38-050 (15) BP-2003-0622
GIs 11#: COMMONWEALTH OF MASSACHUSETTS
=° CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0622
Project# JS-2003-1024
Est. Cost: $20000.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Associated Building Wreckers Inc 019428
Lot Size(sa. ft.): 226512.00 Owner: NORTHAMPTON STATE HOSPITAL
Zoning: PV Applicant• Associated Building Wreckers Inc
AT. BLDG #19 - 10 CHAPEL ST
Applicant Address: Phone: Insurance:
P O Box 2851 (413) 732-3179 Workers
Compensation
SPRINGFIELDMA01101 ISSUED ON:2/3/03 0:00:00
TO PERFORM THE FOLLOWING WORK.-DEMOLISH 360 SQ FT BLDG
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 2/3/03 0:00:00 11817 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2003-0622
APPLICANT/CONTACT PERSON Associated Building Wreckers Inc
ADDRESS/PHONE P O Box 2851 (413)732-3179
PROPERTY LOCATION BLDG#19- 10 CHAPEL ST
MAP 38 PARCEL 050 001 ZONE PV
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
T_ypeof Construction: DEMOLISH 360 SQ FT BLDG
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 019428
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 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.
Versionl.7 Commercial Building Permit May 15,2000Y e
,City of Northampton
r Building Department
212 Main Street
Room 100
,= Northari pton, MA 01060
p�hbn`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
R S Llk y '
1.1 Property Address:
NA&V 2L/ /0 011 1-51 P
G7�h� fr�lrlc , VA
k ,
., � a
2.1 Owner of Record:
Dirtl� 07 4) &112J ll�yd? st 04 4/4
Name(Print) Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
4,--O XiAcM�6111Mi�1
Name(Print) Current Mailing A ess:
arm- /yw/vVk1
Signature Telephone
mg
Item (Dollars) x
Estimated Cost Dollars to be
completed by permit applicant
1. Building
2. Electrical "
3. Plumbing
3 �y
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 +4 + 5)
Version 1.7 Commercial Building Permit May 15,2000
--f
a s
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑
Exterior Alterations Demolition New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building[ ] Repairs [ ]
Rg
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ lA ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
1 Institutional ❑ 1-1 ❑ 1.2 ❑ 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:
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION
Floor Area per Floor(sf) 1st
1st 2nd
2nd 3rd
3rd 4th
4th
Total Area(sf) U G' Total Proposed New Construction (sf) Ell
Total Height(ft)
Total Height ft -------------------.
Versionl.7 Commercial Building Permit May 15,2000
7. Water S pply(M.G.L. c.40, §54) 7.1 Flood Zone Information: 7.3 Sewage sposal System:
Public Private ❑ Zone: Outside Flood Zone ❑ Municipal On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage )j„(, %
Open Space Footage lXU %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Findin 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 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_
No
IF YES, describe size, type and location:
Version 1.7 Commercial Building Permit May 15,2000
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
`�"�� "'�' "'""" W�� G• Not Applicable
Company Name:
z Ajbul�L �c�ific�
Responsible In Charge ofGowAFwetien
,W N
ai-J) ,� � D l l D5
Address Uv
Sig ture Telephone
Versionl.7 Commercial Building Permit May 15,2000
t
Independent Structural Engineering Structural Peer Review Required Yes......❑ No......
N'`'` auaml& as Owner of the subject property
hereby authorize At6ocIA'd (1j to act on
my behalf, in all matters relative to work authofized by this building permit application.
Signature of Owner Date
I, A15 CY It e(r/i�C�i llli�J� �l�L((;/55 Inc.
as Owner/Authorized Agent
hereby declare that the statement-9 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.
