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HomeMy WebLinkAbout2017 - Demo House Field Inspection Notice Town of Montville Building Department September 13, 2017 2016 Ct Building Code Address: 28 Broadview Avenue Job Description: Demo Single Family Residence—Abandon Septic &Well Permit Number(s) D2017-0011 Permit Date: August 30,2017 Not Approved Approval INSPECTION Date: Deficiencies Special Date Conditions Demo • Site is clean and 9/13/17 DJ restored • • Final inspection and 9/13/17 DJ certificate of approval Rev.Date: 1/18/06 Page 1 of 1 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 DEMOLITION PERMIT Permit Number: D2017-0011 Date: 30-Aug-I 7 Map/Lot: 107/006-000 Owner ID: 376000 Project Location: 28 BROADVIEW AVENUE Unit: Job Description: Demo Single Family Residence-Abandon Well&Septic System Owner Nam MTIC Acquisitions LLC Tenant Name N/A Careof: 13 Crow Hill Road Uncasville - CT 06382- Telephone: (860)8_62-610.0__ _ Applicant Name David Rubino Telephone: (860)608-7680 DBA: Rubino Construction Lic/Reg Type B Lic/Reg N 1997 501 Taylor Hill Road Exp Date: 31-Mar-18 Griswold CT 06351- Construction Value Permit Fees Construction Information Building Value: $74,640.00 Building Fee: $750.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2016 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $74,640.00 Penalty Fee: $0.00 Permit Code: M1 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $0.00 Total Fee Paid: $750.00 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL, ELECTRICAL PERMIT INSPECTIONS ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Q Certificate •f Approval fi••te of Occupancy „404.1„: 4049 Building Official's Approval: Building Department 310 Norwich-New London Tpke. Tel.860-848-6782 Uncasville, CT 06382 Fax. 860-848-7231 DEMOLITION APPLICATION FORM Permit No.� 7 —Ot( I Property Address: 28 gRoAbvt�vv 4\n"75 (Number) (Street) ' t (Unit) Job Description: j3E�1'i C t+U�; A / L 1Al , S� )� 1 L i IJi. \,k)�l� Owner: G, i\) —t- Address: :) (----LVW k1 City: U',-✓ar r ;11e State: CT Zip Code: U b3 v 2 Telephone( l 1tin :3t L i OV Applicant: \)1�' V lam.' DBA: V1 y\lc) �lJu.�\l~ TtL,►v Address: c(.:,i 1 A' (� t--;\1 �1 City: V`\ OL. State: LT Zip Code: ae.,-s I Telephone( P&j (.2011 7t 3tD Contractors-Complete the Following: License Type: aSS rS License No.: c1 cl 7 Expiration Date: 3 7.I-I Ci We the undersigned agree to comply with all the restrictions and regulations set forth in sections 29-401 through 29-415 of the Connecticut General Statutes entitled"State Demolition Code"and hereby certify that the proposed work will conform to the State Demolition Code, State Building Code and all other codes as ado ted by the State of Connecticut and the Town of .ntville. Owner Signature: •c • / Date: 8 j Lf` /7 Contractor Signatur:. Date: 9- i 4`i 1 Zoning and Wetlands Approval Uncas Health District approval ALL,-!, !,, . _ ` Zit•/ Note: If asbestos abatement requires removal of building compifents i.e. dosend/or windows the abatement must be completed and the clearance letter submitted to the district prior to any further demolition of the structure. Tax Assessor-Assessed Value of Structure to be Demolished $1 ? l !V Demolition Fee: I See Reverse Side for Items Required for Submission of Application DemoRtionTema Application LTomr. Revised 02/01/17 Town of Montville Building Department File Receipt Date: 29-Aua-17 ReceiptNo: 12602 Received From: David Riihino Job Address: 28 Broadview Ave Town Fees Collected State of Connecticut Fees Collected Bldg Cash: 50.00 State Cash: $0 00 Bldg Check: 5750.00 State Check: 50.00 Bldg Credit: 50.00 State Credit: 50.00 Fire Cash: 50.00 Fire Check: 50.00 Fire Credit: $0.00 Construction Value: 50.00 Demolition Value: $74.640M0 CheckNo: 3755 Received By: Carmen Kneeland C(4 n kelkA,✓11.14_ k-,4 A CSl h n! 0 0 o ' ti Li LL -J o U v J c0 Q N- N- > 2 , a) Ce W a) z a 0 J 0 2 W 0 > d Tts Ws •L t4 dc LO d CCE co C co U N N d L David Fowler From: ctnewservice@eversource.corn Sent: Wednesday, September 21, 2016 10:31 PM To: David Fowler Subject: Removal of Service Completed (2793926) WARNING: External email. Please verify sender before opening attachments or clicking on links. WARNING: External email. Please verify sender before opening attachments or clicking on links. From: CLP New Service Clearing Desk/NUS@NU Date: 19-SEP-16 To: Fowler,David Subject: Removal of Service Completed (2793926) Dear Customer, Your CL&P Demolition/Construction Service Removal Request: 2793926 for Job Location: 28 BROADVIEW AVE, MONTVILLE, CT has been completed. Service Removal Date: 19-SEP-16 This letter is to confirm the removal of the existing Connecticut Light & Power(CL&P) electric service and meter(s) at the above address for the purpose of demolition/construction of the building. If you have any questions, please contact the CL&P Clearing Desk: Phone: 1-888-544-4826 Fax : 1-877-285-4448 This electronic message contains information from Eversource Energy or its affiliates that may be confidential, proprietary or otherwise protected from disclosure. The information is intended to be used solely by the recipient(s) named. Any views or opinions expressed in this message are not necessarily those of Eversource Energy or its affiliates. Any disclosure, copying or distribution of this message or the taking of any action based on its contents, other than by 1 TOWN OF MONTVILLE WATER POLLUTION CONTROL AUTHORITY 310 NORWICH-NEW LONDON TPKE UNCASVILLE, CT 06382 Phone-860-848-6776 Fax-860-848-4354 August 15, 2017 Re: 28 & 40 Broadview Ave To whom it may concern; The above property, 28 & 40 Broadview Ave is not connected to city sewer or connected to city water. Regards, Maureen Benway Town of Montville WPCA Y= 4 Rubino Construction 501 Taylor Hill Rd, Griswold, CT 06351 860-608-7680 860-961-8736 daverubino@sbcglobal.net August 15, 2017 Ahmad Najeh S &Vicki R 7720 Citrus Hill LN Naples, FL 34109 Re: Notice of Intent, demolition of 28 Broadview Ave This letter serves as notification that demolition will take place at: 28 Broadview Ave, Uncasville, CT 06382 Rubino Contruction U.S. Postal Service- CERTIFIED MAIL° RECEIPT Domestic Mail Only ..0 For delivery information,visit our website r.;www.c�ps.cam�. O NAF s4 i' co :;< �-. Certified Mail Fee .D Extra Services&Fees(check box,add fee- ❑Return Receipt(hardcopy) $ 1_ ) O ❑Return Receipt(electronic) $ 6 I ' ,xRostmark ! O ❑Certfied Mail Restricted Delivery $ i ('i!../,'"f 1 CJ'Here ❑Adult Signature Required $ ❑AduR Signature Restricted Delivery$ r� Postage ('yKrl fes▪- Total Postage and Fees 03/16/2017 ,i Sent Toil. l 7 �t,� f� _YQ_fT49, Street and Apt No'`or POox N� —v city,s,-ta;?