36-086 (5) Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
and the Northampton Wetlands Protection Ordinance — Chapter 24
D. Appeals
The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land
upon which the proposed work is to be done, or any ten residents of the city or town in which such land is
located, are hereby notified of their right to request the appropriate Department of Environmental
Protection Regional Office (see Appendix A) to issue a Superseding Determination of Applicability. The
request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee
and Fee Transmittal Form (see Appendix E.- Request for Departmental Action Fee Transmittal Form) as
provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A
copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation
Commission and to the applicant if he/she is not the appellant. The request shall state clearly and
concisely the objections to the Determination which is being appealed. To the extent that the
Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands
Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction.
wpaform2.doc•rev.12/15/00 Page 5 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
and the Northampton Wetlands Protection Ordinance — Chapter 24
B. Determination (cont.)
❑ 5. The area described in the Request is subject to protection under the Act. Since the work
described therein meets the requirements for the following exemption, as specified in the Act and
the regulations, no Notice of Intent is required:
Exempt Activity(site applicable statuatory/regulatory provisions)
❑ 6. The area and/or work described in the Request is not subject to review and approval by:
Name of Municipality
Pursuant to a municipal wetlands ordinance or bylaw.
Name Ordinance or Bylaw Citation
C. Authorization
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on ® by certified mail, return receipt requested on
_ September 28, 20004
Date Date
This Determination is valid for three years from the date of issuance (except Determinations for
Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not
relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances,
bylaws, or regulations.
This Determination must be signed by a m r y of the Conservation Commission. A copy must be sent
to the a propriate DEP Regional Office ( ee ppendix A) and the property owner(if different from the
appli n Si at res: f.
September 23, 2004
Date
wpaform2.doc-rev.12115/00 Page 4 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
and the Northampton Wetlands Protection Ordinance — Chapter 24
B. Determination (cont.)
❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not
subject to the Massachusetts Wetlands Protection Act:
❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent lots formerly or presently owned by the same owner.
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post-marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Act or the
Buffer Zone.
❑ 2. The work described in the Request is within an area subject to protection under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but
will not alter an Area subject to protection under the Act. Therefore, said work does not require
the filing of a Notice of Intent, subject to the following conditions:
• Existing silt fencing around the wetland on the adjacent property must be maintained and
repaired or replaced as necessary for the duration of this project.
• Entrenched silt fence shall be installed along the property/work limit line noted on plan
submitted, and along Westhampton Road to keep all runoff on site.
• Silt fencing shall be armored with hay bales, two stakes per bale, on the wetland side,with
orange construction fencing in front, along the entire property line adjacent to the wetland.
• The Commission must be notified after erosion controls are installed and before the start
of work
• All silt fencing shall remain in place until the ground is stabilized by vegetation and
removal is authorized and required by the Conservation Commission.
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent,
unless and until said work alters an Area subject to protection under the Act.
wpaform2.doc•rev.12/15/00 Page 3 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
and the Northampton Wetlands Protection Ordinance — Chapter 24
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the
Wetlands Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) has been
received from the issuing authority (i.e., Conservation Commission or the Department of
Environmental Protection).
❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act.
Removing, filling, dredging, or altering of the area requires the filing of a Notice of Intent.
❑ 2a. The boundary delineations of the following resource areas described on the referenced
plan(s) are confirmed as accurate. Therefore, the resource area boundaries confirmed in this
Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its
regulations regarding such boundaries for as long as this Determination is valid.
❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination,
regardless of whether such boundaries are contained on the plans attached to this Determination or
to the Request for Determination.
❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to
protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work
requires the filing of a Notice of Intent.
❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will
alter an Area subject to protection under the Act. Therefore, said work requires the filing of a
Notice of Intent.
❑ 5. The area and/or work described on referenced plan(s) and document(s) is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Name Ordinance or Bylaw Citation
wpaform2.doc•rev.12/15/00 Page 2 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, W
and the Northampton Wetlands Protection Ordin :fg,'"ptpr 4
A. General Information R I
Important: I �, 1
When filling out From: I , o�, 2 �P.n L)
forms on the The Northampton Conservation Commission
computer, use
only the tab
key to move To: Applicant �ropsrtp-Owner-{tf--d-WEe t €rem applicant):
your cursor-
do not use the Sean Hoye _ Robert Crafts
return key. Name Name
41 South Street #42 _ 109 East Street
Q Mailing Address Mailing Address
Easthampton MA 01027_ Chesterfield MA
City/Town State Zip Code City/Town State Zip Code
remm
1. Title and Date(or Revised Date if applicable) of Final Plans and Other Documents:
Existing House Plot, 195 Westhampton Rd., 1"=40', by Sean M. Hoye
Title Date
Proposed House Plot, 195 Westhampton Rd., 1"=40', by Sean M. Hoye
Title Date
Title Date
2. Date Request Filed:
August 19, 2004
B. Determination
Pursuant to the authority of M.G.L. c. 131, § 40, the Conservation Commission considered your
Request for Determination of Applicability, with its supporting documentation, and made the following
Determination.