z(int
Print Name
Jau
Slinature of Owner/Agent Date
MEMMEMEMEM -
101 Licensed Construction
�Supervisor:
n� Not Applicable ❑
Name of License Holder ; wf' L /�I.tJ U/►i�1� ��q �9
License Number
AMoll)� .�'.�� S�/'I�l��l�lGl �lA U/l�i�� 9Ay QM)
Address �—'�—� Expiration Date
Sign re Telephone
7, x
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...... 0
A (MMM
A:CQRD. 'CERTIFICATE OF LIABILITY INSURANCE
DA
1 10TE/16/200WM2
PRODUCER Serial# 83521 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION
NORTHOATE INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P 0 BOX 3182 HOLDr=pR, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
SPRINGFIELD, MA 01101-3182
ALTER THE COVERAGE&FFORDED BY THE POLICIES BELOW.-
INSURERS AFFORDING COVERAGE
INSUREDASSOCIATED BUGRANITE -�9
BUILDING WRECKERS,INC. �_rNsunRx STATENSURAN _C_o _
352 ALBANY STREET INSURER 0:
SPRINGFIELD,MA 01105 INSURER C:
INSURER D:
ATTN:JOANIE SAVAGE INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES CIRSCRISEO HEREIN IS SUNJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIU.AGGREGATE LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Iff7—TYPE OF INSURANCE i POWCYNUMBAR IM 0 POLI
A EXP
mm ron umrm
GENERAL LL4B1UTY EACH OCCURRENCE IS
COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE(Any&V rwo)
CLAIMS MADE ED OCCUR MED EXP(Any W*permn)
PERSONAL&ADV INJURY is
GENERALAwREGATF-
719EN'L AGGRj;ATf 11MITAPPLIES PER!
—1 pRo- [7 Loc PRODUCTS-COMPiOP AGI3 S
POLCY I IJSCT
AUTOMOBILE LIABILITY" COMBINED SINGLE LIMIT
ANY AUTO (Ea=Went)
ALL OWNED AUTOS
BCOILY INJURY
SCHEDULEDAUTOS (Parpomon)
HIRED AUTOS
BODILY INJURY
1 NON-OWNED AUTOS i(P&aoddent)
PPR;Z
DAMAGE
GARAGE LIABILITYAUTO ONLY.EAAOCIOENT S
_I ANYAUTQ
OTHERTHAN EAACC S
AM ONLY,
AGG
JJE�XRSS UAVIIUTY EACH OCCURRENCr
OCCUR CLAIMS MADE AGGREGATE
-7
DEDUCTIBLE J $
77 RETENTION
1
WORKERS COMPENSATION AND X �TORY
& I
RY LA
AIETS
A I EMPLOYERS'LIABILITY 6257083 211102 2/1/03 E.L.EACH ACCIDENT 1,000,000
F-L CISRASE-EA EMPLOYE S 1,000,000
Ass-POLICY LIMIT 9 1,000,000
OTHER
iDESCRIPTION OFOPEPA-nDNWLOCATIONWVr-#OCLES/EXCLUSIONSADDED IBYENVORSELt2N7'MPECALPROM[cm
JJOB, NORTHAMPTON STATE HOSPITAL SOUTH CAMPUS BUILDING#19,20,21,24&25 CHAPEL STREET NORTHAMPTON,
jMASSACFIUSETTS
i
FAX TO 413-7214-6224
CERTIFICATE HOLDER
1 ADDITIOhAl.11V48IJRFD;INSUMM L.ET?9p_ CANCELLATION
MASS DEVELOPMENT SHOULD ANY OF THE ABOVE DESCRIBED POtjCIjM gE CANCELLED BEFORE THE ZXPIkATION
DATE THEREOF,THE ISUING IN$URER WILL ENDEAVOR To MAIL 10 g)Ayswmrm
43 BUENA VISTA STREET
DEVENS,MASSACHUSETTS 01432 NOTICE TO THE CA"IFICAT2 HOLDER N"ED TO THE LEPt,BUT FAILURE TO CO SO SHALL
IMPOSE NO ORUGATION OR LIABILITY OF ANY'ONO UPM THE INSURER,ITS AGENTS OR
—REPPESENTATIVM
AVTHoF=WREBWTAjM
ACORD 25-$(7/97) Q ACORD CORPORATION 1588
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon.
ACORD25-S(7/97)2 of 2 #M14753
MAssDEVELOPMENT
September 24, 2002
Devens
43 Buena Vista Street Andrew Mlrkln, Principal
Devens,Mas_achusetts Associated Building Wreckers
0437 352 Albany Street
Tei 978-772-6340 Springfield, MA 01105
Fax 978-772-7577
m v/cevenscertei:coro
Main Office:
Dear Mr. Mirkin,
75 Federal Street
Boston Massachusetts This letter is to inform you that MassDevelopment has voted to award the contract for the
C2110 Demolition of the Residential Structures in the South Campus to Associated Building
Tel,617-330-2000 Wreckers. Contracts for this project are currently in the mail for your execution. Please
800-445-8030 execute the contracts and provide a Payment Bond, Performance Bond and the proper
Fax:617-330 7001 insurance certificates in accordance with the contract documents. We will be notifying
v✓rrw.massdevelopertmm
you of a pre-construction meeting to be held at the site.
We look forward to another successful project with your firm.
Yours truly,
Alan M. Delaney
Manager of Engineering
eo,etnnr Cc: Larry Vincent, Clerk of the Works
RoBts 3,31L, Rosalind Whitney, Contracts Administrator
enen,r
Me Hoy,
F e,se,,:-CEO
.SEC-1.1-02 IdED 13; 16 Bay State Gas (Spf io) FAX N0. 413 739 5272 P, 01
BaY StateGae
-�
A NfSource Company
December 11, 2002
Associated Building
252 Albany St
Springfield, Ma
01101
Dear Associated,
The address listed below has had the gas service(s)
disconnected and is now ready for demolition.
ADDRESS : ( SEE BACK)
TOWN , Town
STATE : Massachusetts
Sincerely,
*�Ck
Jeffrey D. Mannheim
Maintenance Administrator
2025 Roosevelt4,venue P.�. 8Ux2C25 Spnngfie,d. Iv1A01102-2025 413-731-g2(jo "81 9?2�
.DEC,-"1-02 WED 13: 16 Bay State Gas (SPfId) FAX NO, 413 739 b2-2
Building #19, 10 Chapel St
Building #20, 16 Chapel St
Building #21, 24 Grove St
Building #24, 219 Earle St
Building #25, Rear of 219 Earle St
Massachusetts Electric
A National Grid Company
December 19, 2002
Attn: Johanma Savage
Associated Building Wreckers, Inc.
352 Albany Street
Springfield, MA 01105
Dear Ms. Savage.
This is to verify that Massachusetts Electric Company removed the electric service at the
following locations:
JNorthampton State Hospital, Building# 19 10
F $ Chapel Street
Northampton State Hospital, Building#20, 16 Chapel Street
Northampton State Hospital, Building#21, 24 Chapel Street
Northampton State Hospital, Building#24, 219 Earle Street
Northampton State Hospital, Building#25, Rear of 219 Earle Street
in Northampton, Massachusetts effective December 19, 2002 for building demolition.
ely,
zm Ic ols
r Supe sor
Dis ution Design
jNfjI
PO Box 507
NorthamDton,MA,01061-0507
413.582.7200
** TOTAL �AGE . 01
10/22/2002 14:00 41:�b8bb,13J AI I 6HUADBANU
UL,L Z-4ty
352-AMMlb Strect,P.O. Box 2851
Springficld,Telassachuscus 01101-2851
Tel: (4-13) '1324179/(800)448-2822
Fax:(413)' 34-6224
DATE: October 16, 2002
TO: DAVE HINC11EY PAX # 413-569-6625
OF: AT&T BROADBAND I FHONFE # 413-562-9923 X286
FIZASE CUT ALL SERVICES AT THE LOCATION OF #15 kHAPEL ST.,
NORTHAMPTON,MA,AS IT IS BEING SCHEDULED FOR DEMOLITION.
ONCE DISCONNECrION HAS BEE'IS COMPLETED,YOU MAY EITHER SIGN
BELOW AND FAX IT TO N2 AT 41 -734-6224 OR YOU MAY FAX Mt
NOTIFICATION ON YOUR COA4PA.'qY LrMRHEAD.
THANK YOU VERY MUCH POR XO `R ASSISTANCE.
SINCERELY,
ASSOCIATED BUILDING WRECKER, INC.
JOANIE SAVAGE
DEMOLITION COORDINATOR
SERVICES AT; #19 CHAPEL ST., NORTHAMPTON, MIA
HAVE BEEN DISCONNECTED AS 01'
PRINT NAAU. SIGNATURE.
REMARKS, IF AMS,
J.0 1w k.0 4 � -. --r -1 - ---- I - I -
H��U- BLLb WRECKEPS Fax:413-734-6224 Nov 6 20021 09:35 P.01
352 Albany Street,P.O. Box 2851
Springfield,Massachusetts 01101-2851
Tel; (+13)732-3179/(800)448-2822
Fm (413) 734-6224
DATE: November 6, 2002
TO; CHARLIE FAX # 413-387-1576
OF: WATER DEPT. FHONE9 413-587-1098
PLEASE CUT ALL SERVICES AT THE LOCATION OF BUILDTNG #192 10 CHAPEL
STREET,NORTHAMPTON,MASSACHUSETTS,AS IT IS BEING SCHEDULED FOR
DEMOLITION.
ONCE DISCONNECTION HAS BEEN COMPLETED, YOU MAY EITHER SIGN
BELOW AND FAX IT TO ME AT 413-734-6224 OR YOU MAY FAX ME
N071171CATION ON YOUR COMPANY LETTERHEAD,
THANK YOU VERY MUCH FOR YOUR ASSISTANCE.
SINCERELY,
ASSOCIATED BUILDING WRECKERS, INC.
JOANIE SAVAGE
DEMOLITION COORDINATOR
SERVICES AT: BUILDING #19, 10 CHAPEL STREET, NORTHAMPTON, MA
I IAVE BEEN DISCONNECTED AS OF 0
Xe-Ltf--S
PR1N7NAME:=(,.. �,,S �,--SIGNATU
RL MIARKS,IF ANY: 7;LS
Ll I A 7—
Jul r-)
Tighe&Bond
• Consulting Engineers
Environmental Specialists
W-3280-7-02
January 29, 2003
Mr. Larry Vincent
MassDevelopment
Northampton State Hospital
Northampton, MA
Re: Asbestos Abatement at the
Residential Structures, Northampton
State Hospital
Dear Mr. Vincent:
Tighe & Bond the final ;tement inspection and confirmatic .; for removal of
.:al listed asbestos containinb Iiratenals (ACM) and hazardous materials at the Residential
Structures, Northampton State Hospital. Buildings 19, 19G, 20, 21, 21G and 25 have been
inspected and cleared of all asbestos and hazardous materials that were listed to be removed prior
to demolition. Buildings 19, 20, and 21 have roofing systems that contain asbestos and will be
removed during demolition activities. Building 24 still contains asbestos containing materials and
is to be demolished under the attached exemption from the Massachusetts Department of
Environmental Protection.
Engineering controls shall be implemented and consist of constant water use during all facets of
demolition, demarcation of the work area in accordance with OSHA regulations, collection and
polarized light microscopy (PLM) analysis of upwind/downwind perimeter air samples and
fulltime presence of a licensed asbestos monitor during all potential asbestos impact work. Once
the basement area is deemed safe, the licensed contractor shall perform abatement via glove bag
methods and the use of negative air. The area will be visibly inspected to confirm that the
Contractor has achieved a level of no visible debris. Upon acceptance of visual inspection, the
remainder of the structure will be razed.
Within all buildings listed, contractor was required to investigate, locate and abate all TSI within
confines of the building interior. If any TSI is encountered during demolition activities, the
contractor is required to stop work and remove any TSI and associated contaminated demolition
debris as ACM in accordance with applicable regulations.
324 Grove Street Worcester, MA 01605 Tel. 508-754-2201 Fax. 508-795-1087
Main Office: Westfield, MA Tel. 4.13-562-1600 Fax. 413-562-5317
Original printed on recycled paper.
Consulting Engineers
Environmental Specialists
If any questions or comments arise please contact the undersigned at 508-754-2201, ext 123, with
any questions.
r
Very truly yours,
TIGHE & BOND, INC.
Daniel J. Dragon
Environmental Scientist
J:\W\W-3280\RESIDENTIAL\CLEARANCE LETTER.DOC
Copy: Gordon Bailey, State Building Inspector
Anthony Patillo, Building Commissioner
Alan Delaney, Engineering Manager
- 2 -
Original printed an recycled paper.