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38B-073 (7) Asbestos Survey December 27,2005 30 Cambridge St-, Springfield,MA Page 3 Although not currently regulated by MA DOS or MA DEP, removal of the Window Glazing- may produce fiber levels above the Occupational Safety and Health Administration (OSHA) Permissible exposure limits(PEL's). For this reason, OSHA has mandated the following minimal requirements when materials containing less than one-percent asbestos are disturbed: 1. the use of wet methods 2. prompt clean-up and disposal of waste and debris contaminated with asbestos in leak tight containers 3. record keeping requirements associated with negative exposure assessment These requirements apply as long as the OSHA PEL is exceeded or might be exceeded. If this document is to be used for the purpose of obtaining bids from asbestos abatement contractors, ATC recommends that such bids be based on the contractor's own verification of quantities, conditions, locations, and scope of work described. If you have any questions, please feel free to call me at(413) 781-0070. Sincerely, ATC Associates Inc. )P5�74-5\ __A� Douglas Montminy MA Licensed inspector AI073770 A am Lesko Operations Manager Enclosures S:\Traditional\00 All Client Files\City of Springfield\Demo.Project\Completed reports\30 Cambridge St.doc to it beautification project in the City of Waltham; provided further, that not less than $150,000 shall be expended for renovations to Hayes Stadium in the town of North Andover; provided further, that not less than $1,000,000 shall be expended for improvements to Houghton's Pond athletic fields; prcvided further, that not less than $2,000,000 shall be expended for capital improvements to the Trailside Museum; provided further, that not less than $1,000,000 shall be expended on rehabilitation to Palmer's Island Lighthouse .. ........ ........... . . . . . $220,950,000 2840-7017 For the design, construction, reconstruction, repair, improvement or rehabilitation of flood control facilities and water resource protection related facilities of the department, including its various pump stations and structures; provided, that $180,000 shall be provided for the :installation of a biofilter system at the Woodland Street Pump Station in the town of West Boylston ............ .............................. .... $30,000,000 Division of Energy Resources 9300-7010 For the Leading by Example Program, so-called, to reduce greenhouse gas emissions and other environmental impacts at state agencies, authorities, and public colleges and universities; to stimulate increased public and private sector investment in clean energy and related enterprises, institutions, and projects in the Commonwealth, including providing economic assistance for the development of these enterprises and non- financial assistance ......... . . ..... ... ........ .. . ..... $2,500,000 9300-7909 For the energy conservation improvement program under section 11 of chapter 25A of the General Laws; provided, that funds in this item shall be allocated from time to time by the commissioner of energy resources for the purposes of the energy audit program, the energy conservation improvement program, and the alternative energy property program, and for other programs that increase energy efficiency and the deployment of renewable resources at public facilities; provided further, that when expending these funds, the commissioner shall take into consideration, among other relevant factors, the amount of available state and federal financial resources, the needs of each program with respect to public buildings and facilities, the volume of requests or expected requests from other entities for assistance under each program, the expected costs and public benefits of each program and, after information has become available from the energy audit program, the priorities and needs indicated by that information; provided further, that funds shall be expended on the buildings and facilities owned by public entities; and provided further, that grants may be issued for the purposes of this item ............ .. . . .. $13,250,000 MASSACHUSETTS DEPARTMENT OF EDUCATION University of Massachusetts Amherst 7100-0299 For the state geologist, provided, that funds from this item may be allocated for the purposes of leveraging additional federal funds to support bedrock, fracture, and geologic surface mapping, natural hazards mapping, and subsurface data preservation in support of the commonwealth's interest in gathering and disseminating geologic information; provided that funds from this item may also be used to support the dissemination of geologic information in digital form .. .. ............... $2,500,000 SECTION 2B. To provide for a statewide program of improvement and preservation of the transportation assets of the commonwealth owned, managed, and maintained by the department of conservation and recreation, the sums set forth in section 2C, for the several purposes and subject to the conditions specified in that section, are hereby made available, subject to the laws regulating the disbursement of public funds, which sums are in addition to amounts previously appropriated for these purposes. SECTION 2C. EXECUTIVE OFFICE OF ENERGY AND ENVIRONMENTAL AFFAIRS Department of Conservation and Recreation 2890-7010 For the design, construction, reconstruction, repair, improvement, or rehabilitation of department of conservation and recreation parkways, boulevards, bridges and related appurtenances and equipment including, but not limited to, the costs of engineering and other services for those projects rendered by department of conservation and recreation employees or by consultants; provided, that funds may be expended for 26 Lk -7 Of 1 Electrical Service Disconnect Notice Reg: Barn Demolition at 227 South St., Northampton, MA To whom it may concern, This letter serves as notification that the electrical service to the barn slated for demolition behind the Northampton Veterinary Clinic has been disconnected; on this day 61 in the month of 20 t � by onnj nam signed DEL - r 2015 signature I I DF 7,77 3 Name and address of Electrical Contractor: ,r~ r Phone: v DEMOLITION REVIEW APPLICATION Activity Tracking Sheet Property: 227 South Street Barn Map: 38B Parcel: 073 Year Built: 1900 Address: 227 South Street Received in Building Department: October 19, 2015 Referred from Building Department: October 27, 2015 Action Taken/ Northampton Historical Commission Action Taken Bv: X Entire Commission Sub-Committee of the Commission Commission Designee/ Staff Date Action Taken: November 11, 2015 Initial Determination Public Meeting held November 30, 2015 Public Hearing Held Determination Made: _X_ Alternate plan has been approved/ delay terminated. Demolition may or may not be approved as part of plan The Commission found unanimously that the barn meets the requirements of the Demolition Ordinance for qualification as Preferably Preserved, but approved an alternate plan to include demolition, with the following conditions: Prior to demolition, photographic documentation, including a sketch plan of the barn to be provided to the Commission The barn shall be architecturally salvaged, and as many portions as possible re-used Following demolition, the cupola shall remain at 227 South Street. The applicant and property owner must consult with the Commission if the cupola is proposed to be removed from the premises. Referred by: Sarah LaValley Date: December 1, 2015 DEMOLITION REVIEW APPLICATION Activity Tracking Sheet Property: 227 South Street Barn Map: 38B Parcel: 073 Year Built: 1900 Address: 227 South Street Received in Building Department: October 19, 2015 Referred from Building Department: October 27, 2015 Action Taken/ Northampton Historical Commission Action Taken Bv: _X_ Entire Commission Sub-Committee of the Commission Commission Designee/ Staff Date Action Taken: November 11, 2015 Initial Determination Public Meeting held November 30, 2015 Public Hearing Held Determination Made: _X_ Alternate plan has been approved/ delay terminated. Demolition may or may not be approved as part of plan The Commission found unanimously that the barn meets the requirements of the Demolition Ordinance for qualification as Preferably Preserved, but approved an alternate plan to include demolition, with the following conditions: Prior to demolition, photographic documentation, including a sketch plan of the barn to be provided to the Commission The barn shall be architecturally salvaged, and as many portions as possible re-used Following demolition, the cupola shall remain at 227 South Street. The applicant and property owner must consult with the Commission if the cupola is proposed to be removed from the premises. Referred by: Sarah LaValley Date: December 1, 2015 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work- :�-2-7 �5+ , N4 0 V�A& Vt -1 The debris will be transported by: &-'%cS The debris will be received by: \ley P-G4 -cyc("� 'F Building permit number- Name of Permit Applicant cw sc Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 °4 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information (� Please()Print Lep-ibly Name (Business/Organization/Individual): o(3-0 `cl &14,1'c:, CQ k5 to, ( � �t-�c C, 't �GG.�, '6� G��'► Address: `� 5 U QJ City/State/Zip: l o;-t, t�-t V� C> C)G z Phone#: 1 9 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 4. ® I am a general contractor and 1 6. New construction employees (full and/or part-time).