Loading...
HomeMy WebLinkAbout0068 BRISTOL AVENUE - HAZMAT n a GREEN ENVIRONMENTAL February 16,2022 CONSULTING SERVICES Mr. Thomas McKean,Director Hyannis Health Department 200 Main Street Hyannis, MA 02601 RE: ASEestos Abatement Notification Barnstable Housing Authority—Elevator Doors 68 Bristol Avenue,Hyannis CONTRACTING SERVICES Dear Mr. McKean, Green Environmental, Inc. (GREEN) would like to inform you of an asbestos abatement project at the Barnstable Housing Authority — 68 Bristol Avenue, Hyannis, MA. The work is scheduled to begin 3/l/22. Attached please find a copy of the project MassDEP Asbestos Notification Form for your records. WASTE MANAGEMENT If you have,any questions, please contact the project manager, David Patti at 781-901- 1608. Sincerely, CIVIL ENGINEERING Green Environmental,Inc. SITE DESIGN 296 Weymouth Street,Unit C Rockland,MA 02370 P:(617)479-0550 F:(617)479-5150 2/16/22,2:54 PM AQ 04-Asbestos Removal Notification Form ANF-001-Transaction#1346681 Massachusetts Department of Environmental Protection 100360550 BWP AQ 04 (ANF-001 ) Asbestos Project# Li Asbestos Notification Form _ Project Revision Project Cancellation A. Asbestos Abatement Description 1. Facility Location: BRANSTABLE HOUSING AUTHORITY 68 BRISTOL AVENUE a.Name of Facility b.Street Address BRANSTABLE v MA 02601 508-280-5703 c.Cityrrown d.State e.Zip Code f.Telephone RODNEY FERNANDES I FACILITY DIRECTOR g.Facility Contact Person Name h.Facility Contact Person Title Instructions 1.Ali Worksite Location: ELEVATOR DOORS sections of this form must i.Building Name,Wing,Floor,Room,etc. be completed in order to comply with MassDEP 2. Is the facility occupied? ❑E a.Yes FD b.No notification requirements of 310 CMR 7.15 and 3. Is this a fee exempt notification(city,town, district, municipal housing authority, state facility, or owner- Department of Labor occupied residential property of four units or less)?A a.Yes C b.No Standards(DLS) notification requirements 4. Blanket Permit Project Approval, if applicable: of 453 CMR 6.12 Approval ID# 5. Non-Traditional Asbestos Abatement Work Practice Approval, if applicable: �— MassDEP Use Only Approval ID# F_ 6.Asbestos Contractor: Date Received GREEN ENVIRONMENTAL 1296 WEYMOUTH ST STE C a.Name b.Address ROCKLAND MA 02370 617-479-0550 c.Cityrrown d.State e.Zip Code f.Telephone AC000688 h.Contract Type: 1.Written C 2.Verbal g.DLS License# 7. 1 MARK SHEEHAN AS06 9907 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# 8. 1 ­­­­1 N/A a.Name of Project Monitor b.DLS Certification# 9. UNIVERSAL ENVIRONMENTAL CONSULTANTS INC AA000177 a.Name of Asbestos Analytical Lab b.DLS Certification# 10. 03/01/2022 03/01/2022 a.Project Start Date(MWDD/YYYY) b.End Date(MM/DD/YYYY) 8:OOAM4:30PM N/A c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11.What type of project is this? F9a.Demolition ®b.Renovation C c.Repair ®d.Other-Please Specify: 12.Abatement procedures(check all that apply): oa.Glove Bag ®b.Encapsulation Elc.Enclosure d.Disposal Only Ce.Cleanup Cf.Full Containment og.Other-Please Specify: POLY ON GROUND,CAUTION TAPE AREA OFF,REMOTE DECON https://edep.dep.mass.gov/eDEP/WebForms/Asbestos/BWPANF001.aspx 1/4 2/16/22,2:54 PM AQ 04-Asbestos Removal Notification Form ANF-001-Transaction#1346681 13.Job is being conducted: a.Indoors©b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be.removed, enclosed, or encapsulated: 60 1.Linear Feet(Lin.Ft.) 2.Square Feet(Sq.Ft.) b.Boiler,Breaching,Duct,Tank � c.Transite Pipe Surface Coatinqs Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. C d.Pipe Insulation �� e.Transite Shingles 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. f.Spray-On Fireproofing � 9.Transite Panels 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. h.Cloths,Woven Fabrics i.Other-Please Specify: 1.Lin.Ft. 2.Sq.Ft. j.Insulating Cement DOOR CAULKING 60 e 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. 15. Describe the decontamination system(s)to be used: 3 CHAMBER WITH FULLY FUNCTIONING SHOWER 16. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): DOUBLE BAGGED AND PLACED INTO A LINED DUMPSTER 17. For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: a.Name of MassDEP Official b.Title of MassDEP Official c.Date of Authorization(MM/DD/YYYY) d.Waiver# e.Name of DLS Official f.Title 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 0 a.Yes o b.No project? B. Facility Description 1. Current or prior use of facility: IRESIDENCE 2. Is the facility owner-occupied residential with 4 units or less? IUI a.Yes F0 b.No 3. 1 BARNSTABLE HOUSING AUTHORITY I 146 SOUTH STREET a.Facility Owner Name b.Address HYANNIS MA 02601 508-771-7222 c.City/Town d.State e.Zip Code f.Telephone 4. RODNEY FERNANDES I 146 SOUTH STREET 77 a.Name of Facility Owner's On-Site Manager b.Address hftps://edep.dep.mass.gov/eDEP/WebForms/Asbestos/BWPANF001.aspx 2/4 2/16/22,2:54 PM AQ 04-Asbestos Removal Notification Form ANF-001-Transaction#1346681 HYANNIS I MA 02601 508-280-5703 �.9 GREEN ENVIRONMENTAL,INC. 296 WEYMOUTH ST,UNIT C a.Name of General Contractor b.Address ROCKLAND MA 02370 617-479-0550 c.City/Town d.State e.Zip Code f.Telephone GREAT DIVIDE INSURANCE g.Contractor's Worker's Compensation Insurer WCA152840922 I 01/01/2023 h.Policy# i.Expiration Date(MM/DD/YYYY) 6.What is the size of this facility? 11400 —7_1 1 a.Square Feet b.#of Floors Note:Temporary storage of Asbestos containing C. Asbestos Transportation & Disposal waste material is only allowed at the place of 1.Transporter of asbestos-containing waste material from site of generation: business of a DLS licensed Asbestos a a.Directly to Landfill orL�=d b.To Temporary Storage Location/Transfer Station contractor or a transfer station that is permitted RED TECHNOLOGIES 10 NORTHWOOD DR by MassDEP and c.Name of Transporter d.Address operated in compliance BLOOMFIELD CT 06002 860-218-2428 with Solid Waste e.City/Town f.State g.Zip Code h.Telephone 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: a.Name of Transporter b.Address 0 c.City/rown d.State e.Zip Code f.Telephone 3. Name and address of temporary storage location/transfer station for the asbestos containing waste material: a.Temporary Storage Location.Name b.Address 0 c.City/Town d.State e.Zip Code f.Telephone 4. Name and location oftinal disposal site(asbestos landfill): MINERVA ENTERPRISES,LLC FRANK STUFANO a.Final Disposal Site Name b.Final Disposal Site Owner Name 8955 MINERVA RD SE c.Address Note:Contractor must IWAYNESBURG OH 44688 330-866-3435 sign this form for DLS d.City/Town e.State f.Zip Code g.Telephone notification purposes D. Certification "I certify that I have personally.examined DEREK BAGGETT 1 DEREK BAGGETT the foregoing and am familiar with the 1.Name 2.Authorized Signature information contained in this document OPERATIONS MANAGER 02/16/2022 and all attachments and that,based on my inquiry of those individuals 3.Position/Title 4.Date(MM/DD/YYYY) immediately responsible for obtaining 617 479 0550 GREEN ENVIRONMENTAL,INC. the information,I believe that the 5.Telephone 6.Representing information is true,accurate,and 1296 WEYMOUTH ST UNIT C IROCKLAND hftps://edep.dep.mass.gov/eDEPMebForms/Asbestos/BWPANFOOl.aspx 3/4 2/16/22,2:54 PM AO 04-Asbestos Removal Notification Form ANF-001-Transaction#1346681 complete.I am aware that there are 7.Address 8.City/Town significant penalties for submitting false IMA I 02370 information,including possible fines and 9.State 10.Zip Code 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." https://edep.dep.mass.gov/eDEP/WebForms/Asbestos/BWPANF001.aspx 4/4 ' TOWN OF BARNSTABLE ,l -`l4/D ��'�' �'"'� UNDERGROUND FUEL AND' CHEMICAL STORAGE SYSTEMS v��v 3,V 5 \00 ��� Cj► ASSESSORS MAP N0. 0 PARCEL NO.. Z4 ' ADDRESS: A r VII;LAGE, NAME;.-. Db�J CONTACT PERSON LOCATION OF TANKS `CAPACITY TYPE OF FUEL E TYPE:' LEAK OR CHEM$CA�, DETECTION SYSTEM! A. #: DATE OF PURCHASE fOEACH:. 1,/ 2. 3. 4, 5. DATE OF° FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE 'PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. �/ f i ;f• Fr TOWN. OF. BARNSTABLE VA W�UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS 'f� ASSESSORS MAP NO. PARCEL NO. ADDRESS' t 9i rod VILLAGE* j YANNI§' MA. 0a(,- ® 3 NAME',_ �:�lSt-f�.l'ai�k I� DS�S'd.�l� .. �.fJ �I�I'�.D7 % _� � � i• �YR 11AA oa40 CONTACT PERSON NA)N F.lV FA M C,E- ���: PHONE NUMBER LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: LEAK _ OR CHEMICAL: DETECTION 9L76 SYSTEM!� e DATE OF PURCHASE OF. EACH: 1. 2. 3. 4. 5. DATE OF FIRE DEPARTMENT PERMIT: 1) J,$ 12 to =� f If TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. V-tit M /Nl WA`1 -Ae��c. �2,ySTO:. Av+ � P (9 P M�of DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 19 V Date Form F.P. 290 TO MAINTAIN AN EXISTING%NEW UNDERGROUND STORAGE FACILITY Part 4 In accordance with the provisions of 527CMR9.24 this permit to maintain an existing/new underground storage facility is granted to Location of property: G `�j-y► „�, Street address Owner of property: / / Full name of person firm or corp ation Restrictions: f.. �r a, 27. A4 too Z Fee Paid:$ !> (M.G.L.A. Chapt. 148 Sec. 10A) This permit will expire 3'f 19pj Date S ature of Head of Fire Dept. or Apointed de ' nee (Owner's Copy to be posted at the storage facility with F.P.290 Part 3) - F FIRE DEPT. FIRE DEPT. STATE USE ONLY CERTIFICATION ' Copy to be certified by local fire departmentl.D.Number and: POSTED AT STORAGE FACILITY y Dater Received ai_ YY Notification is required by Federal law for all underground tanks that have been 4. pipeline facilities (including gathering line) regulated under the Natural Gas used to store regulated substances since January 1,1974,that are in the ground as of Pipeline Safct}Act of 1969.or the Hazardous Liquid Pipeline Safcn Act of 1979.or May 8,1986,or that are brought into use after May 8,1986.The information requested N'hich is an intrastate pipeline facilit}'regulated under State laus: is required by Section 9002 ofthe Resource Conservation and Recovery Act,(RCRA), S.surfacc impoundments.pits,ponds.,or lagoons: - as amended. 6.storm or waste water collection systems-. The primary purpose of this notification program is to locate and evaluate under- 7•Ilow-through process tanks: ground tanks that store or have stored petroleum or hazardous substances. It is 8.liquid traps orassociated gathering linesdirecth related to oil orgas)Sroducuonand gathering operations: escorted that the information you girds.y will be based on reasonably available 9. storage tanks situated in an underground area (such as a basement, cellar.- records.or.in the absence of such-records.your knowledge,belief.orrecollechon. ,mineworking,drift,shaft.or wnnell if the storage tank is situated upon or about the Who Must Notify? Section 9002 of RCRA.as amended. requires that. unless surface of the floor. exempted.owners of underground tanks that store regulated substances must notify designated State or local agencies of the existence cif their.tanks.Ouner means— What Substances Are Covered? The notification requirements apply to under- (a) in the case of an underground storage tank in use on November 8, 1984.or ground storage tanks that contain regulated substances.This includes am substance brought into use after that date,any person who owns an underground zforage tank defined as hazardous in-section 101 (14) of the Comprehensive Em'ironmental used for the storage-use.or dispensing of regulated substances,and Response.Compensation and liability Act of 1980(CERCLA).with the exception of (b) in the case of any underground storage tank in we before N'ovembcr K. 1984. those substances regulated as hazardous waste under Subtitle C of RCRA. It also but no longer in use on that date-any person who owned such.tank irnmcdiatcl}before includes petroleum.e.g..crude oil or am'fraction thereol'which is liquid at standard the discontinuation of its use. conditions of temperature an&pressurr(00 degrees Fahrenheit and 14.7 pounds per What Tanks Are Included? Underground storage tank is defined as any one or square inch absolute). combination of tanks that(1)is used to contain an accumulation of"regulated sub- Where To Notify?:C'omple.ted notification forms should.be sent tit the address stances."and(2)whose volume(including connected underground piping)is 1017i or given at the top of this page. more beneath th;ground.Some examples are underground tanks storing:1.gasoline. used oil,or diesel fuel.and 2.industrial solvents.pesticides.herbicides Or fumigants. When To Notify? 1.Owners of underground storage tanks in use-or that hasc hero What Tanks Are Excluded? Tanks remoxed from the ground-are not suhiect to taken out of operation after Januim 1. 1974.but still in the ground.must notify by Mas 8. 1986.2.Owners svho bring underground storage tanks ihio use after Ma}'8; notification.Other tanks excluded front notification arc: 1.farm or residential tanks o1 1.100 gallons or less capacity used for stirring motor f ue1 1986.must notil'c within?0 days of bringing the tanks into use. for noncommercial purposes: Penalties: Any owner who knowingly fails to notify or submits false information 2.tanks used for storing heating oil lirr consumptive use on the premises is here stored: shall be subject to a civil penalty not to exceed$10,000 for each tank for which 3.septic tanks: notification is not given or for which false information is submitted. Please type or print in ink all items except"signature"in Section V.This form must by completed for Indicate number of each location containing underground storage tanks.If more than 5 tanks are owned af4-his location, continuation sheets photocopy the reverse side,and staple continuation sheets to this form. attached Owner Name(Corporation,Individual,Public Agency,or Other Entity) (If same as Section 1,mark box here❑) �► ��♦ Facility Name or Company Site Identifier,as applicable Street Address o Street Addlress or State Road,as applica le ity State ZIP Code ty Aree�C: ae o Phone Number M City(nearest) State ZIP Code Type of Owner (Mark all that apply®) Current State oral G ❑ Private or Indicate,, Mark box here if tank(s) Corporate number of are located on land within ❑ ❑ Former ❑ Federal Gov't ❑ Ownership tanks at this an Indian reservation or (GSA facility LD.no. uncertain location on other Indian trust lands ) Name(If same as Section I,mark box here ❑) Job Titl Area Code Phone Number i�A/ S/ri OI✓ Ctr' 6� dw y L ❑ Mark box here only if this is an amended or subsequent notification for this location. I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents,and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe.t'hat the submitted information is true,accurate,and complete. Name and official,titl o wner or owner's authorized representative Si attire Date Signed • ,. Form F.P. 290 Part 3 Pagel ti Owner Name(from Section 1) Location(from Section II) Page No. ;of., Pages Tank Identification No.(e.g.,ABC-123),or , Tank No. Tank No. Tank No. Tank No. Tank No. Arbitrarily Assigned Sequential Number(e.g.,1,2,3...) 1.StatusTank( Currently in Use (Markrk allll that apply®) Temporarily Out of Use 0 Permanently Out of Use Brought into Use after 5/8/86 2.Estimated Age(Years) 3.Estimated Total Capacity(Gallons) 4.(Material of Construction' Steel C� 0 0 (Mark one OD) Steel Fiberglass Reinforced Plastic 0 0 0 Unknown O O O Other,Please Specify S.Internal Protection (Mark all that apply E) Cathodic Protection 0 0 Interior Lining(e.g.,epoxy resins) None 0 0 Unknown 0 0 0 ] Other,Please Specify External Protection Cathodic Protection (Mark all that apply E) Painted(e.g.,asphaltic) 0 0 0 0 Fiberglass Reinforced Plastic Coated 0 0 0 0 None 0 0 0 Unknown [� 0 Other,Please Specify 7.Piping Bare Steel 0 (Mark all that apply E) Galvanized Steel 0 Fiberglass Reinforced Plastic Cathodically Protected 0 0 0 0 Unknown 0 Other,Please Specify 8.Substance Currently or Last Stored a. Empty. In Greatest Quantity by Volume b. Petroleum (Mark all that apply,E) Diesel 0 0 Kerosene Gasoline(including alcohol blends) 0 0 0 0 Used Oil 0 Other,Please Specify c. Hazardous Substance Please Indicate Name of Principal CERCLA Substance OR Chemical Abstract Service(CAS)No. Mark box IN if tank stores a mixture of substances 0 0 0 0 d. Unknown 9.Additional Information(for tanks permanently taken out of service) a. Estimated date last used(mo/yr) b. Estimated quantity of substance remaining(gal.) c. Mark box 13 if tank was filled with inert material (e.g.,sand,concrete) 0 Page 2 c . 7 THE COMMONWEALTH OF MASSACHUSETTS Z FIRE DISTRICT OF HYANNIS, MASS. FIRE DEPARTMENT I? 4� FIRE PREVENTION DIVISION PERMIT FOR STORAGE OF FUEL OIL Idcharc z-riog Name ---barn. table Ho'aSlila Name nrio-( i. ::F>� 10 ---- - == --- - 68 iOwner or Occup.) — ! (Installer)- - :r 1st of iiw, 'Y'' 1074 Address - -- - -Address -----------•----------------- - -- - -- ------------------------------ 014??1 Certif Comp. # — - — ----- 77 .8694 7T-5-0<.16 PhoneNo- ----------- --- __--- --Phone'No. ---------------------------- •------- -- .RNER) ( TORAGE) , 1c-cc ..:�,. �L�,.:.. .. :r ound Name ----------- - -- g --T---Type of Tank - -- -- - k.h'. liE;cket :1 275 Manufacturer ----_--------_--_--�_ Capacity -----_; _ gals. (or) Size - Model No Ul i Size T-----,ho,pation Type-_------ Mass. Approval No----------.-___— Permit Issued % of Carbon Dioxide__.—_______— Draft._____________.____.____ Smoke Density— _ Stack Temp-----------__---.• b:i chard h. Farrenkopf Nozzle Size__T1 f�SFee6___ y Appl. Reed s�t3�c�12lCOp 1` �Iea,�„of 'h a Department) Issued By: _..._ -- ----- —By --------`--�/--l----C-(,5 li I N WAy -- i �� 1 1