HomeMy WebLinkAboutDean St. #196 - 1/27/1994EAST COAST ENVIRO TECH TEL NO.508 947-1228
Jan 18,94 15:06 P.02
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DEPARTMENT OF PUBLIC HEALTH/DEPARTMENT of LABOR & INDUSTRIES
NOTIFICATION of DELEADING WORK
All sections of this form must be completed in order to comply with
the notification requirements of M.G.L. C. 111 8,151
FILE NUMBER
Lead Paint Inspector Glenn Maltais Date of Inspection 1/12/94
Contractor performing project Glenn )tpll,$U
License 0g()t00085
AQdrgss 2L P92ieat
Building Name (if any) Floor 1st&2n4
Street Addres 1 6 Dean Street Apt. No. N/A
City Mansfield Zip 02048
Deleading Hethod4 DRY SCRAPING HEAT GUN ENCAPSULATION DEMOLITION
(circle all that app y
POWER SANDING CAUSTICS REPLACEMENT OTHER
If "other" selected, please explain
Check one, dwelling is Multi -family single family X
Start date 1/24/94 Completion Data 1/27/94
When will work be donee 7e00 am 300 pm weekends? No _
Project Supervisor Name Patrick Dale License I D5000789_
Property Owner Mr. Stanley Terleakey
Address Post Office Box 948665
City La Jolla state CA Zip 92037
Telephone (691) 793-0433
In case of emergency, contact what pereoni Glenn Hal&&is..__
Phone,Area code required day_(508) 622-4363,,OVOhinq
(OVER)
EAST COAST ENVIRO TECH TEL NO.508 947-1228 Jan 18,94 15,07 P.03
In accordance with Chapter 773 of the Acts of 1987. Massachusetts
General Laws C, 11.1 3,197. 454 CMR 22.00 and 105 CMR 460.00, notice
Of the data and methods) of removal or covering of paint, plaster
Roil or other accessible material Containing dangerous levels of
lead, is to be provided to the following persons at least five days
Prior to the beginning of deleading.
1. Occupants of the dwelling unit
2. All other occupants of the residential premises, if any
3. Director, Childhood Lead Poisoning Prevention Program Department
of Pup11c Health, 305 South Street, Jamaica Plain, Ma 02130
4. Lead Removal Program, Bureau of Technical services Department
of Labor and Industries. Division of Industrial 64fety
100 Cambridge Street, Room 1t01, Boston, He. 02202
5. Local Board of Mealth/Code enforcement Agency
6. Massachusetts Historical Commission
(if premises is listed on the State Register of Historic Places)
The undersigned hereby states, under the penalties of perjury, that
s/he has read and understood the Commonwealth of Massachusetts
Deleading Regulations, 454 CMR 22.00, and Lead Poisoning Prevention
and Control Regulations, 105 CMR 460.00, and that the information
contained in this notification is true and correct to the best of
his/her knowledge and belief.
Date 1/18194 signed,
Titled president
Companyo east Coast enviro-Tech Ino,
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