19 Notification of Deleading 2003 05/22/2007 TBP 17:28 FAX 413 525 0678 ABIDE INC LEMUR/Uri
1
a b i d e
Abide, Inc., Environmental Contracting
LEAD NOTIFICATION FAX COVER SHEET
DATE: Sin 1o3
ATTENTION:
[ ✓r irector,CLPPP(Boston)
[ "Director,LEAD PROGRAM(Boston)
Town/City of No R T1-1 AM PTO N
(Local Board of Makh)
[ Massachusetts Historical Commission
FROM: FRANK TILLI/ABIDE,INC.
REGARDING:
[ /PROJECT NOTIFICATION
[ ] REVISED NOTIFICATION
[ OTHER:
FAX #:
617-284-8410
617-727-7568
y)%- 587- 1ZZ
617-727-5128
NUMBER OF PAGES (including this one): 3
COMMENTS:
If you experience problems in receiving this transmission,please call 413-525-0644.
CONFIDENTIALITY N017CE: The document.accompunyin6 this rekeopY transmiffion may contain confidential and miyacgcd
information from Abide,Int This in(omwion is intended for the use oldie add:cssed individual or
entity. If you um not the incnded rceipimt be tune that any disclosure,copying distobmian,Of
use of the contents ofthis traosmusien.5pt hiM d. If you have rem.cd this umsmis.iml in csror,
please notify m by tclryhone(413525-0604)immediately. Thank you.
P.O. Box 886 East Longmeadow, MA 01028
Phone 413-525-0644 • Fax 413-525-0678 • www.abideinc.com
ABIDE, INC. PROJECT # p327(o— I
COMMONWEALTH OF MASSACHUSETTS
Department of Labor L Industries and Department of Public Health
NOTIFICATION OF DELEADING WORK
All auctions. of We fen aunt be completed in order to comply
with the notification requirements of M.G.L 0.111 5 197,
454 Ca 22.00 and 105 Cat 460.000 as moat recently aronaed
Contractor performing project
CVUL/VV.
FiIE MaaYR: ocraiCY USE)
ABIDE, INC. (Frank Tilli) license # DC001619
Vir/o3
Exp.date
Lead Paint Inspector N Ink Enc..hckra. License I = 2515
Date of Inspection BJTr/Oz.
If low-risk deleading work is being performed, complete the following line:
Property owner Agents)
Address of Project
Building Name (if any)
Street Address IS P.\3r�rwt art vt
City
Nuri'1-w„w,ikon
Deleading method: Wet/Dry Scraping
Liquid Encapsulant Covering
If "Other" selected, please explain
Heat Gun
Demolition
RE/AOvAL
{Res2 f sr
Apt. No. FIuJR A RCh1
Floor
Zip :oioGo
Caustic;"
Replacement : ocher
ONLY
Check One. evening is mulct-holly
Start date
G 1143
Completion dace
When will work be done: A.M. `� .00- P.M. S'.00
Weekends' (It-.
Project supervisor's name Robert P. LaMountain License # D53605
Property Owner 3 .rvi aknrA J'l�4nnit /tlt1o (-
Address yy,, 19 P ,19C,rel brkv�_ ,^
City ftvrthcze & \ State /'IA- Zip OIO( Q.— _
p
Telephone 4t3 — SS1- 9y2
Frank Tilli , President
In case of emergency concoct
Phone: day 413-525-0644 evening 413-525-0644
lover)
05/22/2003 ]Hl' 11:Ztl FAA 411 She U0(0 ADUlt ldt.
In accordance with Massachusetts General Laws c. 111 S 192 04B 22.00 ano 105 CIO. 460.000 notice
of the date and methods(al of removal or covering of paint. plaster Or other accessible sible material!:
Dining dangerous levels of load is to be provided and most be received oy the following
Persons, at least ten (10) days prior to beginning of deleading.
Occupants of the dwelling unit
All other occupants of the residential premises, it any
Director, Childhood Leading Poisoning Prevention Program
Department of Public Health. 470 Atlantic Avenue, Burton, MA 01110
Fax (617) 284-8410
Director, AaDesms 6 Lead Program Fax (6121 727-756B
Department of Labor a Industries -
Room 11006, 100 Cambridge Street
Boston, MA 02202 �.a� �r,�T]�A��
Local Board of Health/Code enforcement Agency C 1 ' I vF /w+ a V -ant"'
Few Pi)S87— 221
Massachusetts Historical Commission
220 Morrissey Blvd,
Heston; MA 02125
netaadtng contractor
(If premises Is listed on the State Register
of Historic Places, this notification must be
made upon receipt of an Order to Correct
violations or t least 30 days prior to
initiating. preventive deleading)
Fax (612) 721-5179
The undersigned hereby stares, under the pains and penalties of perjury, that
he/she has read and understood the Commonwealth of Massachusetts Deleading
Regulations, 454 CMR 22.00 and Leading Poisoning Prevention and control
Regulations, 105 CMR 460.000, and that the information contained in this
notification is true and correct to the best of his/her knowledge and belief.
/ �'
Date 5/2L '03 signed.M46/1k i Frank Tilli
r is
title: President
company, ABIDE, INC.
property Owner (If owner or unlicensed owner's agent will be performing low-risk deleadln9 work)
I certify that I have complied with the training requirements of the
Commonwealth of Massachusetts Lead Poising Prevention and Control Regulations,
105 CMR 460.175, for owner/agent low-risk abatement and contaiiunlnt. I
further certify that I or my agent will be performing
the following low-risk activities (I have circled all that apply) :
applying liquid ercapsu lint
applying exterior vinyl siding
removing doors, cabinet doors, shutters
capping baseboards
covering snrfaCes
I certify that all the information contained in (his notification Is true and correct n' the
best of my knowledge and belief.
Date: Signed.
ABIDE, INC. PROJECT # 03Z-i&-
REV In/12/95