+a -°--C--17T12S- -2-11 c,)f.. PS Form 3800,April 2015 PSN 7530-02-000-9047 See Reverse for Instructions STATE OF CONNECTICUT I State Use Only j ' ci<< Post Mark Date: 1)EPAWPMENT OF PUBLIC 11EAL'1'H Check#: . •� Amount: ' 114, Transmittal# Record #: his form is to be completed, postmarked and filed with the Connecticut Department of Public Health ten (10) days prior to e start of asbestos abatement, as required by the Regulations of Connecticut State Agencies, Section 19a-332a-3. In case of nergency notifications, this form is to be completed and postmarked within one (1) working day following the start of bestos abatement. The U.S. EPA may require notification of abatement or demolition, as per 40 CFR, Part 61, the asbestos ESHAP regulation. Faxed originals are not acceptable. Revisions may be faxed unless a fee is required. Mail completed notification to the address listed below 1. TYPE OF NOTIFICATION -A. NEW X B. BLANKET C. CANCELLATION/POSTPONED (C) -- (P) D. REVISED (ITEMS REVISED) REVISION# E. EMERGENCY DESCRIBE NATURE OF EMERGENCY 1. ABATEMENT CONTRACTOR: - NAME: l� ra-G-vaf f CLICENSE# q 7 ADDRESS: OTi g9-r a -2� CITY: e- STATE: GCo�-t--,_ ZIP: D 6 •'� 0 V18-= a qPHONE#: (PC0)VY8J0 CONTACT PERSON: r y� t �a,li��LJ/1..., 3. FACILITY OWNER/ PERATOR'. '"�" 9��rd NAME: ADDRESS: t 3 6.44-- /�_.:-(:�'S' /mss{. . CITY: STATE: ZIP: © 3 P PHONE#: (%0))(pa - ?CR 0::, CONTACT PERSON: atg- - ` }' 1. NAME OF FACILITY: (MUST BE FILLED IN) NAME: ADDRESS: ' CITY: 9.�, 410.,LaQlZZ STATE: Gam. ZIP: c .(A) START DATE: `r r 3 - I '> 5.(B) COMPLETION DATE: er — /0 -- FOR PROJECTS INVOLVING 160 SQ. FT OR MORE OF ASBESTOS • IF APPLICABLE .(A) TOTAL COST OF ABATEMENT: Jfr 3 000. D 6.(B) REVISED COST J Phone: (860) 509-7367!Fax(360) 509-7378 - Tel I/erier /in-tl:r Ilrnl iS ii ?U'I-7/V/ N. 41(1 Cupilnl it i-crrrrr - 1-IS a5I.AIR l' (). lint 340-(()N 11(n7/,rd. C-7 06/.+4 Ali blunt O/r/rurrrrrrr:r Lur/ri:,1: r • ' IF FACILITY: L(K-I2) R. PUBLIC BUILDING ('. MANUFACTURING' D. OFFICE �tE.COLLEGE C.CHURCH/SYNAGOGUE II. RESIDENTIAL.ii DWELLINGS OF L I.OTHER (SPECIFY) BUILDING DATA: a ° 5'0 SQUARE FEET: #OF FLOORS AGE: .J. ABATEMENT CLASSIFICATION : A. RENOVATION 8: DEMOLITION x C:ORDERED DEMO(AGENCY ISSUING ORDER): NOTE: Attach Demolition Order !0. ABATEMENT TECHNIQUE: A. FULL CONTAINMENT WITH NEGATIVE AIR X. II. ALTERNATIVE WORK PRACTICE (PRE-APPROVAL REQUIRED • Project Designer/LICENSE# C. EXTERIOR ABATEMENT •. X D SPOT REPAIR(>2i SQ.FT.TOTAL) 1. ABATEMENT METHOD: 12. TYPE OF DECONTAMINATION SYSTEM: A. REMOVAL X. A. CONTIGUOUS B. REMOTE B. ENCAPSULATION C. ENCLOSURE 3. TYPE AND AMOUNT OF ASBESTOS TO BE ABATED: (REPORTED IN SQUARE FEET): FRIABLE MATERIAL NONFRIABLE MATERIAL A. SPRAYED/TROWELED ON: Category I B- BOILER INSULATION: L: FLOOR COVERINGS/TILES. /, -v 0 -- C• TANK INSULATION: ROOFING.SPECIFY: 09/ Arr D. BREECHING INSULATION: • K_ GASKETS.PACKINGS: /} At E. DUCT INSULATION: Category (1 F• CEILING TILES: L. TRANSITE BOARD: G. OTHER.SPECIFY: M. OTHER.SPECIFY H. PIPE INSULATION (FILL OUT BELOW) jPipe diameter) " (Linear Feet) x (Conversion Factor)* = Total Sq. Ft. (*see Not if Conversion table) • x = x = Total Square Feet WASTE DISPOSAL SITE(IF MULTIPLE SITES, LIST SEPARATELY): NAME: ADDRESS: /r acr/A,Al q0 CITY.STATE.ZIP p , OWNER_OPERATOR HAULER/WASTE TRANSPORTER: • N:sME: _ 1 7� ADDRESS: t?3 FY.STATE.ZIP: ?Cfi nS O Name of Individual Completing This Form Revision date: 02107'02 - I Rubino Construction 501 Taylor Hill Rd, Griswold, CT 06351 860-608-7680 860-961-8736 daverubino@sbcglobal.net In accordance with Connecticut General Statutes Sec. 29-406, we, Rubino Construction, hereby agree to save harmless the Town of Montville and it's agents from any claims arising out of negligence of the applicant or his/her agents or employees in the course of the demolition operations assiociated with 28 Broadview Ave, Uncasville, CT 06382 David A Rubino Rubino Construction Coritgrniatto and •ro•r••rt>a below. V,7tA;J` C..,,ly t ..41,__iiijiw b Mark out Check-list cdli :91.i. Ticket # Excavator Details Contact: Mr Dave Rubino Caller Id: 48147 Address: 501 Taylor Hill Rd Ph: 860-608-7680 2017330357 .3 Griswold Cell: Not Supplied Email: daverubino@sbcglobal.net Fax: Not Sus'lied Dig Site an= cketDetails . . _. Ticket Type Routine User Reference Not Supplied Ticket Date 08/17/2017 10:34:04 i Work Start Date 08/22/2017 ----------- --------------- Ticket Expiry 09/16/2017 28-40 Broadview Ave MONTVILLE s Address Construction i Type of work Demolition I Machine Exc I. .I ' Location of Private Property _ ; Workplace '. `J klp-Me ••... Location in Road Not Supplied Excavator Rubino Construction ----._•_•-- Is Pre-marked YES Cross-Street Route 32 044., + Notes/ Description of works ---- ----- demolish bldgs abandon septic&well--working over entire props 28&40 WARNING:Check that the map location and the details contained in this document are correct,if not please contact the call center to 'make the necessary corrections.Some utilities may not see your i map drawing so be sure your"remarks"are as descriptive as 1 possible.CT regulations require the proposed dig site must be pre-i `marked in white paint,white flags or white tipped stakes before the location request can be made. •Do not proceed with any excavation until all Public Utility owners listed have marked out their facilities or have contacted you directly. •Ensure you adhere to any State legislative requirements regarding safe digging requirements. •If you damage an underground Public Utility you MUST advise the Public Utility owner immediately. For more information on safe excavation practices,visit '°�° ". 2�4fz _4 e. :a ':,,4,,s . •� ,sWetr; >A A .a. s ?....i=a . aim,; The Public Utility owners listed below have been requested to mark out the location of their facilities. Please note they may contact you directly to clarify any aspects of your ticket. heck List Phone After Hours Status ResponseDate'. ATLANTIC BROADBAND 888-536-9600 814-410-2316/814NOTIFICATI Y/N 515-2735 ON SENT EVERSOURCE ELECTRIC 800-778-9140 800-778-9140 NOTIFICATI YIN ON SENT EVERSOURCE GAS 203-317-4501 800-942-7529 NOTIFICATI Y/N ON SENT FRONTIER COMMUNICATIONS 1-800-598-0628 1-800-598-0628 NOTIFICATI Y/N ON SENT TOWN OF MONTVILLE 860-848-3830 860-625-7582 NOTIFICATI Y/N ON SENT END OF UTILITIES LIST Request Utility Locates Online at www.cbyd.com - 24 hours a day 7 days a week PIS; 414N DEPARTMENT OF ADMINISTRATIVE SERVICES STATE OF CONNECTICUT DIVISION OF