165 Notification of Deleading Work 2009 r
V
08/11/2009 TUE 15:57 u +++ nortna.pton noaru neaILn
Job#09366
Department of Public Health&Department of Labor
NOTIFICATION OP DELEADJ NC WORK
All sections of this form mast be empbled in order to eampb with
the nottflmlha ra ptiraneeb orM.C.t.0.1113197,
414 ChM 2200 and 105 CMR4aa00,as most recently amended
coniractaperfael.gpmjtaAbide, Inc. unnusD0001619 Exp.Dte8/25/09
Lad part sonar Eileen Manley
ALIDDE vx
Str vet Address 165 South St.
city Northampton, MA
Date of Inspection 7/24/08 utate#13305 El.Daa TBA
Ann Number 2nd fl
Zip 01060
propertyoarChris Colby _Address 245 Osborne Rd. Ware. Ma
Tdepbant Nmba 413-2376591
Dekading MNhod:3t1 WtbDry Ssrapiag
IPIDeeaatrs
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Cheek tom Dwelrmau moki-fmdy
Start Dar 08/20/2009
sink-way! 1 other I I
cmpetb.Dar 09/11/2009
When MI work be do.e: AM PM 5 (Medfy then as AIM Weetaadr? tha
Project Supervisor Name Jerry Gray faean#DS3T70 Rrp.Date 08/10/10
Warhws Commando,PokyNmberAWC7013278012008 canto.AIM Mutual Insurance
ix ease oremageaty rasa Frank Tilli,VP Tads 413 )525-0844
(Contractor's Deprecate/a)
PELEADPIG CONTRACTOR
The aadmt2md body nata,..dn at palm and panda atpajury,that k fsbebn read ad aadmred the Comeavdtba
Manaehtaa Ddndas Rgdaaeai 44 CMR Zia,rind Stint Farming Pmveafla aad Cesoet Nmdallo.s,1131:311t461.000,and
that the huntsman eaten In 1kb nolfalte.Is the and correct to the bat of kWer kaowlledge and beef.
Date 6/24/09 ximaa#0--_
Comm Nom Abide, Inc.
Address P.O. Box 886, East Lone meadow, MA 01028
Telephone Nmba413-525-0644
Abide#09366
Notified: 8/11/09
ElIVE
OVER-*
D
AUG 1 2 2009
NORTHAMPTON BOARD OF HEALTH
n
Paget of 2
In accordance wbh Massachusetts Cetera Lain C.III$197,454 OM 22.66 mud 10 ChM 4660 06,00tleof the date sad aeledls)of
removal or cowries of paint,plasm raker acceuble aakdak naWwbg do rea kids of lea k to be pnavidcd DA man he sadvrd
by the fodowleg agenda,at lnd Tgl(10)days prior to the beghmhg ofddeadiog
NOTIFICATIONS MAY BE FAYOID.
1. DepatatentoMLabr,Lead Program,MelteatOccaaikmlSakq'
19 Suchard Street,la Floar,Boston,MA 92114 FAX 6114264965
2. Ilkecrr,C adbeod Lead?abode{Preece=Pro raa
Department of Public Health,DogovaRaath Baid'mg,S Rudolph WAWA Ceske,MA(0021 FAX 7917744700
3. Oteapanis of dwdgeg mat
4. AR other ocnpoats of the rSdeatial preaasn,If any
S. Local Board aa mascot EafrctsatAgnry i-([ 3 -5-87•/ 2 2!
6. Massachusetts DktMral Coemkaiee (1L preteens re bled ow the State Register etBMus*
7a2 Mabry Hlvd. Places,this notification nustbe wade upon receipt at au
Hrta.MA 02202 Order to Cant Viokti®r r et least 26 dap prirw
FAX(617)727d123 [dWOag preventive ddeadlag)
NOTIFICATIONS SHALL it COMPLETED IN THEIR ENTIRETY,DATPD AND Sarum-INCOMPIETE NOTIFICATIONS WILL NOT
BE ACCEPTID AND WILL RE RETURNED AY THE DEPARIbffifr OF LABOR&WOOKFORCE DEVELOPMENT.
PROPBETYOWNER(If ownror unlicensed ovum's egret will be pedomug bwtik ddrdkg mut,complete the blbwugk
ply Opp. Not Applicable
Alter°
Address
Tekpkoae Number
I coley that I have complied with the baking mpinmu+dc of the Cumusoewrkh of Manrchostlk Led Poatoo®g Pwv®nn and Coned EgoisOms,105
CMR460.175,Ibrowwtlagmt bw-chats J.-i- andmdaureot I fmkrcatify thatl or my agent will be petroleums the follow*kwtek activities
(1 have circled Ott apply):
sPIDOMDF44 meuprdant
capping baseboards tuwrog derv,cabinet dare,chatltea
applying exterior viay)*Nag ern*srfaces
I certify data i the iebrmrmmntsuwd m dos notification is br and cernd to the best of my knowledge adbelk2
Date 51441
Revised t22007
Abide#09366
Notified: 8111/09
110/ lOn 10.00
abide
environmental contracting • coatings• restoration
LEAD NOTIFICATION FAX COVER SHEET
DATE: (II 1116 9
ATTENTION:
[
Director,CLPPP(Boston)
] Director,LEAD PROGRAM(Boston)
[✓r Town/City of 34 r
/(fassal Board of Health)
Massachusetts Historical Commission
FROM: FRANK TJLLI/ABIDE,INC.
REGARDING:
['✓] PROJECT NOTIFICATION
[ ] REVISED NOTIFICATION
[ ] OTHER:
NUMBER OF PAGES (including this one):
l
COMMENTS:
3
FAX#:
781-7746100
617-626-6965
9 T 5P7. 1.22t
617-727-5128
If you experience problems in receiving this transmission,please call 413-525-0644.
CONFIDENTIAIJTY NOTICE:The danmes%accompanying this telecopy vammissim maymotile smfideatia%and privileged
information from Abide,Inc. Th'vmfmmsiion is intended far the use of the add,med Wielded or
entity. If you are not the intended recipient,be ow=that any dixbutc,mp,+ng,distnTsrtm,or
use of the motena of this moa®csim is prohibited. If you base methyl tha bammeeoe in arm,
please notify us by telephone(413-525-0644)immediately. Thank you.
p.o.box 886 I east Longmeadow,ma 01028 1 phone 413,5250644 I fax 411525.0678 I www.abideinc.can
Abide,Inc.is COMMA certified by the Commonwealth of Massachusetts,Department of&ntnm and Technology.
Abide,Int.'s standard TERMS MD CCNDMONS require payment for services in presentation ol invdte lmoa-s apaid after 10 DAYS
are pat due and subject to a FINANCE CHARGE computed at a o ooLli&rate of 11/H(ANNUAL FERCFM,AGE DAR or tam or the naxi-
oven permmage Mewed ty lne law.Went is rmfandme for legal and Wlection costs if necessary to totted past due mmumn.
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