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HomeMy WebLinkAbout0182 HOLLINGSWORTH ROAD - Health (2) 182-HOLLINGSWORTH ROAD OSTERVILLE A= 140 - 087 TOWN OF BARNSTABLE LOCATION ��? a ��"� W006+ Pc SEWAGE# VILLAGE()_4P.K,Q111C ASSESSOR'S MAP&PARCEL I�d o D*7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY Tbmpfd LEACHING FACILITY:(type) (size) NO.OF BEDROOMS 3 J, OWNER 'Irl 4m P PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of D BYl �a acility Feet FURNISHE �' � 1/���b Ga�6� �o� '° Commonwealth of Massachusetts `_. 100227068 Asbestos Notification Form ANF-001 Asbestos Project# Project Revision i ' ❑ Project Cancellation A. Asbestos Abatement Description 1.Facility Location: GINTARAS&RUTA DEGESYS 182 HOLLINGSWORTH ROAD Name of Facility Street Address Instructions 1.All BARNSTABLE MA 02655 0000000000 (ge �ZvJ 0 1� sections of this form City/Town State Zip Code Telephone must be completed in X X order to comply with MassDEP notification Facility Contact Person Name Facility Contact Person Title requirements of 310 Worksite Location: ATTIC CMR 7.15 and Department of Labor Building Name,Wing,Floor,Room,etc. Standards(Dl-S) 2. Is the facility occupied? G'Yes IJ 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 applicable: Approval ID# Form To: Commonwealth of 6.Asbestos Contractor: Massachusetts NEW ENGLAND SURFACE MAINTENANCE 850 WASHINGTON STREET P.O.Box 4062 Boston,MA 02211 Name Address WEYMOUTH MA 02189 7813372117 City/Town State Zip Code Telephone A0000196 Contract Type: F Written r Verbal DLS License# 7. JOHN P.VALLIQUETTE AS060773 Name of Contractor's On-Site Supervisor/Foreman DLS Certification# 8, RICHARD K.BOWEN AM061044 Name of Project Monitor DLS Certification# 9, FU ENVIRONMENTAL INC AA000144 Name of Asbestos Analytical Lab DLS Certification# 10. 9/3/2015 9/13/2015 Project Start Date(MM/DD/YYYY) End Date(MM/DD/YYYY) 7-4 7-4 Work Hours-Monday Through Friday Work Hours-Saturday&Sunday 11.What type of project is this? Demolition [ Renovation Repair ❑ Other-Please Specify: Revised: 11/13/2013 Page 1 of 4 'Commonwealth of Massachusetts 100227068 Asbestos Notification Form ANF-001 Asbestos Project# j Project Revision Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): Glove Bag ❑ Encapsulation Enclosure Disposal Only Cleanup Full Containment F- 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: 800 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 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 VERMICULITE 800 Lin.Ft. Sq.Ft. Lin.Ft. Sq Ft. 15.Describe the decontamination system(s)to be used: AS REQUIRED 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g): AS REQUIRED 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/DD/YYYY) Waiver# 18.Do prevailing wage rates as per M.G.L.c. 149,§ 26,27 or 27A—F apply to this ❑ y� No project? Revised: 11/13/2013 Page 2 of 4 Commonwealth of Massachusetts 100227068 Asbestos Notification Form ANF-001 Asbestos Project# r Project Revision 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? [j Yes ❑ No 3.GINTARAS&RUTA DEGESYS 182 HOLLINGSWOTH ROAD Facility Owner Name Address BARNSTABLE MA 02655 0000000000 City/Town State Zip Code Telephone 4.X X Name of Facility Owner's On-Site Manager Address X MA 00000 0000000000 City/Town State Zip Code Telephone 5.X X Name of General Contractor Address X MA 00000 0000000000 Note:Temporary storage of Asbestos City/Town State Zip Code Telephone containing waste X material is only allowed at the place Contractor's Worker's Compensation Insurer of business of a DLS X 1/1/2016 licensed Asbestos Policy# Expiration Date(MM/DD/YYYY) contractor or a transfer station that is 6.What is the size of this facility? 1700 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: r Directly to Landfill or � To Temporary Storage Location/Transfer Station NEW ENGLAND SURFACE MAINTENANCE,LLP 850 WASHINGTON STREET Name of Transporter Address WEYMOUTH MA 02189 7813372117 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: RED TECHNOLOGIES 10 NORTHWOOD DRIVE Name of Transporter Address BLOOMFIELD CT 06002 8602182428 City/Town State Zip Code Telephone Note:Contractor must sign this form for DLS Revised: 11/13/2013 Page 3 of 4 Commonwealth of Massachusetts 100227068 Asbestos Notification Form ANF-001 Asbestos Project# "i j Project Revision Project Cancellation nuunuauun puNuxa C.Asbestos Transportation&Disposal: (cont.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: REDTECHNOLOGIES 203 PICKERING STREET Temporary Storage Location Name Address PORTLAND CT 06480 8603421022 City/Town State Zip Code Telephone 4.Name and location of final disposal site(asbestos landfill): MINERVA ENTERPRISES MINERVA Final Disposal Site Name Final Disposal Site Owner Name 9000 MINERVA ROAD Address WAYNESBURG CH 44688 3308663435 City/Town State Zip Code Telephone A Certification "I certify that I have personally examined the foregoing and am JIM DOYLE JIM DOYLE familiar with the information Name Authorized Signature contained in this document and PARTNER 8/19/2015 all attachments and that,based on my inquiry of those PosilioNTitle Date(MM/DD/YYYY) 7813372117 NESM,LLP individuals immediately responsible for obtaining the Telephone Representing information, I believe that the 850 WASHINGTON STREET WEYMOUTH information is true,accurate,and Address City/Town complete. I am aware that there MA 02189 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 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 z" 21'-0" 1.) CONTR/ wt �-°� > 3'-0" &DIMES 2) CONTRA DETAIL♦ I 3) ROUGH EXIST. ;F)Rsr,F PATIO EXIST. EXIST. 4•) ALLtCQ BEDROOM BEDROOM STATE e 5.) '110 IV)P A B C q 6.).ALL°SHE C335 EN A3 OR HOR c33s 7-) ALL.LVL! — I SINK DW i L O © 8•) FOLLOVI / I _, ALL SIMI _ 0 EXIST. (FLAT CEILING) I ij II �1 - 0 o 9•) ALL COI! GARAGE // 5 I d TO BE31 BREE E- �XIST 8;x'e'I B€aBavr•—0. r6s. 10.)VERIFY, 'i. I RA E I _ q 2'6"DOOI i / ,� CLO 3 DURING WAY 1 O 11 / SHIPS © C� 11.)TIMBER I * 1 ISLAND - 1I y __ _-- _—_— 6 LP`DDERUP 12.)FOLLOW I I1 i ROR, 1 1 I I I © EXIST. EFFICIEN RE ' I R 1 REMOD. BATH INSTALLS #, /_ HALL 13.)ALL HEAL REMOD. 3'-0" —— 14.)THIS STIR ` KITCHEN BUILT-IN ' CABINET CLp CLOS. MANUAL' (VAULTED CEILING) (VERIFY KITCHEN I p IECC20' LAYOUT W/OWNER) - �� 11 CLIMATE ZI _y `4 TABLE 402. FENESTRATION © U-FACTOR EXIST. VERIFY HEADROOM _ O.]2 DINING AT EXISTING WALL NOTES: EXIST 1.R-VALUES! (VAULTED CEI NG) 3'-B" { 2.15119 MEAN EXIST. BEDROOM'".# OF THE HC LIVING a •� 3.REFER TO 1 � (VAULTED CEILING) ;.; 4.13+5 MEAN 421 R13 CAVE °J T ti. �, A II 4. .; DN. JOINT DESCRIPTION ROOF FRAMING: ` _—_�` 1 II 4 .�5.?`:I BLOCKING TO RAFTER(TOE NAILED) _ RIM BOARD TO RAFTER(END NAILED) E I I hi 3« WALL FRAMING: PLATES A INTERSECTIONS(FACE NAILED) kl 1 I STUD TO STUD(FACE NAILEDI B I 1 `' Ty �+{- ) HEADER TO HEADER(FACE NAILED) A' - FLOOR FRAMING—jOfST TO : - r,)( S-5 " R� p1` '' BLOCKING TO JOOISTS�OE NAILED TE OR ER(TOE NAILEI ¢�(y ` 30'-0" : �"; BLOCKING TO SILL OR TOP PLATE ROE NAILED) T.:•, e� LEDGER STRIP TO BEAM OR GIRDER(FACE NAILEC } f FIRST FLOOR PLAN A JOIST ON LEDGER TO BEAM(TOE NAILED) /f b BAND JOIST TO JOIST(END NAILED) ',15•.1y. �,:. BAND JOIST TO SILL OR TOP PLATE(TOE NAILE00 ROOF t TF p*( T• SHEATHING:WOOD STRUCTURAL PANELS(PLYWOODI RAFTERS OR TRUSSES SPACED UP TO 16-o.c. ^1i 1,�. y �����D' (�K1_d �^r RAFTERS OR TRUSSES SPACED OVER 16" .c. ^Ib' GABLE END WALL RAKE OR RAKE TRUSS W10 OVER GLE END WALL RAKE OR EXISTING WALLS t W�STRUCTURALOUTLOOKERSKETRUSS GABLE END WALL RAKE OR RAKE TRUSS W/LOOKO CONSTRUCTION TO BE REMOVED; r, ' CEILING SHEATHING: NEW CONSTRUCTION ( 1 l/\//(8��(T GYPSUM WALLBOARD _{ LID `� WALL SHEATHING: U i ��02 U��I� S�c��Y� �