22 Deleading Notification 2000 Alk
ABIDE, INC. PROJECT # 003416
COMMONWEALTH OF MASSACHUSETTS
IPIUUZ/U00
AIN
Department of Labor L Industries and Department of Public wealth
NOTIFICATION OF DELEADING WORK
All sections of Clam for. must he completed in a ae to comply
eith the notification requirements of M.G.L. eeiii 5 191,
454 061 22.00 and 105 Ott 460.000 as most recently amended
FILE MISER:
(AGENCY USE)
Contractor perfomeng project ABIDE, INC, (Frank Tilli) License # DC001619
Lead Paint Inspector •Anft Collin% CrocMi*re,
Exp.date
August 31, 2001
License I/tl 2'7 2.4f
Date of Inspection 4lyloe
It low-risk deleading work is being performed, complete the following line:
Property owner Agent{s)
Address of Project
Building Name (if any) Floor
Street Address 2.2 Col.tytngus Ai/LNUE.
city N R'li'IA PTbtJ Rip OIOCef')
Apt. No.
neleading method: Qt/Dry Scraping] Heat Gun Caustics
Liquid Encapsulanc ousting Demolition p cemen . Ocher
If "Other" selected, please explain
mete One,
Start date
dwelling is au family
10121 00
.s nglo Lowly V
Completion dare
I O/f3/00
When will work be done: A.M- -7;03 - P.M. S: _ Weekends? A0
Project supervisor's name Robert P. LaMDuntain License 405360
Property Owner PAM SCHWA-21Z- Gild JOEL FELbfnAn/
Address L4% Mu&Ro€ STR-Qg j
City
NoR7r7AM PTO&
Telephone 413- s$6 - 1 it 3
In case of emergency contact
Phone: day
413-525-0644
State.
MA _ zs„ OJ.otio_
Frank Till i , President
evening
(over)
413-525-0644
VP ViiroUti rni vo
In accordance with Masaacbveectf General Laws c. 111 f 197 OCR 2[.00 d 105 O 460.000 notice
or the date •ha methods CS) of removal or Catering of paint, piaster or other accessible mated alt
containing dangerous levels of lead IS to be provided and must be received by the following `
Persons, at least ten t10) days prior to beginning of deleading.
occupants of the awaiting unit
All other occupants of the residential premises. if Lily
Director, Childhood Leading Poisoning Prevention Program Fax 16171 753-0436
Departhent Of Public xealth. 170 Atlantic Avenue, Boston, MA 02110
Detector, Asbestos f Lead program
Department of Labor f Industries
Room 11006, 100 Cantrldge Street
Boston, MA 02202
Fax (6171 727-7560
p� Fvt(416i sal - 112-1
Local Board of xealth/Code Enforcement Agency N W14'if•1� 6f H EACTI'1
NurtTMAMf O cite
Massachueetts HISto[ICal Commission (If premises Is listed on the State Register
220 Morrissey Blvd. of Ristodc places, this notification must be
Boston, Mn 02125 made upon receipt of an Order to Correct
Violations or at least 10 days prior to
initiating preventive Oeadinn
Fax i 727-5170
Delsading Cortauter
The undersigned hereby states, 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 9 'I -OO signed: rio,,k- ! Frank Tjylli
Title: President
Company: ABIDE, INC.
Proprty der (If owner or unlicensed owner's agent will be performing low-r1St deleeall nq 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 containment. T
further certify that I or my agent will be performing
the following low-risk activities It have circled all that apply) :
applying liquid encapsulant capping baseboards
applying exterior vinyl siding covering cur races
removing doors, cabinet IXarr, shutters
I certify that Al) the information contained in this notification is trot noa correct co too
best of my knowledge and be l ieC.
Oate: Signet:
ABIDE, INC. PROJECT # 00396
REV 10/12/95
II u, ,
a b i d e
Abide, inc.,Environmental Contracting
LEAD NOTIFICATION FAX COVER SHEET
DATE: ci I -07
ATTENTION: FAX #:
[ !rector,CLPPP(Boston) 617-284-8410
[ LEAD PROGRAM(Boston) 617-727-7568
[4 own/City of Nct-NRMPTON 9)3 -5$i - 3 22 I
(Local Board of Health)
[ ] Massachusetts Historical Commission 617-727-5128
FROM: FRANK TILLJABIDE,INC.
REGARDING:
(4 PROJECT NOTIFICATION
[ I REVISED NOTIFICATION
[ 1 OTHER:
NUMBER OF PAGES (including this one): 3
COMMENTS:
If you experience problems in receiving this transmission,please call 413-525-0644.
CONFIDENTIALITY NO]rr: The docnrnts.ccompnying mi,skimpy trvrtmi.sion may contain confidential and privileged
'mbrlua$ion Loin Abide,Inc. Dm automation is intender for tbrux of the addressed individual or
entity. If you re muds intended recipient,be aware rhn any disclosure,copying.disvibmina Of
u,c of she tuna.!,of this uramission n prohibited. If you have received this tnosmiv'un in erns,
elms Unify is by telephone(4l3-515.0644)Immedimely. /bank you.
P.O. Box 886 East Longmeadow, MA 01028
Phone 413-525-0644 • Fax 413-525-0678 • E-mail ABIDE I @aoi.com