23B-046 (132) JUL-03-00 MON 09 :39 AM NORWICH LABORATORIES 413 549 6884 P. 08
NORWICH LABORATORIES, INC.
Hatfield Center
62 Main Street
Hatfield, MA 01038
413-247-3000
BULK SAMPLE ANALYSIS REPORT
Client: Cooley Dickinson Hospital Report Date: 6/23/00
Location: First Floor, South Wing Contractor:
Sample # Sample Location -T Lab # Date Description Asbestos
8A Side Room
8439 6/23/00 Small Square Ceiling Tiles No Asbestos Detected
8B Side Room
8440 6123100 Small Square Ceiling Tiles No Asbestos Detected
8C Side Room
8441 6123100 Small Square Ceiling Tiles No Asbestos Detected
9A
8442 6/23/00 Cove Base & Mastic No Asbestos Detected
9B
8443 6/23100 Cove Base & Mastic No Asbestos Detected
9C
8444 6/23/00 Cove Base & Mastic No Asbestos Detected
Analysis is by polarized light microscopy,EPA Test Methods#600fM4-82.020
`Tbe sample was inhomogeneous and sub samples of the oomponents were analyzed separately.
These analyses were combined in proportion to their abtutdance and a single analysis provided for the sample.
'*The EPA has no apptovod test method for the identif icatlon of asbestos in floor tiles. Asbestos fibers is floor tile are below the detection limits for
current PLM tochniques. The identification of any asbestos in floor rile is indication that it is ACM,however the absence of identification of asbestos
in floor tile by PLM is In itself inconclusive.
NOTE: The results relate to only the particular sample analyzed. This report may not be reproduced,except in full,with the approval of Norwich
Laboratories,Inc. The percentage of asbestos reported is determined visually and is a qualitative measure.
Sampled By: Nina Inchardi Analyzed By: Nina Inchardi
Approved By: Nina Inchardi Laboratory Director:
�- ' ;�5.
JUL-03-00 MON 09 :38 AM NORWICH LABORATORIES 413 549 bUU4
NORWICH LABORATORIES, INC.
Hatfield Center
62 Main Street
Hatfield, MA 01038
413-247-3000
BULK SAMPLE ANALYSIS REPORT
Client: Cooley Dicldnson Hospital Report Date: 6/23100
Location: First Floor, South Wing Contractor:
Sample # Sample Location
Lab # Date Description Asbestos
6A
8431 6/23/00 Plaster Around Corridor "Nite-Lite" No Asbestos Detected
6B
8432 6/23/00 Plaster Around Corridor "Nite-Lite" No Asbestos Detected
6C
8433 6/23/00 Plaster Around Corridor "Nite-Lite" No Asbestos Detected
6D
8434 6/23/00 Plaster Around Corridor "Nice-Lite" No Asbestos Detected
6E
8435 6/23/00 Plaster Around Corridor "Nite-Lite" No Asbestos Detected
7A
8436 6/23/00 Square, Perforated Drop Ceiling Tiles No Asbestos Detected
7B
8437 6/23/00 Square, Perforated Drop Ceiling Tiles No Asbestos Detected
7C
8438 6/23/00 Square, Perforated Drop Ceiling Tiles No Asbestos Detected
Analysis is by polarized light microscopy, EPA Test Methods N6WIM4-82-020
'The sample was inhomogeneous and sub samples of the components were analyzed separately.
These analyses were oombined in proportion to their abundance and a single analysis provided for the sample.
"The EPA has no approved test method for the identification of asbestos in floor tiles. Asbestos fibers in floor tile are below the detection limits for
current PLM techniques. The identification of any asbestos in floor file is indication that it is ACM, however the absence of identification of asbestos
in floor file by PLM is in itself inconclusive.
NOTE: The results relate to only the particular sample analyzed. This report may not be reproduced,except in full,with the approval of Norwich
Laboratories,Inc. The percentage of asbestos reported is determined visually and is a qualitative measure.
Sampled By: Nina Inchardi Analyzed By: Nina Inchardi
Approved By: Nina Inchardi Laboratory Director: 1
JUL-03-00 MON 09 :37 AM NORWICH LABORATORIES 413 549 6884
P. 06
NORWICH LABORATORIES, INC.
Hatfield Center
62 Main Street
Hatfield, MA 01038
413-247-3000
BULK SAMPLE ANALYSIS REPORT
Client: Cooley Dickinson Hospital Report Date: 6/23/00
Location: First Floor, South Wing Contractor:
Sample # Sample Location
Lab # Date Description Asbestos
4A
8426 6/23100 Plaster On Lathe - Wall Material No Asbestos Detected
4B
8427 6/231.00 Plaster On Lathe - Wall Material No Asbestos Detected
4C
8428 6/23/00 Plaster On Lathe - Wall Material No Asbestos Detected
4D
8429 6/23/00 Plaster On Lathe - Wall Material No Asbestos Detected
4E
8430 6/23/00 Plaster On Lathe - Wall Material No Asbestos Detected
5
XXXX 6/23/00 No Sample #5 XXXXXX
Analysis is by polarized light microscopy,EPA Test Methods N600/M4-82-020
*The sample was inhomogeneous and sub samples of the components were analyzed separately.
These analyses were combincd in proportion to their abundance and a single analysis provided for the sample.
**The EPA has no approved test method for the identification or asbestos in floor tiles. Asbestos fibers in floor tile are below the detection limits for
current PLM techniques. The identification of any asbestos in floor file is indication that it is ACM,however the absence of identification of asbestos
in floor the by PI.M is in itself inconclusive.
NOTE: The results relate to only the particular sample analyzed. This report may not be reproduced,except in full,with the approval of Norwich
Laboratories,Inc. The percentage of asbestos reported is determined visually and is a qualitative measure.
Sampled By: Nina Inchardi Analyzed By: Nina Inchardi I
Approved By: Nina Inchardi Laboratory Director: cep ?
JUL-03-00 MON 09 :36 AM NORWICH LABORATORIES 413 549 6884 P. 05
NORWICH LABORATORIES, INC.
Hatfield Center
62 Main Street
Hatfield, MA 01038
413-247-3000
BULK SAMPLE ANALYSIS REPORT
Client: Cooley Dickinson Hospital Report Date: 6/23100
Location: First Floor, South Wing Contractor:
Sample # Sample Location
Lab # Date Description Asbestos
IA Office Areas
8417 6/23/00 Sheetrock Walls No Asbestos Detected
1B Office Areas
8418 6/23/00 Sheetrock Walls No Asbestos Detected
1C Office Areas
8419 6/23/00 Sheetrock Walls No Asbestos Detected
2A
8420 6/23/00 Sheetrock Tape No Asbestos Detected
2B
8421 6/23/00 Sheetrock Tape No Asbestos Detected
2C
8422 6/23/00 Sheetrock Tape No Asbestos Detected
3A
8423 6/23/00 Pyrobar - Wall Material No Asbestos Detected
3B
8424 6/23/00 Pyrobar - Wall Material No Asbestos Detected
3C
8425 6/23/00 Pyrobar - Wall Material No Asbestos Detected
Analysis is by polarized light microscopy,EPA Test Methods#600(M4-82-020
*The sample was inhomogeneous and sub samples of the components were analyzed separately.
'these analyses were combined in proportion to their abundance and a single analysis provided for the sample.
**The EPA has no approved test method for the identification of asbestos in floor tiles. Asbestos fibers in floor tile are below the detection limits for
current PLM techniques. The identification of any asbestos in floor tile is indication that it is ACM,however the absence of identification of asbestos
in floor the by PLM is in itself inconclusive.
NOTE: The results relate to only the particular sample analyzed. This report may not be reproduced,except in full,with the approval of Norwich
Laboratories, Inc. The percentage of asbestos reported is determined visually and is a qualitative measure.
Sampled By: Nina Inchardi Analyzed By: Nina hargi
Approved By: Nina Inchardi Laboratory Director:
JUL-03-00 MON 09 :35 AM NORWICH LABORATORIES 413 549 6884 P. 04
Non-Asbestos Materials
The following materials were tested via polarized light microscopy, and found to be non-asbestos
containing:
• Plaster
• Pyrobar
• Sheetrock
Drop Ceiling Tiles
Recommendations
The Federal EPA NESHAPs regulations and Massachusetts Asbestos Regulations require all asbestos
containing material to be abated by a licensed asbestos abatement contractor prior to building demolition.
A final visual inspection by an industrial hygienist must be conducted to insure complete and proper
removal of all asbestos materials.
Norwich Laboratories, Inc. 2
JUL-03-00 MON 09 :34 AM NORWICH LABORATORIES 413 549 bUU4
Introduction:
The following pre-renovation survey was conducted at Cooley Dickinson Hospital, First Floor,
South Wing by a licensed asbestos inspector. The purpose of the inspection was to locate and
assess the condition of asbestos building materials in accordance with the EPA NESHAPs
regulations prior to renovations planned in the First Floor, South Wing.
The building inspection was conducted following AHERA protocol, and samples were collected
of materials deemed suspect for asbestos content by the licensed inspector. Bulk samples were
then transported to Norwich Laboratories, Inc. licensed asbestos analytical lab, where they were
analyzed via polarized light microscopy_
Building Description
The brick building with materials dating to the 1930's has interior walls that are a mixture of
sheetrock, plaster on wire lathe,and pyrobar. The heating system is forced hot air. Drop ceiling
tiles have cement above them and wires and conduits run through the chase. Sprinkler system
pipes are bare and run horizontally through the walls. Plumbing pipe chases were not open at
the time of the inspection; making it infeasible to ascertain the presence of any pipe cover.
Planned renovations should proceed with caution in this area. Norwich Laboratories should be
contacted if any further suspect materials are revealed during the renovation process.
Planned Renovations
Planned renovations include the demolition of interior walls and drop ceiling tiles. Flooring,
which is assumed positive for asbestos content based on previous testing, will not be disturbed.
Ceiling plaster is also to remain intact.
Sampling
Samples were collected by our licensed asbestos inspector using the EPA sampling protocol. All
building components which will be impacted by renovation activities were sampled and tested
via polarized light microscopy.
Hidden Materials
Materials, such as pipe cover, behind walls were inaccessible at the time of the inspection. If
materials suspect for asbestos content are'revealed during demolition of wall components, stop
work immediately and do not resume until the material is tested for asbestos content.
Norwich Laboratories, Inc. 1
JUL-03-00 MON 09 :34 AM NORWICH LABORATORIES 413 549 6884 P. 02
NORWICH LABORATORIES, INC.
62 Main Street
Hatfield, MA 01038
(413)247-3060
Fax (413)247-0016
Asbestos Pre-Renovation Survey
At
Cooley Dickinson Hospital
First Floor, South Wing
Northampton, MA
Prepared By: Norwich Labora , Inc.
Inspector: Nina Inchardi
Inspector License #: AI
Report Date: June 23, 2000
C)
o ZR, a
o b 0
W r� O
m O
C,' cNr /�1 CT1
n' N) � �p
cv v eo
m � � � 1"P m
U) � O
m
A Oil a o
0) b 1 N o ro O
o m
°
A ~ a
v �
c
ce ^► o
fi
n �►
o m `', O e r n tit.
-� > y
m
3 Z N A
cp
,—. Z p
a R cn `' x z
r
C7 � f0
co
I �-
Cl) y• � A
A o A
C y Z
r -
4.•C1iMlP�.
9 e G2t1 of 'Nort4 illptan
e � �i3f ACh Rffltf �
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building 'a
Northampton, Mass. 01060 y
WORKER'S COMPENSATION INSURANCE AFFIDAVTr
with a principal place of business/residence at:
Coaley O ,cK tAJsav HosP,'raL i
30 t1-oCOST S✓, - tii✓IjomAj /�IQ� 0/06d (phone#)
(s�eticity/state/a p)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the foHoWing workers compensation coverage for my
employees working on this job:
S"eL-f i�,ru2 eat_ _ G�c�wse 760 /0 99
(Insurance Company) (Policy Number) (Expiration Dare
(+/� a sole Dropriet9r general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contactor) ;Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Comppan}vPolicy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Tolicy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additieaal shed ifnwc=uv to in�inform oa pertaining to all oo±r*a )
( I am a sole proprietor and have no one working for me.
P P $
( ) I am a home owner performing all the work rnyself.
NOTE:please be aware that while homeowners who employ perwm to do may*+— �000suvdioo or repair work on a dwelling of
not more than throe units is which the boamw ocr resides of on the groat apptutenaust ihrrcto an not Sa x mily ooandcrcd to be
employees under the worker's compeusation Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the
legal statue of an employw under the Workar's Compemdioa Act
I understand that a copy of this=Lcawat may be forwarded to tho Dtpertmm2 of Indtutrial Ao6dea&OtSoe of Iasrusoce for the
coverage vcxificstioo and that failure to socu a coverages under seuion 15A of MOL 152 can lead to tha imposdian of mmilW pcaalbes
consisting of a fax of up to 11,390.00 and(or hnpriso� of up to ooe year and civil pmatlia in the form of a Stop Work order and a
fum of 3100.90 a day&pwA tm.
For dgMta=W use oaty
Permit Number
C9 des oQ MaO Lot#
i of a tt= e
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
dependent Structural Engineering Structural Peer Review Required Yes......❑ No......❑
SECTION 11 -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, `C4 G'/ Dto lit.l.5�.�t [` as Owner of the subject property
hereby authorize t` o r�4 to act on
pV-Oehalf, in all matters relative to work autho ed by this building permit application.
O ature of Owner Date
I, y1ne_� .0 A 'YV-�_- V�j 4frc as Owner/Authorized Agent
hereby declare that the statements Ud 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.
_,�:����'-d`� 'YV1 �/V���"�-7�=Sri'✓t
Prime
T
0 cvx ely 7� 9 C Wit?
Signature of Owner/Agent C I Date
#'-_CTION 12 -CONSTRUCTION SERVICES
10.1 Licensed Construction Su ervisor: Not Applicable ❑
Name of License Holder :
License Number
plume/1 4 -ba. ea 5�'h� PT�� /na . 0/0,71] 6-- l 11
Address Expiration Date
ign re T ephone
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....... No...... ❑
Version 1.7 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)
.1 Registered Architect:
Not Applicable 0
Name(Registrant):
Registration Number
Addre `7 \
Expiration Date
- t-IIIYJA&,� J-1 -; -
Signa a Telephone
92 Registered Profess'ona n ks):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
ignature Telephone Expiration Date
OPOK
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
C Wl Scm mS ^L Inc 10e)k Not Applicable C
Company Nam d.
Il`NCb+ VVArWl2� � C¢5 t C24 ¢`�'Ci Tt`�'
Responsible In Charge of Constru on 1
�0 �0 We�� C —. qA_4:� -t LA k Wa
•ddr
a�gnature Telephone
Version 13 Commercial Building Permit May 15,2000
7.Water Supply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
'ublic ❑ Private ❑ Zone: Outside Flood Zone ❑ Municipal ❑ On site disposal system ❑
opft,, 8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size C
Frontage 5
Setbacks Front IDA! lmk
Side L: R:A a. L: R:
Rear
Building Height
Bldg.Square Footage ! q %
Open Space Footage ! / %
(Lot area minus bldg&paved /Q i�1 ��r '
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 YES
IF YES, date issued: -tv4, ,jej l9gq& 13°et,4 lq'�66 r z
$'rec6l P CA vim. f_- 140 CAUS-(7 1944.
IF YES: Was the permit recorded at the Regi6ry of"Deeds?
NO DON'T KNOW YES x
IF YES: enter Book 4%- _ Page Al �-- and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES ` -
IF YES, has a permit been or need to be obtained from the Conservation Commission? NO
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location: V00 4w —C-'d'&u.vl.j
D. Are there any proposed changes to or additions of signs intended for the property ?YES_
No
eow
IF YES, describe size, type and location:
Versionl.i Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
UBIC'FEET OF ENCLOSED SPACE
interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
❑ ❑
Exterior Alterations emolition� New Signs [ ] Change of Use [ ] Other [ ]
❑ e j ►$-t-riv4 -I)GIYAp Accessory Building j ] Re(palir�s [ }
SECTION 5- USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business AL'S _KY`EC-@ 2A ❑
E Educational ❑ 2B ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 2Ic 3A ❑
Institutional ❑ I 1 I ❑ 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:
.t Mixed Use ❑ Specify:
.. Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: T"" Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): 2.
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
OFFICE USE ONLY
Floor Area per Floor(sf) 15t
2nd
1st woo� i
2nd 3rd
4tn �-
3rd t
4 t
Total Area (sf) Total Proposed New Construction (sf) � �3
....................... . A.-- � ; y
".al Height(ft) '�f�`OW
A �
Total Height ft
I
Versionl.7 Commercial Building Permit May 15 2000
,�,rm Cily) f Northampton
BWildi g Department
212 Main Street
oom 100
Northampton, MA 01060
phone 413-587-1240 Fax 413.587-1272
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 1o,,b6 compieted'by office `
_ C �D CU S_6 Map lot Unit
Aq M;-7j�A �� s`�� Zone Overlay District
Elm St:D[strfct` CB.Distrfct
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
'ame(Print) v Current Mauling Address:
rr
-iature Te ephon
2.2 Authorized Agent: �0(��� yf fi e" &At '96pl-a
E-Ovl - 5,f-
pfn ;f' l J'I 2vvta]�nrl
e rint) Current Mailing Address:
Signature Telephone
SECTION 3 --ESTIMATED CONSTRUCTION COSTS
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 from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 +2 + 3 +4 + 5) Check Number
This Section For Official Use Only
Zuilding Permit Number: B fti —Y,3 Date Issued:
nature:
Building Commissioner/Inspector of Buildings Date
t
File#BP-2001-0033
APPLICANT/CONTACT PERSON COOLEY DICKINSON HOSPITAL INC
ADDRESS/PHONE LOCUST ST (413)582-2313 Q
PROPERTY LOCATION 30 LOCUST ST
MAP 23B PARCEL 046 ZONE M
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: SOUTH WING(OLD PEDIATRICS)-INTERIOR DEMOLITION ONLY
New Construction
Non Structural interior renovations
Addition to Existing -
Accessog Structure
Buildinp,Plans Included:
Owner/Statement or License 074595
3 sets of Plans/Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: §_-w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 Co n Permit from CB Architecture Committee
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.
r
Y
30 LOCUST ST BP-2001-0033
GIs#: COMMONWEALTH OF MASSACHUSETTS
,Map:Block:23B-046 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2001-0033
Project# JS-2001-0057
Est.Cost:
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO
Const,Class: Contractor: License:
Use Group: COOLEY DICKINSON HOSPITAL 074595
Lot Size(sq.1): 667077.84 Owner. COOLEY DICKINSON HOSPITAL INC
Zoning:M Applicant: COOLEY DICKINSON HOSPITAL INC
AT: 30 LOCUST ST
Applicant Address: Phone: Insurance:
LOCUST ST (413)582-2313 Q
NORTHAMPTONMA01060 ISSUED ON:7 111 100 0:00:00
TO PERFORM THE FOLLOWING WORK.-SOUTH WING (OLD PEDIATRICS) - INTERIOR
DEMOLITION ONLY
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
rk Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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 7/11/00 0:00:00 491094 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo