HomeMy WebLinkAboutLinden St. #28 apt.1 - 5/1/1997I
I
h
DEPARTMWV Or PUaLIC HEALTH/DEPARTMENT Of LABOR 4, IND SMUE.S
NOTIFICATION OF DI LM)IN(; WOItTC
All Sections of this form must bo filled out in order to comply with the
notifications requirements of M.G.L.C. 111 197.
I
PILE-WM13ER
Contractor Performing Project: Paint By Nwmbers, Inc. License Op,C.000021
Lxpiration Date: 1-10-98
'I
Lead Paint Insp ctor David Carter 14i*se # I3134
—`Expiratjdq Date:
R}hato of I{1Spect#.on:g7
If low -risk deluding work is being performed, completeT' folloM1ilpg line:
Property owners
ADDRESS OF PROJECT:
Buildi.f any) loom_ T
Street Address 28 Linden Street ^Apt, No. 1 `
City Mansfield) MA. Zip Code''02048
DET.EADIRCa MF,IF(OQ� WET/DRY SCRAPING HEAT GUN LIQUID ENCAPSULAM
COVE4ING DEMOLITION CAUSTICS RF,PLACL NP. OTHER
if "other" selected, please
Check one; dwelling is multi family x niggle family,;
START DATE 4/"9/97 CoMPLuVION DATE 5/1/97
When will work be done: AM x PM x Weekends xxx
Supervisors Mark Reynolds Lic, # D.S.000126
David Damon Lic. # D.S,000907
Arnold Thomas Lic, #,D.S.000854
Steven Cappiello Lic, # D.S.000843
Property Pwner:
TriAraaw • 2
Holske
Linden Street
City; Mansfield, --State:,
Phone: (5081 339� 2124 _
In .Case of emerCency,contact Owner
Phocte;Day( ) _ame.. _Evoning(
T.—
MA -- Zip 02048
�I Ii �
llh 4 t d,iB I x I lid I �
i
tei clays Prkr, to the beginning of riiryr3irg.
1. Occupants f the dwelling unit.
2. A} etheroccupants of the residential prunlss�,�!i
i �
3.,{?�}:ector ojhe Child)ihcxl lead Poisoning Prev�c rarfi rl (�
6ept4 'of, pytplic Health Fd#' l¢17,)943-6g31
470 htlanticlAve. Boston. MA 02210--2224 , (617)753-8436'
4. girecI Asbestos and Lead Program Fax (617)747-7566
Dept,, of habpr & Industries
100`C4vbrldgg St. Roan 1106 Boston, W. 022p2,
5. Focal Board of Health / Code Enforcenent Agency
6. Massachusetts Historical Comriission (If
40'Morri.sse Blvd. of
00000f MA'0�125 be
yil
in
!hs 4Pd 11'hWE�y Otata;, trrhr lrstaltics of I)W7uCY, tlttt.
Q7=wl aati `Of Mass:"Tlsgi lations, 454 CM 22.00 0-1
aintrol Paplaticm, 105 CM 460.000 and that ite in a
true aid oxtect to thEbt- e bof his/h r lu a lcdp arch
is listed on the State Register
:,places,"'this notification must
> receipt of an Order to Correct
or at'least '30 days Prior to
r
�a<eventiyd'deleading.)
�& uri�sfood the �
Date. 3/28/97 Signed
Title: PRESIDM
Company: PALM ii$ NWI INC.
OAW asrtity (u Il �l lar s awit will W k
EOD
�. r - -
I _.. _ I m with tt)e training mw retiltts of 1W
g
Ratsapi}s3 k ioa aryl Q»tsai Pox - tians, 105 GR 460.175, €fir 4a C/a
=itaimliwit. I further ox- tify that I or Katy arpit will be perl:ca�mnl the fplU
have circled all
�ti-40y)
awy(ng '�. qud pant CciI laI oD\kX'iTV t
18ldJ479 c]xSdxYs afYi StUtir.'.I.s ct{ily txts-'rir,,r "l!
I acetify that all the Infumtkin outtalnrl in this Intificatini is tap
attili
7-7
Date;---
i
!i
i
I
to the hest.