97 Project Revision Notifications 2010-2011 mportant:
Nben filling out
orms on the
nmputer,use
mly the tab key
o move your
:ursor-do not
me the return
ey.
T
a
VSTRUCTIONS
This form is
my available for
nline filing of
roject date
;visions.
Enter project
ecal number.
Validate that
re project
motion is correct
v the entered
ecal.
Enter your new
"(Oct dates.
Certify your
obhcation.
ubmit date
langes.
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
100114909
Decal Number
A. Facility Location
HAMPSHIRE HEIGHTS
1.Name of Facility
7 HAWLEY STREET
2.Street Address
NORTHAMPTON
3.City
4077372000
6.Telephone Number
MA
4.State
5.Zip Code
B. Project Cancelled
Check here if this project is/was cancelled.
C. Project Dates
1/10/2011
L Original Start Date(mrTdd/yyyy)
1/24/2011
3.Latest Revised Start Date(mm/dd/yyyy)
1/10/2011
2.Original End Date(mm/ddryyyy)
1/24/2011
4.Latest Revised End Date(mm/dd/yyyy)
D. Revised Project Dates
12/3/2011
1-Revised Start Date(mm)ddryyyy)
12/3/2011
2.Revised End Dale Date(mmldd/yyyy)
E. Other Project Revisions
F. Revision History
EDEP:01/06/2011 10:37:10 AM
nfO6pdmdoc•rev.2/5/04
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention—Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
1100114909
Decal Number
1
G. Certification
The undersigned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of
Massachusetts regulations for the Removal, Containment or Encapsulation of Asbestos.453 CMR 6.00 and 310
CMR 7.15,and that the information contained in this notification is t - and • rect tot best• his/he'knowledge
and belief. 'OP -
(FAITH LEMAY
1. Name
IADMIN ASSIST
2. Position/Title
IACCUTECH INSULATION &CONTRACTING, II
4. Representing
1100 STATE ST. BLDG 119, PO BOX 376
6. Address
(LUDLOW
7 City/Town
it06pdrndoc•rev.2/5/04
aith LeMay
Authorized Signature
1/2412011
3 Date mmldc
[4135835500
S. Telephone_.
LA
1 (01056
8 Zip Code
Int:
;Ming out
in the
ter,use
e tab key
e your
-do not
return
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
A. Facility Location
'HAMPSHIRE HEIGHTS
1.Name of Facility
197 HAWLEY STREET
2.Street Address
;NORTHAMPTON
3.City
a14077372000
6.Telephone Number
100114909
Decal Number
MA
4.State
5.Zip Code
tUCTIDNS B. Project Cancelled
is form is
vaiiable for I I Check here if this project is as cancelled.
filing of
1 date
ans.
ter protect
number C. Project Dates - 1
tidate that
roject ;1110!2011 2 p"o nal End Date(mmldid yam_
on is correct 1.original Start Date(mmadd/ym) --
e entered
4.Latest Revised End Date(mldlyyyy)
3 Latest Revised Start Date(mmlddlyyyy) md
nter your new
dates.
ertity your
cation D. Revised Project Dates
it date --� —
- "--" %1124/2011
I Iges 11/24/2011—
. I ---- 2 Revised Start Date ly
( mlddyyy) Revised End Date D t ( m/dd/yyity)
E. Other Project Revisions
F. Revision History
L_------
antospdmdoc•rev.2)5/04
--1
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
G. Certification
The undersigned hereby states,under the penalties of perjury,that he/she has read the CMCommo
6 nw 0 and 310 of
Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos,453
CMR 715,and that the information contained in this notification Is tr nd corr t tothy best his/11er knowledge
and belief. % ,
h LeMay
d Signature
1/6/2011
o to t Idol wl
1,1001 01 94949
Decal Number
FAITH LEMAY
1. Name
ADMIN ASSIST
2. Position/Title 4135835500
ACCUTECH INSULATION &CONTRACTING,II 4135835500
5 Telephone
4 Re STATE 19 PO BOX 376
100 STATE ST. BLDG 119,
LUDLOW [ 1
6. Address
01056
--__. _—_ .___.__.
--- B. Zip Code
]. CiryROwn
anf06pdm doc rev.2/5/04
I
out
se
key
not
im
Massachusetts Del. it of Environmental Protection
Bureau of Waste Preve. —Air Quality
Project Revisio Notification
For Asbestos Notification a.NF-001 and AQ 06
A. Facility Loca ion
HAMPSHIRE
NONS
rm is
able for
g of
to
project
nber.
he that
ct
s correct
itered
your new
Fates.
Pi your
pn.
date
1.Name of Facility
97 HAWLEY STREET --
.Street Address
NORTHAMPTON MA
MAState
3.City 4.
4077372000
6.Telephone Number
100114915
Decal Number
B. Project Cancelled
Check here if this project is/was cancelled.
C. Project Dates
121912010
I.On ma
Start oat
mmlel
5.Zip Code
Latest Revised Start Date(mmiddl
y)
D. Revised Project Dates
1213012010 — ---
1.Revised Start Date(mm /ddlyyyy)
E. Oth Project Revisions
2 O t E tl9-- NwY) __
12/31/2010
4.Latest Revised End Date(rimlddlyy)y)
2.Revised Date (mmiddiwyy)
F. Revision History
EDEP: 12109/2010 04:44:09 PM OTHERPROREV: CUSTOMER NOT READY.
1106pdrn.doc•rev.2/5104
i
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
G. Certification
The undersigned hereby states,under the penalties of perjury,that he/she has read the om ono nwealth
310 of
Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos.
CMR 7.15,and that the information contained in this notification is tr e and c rr t to the e his/her knowledge
and belief. —� �17�,�GG�!�G//
FAITH LEMAY
Name
ADMIN ASSIST
100114915
Decal Number
Authorized i nature
12/29/2010
3. Date mmlddr
4135835500
2 PosttionfTitle
ACCUTECH INSULATION &CONTRACTING, I
4
Re•resentin•
00 STATE ST. BLDG 119, PO BOX 376
6. Address
LUDLOW
1, Cirylrown
d06pdrn.doc•rev.95/04
5. Tele•hone
01056
Zip Code
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention — Air Quality
Project Revision o Notification
For
A. Facility Location
HAMPSHIRE HEIGHTS ______
,ry 1.Name of Facility
HANLEY STREET
EET
2.Street NORTHAMPTON ----_, —
--�
3.City
4077372000 _
6.Telephone Number
00114915
Decal Number
ONS
1 is
Ile for
of
oiect
Der.
that
correct
erect
four new
des.
your
in.
ate
B. Project B.
Check here if this project islwas cancelled.
C. Project Dates
121912010 ---
3.Latest Revised Sled Date(mmldtllyyyy)
D. Revised Project Dates
1.Revised Start Date(mml4dlyyyY)
E. Other Pro .e-_ctRevisions
CUSTOMER NOT READY.
F. Revision History
406pdm.doc•rev.215104
MA
tate
4
I 121912010 — — - --..
2.On al End Date mmlddl As
4.Latest Revised End Date(mmlddlyyyy)
[a:172010'p.Revised End Date Dale(mmlddlyyyy)
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention — Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
G. Certification
under the penalties of perjury,that he/she has read the Commonwealth of
Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310
The undersigned hereby states,
CMR 7.15,and that he inf for the Removal,min
CMR 7.15,and that the information contained in this notification is true and correct to the best of his/her knowledge
and belief.
ADMIN ASST_
FAITH LEMAY___
_ _ --- _-'_. 'l i Lem ay
1. Nam Autlan4ed
arum_
_ ____
1219/2010
121912010
_ "ate I m I
ACCUTECH INSULATION C_IN 41358355 2 P a
5 T le hone _ ___ _— �
1. Re STATE 100 STATE STREET BUILDING#119 -P.O. BOX 376
6. Address _-- — 01056
LUDLOW _ —_""-- B. Zip Code
100114915
Decal Number
7. City/Town
d06pdrn doe•rev.2/5/04
11/1012011
t Original Start Date(mmIddlwyY)
1213/2011
3.Latest Revised Start Date(mmlddlyyyy)
[1(10(2011
2.Original End Date(mmlddlyyrv)
[ 121312011
4.Latest Revised End Date(mmlddlyyyy)
I
•
g out
ne
use
lb key
our
o not
turn
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention—Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
100114909
Decal Number
A. Facility Location
3TiONS
arm is
table for
ng of
ate
project
mbar.
ate that
tct
is correct
rntered
r your new
dates.
iy your
lion.
date
[HAMPSHIRE HEIGHTS
1.Name of Facility
7 HAWLEY STREET
2.Street Address
NORTHAMPTON
3.City
14077372000
6.Telephone Number
5.Zip Code
B. Project Cancelled
n Check here if this project is/was cancelled.
C. Project Dates
[
[
D. Revised Project Dates
1/31/2011
1.Revised Start Date(mmlddlyyyy)
1/3112011
2 Revised End Date Date(mmlddlyyyy)
E. Other Project Revisions
F. Revision History
EDEP:01(06/2011 10:37:10 AM EDEP: 01/24/2011 11:00:20 AM
O6pdrn doc•rev.2/5/04
1ADMIN ASSIST
2. Position/Title
1ACCUTECH INSULATION &CONTRACTING,
4. Representing
100 STATE ST. BLDG 119,PO BOX 376
6. Address
3
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
1100114909
Decal Number
G. Certification
The undersigned hereby states,under the penalties of perjury,that he/she has read the C Commonwealth
6 nw and 310
of
Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos,
CMR 7.15,and that the information contained in this notification is trucand col-motto the best his/her knowledge
and belief.
(FAITH LEMAY
1. Name
11
C?"
' LeMay
11/2812011
3. Date fmm/dd/anv)
14135835500
5. Telephone
uthorized Signature
(LUDLOW
7. City/Town
O6pdm.doc•rev.2/5104
11056
8. Zip Code