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Home My WebLink About0048 SPRUCE STREET - Health 48 SPRUCE STRE A=310.224 f y Commonwealth of Massachusetts ----"__ Asbestos Notification F m ANF-001 F00238538 Asbestos Project# H ❑ Project Revision G ❑ Project Cancellation a a A.Asbestos Abatement Description ;�;.. f.• 1.Facility Location':-*' �. STEVEN BRIGGS 48 SPRUCE ST. ~' Name of Facility Street Address 7 HYANNIS MA 02601 7742083762 •• " Instructions 1.All m' sections of this form City/Town State Zip Code Telephone C-"3 must be completed in SAME OWNER order to comply with MassDEP notification Facility Contact Person Name Facility Contact Person Title requirements of 310 CMR 7.15 and WorkSite Location: RESIDENCE Department of Labor Building Name,Wing,Floor,Room,etc. Standards(DLS) 2. Is the facility occupied? p Yes ❑No notification requirements of 453 CMR6.12 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 Yes ❑ 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 le:,_�% Approval lD# - Form To: n ,.� Commonwealth of 6.Asbestos Contractor: Massachusetts ASBESTOS MAN REMOVAL 929 STATE ROAD P.O.Box 4062 Name Address Boston,MA 02211 'c �.__ �.... .- .FLYMO,UTH .�...........,...,._ . .:,.. ...,.. MA ,.,.02360,. .. . 5082245500 City/Town State Zip Code ... Telephone A0000342 Contract Type: ❑Written ❑Verbal DLS License# 7. JOAN BERTON AS002057 Name of Contractor's On-Site Supervisor/Foreman DLS Certification# 8, N/A Name of Project Monitor DLS Certification# 9. N/A Name of Asbestos Analytical Lab DLS Certification# 10. 3/17/2016 3/17/2016 Project Start Date(MM/DD/YYYY) End Date(MM/DD/YYYY) 7AM-2PM 7AM-2PM Work Hours-Monday Through Friday Work Hours-Saturday&Sunday 11. What type of project is this? ❑ Demolition B Renovation ❑ Repair ❑ Other-Please Specify: Revised: 11/13/2013 Paged of4 ' 4 Commonwealth of Massachusetts 100238538 Asbestos Notification Form ANF-001 ------ --- Asbestos Project# E ❑ Project Revision ❑ Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): R Glove Bag ❑ Encapsulation ❑ Enclosure ❑ Disposal Only ❑ Cleanup ❑ Full Containment ❑ Other-Please Specify: 13.Job is being conducted: Indoors ❑ Outdoors 14.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 120 Linear Feet(Lin.Ft.) Square Feet(Sq.Ft.) Boiler,Breaching,Duct, Transite Pipe Tank Surface Coatings Lin.Ft. Sq.Ft. Lin.Ft. Sq.Ft. Pipe Insulation 120 Transite Shingles Lin.Ft. Sq.Ft, Lin.Ft. Sq.Ft. Spray-On Fireproofing Transite Panels Lin.Ft. Sq.Ft. Lin.Ft. Sq.Ft. Cloths,Woven Fabrics Other- Please Specify: Lin,Ft. Sq.Ft. Insulating Cement Lin.Ft. Sq.Ft. Lin.Ft. Sq.Ft. 15.Describe the decontamination system(s)to be used: REMOVE ASBESTOS USING THE GLOVEBAG METHOD 16.Describe the containerization/disposal methods to comply with 310 CM 7.15 and 453 CMR 6.14(2)(g): WET DOWN ASBESTOS AND DOUBLE BAG USING MIL MARKED AND LABELED BAGS 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: Name of MassDEP Official Title of MassDEP Official Date of Authorization(MM/DD/YYYY) Waiver# Name of DLS Official Title of DLS Official Date of Authorization(MM/DDNYYY) Waiver# 18.Do prevailing wage rates as per M.G.L.c. 149, §26,27 or 27A—F apply to this ❑ Yes [] No project? Revised: 11/13/2013 Page 2 of 4 r. Commonwealth of Massachusetts 00238538 ._ Asbestos Notification Form ANF-001 - �.............. Asbestos #Project# ❑ Project Revision i .z ❑ Project Cancellation B. Facility Description 1.Current or prior use of facility: RESIDENCE 2.Is the facility owner-occupied residential with 4 units or less? ❑� Yes ❑ No 3,SAME AS ABOVE SAME Facility Owner Name Address SAME MA 02601 7742083762 City/Town State Zip Code Telephone 4.N/A N/A Name of Facility Owner's On-Site Manager Address N/A MA 02601 7742083762 City/Town State Zip Code Telephone 5.N/A N/A Name of General Contractor Address N/A MA 02601 7742083762 Note:Temporary storage of Asbestos City/Town State Zip Code Telephone containing waste N/A material is only allowed at the place Contractor's Worker's Compensation Insurer of business of a DLS 99999999999999999999999999999999 9/9/9999 licensed Asbestos Policy# Expiration Date(MM/DD/YYYY) contractor or a transfer station that is 6.What is the size of this facility? 2000 2 permitted by MassDEP and operated in Square Feet #of Floors compliance with Solid Waste Regulations C. Asbestos Transportation & Disposal 310 CMR 19.000 1.Transporter of asbestos-containing waste material from site of generation: ❑ Directly to Landfill or M To Temporary Storage Location/Transfer Station ASBESTOS MAN REMOVAL CO 929 STATE RD Name of Transporter Address PLYMOUTH MA 02360 5082245500 City/Town State Zip Code Telephone 2.If a temporary storage location/transfer station is used,list name of transporter of asbestos containing waste material from temporary storage location/transfer station to final disposal site: JOB ROLLOFF POB 609 Name of Transporter Address HAMPSTEAD NH 03841 6173891445 City/Town State Zip Code Telephone Note:Contractor must sign this form for DLS Revised: 11/13/2013 Page 3 of 4 ii Commonwealth of Massachusetts. 100238538 Asbestos Notification Form ANF-001 Asbestos Project# y ❑ Project Revision t ❑ Project Cancellation nuu nuauun NwNww C.Asbestos Transportation&Disposal: (cont.) . 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: ASBESTOS MAN REMOVAL CO 25 ADAMS ST. Temporary Storage Location Name Address BRAINTREE MA 02184 5082245500 City/Town State Zip Code Telephone 4.Name and location of final disposal site(asbestos landfill): TURNKEY LANDFILL WASTE MANAGEMENT Final Disposal Site Name Final Disposal Site Owner Name 90 ROCHESTER NECK RD Address ROCHESTER NH 03839 6033390039 City/Town State Zip Code Telephone D. Certification "I certify that I have personally examined the foregoing and am PAUL ILACQUA PAUL ILACQUA familiar with the information Name Authorized Signature contained in this document and PRESIDENT 3/4/2016 all attachments and that,based Position/Title Date(MM/DD/YYYY) on my inquiry of those 5082244550 AMR CO individuals immediately responsible for obtaining the Telephone Representing information, I believe that the 929 STATE RD PLYMOUTH information is true,accurate,and Address City/Town complete. I am aware that there MA 02360 are significant penalties for submitting false information, State Zip Code 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 proniulgated.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 TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. D PARCEL NO. '2 2 ADDRESS OF TANK: ��nU C�- � � VILLAGE: N u m b e r Y t r w4D t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: < � PHONE: INSTALLATION DATE: BY: INSTALLER ADDRESS: ovy- �ACERT.N0. n2Q S3A *TANK LOCATION: ba- 0neJ-- cge (occofR S ma -'rI�ANw 1-OQAT I ON W S TH mmomm=y TO =u Z LD 2 NO) CAPACITY 5 TYPE OF TANK fC& AGE -J_YRS. FUEL/CHEMICAL - TESTING CERTIFICATION Cfl'] PASS C ] FAIL DATE �E s/T LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND / ZONE OF CONTRIBUTION C-le- YES C ] NO DATE TO BE REMOVED ' FIRE DEPT. PERMIT ISSUED C YES C ] NO DATE -All A CONSERVATION C ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. DATE * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRArT�ION MAP NO. I_D PARCEL NO. ADDRESS .OF TANK: 146 Pru c.2 ��l VILLAGE: Hvu0AA, C, MAILING ADDRESS ( IF DIFFERENT FROM ABOVE),::„....•..—�� OWNER NAME: PHONE: tC INSTALLATION DATE: G 9 BY C� � C1 ut c o r , INSTALLER AD-DRES-S-: *TAN—LOCAT I ON s_ 4e ba ,±l1 .. C) Cejlw�^ Qev, c bc�cra z nc'• TANK I:OQAT S ON W ICTH" IR'Q�PQCT T;O' EIUY LD iN0) - CAPACITY �5 TYPE OF TANK -�- ,I" AGE L YRS. FUEL/CHEMICAL . , 'f . �'' �TESTING" CERTIFICAT,ION' U/J PASS [ ] FAIL DATE LEAK ',DETECTION [ ] CHECK IF; N/A TYPE/BRAND} ZONE ,OF CONTRIBUTION [ J�YEB [ ] NO- DATE TO BE REMOVED FIRE' DEPT. PERMIT ISSUED [ YES [ ] NO DATE CONSERVATION [ ] CHECKJF N/A DATE BOARD OF HEALTH TAG NO. "[ # ,�,* �' r A, DATE �c. PLEASE PROVLDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD .. _.. .. -.-_ _ ...-.. _ .._._.-._. _. r.._-_ .,..:..�,a..,......b._..,-.,,mi......'.h`a...,..,.a.mu...._.-".�, ...,.e._,..a .3._...e:.n�_,W..« u. _..........-.. -. T:s' - ......_ u � ...........a.r..._e_..�.r_.._..,.e _. TOWN OF BARNSTABLE - UNDERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATION 1 eft { MAP NO. PARCEL NO. ADDRESS OF TANK: rc.4 C1Z o4r6e A VILLAGE: �►n+ `, MAILING ADDRESS ( IF DIFFERENT FROM ABOVEJ-:.b 'k�"" OWNER NAME: Van f"t � PHONE: " ✓t T+ CC € ' INSTALLATION DATE: I-) q BY: 1-k C Q INSTALLER A�dRSS-:- "'- W -CERT iJO. C :G " N: 4e, {_ � *TANK LOCATIOe, -bazw yrm? f /\ _ ~"^ a ,. % - (-DCOCF?ZDQ'�-`TANK l_OOATZON WZ';TH RQOP. QC1^- T'0--m1:JZL'SD`Z"IV O'p- - " CA�PACITY '27 TYPE-OE TANK . AGE --J_YRS. FUEL/' CHEMICAL r P J " TES ING CERTIFICATION`S [� _PASS [ ] FAIL ' DATE is ICJ LEArK IETECTINO : t ] CHECK IF ,N/A_;,: ,.TYPE/'BRAND h :;ZONE, OF CONTRIBUTION t k YES` [ ] NO. DATE TOE:BE REMOVED �I a t , "FIRE) D?EPT. PERMIT ISSUED [ �a YES [ ] NO DATE CONSERVATION t ] . CHECK IF N/A DATE s BOARD OF HEALTH TAG NO. [ DATE 7 1 „PLE.ASE RJR, 1D ,AECH, ET ,-$HOW I NQ,,THE, TANK.. LOCAT._LON,,ON....THE BACK .OF. THIS CARD 3...:...::,`.,..�„d..:.::.a.u,.,e.::;.c,.;.m:..�,:r.m,; ...,...:::.k,.,e_,.:,v..c:�:,;.,_tx_n:.xa7. «e:..„�..s.,..�z...:4w..,.,..,•,d,,.::a.t.,:.v :.-.:,:c. -,.... a.:.:ue�.tiiafi: jN�N �- r �� i -� ��-.. .�� P �� f The Commonwealth.of Massachusetts Department of Public Safety = 527 CMR 4.00 Form 1_ Application for Permit, Permit,and Certificate of Completion for the Installation or Alteration of Fuel Oil Burning Equipment and the Storage of Fuel Oil (City or Town) (Date) Permit #'s: FD " `� Elec. FDID #: �i/, �� Fee Paid: Owner/Occupant Name: , I t/`�c, �;�j,-s Gt�1 c, Tel.#: ,1 Z.31S 7— Installation Address: `` ,��-�� _ 5 - Serviced Floor or Unit #: t ❑Heating Unit ❑Domestic Water Heater ❑Power Vent=d,'❑Other Burner: p New Utxisting ❑Location: Q5c &� Trade Name: Mfg: Type: Model# or Size: Nozzle Size: 2r uel Oil ❑Kerosene ❑Waste Oil Storage Tank: ("New ❑Existing Location: B�1- _ r Type:<�" Capacity: gallons No. of Tanks: Special requirements (or additional safety devices) p OSV Valve Ur0i1 Line Protected ❑Sheet Rock Q Sprinkler AFUE: ❑yes ❑no EF:❑yes ❑ no (Furnace and Boilers) (Water heater) Co. Name: 141 j Vc�?i Cg,,) 4�-rv1 yr roe -5e-rV1 C.e_ Tel.# Address: PO . P, k' V 7 Z City: �G Q�'J Zip: oZ�G, Completion Date: ' Combustion Test: Gross Stack Temp.: Net Stack Temp: CO2 Test Breech Draft: Smoke: Overtire Draft: Efficiency Rating %: I, the undersigned certify that the installation of fuel burning equipment has been made in accordance with M.G.L. c. 148 and 527 CMR 4:00 currently in effect. Furthermore, this installation has been tested in accordance with such requirements, is now in proper operating condition and complete instructions as to its use and maintenance have been furnished to the person for whom the installation (or alteration)was made. Installer: Print Name Cert of Comp. # /, '�igndture (no stamp) Address: G F Awl ✓? 3 R Dr City: 50 r 1 Once signed by the fir departme , is is a PERMIT for the storage and use of oil bumittfig equipment. Approved by: ----� , ,!, ; Date: � .,.. . REFER TO CHECKLIST ON REVERSE SIDE Form Distribution: White: Fire Dept. (Application) Yellow: Installation (Permit To Store) Pink: Installer(Permit To Install) This form approved by the State Fire Marshal and provided courtesy of the Mass.Oil Heat Council. Form design in NCR by Cotuit and COMM Fire Depts. July 1,1996 Town of Barnstable o� STABLZ Department of Health, Safety, and Environmental Services MASS. Public Health Division °TEDN10.�A P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 14, 1999\ Ms.Marjorie M.Briggs 48 Spruce St., Hyannis,MA 02601 Ale RE: Unde ground Fuel Storage System located at 48 Spruce St., and listed as Assessor's Map 310 ,Parcel 224 Dear Sir/Madam, Our records indicate that you have a#2 fuel oil above ground storage tank that is presently unregistered with the Health Department. Please complete the enclosed Registration card(s). Include any evidence of the date of purchase and installation,a copy of the permit from the Fire Chief within ten(10)days of your receipt of this letter. Upon entire completion of the Registration card(s),you will be issued a brass valve tag(s)by the Board of Health. These valve tags shall be picked up by you or your representative at the Health Department located in the Barnstable Town Hall. The tag(s)shall then be attached to the filler pipe/cap of the above ground tank(s). Please return completed Registration card(s)to: Town of Barnstable Health Department,P.O.Box 534, Hyannis,MA 02601,as soon as possible. If you have any questions,please telephone(508)862-4644. Office hours are Monday through Friday from 8:15-9:30 a.m. and 1:00-2:00 p.m. PER ORDER OF THE BOARD OF HEALTH mas A.McKean Director of Public Health r ar eta�;310224 ®= V �C t� � 002279 a n 0000000 ,r £uer,® rt BRIGGS,MARJORIE M to Mass 101LlY 48 SPRUCE ST HYANNIS � MA 02601 r ee to ; 000000 � ��e�e�"'P, 1506938 �• � h r\ '� � „�s,`��y't fan ary st BRIGGS,MARJORIE M £ dM 0000 e ye 1506/938 1l ., and.. 19900 } 8 g 59100 xeaures ..0000000900 ' tUCtI 48 SPRUCE STREET p d` de 1518 0065 a e ►st HY Unassigned Road Name a odes 0000 � s kiYAiNiNlb PIKE 1AIVAKINIVINI 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 Hyayr�oyld�V�Sy.�p��Brunelle t3E3�3�iiY CHI1 EFVWk 51110he �etectvr t Save 4. ved BUSINESS: 775.,300 EMERGENCY: 775.2323 To L/ Town of Barnstable , Board of Health - T. McKean Town of Barnstable , Conservation Commission - From ; Fire Prevention Bureau, Hyannis Fire Department Subject The installation of above ground storage tanks . Date ; KI L Persuant to the applicable sections of 527 CMR - Fire Prevention Regulations , this Department has inspected the following location for above ground storage. ADDRESS : 48 Spruce St. Hyannis OWNER/OCCUPANT Irving Briggs PHONE 775-2362 r SIZE OF TANK (S) 275 Oval Steel / BASEMENT COMMODITY STORED . : # 22 fuel PURPOSE FOR STORAGE : Heatin THIS INSTALLATION IS : PRE-EXISTING A REPLACEMENT NEW This installation complies does not comply with the required installation regulation listed below. FIRE .PREVE\`TION OFFICE For: PAUL D. CHISHOLM, CHIEF HY�\'\IS FIRE DEPARTME`:T