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31B-159 (12) The PB has approved a site plan end the CBAC has approved a permit. Unlike special permits, neither ordinance requires that the permit or site plan be recorded at the registry of deeds and neither ordinance makes any provisions for dealing with appeals. Since both approvals are in place and all building code requirements are met, I see no reason to withhold the permit. That said, I do believe that until the appeal is resolved, work must proceed in accordance with the current approved site plan and the CBAC permit. I'd include a cover letter with the permit; "1 have examined the application for a permit to demolish the building known as the Christian Life Center at 99 King Street in Northampton. I am satisfied that the proposed work conforms to the requirements of the Massachusetts State Building Code. I have issued the permit. Work may proceed in accordance with the terms and conditions of the approved site plan and the central business architecture permit. 1 have included copies of those documents." I need to act by next Tuesday. Let me know what you think. Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg 212 Main Street Northampton, MA 01060 (413) 587 -1240 This transmission is intended solely for the person or entity to whom it is addressed. It may contain privileged and confidential information. If you are not the intended recipient, please be notified that any dissemination distribution or copying is strictly prohibited. If you have received this transmission by mistake, please let us know and then delete it from your system. 2 Louis Hasbrouck From: Alan Seewald [AS @sjsamherst.com] Sent: Thursday, June 07, 2012 9:50 AM To: Louis Hasbrouck Cc: Carolyn Misch; Wayne Feiden; Charles Miller; Mayor of Northampton Subject: RE: Demolition permit for the Christian Life Center agree with this approach. Alan Seewald Seewald, Jankowski & Spencer, P.C. Five East Pleasant Street Amherst, MA 01002 Tel: 413 549 0041 Fax: 413 549 3818 ASSJSAmherst.com This transmission is intended solely for the person or entity to whom it is addressed. It may contain privileged and confidential information. if you are not the intended recipient, please be notified that any dissemination, distribution or copying is strictly prohibited. If you have received this transmission by mistake, please let us know and then delete it from your system. From: Louis Hasbrouck [ mailto :lhasbrouck@anorthamptonma.gov] Sent: Wednesday, June 06, 2012 5:03 PM To: Alan Seewald Cc: Carolyn Misch; Wayne Feiden; Charles Miller; Mayor of Northampton Subject: Demolition permit for the Christian Life Center Alan, I have decided to issue the building permit to demolish the Christian Life Center on King Street. The city's zoning ordinance requirements for site plan review states "350 -11 Site Plan Approval: 350 -11.4 Requirements. These requirements are superimposed over any other requirements of this Zoning Ordinance. The Building Commissioner may not issue any building or zoning permits for any intermediate or major projects until the site plan has been approved by the Planning Board through a simple majority vote of the members present. The site plan process shall be conducted by the Planning Board in conformance with the filing, review and public hearing requirements for a special permit, except in the case of alternative energy research and development (R &D) and manufacturing facilities, as defined in the Green Communities Act. Editor's Note: See Acts of 2008, Ch. 169. For alternative energy R &D and /or manufacturing, review periods are guaranteed not to exceed one year from the date of initial application to the date of final Board action. Said applications shall be reviewed within 45 days, and the applicants will be notified of what additional submissions are necessary to meet this one -year final action deadline. The Planning Board shall use the criteria of § 350 -11.6 for approving or disapproving the site plan. As with special permits, any appeal of a site plan decision by the Planning Board shall be made in accordance with MGL c. 40A, § 17" The city's Central Business architecture permit process, 156 -6 states "Except for activities exempted above, no building or structure within the Central Business Architecture District shall be constructed, altered, or demolished in any way without a central business architecture permit from the Central Business Architecture Committee issued in accordance with this chapter, nor, without such a permit, shall such activities be issued a building permit or demolition permit. (See also MGL c. 143, § 3A.) 1 Planning - Decision City of Northampton Hearing No.: PLN -2011 -0001 Date: April 26, 2011 Aelan Tierney votes to Grant Bruce Kriviskey votes to Grant Bob Walker votes to Grant Joseph Blumenthal votes to Abstain MOTION MADE BY: SECONDED BY VOTE COUNT: DECISION: Aelan Tierney Barry Steeves 4 -1 Approved with Conditions MINUTES OF MEETING: Available in the Office of Planning & Development I. Carolyn Misch, as agent to the Central Business Architecture Committee, certify that this is a true and accurate decision made by the Central Business Architecture Committee and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. 1 certify that this decision has been mailed to the Owner and Applicant. Any issuance or denial of a permit by the Committee may be appealed to the Northampton Planning Board, by an applicant or other aggrieved party, provided such appeal has been filed within 21 days of the filing of said decision with the City Clerk. The Planning Board shall limit its consideration of such an appeal to considering errors of the Committee and shall need a two- thirds vote of its members to overturn the action of the Committee. GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. • Planning - Decision City of Northampton Hearing No.: PLN- 2011 -0001 Date: April 26, 2011 APPLICATION TYPE: SUBMISSION DATE: Central Business Arch. District Perm 7/2/2010 Applicant's Name: Owner's Name: NAME: NAME: ROMAN CATH BISHOP OF SPFLD ROMAN CATHOLIC BISHOP OF SPRINGFIEL ADDRESS: ADDRESS: 3 Elm St KING ST TOWN: STATE ZIP CODE: TOWN: STATE: ZIP CODE: NORTHAMPTON MA 01060 NORTHAMPTON MA 01060 PHONE NO.: FAX NO.: PHONE NO.: FAX NO.: EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO.: SITE ZONING: COMPANY NAME: 91 KING ST CB(1001/ TOWN. ACTION TAKEN: ADDRESS: NORTHAMPTON MA 01060 Approved With Conditions MAP: BLOCK I LOT: MAP DATE. SECTION OF BYLAW: 31B 192 001 156: CENTRAL BUSINESS ARCHITECTURE TOWN: STATE ZIP CODE: Book: Page: REVIEW PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK: Demolition of building. HARDSHIP: CONDITION OF APPROVAL: 1) Two landscaped islands shall be added to center parking area. At minimum, the dimension of each of these islands shall be the width of one parking space and the length of two parking spaces (8.5' x 369. 2. Four additional street trees shall be planted along the frontage. Trees shall be selected from Northampton Tree Committee list. FINDINGS: The Committee based its approval for the demolition of the structure within the Central Business District based upon the plans submitted with the application as follows: 1. St. Elizabeth Ann Seton Parish Revised Site Plan Submission, dated March 31, 2011 by The Berkshire Design Group, Inc. Plan Sheets EX, 1, 2, 3, SL-1B, Al. The CBAC determined that because the buildings on the church "campus" function as a site, demolition of the building for the purpose of providing an adequately landscaped parking lot does not detract from the character of downtown. The use is being reconfigured while maintaining the function /use. Allowing reconfigured parking, facilitates the Churches' ability to build a new function hall, arguably results in greater usage and vibrancy of the project site. Specifically, 156- 6(D2c) "In the event elements of the project or the project in its entirety does not meet the above standards, the Committee can waive some or all of the standards if such waiving will clearly preserve and enhance the pedestrian -scale character, culture, economy and welfare of downtown Northampton by preserving historic and architecturally valuable buildings and features, and by encouraging compatible building design." COULD NOT DEROGATE BECAUSE. FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY APPEAL DATE: 4/28/2011 7/7/2010 8/3/2010 4/28/2011 REFERRALS IN DATE: HEARING DEADLINE DATE. HEARING CLOSE DATE. FINAL SIGNING BY: APPEAL DEADLINE: 6/30/2010 9/5/2010 4/14/2011 4/28/2011 5/17/2011 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 6/30/2010 7/14/2010 4/14/2011 4/26/2011 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 7/7/2010 7:15 PM 5/29/2011 5/29/2011 MEMBERS PRESENT VOTE: Barry Steeves votes to Grant GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. Planning - Decision City of Northampton Hearing No.: PLN -2011 -0042 Date: May 11, 2011 Debin Bruce votes to Grant Katharine G. Baker votes to Grant Stephen Gilson votes to Grant Francis Johnson votes to Grant MOTION MADE BY: SECONDED BY VOTE COUNT DECISION: Francis Johnson Debin Bruce 5 Approved with Conditions MINUTES OF MEETING Available in the Office of Planning & Development. This second vote on the permit represents the Planning Board's confirmation of vote with majority of members voting in favor. 1, Carolyn Misch, as agent to the Planning Board, certify that this is a true and accurate decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. I certify that a copy of this decision has been mailed to the Owner and Applicant. Notice of Appeal An appeal from the decision of the Planning Board may be made by any person aggrieved pursuant to MGL Chapt. 40A, Section 17 as amended within twenty (20) days after the date of the filing of the notice of the decision with the City Clerk. The date is listed above. Such appeal may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. Planning - Decision City of Northampton Hearing No.: PLN- 2011 -0042 Date: May 11, 2011 10. Snow shall be plowed to the rear of the site. 11. Lights off within one hour after the last function. No more than 4 pole lights shall remain on during the night. FINDINGS: The Planning Board approved the site plan for the layout of a new 14,000 square foot function hall and associated site development by a 3- 2 vote of eligible planning Board members present. The Board based its decision on the following plans and information submitted with the application: 1. St. Elizabeth Ann Seton Parish Revised Site Plan Submission, dated March 31, 2011 by The Berkshire Design Group, Inc. Plan Sheets EX, 1, 2, 3, SL -1B, Al. A. The requested use protects adjoining premises against seriously detrimental uses. If applicable, this shall include provision for surface water drainage, sound and sight buffers and preservation of views, light, and air; Stormwater management will be contained on site and plantings will be added between the new building and the residences to the north. B. The requested use/site will promote the convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets, minimize traffic impacts on the streets and roads in the area. Through condition, the connection to the bike path will accomplish compliance with this standard. if applicable, this shall include considering the location of driveway openings in relation to traffic and adjacent streets, access by public safety vehicles, the arrangement of parking and loading spaces, and provisions for persons with disabilities; The Planning Board granted the relocation and widening of two curb cuts based on separation of pedestrian /bicycle and vehicular traffic. The project, including any concurrent road improvements, will not decrease the level of service (LOS) of all area City and state roads or intersections affected by the project below the existing conditions when the project is proposed and shall consider the incremental nature of development and cumulative impacts on the LOS. Given the off -peak trips anticipated and noted in traffic letter and assuming the rail trail access condition recommended, staff believes this criteria has been met. C. The requested use will promote a harmonious relationship of structures and open spaces to the natural landscape, existing buildings and other community assets in the area; Landscaped islands to break up the mass of 82 parking spaces will meet this criteria. D. The requested use will not overload, and will mitigate adverse impacts on, the City's resources, including the effect on the City's water supply and distribution system, sanitary and storm sewage collection and treatment systems, fire protection, streets and schools. The construction materials and methods for water lines, sanitary sewers, storm sewers, fire protection, sidewalks, private roads, and other infrastructure will be in accordance with Department of Public Works standards. E. The requested use meets any special regulations set forth in this chapter. There are none specified in the zoning. The Board did approve a waiver from the standard 16' pole heights to 18' and 20' due to the limited space available for installing new poles. The lights will be on the south side of the new structure and generally screened from the residences. F. Compliance with the following technical performance standards: (1) Curb cuts onto streets shall be minimized. Access to businesses shall use common driveways, existing side streets, or loop service roads shared by adjacent lots when possible. More than one curb cut shall be permitted only when necessary to minimize traffic and safety impacts. The Board approved the widened double curb cuts based on the condition that safety improvements for non - motorized access will be created at the rear of the site along the rail trail. (2) Pedestrian, bicycle and vehicular traffic movement on site must be separated, to the extent possible, and sidewalks must be provided between businesses within a development. Adequate separation and accommodation for bicycles/pedestrians will be met through conditions. (3) Major projects, except in the Central Business District, must be designed so there is no increase in peak flows from the one- or two - and ten -year Soil Conservation Service design storm from predevelopment conditions (the condition at the time a site plan approval is requested) and so that the runoff from a four- to ten -inch rain storm (first flush) is detained on site for an average of six hours. These requirements shall not apply if the project will discharge into a City storm drain system that the Planning Board finds can accommodate the expected discharge with no adverse impacts. In addition, catch basins shall incorporate sumps of a minimum of three feet and, if they will remain privately owned, a gas trap. A Department of Public Works stormwater permit was issued. COULD NOT DEROGATE BECAUSE: FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY: APPEAL DATE: 9/2/2010 9/16/2010 10/14/2010 5/12/2011 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE. FINAL SIGNING BY: APPEAL DEADLINE: 9/9/2010 7/15/2011 4/14/2011 5/12/2011 5/31/2011 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 9/9/2010 9/23/2010 4/28/2011 5 /11/2011 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 9/16/2010 1/14/2011 7/13/2011 MEMBERS PRESENT: VOTE: Andrew Weir votes to Grant GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. Planning - Decision City of Northampton Hearing No.: PLN -2011 -0042 Date: May 11, 2011 APPLICATION TYPE: SUBMISSION DATE. PB Major Site Plan 5/11/2011 Applicant's Name: Owner's Name: NAME: NAME: ST ELIZABETH ANN SETON PARISH ROMAN CATHOLIC BISHOP OF SPRINGFIEL ADDRESS: ADDRESS: 3 ELM ST KING ST TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: NORTHAMPTON MA 01060 NORTHAMPTON MA _ 01060 PHONE NO.: FAX NO.: PHONE NO.: FAX NO.: EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO: SITE ZONING: COMPANY NAME: 91 KING ST CB(100)/ TOWN: ACTION TAKEN: ADDRESS: NORTHAMPTON MA 01060 Approved With Conditions MAP: BLOCK: LOT: MAP DATE: SECTION OF BYLAW: 31B 192 001 Chpt. 350- 11: Site Plan Approval TOWN: STATE ZIP CODE: Book: Page: PHONE NO FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK. Demolish 2 buildings and construct new 14,000 sq. ft. parish center building with associated site improvements inclduing 140+ space parking lot with two 24' wide curb cuts. CONFIRMATORY VOTE HARDSHIP: CONDITION OF APPROVAL 1) Final plans incorporating conditions herein shall be stamped and submitted prior to any work on the site. 2. To meet the criteria in 350 -8.9F, two landscaped islands shall be added to center parking area. At minimum, the dimension of each of these islands shall be the width of one parking space and the length of two parking spaces (8.5' x 36). 3. Four additional street trees shall be planted along the frontage. Trees shall be selected from Northampton Tree Committee list. 4. Tree protection measures shall be installed prior to any site work for trees at the entrance. 5. Water and sewer line connections shall be made in accordance with Department of Public Works standards. 6. In order to provide separated, safe non - vehicular access for parishioners to this site, a 6' wide bituminous connection from the parking lot to the rail trail shall be installed. Construction materials and specifications shall be in accordance with Office of Planning 8 Development standards for rail trail construction. The connection shall be made either on the applicant's property or, at the property owner's choice, on abutting property prior to completion of any portion of the parking lot. 7. Approval of the layout of the parking lot and the two curb cuts is contingent on the rail trail access being provided. At the applicant's choice, if they find the rail trail connection impossible, they can request an amended approval from the Planning Board showing no rail trail connection but instead showing only one curb cut and improved pedestrian and bicycle connection on the site. 8. These approved plans include a traffic waiver based on limited weekday use of the new building. If the days of the week in which the building is used changes to functions that occur during the PM peak periods Monday through Friday (for at least 50% of the functions), traffic mitigation will be required in accordance with the increase in peak trips generated as described in the zoning. 9. Upon completion of parking, applicant shall submit a stamped lighting plan showing that installed light levels comply with zoning and plans shown for CB. GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. City of Northampton s s ics Massachusetts r� Ak DEPARTMENT OF BUILDING INSPECTIONS 'p 212 Main Street • Municipal Building Northampton, MA 01060 . .