E §5, for response action costs. This liability is "strict", meaning that it is not based on fault,but solely on your status as.,owner, operator, generator,transporter,disposer or other person specified in M.G.L. c.21E §5. This liability is also "joint and several',meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. This information is available in alternate format.Call Donald M.Comes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep Printed on Recycled Paper 2 MassDEP encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by MassDEP in taking such actions. You may also avoid the imposition of, the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L. c.21E isattached'toi this notice. You should be aware that you may have claims against third parties for damages,including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. MassDEP encourages you to take any action necessary to protect any such claims you may have against third parties. At the time of oral notification to MassDEP, the following response actions were approved as an Immediate Response Action(IRA): • Continued assessment. • Excavation and disposal of up to 20 cubic yards of contaminated soil. • Removal of other contaminated media within UST. • All Remediation Waste must be properly stored/handled and disposed of within 120 days from the date of generation per 310 CMR 40.0030. ACTIONS REQUIRED Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee.of$1;200 be submitted to MassDEP when an RAO statement is filed greater than 120 days from the. date of initial notification. Specific approval is required from MassDEP for the implementation of all IRAs pursuant.to 310 CMR 40.0420 and 310 CMR 40.0443, respectively. Assessment activities, the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form(BWSC-103,attached)be submitted;to MassDEP within sixty(60)calendar days of August 21,2007. You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals by calling (617) 556-1091 or visiting http//www.state.ma.us/lsp. MassDEP has David Bennett of Bennett &O'Reilly as LSP-of-Record for this release. Unless otherwise provided by MassDEP, potentially responsible parties ("PRP's") have one year from the initial date of notification to MassDEP of a release or threat of a release, pursuant to 310 CMR 40.0300, or from the date MassDEP issues a Notice of Responsibility,whichever,occurs earlier,to file with MassDEP one of the following submittals: (1) a completed Tier Classification Submittal; (2) an RAO Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the first two 3 submittals for this disposal site is August 21, 2008. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to, have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21E and the MCP.- If you have any questions relative to this Notice,please contact Andrew L. Jones at the letterhead address or at (508) 946-2785. All future communications regarding this release must reference the following Release Tracking Number: 4-20719. Very truly yours, (✓ova-� Daniel Crafton,Acting Chief Emergency Response/Release Notification Section C/ALJ/re P:W-20719-1ORdoc Attachments: Release Notification Form;BWSC-103 and Instructions Summary of Liability under M.G.L. c.21E fc: Board of Health Board of Selectmen Fire Dept ec: David Bennett,LSP Bennett&O'Reilly dbennettO,bennett-oreilly.com COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENERGY & ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PRO SOUTHEAST REGIONAL OFFICEtopy 20 RIVERSIDE. DRIVE, LAKEVILLE, MA 02347 608.946- DEVAL L.PATRICK IAN A.BOWLES Governor Secretary TIMOTHY P.MURRAY ARLEEN O'DONNELL Lieutenant Governor Commissioner URGENT LEGAL MATTER: PROMPT ACTION NECESSARY August 27,2007 Mr.Craig Ashworth,President RE: BARNSTABLE-BWSC E.B.Norris&Son,Inc. Residential Dwelling PO Box 486 307 Main Street,Osterville Hyannisport,MA 02647-0486 RTN#4-20719 NOTICE OF RESPONSIBILITY M.G.L. c.21E,310 CMR 40.0000 ATTENTION:Mr.Ashworth On August 21, 2007 at 10:33 am the Department of Environmental Protection ("MassDEP") received oral notification of a release and/or threat of release of oil and/or hazardous material at the above referenced property which requires one or more response actions. During the removal of a 750-gallon gasoline Underground Storage Tank(UST),soil headspace measurements in excess of 100 parts-per-million were encountered. This condition poses a 72-Hour Notification Condition as per 310 CMR 40.0313 (2). The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan (the "MCP"), 310 CMR 40.0000,require the performance of response actions to prevent harm to health, safety,public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. MassDEP has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. MassDEP also has reason to believe that you(as used in this letter, "you" refers to E.B. Norris & Son, Inc.) are a Potentially Responsible Party (a "PRP") with liability under M.G.L. c.21E §5, for response action costs. This liability is "strict",meaning that it is not based on fault,but solely on your status as owner, operator, generator,transporter,disposer or other person specified in M.G.L. c,21E §5. This liability is also "joint and several',meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. This information is available in alternate format.Call Donald M.Comes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207. DEP on the World Wide Web: http:/Am&w.mass.gov/dep 10 Printed on Recycled Paper 2 MassDEP encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials. By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by MassDEP in taking such actions. You may also avoid the imposition of, the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L. c.21 E is attached to this notice. You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but.are governed by laws which establish the time,allowed for bringing litigation. MassDEP encourages you to take any action necessary to protect any such claims you may have against third parties. At the time of oral notification to MassDEP, the following response actions were approved as an Immediate Response Action(IRA): • Continued assessment. • Excavation and disposal of up to 20 cubic yards of contaminated soil. • Removal of other contaminated media within UST. • All Remediation Waste must be properly stored/handled and disposed of within 120 days from the date of generation.per 310 CMR 40.0030. ACTIONS REQUIRED Additional submittals are necessary with regard to this notification including,but not limited to,the filing of a written IRA Plan, IRA Completion Statement and/or a Response Action Outcome (RAO) statement. The MCP requires that a fee:of$1,200 be submitted to MassDEP when an RAO statement is filed greater than 120 days from the date of initial notification. Specific approval is required from MassDEP for the implementation of all IRAs pursuant.to 310 CMR 40.0420 and 310 CMR 40.0443, respectively. Assessment activities, the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. In addition to oral notification, 310 CMR 40.0333 requires that a completed Release Notification Form(BWSC-103,attached)be submitted to MassDEP within sixty(60)calendar days of August 21,2007. You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at-this site. You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals by calling(617) 556-1091 or visiting http://www.state.ma.us/lsp. MassDEP has David Bennett of Bennett &O'Reilly as LSP-of-Record for this release. Unless otherwise provided by MassDEP, potentially responsible parties ("PRP's") have one year from the initial date of notification to MassDEP of a release or threat of a release, pursuant to 310 CMR 40.0300,or from the date MassDEP issues a Notice of Responsibility,whichever occurs earlier,to file with MassDEP one of the following submittals: (1) a completed Tier Classification Submittal; (2) an RAO Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the first two i 3 submittals for this disposal site is August 21, 2008. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G.L. c.21E and the MCP. If you have any questions relative to this Notice,please contact Andrew L. Jones at the letterhead address or at (508) 946-2785. All future communications regarding this release must reference the following Release Tracking Number:4-20719. Very truly yours, Daniel Crafton,Acting Chief Emergency Response/Release Notification Section C/ALJ/re P:W-20719-10Rdoc Attachments: Release Notification Form;BWSC-103 and.Instructions Summary of Liability under M.G.L.c.21E fc: Board of Health Board of Selectmen Fire Dept ec: David Bennett,LSP Bennett&O'Reilly dbennett(@bennett-oreilly.com