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38C-077 (2) • Client#: 27633 ASSBUI ACORL1 CERTIFICATE OF LIABILITY INSURANCE DATE( 09 DYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chittenden Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1391 Main Street, 3rd Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Springfield, MA 01101 413 781 -6871 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Steadfast Insurance Co Associated Building Wreckers, INC INSURER B: American International 352 Albany ST INSURER C: Springfield, MA 01105 INSURER D: INSURER E COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRC DATE (MMIDDIYYI DATE (MM /DDIYY) A GENERAL LIABILITY GL0586686404 03/15/09 03/15/10 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100,000 PREMISES (Ea occurrence) _ CLAIMS MADE X OCCUR MED EXP (Any one person) $10,000 X PD Ded:10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2 , 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 - I POLICY n PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS /UMBRELLA LIABILITY 5E0903618301 03/15/09 03/15/10 EACH OCCURRENCE $5,000,000 X I OCCUR CLAIMS MADE AGGREGATE $5,000,000 DEDUCTIBLE _ $ X RETENTION $ 10000 $ B WORKERS COMPENSATION AND 005855045 02/01/09 02/01/10 OR STATU- 1 X I TORY I IMITS EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 A OTHER Pollution CPL903860902 03/15/09 03/15/10 $1,000,000 each claim $2,000,000 total all claims DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: collapsed accessory structure, 8 Easthampton RD, Northampton, MA Certificate Holder and the City of Northampton arenamed as additional insured under general liability as required by written contract for work performed by insured subject to terms and conditions of the policy. CERTIFICATE HOLDER CANCELLATION 10 Days for Non - Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION M &S Holdings LP DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 8 Easthampton RD NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Northampton, MA 01060 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE -4 ACORD 25 (2001/08) 1 of 2 #S51992/M51750 MEH © ACORD CORPORATION 1988 Massachusetts Department of Environmental Protection • Bureau of Waste Prevention • Air Quality 100086858 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s) surveyed for the presence of asbestos containing material (ACM)? N Yes E No If yes, who conducted the survey? James Beaudry b, Surveyor Name 1A1000202 c. Division of Occupational Safety Certification Number 04/22/2009 106/05/2009 _ W 7. Construction or Demolition: a. Start Date (mm /dd /yyyy) b. End Date (mm /dd /yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: 0 seeding 0 paving wetting shrouding b. If other, please specify: 19 0 covering 10 other 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? a. Name of DEP Official * b. Title c. Date (mm /dd /yyyy) of Authorization d. DEP Waiver Number D. Certification "' 1 certify that I have examined the Johanna Savage - o above and that to the best of my a. Print Name knowledge it is true and complete. The signature below subjects the b. Authorized Signature signer to the general statutes 9 9 Demo Coordinator -o regarding a false and misleading c. Positionrl itle � o statement(s). Associated Building Wrecker, Inc. d. Re.resentin. � co e. Date (mm /dd /yyyy) ag06.doc • 10/02 BWP AQ 06 • Page 3 of 3 Ill r ' Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality [100086858 L BWP AQ 06 Decal Number Notification Prior to Construction or Demolition General Statement: If B . General Project Description (cont.) asbestos is found during a 4. General Contractor: Construction or Demolition [Associated Building Wrecker, Inc. operation, all responsible parties a. Name must comply with 352 Albany Street 310 CMR 7.00, b. Address 7.09, 7.15, and Springfield MA 01105 Chapter 21 E of the I General Laws of c. City /Town d. State e. Zip Code the Commonwealth. 1(413) 732 -3179 This would include, f. Tele.hone Number area code and extension .. E -mail Address optional but would not be limited to, filing an Andrew Mirkin asbestos removal h. On -site Manager Name notification with the Department and /or a notice of release /threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department, if applicable. Associated Building Wrecker, Inc. a. Name 352 Albany Street b. Address Springfield MA 01105' c. City/Town d. State e. Zip Code (413) 732 -3179 f. Tele.hone Number area code and extension ' s. E -mail Address (optional) Fred VanDerhoof 1 h. On -site Manager Name 2. On -Site Supervisor: William Babcock On -Site Supervisor Name 3. Is the entire facility to be demolished? Yes D No N 0 4. Describe the area(s) to be demolished: o Entire existing structure. N ∎ O ° 5. If this is a construction project, describe the building(s) or addition(s) to be constructed: - o n/a - a Q • ag06.doc • 10/02 BWP AQ 06 • Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality 100086858 BWP AQ 06 Decal Number Notification Prior to Construction or Demolition Important: A. Applicability When filling out Pp Y forms on the computer, use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor - do not re use the return (DEP), Bureau of Waste Prevention - Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR7.09 (2) ten (10) days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. Vero B. General Project Description 1. a. Is this facility fee exempt - city, town, district, municipal housing authority, owner- occupied Instructions residence of four units or less? Li Yes Q No 1. All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: Department of fire damaged residential structure Environmental Protection a. Name notification 8 Easthampton Road requirements of b. Address 310 CMR 7.09 !Northampton MA 01060 c. City/Town d. State e. Zi • Code (413) 585 -0291 f. Telephone Number (area code and extension) .. E -mail Address o•tional 12,440 1 j h. Size of Facility in Square Feet - i. Number of Floors j. Was the facility built prior to 1980? Q Yes EJ No k. Describe the current or prior use of the facility: fire damaged residential structure I. Is the facility a residential facility? al Yes E No 1 �o m. If yes, how many units? Number of Units ° 3. Facility Owner: IM &S Holdings LP -O a. Name - o 18 Easthampton Road b. Address [Northampton MA 1 01060 c. Citv/Town . i • • • ° 1(413) 585 -0291 f T-1 -• .n- N m.-r - -. ..-an. -x - is •. E-mail A..r- _ •ai.n.l __ _ _ __ o Steve Boulanger h. Onsite Manager Name ag06.doc • 10/02 BWP AQ 06 • Page 1 of 3 2FR -2 -2009 09:54A FFCM:. TO:141 :7=96224 F.2 U4 b is C3 bLUf l t Ht7t1 I: �Tnrr, Np Mier r, 4111 RAI strike since i 36 Gunn Road Ext. Southampton, MA 01073 Phone 413 -527 -2032 Fax 413- 529 -0344 April 2, 2009 Richards Plumbing & Heating, Inc. 8 Easthampton Road Northampton, MA 01 060 Attn: Steve Subject Fire Damage Gentlemen: This is to confirm that on February 23, 2009, we completely severed electrical power to the fire damaged building at the above address. Any other information needed, please contact us accordingly. Respectfully, Bergeron Electrical Services, Inc. aFR -2 -2009 09:55A FRCM:. TO:141373 -16224 P.3 Gas 4 .1) Bay state A 1ViSaurce Company 2025 Roosevelt Avenue P4, Box 2025 Springfield , MA 01102 -2025 April 2, 2009 M &S Holdings LP 8 Easthampton Rd Northampton Ma 01060 Dear Steve, The address listed below has had the gas service(s) disconnected in the parking lot and is now ready for demolition. ADDRESS : 8 Easthampton Rd (rear) TOWN : Northampton STATE : Massachusetts Sincerely, 't f Terri Workforce Planning ;FF -2 -2O 9 09: ',41:1 FROM:• TO:14137346224 F. 1 4 -2 -09 M & S Holdings LP 8 Easthampton Road Northampton, MA 01060 ( 413) 585 -0291 Tel ( 413 ) 585 -0299 Fax To Associated Building Wreckers, Inc. 352 Albany Street Springfield, MA 01105 Please note: M & S Holdings has obtained a disconnect service letter for the electrical and gas line at 8 Easthampton Road, Northampton. We are faxing copies to you along with this fax. No other utilities are in this building.( water, oil,propane, etc. ) We look forward to your services in the removal of this structure. Please let us know if you need anything else from us. Steven A. Boulanger M & S Holdings LP Zimbra: abwinc@comcast.net Page 1 of 1 SmartZone Communications Center Collaboration Suite abw_inc @comcast.net Response to Dig Request Monday, April 13, 2009 11:11:06 AM From: agt_comm @irth.com To: ABW INC @COMCAST.NET To: ASSOCIATED BUILDING WRECKERS Attn: JOANIE SAVAGE Voice: 4137323179 Fax: 4137346224 Re: Response to Dig Request This is an important message regarding your request for us to locate our facilites around your excavation area. Ticket: 20091510138 County: Hampshire Place: NORTHAMPTON Address: 8 EASTHAMPTON RD WT11 (TGP - Agawam): Based on the information you provided the One Call Center, our Tennessee Gas Pipeline high - pressure natural gas pipeline facilities are cleared from the work area described on the One Call Center ticket. If you have any further questions, please contact our office at 508 - 435 -6812 If you have any questions please contact our local office. This message was generated by an automated system. Please do not reply to this email. http : / /sz0174.wc.mail.comcast.net /zimbra /mail 04/ 13/ 2Mq DIG SAFE SYSTEM, INC. - Create Nev Quick Ticket Page 1 of 1 Request Number: 20091510138 Date 04/10/2009 Time 14:27 Latitude: Longitude: State: MASSACHUSETTS Municipality: NORTHAMPTON Address / Intersection: 8 EASTHAMPTON RD Nearest Cross Street 1: EARLE ST Nearest Cross Street 2: Additional Information: DEMOLITION OF PARTIALLY COLLAPSED STRUCTURE Nature Of Work: DEMOLITION OF ENTIRE EXISTING STRUCTURE Area Of Work: PRIVATE PROPERTY Area Is Premarked: Y Start Date: 04/16/2009 Start Time: 14:30 Caller: JOANIE SAVAGE Title: DEMO CO ORDIN Return Call: BEF 430PM Phone #: 413 - 732 -3179 Fax #: 413 - 734 -6224 Alt. Phone #: Email Address: ABW_INC @COMCAST.NET Contractor: ASSOCIATED BUILDING WRECKERS Address: 352 ALBANY ST City: SPRINGFIELD State: MA Zip: 01105 Excavator Doing Work: ASSOCIATED BUILDING WRECKERS, INC. Member Utility List Code Abbreviation Name MC MASSEL MASS ELECTRIC COMPANY SP VERIZN VERIZON TV COMCAS COMCAST WG BSTGAS BAY STATE GAS WT11 TENGAS TENNESSEE GAS PIPELINE CO ON ONTARG ON TARGET LOCATING RJ IDM INNOVATIVE DATA MANAGEMENT • There may be non - member utilities in the area that you need to notify. • Electric and other companies may not mark lines they don't own or maintain. You may want to contact them for more information. • The excavator is responsible to maintain markings placed by member utilities... DIG SAFE ENCOURAGES A COPY OF THIS ELECTRONIC TICKET ON SITE AT ALL TIMES. Create New Create From Existing Print Ticket ) [ Return To Menu j [ Return To Home J http://digsafeform.digsafe.com/cgi-bin/dlcgi.exe 04/10/2009 • 352 Albany Street, Springfield, Massachusetts 01105 Tel: (413) 732 - 3179/(800) 448 -2822 Fax: (413) 734 -6224 March 11, 2009 Steve Boulanger M &S HOLDINGS LP 8 Easthampton Road Northampton, Massachusetts 01060 Thank you for the award of this contract. For the sum of and savage rights, we agree to demblish the fire damaged outbuilding located behind 8 Easthampton Road, Northampton, Massachusetts. Associated Building Wreckers work includes: 1) Demolition of the fire damaged building and removal of all debris to an approved facility except for one studwall, leaving the slab in place, as discussed. 2) Removal and disposal of fire damaged debris outside the building. 3) Taking out the demolition permit and furnishing a certificate for demolition general liability and worker's compensation insurance, upon request. 4) Using water for dust control, as needed. 5) Performing a pre - demolition asbestos survey, as required. M &S Holdings L.P. will be responsible for: 1) Separation of stud wall to remain, as discussed. 2) Any service disconnections, including cutting, capping and /or relocating (only services onsite is electric and gas). 3) Obtaining any historical permits, special notifications, such as conservation, and /or surveys, if required. 4) Any repair to parking area, concrete slab or remaining stud wall, if required. 5) Cost associated with any hazardous materials found at the site. 6) Making the job accessible to work by removing parked cars and trailers, as discussed. 7) Disposal of any propane and /or oxygen tanks on site. 8) Making payment in full upon completion within thirty (30) days. Option #1: To provide and install approximately 150 - 2001.f. of silt fencing along the top of the slope behind the building will cost This plan would have to be accepted by the Conservation Commission, as they may require hay bales. We do not think hay bales would be effective for this project. M &S Holdings LP acknowledges that the Owner of the property and is not in bankruptcy or petitioning for bankruptcy. Any balance that becomes past due for any reason will be charged a service charge of 1.5% per month, 18% annually. If it should become necessary to turn this account over for collection, the billed party agrees to pay all collection costs plus reasonable attorney's fees incurred. M &S Holdings LP is unaware of any hazardous materials or wastes on the property and knows of no legal reason, regulation, or other circumstances, which might prevent or in any way interfere with the right or ability of Associated Building Wreckers, Inc. to perform the above work if any hidden conditions do exist on this job, they are the owner's responsibility. t � <erely, iat:t Buildin, - cke c. Agreed and Accepted: I LA • [ By: -1 9 An. rew Mirkin, President Steve Boulanger, Owner Date M &S Holdings LP Options, Agreed and Accepted: By: 3_L3 - 0 9 Steve Boulanger, Owner Date M &S Holdings LP P: \Msword\ D EMO_CTRTS_ 2009 \8_Easthampton_Rd_Northam pton_ MA.doc ' The Commonwealth of Massachusetts ¢ �� Department of Industrial Accidents 0 Office of Investigations 600 Washington Street Boston, Mass. 02111 www.mass.£rov /dia Workers' Compensation Insurance Affidavit: General Businesses Applicant information: Please PRINT legibly Business /Organization Name: '4. 5OC /(JPc /L(//e/225 7frCA/ i2l Address: 55 /I /t � t City /State /Zip: , . . . y � � � f / f � � �� l�'� C G - ) Phone # 4 47 n 1 2 `D / ;Q Are you an employer? Check the appropriate box: Business Type (Required): 1. VI am an employer withXt mployees (full and/or 8. [ Retail part- time)* 2. 9. 1 Restaurant /Bar /Eating Establishment 3. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. 10. 1 Office and /or Sales (incl. real estate, auto, etc.) [No workers' comp. insurance required] 11. 1 Non -profit 4. ❑ We are a corporation and its officers have exercised their right of exemption per c. 152, §1(4), 12. ❑ Entertainment and we have no employees. [No workers' comp insurance required] ** 13. ❑ Manufacturing 5. 6. ❑ We are a non -profit organization, staffed by 14. Health Care volunteers, with no employees. [No workers' comp. insurance required] 15. ❑ Other 7. *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. * *If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an organization should check box #1. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy information. Insurance Company name: kneritGh/?J/7 /o'/2d1/L2/J(d/ %) Insurer's Address: City /State /Zip: r � Policy # or Self -ins. Lic. # % ((MI Expiration Date: i /'/t2 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and /or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250,000 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certt g y the pains and penalties of perjury that the information provided above is true and correct. Signature 34/ l l Altigt-- i i - J r9 Date � ' t Print Name . �(?/ cii0t/ (i f/ / J Phone # 'IL -15 -3/ / , q Official use only. Do not write in this area to be completed by city or town official City of Town: Permit /license # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Licensing Board 5. Selectmen's Office 6. Other Contact person: Phone # Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , , ..T ±� / �/ 5 _..__,_ _ _. ......_._ _ . _._..,_ as Owner of the subject property hereby authorize S D�!/�' /_[Cl i 1dl l'I/ ell.0 r ic. ._._, ,._. to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date � n_ /� /�� Ili �C e Ire I, s 1� �/ _! l .. C ..._ _. .... .. _ ...._.a , as(o /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Si, ned under, the, pains nd Rena lties of,,,perju, . .. _.._ „ Print Na Signature of O er /Agen Date SECTION 12 CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : � C., i 2Z L�.,... � ,,..�,�. � �� ....�.�,A..a.,mw .w,�, _._ w. i �� 7 License Number ' l i 0e i�r ,�D� r� l��t� , /i, pt — t 7/7":::L50:1694 Address j . "7.Z j Expiration Date i t _7 / _0/ Signature Telephone SECTION 13 - 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 410 No 0 Versionl.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable Name (Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor Not Applicable Company Name: Responsible In Charge of Construction Address Signature Telephone Versionl.7 Commercial Building Permit May 15, 2000 8 ; NORTHAV'"ON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage ___ __ _.___ _ _ __..._. ' Setbacks Front ) r"--1 µ Side L..._ . _.:_. R . ,. _ .. L• .,._.. J R. I Rear _ '�._.i Building Height r-- [ 1 1 ...i 3 i Bldg. Square Footage % Open Space Footage % �^ B 4 (Lot area minus bldg & paved _ �__ _ 3___. _ parking) # of Parking Spaces , ....„._.i Fill: t i (volume & Location) .. .... . _,,, -e A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW ® YES 0 IF YES, date issued: [ i IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book I Page, j and /or Document # L B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW ! YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: 1 m C. Do any signs exist on the property? YES 0 NO 0 C ricf k 1 Ui ) IF YES, describe size, type and location: 1 D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO ft IF YES, describe size, type and location: f E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition pd Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. Of Proposed Work: . t ' C� titi �1 � , r1 V P c` Ca C,) Se(1 1P (1—" I C.f�e ? r � C , (15 CY ( U1 C ` ? 2 , A , P A N D CONSTRUCTION TYPE ( �1 f s1ru t'� q g C i lit� / -V t ( I : l M1 I l' / t�1 � in SECTION 5 - USE GROUP h USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B l ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: _. -.. S Special Use ❑ Specify: _. _._.__._..._ ___ __..._. ..__......�...�....._._____�_ _ .. „ ._. ...M __..___._ . . _. ......... COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: L ___ _________ _ _, „ Proposed Use Group: w__._..___.._____.m,__._...___. _._ . ._,..._I Existing Hazard Index 780 CMR 34): , m..v... �,..J Proposed Hazard Index 780 CMR 34): 1.....,_,w> _ ...,, . SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION pFFICE USE ONLY, ., Floor Area per Floor (sf) k V' I� /� z a ,, , , „ m,-.. ,..„. _____ __ 1 st I .,,,, ..., ..,..„,, 1st , ___ _ i ., „ .,, , ,,,,,,,,, , , r ____ ..... 2nd 1 �g � t .. 2nd i * 3rd I I 4th 4th i Total Area (sf) Qd / Total Proposed New Construction Ssf1 { Total Height (ft) Total Height ft 7. Water qt (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage DiAjiiii System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal [ On disposal system ❑ Versionl.7 Commercial Building Permit May 15, 2000 Department use only Citylo Northampton Status of Permit: Building Department Curb CutlDriveway Permit 2009 212 Main Street Sewer /Septic Availabilit .F1 - -k 2 �" Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Pans phone 413`687 -1240 Fax 413- 587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office c Map Lot Unit f / //cv/ C✓Pet sO / ;Cuff? _ 0 l' �1 )//)( 1 )/73/1/1) A f C r—th d /7)) u Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: / , o �/ �/ Name � " �L0 //„ _ L +._ Cur n � ��g (a/�� � / i � /�/C��1fi✓/r T. t dress: lfh�ll'� Signature �l 4 (, i nt C C G��' c C l /�i ��ITe le phone 2.2 Authorized Agent: Name Print ��d�/(I% � 7� CCAirfli) Current Mailing dress: Signature v '1 Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 45/4-5-00, (a) Building Permit Fee C11 /77 11 tic4 U 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3+4 + 5) IT - `60Q, 00 Check N 3O3 7q a Lits "0 This Section For Official Use Only Building Permit Number D ate I ssued Signature: Date Building Commissioner /Inspector of Buildings File # BP- 2009 -0880 APPLICANT /CONTACT PERSON ASSOCIATED BUILDING WRECKERS INC ADDRESS /PHONE 352 ALBANY ST SPRINGFIELD (413) 732 -3179 PROPERTY LOCATION 8 EASTHAMPTON RD MAP 38C PARCEL 077 001 ZONE GI(95) /SC(5) / /WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � 3 Q q Fee Paid 6 Typeof Construction: DEMOLISH SHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 062382 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF O,WqATION PRESENTED: V 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 Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay Az- . 2- 0 e Signature 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 of MGL 40A. Contact Office of Planning & Development for more information. BP- 2009 -0880 �.A GIS #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2009 -0880 Project # JS- 2009 - 001289 Est. Cost: $4500.00 Fee: $20.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ASSOCIATED BUILDING WRECKERS INC 062382 Lot Size(sq. ft.): 27442.80 Owner: M & S HOLDINGS LIMITED PARTNERSHIP Zoning GI(95) /SC(5) / /WP Applicant: ASSOCIATED BUILDING WRECKERS INC AT: 8 EASTHAMPTON RD Applicant Address: Phone: Insurance: 352 ALBANY ST (413) 732 -3179 Workers Compensation SPRINGFIELDMA01105 ISSUED ON:4/28/2009 0:00:00 TO PERFORM THE FOLLOWING WORK: DEMOLISH SHED POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 4/28/2009 0:00:00 $20.00303742 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo