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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.