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24B-030 (12) CITY OF NORTHAMPTON, MASSACUSETTS DEPARTMENT OF PUBLIC WORKS 125 LOCUST STREET 4D NORTHAMPTON,MA 01060 413-587-1570 FAX 413-587-1576 George Andrikidis, P.E. Director;City Engineer September 17, 2002 Anthony Patillo, Building Inspector SEP 1 8 2002 Municipal Office Annex ` 212 Main Street OED OF 81111pi Nr,MPECT►ONS Northampton, Ma 01060 *i{7�t=: �� TON, VOt06u Dear Mr. Patillo: The water service at 304 King Street has been shut off at the curb stop and the water meter removed from the premises as of September 17, 2002. Please contact me if you have any questions. S' rely, Charles Borowski Superintendent of Water CB/dws Cc: George Andrikidis, Director of Public Works Ned Huntely, Assistant City Engineer Y MON 15:13 FAX 97814328 F L ROBERTS Gi 2002 14:1:� 5222618052 CONVERGENT COMM PAGE 0210 Conversent Communications Steve, The tofephone service at 301"King St, Wotthhampton, W, is not active in our switch.The order has been canceled. . Thank you, Steve O'Connor Convetsent Communications ! "` Corporate Office ' 313 Saswn Po5t Rcnad West %Suite 40 - Marlboro,MA 01752+ 508.486.630C CITY OF NORTHAMPTON, MASSACUSETTS DEPARTMENT OF PUBLIC WORKS 125 LOCUST STREET 4D NORTHAMPTON, MA 01060 413-587-1570 FAX 413-587-1576 George Andrikidis, P.E. Director,City Engineer r1' S I; V September 17, 2002 Anthony Patillo, Building Inspector Municipal Office Annex 212 Main Street Northampton, Ma 01060 Dear Mr. Patillo: The water service at 304 King Street has been shut off at the curb stop and the water meter removed from the premises as of September 17, 2002. Please contact me if you have any questions. S' c rely, �ir 1-U -L�Q� Charles Borowski Superintendent of Water CB/dws Cc: George Andrikidis, Director of Public Works Ned Huntely, Assistant City Engineer 13 2E102 11 : 04 AM FR TO 914132537071 P . 01 '\'X'�Isachusetts Electric _._._._k National Grid Company September 13, 2002 Thomas Laramee 92 West Broad Street Springfield,MA 01101 D!ar Mr. Laramee: This is to verify that Massachusetts Electric Company removed the electric service and meter at 3t14 King Street, Meter#093229879 in Northampton, Massachusetts effective September 10, 02 For building demolition. Sincerely, J'f�"z Nich s Si r tio0 un Design JrI/jl PO Sox 507 Northampton, MA 01061-0507 413.5$2.7200 ** TOTAL PAGE . 01 N, a l Make application to local l=ire Department. Fire Department retains original application and issues duplicate as Permit. : errre/x�o� uxe � uea— � dxPJUe7zGo�rt APPLICATION and PERMIT Fee: ue tank removal and transportation to approved tank disposal yard in accordance with the provisiars M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: ».' Cwner Name(please print) L%' (1c) X �//O2 ro Slow Moval Contractor Contamination z^„Name L> .7C I\-1,r f'A t Co.or individual /L5-7�n/l_ -C ,Address 2D VcS t Address + Pmr Signature it pplyin r rmit) Signature(it applying for permit) XIFCI' CkAilied Other U rFCi'Certified Q LSP# Other s • r `,-,_<Location `a X .6 1 ____._ Steel Address ciy a«ac3ty(gallons) /d COD _ Substance Last Stored e'-9 6 ry, w Tznk Dimensions (diameter x length) I Mr-Tis-11n. Firm transporting waste. i tn�ti'��c3� State Lic.# waste manifest# F.P.A.# -oved tank disposal yard _ _ __ ___ Tank yard# Type of inert �J116 Tank yard address i — nr Town FDlD# Permit# _ 4 Date of issue __.___ Date of expiration _ approval number. 2t�L. ��Jqd _ _ J Dig Sale Toll Free Tel. Number-600-322-4844 l t Signature/Title of Offleer granting permit A`!er removal(s)("Consumptive Use'fuel oil tanks exempted)send Form FP-2908 signed by Local l=ire Department to Office )f the State Fire Marshal, UST Regulatory Compliance Unit,P.O.Box 1025,Stow,MA 01775. -►ntornational Fire Code institute Make application to local Fire Department._ Fire Department retains original application and issues duplicate as Permit. 'F,; �e�h.a�Gme-nta�C-�i�xe Ve<.wuicc�a �ocr�r�al a�'C.�'raxe ��ir.�nliarL APPLICATION and PERMIT D D, storage tank removal and transportation to approved tank disposal yard in accordance with the provision s M.G.t_. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: r.. - - P Owner Name(please print) _ �, 4-"Y, ` X aro p..ne A'W Q//02 Z Gq ;1P • • • ^ • • EMU CornrianyName� l�+c C�An7� /�� ``ll�lrCr'� Co.orindividual � �'S cx/ >> ue -S' 1 �. rf PMV } Address,ZD S� L v c �lL -T 1,FY i 1� 1/.�hc�t Address POW Signature if applyi to permit) Signature(it applying for permit) i i zG!'Certified Other ❑IFCI"Certified Q t_SP#_ __ _ Other Tank Locations T� l i►Z r£L /�fCYZ%�i�i71 r?� S+wt Addrou City Tank Capacity(gallons) /d COD Substance Last Stored Tank Dimensions (diameter x length} X .:•�-,;arks: � �_K- �- ,�- ___ Firm transporting wasteIs?%�- l ��ZoS State t ic.# Hazardous waste manifest# E.P,A.# _� Approved tank disposal yard X16 _ Tank yard# Tyne of inert gas( ,l lgrL)-� PP IZGE- Tank yard address A r:Own FDiD# _Permit# _ Date of issue Date of expiration _ 1 Dig sate approval number: 2 'Z ('V ?T Dig Sale Toll Free Tel.Number-800-322-481 ignature/Title of Officer granting permit Atter removal(s)("Consumptive Use"fuel oil tanks exempted)send Form FP-2908 signed by Local Fire Department to Office the 3'-e�Fire Marshal, UST Regulatory Compliance Unit, P.O.f3ox 1025,Stow,MA 01775. -!nt-mational Fire Code Institute A Make application to local Fire Department. Fire Department retains original application and issues duplicate as Permit. I', APPLICATION and PERMIT `or storage tank removal and transportation to approved tank disposal yard in accordance with the provisions _ Chapter 148, Section 38A,527 CMR 9.00, application is hereby made by: Tank Owner Name(please print) + �. Q 7-9 00 x Address (/. `�J �f�ht�v—Y�CLj� /r�� Q//OZ Sbee/ "Y Rernoval Contractor ) 7Co.Compan y Name � �' 1�% 6A7i,06 � ►Z iC - dividuaf �CS c �5»�✓j.Si iZ �� y V c slam_ C1 f 3'V1 I UI C)0 :� Address rrwo ttre(if ap n for permit) Signature(if applying for permit) r �nC _ IIFCI'Certitie Other D IFCI'Certified ❑LSP# Other } Tank Location 305 T� I 'J� �i 2 e�� Z i�i��J7 --,-OA- sreer Address city Tank Capacity(gallons) /C3 Substance Last Stored �.�L�A)4= * Dimensions (diameter x length) X 3/ G Disposal Firm transporting waste 6-),774- r ��lyC"F--S State tic.# Hazardous waste manifest# E.P.A.# vt�r?;ank disposal yard Tank yard v,ae of inert gasL_l fJ�� t�J�L1-' Tank yard address �/4 City or Town FD1D# Permit# Oate of issue Date of expiration Dig safe approval number: 2MIL 3(n/70 Free Tei. Number-800-322-484-,. Signature 1 Title of Officer granting permit JJ o.at!sl("Consumptive Use'fuel oil tanks exempted)send Form FP-2908 signed by Local Fire Department to Office )i the °^Pire Marshal, UST regulatory Compliance unit,P.O.Box 1025,Slow,MA 01775. '9,.1-mational Fire Code Institute BOLDUC MECHANICAL SERVICES 20 SYLVESTER HAMILTON ROAD CHESTER, MA 01011 (413) 354-6350 September 9, 2002 Chief Brian P. Duggan Northampton Fire Department Carlton Drive Northampton, MA 01060-2373 Re: F. L. Roberts&Company 305 King Street Dear Chief Duggan; Bolduc Mechanical Services has been hired by F.L Robert&Co. to remove the gasoline dispensing equipment at their 305 King Street site. After the demolition phase another contractor will build a Car Wash facility. Roberts proposes to utilize the three underground tanks as storage tanks for the car wash effluent. We understand that the Building Department has requested additional information prior to approving this use. Assuming that the Building Department approves the new use, we are seeking your approval to clean and abandon the tanks from their original use. The tanks will be emptied, purged and cleaned of all gasoline sludge and vapors. We will be removing all the gasoline dispensing equipment. Attached are three permit applications for abandoning the tanks. Should you have additional requirements for the abandonment, we will gladly comply.We also request you guidance on the fee for this work. If you have any questions or require additional information, please call me at(413) 374-9606. Sincerely, Terry Kennedy Project Manager ENVIRONMENTAL COMPLIANCE SERVICES, INC. r Mr. Tom Laramee F.L.Roberts and Company,Inc. September 5,2002 Page 4 i It is the opinion of ECS that abatement measures are not needed to address materials which contain asbestos in accordance with applicable federal, state, and local regulations including but not limited to OSHA, USEPA, MADEP and MA-DLWD-DOS. ECS has provided for guidance the Massachusetts Department of Environmental Protection's Policy Concerning Non-Friable Asbestos Containing Materials as Attachment III. This Policy details handling and disposal requirements for nonfriable roofing materials. 3.2 -Lead TCLP lead sample data (Sample ID # FL-1), did not indicate the presence of lead above method detection limits (0.400 mg/L). Based on this data,building demolition materials may be disposed of as non- hazardous municipal or Construction and Demolition (C&D) waste in accordance with applicable regulations. ! If you have any questions pertaining to this matter,please do not hesitate to contact our office. Sincerely, ENVIRONMENTAL COMPLIANCE SERVICES,INC. Christopher L. Godfrey Y Project Manager•Asbestos Inspector#AI72140 1 Mark A. Haynes Operations Manager CLG/MAH/dm Attachments r. ENVIRONMENTAL COMPLIANCE SERVICES, INC. Mr. Tom Laramee F.L.Roberts and Company, Inc. September 5,2002 Page 3 i The attendant's booth is a single-story block structure containing a bathroom, storage area, and attendant's area. A small storage shed located in the rear of the property contained various stored items. Building materials suspected of containing asbestos were observed throughout the subject buildings. Various types of building materials such as ceiling tiles, sheetrock (with associated joint compound), caulkings, floor tiles and various construction mastics were encountered. A total of 32 bulk samples were collected and submitted to an accredited laboratory for asbestos identification by Polarized Light Microscopy (PLM). Laboratory PLM data is provided as Attachment I. All samples were submitted to ProScience Analytical Services, Inc. of Woburn, Massachusetts, a certified Massachusetts laboratory. There are six minerals grouped into the term "asbestos". Chrysotile, Amosite, and Crocidolite are asbestos minerals most commonly found in building materials. Exact sample types and compositions are included with the Laboratory Certificates. An ACM is defined as a material containing one percent or greater asbestos. Suspect ACMs were listed by functional space in which asbestos was determined to exist. The location, characteristics and assessment were completed for each ACM. Laboratory results of ACM samples are included as Attachment I. Laboratory results indicated that the roofing tars located on the rear storage shed contained asbestos at concentrations greater than or equal to one percent. 2.2- Lead ECS also collected a composite sample of various building materials for waste characterization using TCLP lead analysis. TCLP lead sample data of this sample (Sample ID #FL-1), did not indicate the presence of lead above method detection limits (0.400 milligrams per liter (mg/L) roughly equivalent to parts per million. Laboratory data of the TCLP lead sample is included as Attachment II. 3.0 CONCLUSIONS AND RECOMMENDATIONS 3.1 - Asbestos The USEPA regulates ACM associated with renovation, demolition, and asbestos abatement projects via the NESHAP regulation (Title 40, CFR Part 61). This regulation requires that buildings be inspected for ACM prior to renovation/demolition projects. It stipulates that all friable ACM as well as non-friable ACM that are in poor condition or will be made friable by renovation activity be removed or otherwise appropriately be abated before they are disturbed. a,a. ENVIRONMENTAL COMPLIANCE SERVICES, INC. i Mr. Tom Laramee { F.L.Roberts and Company,Inc. I September 5,2002 I Page 2 f them. Thermal Systems Insulation (TSI), surfacing materials and floor file installed before 1980 must be presumed to be asbestos containing materials (PACM) unless appropriate inspection and sampling analysis proves otherwise. To minimize the potential for accidentally disturbing the materials, OSHA requires the owner or property manager to: • communicate hazards to those personnel who may have contact with ACM, provide asbestos awareness training to all custodial personnel, and • provide more extensive training (16 hours), as appropriate, to maintenance personnel or other workers who repair,remove,or otherwise disturb PACM. Hazards may be communicated to employees,tenants, and outside contractors by labeling ACM,by posting written notices, or by verbally communicating information on asbestos hazards. If any operations are conducted where fiber release may be generated above the Permissible Exposure Limit (PEL), more extensive requirements apply. The USEPA regulates ACM associated with renovation, demolition, and asbestos abatement projects via the National Emissions Standard for Hazardous Air Pollutants (NESHAP)regulation(Title 40, CFR Part 61). This regulation requires that buildings be inspected for ACM prior to renovation/demolition projects. It stipulates that all friable' ACM as well as non-friable ACM that are in poor condition or will be made friable by renovation activities be removed or otherwise appropriately be abated before they are disturbed. 2.0 SUMMARY 2.1 - Asbestos ECS personnel performed an inspection for the presence of ACM which could be potentially disturbed during demolition or renovation activities. The inspection was performed on the interior and exterior portions of the attendant's booth, and the storage shed located in the rear of the property. Areas not inspected included the Banknorth ATM booth, and the roof areas of the canopy (metal) and attendant's, booth (rubber membrane roofing). Roof flashing compound was accessed and sampled on the attendant's booth. 'Friable—easily pulverized,crumbled or crushed by hand pressure. I ENVIRONMENTAL COMPLIANCE SERVICES, INC. i September 5,2002 File No. 14704.0 i Document No.22961 I F.L. Roberts and Company,Inc. 93 West Broad Street Springfield,MA. Attn: Mr. Tom Laramee RE: Asbestos Survey and Waste Stream Characterization F.L Roberts Gasoline Station 304 King Street Northampton,Massachusetts Dear Tom: As per your request, Environmental Compliance Services, Inc. (ECS) has completed an inspection for the presence of asbestos-containing materials (ACM) and Toxicity Characteristic Leaching Procedure (TCLP) lead waste stream characterization at the gasoline station located at 304 King Street, Northampton, Massachusetts, 1.0 REGULATORY GUIDANCE 1.1 - Asbestos The United States Environmental Protection Agency (USEPA), the Massachusetts Department of Environmental Protection (MADEP), the United States Occupational Safety and Health Administration (OSHA), and the Massachusetts Department of Labor and Workforce Development, Department of Occupational Safety (MA-DLWD-DOS) are responsible for regulating the release of asbestos into the environment and protecting workers for exposure to airborne fibers. The USEPA and MADEP are responsible for developing and enforcing regulations necessary to protect the general public from airborne contaminants that are known to be hazardous to human health. OSHA and the MA-DLWD-DOS are responsible for the health and safety of workers who may be exposed to asbestos in connection with their jobs, including asbestos abatement, maintenance, and custodial activities, and renovation work. They specify requirements for the work practices and engineering controls f that must be utilized during asbestos abatement projects. They also require that ACM, be repaired, removed, or otherwise appropriately abated before maintenance, renovation, or demolition work disturbs 588 Silver Street 30 Harris Place 18 Shepherd Street 1209 Tech Blvd.,Suite 202 74 Boston Post Road lawam,MA 01001 Brattleboro, VT 05301 Brighton,MA 02135 Tampa, FL 33619 Madison, CT 06443 413-789-3530 601-257-1195 617-782-4417 813.611-5900 203-245-3322 7x 413-789-2776 Fax 802-257-1603 For 617-9sd-%79 c„d R74.612coin •� i I Environmental Compliance SERVICES, INC. i ASBESTOS SURVEY AND WASTE STREAM CHARACTERIZATION F.L.ROBERTS AND COMPANY,INC. 304 KING STREET NORTHAMPTON,MASSACHUSETTS Prepared For: Mr. Tom Laramee F.L. Roberts and Company, Inc. 93 West Broad Street Springfield,Massachusetts File No. 14704 Document No. 22961 September, 2002 1VLAIN OFFICE: 1209 Tech Boulevard 30 Harris Place 74 Boston Post Road 18 Shepard Street 588 Silver Street Suite—202 Suite—A Agawam,Massachusetts Tampa,Florida Brattleboro,Vermont Madison,CT Brighton,Massachusetts 01001 33619 05301 06443 02135 Voice:(413)789-3530 Voice(813)643-8887 Voice(802)257-1195 Voice(203)245-3322 Voice(617)-7824417 Fax:(413)789-2776 Fax(813)643-3847 Fax(802)257-1603 Fax(203)245-3494 Fax(617)782-5939 Visit us on the web at WWW.ECSCONSULT.COM Email address: ecsinfo @ecsconsult.com f Northampton Fire Department Memorandum a TO: Tony Patillo AUK i From: B. P. Duggan Date: August 21, 2002 Re: F.L. Roberts Car Wash, 304 King Street Secondary to a review of the plans that you submitted to me on August 20, 2002, 1 concur with the issuance of a building permit for this property subject to the following conditions: No Fire protection narrative accompanied the plans, any fire protection features required are subject to review and should be presented to me immediately. 5 Pound ABC Dry Chemical Fire Extinguishers are required at the exits. • If this is to replace the existing gas station,the demolition of the existing structure may require a fire detail. If this replaces the existing gas station, all existing tanks must be removed. /0 0 0 c> �/I 1-5 CGS,¢�✓ •Page 1 g� ere Gxfi� of wart 1 aillpflail L $ Blasaxc}lnsrtta' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 y ' WORKER'S COMPENSATION INSURANCE AFFIDAVIT 1V1c h>a,�lcA C S��gIc�� (IicenserJpermittlre) with a principal place of business/residence at: 2V S,/t c /Or),'1704) c✓ 0&5zs 1/L 1W- - (phone#) (strret/6 ty/stafrla p) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the follollving worker's compensation coverage for my employees working on this job: (Insumnce Company) (Policy Number) (Expiration Date) I am sole proprietor eneral contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies, gt2L 1, A�2.r) C'�� i Fjth�Ss��YL�fIT/cGl��2�CC'� (Name of Contractor) (Insurance Company/Policy f4umbcr) — (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (at a+additioml shod if necessary to incaude information pexaining to all ooat ad ) ( ) I am a sole proprietor and have no one working for me. ( ) 1 am a home owner performing all the work myself. NOTE:please be aware that while homeowners who employ perrons to do mamtr ante suction or repair work on a dwelling of not ntoeo than throe units is which the bomoowner raids or on the grounds appuctenad thereto arc oot generally ooandcred to be eatploycra under the w%ket's compensation Ad(GL152,ss 1(5)),application by a homeowner for a Uccase or pcaTdd may evidence the legal rubs of an employer under the Workees Compensation Ace. I understand that a Copy of thin rxatemeni may be foevvanded to tbo Departn ors of IrAitrial Amidza&Offioo of in-for the coverage verification and that failure to secure coverage under section 25A of MGL 152 can lead to the is on of-k'h l penalties oombting of a fine of up to S1,300.00 and/or imprison of up to one year and civil pcaaltics in the form of a Stop Work Ord--and a fim of 5100.00 a day For .� Permit Ntlln V/0 Z_ Map# _Lot# SAg zb=of icense&PC'rr it#ce • Version 1.7 Commercial Building Permit May 15,2000 SECTfON:10 STR III CT.UR#L PEER,,,,REVIEW(780 CMR 1T011) Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ SECTION 11 OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERSaAGENT,OR Ci7NTR#+ TOR'lPPL1ES FOR.'BUILDIIYG PERMIT �., ,3.h.__ I, S I L.—C_ 1\(X�—(L I S / as Owner of the subject property hereby a e__)_ f Cc crl//11 �L�✓�7C.. �t��9Ni('fl Spy/� to act on m alf, in all ter r ative to work authorized b this building permit application. I _:::� I ( la/a2 Signatur of 0 Date / I�n/C'� e7��i✓� �/ ��✓.�c- � ��,��/�//� si=p?�/i cc� , as Owner/Authorized Agent hereby declare that the statements an 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 CQNSTRCJCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: / 2 r✓C'�= � '��`/ CS o 7qc)7 License Number Address r Expiration Date Signature Telephone SECTION;13 WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.GL 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....... No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 SECTION:9 PROFESSIONAL DESIGN'ANQ CONS 1`RUCTfdN SERVICES `FOR BUILDINGS AND STRUCTURES SUBJECT?4 CONSTR ICTIO l C01VTI PURSUANT TO 780,CMR 11fi.(CONTAfNING MORE THAN,35,0;00 C.F.'OF,ENCLOSEQ SFACE) 9.1 Registered Architect: Not Applicable ❑ Name(Registrant): Registration Number Address Expiration Date Signature Telephone 92 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 7. Water upply(M.G.L. c.40, § 54) 7.1 Flood Zone Information: 7.3 Sewage isposal System: Public Private ❑ Zone: Outside Flood Zone Municipal Pk On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size 's Frontage G E3 Setbacks Front 44 Side L: ,SS R: 4-5 L: R: Rear 35 Building Height 17.5 Bldg. Square Footage 270 1 5 % Open Space Footage _ % �(Lot area minus bldg&paved '� 22— parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW X YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 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.Z No IF YES, describe size, type and location: ��'� ti ' Version 1.7 Commercial Building Permit May 15,2000 SECTION4-CONSTRUCIQN SERVICES FOR'PROJEGTS LESS THAN 35,000 CUBIC FEET OFH ENCLOSED SPACE �. .� ,.; Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ Exterior Alterations Demolition ( New Signs [ ] Change of Use [ ] Other [ ] ❑ / Accessory Building[ ] Repairs [ ] DESC2�P�z `�c.M n ► X 1,91 SECTION 5 3•l7SEiGRQUR A3Nt3GQNSTtUCT�Qf YfE USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ lA ❑ A-4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ E Educational ❑ 2B ( ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 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 ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANG [fV 1ISE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SEC TION'6,BUILDING HEIGHTAND AREA' BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) St I x�� 1st D d .x� 2 n 2nd 3rd sa; 4th z 3`d 4th , . k� wy Total Area (sf) 2-1 D Total Proposed New Construction (sf) , Total Height(ft) Total Height ft -------------------- f. Versionl.7 Commercial Building Permit May 15,2000 r---- f Northampton II Department ��-- I lain Street j { m 100 1 0 20%rtl i i ton, MA 01060 phone 413-5 71:140 Fax 413-587-1272 SUILDING INSPECTIONS- APO � , RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTfON..1 SITE INFORMATION 1.1 PrODetiv Address: �e tiorrt bdxcomPfeted by offic 0 217-1, ---"--;Ori m A W b � SECTION,2- PRQPERTY O,WNERSHIPlAUTHORIZED AGENT 2.1 Owner of Record, C1102-- C) I'V41 CL.0 /',I A Name(P ) - ''f Current Mailing Address: 4-13 781 -_7441 Signature Telephone 2.2 Authorized Agent: Name(P int) Current Mailing Address: 19 17 ll�IZ57— 111 1-3. CVCJaZ P/ L-/ 3) Signature Telephone SECTION' • ESTIMATE '= �N TR CTI N C0 TS Item Estimated Cost(Dollars)to be Official°Use Only completed by ermit applicant 1. Building (a) Building,Permit Fee 2. Electrical (b) Estimated Total Cost of` Construction fr6m,(6), 3. Plumbing Building Permit Fee, 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 +3 +4+ 5) Check Number „�, , : ^” This Sect'on For Official Use�'OnI Bulls Permlt"I�urnsr Date Issued s u, ', duIldir g Co hth ti lnspec#off of Building File#BP-2003-0250 APPLICANT/CONTACT PERSON BOLDUC MECHANICAL SERVICES ADDRESS/PHONE 20 SYLVESTER HAMILTON RD (413)354-6350 PROPERTY LOCATION 304 KING ST MAP 24B PARCEL 030 001 ZONE HB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T_ypeof Construction: DEMO 18 X 15 KIOSK BLDG/W CANOPY New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure Building Plans Included• Owner/Statement or License 077407 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION 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 C ssion 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. f ON 51 6 ST BP 2003 0250 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-0250 Project# JS-2003-0441 Est.Cost: $0.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BOLDUC MECHANICAL SERVICES077407 Lot Size(sq. ft.): 19514.88 Owner: F L ROBERTS&COMPANY INC Zoning:HB Applicant: BOLDUC MECHANICAL SERVICES AT. 304 KING ST Applicant Address: Phone: Insurance: 20 SYLVESTER HAMILTON RD (413) 354-6350 C H EST E R M A0 1011 ISSUED ON.-9117102 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMO 18 X 15 KIOSK BLDG/W CANOPY 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 9/17/02 0:00:00 5419 $35.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo