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HomeMy WebLinkAbout0026 PARK STREET - Health 26 PARK STREET, HYANNIS A= I LVI Environmental Services Inc. 195 Corporation Way Medford, MA 02155 SERVICES` Tel: (781) 396-8800 Fax; (781) 395-8305 www.lviservices.com - boston@lviservices.com NOTIFICATION OF ASBESTOS ABATEMENT ATTENTION: HEALTH AND SAFETY OFFICER /r/4 o � 53 LVI Environmental Services Inc. will be conducting an asbestos abatement project at the following location during the dates listed below. BUILDING LOCATION: 1- � a n _ Ad oo►- START DATE: / OD END DATE: I LD 0 Please take the necessary precautions in the event you are required to enter the building during an emergency. Asbestos signs will be clearly posted in all areas where removal work is being conducted. If you have any questions please contact our office at any time. Thank you for your attention in the regard. Sincerely, LVI Environmental Services Inc. ` Project Coordinator Commonwealth of Massachusetts Asbestos Notification Form -ANF-001 ' 539376 ' Asbestos Abatement Descrlptlon —' 1. Facility location Ca e Cod Hos ital P P 26 Park Street INSTRUCTIONS Nsno n d: Atl/ress Hyannis 02601 t.All sections of[his - 00 8) 771 15 larmmustbecompleted Clry/lowrr lip code. felopinno In order lo comply wim South Wing — 2nd,Floor,. the BaDarlmont of M Environmental "'`' " ' •• wnark rho wcntslte laanom DurlOing find wlrq Wool roan Protection notification p .Is file tacit/ a requirements of 3lo CMR facility occupied? Wes 0 No: L15(ten*vAingdays Prior notircallanIs 3. Asbestos Contractor, ? �. required o/any abalemenr „ projecQ;and the kV.LRG� ""Seryces Inc, 195•,"Corporation,Way Depadment of Labor Nsne a Address ..................... and Industries - I notificationfequlremenis Me.df.o.rd of453 CMR 6.12 (fen clryiluwn """' ""''" Q1. .� (781) 396-$t3U0 days pilot nofiflcallon is' zip cmb .... required of ANY q abalementprglecfglealer D[IticeucyAC 000097 ` IAanNreellnearor h Conlndlypo(wdneNvabalj Written squarelee�. 4. On-Silo Project Supervlsor/6romans d 1 2.Subnul0rlginalForm Brown Butler Y AS`5088T d' ' To: :..,. • Nsnr - .... > Consnonweailhol `` OUc-NIGIion/ Y """"""""""' Massachusetts 5. Project Monitor: Asbestos Program ` "? P,O,B,120007 Diversified Environmental s AA 006107' Boston,MA 02112• ••• - Nsno 0007 -,,U(ICapDnrlonr .;,,.. ......... ..... 6. Asbestos Analytical Lab, 3. This form may be s used for nolifying the Ul tiri G.e...CR.I}§............. g Group AA 000145 U.S.Envhonmenlal Nsuo ..•. UUCdullurron/ ..... .............. .........................ProtedionAgencyRegion r .. ��. IOf asbestos demolilionl 7• Project Stan date 7 am — 3:30 pm renovallonOperations -=1--y�e ddate����specific work hours Mon.Fri._ ( ) _(Sal.Sun.)—.— CFO to NESHAPS(40 - •• ` CFOSubpadM). 8. What type of project Is tills? (circle Ono) °dcmondon' . � rqulr rorgvallan ' ,. uflrer/r.pdrinJ •• ` v corogKw neoay::;;.. 9. Describe the asbestos abatement procedures to b0 used (chcle):�plavebap •:xlosuro Adlromib.uml io„ae, erxapsurallon dlsposalonry I o11br(erphlNa a .:Y. k. rew cdo 1 • 10. Is the job being conducted ❑Indoors. O outdoors?. u . rnrtmdoaor cn 150 11. Total amount of each type of Asbostos Containing Materials(ACM)to be dandled on pipes or duels(linuar IL)___ or ouicr ' surfaces(square it.) ___to be'•removed,enclosed or encapsulated; //nearlsquare(eet and' fittings r boiler,brealedoflayetidf link perpiprlarnmalin. i5__ Iherrwl,;olldcoreplpelnsulalion _ /150 canugafedorlayeredpaperplpelnsulallan, ,,,_/ Insulatingcement ;spray-on lireproofrng.................. clorhs,"Yen/abdcs.................. —�— IioweUspra}rercoalings other(010ase 12. Describe the decontamination system(s)to be'used,` xx Three Chamber decontamination facility with 'shower: ........................... TbzA••..Chaznb,ex..,.d� .R.tlttii!}�1}a(ion facility with wash sta'riori _. 13. Describo the containerizallon/dlsposal methods to comply with 310 CMR 715 and 453 CMR 6.14 2 AD];.AQM shall be handled"wet (hand to bad) All waste )s/loll be a :Properly,.:packaged,..:.lab.eled and..a.ra R.R.xG�d...G4 PP ........ • ,roycd..landl`ill 14 .For Emergency Asbestos Abatement Operati ns the DEP and DLI officials who evaluated file onlergoncy: + k Nsnoo1DErori nue r.. Idyl DaleilAur/ndnrlon r� NnncolDLlOi/ldd ... . .... i= DareDlAuaariniton ........................... Waiver/ i a "to 15. Do prevailing wage rates apply as per M.G.I..c,149.§26,27,or 27A•F to this project? 0 Yes tyNo Rev.6/92 w Facility Description I Currontor pfloruscoffaclllty: Hospital .................................................................................... ............ ...................................... .......... ........... 2. Is the facillty ownor-occuplod residential with 4 units or less? 0 Yes 1 No 3, Facility Owner: Cape Cod Hospital 27 Park Street . ........ .. '—.....— A"d"J................ *t'v`s's' * ** —............ ........... Nuro Hyannis 02601 (508) 771-1800 * ....................... .......Gy/rown10 MAI 4. Facility's Owner's On-Silo Mana0ar: Terry Whittimore 27 Park Street .......... ....................................... A"O"i,t olls's, .......... ........... Nma Hyannis 02601 (508) 771-1800 .............I.................. ........... ...........I........................... ......................... ................................................. Cry/lows lip co 5. General Contractor. N/A Nana........... .......... Addross ...........I...................... ........................................................... ...............1—.................... ..... ....... ...........•............................. CitylTo wn Zip code Tolophom workof$COMD.Imurot polkyl EXP.0310 G. What Is the size of the facility? 800K—(sq it) 4—(I of floors) Asbestos T-ansporiallon and Disposal I. Transporter of asbes tos-containing waste material from silo to temporary storage silo(il nocessmy)to linal disposal site: LVI Environmental Services 195 Corporation Way . . . ..... ................................................ .......................1.............. .................. .............................. .0215.5................................... ..(181.) 39.6.7.8.800....................... 10 co 2. Transporter of asboslos-contalrilno waste material from romovall temporary storage situ to final dispos;A situ: C.o.... Inc,.......P.O. ..B...O.... .X .4..1i...................................................... .......................... .. . . NJlIV Mmij Portland, CT 06480 800-272-3867 Role:Tratislor io Cock V staliolls Inusl complfy vilth lho 3. Refuse Iransferstalon and-ownor(11 applicable): Solid Wasle oivislonr0oula. ................................................... ............................................................................................... ................. Ilon$010 CMR Zl� Address ..... .. .... ............... . Clry/rown 4. Final Disposal Site; VAl 1 .4.10 411 ............... ioullonNno omm Holm Pleasant Valley Rd ........... AcNrose Irwin PA 15642 (7211) 744-4000 .............................. .......... ........................... Certification Tho undorslonod heretyystates,undo r the penalties of perjury,that he/she has road III o Commonwealth of Mass ach usolls Regulations for the Removal,Conteiriment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 7.15;and that the Info rmallon contained In this notification Is true and correct to the best of hls/hef kno green ollol. 'o 3/30/00 DavidP Zearson............................................ . ............................................ PAINviv Au Note;Contractor niusl sioll this ident LYI Evirdninental Srvc (781) 396--W,100 form for OU poy"A.WS, nolilicallon purposes 195 Corporation Way................................ ..Medford 02 1 35 ................. ....................... ...... Medford.......................I................................ .........."............ . Awks UK- iq,CoLlu Fee exempt(City,Town,district,municipal housing authority,owner-occuplod rosidontlal of four units or loss)70 yos tNo Sticker I(fromiron(of form): �� �IJ�1�-`9 ► ��it� © ��O ® � Connolly IL-W DISNWASNER r NELN 1%B WALL W O t2BB 1 LOLATIOw j'6tP.BD.EA.SIDE R(� 1 REI•PyJE w:LOcnTE EXI5rIN5 41ER,rMYER TO GOORDMATE IN FIELD, j e S 1 ence - E%I6TIN6 MSTAIR6 LINEN GLOSET'SEE SEGOIm FLOOR RNU � 4'(]BB•1 -o'IB+'1 ' DIff.IWA5IER 1{ I 51• :E O0 0O _} R[rclaar �`� BmauosM-nBr -------T+L_._�__-_ �nsCiSLfrlv ArSw�"wAiRTvRAEA8T IDEcN ErsOR�n0V. 09oe6 2�f 1EyADrew_ OO ao gor B' B . .. 26 Park Place Hyannisport,MA 0 2647 O BDRM O ' ' f -.•usBr s<•1.'7 ,•lar " - Rri+aiEE%Isnwb I I aEl•love g OAHIIETS• J PONDER E%ISTIN6 DOOR I td=W CABINETS L O`` a' O p I cvuNraLz I I __ Pw.Ls. cgiNrEa Fvo '_. REUSE f- I RUMBIN6L Z ° E%ISnN6 REF. r I I' FI%rIARES. 'F _ I iL_J REF. , FJt15Tl 30'DR - ,atur I (FSEEFLrm �__ �__---__--- .O y OR LOLATIOw F i I I REF. B SA � r�1 s•o•orrwNb O 32"DR. O_-M&ED. Bennett Sullivan Associates,Inc. Q PORCH 7 u .. PoROI Iff_W 50'e WIDE �R P00.01 Architects and.Planners E�iclsTiNb DeoR d u �E81R�pppR _ Suite 201,Three Pomperaug Office Park wAu.IitEP.FOR Southbury, Connecticut 06488 raaw oFENIN6. _ _ r------ 203.264.8202- r---- r-_- - - . p� LrvB+c j Dmvsc _ ____ Ltm+D . . _ °mrNc _ ____ LlvwD f . � I I r-lo•nor ua -m-nor" uP ul= - "' IA' General Notes -a,and°0 iacu corms®ma d«i,,and plms k&=i WertovwrRseseated Wereby..o bymdttmaw Weper of Dcnnctt S°Ilivm Avenel Archie and PI....N.Fm EXISTINO FIRST FLOOR PLAN DEMO FIRST FLOOR PLAN PROPOSED'FIRST FLOOR PLAN "«`°``"dIh nB and"Y myP nuBmmc«pvN co fw my elcept wiW sp ws.nev mi ov°[We Erm BmveH - - S.M.coo Al­­gvmeWio-nuv Naned dPrIa,mwinc SCALE:I/4" I-0" An SCALE:I/4' SGALEr I/4 '-0 ilsubo&lvm ®,�M^P Wtidn wioby15« mk andd N bas cnmmc«xd - - 1Lfsvffim of Bcmcn Sugivm Avwciaves,Arrbimna and Mmocrs, - - - _ mlr«PnmiMerrltda.do,;°inrsn°d°rww,cao-.n ur,.ws. The Cmo-enaysdcly:vrymoble for We fidd in¢ryaeudov o[ - - - Ne drewwSs mdlhe o«<s R^^ivi^61a Wis dnxiug . CC1 't q a .w O B•an2r O _ . . _� \.. .rm -I•DBar r — - - -� - _ :i �-1 N . �. � s MASTER BEDROOM - � �---..- • MASIERBEOROOM //'�F�� a 2'-B•r3or y SHOWER Mom �SEy PERMIT 24 - ^ C�­21]2. _ 2 DR - NASrER/DRY�ER1-x w� s SET oo FIRST FI.mR iO � FOR CONSTRUCTION . FJOSTINB LIIIJENN CLOSET f�l - o 26 [7Rn „ n N. RCVlS10I1S < _ + No. Date Description Initials wl -ro•V.1 a' 9•0'Cw7 -.•tw•1 . gBm0.00M BEpt) ROOM i - gmR00M BEDROOM ' W C r, t r L O Y _ DrawingTitle o 4•trJr .Q IV Floor Plans o ' N , IS . Sole 1/4"-P-0" EXISTING SECOND FLOOR PLAN PROPOSED SECOND FLOOR PLAN Daw April23,2012 SCALE:I/4'=I'-0' Down By CGM/HJS - Checked By H1S _ _ - BSA Job Number- 11023 Drawing Number A. 101 Bennett Sullivan Associates,Inc o Copyright 2012 0