CONSTRUCTION SERVICES OFFICE OF THE STATE FIRE MARSHAL DEMOLITION CONTRACTOR LICENSE LICENSE NO: 1997 CLASS :B This License is being issued pursuant to Connecticut General Statute 29-402 to: Rubino Construction 501 Taylor Hill Rd Griswold CT 06351 Designated Technical Expert: David Rubino Class B is limited to the demolition of buildings not to exceed 2 1/2 stories or 35 feet in height Issued by: �� ,1 / 4 < , Commissioner Date Issued: 2017/04/01 Expires : 2018/03/31 450 COLUMBUS BLVD-STE 1304 HARTFORD CT 06103 Phone: (860) 713-5580 Fax: (860) 713-7424 www.ct.gov/dcs An Affirmative Action/Equal Opportunity Employer acoRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `� 08/18/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Byrnes Agency, Inc. - Norwich NAME: Aimee Santiago PHONE 1 FAX 6 Consumers Avenue _Lac,No.Ext): (860) 886-5498 I(A/C,No):(860) 859-5075 E-MAIL Norwich CT 06360-7521 ADDRESS: asantiago@byrnesagency.com INSURER(S)AFFORDING COVERAGE _ NAIC# INSURER Insurance Company 14788 INSURED (860) 376-0380 INSURER B:Main Street America Assurance 29939 David Rubino Dba David Rubino Construction - - INSURER C:United Ohio Insurance Co 13072 501 Taylor Hill Rd INSURERD:Hartford Underwriters 30104 Griswold CT 06351 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 18294 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDL SUBR 1 POLICY EFF I POLICY EXP LTR, TYPE OF INSURANCE INSD WVD POLICY NUMBER !(MMIDDIYYYY)I(MM/DD/YYYY) LIMITS B XI COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE 1 $ 2,000,000 DAMAGE TO RENTED I CLAIMS-MADE X I OCCUR MPS0919R In/23/2016110/23/20n PREMISES(Ea occurrence) $ 500,000 I MED EXP(Any one person) $ 10,000 I PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PRCT- 1 PER: GENERAL AGGREGATE $ 4,000,000 OI POLICY 1 JELOC I PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: ! $ AUTOMOBILEUABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 C ANY AUTO CPP0022010 04/12/2017104/12/20181 BODILY INJURY(Per person) $ OWNED I X SCHEDULED BODILYINJURY(Perccident J$ AUTOS ONLY AUTOS ), HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ A 1 X UMBRELLALIAB X OCCUR CUS0919R 110/23/201610/23/2017EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE . AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10,000 Aggregate $ 1,000,000 'WORKERS COMPENSATION PER 0TH- D IANDEMPLOYERS'UABIUTY Y/N j 6S6OUB-2E86560-7-17 104/15/2017104/15/2018 X STATUTE I ER 1 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE! $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 1 1 j 1 j1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Montville ACCORDANCE WITH THE POLICY PROVISIONS. Building Department - 310 Norwich New London Tpke. AUTHORIZED REPRESENTATIVE 4-, -i �' Uncasville CT 06382 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 From: Daverubino daverubino,4sbcgloba;.net B Subject: Fwd:Demo Letter t= Date: August 19,2017 at 9:43 PM To: Lori Dziedzic loriadzi@gmail.cam Sent from my iPad Begin forwarded message: From: David Fowler <dfowler@moheganmail.com> Date: August 18, 2017 at 10:58:04 AM EDT To: "daverubino(a sbcglobal.net" <daverubino(a sbcglobal.net> Subject: FW: Demo Letter FYI From: Paula Camillucci Sent: Friday, August 18, 2017 10:57 AM To: David Fowler Subject: FW: Demo Letter From: Giannattasio, Mark [mailto:mgiannattasio(Thatlanticbb.com] Sent: Friday, August 18, 2017 10:57 AM To: Paula Camillucci Subject: Demo Letter WARNING: External email. Please verify sender before opening attachments or clicking on links. Friday, August 18, 2017 Paula Camillucci Re: 28 Broadview Ave. 40 Broadview Ave Uncasville,CT To Whom It May Concern: This letter confirms that there are no cable drops of Atlantic Broadband attached to the property referenced above as of the date of this letter. Sincerely, Mark Giannattasio 'J Tw Xy;"s, I Mark Giannaitasio Construction Supervisor Atlantic Broadband 61 Myrock Ave Waterford, CT 06385 I Direct # 860-629-6778 Cell # 860-857-5292 signiture ATLANTIC BUSINESS broadband BUSIN ESS i 4 i 1 1 r % rA - Mystic Air Quality Consultants, Inc. ea fia►� _;r��, 1204 North Road, Groton, Connecticut 06340 n0= 1987 /5 www.mysticaincom magc2®riol.com 800 247-7746 4'SULT Q' August 28, 2017 Mr.Jim Butler Asbestos Removal&Containment 88 Leitao Drive Oakdale,CT 06370 Re: Post Abatement Inspection(8/27/17) Pre-Demolition Review 28 Broadview Avenue Uncasville,CT Location: Interior(Including Attic)&Exterior Dear Mr.Butler: On August 27th,2017 our asbestos abatement project monitor,David Goldstein(monitor license#000022)completed visual inspections at the above location for fulfillment of criteria for inspection prior to demolition. This site review was for the purpose of determining whether the asbestos-containing materials sited in the asbestos inspection were completely removed in order to allow for demolition to go forward,with regard to asbestos issues. ACM Materials At this time,all of the stipulated asbestos-containing materials are completely removed from the structure and property.There is no visible asbestos related dust or debris remaining from these materials in the building,as required by US EPA NESHAPS and the State of Connecticut regulations to allow demolition to proceed. . As the contractor requested,there were no final air tests performed at this site.As such,there can be no entry into this building by any service contractors or other non-asbestos personnel. Should such entry be needed,you will need to contact Mystic Air to return to conduct air tests. Thank you for selecting Mystic Air Quality for these services. Sincerely, C opher J.Eident CIH,CSP,RS CEO • Mystic Air Quality is an AIHA-LAP, LLC Accredited Lab FAX 860 449 8860 f cQ& �f� - Mystic Air Quality Consultants, Inc. z.- 1204 North Road, Groton, Connecticut 06340 Cb 1987 .6,`3 ft1t7w'.mysticainc o,rt rnagc2@flol.conr 800 247-7746 4rSULT P-- Report of Inspection of Asbestos Removal, AL Renovation, and/or Demolition Project FIT [ ] NTE M Date: t 5 3/:2 /f Site Location: 2-e9 ,,•►�o'i/.1 E -1 Building Identification:Ville,+S vi e r:, C 7- Containment Containment Location: J27' c Z—",T,?�re f , 7v 71/ /LA'S CxJrrz/c,,-z. [FINAL INSPECTION PASSED [ ] INSPECTION INDICATES MORE WORK TO BE DONE CHECKLIST: Residual Dust On: YES NO YES TO a. Floor f. • b. Horizontal Surfaces g. Ducts c. Pipes h. Register d. Ventilation Equipment i.tights e. Vertical Surfaces FIELD NOTES: ,i»u // A FINAL Am SAMPLE RESULTS: [ EM—to be Analyzed I PCM—Analyzed on Site Sample# Sample # _ Sample# Sample # i. 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