Project Description (if applicable):
Demolition of existing single-family house and construction of a new single-family house
Project Location:
195 Westhampton Road Florence
Street Address City/Town
36 86
Assessors Map/Plat Number Parcel/Lot Number
wpaform2.doc•rev.12/15/00 Page 1 of 5
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Pre-.Renovation Asbestos Survey-195 Westhampton Road,Northampton,MA
195 'Westhampton Road
Nortbsimpton, MA
Asbestos ample Collection Summa
SAMPLE N MATERIAL LOCATION
1 A Sheetrock Thoughoui,
1B Sheetrock Thou nut
IC Sheetrock Thoughout
2A hoof Exterior
215 Roof Exterior
2C Root' Exterior
3A Blown-In Insulation 'Thou ut
3B Blown-In Insulation Thousbo ut
3C Blown-In Insulation L Thou hoot
Materials Positive for Asbestos Content
No materials were found to be positive for asbestos content. Please reference the Bulk Sample Analysis
Reports.
Non-Asbestos Materials
The following materials were tested at the time of this inspection report and shown to be negative for
asbestos content:
• Sheetrock
• Blown-In Insulation
• Roofing
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 i.rksure complete
and proper removal of all asbestos materials.
Norwich Laboratories,Inc. -62 Main Street-P.U.Box 72-Hatfield, MA 01038 2
Pere-Renovation Asbestos Survey- 195 Westhampton Road,Northampton,MA -
Introduction
The following pre-renovation asbestos survey was conducted on July 22, 2004, at 195 Westhampton
Road,Northampton, ILIA, 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 demolition.
The building inspection was conducted following AHEItA protocol, and samples were collected of
materials deemed suspect for asbestos content by the licensed inspector. Bulk samples were then
shipped to EMSL Analytical Laboratories, Inc., where they were analyzed via polarized light
microscopy.
Building Description
The building is a small ranch style house, which is scheduled for demolition. Most of the interior has
been gutted to the bare studs, but some of the sheetrock remains. The basement has bare heating ducts
for forced hot air heat. The floors are bare wood throughout.
Sampling
Samples were collected by our licensed asbestos inspector using the EPA sampling protocol. The
inspector collected bulk samples from the following types of suspect building materials: sheetrock,
blomm-in insulation and roofing material
Norwich Laboratories,Inc. -62 Main Street-P.U.Box 72-Hatfield,MA 01038 i
,
Norwich Laboratories, Inc.
62 Main Street,P.O. Box 72
Hatfield, MA 01038
(413)247-3000
Fax; (413)247-0016
Pre-Demolition Asbestos Survey
Of
195 Westhampton Road
Northampton, MA p
AUG - 4 2004
DEPT OF SUIL .a INSPECTIONS
NORTRAMIETON,MA 01060
Prepared By: Norwich Laboratories, Inc.
Licensed Inspector: Nina Inchardi
License #: Al 071.017
Report Date: July 27, 2004
CITY Or NORTHAMPTON, MASSACHUSETTS
DEPAIITM ENT OF PUBLIC WORKS
125 LOCUST STREET
NORTHAMPTON, MA 01060
413-587-1570
FAX 413-587-1576
George Andrikidis,.P.E.
IJirector,City Engineer
May 24, 2004
Anthony Patillo, Building Inspector
Municipal Office Annex
212 Main Street
Northampton, Ma 01060
Dear Mr. Patillo:
The domestic water service to house# 195 Westhampton Road has been physically
disconnected from Northampton's water distribution system. This dwelling has a meter
pit just beyond the city's curb stop and the meter has been removed.
Please contact me if you have any questions.
- ,(2
David Sparks
Superintendent of Water
Cc: George Andrikidis, Director of Public Works
Ned Huntely, Assistant City Engineer
Massachusetts Electric
A National Grid Company
July 27, 2004
Robert Crafts
109 East St.
Chesterfield, MA 01012
To Whom It May Concern,
This is to verify that Massachusetts Electric has removed the electric service and meter at
195 Westhampton Rd., Meter#0 15 823 027 in Northampton, Massachusetts effective
July 26, 2004, for Building Demolition.
Sincerely,
Jim Nichols
Supervisor
Distribution Design
JN/ep
PO Box 507
Northampton, MA 01061-0507
413.582.7200
........................ ............... .......... ....................................... .................. ........................... ..................................................................................................................................................................
.............. .......................
020 Cty Charge Comp As Ordered 11105102 Poleordy 10121102 100 M2 ORT 11105102 J10 5523 50267 DOO
CP,AFTS,R W 8773100280143773 Video
Services: -Std Cable,+13asic,Trap,+Bwlc
16 Upgrade Service Comp As Ordered 090102 Notruck 10101102 09/21102 EA 09721 102 ZZO 9999 99999 000
CRAFTSJR W 87 731 002 801 43773 Video
Services: +Dg(34d HblSh,-YE
Change Service
pisll-0 Change
I Chsi Sic Notruk
Chsi Upgr Silk To P
Chsi Add OLdft-Sep
kid Chsl+rietwrk
Upgrad Chsi Netwrk
Cdp Charge
-Cdp Add alp
Remove Cdp
Rmove Cdp-Eq*In
..........................................
21
1A 0
02 August 4,2004
Building Commisioner
City Of Northampton
Sir,
I have tried to obtain a letter of disconnect from the phone company Verizon. On all four
occasions I was told that the company does not issue letters such as that.
To that end,I was told that if you needed to verify the status of service at 195
Westhampton Road,you could call(413)-785-0500 and they would be able to assure you
that there is no current active service at that residence. The service for that house was
shut off and disconnected on 22 April 2004.
If yo have any questions please feel free to call me. The number is (413)-563-9903.
Thank you,
Sean M. Hoye
y.
8.1 Licensed.Construction Supervisor: Not Applicable ❑
Hamg of License Holder
License Number
Address Expiration Date
Signature Telephone
Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
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...... ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Six* Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or faun
structures.A person ffho constructs more than one home In a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Officials that he/she shall be
responsible for all suc h work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be.liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zo g Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
:.;
New House Addition Replacement windows Alteration(s) Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition New Signs [O] Decks [0 Siding[CI] Other[CJ
Brief pescri Hon of ProposedL �n ,
Work:
Alteration of existing bedroom Yes No Adding new bedroom_Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
AIR III I � Oil
a, Use of building:One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
L Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank City Sewer Private well City water Supply
�
1.
� �»
as Owner of the subject
property
hereby authorize
to act on my behalf,' a I matters relative to work auth rized by this building permit application.
Sig ature of OvKer JT Date
1,-- aars J_ , as Owner/Authorized
Agent hereby declare that the statem nts and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed uunrdder the pains and penalties of perjury.
Print� -t t �!
Signature of Owner/Agent v Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size 15 SJC
Frontage
Setbacks Front ,
Side L: R ( 0 L:_ R•
Rya 0
Building Height t
Bldg.Square Footage olDal % 31;10
Open Space Footage %
(Lot area minus bldg&paved ��� (� .3 t t 0 3 i a-
#of Parking Spaces `
Fill: �
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO__ DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO , _ DONT 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. AWhere any proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
r i of Northampton
! l Q v II 'Iding Department
t— 12 Main Street
G _ 4 2004 Room 100
Nort mpton, MA 01060
! 13-5 7-1240 Fax 413-587-1272
_..—--- APPMATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
1.1 Property Address: 0157
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21 Owner of RecoM: `
i0me(Print) Current Mailing Address:
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2.2 Authorized gent:
Name(Print) Current Mailing Address:
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Signature Telephone
Item Estimated Cost(Dollars)to be drat )
completed by ermit applicant
1. Building
f
2. Electricaly �i (
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4
3. Plumbing � F "
4. Mechanical(HVAC)
5. Fire Protection
6. Total=0 +2+3+4+5) 0 —
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File#BP-2005-0148 /Y4
APPLICANT/CONTACT PERSON CRAFTS ROBERT W
ADDRESS/PHONE 109 EAST ST WILLIAMSBURG (413)296-0134 Q
PROPERTY LOCATION 195 WESTHAMPTON RD
MAP 36 PARCEL 086 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: DEMOLISH SFH
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure -
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO 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 mmission
0 10
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.
195 WESTHAMPTON RD BP-2005-0148
GIs#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:,36-086 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-2005-0148
Project# ]S-2005-0162
Est. Cost:
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sg.ft.): 41599.80 Owner: CRAFTS ROBERT W
Zoning: SR Applicant: CRAFTS ROBERT W
AT. 195 WESTHAMPTON RD
Applicant Address: Phone: Insurance:
109 EAST ST (413) 563-9903 ()
CHESTERFIELDMA01012 ISSUED ON.9/30/04 0.00:00
TO PERFORM THE FOLLOWING WORK.-DEMOLISH SFH
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• Receipt No: Date Paid: Check No: Amount:
Building 9/30/04 0:00:00 2710 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo