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25C-172 (6) 129 NORTH ST BP-2021-1561 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25C- 172 CITY OF NORTHAM PTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CON"I R.AC I ORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:demolition BUILDING PERMIT Permit# BP-2021-1561 Project# JS-2021-001847 Est. Cost: $17200.00 Fee: $30.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ASSOCIATED BUILDING WRECKERS INC 109660 Lot Size(sq.ft.): 10541.52 Owner: FISHER MICHAEL Zoning: URC(100)/ Applicant: ASSOCIATED BUILDING WRECKERS INC AT: 129 NORTH ST Applicant Address: Phone: Insurance: 352 ALBANY ST (413) 732-3179 Workers Compensation SPRINGFIELDMA01105 ISSUED ON:7/1/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:DEMO 3 CAR GARGE, BREEZEWAY AND SCREENED PORCH 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 UP II VIOLATION OF ANY OF ITS RULES AND REGULATIONS. I h� Certificate of Occu•anc Si_nature i kit FeeType: Date Paid: Amount: Building 7/1/2021 0:00:00 $30.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner / •7., ,,, i y% , ..ss. a kx �n.�1h , . ��� ova �'� �.� -N. tira,4, �, The Commonwealth of Massachus Pi.0 PC7 Board of Building Regulations and Stan ti {��n CIPALITY '''0,,,.- . �_J Massachusetts State Building Code, 780 C r aw;fn es USE Building Permit Application To Construct, Repair,Renovate Or ° c ised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: lg,P•-�J• )(j(L f Date Applied: 9 • ,, b .',, 7 ►��al Building Official(Print Name) Signature ate SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Num 129 North Street 25C-172-001 1.1a Is this an accepted street?yes V no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided N/A N/A N/A N/A N/A N/A 1.6 ` / Water/ Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public @' Private 0 Zone: _ Outside Flood pone? Municipal® On site disposal system 0 Check if yes SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Michael&Barbara Fisher Wilbraham MA 01095 Name(Print) City, State,ZIP 3 Marilyn Drive (413)949-1333 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction ❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 1i Addition 0 Demolition Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: Rough separation of breezeway connector from main house.Machine demolition and removal of 3-car garage,breezeway and screened in porch at residential structure.Live load debris onto ABW trailers.Dispose of at a licensed facility. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 17,200.00 1. Building Permit Fee: $ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ �I Suppression) Total All Fees: Q 0 S Check No y6 .7 eheck mount: ✓U Ca Amount: 6.Total Project Cost: $ 17,200.00 13paid in Full 0 utstandin nce 'ue: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-109660 10/31/2021 Andrew Mirkin License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 352 Albany Street No.and Street Type Description Springfield, MA 01105 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (413) 732-3179 abw_inc@comcast.net I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 169969 8/24/2021 Associated Building Wreckers, Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 352 Albany Street abw_inc@comcast.net No.and Street Email address Springfield, MA 01105 (413) 732-3179 City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuaance of the building permit. Signed Affidavit Attached? Yes $I No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Associated Building Wreckers, Inc. to act on my behalf,in all matters relative to work authorized by this building permit application. Michael Fisher 6/21/2021 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Andrew Mirkin 6/21/2021 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" 1 The Commonwealth of Massachusetts v +, Department of Industrial Accidents s ' 1 Congress Street,Suite 100 t i_! Boston,MA 02114-2017 °\,k. %V www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Name(Business/Organizational/Individual):Associated Building Wreckers, Inc. Address: 352 Albany Street City: Springfield State: MA Zip: 01105 Phone#: (413) 732-3179 Are you an employer?Check the appropriate box: Type of project(required): ✓11. I am an employer with 33 employees(full and/or part time)* n 7. New construction 2. I am a sole proprietor or partnership and have no employees working for me in any I 18. Remodeling capacity. [No workers'comp.insurance required.] ✓ 9. Demolition 3. I am a homeowner doing all work myself. [No workers'comp.insurance required]t I I10. Building addition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. 11. Electrical repairs or additions I will ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. n12. Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached 13. Roof Repairs sheet. These sub-contractors have employees and have workers'comp.insurance.± 6. We are a corporation and its officers have exercised their right of exemption per MGL. i 14. Other c. 152,§1(4),and we have no employees. [No workers'comp.insurance required.] 1 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners 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 attach an additional sheet showing the name of the sub-contractors and state whether 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: Great Divide Insurance Co. Policy#or Self-ins. Lic.#: WCA1545165-20 Expiration Date: 2/1�2022 Job Site Address: 129 North Street, Northampton, MA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL.c. 152,§25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ✓ I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct,and that clicking this checkbox and typing my name in the field below will act as my signature. Name: Andrew Mirkin Date: 6/28/2021 Phone#: (413) 732-3179 Email: demo@buildingwreckers.com (") City of Northampton s,S . ._,S'. Massachusetts �� '� i. i' i. * !G.1 DEPARTMENT OF BUILDING INSPECTIONS y �� . 212 Main Street •• Municipal Building `,j �� Northampton, MA 01060 JS't,4 3,�`,�p CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: USA Hauling & Recycling - 120 Old Boston Rd. Wilbraham. MA The debris will be transported by: Name of Hauler: Associated Building Wreckers, Inc. ISignature of Applicant: Date: 6/21/2021 ASSOBUI-01 DKELLEY ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/1/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. 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). PRODUCER CONTACT Denise Kelley, CISR NAME: People's United Insurance Agency,Inc. PHONE FAX One Monarch Place, 10th Fir (ac,No,Ext):(413)327-7517 (ac,Ney(413)327-7517 Springfield,MA 01144 AADMDRESS:Denise.Kelley©AssuredPartners.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Nautilus Insurance Company 17370 INSURED INSURER B:Colony Insurance Company 39993 Associated Building Wreckers,Inc. INSURER C:Great Divide Ins.Co. 25224 352 Albany Street INSURER D: Springfield,MA 01105 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMMIDD/YYYY1 (MM/DD/YYYYQ A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I X OCCUR X X ECP2031158-10 2/1/2021 2/1/2022 PREMISES fEaENccuErrence) $ 100,000 _ I MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEMAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY X JE o- LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea acci n 3 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident $ B UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE X X EX04257660 2/1/2021 2/1/2022 AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION X H AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X WCA1545165-20 2/1/2021 2/1/2022 1,000,000 OFFICER/MEMBER EXCLUDED? N N I A E.L.EACH ACCIDENT $ (Mandatory1,000,000 in NH) E.L.DI$�AS�-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ A Pollution Liability X x ECP2031158-10 2/1/2021 2/1/2022 See Description Box DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Pollution Liability Limit:Limit Per Occurrence; 1,000,000: Limit Aggregate;$3,000,000 Please be advised the below listed certificate holder is listed as Additional Insured on a Primary and Non-Contributory basis in regards to the General Liability,Pollution Liability,Umbrella(Excess)Liability,and Workers Compensation policies listed above when being required by written contract.Waiver of Subrogation in favor of certificate holder for all above listed policies. Umbrella(Excess)Policy is written on a follow form basis over the above listed General Liability,Pollution Liability,Employers Liability(Workers Compensation),and the Auto Liability with Commerce Insurance,Policy#19MMZP4610. SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE Pea ee Zf. €ed laa.unaaee /49eac f. lac, ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:ASSOBUI-01 DKELLEY LOC#: 1 AFRO ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED People's United Insurance Agency, Inc. Associated Building Wreckers, Inc. 352 Albany Street POLICY NUMBER Springfield,MA 01105 SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: RE: Any and all jobsCity of Northampton is listed as additional insured under general liability as required by written contractfor work performed by insured subject to terms and conditions of the policy. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 6/28/2021 Ticket (DIG SAFE SYSTEM, INC - MA) 06/28/2021 08:21:06 -BB -MC -ML -WG *** INTERNET TICKET *** ***** REGULAR ***** TIME. .08:21 DATE..06/28/2021 REQUEST NO. . .20212600592 STATE MASSACHUSETTS MUNICIPALITY NORTHAMPTON ADDRESS..129 STREET. . .NORTH ST NEAREST CROSS STREET 1..PARS DEMO OF GARAGE AND CONNECTOR NATURE OF WORK..DEMOLITION EXTENT OF WORK STREET TO HOUSE AREA IS PREMARKED..YES START DATE 07/01/2021 START TIME..08:30 CALLER JOHN JEFFRESS TITLE RETURN CALL PHONE # 413-732-3179 FAX # ALT. PHONE #... 800-448-2822 EMAIL ADDRESS DEMO@BUILDINGWRECKERS.COM CONTRACTOR ASSOCIATED BUILDING WRECKERS ADDRESS 352 ALBANY ST CITY SPRINGFIELD STATE MA ZIP 01105 EXCAVATOR DOING WORK..ASSOCIATED BUILDING WRECKERS https://exactix.d igsafe.com/tickets/view/5030893e-d80b-11 eb-83f5-7aeb55a 1 a6c9#tab2 1/2 6/28/2021 Ticket $ervlce Area aft(5) Contact Alternate Contact Emeraecy Contact VERIZON TELEPHONE (800)624-9675 *Principal NATIONAL GRID ELECTRIC- MASS ELEC USIC LOC ELECTRIC (800)778-9140 *Principal MCI TELEPHONE (800)624-9675 *Principal EVERSOURCE GAS OF MA GAS (800)688-6160 WG HIT GAS LINE NUMBER *Principal (800)525-8222 This Dig Safe ticket expires on:07/28/2021 There may be non member utilities in the area that you need to notify. Electric and other utilities may not mark lines they don't own or maintain.You may need to hire a private company to locate these lines. The excavator is responsible to maintain marks placed by the member utilities. https://exactix.digsafe.com/tickets/view/5030893e-d80b-11 eb-83f5-7aeb55a 1 a6c9#tab2 2/2 i I l ICI CJ //- Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration I Type: Co poration .. y Registration: 1 65 ASSOCIATED BUILDING WRECKERS, INC:1 „ Expiration: OB! 4,2021 352 ALBANY ST. SPRINGFIELD,MA 01056 \a� fi Update Address and Return Card. SCA i 0 20M-05,17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Expiration Office - Consumer Affairs and Business Regulation BIS 1 08/24/2021 1000 ington Street -Suite 710 ASSOCIATED BUILDING WRECKERS,INC. Bos'• A 02118 ANDREW H.MIRKIN 352 ALBANY ST. r�l.�••+ �zaodt _ �► - SPRINGFIELD,MA 01056 Not valid ou Undersecretary Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617) 727-3200 or visit www.mass.gov/dpl Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-062382 Expires: 10/31/2021 ANDREW H MIRKIN 299 TANGLEWOOD DRIVE LONGMEADOW MA 01106 t f i/`*;_I Commissioner ti/,,,,.� s - THE COMMONWEALTH OF MASSACHUSETTS -*-4 _. EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT DEPARTMENT OFLABOR STANDARDS y C "—�'' 19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114 ;„ y ASBESTOS CONTRACTOR LICENSE ASSOCIATED BUILDING WRECKERS,INC. 352 ALBANY STREET SPRINGFIELD MA 01 105 LICENSE: AC000898 EXPIRES: Thursday,August 05,2021 IN ACCORDANCE WITH MGL CH. 149§6B AND 453 CMR 6.04 , THIS CERTIFICATE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS 'I'O TIIE CONTRACTOR ABOVE FOR THE PURPOSE OF ENTERING INTO OR ENGAGING IN ASBESTOS WORK. THIS LICENSE IS VALID FOR A PERIOD OF ONE(1)YEAR. I I MI L FLANAGA ECTOR Please detach this mailing tab and keep your license certificate in an accessible location. A copy of this license must be maintained at each worksite. t ASSOCIATED BUILDING WRECKERS,INC. 352 ALBANY STREET SPRINGFIELD,MA 01105 POISSANT ELECTRIC, INC. 266 Haydenville Road,PO Box 113 Whately, MA 01093 "Family Owned and Operated since 1971" June 3, 2021 Steven Hill, Project Manager Associated Building Wreckers, INC. 352 Albany St Springfield, Ma Dear Steven: The electrical has been disconnected to the garage at 129 North St. Northampton, MA; please let me know if you require any other information. Thank you, Rob Poissant Poissant Electric, Inc. Braman Termite& Pest Elimination Service Inspection Report BRAMAN P.O. Box 368 Detailed Service Report #2105955 Agawam, MA 01001-0368 7c'»nite o`'Pest E(imittatiozi 800-338-6757 Client: 10001556 Service Location: 10001556 Associated Building Wreckers Associated Building Wreckers 352 Albany Street Massachusetts Springfield,MA 01105 Springfield,MA 01109 Phone: 413-732-3179 x0 Phone: 413-732-3179 x0 Customer Signature: Technician Signature: Licenses/Certifications MA-37551 41 OZ no one on sight-spoke to matt on Ryan Wilson Time In: 6/17/2021 01:18 PM Terms: NET 30 phone Time Out: 6/17/2021 01:48 PM Order # Service Description Quantity Unit Cost Amount 2105955 Rodent Service 1.00 Service Comments Order Instructions: Rodent Abatement.129 North St,Northampton,Ma.Breezeway,screened in porch and garage that are connected to the house(not the house).PO#2276.*arrive 1-2 Contact Matt West at 413-588-4231* Tech Comment: Service complete for 129 North Street Northampton. Inspection to garage and porch areas,and located light mouse activity inside garage. Installed bait stations in and around garage/porch.See report for details Materials Summary EPA# Active Ingredient Finished Quantity Application Method Application Rate Material Applied Lot# AI Concentration Undiluted Quantity Application Equipment Sq/Cu/L Ft Contrac Blox 12455-79 Bromadiolone 22.000 Each Baiting N/A K38545-83622 0.0050 22.000 Ounces N/A Target Pests:Mouse Areas Applied:Garage/Porch->Device 1,Garage/Porch->Device 2, Garage/Porch->Device 3,Garage/Porch->Device 4,Garage/Perch->Device 5, Garage/Porch->Device 6, Garage/Porch->Device 7 PestWith Without Total Device Exceptions Summary Quantity Device Summary Activity Activity Inspected Replaced Removed Skipped None Noted Exterior Rodent Bait Station 0 7 7 0 0 0 -Totals 0 7 7 0 0 0 Additional pest findings may have been observed.Please see conditions and comments for more details. Area Inspections Area Inspected Pest Findings Time 129 North Street Northampton 1:35 PM 129 North Street Northampton-> Garage/Porch 1:35 PM Exterior 1:33 PM Device Inspection Details Area Device Name Device Type Activity Pest Findings Time 129 North Street Northampton->Garage/Porch 1 Exterior Rodent Bait Station None 1:39 PM 2 Exterior Rodent Bait Station None 1:37 PM Printed: 6/22/2021 Page: 1/3 Braman Termite& Pest Elimination Service Inspection Report BAN P.O. Box 368 Detailed Service Report #2105955 Agawam, MA 01001-0368 7enmtt' cs` •list I-Izntiudtioui 800-338-6757 Device Inspection Details Area Device Name Device Type Activity Pest Findings Time 3 Exterior Rodent Bait Station None 1:40 PM 4 Exterior Rodent Bait Station None 1:36 PM 5 Exterior Rodent Bait Station None 1:37 PM 6 Exterior Rodent Bait Station None 1:38 PM 7 Exterior Rodent Bait Station None 1:39 PM Total Devices: 7 Skipped: 0 No Activity: 7 Activity: 0 Material Application Details Material Applied Active Ingredient AI% Application Method EPA# AI Concentration Application Equipment Sq/Cu/L Ft Contrac Blox Bromadiolone 0.0050% Baiting 12455-79 N/A N/A N/A Target Pest: Mouse Area/Device Name Finished Quantity Undiluted Quantity Technician Name Time 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:35 PM -> 1 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:39 PM -> 1 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:35 PM -> 2 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:35 PM ->3 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:39 PM -> 3 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:36 PM ->4 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:36 PM -> 5 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:36 PM -> 6 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:38 PM ->6 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:37 PM -> 7 Weather: 0°,0 MPH 129 North Street Northampton->Garage/Porch 2.0000 Each 2.0000 Ounces Ryan Wilson 01:39 PM ->7 Weather: 0°,0 MPH Printed: 6/22/2021 Page: 2/3 Braman Termite&Pest Elimination Service Inspection Report 5AN P.O. Box 368 Detailed Service Report #2105955 Agawam, MA 01001-0368 p 'Termite c •Pest 'Efiin that ron 800-338-6757 Material Application Details Material Applied Active Ingredient AI% Application Method EPA# AI Concentration Application Equipment Sq/Cu/L Ft Contrac Blox Bromadiolone D.0050% Baiting 12455-79 N/A N/A N/A Target Pest Mouse Area/Device Name Finished Quantity Undiluted Quantity Technician Name Time Printed: 6/22/2021 Page: 3/3 September Lane Labs, INC. 83 September Lane Beacon Falls, CT 06403 203-668-8533 05/26/2021 Associated Building Wreckers, INC. 352 Albany Street Springfield, MA 01105 RE: 129 North St Northampton, MA ASBESTOS SURVEY September Lane Labs, INC. conducted a pre-demolition asbestos inspection of the garage and sun porch located at 129 North Street in Northampton, MA Massachusetts Licensed Asbestos Inspector- Marco Carralero -Al# 900719 EXP. 12/14/2021 20 samples were taken of 10 building materials suspected of containing asbestos. Samples numbers, descriptions, locations, and approximate quantities of asbestos-containing materials are listed below. 10A-B Flashing Mastic Main Garage Roof 5% Chrysotile 60 LN. FT NOTES: (1) All quantities are approximations and asbestos contractors should inspect and quantify scope of work. (2) Any building materials other than wood, metal, or glass not tested for asbestos are assumed asbestos-containing until proven negative. Asbestos Not Detected in the Following Building Materials: Foundation Mortar Black Mastic on Attached One Car Garage on Right Roofing Felt and Shingle Materials Window Glazing Massachusetts Department of Environmental Protection• 100347261 BWP AQ 04 (ANF-001) �__ Asbestos Project # Asbestos Notification Form Project Revision r Project Cancellation A. Asbestos Abatement Description 1.Facility Location: GARAGE Instructions 1.All a.Name of Facility ..Street Address sections of this form NORTHAMPTON MA 01060 4135884231 must be completed in order to comply with c.City/Town d.State e.Zip Code f.Telephone MassDEP notification MATT WEST OWNER requirements of 310 CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title Department of Labor Worksite Location: GARAGE ROOF Standards(DLS) i.Building Name,Wing,Floor,Room,etc. notification requirements of 453 2. Is the facility occupied? r a.Yes Fi b.No CMR 6.12 3. Is this a fee exempt notification (city, town, district, municipal housing authority, state facility, or owner-occupied residential property of four units or less)? r a.Yes P b. No MassDEP Use Only 4.Blanket Permit Project Approval,if applicable: Date Received Approval ID# 5.Non-Traditional Asbestos Abatement Work Practice Approval, if applicable: Approval ID# 6. Asbestos Contractor: ASSOCIATED CONTRACTORS WRECKERS INC 352 ALBANY STREET a.Name b.Address SPRINGFIELD MA 01105 4137323179 c.City/Town d.State e.Zip Code f.Telephone AC000898 h. Contract Type: P, 1.Written r 2.Verbal g.DLS License# JAMES BEAUDRY AS074322 7. a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# 8 MARCO A.CARRALERO AM041931 a.Name of Project Monitor b.DLS Certification# 9 EMSL ANALYTICAL AA000191 a.Name of Asbestos Analytical Lab b.DLS Certification# 10. 6/21/2021 6/21/2021 a.Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYN'Y) 700-330 N/A c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11. What type of project is this? 17 a.Demolition r b. Renovation r c. Repair r d. Other-Please Specify: R eviced' 1 1/13/201 3 Page 1 of 4 Massachusetts Department of Environmental Protection 100347261 Asbestos Project # BWP AQ 04 (ANF-001) � '41111111111.111 L `� Asbestos Notification Form r Project Revision r Project Cancellation A. Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): r a.Glove Bag l- b.Encapsulation r c. Enclosure r d. Disposal Only r e. Cleanup r f.Full Containment Fi g. Other-Please Specify: EXTERIOR NON-FRIABLE 13. Job is being conducted: r a. Indoors 17 b. Outdoors 14 a. Total amount of each type of asbestos Containing materials (ACM)to be removed, enclosed, or encapsulated: 60 1.Linear Feet(Lin.Ft.) 2.Square Feet(Sq.Ft.) b.Boiler,Breaching,Duct, c. Transite Pipe Tank Surface Coatings 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. d. Pipe Insulation e.Transite Shingles 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. f. Spray-On Fireproofing g.Transite Panels 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. h. Cloths,Woven Fabrics i. Other-Please Specify: 1.Lin.Ft. 2.Sq.Ft. j. Insulating Cement TAR,FLASHING 60 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. 15. Describe the decontamination system(s)to be used: REMOTE CHANGE ROOM WITH TEMPERED WATER AND FILTRATION 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): PROPERLY WETTED,DOUBLE BAGGED,LABELED AND DISPOSED OF PROPERLY 17. For Emergency Asbestos Operations, the MassDEP and DLS officials who evaluated the emergency: a.Name of MassDEP Official b.Title of MassDEP Official c.Date of Authorization(MM/DD/YYYY) d.Waiver# e.Name of DLS Official f.Title of DLS Official g.Date of Authorization(MM/DD/YYYY) h.Waiver# 18. Do prevailing wage rates as per M.G.L. c. 149, § 26, 27 or 27A—F apply to this a.Yes r b.No r project? no.,;..A,4• 1 1/1 ZY)n1 2 Page 2 of 4 Massachusetts Department of Environmental Protection f 100347261 i ''� _ i BWP A 04 ANF-001 - Q Asbestos Project # Asbestos Notification Form r Project Revision r Project Cancellation B. Facility Description GARAGE 1. Current or prior use of facility: 2. Is the facility owner-occupied residential with 4 units or less? r a.Yes 1 b. No 3. MATT WEST PO.BOX 35 a.Facility Owner Name b.Address CONWAY MA 01341 4135884231 c.City/Town d.State e.Zip Code f.Telephone 4 MATT WEST PO.BOX 235 a.Name of Facility Owner's On-Site Manager b.Address CONWAY MA 01341 4135884231 c.City/Town d.State e.Zip Code f.Telephone 5 ASSOCIATED BUILDING WRECKERS 352 ALBANY STREET a.Name of General Contractor b.Address SPRINGFIELD MA 01105 4137323179 c.City/Town d.State e.Zip Code f.Telephone GREAT DIVIDE INSURANCE g.Contractor's Worker's Compensation Insurer WCA1545165-20 2/2/2022 h.Policy# i.Expiration Date(MM/DD/YYYY) 400 1 6. What is the size of this facility? a.Square Feet b.#of Floors Note:Temporary C. Asbestos Transportation & Disposal storage of Asbestos containing waste 1. Transporter of asbestos-containing waste material from site of generation: material is only � allowed at the place r a.Directly to Landfill or IT' b. To Temporary Storage Location/Transfer Station of business of a DLS licensed Asbestos contractor or a transfer ASSOCIATED BUILDING WRECKERS 352 ALBANY STREET station that is c.Name of Transporter d.Address permitted by MassDEP and SPRINGFIELD MA 01105 4137323179 operated in e.City/Town f.State g.Zip Code h.Telephone compliance with Solid Waste Regulations 310 CMR 19.000 2. If a temporary storage location/transfer station is used, list name of transporter of asbestos containing waste material from temporary storage location/transfer station to final disposal site: RED TECHNOLOGIES LLC 10 NORTHWOOD DRIVE a.Name of Transporter b.Address BLOOMFIELD CT 06002 8602182428 c.City/Town d.State e.Zip Code f.Telephone Revised: 11/13/2013 Page 3 of 4 Massachusetts Department of Environmental Protection — — _— 100347261 1 L BWP AQ 04 (ANF-001) Asbestos Project # o Asbestos Notification Form r Project Revision r Project Cancellation C.Asbestos Transportation &Disposal: (cont.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: RED TRANSFER&LOGISTICS 203 PICKERING STREET a.Temporary Storage Location Name b.Address PORTLAND CT 06480 8603421022 c.City/Town d.State e.Zip Code f.Telephone 4.Name and location of final disposal site(asbestos landfill): MINERVA ENTERPRISES MINERVA ENTERPRISES a.Final Disposal Site Name b.Final Disposal Site Owner Name 9000 MINERVA RD. c.Address WAYNESBURG OH 44688 3308663435 d.City/Town e.State f.Zip Code g.Telephone Note:Contractor must sign this form for DLS notification purposes D. Certification JAMES BEAUDRY JAMES BEAUDRY "I certify that I have personally 1.Name 2.Authorized Signature examined the foregoing and am PROJECT MANAGER 6/3/2021 familiar with the information contained in this document and 3.Position/Title 4.Date(MM/DD/YYYY) all attachments and that, based 4137323179 ASSOCIATED BUILDING WRECKERS on my inquiry of those 5.Telephone 6.Representing individuals immediately 352 ALBANY STREET SPRINGFIELD responsible for obtaining the 7.Address 8.City/Town information, I believe that the MA 01105 information is true, accurate, and complete. I am aware that there 9.State 10.Zip Code are significant penalties for submitting false information, including possible fines and imprisonment. The undersigned hereby states that I have read the Commonwealth of Massachusetts regulations governing asbestos abatement (453 CMR 6.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." n....:..,..1. 1 i it l/1m l Paee 4 of 4 1 Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: BAYSTATEI Transaction ID: 1284846 Document: AQ 04 -Asbestos Removal Notification Form ANF-001 Size of File: 231.23K Status of Transaction: in Process Date and Time Created: 6/3/2021:3:44:35 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection BWP AQ 04 (ANF-001) PreForm [I' Asbestos Notification Form ✓ This is a revision to an existing form. Project ID for existing form to be revised: r This job is being conducted under a Blanket Permit. MassDEP assigned Blanket Authorization ID: ✓ This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: ✓ This job does not require the use of an asbestos contractor licensed by the MA Department of Labor Standards because(please check one box below): r This job involves breaking,shearing or slicing of non-friable asbestos-containing material only(e.g.cement shingles/panels,cement pipe,asphalt roofing or siding,vinyl floor tiles,etc.)in a manner that does not generate asbestos dust or render the material friable, as allowed by the Department of Labor Standards(DLS)at 453 CMR 6.13(2)(a)5. All work must be done in compliance with the applicable regulations at 310 CMR 7.15; or r This job involves work on asbestos containing material that is classified by the Department of Labor Standards (DLS)as a `Small-Scale Asbestos Project,' an `Asbestos-Associated Project', or an`Asbestos Response Action' by qualified`in-house'personnel as allowed by the Department of Labor Standards(DLS)at 453 CMR 6.00,and will be performed in accordance with all the requirements of 453 CMR 6.13 (1)(a),453 CMR 6.13 (2)(a)1. and 3., and 453 CMR 6.14 (1)(a), as applicable. All work must be done in compliance with the applicable regulations at 310 CMR 7.15. r None of the above conditions apply, generate a new form. Revised: 11/13/2013 Page 1 of 1 6/3/2021 ' eDEP-MassDEP's OnlineFiling System MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System Username:BAYSTATE1 Nickname:BAYSTATE CONTRACTING MED My eDEP I Forms* My Profile* Help j Notiticatic. Receipt Forms Signature Payment Receipt Summary/Receipt print receipt Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select "My eDEP" to see a list of your transactions. DEP Transaction ID: 1284846 Date and Time Submitted: 6/3/2021 3:42:34 PM Other Email : DEP Transaction ID: 1284846 Date and Time Submitted: 6/3/2021 3:42:34 PM Other Email : Form Name: AQ 04 - Asbestos Removal Notification Form ANF-001 Form Name: AQ 04 -Asbestos Removal Notification Form ANF-001 Payment Information DEP code: 206919 Date: 6/3/2021 3:42:19 PM Amount ($): 100 Billing Info: JAMES BEAUDRY --- Payment Transaction Number: 159d77f0- df9d-41 b2-b666-dd66b8b7a187 --- Payment Invoice Number: 31 D5F746- 5B5D-4FE8-B619-920097AEB4D 1 My eDEP MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System ver.15.21.0.0© 2021 MassDEP httos://edeo.deo.mass.00v/eDEP/Pages/Payment/PaymentLanding.aspx 1/1 September Lane Labs, INC 83 September Lane Beacon Falls, CT 06403 203-668-8533 06/21/2021 Associated Building Wreckers, INC. 352 Albany Street Springfield, MA 01105 Project Manager: Stephen Hill Project No: 129-NS-NHM 129 North Street Northampton, MA The asbestos abatement project is considered completed because the post- abatement criteria for the asbestos abatement have been satisfied. On June 21, 2021, a Licensed Project Monitor completed a final visual inspection. No visible debris was found. ABATED ACM: Garage Roofing Mastic/Tar Marco Carralero MA License # AM041931 • 'I .r ■■■■ III IniN. 104,- - . • , .. L...' 4 M */1/11."-------- }•"' ! _JIM,' _____..L.,. , .4111111111.- I. ,, ' it `.R • i I L 1/. ///' • r t , • • 4 �I • DSO. _ _ • i J r r . t 6/9/2021 Northampton,MA:Assessor Database: Northampton, MA : Assessor Database Property Search: Parcel ID: Owner Name: Street Number: Street Name: 129 NORTH ST v Search Reset Property Detail: Parcel ID: Card: Street Name: Street Number: Zoning: State Class: Acres: Plot: 25C-172-001 1 NORTH ST 129 Two-Family 0.24 Owner Information: Property Images: Owner Name: FISHER, MICHAEL A& Picture: Owner 2 Name: BARBARA FISHER # Owner 3 Name: —, 1 Street 1: 3 MARILYN DR ; - , • City: WILBRAHAM • ,. ~"',. • State: MA - Zip: 01095 . .%, I .401.4; ' Dwelling Information: - ' Style: CONVENTIONAL V Year Built: 1900 , Exterior Walls: ALUM/VINYL s- VIII Story Height: 2.0 - Attic: UNFIN Basement: FULL Bsmt Gar Spaces: 0 Total Living Area: 2340 Total Living Area Minus FBLA: 2340 Sketch: Finished Basement Area: 0 it 114.10 op i,9 nr C 10 Xttl b t' � 2v Rec Room: 144 p 0 s c m ` t 11 I�w 300 o H rus 241 Heating System: GAS/STEAM ,* a ,; n Central Air: No u G ,2 Fireplaces: 0 ` it s P as Rooms: 10 " i Bedrooms: 4 2t •21 Full Baths: 2 Half Baths: 0 I. c —`— Valuation: Appraised Land: $137,700.00 2r Appraised Bldg: $244,400.00 Appraised Total: $382,100.00 northampton.ias-clt.com/parcel.detail.php?id=25C-172-00101 11/2 6/9/2021 Northampton,MA:Assessor Database: The information delivered through this on-line database is provided in the spirit of open access to government information and is intended as an enhanced service and convenience for citizens of Northampton, MA. The providers of this database: Tyler CLT,Big Room Studios,and Northampton, MA assume no liability for any error or omission in the information provided here. Comments regarding this service should be directed to:jsarafin@northamptonassessor.us Wed.June 9, 2021 : 03:39 PM : 0.04s : 10mb gUNm northampton.ias-clt.com/parcel.detaiiphp?id=25C-172-00101 2/2