= °i *, Saint Elizabeth Ann Seton Parish Reverend John Connors 3 Elm Street Northampton, MA 01060 June 8, 2012 re: Christian Life Center demolition permit 31B-159 Dear Reverend Connors, I have examined the application for a permit to demolish the building known as the Christian Life Center at 99 King Street in Northampton. I am satisfied that the proposed work conforms to the requirements of the Massachusetts State Building Code. I have issued the permit. Work may proceed in accordance with the terms and conditions of the approved site plan and the central business architecture permit for this project. I have included copies of those documents. Feel free to call if you have any questions. Our telephone number is (413) 587 -1240 Louis Hasbrouck Building Commissioner City of Northampton Iasbrouck (a�city.northampton.ma.us O'REILLY, TALBOT & OKUN ASSOCIATES 293 BRIDGE STREET SUITE 500 SPRINGFIELD, MA 01103 413- 788 -6222 Asbestos Abatement Visual Clearance inspection • Project Number. f 7 Lf q- L' 0Lt • Site Surveyed: Project Name: Si c td Address t-, S (��T Location of Containment: L I 01 n s veab 1 d Tom/ K-Ar 1 Date Inspected: 4 ((xi/ Z Asbestos Abatement Contractor: c - 145 Asbestos Supervisor: 14ec'b . Usual Clearance Result (circle ono: Pass Fail Reason for Failure: Description of Asbestos Abatement 1 s r ,q T - t Fri aec1 (i -rest- o "" 4 / 1- q"-) The above asbestos abatement regulated area has been visually inspected by the • asbestos abatement supervisor and asbestos abatement project monitor. The regulated area was • , and all surfaces were free of visible debris. I � ' A5 / /a3 S -P z2'L Q Asbesto Supervisor/ DOS # Asbestos Project Monitor / DOS # O'REILLY, TALBOT & OKUN ASSOCIATES 293 BRIDGE STREET SUITE 500 SPRINGFIELD, MA 01103 413 - 788 -6222 Asbestos Abatement Visual Clearance Inspection Project Number: I Pi 1- 4 1-- o�( Site Surveyed: Project Name: ir.1 /e2 C,r Address 99 5+, A/ 7 Alpiod.0 t/44 55_ Location of Containment: / °f2oaR OM 4 6-vi"frii5nh Date Inspected: Al '/3 -IZ Asbestos Abatement Contractor: 441 t*b cb .5 wcit Asbestos Supervisor: /464, 5u.4R1 Z. Visual Clearance Result (circle one): Pass Fail Reason for Failure: Description of Asbestos Abatement Ca .u7 1 q/.v�nEAlf R JO ✓.9L o J' 44/0"00,0/4A7 S/ _,V22 f „emu PhAti,:ur .o ,dsb<. The above asbestos abatement regulated area has been visually inspected by the asbestos abatement supervisor and asbestos abatement project monitor. The regulated area was dry and all surfaces were free of visible debris. 1164, A 5al-1103 Asbestos Supervisor / DOS # Asbestos Project Monitor / DOS # Phase Contrast Microscopy (PCM) Fiber Count NIOSH 7400 Method, Revision 3, Issue 2, 8/15/94 PROJECT NO: 1971 -11 -05 CLIENT: Diocese of Springfield PROJECT: 99 King Street, Northampton, Mass. ADDRESS: 65 Elliot St. - P.O. Box 1730 Living Rm. & 1st Floor Office Springfield, MA 01101 Date: 4/13/12 POC: Rev. John Connors Scope: Final Air Clearance - Floor Tile & Associated Mastic and Wall Panelin • Mastic k a ^si . v� . Y : a* r a :77 � ,v 'r k, Z D SWD- 041312 -01 Rectory - Living Room - South 4/13/2012 8.5 100 1248 10.83 0.003 0.004 End SWD- 041312 -02 Rectory - Living Room - North 4/13/2012 7 100 1232 8.92 0.003 0.004 End SWD -041312 -03 Blank 4/13/2012 0 100 SWD -041312 -04 Blank 4/13/2012 0 100 SWD- 041312 -05 Rectory -1st Floor Office - 4/13/2012 20.5 100 1232 26.11 0.008 0.004 South End SWD- 041312-06 Rectory -1st Floor Office -North 4/13/2012 19 100 1232 24.20 0.008 0.004 SWD-041312 -01 (Recount) 9 100 1248 11.46 0.004 0.004 QC Checks: DA Analyst Name: Steve Dolinski Analyst Signature: il�r4,c O'Reilly, Talbot & Okun Associates, Inc. - 293 Bridge Street, Suite 500 - Springfield, MA 01103 Phone: (413) 788 -6222 - Fax (413) 788 -8830 EnvironmentalSafetyHealthGeotechnical O'Reilly, Talbot & Okun ~ I 40311132133110- 293 Bridge Street ( A S S O C I A T E S ] i Suite 500 Springfield, MA 01103 Tel 413 788 6222 J1749 -48 -04 Fax 413 788 8830 April 26, 2012 www.oto- env.com Rev. John Connors St. Elizabeth Ann Seton Parish 3 Elm Street Northampton, Massachusetts 01060 Re: Asbestos Clearance Air Monitoring Former Sacred Heart Parish • Living Rm. & 1' Floor Office 99 King Street Northampton, Massachusetts Dear Rev. Connors: Attached please find the final report regarding asbestos abatement clearance monitoring conducted on April 13, 2012 following the removal of floor tile /mastic and wall paneling mastic from the above referenced site. The abatement was performed using the full containment removal methodology. The regulated areas were cleaned using HEPA vacuums and wet methods. The negative pressure enclosures were inspected and found to be free of visual debris. The final post air sample results for the full containment areas were below established regulatory limits. Thank you once again for the opportunity of providing the Diocese of Springfield with these industrial hygiene services. Please do not hesitate to call me, should you have any questions. Sincerely, O'Reilly, Talbot & Okun Associates, Inc. Steve Dolinski Assistant Project Manager Attachment: Limitations, Visual Clearance, Laboratory Results c: Mr. William LaBroad - Diocese of Springfield Attorney Rob Quinn — Egan, Flanagan & Cohen Rich Wilk - CMG O:\J 1700\ 1749 Springfield Diocese \48-14 living Rsn. & 1' 11 Office - 99 King St. Northampton MA -Final Air Clearance \FAC Coy f er .doc O'REILLY, TALBOT & OKUN ASSOCIATES 293 BRIDGE STREET SUITE 500 SPRINGFIELD, MA 01103 413 - 788 -6222 Asbestos Abatement Visual Clearance Inspection Project Number: MY -dig- otz Site Surveyed: p Project Name: fD/fATX R IC Ado / Address ?9 /1 �N stRECt AARf AM f Location of Containment: Bi25A.MA,07 Date Inspected: -Y- /6 Asbestos Abatement Contractor: 8Ay.SfA CcNfRActSeRVICkSrArc, Asbestos Supervisor: �t J GUAR Z- Visual Clearance Result (circle one): Pass Fail Reason for Failure: Description of Asbestos Abatement • G L o J l f , BA 9 R EMDVA L a 4/08 o r p i pp ,.>rs,JA7 OA) The above asbestos abatement regulated area has been visually inspected by the asbestos abatement supervisor and asbestos abatement project monitor. The regulated area was d and all surfaces were free of visible debris. 1 4 ! 1 • /03 Asb / DOS # Asbestos Project Monitor / DOS # O'REILLY, TALBOT & OKUN ASSOCIATES 293 BRIDGE STREET SUITE 500 SPRINGFIELD, MA 01103 413- 788 -6222 Asbestos Abatement Visual Clearance Inspection Project Number: /' yq — y8' - 6 y Site Surveyed: !� Project Name :o RM E , 'C ECi Address 99 )4/..5 31/.. NoR7 Mfr? A) i2,9.s5 . Location of Containment: Si a c , tJA RA cr.. Date Inspected: 1 1- /6- /2. Asbestos Abatement Contractor: :41i 1 • .v , • CI ti. I J .VC, Asbestos Supervisor: i 7 l2 SUA / Z- Visual Clearance Result (circle one): Pass Fail Reason for Failure: Description of Asbestos Abatement • J LL c ,o i�A r �.nn Ian»{' R �cJti+ a/�Z o F g " X q f�oa� •h 6 AS50 r 4' Ff) MAT. " yo The above asbestos abatement regulated area has been visually inspected by the asbestos abatement supervisor and asbestos abatement project monitor. The regulated area was dry and all surfaces were free of visible debris. 111.1. • t3 , c CC. /AMt)' 077 Asbes os Supervisor / DOS # Asbestos Project Monitor / DOS # O'REILLY, TALBOT & OKUN ASSOCIATES 293 BRIDGE STREET SUITE 500 SPRINGFIELD, MA 01103 413- 788 -6222 Asbestos Abatement Visual Clearance Inspection Project Number: ) /9 - ItS - 0 if Site Surveyed: pp / Project Name: A kfr Ele /�edORy Address Sf, No et//9Mpto,v M4S Location of Containment: R R 6,J4R A/C E. Date Inspected: y - / 6 - /2 Asbestos Abatement Contractor: /1 y7Az.6 CCArfR 4 - 7 1 id, SEk ✓)C5S Xx y,�di Asbestos Supervisor: f SuR.R E J Visual Clearance Result (circle one): Pass Fail Reason for Failure: Description of Asbestos Abatement • is L C C.o)J4"A JJ m F T RE. A4.0 VA L, p f g " )(9 0 fL.061'Q 4 f' 4,450 r,i A N ? c - Y0 The above asbestos abatement regulated area has been visually inspected by the asbestos abatement supervisor and asbestos abatement project monitor. The regulated area was dry and all surfaces were free of visible debris. 7 - AS0 ?I a l �M o '77a Asbestos Supervisor / DOS # Asbestos Project Monitor / DOS # Phase Contrast Microscopy (PCM) Fiber Count NIOSH 7400 Method, Revision 3, Issue 2, 8/15/94 PROJECT NO: 1749 -48 -04 CLIENT: Diocese of Springfield PROJECT: 99 King Street, Northampton, Mass. ADDRESS: 65 Elliot St. - P.O. Box 1730 Rear Entrance & Side Entrance Springfield, MA 01101 Date: 4/16/12 POC: Rev. John Connors Scope: Final Air Clearance - Floor Tile & Associated Mastic SamplegID : Sample r Location Date # Volume Fibers /m Fibers /cc = C LOD (less than) SWD- 041612 -01 1st Floor - Sid End Entrance - South 4/16/2012 9 100 1224 11.46 0.004 0.004 SWD- 041612 -02 1st Floor - Sid End Entrance -North 4/16/2012 11 100 1224 14.01 0.004 0.004 SWD- 041612 -03 Blank 4/16/2012 0 100 SWD- 041612 -04 Blank 4/16/2012 0 100 SWD- 041612 -05 1st Floor -Rear Entrance 4/16/2012 7.5 100 1236 9.55 0.003 0.004 South End SWD- 041612 -06 1st Floor - Rear Entrance - North 4/16/2012 7 100 1236 8.92 0.003 0.004 nd SWD- 041612 02 (Recount) 4/16/2012 10 100 1224 12.74 0.004 0.004 QC Checks: 4 Analyst Name: Steve Dolinski Analyst Signature: Yt� O'Reilly, Talbot & Okun Associates, Inc. - 293 Bridge Street, Suite 500 - Springfield, MA 01103 Phone: (413) 7884222 - Fax (413) 788 -8830 Envi r nmentalSafetyHealthGeotechnical O'Reilly, Talbot & Okun H 111 a=1M. 293 Bridge Street [ A S S O C I A T E S ] 1, Suite 500 Springfield, MA 01103 Tel 413 788 6222 J1749 -48 -04 Fax 413 788 8830 April 26, 2012 www.oto-env.com Rev. John Connors St. Elizabeth Ann Seton Parish 3 Elm Street Northampton, Massachusetts 01060 • Re: Asbestos Clearance Air Monitoring Former Sacred Heart Parish Side Entrance & Rear Entrance 99 King Street Northampton, Massachusetts Dear Rev. Connors: Attached please find the final report regarding asbestos abatement clearance monitoring conducted on April 16, 2012 following the removal of floor tile/mastic from the above referenced site. The abatement was performed using the frill containment removal methodology. The regulated areas were deaned using HEPA vacuums and wet methods. The negative pressure enclosures were inspected and found to be free of visual debris. The final post air sample results for the full containment areas were below established regulatory limits. Thank you once again for the opportunity of providing the Diocese of Springfield with these industrial hygiene services. Please do not hesitate to call me, should you have any questions. Sincerely, O'Reilly, Talbot & Okun Associates, Inc. • Steve Dolinski Assistant Project Manager Attachment Limitations, Visual Clearance, Laboratory Results c: Mr. William LaBroad - Diocese of Springfield Attorney Rob Quinn — Egan, Flanagan & Cohen Rich Wilk - CMG ON I700 \ 1749 Springfield Diocese \ 48-04 Side Ent. & Rear Ent. - 99 King Sc Northampton MA -Final Air Clearance \ FAC Co. Ltr .doc b , , L. Massachusetts Department of Environmental Protection • Bureau of Waste Prevention • Air Quality 1100147939 BWP AQ 0 6 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)? ❑ Yes 51 No If yes, who conducted the survey? b. Surveyor Name c. Division of Occupational Safety Certification Number 7. Construction or Demolition: =5/15/2012 6/15/2012 / 20 _ ..._._... _...........: 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: r — seeding ` = paving b. If other, please specify: i✓ wetting _ shrouding covering other 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? N/A a. Name of DEP Official ,N /A b. Title 5/1/2012 a c Date (mm /dd /yyyy) of Authorization N/A d. DEP Waiver Number D. Certification I certify that I have examined the ANDREW MIRKIN -- o above and that to the best of my a. Print Name „" am� o knowledge it is true and complete. [Andrew Mirkin The signature below subjects the b. Authorized Signature .._._..... . signer to the general statutes PRESIDENT o regarding a false and misleading Psiion 0 statement(s) !ASSOCIATED BUILDING WRECKERS, INC 15/0 012 e. Date (mm /dd /yyyy) , 0 0 Q • ag06.doc • 10/02 BWP AO 06 • Page 3 of 3 • 1:10 Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality =100147939 . BWP AQ 06 Notification Prior to Construction or Demolition General Statement: If B. General Project Description (cont.) asbestos is found during a ruction or • General Contractor: Const Demolition ASSOCIATED BUILDING WRECKERS, INC. operation, all ° responsible parties a. Name must comply with L352 ALBANY STREET 310 CMR 7.00, b. Address 7.09, 7.15, and Chapter 21E of the [STRINGFIELD 1MA 01105 General Laws of c. City/Town d. State e. Zip Code the Commonwealth. [4137323179 L This would include, f, Tele ph on e Number (area code and extensions sLE-mail Address (optional but would not be limited to, filing an [FRED VANDERHOOF 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 WRECKERS, INC. a. Name 352 ALBANY STREET b. Address SPRINGFIELD iMA 01105 c. City/Town d. State e. Zip Code 4137323179 = f. Telephone Number area code and extension) g. E-mail Address CORTOnaT) FRED VANDERHOOF h. On Manager Name 2. On-Site Supervisor: :WILLIAM BABCOCK On-Site Supervisor Name 3. Is the entire facility to be demolished? 11 Yes 1 No N 4. Describe the area(s) to be demolished: o ,ENTIRE FACILITY 0 ° 5. If this is a construction project, describe the building(s) or addition(s) to be constructed: ;N/A 0 0 U aq06.doc • 10/02 BWP AQ 06 • Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality 100147939 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 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 CMR 7.09 (2) ten (10) days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. B. General Project Description VAR 1. a. Is this facility fee exempt - city, town, district, municipal housing authority, owner - occupied Instructions residence of four units or less? [ Yes n No 1. All sections of b. Provide blanket decal number if applicable: this form must be Blanket Decal Number completed in order to comply with the 2. Facility Information: Department of Environmental [CHRISTIAN LIFE CENTER Protection a. Name notification [99 KING STREET requirements of �......_ b Address 310 CMR 7.09 Northampton ; MA 01060 c. City /Town d. State _ e Zip Code 1 f. Telephone Number (area code and extensions g. E-mail Address(optional 1500 1 P h. Size of Facility in Square Feet i. Number of Floors j. Was the facility built prior to 1980? ✓ Yes ? ; No k. Describe the current or prior use of the facility: (CHRISTIAN LIFE CENTER I. Is the facility a residential facility? Yes j/, No r m. If yes, how many units? Number of Units ° 3. Facility Owner: N ST. ELIZABETH ANN SETON o a. Name ° 13 ELM STREET b. Address [ NORTHAMPTON MA 01105 (0 it /Town d. State e. Zip Code f Telephone, Number (area code and extension) _,„ _ .q E Address (ontionall_. - ,_, 0 RICHARD WILK h. Onsite Manager Name ag06.doc • 10/02 BWP AQ 06 • Page 1 of 3 IIII eDEP - Mas DEP's OnlineFiling System https: / /edep.dep.mass.gov /Pages /PrintReceipt.aspx • MassDEP Home I Contact I Idback I Tour 1 Privacy Policy MassDEP's Online Filing System Usemame:BAYSTATE1 Nickname: BAYSTATE CONTRACTING ECU ° My eDEP Formsi My Profiles Help Receipt j Forms 3ture Receipt Summary/Receipt print receipt Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select "My eDEP" to see a list of your transactions. DEP Transaction ID: 465231 Date and Time Submitted: 4/17/2012 7:41:40 AM Other Email : Form Name: Project Date Revision Notification DECAL # and Facility information Form Name: ANF001 DECAL # : 100145232 Facility Name: FORMER CHRISTIAN LIFE CENTER 13UILDIN Address: 99 KING STREET, NORTHAMPTON, MA4133745453 Original Project Dates Start Date: 4/10/2012 - End Date: 5/4/2012 Revised Project Dates Start Date - End Date My eDEP MassDEP Home 1 Contact 1 3dback 1 Tour 1 Privacy Policy MassDEP's Online Filing System ver.11.5.7.0© 2011 MassDEP 1 of 1 4/17/2012 7:41 AM Nei' • Massachusetts Department of Environmental Protection 100145232 Bureau of Waste Prevention — Air Quality Decal Number Project Revision Notification For Asbestos Notification ANF -001 and AQ 06 G. Certification The undersigned hereby states, under the penalties of perjury, that he /she has read the Commonwealth of Massachusetts regulations for the Removal, Containment or Encapsulation of Asbestos, 453 CMR 6.00 and 310 CMR 7.15, and that the information contained in this notification is true and correct to the best of his /her knowledge and belief. JAMES BEAUDRY JAMES BEAUDRY 1. Name Authorized Signature PROJECT MANAGER 4/17/2012 2. Position/Title 3. Date (mm/dd /vvvv) BAYSTATE CONTRACTING SERVICES,INC. 4137810821 4. Representing 5. Telephone 352 ALBANY STREET 6. Address SPRINGFIELD 01105 7. City/Town 8. Zip Code anf06pdm.doc • rev. 2/5/04 Massachusetts Department of Environmental Protection 100145232 Bureau of Waste Prevention — Air Quality Decal Number Project Revision Notification For Asbestos Notification ANF -001 and AQ 06 Important: A. Facility Location When filling out y forms on the FORMER CHRISTIAN LIFE CENTER BUILDIN computer, use only the tab key 1. Name of Facility to move your 99 KING STREET cursor - do not 2. Street Address use the return key. NORTHAMPTON MA 3. City 4. State 5. Zip Code ti 4133745453 6. Telephone Number j INSTRUCTIONS B. Project Cancelled 1. This form is only available for Check here if this project is/was cancelled. online filing of project date revisions. 2. Enter project C. Project Dates decal number. 3. Validate that 4/10/2012 5/4/2012 the project location is correct 1. Original Start Date (mm/dd /yyyy) 2. Original End Date (mm/dd/Wyv) for the entered decal. 3. Latest Revised Start Date (mm /dd /yyyy) 4. Latest Revised End Date (mm/dd /yyyy) 4. Enter your new project dates. 5. Certify your notification. D. Revised Project Dates Submit date changes. 4/17 /2012 _ 1. Revised Start Date (mm /dd /yyyy) 2. Revised End Date Date (mm/dd /yyyy) E. Other Project Revisions F. Revision History anfo6pdm.doc • rev. 2/5/04 DIG SAFE SYSTEM, INC. - Create New Quick Ticket Page 1 of 1 Request Number: 20121308593 Date 03/29/2012 Time 12:00 Latitude: Longitude: State: MASSACHUSETTS Municipality: NORTHAMPTON Address / Intersection: 101 KING ST Nearest Cross Street 1: TRUMBULL RD Nearest Cross Street 2: EDWARDS SQ Additional Information: Nature Of Work: DEMO OF THE FORMER RECTORY Area Of Work: PRIVATE PROPERTY Area Is Premarked: Y Start Date: 04/20/2012 Start Time: 12:00 Caller: TALIA Title: 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: Member Utility List Code Abbreviation Name AJ COMCAS COMCAST - SOUTH BURLINGTON F103 FVCOLL FIVE COLLEGE NET LLC J8 FBRTEC FIBERTECH NETWORKS - MA MC NGRDEL NATIONAL GRID ELECTRIC -MASS ELEC ML MCI MCI SP VERIZN VERIZON WG CMAGAS COLUMBIA GAS OF MASSACHUSETTS 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 I Create From Existing ) , Print Ticket ) ( Return To Menu ) I Return To Home http://digsafefon 03/29/12 Associated It wilding Wreckers, Inc. 352 Albany St., Springfield. MA 01105 Tel: (413) 732 -3179/ (800) 448 -2822 Fax: (413) 734 734 -6224 March 29, 2012 To: John Hall Fax: 413 587 -1576 Of: Northampton DPW Sewer Dept. Phone: 413 587 -1574 Please be advised that the Christian Life Center and Rectory buildings located at: 99 King Street in Northampton, MA are being scheduled for demolition. When demolition is complete, the sewer will be properly capped and we will call to request an inspection. Thank you, Associated Building Wreckers, Inc. May 10 12 04:06p Water 4135871576 p.2 Q-�ypT CITY OF NORTHAMPTON, MASSACHUSETTS tuv ° ti DEPARTMENT OF PUBLIC WORKS 4 6 ,,, 4:A 1; 12 Locust Street � f Northampton, MA 01060 -2066 C it as .- ; 413 -587 -1570 Fax 413- 587 -1576 Edward S. Huntley, P.E Director May 10, 2012 Louis Hasbrouckk, Building Inspector Municipal Office Annex 212 Main Street Northampton, Ma 01060 Dear Mr. Hasbrouckk: The water services at #101 King Street and #91 King Street have been shut at the curb stop and the water meters have been removed from the premises as of 5/9/2012. Please contact me if you have any questions. - ,Sinc David Sparks Superintendent of Water Cc: Ned Huntley, Director of Public Works Jim Laurila, City Engineer I 1'1 VL ClL • Associated Building Wreckers, Inc. 352 Albany St., Springlield„ MA 01105 Tel: (413) 732-3179/ (800) 448 -28; t2 Fax: (413) 734 734-6224 March 28, 2012 To: Daryl Cullivan Email: darylj.c,ullivan @verizon.com of: Verizon Phone: 508-820-3538 Please cut all services to the Christian Life Center and the Rectory buildings at the following location as they are being scheduled for demolition: 99 King Street Northampton, MA Once disconnection has been completed, you may either sign. below and fax it to 413 - 734 -6224 or send a notification on your company letterhead Thank you very much for your assistance in this matter. Sincerely, Associated Building Wreckers, Inc. SERVICE AT: HAVE BEEN )]zSCINNECT A . • AS OF A PRINT NAME: ,4 11 1►' j SIGNATURE: tnrw . _ �� REMARKS, YF ANY: pill/GC /I 1 Page 1 of 1 Talia Totten From: Romito, Jeff [Jeff_Romito @cable.comcast.com] Sent: Wednesday, May 02, 2012 1:01 PM To: Talia Totten Subject: Re: 99 King Street Northampton, MA Yes this is all set. Sorry for the delay. Sent from my iPhone. On May 2, 2012, at 12:05 PM, "Talia Totten" < Talia @buildingwreckers.com> wrote: Any luck getting this one shut off? From: Talia Totten Sent: Wednesday, March 28, 2012 4:31 PM To: 'Romito, Jeff Subject: 99 King Street Northampton, MA Please see the attached. There are multiple buildings on the property. We are demolishing the Christian Life Center and the rectory, both free standing. The actual Church is to remain. We demolished 2 other buildings on this site in august of 2010, so you might not have services there at all. Let me know if you need any more info. Thank you, Talia <Comcast.doc> 05/02/12 Talia Totten From: JBejune @nisource.com Sent: Wednesday, May 02, 2012 2:17 PM To: Talia Totten Subject: Re: FW: 99 King Street Northampton, MA Hi Talia, The application for disconnect stated 99 King St but there was actually is two addresses, the Church @ 99 and the rectory @ 101. We cut off the rectory @ 101 King St. There is no gas at any other building on this property. Thanks Jackie From: Talia Totten <Talia @buildingwreckers.com> To: "jbejune @nisource.com" <jbejune @zisource.com> Date: 05/02/2012 12:05 PM Subject: FW: 99 King Street Northampton, MA L. -Ii Jackie, T received the shut off confirmation for the Rectory, 101 King Street (thank you). Are we still waiting on the Christian Life Center or is the confirmation you sent for both buildings? Thanks, Talia From: Talia Totten Sent: Wednesday, March 28, 2012 4:23 PM To: jbejune@nisource.com Subject: 99 King Street Northampton, MA 1- -Iey Jackie, Please see the attached. There are multiple buildings on the property. We are demo -ing the Christian Life Center and the rectory, both free standing. The actual Church is to remain. Oh, and we took out 2 other buildings on this site in august of 2010, so you might not have services there at all. Let me know if you need any more info. Thanks! [attachment "Columbia gas.doc" deleted by Jackie Bejune /BSG /Enterprise] v�r ��r Lv1L 11. JV Y1Jl JGfJ7J ! HVL Vl/ Vl Associated. Building Wreckers Inc. 352 Albany St., Springfield. MA 01105 Tel: (41.3) 732-3179/ (800) 448 -2822 Fax: (413) 734 734 -6224 March 29, 201.2 TO: Jackie Email:jbejun.c@n.isource.com OF: Columbia Gas PHONE: 413 781 9200 Ext 2115 Please cut all services to the Christian Life Center and the Rectory buildings at the following location as they are being scheduled for demolition: /0 / . -99' King Street Northampton,MA Once disconnection has been completed, you may either sign below and fax it to 413- 734.6224 or send a notification on your company letterhead. Thank you very much for your assistance in. this matter. Sincerely, Associated. Building Wreckers, Inc. SERVICE AT: / 1-6) ( ' HAVE BEEN DISCONNECTED AS OF 41 A PRINT NAME: SIGNATURE: _ _�/`!. REMARKS, IF ANY: From:Nat i ona I Grid 17815221067 05/01/2012 12:26 #030 P.0011002 • • natiOriegrta The power of actiori, 40 Sylvan Rd Waltham, MA 02451 To: Associated Building Wreckers Fax: 413 734-6224 From: Becky Kelly Date: May 1, 2012 Re: Demo Letter Pages: 2 (Including Cover) Cc: None Urgent 2 For revew (.1, Piease comment 7 Please reply ri Please recycle _ . . .... „ ... ... __..___ . Erom:National Grid 17815221067 05)01/2012 12:26 #030 P.002'002 w rot Ion airid The rao,,,A3r , yf aC• o Reservoir Woods 40 Sylvan Rd Waltham, MA 02451 May 1, 2012 Associated Building Wreckers Fax: 413 734 -6224 RE: Service Removal for Building Demolition. Attn: This letter is to confirm that, per your request; National Grid has removed the electrical service, and meters, located at 99 King Street in Northampton on April 30, 2012. If you have any questions or need further assistance, please feel free to contact me at (508) 357- 4661. Sincerely, - � ri `/ ' f z a ' 7 <e[ nationalgrid Customer Oldet I�ullillmcn� Central & Western MA 21 Office 508- 357 -4661 a Fax 315 -460 -9149 Aso iocege of apringfittb 65 Elliot Street - P.O. Box 1730 bpringfierb flftwadjuatto 01102 OFFICE FOR FISCAL AFFAIRS Tel: (413) 452 -0687 william .Iabroad(ai)diospringfield.org Fax: (413) 785 -5449 April 24, 2012 Mr. Andrew Mirkin, President Associated Building Wreckers, Inc. 352 Albany St Springfield, MA 01105 Re: St. Elizabeth Ann Seton Parish, Northampton Dear Mr. Mirkin: Enclosed is an original, fully executed Contract between the Roman Catholic Bishop of Springfield and Associated Building Wreckers, Inc. for demolition of the former Christian Life Center and Rectory at St. Elizabeth Ann Seton Parish, Northampton. By copy of this letter, I am sending an original of the fully- executed Contract to Rev. John E. Connors, Pastor of St. Elizabeth Ann Seton Parish. We have retained an original for our file. Thank you and if you have any questions, please give me a call. Sincerely yours, Yact-&-.1;-**t., GetLt-L— William F. LaBroad, Jr. Finance Officer /j Enclosure c: Rev. John E. Connors, Pastor, St. Elizabeth Ann Seton Parish (w /enclosure) , \ The Commonwealth of Massachusetts Department of Industrial Accidents �� Office of Investigations �, .i 600 Washington Street r Boston, MA 02111 4 t Z,4 ,W www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): Associated Building Wreckers, Inc. Address: 352 Albany Street City /State /Zip: Springfield, Massachusetts 01105 Phone #: 413 732 -3179 Are you an employer? Check the appropriate box: Type of project (required): 1. ® I am a employer with 26 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub contractors 6. n New construction listed on the attached sheet. 7. ❑Remodeling 2. n 1 am a sole proprietor or partner- ship and have no employees These sub contractors have 8. © Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance!, 9. ❑Building addition required.] ui 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions ] 3. ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, 'Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Great Divide Insurance Company Policy # or Self -ins. Lic. #: WCA 154516510 Expiration Date: 02/01/201/ .lob Site Address: C i e i VI ∎ C_ 4 v�e tf k �j^,.'.;cr - (, :vie C . , � \c�) City /State /Zip: i..ic.- r_{!_ � ,.,,t,,, 1 ._ Utz c,C) 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 $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA f insurance coverage verification. I do hereby certify under I ains and penalties of'per.jury that the information provided above is true crud correct. Signature: ` �` -_ �_ Andrew Mirkin, President Dale: C::. i -C f Phone #: 413 732 -3179 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit /License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 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 I as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, , as Owner /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. Signed under the pains and penalties of perjury. Print Name Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of t icense Holder : Andrew Mirkin 62382 License Number 29 'anglewood rive Longmeadow, Massachusetts 01106 10/31/2013 Ad r es 4 Expiration Date /� r , / �! , ' _m__, (413) 732 -3179 Signature .h . ; /-1; , (r.,, 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 0 No 0 Version! .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 ri 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 Associated Building Wreckers, Inc. Not Applicable ❑ Company Name: Andrew Mirkin Responsible In Charge of Construction 352 lbany Street S ringfield, Massachusetts 01105 Addre s i \ 1 , � �� (413) 732 -3179 I Signature x'� i e ,,„ 4- i- . .,(,":;,A Telephone Version1.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be tilled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW C YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW CD YES Q IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO (J DON'T KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO C) IF YES, describe size, type and location: 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 C) IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Version] .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 p Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Demolition of the Former Sacred Heart Christian Life Center Of Proposed Work: SECTION 5 - USE GROUP AND CONSTRUCTION TYPE 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 I ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 0 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B I ❑ U Utility ❑ Specify: L M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) 15 1St 2 nd 2 na 3rd 3 d 4 tn 4 th Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public p Private ❑ Zone Outside Flood Zone 12 Municipal 1511 On site disposal system Version! .7 Commercial Building Permit May 15, 2000 Department use only i City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability W 1 4 9019 Room 100 Water /Well Availability � y GY L 'rthampton, MA 01060 Two Sets of Structural Plans Plot/Site Plans j1EPT. BUILDING INS 41 -587 1240 Fax 413 - 587 -1272 NORTHAMPTON MA01 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 99 King Street - Christian Life Center Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: St. Elizabeth Ann Scton Parish 3 Elm Street Northampton, Massachusetts Name (Print) Current Mailing Address: (413) 584-7310 Signature Telephone 2.2 Authorized Agent: Richard Wilk, Consultant Management Group 589 Prospect Street Chicopee, Massachusetts 0 Name (Print) Current Mailing Address: (413) 374 -5453 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 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) Check Number 2/0 0 This Section For Official Use Only 1 Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0996 b Lp ' 510111/ APPLICANT /CONTACT PERSON ASSOCIATED BUILDING WRECKERS INC N i ADDRESS/PHONE 352 ALBANY ST SPRINGFIELD (413) 732 -3179 6I I 12 ' PROPERTY LOCATION 99 KING ST MAP 31B PARCEL 159 001 ZONE URC[100) /CB(1)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out #d--07-) Fee Paid J/6 Typeof Construction: DEMOLISH CHRSITIAN LIFE CENTER 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 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 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 eNt2— 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. 99 KING ST BP- 2012 -0996 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31B - 159 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: demolition BUILDING PERMIT Permit # BP- 2012 -0996 Project # JS- 2012- 001720 Est. Cost: Fee: $200.0o PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ASSOCIATED BUILDING WRECKERS INC 062382 Lot Size(sq. ft.): 146797.20 Owner: ROMAN CATHOLIC BISHOP OF SPRINGFELD -REV ANTHONY MENARD Zoning: URC(100) /CB(1)/ Applicant: ASSOCIATED BUILDING WRECKERS INC AT: 99 KING ST Applicant Address: Phone: Insurance: 352 ALBANY ST (413) 732 -3179 Workers Compensation SPRINGFIELDMA01105 ISSUED ON:6/8/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: DEMOLISH CHRSITIAN LIFE CENTER 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 6/8/2012 0:00:00 $200.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner