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17C-283 demo application.pdf
File #BP-2022-1166 609 APPLICANT/CONTACT PERSON:WRIGHT BUILDERS 48 Bates St NORTHAMPTON, MA 01060413586-8287 PROPERTY LOCATION 22 LILLY ST MAP:LOT 17C-283-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permi ' -d out Fee Paid 30.00 Type of tons.- ion: demo garage/carriage house New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved )( Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR SpecialPermit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed xOther Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board ofHealth Permit from Conservation Commission Permit from CB Architecture Committee X Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay I 9/ 4) _ SiL4 ature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission,Department of public works and other applicable permit granting authorities. Variances are granted only to those applicants who meet the strict standards ofMGL 40A.Contact Office of Planning&Development for more information. c_t I V E4) The Commonwealth of Massachusetts Wt oard of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MIUSALITY SEi 9 Bt1il tnbrmit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling I_', T OF f,U(l DING INSPECTIONS I This Section For Official Use OnlyNOflTIlAMr'TON.MA 0101,0 } wilding Permit Nminbc.. „, .r //U a Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 22 Lilly Street Florence,MA 01062 17C 283-001 1.1 a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB Return area to grass 10,890 SF.25 Acres 82.5' Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 50' 82.5' 4' 10' 20' 32' 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public M Private 0 Zone: Outside Flood Zone?Municipal M On site disposal system 0Checkifyes® SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Katrina Karkazis Florence,MA 01062 Name(Print) City,State,ZIP 22 Lilly Street 415-810-8481 karkazisagmail.com No.and Street Telephone Email Address New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition El Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: Demolition of the garage/carriage house on back of property.There will be no new structure in its place.Only the carriage house/garage. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use OnlyLaborandMaterials) 1.Building 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical Standard City/Town Application Fee Total Project Cost3(Item 6)x multiplier x 3.Plumbing 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fees: 1 I,, Check No.(/' ( heck Amount: "J Cash Amount: 6.Total Project Cost: $ 0 Paid in Full Outstanding Balance Due: Demo Permit Fee - $30.00 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-065521 1/25/2024 Steven Barrett License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 97 Federal Street PO Box 503 No.and Street Type Description Belchertown,MA 01007 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413)586-8287 sbarrett@wright-builders.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(MC) 101536 6/25/2024 Wright Builders, Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 48 Bates Street nwrioht iwright-builders.com No.and Street Email address Northampton,MA 01060 413)586-8287 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes l No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Wright Builders Inc to act on my behalf,in all ers relative to work authorized by this building permit application. Katrina Karkazis 04-//e 2- Print Owner's Name(Ele onic S' ) Date SEC ON 7b: OWNER'OR AUTHORIZED AGENT.DECLARATION By entering my name below,I hereby attest under the pains and penalties ofperjury that all of the information contained in this application is true and to to the best of my knowledge and understanding. Wright Builders Inc if/r/20 ZZ Print Owner's or Authorized A s Name lectronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 840 SF including garage,fmished basement/attics, decks or porch) Gross living area(sq.ft.) 0 Habitable room count 0 Number of fireplaces 0 Number of bedrooms 0 Number of bathrooms 0 Number of half/baths 0 Type of heating system 0 Number of decks/porches 0 Type of cooling system 0 Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Demo Permit Fee$30.00 City of Northampton a.. ti 5 f •. Massachusetts I• 4 W 4 DEPARTMENT OF BUILDING INSPECTIONS r 212 Main Street • Municipal Building yeti lbb Northampton, MA 01060 s6 ON'‘' CONSTRUCTION DEBRIS AFFIDAVIT FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 686 Main Street Holyoke MA OR Valley Recycling 234 Easthampton Road Northampton MA The debris will be transported by: Name of Hauler: J&J Trucking OR Associated Building Wreckers Signature of Applicant: Nicholas Wright Date: 8/8/2022 Cki.)-\- t\i icy 8= -r_ ___„ 0(e),, BUILDING DEPARTMENT DEMOLITION PERMIT SIGN-OFF SHEET Date: g-aocv Address: (-9 I J f/t F F/ rerice.. Building Use: Grower: " o + & AfiC . Phone: 536 -- g.„?'7 (N,*) egkcivOwner's Address:fro,a r UTILITY CUT OFF Signature of Authorized Representative of Utility Department required) As required by the Massachusetts State Building Code (780 CMR), a permit to demolish shall not be issued until a release from the utilities is obtained, stating that their respective service connections and appurtenant equipment have been removed or sealed and plugged in a safe manner. Eversource (Gas) Signature Title National Grid (Electric) Signature Title t,1th,&DPW (Water) c LQ ,, - - p Signature Title DPW (Sewer) 1144&da t Ste o_ 8 "iy a2- Ol t d, q, Signature Title iJ DPW (StOrm water A/g' 6 pZQ Signature Titl 0 DPW (Tree Warden) r7- lrS O'1go?a--- rtgnat a Title DPW Director Si ature Title Historic Comm. Review Signature Title The['rrrrinlunlrcrrlrlt ofMassachusetts Department ofindustrinlAccidents 1) I Congress Street,Suite 100 1.4 Boston. MA02114-2017 wwir.nlas'tigoi'Idia 11 urkers'Compensation Insurance Af idaa it:Builder/Coatractors!Eketririr[nsd'Plumbers. it BE FILED WITH"III PERMEITING AI1'lIORI'I' . Applicant Information Phase Print lreibh Name ii3 reanraati n individual0: Wright Builders Inc Address: 48 Bates Street C'ttti Slaty Lela: Northampton, MA 01060 Phone#: (413)413 586-8287 arc awlm an cntphwer?('hetk die arpprupriait•trot.Type ofproject(required): l.31 not entpltxtr ttLth 23 ertrluaecs"tall and era Pori-tirnel-' 7. Q New construction I anal a sulk Fop team cur pusuntaalaap and have no eurplunta.s work ia= Guy nue in 8. o Reiix delingatn,eapacat_a..[Nu IA rll'r ccanr.insurance requited"9. Q DetnulitiexaIantalamalwaaemaluintalltNuworths`curt insurance required_] t.©i an tuntaiionowra and will be hiring ounitacturs W t wentooduttall on my pnoponty. I will ID o Building addition rruurt iliac all to:Inaactum cieht-r lute workers'er necp naatatnt nuuMICI:tar oftteethe I I.Q Electrical repairs or additions proprietors'H itla rru tanplu?;ces. 12.0 Plumbing repairs or additions 30 I ant a aenimal e1.ntrat'tuI and I hr..:hied the salh,cuntractor.llstn tnr the attached sheen. BE]1 Roof repairsliresesub-c tarn:untraccon.tu :duple,cr nsandIsaacworkers'cop.utxurance r l 14.0Other11.'e arc a t-anap ocaio VII and of s tdtlLcces lull a etene7Xd then nt'ht of exemption per 5t( tL l ? I II41.and w c hose On tvrLtl lwones.[' it w vrl crs'comp.insurance required.] Lank applicant that tltoi:ks box-1 inunt atom till out the section t!eluw showing their wtlrktms'to n[pensahmepolity i o,tnatien_ t llxnrxvawipers w hu submit this attLtk-stt mttlicaioary tln_s are doing all work and then Lae imutsidc emu-odors whet=boo R a crew attlitlasit ittIratnulr suaeh. t(`untaac&an that check this bat must attained an niMhtiuotal sheet slhtaw nut the n:man:o1 the sub-ecintraeturs and nut whether or not those imbues'Ilan,: cargoktct-s_ if the sub-c natractttrs hate tmrplay'tes.thi.10 nubit peptide their workers'contr.Polack nuanbcr_ I um an employer that is providing workers'compensation insurance for my employees. Below is the policy andjab site information. Insurance Company Name: A.I.M Mutual Ins Co Policy#or self- .Lie.#: MCC-200-200053((4-2021 A Expiration Dote: 3/1/2023 lob Site Address: 22 Lilly Street (Deltinb r(,r )ct M A ` CieyState''Zip:_ Florence MA 01062 Attach a copy of the corkers'compensation policy deehn[lto pattr]showing the polio number and expiration dates. Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable Iry a line up to SI,5110.00 anml or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S250.00 a day against the violator.A copy of this statement may be forwarded to the()thee of Ins rs[igatiotts of the DIA for insurance coverage verification. I do hereby certify under the pains andpenaltiesWrightof erjnrr that the information provided above is true and correct Signature: Nicholas S Z.Z Z Date: 8/8/2022 Phone (413)586-8287 Official Use only: Di'not write in this area,to be completed by cite`or town official C itr. ur Tonal: Permitl.icense/1 Is.suitap.lulltorils 4 circle one): I. Board of Ilraltlt 2. Ituildinl„t l)ep:trlutt ul 3.('ityflown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Oilier ontset Person: Phone#: ASBESTOS REMOVAL All residential, commercial and institutional buildings are subject to Massachusetts Department of Environmental Protection (MassDEP) asbestos regulations at 310 CMR 7.15. Therefore, owners and/or operators (e. g. building owners, renovation and demolition contractors, plumbing and heating contractors, flooring contractors, etc.) need to determine al asbestos containing materials (ACMs), both friable and non-friable, that are present at the site, and whether or not those materials will be impacted by the proposed work, prior to conducting any renovation or demolition activity. Examples of commonly found ACMs include, but are not limited to, heating system insulation, floor tile and vinyl sheet flooring, mastics, wallboard, joint compound, decorative plasters, window glazing, asbestos containing siding and roofing materials and fireproofing materials. Failure to identify and remove all ACMs prior to its being impacted by renovation or demolition activities, can result in significant penalty exposure, and higher clean-up, decontamination, disposal and monitoring costs. A DOS certified asbestos consultant must be contracted to determine if asbestos is present and whether removal/repair is necessary. If the building is a state owned facility, contact DCAM and DOS. DOS provides a list of licensed asbestos abatement contractors and consultants. You may wish to inquire if a contractor has any history of violations. Only DoS licensed and DOS certified asbestos abatement contractors and consultants may be hired to perform asbestos related work in Massachusetts. Received by: Edward Nowak#15386 Owner Print Name Title Please see attached signed testing documents and report from Jees Enviromental - DOS Certified Signature Date ti•1eurofins EMLab P&K Report for: Ed Nowak JEES 22 Park Rd Charlton, MA 01507 1 Regarding: Project: Kashazis; Home Remodeling EML ID: 3002150 Approved by: Dates of Analysis: Asbestos PLM: 08-12-2022 Approved Signatory Renee Luna-Trepczynski Service SOPs:Asbestos PLM (EPA 40CFR App E to Sub E of Part 763&EPA METHOD 600/R-93-116, SOP EM-AS-S-1267) NVLAP Lab Code 500031-0 All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report.The results relate only to the samples as received and tested.The results include an inherent uncertainty of measurement associated with estimating percentages by polarized light microscopy. Measurement uncertainty data for sample results with> %asbestos concentration can be provided when requested. Eurofins EMLab P&K("the Company")shall have no liability to the client or the client's customer with respect to de isions or recommendations made,actions taken or courses of conduct implemented by either the client or the client's custo eras a result of or based upon the Test Results. In no event shall the Company be liable to the client with respect to the Test Re ults except for the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or conseq ential damages or lost profits or revenues to the fullest extent such liability may be disclaimed by law, even if the Compa y has been advised of the possibility of such damages, lost profits or lost revenues. In no event shall the Company's liability wit, respect to the Test Results exceed the amount paid to the Company by the client therefor. Eurofins Aerotech Built Environment Testing,Inc.an affiliate ofEurofins EPK Built Environment Testing,LLC d/b/a Eurofins EMLab P&K EMLab ID: 3002150, Page 1 of 3 Eurofins EMLab P&K 1501 West Knudsen Drive,Phoenix,AZ 85027 800) 651-4802 Fax(623) 780-7695 www.emlab.com Client: JEES Date of Sampling: 08-10-2022 CIO: Ed Nowak Date of Receipt: 08-12-2022 Re: Kashazis; Home Remodeling Date of Report: 08-15-2022 ASBESTOS PLM REPORT Total Samples Submitted: 8 Total Samples Analyzed: 8 Total Samples with Layer Asbestos Content>1%: 0 Location: NW-WC-1,Cottage Window Caulking Lab ID-Version$: 14449254-1 Sample Layers Asbestos Content White Caulk with Multilayered Paint ND Composite Non-Asbestos Content: < 1%Cellulose Sample Composite Homogeneity: Good Location: NW-WC-2, Cottage Window Caulking LabID-Version$:14449255-1 Sample Layers Asbestos Content White Caulk with Multilayered Paint ND Composite Non-Asbestos Content: < 1%Cellulose Sample Composite Homogeneity: Good Location:NW-FT-3,Closet White Blue VAT (No{ 13u-rh) Lab ID-Version$:14449256-1 Sample Layers Asbestos Content Off-White Floor Tile 1%Chrysotile Black Mastic ND Sample Composite Homogeneity: Moderate Location:NW-FT-4,Closet White Blue VAT (POT Liec,.14 dl = t3 ervt Lab ID-Vdrsion$:14449257-1 Sample Layers Asbestos Content Off-White Floor Tile 1%Chrysotile Black Mastic ND Sample Composite Homogeneity: Moderate The test report shall not be reproduced except in full,without written approval of the laboratory.The report must not be used by the client to claim product certification,approval,or endorsement by any agency of the federal government.Eurofms EMLab P&K reserves the right to dispose of all samples after a period of thirty(30)days,according to all state and federal guidelines,unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually.ND means no fibers were detected.When detected,the minimum detection and reporting limit is less than I%unless point counting is performed.Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. A"Version"indicated by-"x"after the Lab ID#with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of"x". Eurofins Aerotech Built Environment Testing,Inc.anaffiliate ofEurofins EPK Built Environment Testing,LLC d/b/a Eurofins EMLab P&K EMLab ID:3002150,Page 2 of 3 Eurofins EMLab P&K 1501 West Knudsen Drive,Phoenix,AZ 85027 800) 651-4802 Fax(623) 780-7695 www.emlab.com Client: JEES Date of Sampling: 08-10-2022 C/O: Ed Nowak Date of Receipt: 08-12-2022 Re: Kashazis; Home Remodeling Date of Report: 08-15-2022 ASBESTOS PLM REPORT Location: NW-LI-3,New Bathroom Flooring (Ivo F IQC4 Lab ID-Version$:14449258-1 Sample Layers Asbestos Content Beige Linoleum with Felt Backing ND Composite Non-Asbestos Content: 30%Cellulose Sample Composite Homogeneity: Good Location: NW-LI-4,New Bathroom Flooring 6N T (vGu l-t-C 36`1-1"' LabID-Version$:14449259-1 Sample Layers Asbestos Content Beige Linoleum with Felt Backing ND Composite Non-Asbestos Content: 30%Cellulose Sample Composite Homogeneity: Good Location: NW-WB-3,Garage Wall Wallboard Lab ID-Version$:14449260-1 Sample Layers Asbestos Content Brown Fibrous Material ND Composite Non-Asbestos Content: 99%Cellulose Sample Composite Homogeneity: Good Location: NW-WB-4, Garage Wall Wallboard LabID-Version$:14449261-1 Sample Layers Asbestos Content Brown Fibrous Material ND Composite Non-Asbestos Content: 99%Cellulose Sample Composite Homogeneity: Good The test report shall not be reproduced except in full,without written approval of the laboratory.The report must not be used by the client to claim product certification,approval,or endorsement by any agency of the federal government.Eurofins EMLab P&K reserves the right to dispose of all samples after a period of thirty(30)days,according to all state and federal guidelines,unless otherwise specified, Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually.ND means no fibers were detected.When detected,the minimum detection and reporting limit is less than 1%unless point counting is performed.Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. A"Version"indicated by-"x"after the Lab ID#with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of"x". Eurofins Aerotech Built Environment Testing,Inc.an affiliate of Eurofins EPKBuilt Environment Testing,LLC d/b/a Eurofins EMLab P&K EMLab ID:3002150,Page 3 of 3 ATHERCHAINMa OF CUSTODY ;y;;eurofins EMLab P&K WWNonne_ II Foe Rein Snow W Clear Noecuhun6a III pIIII II III III II Ili --Marlton,NJ:3000 Limon Dr E.Ste.A.Marlton,NJ 08053•(866)871-1984 Moderate X,\ 0030021 S 0Phoenix,A 1501 Wes Knudsen Drive.Phoenix,AZ 85027•(800)651.4802 Heavy S or rap Tape,atsL SSF,CA:6000 Shoreline CL Ste.205,S.San Frarrison.CA 94080•(86S)688-6653 Trey Swill,.8uk CONTACT INFORMATION NES 115386) 22 Park Rd Charlton MA 01507 g P M1 ce.m aan __`,_ Address: t$ IContact:Ed Nowak t \ v ( g _ QSpecialInstrucCons. Re \ `eV'`ACV\ /i , ` i ¢Phew 508- 523-5923 U J aa33 PROJECT INFORMATION TURN AROUND TIME CODES (TAT)1 g 1 P,o ort ID: - UC ...]y\ STD-Standard(Default) 2pm1 Li,!..,d I (iRusheereceivedafter0SProjecttoranweekends,w81 be g Enes:m an, \ r}.'A ND-Next Business Day considered received the 8 5 I nPuerta3empkrgneMbualrresadaPloaso zip Coe*: Dealfha; 1 ' 3ai E i 9fl-j ,2 -giwil ,1 ti WH-WeekendrHofidayrASAP weekend analysis needs. ! g t gY emWe Total at cI- H TAT NOTESSAMPLEIDDESCRIPTIONTYPalwawa) VdurrrarArea mrrra ofdee,TersP,RN,sec) m O $ 3 d' `l l P l o ( 2 m & ',as ..Icabls r P ti. _. C A N,•'6. yam 11 i la. ma i SAMPLE TYPE CODES RELINQUISHED BY DATE a TIME RECEIVED.BY DATE&TIME Bc-BoCassa e." CP-ConWotPlate T_Tspe O_Other. , 1 1/ f I) Glut. 7G..vwJr_ cis 1(-t-., Al S-Andersen ..- ST-Spore Trap SW-Swab I f' 5 I'_. SA9_Surface Air Samp or B-Bulk —._SO-Soil e7.r 0, NP-Non-potable Water PP.Potable Water 0•Dust r 7 a""" CITY OF NORTHAMPTON, MASSACHUSETTS PENDING APPROVAL DEPARTMENT OF PUBLIC WORKS 22 LILLY STREET th.:' r 4) 125 Locust Street vim. S Northampton, MA 01060 Trench Permit Number: 2023-063 L =413-587-1570 Fax 413-587-1576 Date Approved: 2 Z Expiration Date: / 0 5 ' Lv for City Use Only) EXCAVATION/TRENCH PERMIT Pursuant to G.L. c. 82A and 520 CMR 14.00 et seq. (as amended) This permit must be fully completed prior to consideration. Submit completed form with permit fee to Northampton Department of Public Works, 125 Locust Street,Northampton, MA 01060. This permit is issued under the provisions of M.G.L.c. 82A, 520 CMR 14.00 and applicable sections of the Revised Ordinances of the City of Northampton, including, but not limited to, Section 285-21. Fee: $250 Check#:63813 Date Issued:8/22/2022 Name of Applicant Primary Phone# WRIGHT BUILDERS 413-586-8287 Street Address Emergency Phone # 48 BATES STREET 413-923-2870 NICK City/Town State Zip Email NORTHAMPTON MA 01060 nwright@wrightbuilders.com Name of Excavator Primary Phone# ASSOCIATED BUILDING WRECKERS 413-732-3179 Street Address Emergency Phone # 352 ALBANY STREET City/Town State Zip Email SPRINGFIELD MA 01005 Name of Property Owner(s) Primary Phone# KATRINA KARKAZIS 415-810-8481 Street Address Emergency Phone # 22 LILLY STREET City/Town State Zip Email 1 NORTHAMPTON MA 01060 Insurance Certificate# Policy Expiration Date ON FILE Name&Contact Information of Insurer ON FILE Dig Safe#& Start Date from Dig Safe Ticket: 2022-330-8521 D\NC.ei Stud 9 )i )?? Project Description/Location of Work. Provide the following: Description of purpose and exact location of proposed work including description of what is to be laid or repaired in the proposed trench (e.g. waterpipe, .sewer pipe, drain pipe, gas line, power line, communication lines, etc.) Sketch or drawing showing all proposed work. Anticipated Start of Work Date. Description: 22 LILLY STREET DEMOLITION OF EXISTING BARN/CARRIAGE HOUSE EXCAVATING SLAB - UNDERGROUND CONCRETE NO OTHER TRENCHING/JUST DEMO Check if applicable: Emergency Work on Private Property Work in Public Right of Way Work within State Layout(attach State Permit) Work within 50' of a Public Shade Tree(see attached Public Shade Tree Regulations) Tree removal required(see attached Public Shade Tree Regulations) Tree protection,trimming, or root pruning required(see attached Public Shade Tree Regulations) Work within 100' of a wetland or 200 Ft.of a stream or river (attach Permit) Work within floodplain (attach permit) Public Water/Sewer/Drain Entry Permit(attach permit, if available) Driveway Permit(attach permit, if available) El Pole and Wire Petition(attach approval) Pg 2/4 To be completed when approved permit is picked up. By signing below,the applicant acknowledges and agrees to all the conditions of approval stated below and validates this permit. jr,9/`( z Applicant Date For City Use—Do not write in this section Department Approvals/Comment Water: 8/22/2022 Sewer/Storm Drain: 8/29/2022 FPC: 9/8/2022 Streets: $/29/2022 Traffic Signals: 8/22/2022 Subject to 5-yr. pavement moratorium Road last paved:r 2003 Special Conditions: Fee 250 Permit Application received(Check payable to the City ofNorthampton) Waived. Reason: Tree mitigation: Permit AP Director of Public Works Date Pg 414 x id take a ride by the site and from what I could tell there is no power to the garage behind 2. Unfortunately, the clearance for no power will have to come from the local wire inspector as ny garages/barns are fed from the house panel. ooe reach out to Roger Ma|o for this letter a ajasinsd@nationalg' d,conl