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18C-182 68 Hatfield Demo 2015-04-01AS5fSScf:,:.fi LA sT AS )i',O File # BP-2015-0882 APPLICANT/CONTACT PERSON L P AUDETTE BUILDERS INC ADDRESSIPHONE 171 LINCOLN ST HOLYOKEOI040 (413) 539-9115·~ PROPERTY LOCATION 68 HATFIELD ST MAP 18C PARCEL 045 001 ZONE URB(IOO)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid TypeofConstruction: DEMOLISH SFH & GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner! Statement or License 021237 3 sets ofPlans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON Tms APPLICATION BASED ON INFORMATION PRESENTED: __Approved t/Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ _________ Intermediate Project: ___S.ite Plan AND/OR ____Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: ,,_________ Findin.c;o.g_____ Special Permit _______ Variance*____ __-----'Received & Recorded at Registry ofDeeds Proof Enclosed'--____ __Other Pennits Required: ___Curb Cut from DPW ___Water Availability ___,Sewer Availability ___Septic Approval Board ofHealth ____Well Water Potability Board of Health ___P.ermit from Conservation Commission __....:Permit from CB Architecture Committee __ Permit from Elm Street Commission Permit DPW Storm Water Management ---C ___ v"'" Demolition Delay Signature ofBuilding Official 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 Healtb, Conservation Commission, Department of public works and otber applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards ofMGL 40A. Contact Office of Planning & Development for more information. City of Northampton Building Department 212 Main Street Room 100 I MA 01060 13-587-1240 Fax413-587-1272 APPLICATION TO CONSTRUCT. ALTER, REPAIR, RENOVATE SECTIPN 1 -SITE.INFORMATI9N . 1.1 Property Address: "e fll1TFIliU J!7: /VtJ/?'TJ-J)9ft)P'10)J j1')A, 2.1 Owner of Record: 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature SECTION 3· -ESTIMATED CONSTRUCTION COSTS: Item 1. Building 2. Electrical 3. Plumbing 4. Mechanical (HVAC) Building PermitNumber:_____~----.;..~_,_- .' Official Use Only .. Signature: _--'-______~~~--'-'-:-~--""'" -.' Bt,llldingCommis~loii~rllrlS~~~ior'of8~ildin~s' :_, '.~ .~,.., Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing I Proposed Required by Zoning TIiis collm1ll to be filled in by Building Department r(~ "! Lot Size I Z, 1iiilfi. : I ! -lIt Frontage I JIrtl i I . ! Setbacks Front ! _'?C I CJ c=J Side d Ii 1) ! R:U~q~] ,r L:C J R:I I I I ! I I Rear tJQPI r=:J r=:J I Building Height IKJ CJ I I Bldg. Square Footage I~OL?l CJ% L.J I ! CJ; Open Space Footage C=I % [_J I I(Lot area minus bldg & paved parking) I # ofParking Spaces c:J \i r-'"i L-.-J ""'~.Fill: I I(volume & Locatioll) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ·0 DO NT KNOW @ YES 0 IF YES, date issued:l ! IF YES: Was the perIT!it recorded at the Registry of Deeds? NO DONT KNOW YES 0 0 0 'r----~ "----<,IF YES: enter Book: Pag and/or Document B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW 0 YES. 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: o o C. Do any signs exist on the property? YES o NO ® IF YES, describe size, type and location: NO ® 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? YES 0 NO ® . IF YES, then a Northampton Storm Water Management Permit from the DPW is required. .; ,",. I, hOwUNiGJ! 1" 8ttIJj!7'I£ , as Owner of the subject property I, hP~;ueJfl!h;. J.f ;0. Bit f);il1.lf " " ,as Owner/Authorized Agenfhereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge ana belief. Signed under the pains and penalties of perjury. SECTION 5-DESCRIPTION OFPROPOSED WORK (chet:k all applicable) AdditionNewHouse 0 Replacement Windows Alteration(s) D Roofing D OrDoors 0 Accessory Bldg. 0 Demolition New Signs [D] Decks [CJ Siding [OJ Other [0] Brief Description of Proposed ~, Work: f{j(trJ1IJJJ.J. Dr 1: 1-.7f;~bltJ. Alteration of existing bedroom ___Yes ___ No Adding new bedroom Yes -"7":"-No Attached Narrative Renovating unfinished basement ___ ____No Plans Attached Roll -Sheet ~~ltf~Ne:W[ffo&~~3~15rrlaam6111~~1[iSiriwW6~f[imfclBffiw~IDtfeW8ioWifi"g: a. Use of building: One Family Two Family Other J) f, m0 b. Number of rooms in each family unit: Number of Bathrooms._____ c. Is there a garage attached? ____-:-____ Dimensions ______________d. Propos"ed Square footage of new construction. 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 1 00 yr. floodplain ___Yes __No j. Depth of basement or cellar floor below finished grade ---,.__________ ___Yes ___ No.k. Will building conform to the Building and Zoning regulations? r. SepticTank__ CitySewer ___ Private well ___ City water Supply ___ SECTIONS -CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Name of License Holder :_--')..~'""'/)!'-I!W",-'""!?",,E,,-,'),-,-)'=b-=1:,-'-.<8_,£,;A,-,/.t-,,--li1.=)i,-~-,,-1-,T,-J;_:______ Not Applicable £" Lic~nse Number Expiration Date Not Applicable £ i79;)1Q7 Company Name 'Registration Number '-7/7 fftU!1'HI7MI'HrJ 's"",-:/c....-_~..:.~::..!:-O~____________ 7t6~11~ Address Expiration Date i SECJION10-WORKERS'COfwU'ENSATION INSURANCE AFFIDA'v'IT(M.GLc;152, §25C(6» I 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 ofone (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. Sixth Edition Section 108.3.S.I. Definition of Homeowner: Person (s) who own a parcel ofland on which helshe 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 farm structures_ A person who 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 Official, that helshe shall be responsible for all such 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 ofthe work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability ofEmployers to Employees for injuries not resulting in Death) ofthe 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 Zoning Laws and State ofMassachusetts General Laws Annotated. Homeowner Signature. ________,____~__________ l'he Commonwealth ofMassachusetts Department ofIndustrial Accidents Office ofInvestigations 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Mfidavit: Builders/Contractor.slElectricianslPlumbers Applicant Information Please Print Legibly N arne (BusinessIOrganizationlIndividual): j..A lJp£)jrf.1£ ;:3....tJil.f I.JJc;:,,~ Address: 71..., NtJ.r<'THI9f1)I'JiJ/~ 57 City/State/Zip: /1v,A,/okJf'J 11'J17. OIO.){'o Phone #: 1/13 5'39 73 f? i *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information, tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, Ifthc sub-contractors have employees, they must provide their workers' comp, policy number. I am an employer that is providing workers' compensation insurancefor my employees. Below is the policy andjob site information. Insurance Company Name: ________________________________-o- Policy # or Self-ins. Lic. '__________________ Expiration Date:._________ Job Site Address:,___________________City/State/Zip:_________ Attach a copy ofthe workers'compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as'civil penalties in the fonn of a STOP WORK. ORDER and a fme of up to $250.00 a day against the violator. Be advised that a copy ofthis statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. en lties ofperjury that the information provided above is true and correct. Date: ;;)-/ J /1 Phone#: 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. Cityffown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.0ther ____________ Contact Person: Phone#: Are you an employer? Check the appropriate box: 1. 0 I am a employer with 4. ~I am a general contractor and I . employees (full and/or part-time). * have hired the sub-contractors 2. 0 I am a sole proprietor or partner-listed on the attached sheet. ship and have no employees These sub-contractors have working for me in any capacity. employees and have workers' [No workers' compo insurance compo insurance.t required.] 5. ~We area corporation and its .3. 0 I am a homeowner doing all work officers have exercised their myself. [No workers' compo right of exemption per MGL insurance required.] t C. 152, §1(4), and we have no employees. [No workers' compo insurance required.] Type of project (required): 6. 0 New construction 7. 0 Remodeling 8. ~Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 13.00ther._______ ----------------------------------------------- INSPECTOR Massachusetts DEPA1?'l'MEN'l' OF BUILDING INSPEC'l'IONS . 212 Main Street • Municipal Building Northampton, MA 01060 Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNEREXE:rv.1PTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two year period shall not be considered a home owner." r The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection·· process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building' permit issued; and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner Iresident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date--------------------------- Address of work location " f·' ____ City ofNorthampton 212 Main Street, Northampton, MA 01060 , Solid Waste Disposal Mfidavit 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 iii, S 150A. Address of the work: The debris will be transported by: CHE7s /IB'J..t.Nf:F The d~brjs will be received by: _--L1'A-=.1(..:..::.IJ_»I_:S_...::-c.=J..I).)J'.~J..::;...'){r.2... _ Building permit number: _____________ Name of Permit Applican:.::.t.-=-_~__;--________ Date Signature of Permit Applicant , \ __ ~.::"',"~('.z lEBEAU A~ tr~4§ ""Ji> !<Jl~~ {·,-tllt til 1"WWI.jt :jrd:I··,VIM~ "'.tUr:h.'~r..~i1 .. i~~ltAI J / I I· IFF I HI!I.D FOR WNI!, . 1.SS' FIlO/,! CORNER ___ __ '-~-'7O,S;--~~~r-..;::::::I3i::f.~WA!J{:::::::::::::::::::::::::NB.'l'2tl'~ 70.89' lBIHl44 NIl' VICTOR C. RUll<QWSKI DEEO 1601-302 PLAN J2N26 118092 Sq. I'aot i Illr. ONLJNE'. I.:W fflOMCORNfR,'-, ,~,---.. . 5670 IIPF' HaO fOR IJNE, 0,44-' FROM CORNER 18C-IM? , NIl' KEHNlml I). tmEAU l' r ,,~"l!e'l"'"Ijg' J 51,."" C i! . .A I':if' ' " -'" W.~"'~'" '~-.,... BRIDGE ROAD II PUBLIC WAY !Pl" ~ J1tr~:",,, 1J/~.'S.2.3'::,., .. . " , ';l : 1sc-il 6 :.' NIl'.' KENNElH C. PARCEL 1 PI,AN 47-20 J ColumlJia Gas of Massachusetts A NiSource Company 995 Belmont Street Brockton, MA02301 Date: March 23, 2015 To Whom It May Concern: The address listed below has had the gas service(s) disconnected and is now ready for demolition. ADDRESS: 68 Hatfield St TOWN: Northampton STATE: Massachusetts Sincerely, Maintenance Administrator Integration Center Columbia Gas Of Massachusetts 508-580-0100 Ext 1293 iJDIVJ.V Ll~- Gmail COMPOSE Inbox(3) Starred Important Sent Mail Drafts (3) 14 Junes Way 2014 Cutaway (2) Chase/Bank Arner" .. Fink & Perras (1) Fleury lumber Invs. Florence Savings B... Hatfield 8T (1) Hatfield St Involc.". Ins" Certificates KlM 5500 lot 9 Old Harvest Lot 9 Invoices (1) lot 12 Old Harvest LPA CORP. (2) Mlsl.(7) Motorcycle New England Sucu... OrchardS! Orchard Sllnvoic ... River Vlew"Bus. (1) Riverview Rent Re... RKMiles Scuderi Travel UO nAl.I:'l.bLV ~1., NUKIHAMPTON, MA 01060 -audla1950@gmail.c ... Page 101'1 M.... DEMO LTR -68 HATFIELD ST., NORTHAMPTON, MA 01060 lobox x Estrella, AnnMarie <AnnMarie.Estrella@nalionalgrid.com> tome nationalgrid 40 SylvanRd Waltham MA 02451 December 22. 2014 Mr. Larry Audette LP Audette Builders 7l7NorthamplonSt. Holyoke, MA 0 I 040 EMAIL: audlal950@gmail.com RE: Service Removal for Building Demolition Dear Mr. Audette: This letter is to confmn, per your request, National Grid has removed electrical service and meter as of December 22. 2014 from 68 H: you have any questions or need further assistance, please feel free to contact me at (508) 357-4605. Sincerely, )'ln~arie 'Estrella Nationalgrid Customer FulfilIment FAX: 315460-9149 PH: 508-357-4605 annmarie.estrella@nationalgrid"com Ref: WR#18556579 This e-mail, and any attachments are strictly confidential and intended forthe addressee(s) only. The content may also contain legal. professional or olhe 1") I")") 1"'''' Ah s://mail. 00 le.com/maiVulOl?tab=vvm CITY OF NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS 125 LOCUST STREET NORTHAMPTON, MA 01060 413-587-1570 FAX 413-587-1576 Edward S Huntley, P.E. Directol' December 15, 2014 Louis Hasbrouck~ Building Inspector Municipal Office Annex 212 Main Street Northampton, Ma 01060 Dear Mr. Hasbrouck: The water service at #68 Hatfield Street has been diSCOlmected from the city water supply and the water meter has been removed from the premises as ofDecember 15, 2014. Please contact me ifyou have any questions . . Nuttelman uperintendent ofWater Cc: Ned Huntley, Director ofPublic Works Jim LauriIa, City Engineer ficcuTech INSULATION & CONTRACTING, INC. STATE STREET, BUILDING #119 1-800-244-8773 P.O. BOX 376 (413) 583-5500 LUDLOW, MA01056 FAX (413) 583-5555 MASSACHUSETTS CERTIFIED WBE October 21, 2014 Mr. Larry Audette E-Mail: audla1950@gmail.com Dear Mr. Audette: We are pleased to submit our proposal for the asbestos abatement project at 68 Hatfield Street, Northampton, MA, 1 y' .". I . +.. 17 [/1..,/ (! ,," '" lUtl.:, c! (.. ~f ,~.:." (.;<:.( Please note the following Terms and Conditions. j\'\c \/12v-n1e"r c;:;b2, :;2c I Lf, PRICE ..... $ 7,500.00 _/dr")~~,o-,. THE CONTRACTOR AGREES TO THE FOLLOWING: 1. To remove approximately 216 linear feet of window caulking from fifteen (15) windows. 2. To remove approximately 68 square feet of VAT in whole using the heat gun process. 3. To remove approximately 2,240 square feet of exterior siding. 4. To remove the storm windows from the windows and leave them inside the building. 5. To pre-clean the work area prior to commencement of abatement activity. 6. To furnish all barricades, scaffolding, aerial lifts, and safety equipment necessary for the safe completion of the project. 7. To undertake asbestos abatement operations in compliance with Federal, State and local regulations. 8. To file all required notifications with appropriate regulatory agencies. 9. To dispose of all asbestos waste at an approved landfill. 10. Forward copies to you of regulatory notifications and waste manifests. 11. To commence work during normal business hours, Monday-Friday. 12. To supply water as needed. THE OWNER AGREES TO THE FOLLOWING: 1. To supply electrical receptacles in all work areas. ffua I"H:l11H:aU k)LTeel-aUOlal':J)U(gJgmall.com -Umail Gmail COMPOSE Inbox (3) Starred Important 8enlMa!1 Drafts (2) 14 Junes Way 2014 Cutaway (2) Chase/Bank Amer... Fink & Perras (1) Fleury Lumber Inw. Aorence Savings R. Hatfield ST (1) Hatfield Sllnvole... Ins. Certificates KLM 5500 Lot 9 Old Harvest Lot 9 Invoices (1) Lol 12 Old Harvest LPA CORP. (2) Misl.(7) Motor cycle New England Sucu... OrchardSt Orchard SI Invole... River View Bus. (1) Riverview Rent Re .. RKMiles Scuderi Travel Page 1 of2 More #68 Hatfield Street Inbox x John Hall <jhall@northamptonma.gov> tome Larry, lNhen you take the building dov;n althis address and plug the house service, caU587-1570 ext. 4330 and tell the secretary tha/you are ready to h. go there and Inspect the cap. ! will then E-Mail the Building Commissioner telling him that I have Inspected the cap, and hov; ft was capped, the date and John Hall (City of Northampton E-mail is a public record e:s:cept ''''hen it falls under one 0'£ the specific statutory exemptior . Click here to &m!Y. or E9rward- 0.45 GS (2%) of 15 GB used 02014 Googte -Terms & privaev ~ 1 "') 11 "') ,">" 1 Ah s:llmail. 00 le.com/mail/u/Ol?tab=·wm ASBESTOS-CONTAINING MATERIALS INVENTORY MATRIX Facili~: 68 Hatfield Street, Northampton, MA Date: 8/2812014 Project #: lPAB-14-B2536 Client: lP Audette Builders, 717 Northampton Street, Holyoke, MA 01040 -audla1950@gmail.com CH -Chrysotile Asbestos ND -No Asbestos Detected PC Point Count AS -Assumed, no sample I CR -Crocidolite Asbestos AM -Amosite Asbestos F -Friable H • Homogeneous KEY: .~~.:.~~!.~P'p)!?~~~~.............................~f..-..~~~.:-!:~~?.I.~.....•...••......••.......•~~.:!':I~! .~~~p.~!?!.............................~.:.~!!TP.~:.~.~~!i.~~....................................... .~~N~J~~~~~t~~!lt:.............................~~.:g.~!!'.~R~~....~~:.R~!~:!?:!!~~~....~I?.:-.~!~~~!~!:'.t.R~t!,!~~~....~~..:-. !!:':~~....~.:.~~P.~~!':~!~.~?~Y!':~E.:'.~....9.:.2!~!:~..................1 EPA Categories: I =Nonfriable ACM, packings, gaskets, reSilient, floor covering, and asphalt roofing products II =All other Nonfriable ACM, excluding Category I RACM -Friable, Regulated Asbestos '" .-/.:... :........ -.<:..; .......'...... .: .. ........:.'. ,; .. »; . ..... .: )......: ...•.<... ..: ......•. :: _.......... " .. ;; .. :•......... '.' ,'. '. "':-~ :.'.: .'. ...-:,. ....... i: .•; ..•.;,>.. Sample/Mat 10 Number MATERIAL DESCRIPTIONITYPE LOCATION SMPLE LOC QTY COND EPA Cat. Lab Results iCOMMENTS .' 01 Cement Siding Shingles Exterior X 13,440 SF IN . II CH 15% I 02A Window Caulk, storm to bottom frame-outer Exterior, right side, outer bead X NA NA NA NO 02B Window Caulk, storm ~o bottom frame-inner Exterior, inner bead X 192 LF DE II CH3% 12 ea 3x5 windows 03 Window Caulk wood·to brick Exterior, Basement windows X 24 LF DE II CH3% 3 ea 1x3 windows I 04 Window Glate, white, behind silicone Bsmnt window, outer/ext. window X NA NA NA ND I 05 Window Glaze, white, behind silicone Bsmnt window, inner window X NA NA NA ND 06 Asphalt Siding Shingles exterior, behind AlC & Waferboard X NA NA NA ND 07 Siding paper, Tan Ext., behind wood clapboards X NA NA NA ND 08A Roofing Shingle/Adhesive Strip Exterior front porch X NA NA NA ND 08B Roofing Shingle/Adhesive Strip Exterior rear entry X NA NA NA ND 09A Felt Paper underlayment under #08 Exterior front porch X NA NA NA NO 09B Felt Paperunderlayment under #08 Exterior rear entry X NA NA NA ND 10 Fiberglass batting Insulation paper, J M Basement walls X NA NA NA ND 11A Joint Compound w/sheetrock ceiling #12 Basement X NA NA NA ND 11B Joint Compound w/sheetrock ceiling Kitchen ceilifl9. X NA NA NA ND 12A Sheetrock ceiling Basement X NA NA NA ND 12B Sheetrock ceiling Kitchen ceiling X NA NA NA ND Page 1 of 3 Forbes &::; Wheeler ASBESTOS·CONTAINING MATERIALS INVENTORY MATRIX Facility: 68 Hatfield Street, Northampton, MA Date: 8128/2014 Project #: LPAB-14-B2536 Client: LP Audette Builders, 717 Northampton Street, Holyoke, MA 01040 -audla1950@gmail.com CH -Chrysotile Asbestos NO -No Asbestos Detected PC Point Count AS • Assumed, no sample CR -Crocidolite Asbestos AM -Amosite Asbestos F· Friable H • Homogeneous KEY: .~~.-.~~!!.-p.p!!~~~~.............................~f.:.~~!!:!:~~~~I~...........................~~.-. ~~!.l?~~P.~.~.............................~.:.l?3!~p'I.~.~.~~.~!i.~~....................................... .~~~!? {~?~~~~i~~t............................!?~.:.I?~~.~~~~....~:.!?~!~!"!'?~!~~....~'?:.~!~!!~~?3!~~.~~~.Q~....~~. :.!!!~~~~....5.: .~~~~~~~!.l!!!~~Y~~~~....~.:.9.!~~~.................. EPA Categories: I = Nonfriable ACM, packings, gaskets, resilient, floor covering, and asphalt roofing products I II =All other Nonfriable ACM, excluding Category I RACM -Friable, Regulated Asbestos i;<;/;·:.<" ..... ::.:...>... ..•.•... .... ";;'.. '. ...• .' ..:... .. ,:.: ,<.;:. • ...•... ; >.; ......1.> ..>'< ..:" .. "< . .i'. ,". .... '•.... .; ':"'>' .i ... ,,::,.. ; Sample/Mat MATERIAL SMPLE EPA Lab ! ID Number OESCRIPTIONITYPE LOCATION LOC OTY COND Cat. COMMENTSResults 13A Plaster ceiling Kitchen ceiling X NA NA NA NO 13B Plaster ceiling Kitchen wall X NA NA NA NO 13C Plaster ceiling 2F Stairwell landing top X NA NA NA NO H 13 Plaster ceiling/walls 2F Stairwell NA NA NA H/ND H 13 Plaster residue/debris 2nd Floor throughout NA NA NA H/ND 14 Flooring Paper black, on wood Kitchen X NA NA NA ND H /14 Flooring Paper black on wood Dining Room . NA NA NA H/ ND 15 g"Gray FloOr Tiles/Black Mastic Kitchen X 8 SF DE I CH3% Mastic NEG. 16 Tan Linoleum remnant Layer 1 Kitchen X NA NA NA NOunder #18 17 Wall Panel Adhesive, brown Kitchen X NA NA NA ND 18 Red Linoleum Remnant Kitchen X NA NA NA ND 19 12: Floor Tiles self-stick Dining Room X NA NA NA ND 20 Floor Levelin.9 Comp~oundLwhite Dining Room X NA NA NA ND 21 9" Red Floor TIles/Black mastic 2nd Floor X 60 SF DE I CH3% MastiC NEG. 22 9" Red Floor Tiles/Black mastiC 2nd Floor '. '.' X .. 60 SF DE I CH2% Mastic NEG., under carpet . 23 Linoleum, white 2nd Floor X NA NA NA ND 24 Attic Insulation (cellulose mix) 2nd Floor in wall cavities X NA NA NA ND 25 Roof Shingles Garage exterior rear X NA NA NA ND 26 Roofing Felt underlayment behind Garage, exterior rear X NA NA NA ND#25 27 Window Glazing, white, thick, inner Garage, inner side metal X NA NA NA NDside windows 28 Sheetrock ceiling Garage ceiling X NA NA NA ND NS Cement Chimney Patch Basement , NS Waferboard Walls 2nd Floor Stairwell j I:' " •.,.; ...'",' ........,...,'::' /".' ......... ' ..". ,:::i,' ,: : "':', .,., :.' " .'. , . , .... . ...... " : ,'.,'.' ...... " .:. ,.<." • '.::'·':'·1 Page 2 of3 Forbes &d Wheeler ASBESTOS-CONTAINING MATERIALS INVENTORY MATRIX Facility: 68 Hatfield Street, Northampton, MA Date: 8/28/2014 Project #: LPAB-14-B2536 Client: LP Audette Builders, 717 Northampton Street, Holyoke, MA 01040 audla1950@gmail.com CH • Chrysotile Asbestos NO -No Asbestos Detected PC Point Count AS -Assumed, no sample CR -Crocidolite Asbestos AM -Amosite Asbestos F -Friable H • Homogeneous KEY: NA -Not Applicable NF -Non-Friable NS -Not Suspect X • Sample Location ......................................................................................................................................................................,. ..................................................................."' ..............................................................................................................................................""'I .9.2~~.{9.~.I'!~t~i~!'.t._..._.............._.......~~.:.'?~:!:I.~~.~~....I?~:_!?~~~C?r~!~~....~I?:.~!9!!if!~~!.!?~~~~~....~~.:.!~!~<:!....~.:.~.~~~~~~!.L!!!~~';f::~~~._..~.:_9.!~::r.._............... EPA Categories: I =Nonfriable ACM, packings, gaskets, resilient, floor covering, and asphalt roofing products II =All other Nonfriable ACM, excluding Category I RACM -Friable, Regulated Asbestos • ..........•.. ' ........• ..J . '. .... ' ....... ,.' .......... .. .:,......' ' ..... .> . .., ..... .................. :'.' . .......... .,..' . ... . '.'.... .... ' . .: Sample/Mat I MATERIAL I ISMPLE I I I EPA 10 Number DESCRIPTION/TYPE LOCATION LOC QTY COND Cat. Lab I.Results COMMENTS . Notes: H =Similar materials to those identified herein that are located in other rooms are homogeneous, where indicated, and no additional samples were collected in those locations if no ;''''.lIpl", number is listed. The following inaccessible areas were not inspected or sampled: Wall and floor utility chases (unknown to exist); Pipe Tunnels (unknown to exist); Air plenums above i permanent plaster or metal ceilings; Below-ground or below-grade (buried areas, parking lot, slab damproofing, etc.); All asbestos-containing material (both friable and non-friable) must be removed from a facility or facility component prior to demolitionlrenovation operations that will disturb I these materials. NIS or NS = Not Suspect as containing asbestos per judgement of Inspector. It is recommended, but not required, that samples of negative resilient flooring & mastics be further analyzed by destroying the interfering matrix materials and isolating any asbestos fibers that may be present and analyzed by Transmission Electron Microscopy (TEM). I Refer to the attached Asbestos Laboratory Report from the independent analytical laboratory. j INSPECTOR: Stephen W Niec JI//i/r MADLS Lie. No. AI072378 Management Planner: Lie. No.: AP073456 I Collected by: FORBES ~WHEELER. 650 Dwight Street, #1337. Holyoke, MA 01041 Analysis by: CEI ~bS • 107 New Edition Court. Cary, NC 27511 1 1 T: 413-221-8233 • F: 866-423-6355 NVLAP Code: 101768-0 • MADLS Lie. #: AAOO0168 Page 3 of3 Forbes ~Wheeler