HomeMy WebLinkAbout0053 SPRUCE STREET - Health 53 Spruce St. (Hyannis)
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k� s hotitication Form— ANF-DD1
Asbestos Abatement Descripflon VL`O
1. Facility location: 9 9
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action natitealion 2 Is the lacilay occupied? Yes 0 No
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unobfations 3. Asbestos Contractor.
°`dd'n''s'r'"'w7 dm New En land Surface M_aintenance,LLP 850 Washin ton Street
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putmml of Labor Yrrrr Addn=
dlndusirles Weymouth, MA 02189 781-337-2117
452 CMR 6.12 (ten Uryra.n --------- - Ib Calf _— l�eyun
fs yid nourcuion a
uixfdAMY AC 000196
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°� 4. On-Site Project SupePor/Foreman:
Stbml Orlq'wl Form 11_1 � ._ __.... _.. o .
Nara OU C.03=404
�omonrrdli of
assachuastts 5. .Project Monitor. _
astas Program
.0.1.120097
aslaa,MA 02112- ,�y„r ai cueadi n/ - —.—..—•------- --
097
6. Asbestos Analytical Lab:
This loan may be 1 _17�Q_ .:u.._..... '�� —
- fd notifying cx � _ .._
.S.EnvitonrTal w Na" Ctl Canfaalon
?ratraionAgyey Recce :_a-.i' ..,,_ �
IalrSestasdamal1k.-J 7. Projects tart date_ J��tOI-enddattLq�J" O�speci(ic:workhours(Mkq!jt ri) d �____...__(SaLSun.)
:enc,r an opesl:WS , ,.•
s�to NE-DWS(40 •rat a t"'A I.,.v..,
UR SubpartM). a. What type of project is this?_(circle one):. . omw6w...-. uric. amu/aO7 1. .
,raGtwlb.0* 9. .Descrihe the asbestos abatementprocedurestobeused (circle):. pbwbw .raava latrMynrte dats9
10. Is the job being conducted ;indoors ❑outdoors 7
.or 11. Total amount of each type Asbestos Containing Materials(ACM)to be handed an pipes or ducts(linear ft.)1?:0 or other
— surfaces(square tt.). to be removed,enclosed or encapsulated:
. _ )IAelf/SQWf
bailer,bran'ft&ct loot srS2 x4nvs... romal,solid core pine ir=Aabon......_f
=nvp ad of ft)wad ww pix irsulauan.A.�,�/_ nwlatinp mawl.................. _J
sprz)o Arwooruq.......:............ trwroYsCvaYa r-atif>¢..............
dolls.wow hors....................._J trar=bawd,rag board.............
oMw(please desrribe)....................
12. Describe tha decontamination system(s)to be used:
-As required- _
13. Describe the containeriaationidisposal methods to compy.with 310 CMR 7.15 and 453 CMR 6.14(2)(g):
Two layers/labelled bags
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-.14: ForrEmeroency Asbestos Abatement 0peabons the DEP and DLI otflcais who evaluated the emergency
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Cir d.tulno'L'Ya� Mawr/
45: Do prevailing wage rates appty as per M.G.L.c.149.§26,27,or 27A-F.o this project? ❑YesNo
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Cr Facility Description
1. Current or prior use of facility. 1 j,1
2. Is the la:il;y cwner-occupied residential with 4 units or kss7 Yes J No
3. Facil'iy Owner.
Abaco
4. Facii;y's Owner's On-Site Manager.
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5. General Contractor.
xam. Addrim
r1,y/Te�e 1'v Cod.
Conuarar',WartarsComp.hwn, Wecy/ Ea9.f.Lte
S. What is the size of the facility?2110sq ft) v of floors)
Asbestos Transportation and Disposal
1. Transporter of asbestos-containing waste material from site to temperay storage site(if necessary)to final disposal sd_
NESM,LLP 850 Washington Street
Adln=
Weymouth, _MA -- --._...:.._....... .0_2.1.89 --......... _781--337-2117
Gy/ram - 4 CD* r esrme
2. Transporter of asbestos-containing waste material from removall to^;crary storage site to final disposal site:
Waste Management .209 Pickering Street
Portland, .CT 06480 860-342-0667
Nat#:Transfer cyan zbede rraax>ne
Statfcns must
comply wrth the3. Refuse transfer station and owner(if applicable):
Solid Was:#
Dh*ian requa- urnr Ado-=
lions 310 CUR
18.00
Ury/rae Lb ode rrmo+e '
4. Final Disposal Site:
Valley Landfill USA 'waste Services
cooeae wme Qwrs xamr
Pleasant Valley Road -
. AM=
Irwin, PA 15642 412-744-4000
ZIP ccov
Certificatfon
The undersigned hereby states,undarthe penalties of perjury,that heishe Fos read the Commoirwealth of yasrachusans ReguStans
for the Removal.Containment or Enca„sulation of Asbestos,,4S3 GNR 6.00 and 310 CMR 7.15,and th a inforr alicn ccnta;;ied In
this notification is true and carted WIN hest of hlvber Icsowiedge and S eliel. /
T:vxure Ste _ ar
Nota:Conf..c:cr partner N M,LLP 781-337-2117
nr:s:;rgn this
for„for DU --------- ---- --------
+�rrmrrr. RmRanuq rrrnrory
1101.-ic:ficn 850 Washington Street Weymouth, MA 02189
pur�o;es
time mire 10 Mae -
Fee exempt(City.Town,district,municipal housing authority.owr er-occupied residential of four units or less)7.�yes no
Slicker I(from front of fnrml �� ,�/ 1 /