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38-050 (16) BP-2003-0620 GIs#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-0620 Proiect# JS-2003-1022 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(sq ft.): 226512.00 Owner: NORTHAMPTON STATE HOSPITAL Zoning: PV Applicant: Associated Building Wreckers Inc AT. Blda #21 - 24 GROVE 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:D E M O L I S H 1,152 SQ FT B L DG 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 Sisnature: 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-2003-0620 APPLICANT/CONTACT PERSON Associated Building Wreckers Inc ADDRESS/PHONE P O Box 2851 (413)732-3179 PROPERTY LOCATION Bldg#21 -24 GROVE 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 Building Permit Filled out Fee Paid 7 777 1 Typeof Construction: DEMOLISH 1 152 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 ommission O 0,3 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 15,2000 y�QQJ City of Northampton 'Building Department 212 Main Street Room 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 1.'1 Prooertv Address:�(�f��plj'���G�',f✓ �V, klo SIA 3. 2.1 Owner of Record: lGldssc�hCi. ' SICU /�m�r � ixy �3 lei U f�-�` V4 Name(Print) Current Mailing Address: 9 is- Signature Telephone 2.2 Authorized Agent: �s�c�� ,moi%/ ��✓r.�C'f�,��'Vic. �.�lfi�xy�xi�.���ir��t�/G� �� G�lll��" Name(Print) Current Mailing Ad r ss: 40- _N4) _N 5 ature Telephone Item Estimated Cost(Dollars)to be completed by permit applicant 1. Building 2. Electrical 3. Plumbing 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 +3 +4 + 5) G'G' Q 10 �►ll, z Version 1.7 Commercial Building Permit May 15,2000 sl �l y uCi �� rticliS , �����rs I.�S 1"HAN a Y Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ Exterior Alterations Demolition New Signs [ ] Change of Use [ ] Other [ ] ❑ Accessory Building[ ] Repairs [ ] 5E0` QN 5» USI: 0,10-A i� +a� UC IQ TrY I USE GROUP(Check as applicable) CONSTRUCTION TYPE A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ lA ❑ A-4 ❑ A-5 ❑ 113 ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ Institutional ❑ 1-1 ❑ 1.2 ❑ 1.3 ❑ 313 ❑ 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: Oh+l ! llI Ial�l 1 � "f 1N�1UIC3i �I RE1 �To # N Aflf(3I � NO I Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): it BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION Floor Area per Floor(sf) 1st 2nd 1st 3 2nd rd 3rd 4th 4th Total Area(sf) ,� �T Total Proposed New Construction (sf) Total Height(ft) Total Height ft ----- ------------- Version 1.7 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: 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 �)f � % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Perm it/Varia nce/Findin YE ever been issued for/on the site? v NO DON'T KNOW S IF YES, date issued: IF YES: Was the permit recorded at the Regi ry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document# r B. Does the site contain a brook, body of water o 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 SC'I'lE, p„ ' ' J f ANt T# El �AtNt� � �� �`3TO �1 �cc�"'AO 9.1 Registered Architect: Not Applicable Uf 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` /� ,,/ 'n A55c ficI A ���g �`f'r�� ��5-�'!G Not Applicable Company Name: Af�.e Vlllfl/ Responsible In Charge of Construction A 5AA71Q VA Address T 'i� -� - 79 Si ature Telephone Versionl.7 Commercial Building Permit May 15,2000 SCfi1�N10 SIUC.TUFALF� 'i1W{780C1�1 110,10 Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ 12()�WLY' I'� T�4Ci� WHEN aW,NEI � IC `QF 4 3 � IiIiJIL7, /t as Owner of the subject property hereby authorize ASSJcIC)M(1 A11V1`0 fff ftit) fix. to act on my behalf, in all matters relative to work authoriiAd by this building permit application. Signature of Owner Date I, /---)5 JCICa/. d filldlnd ffl-ff "fin IC. as Owner/Authorized Agent hereby declare that the statem is 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. Print Name ` i nature of Owner/Agent Date SCl +l + � 401, 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone ,11 did W 4Mp -r ,. �. 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 4f the building permit. Signed Affidavit Attached Yes....... No...... 0 DATE MMWrn CERTIFICATE OF LIABILITY INSURANCE _7 1011[M6/2002 PRODUCER Serial# 83521THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION NORTHGATE INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P 0 BOX 3182 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW SPRINGFIELD, MA 01101.3182 INSURERS AFFORDING COVERAGE INSURED ASSOCIATED BUILDING WRECKERS,INC. INSURER A; GRANITE STATE INSURANCE CO, 352 ALBANY STREET INSURER B. — — SPRINGFIELD,MA 01105 INSURERC: INSURER 0: ATT tj:j0ANIE SAVAGE-- INSURER E_ COVERAGES THE PCILJCI ES 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDrrION$OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSW DTQY EX—PIRAT06 T. TypECIFINSURANCE POUCY NUMBER ?MM 1-411 DATE fMMIbDrffI Ljmrrs FACH OCCURRENCE is GENERAL LIABILITY COMMERCIAL GENERAL f."ILITY i FIRE DAMAGE(Pray orae rov) $ CLAIMS MADE ED OCCUR MED E%P(Any me person} I PERSONAL&ADV INJURY GIENEIRALAGGRErsm- 3 7WN'L AGGREGATE LIMIT APPLIES PER! 1PRooucTs.c I ompiop Ago s CT- LOC POLICY F�jppoJE ALrrOMOINLK UmUITY COMBINED SINGLE LIMIT (Es=Went) ANY AUTO ALL OWNED AUTOS BO?!LY INJURY SCHEDULED AUTOS 7 HIRED AUTOS 9001LY,INJURY NON-OYMED AUTOS ,Per=deep P:P .&RTY DAMAGE GARAGE LIABILITYAUTO ONLY.FAACCIDENT I ANY AUTOEAACC I -OONLY'. 'N . { AUTO� AGG s TEXCW UA9I1UTY P EACH OCCURRENCE s OCCUR CLAIMS MADE AGGREGATE 9 —7DF.OUOTI8I E RETENTION $ QTH-j WORXERS COMPENSATION AND ER EMPLOYERS'LIABILITY '6257083 211 E.L.EACH ACCIDENT A 102 211/03 1 i 1.000,000 EL DISEASE-EA EMPLOYEE S 1.000,000 E.L.DISEASE-POLICY LIMI;'7s 1,000,000 OTHER DESCRIPTION OF 0".PATIDMVLOUTIONWVr.FQCLASWEXCLUSIONS ADDU BY&NDORSEMENTNIPECIAL PROVISIONS 1,105. NORTHAMPTON STATE HOSPITAL SOUTH CAMPUS BUILDING#19,20, 21,24 3 25 CHAPEL STREET NORTHAMPTON, EMASSACHUSETTS FAX TO 413-734-6224 CERTIFICATE HOLDER ADDITIZI.INSURED;INSU RUR LETTER. CANCELLATION SHOULD ANY OF rNMASOVE DESCRIBED POLICIES BE CANCELLED BEFM THE EXPIRATION MASS DEVELOPMENT DATE THEREOF,THE ISSUING INSURER MLL IINDFAVOR TO MAIL 10 DAYS WRITTEN 43 BUENA VISTA STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00$0 SHALL DEVENS,MASSACHUSETTS 01432 IMPOSE NO O2UGAnON OR LIABILITY OF ANY KIND UPON THE INWRER,ITS AGENTS OR —ROWSENTATIVES AUTH �NTATIVE ;; ow-01WRES : e ACORD 25-S(7/9'r) Q ACO RD CORPORATION 1988 0 Tit� of 1z DEPARTMENT OF BUILI)WG INSPECTIONS 212 Main Street * Municipal Building Northampton, Mass. 01060 WORKER'S CONVENSATION INSURANCE AFFr.DAVFr with a principal place of business/residence at: (phone-4) (Str=t/City/Stald2ip) do hereby certify, under the pains and penalties of pequry, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expimtion Date) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Conipany/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioctai zbod ifneocnary to include infbrmstion pertaLoing to all ooatmders) I am a sole proprietor and have no one working for me. I am a home owner performing all the work myself. NOTE:pit=be aware that while homeowners who employ perro=to do maintenance,constructioaor repair work on a dwelling of not Moto than three units M which the homeowner resides Or On the grounds appurtenant thereto are not generally oonsiderod to be employers unclear the worker's compers4on.Act(GI.152-ss 1(5)),application by a homeowner for a license or permit May evidence the legal status of an employer under the Workoeg ConVaixtation Act. I understand that a copy of this cutcmeat may be forwarded to the Depaxtacat of Industrial Aocidan&Offloo of Iwxeraooe for the coverage vafficdtoa and that kiture to a==coverage under section 25A of MOL 152 can lad to the ultpOuftOd Of criminal penalties ooqsb6rtg of a fine of up to S1,500.00 md(or�of up to one year and civil penalties in the form of a Stop Work Order and a fine of$100.00 a day against M For depxitmental use only Permit Number M aO Lot# Signature of LicenseJ-Permittee Late MASSDEVELOPMENT September 24, 2002 Devens 43 Buenavlsta street Andrew Mirkin, Principal Devens,Massachusetts Associated Building Wreckers 0142 352 Albany Street Tel.978-772-6340 Springfield, MA 01105 Fax 978-772-7577 www.d even scenter,cow 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 02110 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 617-330-200i insurance certificates in accordance with the contract documents. We will be notifying u",/massdeeelopmentcOl 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 j,r E 5 m, C,vet Cc: Larry Vincent, Clerk of the Works B,a H,7 Bt_, Rosalind Whitney, Contracts Administrator C air mon M., .­o.Hc_,rq, Pres dPrt!eeo DEC-11-02 -WED 13: 16 Bay State Gas (Spfid) FAX N01 413 739 5272 p, 01 t4) Ba y tate Gas A NiSource Company December 11, 2002 Associated Building 252 Albany St Springfield, Ma 01109 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, 1� Jeffrey D. Mannheim Maintenance Administrator 2025 ROOSeveit\VenUe P.0. 209 20,:25 3pw)gfie d MA 01 l,2-2025 413-731-9200 F3X ill3-781 a??, DE.V271 1-021WED 13, 16 Bay State Gas (SPIld) FAX 110, 413 -(39 52-(2 F, U? 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 ARML December 19, 2002 Atte: Johanna 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: Northampton State Hospital, Building# 19, 10 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. CS, . ely, rm Nc ols Supe sor Dis ution Design ]Nfjl PO Box 507 Northampton, MA 01061-0507 413.582,7200 ** TOTAL �AGE . 01 —'10/22/2002 14:00 4135865733 ATT BROADBAND NAUE e4 •---' ---••, •• ,�•••• w, -,iv - vcc-+ V4 1V LUUZ 1L •4r.UJ 352 Alban Sweet,P,O. Box 2851 Springfield, assachuserm 011,01-2851 Tel: (413) 7 2-317'91(800) 448-2822 Fa (413)734-6224 DATE: October 16, 2002 i TO: DAVE HENCHEY FAX # 413-568--6625 OF: AT&T BROADBAND PHONE # 413-56Z-9923 XZ86 PLEASE CUT ALL SERVICES ,AT THE LOCATION OF #21`CHAPEL ST., NORTHAMPTON,MA, AS IT IS BEING SCHEDULED FOR DEMOLITION. ONCE DISCONNECTION HAS BEES COMPLETED,YOU MAY EITHER SIGN BELOW AND FAX IT TO ME AT 413-734-6224 OR YOU MAY FAX AME NOTIFICA'T'ION ON YOUR COMP LETTERHEAD. THANK YOU VERY MUCH FOR YOUR ASSISTANCE. SINCERELY, ASSOCIATED BUMI?ING WRECK7, INC. JOANIE SAVAGE y DEMOLITION COORDINATOR SERVICES AT: #21 CHAPEL ST., NORTHAMPTON,MA HAVE BEEN DISCONNECTED AS OF —&-J-2-6-2 .PRINT NAME: ZSIGNATURE: REMARK IF ANY: j I I k b u e u ZI: e e a Ljrw 'r I ,j ASSOC BLDG WRECKERS Fax*-413-734-6224 Nov 6 2002 09!36 F',04 352 Albany Street,P.O.Box 2851 Springfield,I1Iassachusctti 01101-2851 SO: Tel;(413)732-3179/(800)448-2822 Fax: (413)734-6224 DATE: November 6, 2002 TO: CHARLIE FAX # 413-387-1576 or. WA7TR DEFT, PHONE # 413-587-1098 FLEASE CUT ALL SERVICES AT THE LOCATION OF BUILDING NORTHAM17ON,MASSACHUSETTS,AS IT IS BEII t R 0 DEMOLITION. ONCE DISCONNECTION HAS BEEN COMPLEITD,,YOU MAY EITHER SIGN BELOW AND FAX IT TO ME AT 413-734-6224 OR YOU MAY FAX ME NOTIFICATION ON YOUR COMPANY LETTERHEAD. THANK YOU VERY MUCH FOR YOUR ASSISTANCE. SINCERELY, ASSOCIATED BUILDING WRECKS S,INC. JOANTIE SAVAGE DEMOLITION COORDINATOR SERVICES AT: BUILDING HAVE BEEN DISCONNECTED AS OF (2t —1Z MINT NAME: Rok-0�S —SIGNATU REMARKS.E—AkM- 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 has completed the final post-abatement inspection and confirmation for removal of all listed asbestos containing materials (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 microscope (PLM) analysis of upwind/dowin:ind 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. 413-562-1600 Fax. 413-562-5317 Original printed on recycled paper. t Tighe"' oriQ"" 9 Engineers Consultin • 9 Environmental Specialists If any questions or comments arise please contact the undersigned at 508-754-2201, ext 123, witll any questions. VP Very truly yours, TIGHE & BOND, INC. Daniel J. Dragon Environmental Scientist J:\W\W-3280\RESIDENTIAL\CLEARANCE LETTER.DOC �c Copy: Gordon Bailey, State Building Inspector Anthony Patillo, Building Commissioner Alan Delaney, Engineering Manager - 2 - Original printed on recycled paper.