* have hired the sub-contractors 2 am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling Fship and have no employees These sub-contractors have g. Wernolition working for me in any capacity. employees and have workers' 9 ®Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ® We are a corporation and its 10.®Electrical repairs or additions 3.® 1 am a homeowner doing all work officers have exercised their 11.®Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.® Roof repairs insurance required.] fi c. 152, §1(4),and we have no employees. [No workers' 13.®Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f 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 whethor 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: Policy#or Self--ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 for insurance coverage verification. I do hereby certibfi,,under the pai. andpenalties ofperjury thatthe information provided above is true andcorrect. Si ature: Date: 1 [ 1 S Phone#: 1 76 O i 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#: SECTIONS-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: �Ct o� tx eS C'S�rT - 0�i 3 L 7 License Number Address Expiration Date Signature Telephone 9.Reciistered Home Improvement Contractor: Not Applicable ❑ 6 C. CG4NSv Company Name Registration Number -)SS a lc.-, 0, 0l®G'21 lZ t10 t Address Expiration Date Telephone u t3..ci9 2 -A i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition New Signs [p] Decks [M Siding(A] Other[Q Brief Description of Proposed r�JJ Work: ,P ��© irk %cl C C- nr ,silo Alteration of existing bedroom Yes V No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: 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 i. 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 SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I r as Owner of the subject property hereby authorize Z 4Q: c� `� s�, cS�I b l \ �`�c z. C C Ct, �CC- � � ►��c�."�� to t on my behalf, in all matters relative to work authorized by this building permit application. c;�' Si ature of Owner Date V 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. �)0<J , C� G, C; Print Naml� (lei Signature of Owner/Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by'Zoning This column to he filled in by Building Department Lot Size Frontage e Setbacks Front Side L: R: L: R: Rear Building Ileight Bldg. Square Footage `'lo Open Space Footage °o (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 O DON'T KNOW �S YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW P YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: Z y r FX4 u-'\t.v 5; ctcn &Y, rc"n C,L:.. D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 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? YEE O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only 9 , _ 1, City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/SeplicAvailability OCT Room 100 VdaterNVeli Rvailability, orthampton, MA 01060 Two Sets of Structural Plans 3-587-1240 Fax 413-587-1272 Plot/Site Plans 1 Other Specify` APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address. This section to be completed by office Map Lot Unit * Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: C)eAvxer c urn Si- ty7o IC F '" { �►'� Cpl e Prin� Current Mailing Address: Telephone Signature 2.2 Authorized Agent: CL� r i4 Name(Print) Current Mailing Address: " X13 -`t Z — 7(zC6 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building Zv I vk (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 Building ermit Number: Date g Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2016-0523 d{Ze APPLICANT/CONTACT PERSON DAVID GIESE ADDRESS/PHONE 755 WESTHAMPTON RD FLORENCE01062(413)992-7609 Q J PROPERTY LOCATION 227 SOUTH ST MAP 38B PARCEL 073 001 ZONE URB(100) 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 BARN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 093679 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: proved Additional permits required(see below) `7 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 mo 'tion Delay /,^ Signature of Buildmg 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. 227 SOUTH ST BP-2016-0523 GIS r1+: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B -073 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate,,ory: demolition BUILDING PERMIT Permit# BP-2016-0523 Project# JS-2016-000874 Est. Cost: Fee: $30.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVID GIESE 093679 l.ot size(sq. ft.): 23217.48 Owner: NORTHAMPTON VETERINARY CLINIC REAL ESTATE TRUST LLC Zonin,,,: URB(100)/ Applicant: DAVID GIESE AT. 227 SOUTH ST Applicant Address: Phone: Insurance: 755 WESTHAMPTON RD (413) 992-7609 O FLORENCEMA01062 ISSUED ON:121912015 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMOLISH BARN 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: Mlildin2 12/9/2015 0:00:00 $30.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner