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25C-026 (2) 26 NORTHERN AVE COMMONWEALTH OF MASSACHUSETTS BP-2021-1809 Map:Block:Lot:25C-026- 001 CITY OF NORTHAMPTON Permit: Demo PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-1809 PERMISSION IS HEREBY GRANTED TO: Project# Contractor: License: Est.Cost: 1000 KOHL CONSTRUCTION 073313 Const.Class: Exp.Date:03/31/2022 Use Group: Owner: LIVING CITY PROPERTIES INC Lot Size (sq.ft.) Zoning: URB Applicant: KOHL CONSTRUCTION Applicant Address Phone:, Insurance: 31 Campus Plaza Rd (413)256-0321 HADLEY, MA 01035 ISSUED ON:09/01/2021 TO PERFORM THE FOLLOWING WORK: • DEMO GARAGE 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 TILE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 3-11 • Fees Paid: $30.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2021-1809 APPLICANT/CONTACT PERSON:KOHL CONSTRUCTION ? 31 Campus Plaza Rd HADLEY, MA 01035(413)256-0321 L '0K PROPERTY LOCATION 26 NORTHERN AVE MAP:LOT 25C-026-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT r Building Permit Filled outFee Paid $30.00 ��� Type of Construction: DEMO GARAGE New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON ORMATION PRESENTED: Approved . Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Perm it With Site Plan Major Project: Site Plan AND/OR Special Perm it 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 SewerAvailability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay ct/i /at Sign ture 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. ____ . ,.__ The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR o m Massachusetts State Building Code, 780 CMR M�IUSE LITY D o x.- m Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 b c cc� ^ One- or Two-Family Dwelling Zz m 2 n' Thisc For Official Use Only Buil Permit Number: tom/' ` II Date Applied: z D N O o m IV m n (I Official(Print Name) Signature Date w SECTION 1: SITE INFORMATION 1.1-Property Address: 1.2 Assessors Map& Parcel Numbers 26.2& Worn-tak64 AVM 25e►- — 026 Oo t 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: , 1.4 Property Dimensions: OM MO CHOKE 1 1501v1CLAL /0 Ooa 50 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 EX/5'TI AJC ,STi2vcrult' r R 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public le Private❑ Zone: _ Outside Flood Zpne? Municipal 110n site disposal system 0 Check if yes L�l' SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: LIVING CLry Pi oPELTles /Nc I t,04. /74 0/0,?r Name(Print) City,Sta ZIP 31 CAmPus PEA Z A et, Yl3 2$6 03at No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition litt Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2:Dira rn..t A Woo* Fkaf*i. g4kiicEI LEAVE' SLAjt ANd P 1 d AiDET10A.J SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Fees: $ Suppression) Check No.10. teck Amount: 30 Cash Amount: 6. Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) eS 073313 3 .31 - 22— rizetEttcK License Number Expiration Date Name of CSL Holder A List CSL Type(see below) al CtMDks Zbi No.and Street Type Description ��� yt/1 A ©�O U Unrestricted(Buildings up to 35,000 cu.ft.) ',1 R Restricted 1&2 Family Dwelling City/Town,3tate,ZIP M Masonry RC Roofing Covering WS Window and Siding }} '' SF Solid Fuel Burning Appliances in 353 Tfl t 11,nijer 0k\ccrn or.c,,,.., I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) r 0iR a s . ,0 1 ►— CoxisTRkicrtio'Iv C HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 31 C gmpus 1 .t-z>s - r l'-® uc to n.co,-\_, N .and Street Email address Any MA 010 33 to aac o 311 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 Issu ce of the building permit. Signed Affidavit Attached? Yes No 0 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 K3>4i_COT,UCti k) nor_ to act on my behalf, ' a matte lative to work authorized by this building permit application. / 2-3/20Z 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. 7 4,i A`��y'�--- ite4 8°zo •zt Print Owner's or Author►zed'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" Lu City of Northampton `t�tiz -rjr�� �` ' ' sir, \ Massachusetts ,t . c• DEPARTMENT OF BUILDING INSPECTIONS Krf. m �: 4 212 Main Street • Municipal Building �+ Cb Northampton, MA 01060 s'tyy 3r" 1,ti1 APPLICATION FOR DEMOLITION PERMIT Attached are the forms required for a Demolition permit. Please fill out all of the attached forms and submit them to the Building Department with the appropriate fee. Please make checks out to the City of Northampton. (Cash not accepted) Please be advised that disconnect signatures from the following departments must be submitted with the application: 1. Eversource (Gas division) 2. National Grid (Electric division) 3. Northampton Department of Public Works - Water 4. Northampton Department of Public Works — Sewer 5. Northampton Department of Public Works — Storm water Management 6. Northampton Department of Public Works — Tree Warden 7. Northampton Historical Commission Review (if built prior to 1945) *Proof of extermination is required to be submitted to the Health Department for all Commercial demolitions and all abandoned residential properties. (Extermination may be required at the Health Inspector's discretion if evidence of rodents exists). Other required documents: • Massachusetts Construction Supervisors License • Copy of Workers Comp Affidavit • Asbestos abatement report A Demolition Permit will not be issued, and no demolition is to commence until ALL required documents are submitted to the Building Department. For further questions or information, please contact this department @ (413) 587-1240 BUILDING DEPARTMENT DEMOLITION PERMIT SIGN-OFF SHEET Date: 7 ZO I Address: it,- ZS /400HEen1 Al\I C Building Use: GAt46E Owner: !NvG Cory Phone: 'OS Z56 03d I Owner's Address: 31 CArOos I AhLEy / 1 A o1033— ND Lin L r-rle-s Ta 5J20-a,! TET1rUT OFF (Signature of Authorized Representative of Utility Department required) As required by the Massachusetts State Building Code (780 CMR), a permit to demolish shall not be issued until a release from the utilities is obtained, stating that their respective service connections and appurtenant equipment have been removed or sealed and plugged in a safe manner. Eversource (Gas) Signature Title National Grid (Electric) Signature Title DPW (Water) Signature Title DPW (Sewer) Signature Title DPW (Storm water) Signature Title DPW (Tree Warden) Signature Title DPW Director Signature Title Historic Comm. Review Signature Title `' The Commonwealth of Massachusetts Department of 1tuhtstriat Accidents l P' fi 1 Congress Street,Smite 100 Boston,MA 0211 4-2017 wwft.»tass.gvv/riin %%trkers'Compensation Insurance Af[idasit:Ifni[ders/Contractors/ElectriciansiPlnnmhers. '1'0I BE FILED'Mtn I IIE PLRMiI Et INC_ 1'111 IR1t1'. annlicant Information Please Print L.ecsiblti Name fl3usincss}Ur antzatitn.Individual) /() i Coles ta,0 Address:_ 1_C_.�Im u_ _._. h2 City/State/Zip: htL. fit � CO/ 35 Phone#. t913 o'ZSb 032,1 Art you an employee Cheek the appropriate twit' ' Type of project(required): 1.0 1 am a cngrkwer with q _... .._employees(full and=or pan-time).' 7_ New construction 2 I am a Atli pntprictot or partnership and have nu employs a working for me in 8. a 'rtnOdelinb any cavity_No workers'comp.insuram x require dj 3�I am a homeowner doing all work myself:.[No workers"conic).irnr;trtau-e ret uiml_j* 9. Demolition 4.0 I am a humcuw r and will be hiring contractor-a to conduct all work on my property. I will I Building addition. `-+ensure that all,ventral-tors either have workers'cur wmation insurance or are sole I I Electrical repots or additions prupnetors with no employees_ 1 2E1 Plumbing repairs or additions 3O I am a gcnaral cuntractot and I have hired the subcontractors lister[on the attached sheet. 13.0Roof repairs These aub-contraetors have tmrtployees and have workers`comp.usurance.« fi.® n:We a a corporation and its officers have exercised their right of exemption pet MUc. 14. 011ie r i 32,§loll,and we leave no empluvees.[No wetriers•ccanp insurance required] *Any applicant that chocks Ixw III must a€su fill out the section below show ink their,surLs r,'eompensatrcrn policy information. liom suwners who submit this affidavit indicating they are daring all work and then hire outside contractors must subrrut a new affistaw it indicating such. .t.-ontractors that check this Liss muss attached an additional sheet showing the name of the soh-contractors and state whether or nut those vanities have employee's. If the sub-contractors base t-rriplusu s,they most provide their workers'comp.polies number 1 rem an employer that is providing workers'compensation insurance for my employees. Below is the policy nod job site information. Insurance Company Name: .1_, Ivy j 1.TIU L. — Policy#or Self ins.Lie.#:1AI VNZ Oo25?22021 A Expiration Date: 2//0/2a. Job Site Address:26 NO irf l-i ..k is WVE_ City/StatelZip:1611-}killSIDO Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tauter 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 S250.00 a day against the violator.A copy of this statement may be forwarded to the Oflee of ln.csti*cation,of the DMA for insurance eo er.wc sersttcation. I do hereby certify under the pains and► penalties of peryur)�that the information provided above ITN true and correct. Siartature: f 'iC ,P f!h Date: CJ -2a 2 Phone 1-P 2Jp "0Ja/ o. sG� •72f trfS 977,3 ce`/ Official use only. Do not write in this area,to be ron►pteted by city or town official ('its or Town: Permit/License# Issuing Authority (circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector b.Other Contact Person: Phone#: City of Northampton • T.CT eZ r Massachusetts ' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 4.11, CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) 11 In accordance of the provisions of MGL c 40, 554, 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: I- CE,yt: Cim' e Al— L py l LL-- The debris will be transported by: Name of Hauler: 4rurTucic) N.6 OJ - 077/E. COI7/ e, i Signature of Applicant: .GL/rG/ t Xer Date: 8,2D., ASBESTOS REMOVAL All residential, commercial and institutional buildings are subject to Massachusetts Department of Environmental Protection (MassDEP) asbestos regulations at 310 CMR 7.15. Therefore, owners and/or operators (e.g. building owners, renovation and demolition contractors, plumbing and heating contractors, flooring contractors, etc.) need to determine al asbestos containing materials (ACMs), both friable and non-friable, that are present at the site, and whether or not those materials will be impacted by the proposed work, prior to conducting any renovation or demolition activity. Examples of commonly found ACMs include, but are not limited to, heating system insulation, floor tile and vinyl sheet flooring, mastics, wallboard, joint compound, decorative plasters, window glazing, asbestos containing siding and roofing materials and fireproofing materials. Failure to identify and remove all ACMs prior to its being impacted by renovation or demolition activities, can result in significant penalty exposure, and higher clean-up, decontamination, disposal and monitoring costs. A DOS certified asbestos consultant must be contracted to determine if asbestos is present and whether removal/repair is necessary. If the building is a state owned facility, contact DCAM and DOS. DOS provides a list of licensed asbestos abatement contractors and consultants. You may wish to inquire if a contractor has any history of violations. Only DoS licensed and DOS certified asbestos abatement contractors and consultants may be hired to perform asbestos related work in Massachusetts. Received by: rZ£, vA .E7"1-_ Pita, W i I HL Cow_ Print Name Title iS re Date Green Environmental Consulting, Inc 180 Pleasant Street, Suite 213 tel/fax 413-341-3418 Easthampton, MA 01027 www.GecEnviro.com August 19, 2021 Mr. Fred Meyer Kohl Construction 31 Campus Plaza Rd Hadley, MA 01035 RE: Pre-demolition Asbestos Survey 26 Northern Ave(Garage) Northampton, MA 01060 Dear Mr. Meyer: Pursuant to your request, Green Environmental Consulting, Inc (GEC) performed a pre-demolition asbestos survey at the above-referenced location. GEC's survey was limited to the garage and shed at the property. Fieldwork associated with the project was performed on July 30, 2021, by Massachusetts-licensed Asbestos Inspector, David Abaci (License#A1071927). Asbestos Sampling and Results A total of 12 samples of suspect asbestos-containing materials (ACMs) were collected and submitted to an accredited laboratory for analysis using Polarized Light Microscopy (EPA 600/R-93/116). Materials found to contain one percent or greater asbestos are considered to be ACMs. No ACMs were identified during GEC's survey. The materials listed in Table 1 were sampled and determined not to be ACMs. Table 1, Non-Asbestos Materials Material Location Reference Sample Number(s) Sub siding paper- black Garage 03225-01A and -01B Storm window caulk Garage 03225-02A and -02B Roofing shingle Garage 03225-03A and -03B Roofing paper Garage 03225-04A and -04B Rolled roof shingle Shed 03225-05A and -05B Rolled roof paper Shed 03225-06A and -06B Refer to Attachment 1 for the asbestos laboratory report and the chain-of-custody for samples collected. Asbestos bulk samples were collected in a statistically random manner, per EPA guidelines. Page 1 of 2 Limited Asbestos Survey(Garage) 26 Northern Ave, Northampton, MA 010560 Limitations This report is intended for the sole use of Kohl Construction. This report is not intended to serve as a bidding document nor as a project specification. Actual site conditions and quantities should be field- verified. The scope of services performed in execution of this evaluation may not be appropriate to satisfy the needs of other users. The use or re-use of this document, the findings, conclusions, and recommendations herein is at the risk of said user. GEC's sampling was limited to specific materials at specific locations as listed in the table above. The sampling information provided should not be used to make assumptions regarding the asbestos content of materials in areas other than those specifically tested. The Massachusetts Department of Environmental Protection (DEP) and the US Environmental Protection Agency (EPA) currently recognize Polarized Light Microscopy(PLM) analysis as an acceptable analytical method for determining the asbestos content in non-friable, organically bound (NOB) materials. However, comparative studies between PLM analysis and Transmission Electron Microscopy (TEM) analysis have shown that PLM analysis may yield false negative analytical results for NOBs such as floor tiles. GEC recommends that, prior to renovation or demolition activities, one sample from each homogeneous area of mastic and other NOB materials that originally tested negative by PLM undergo confirmatory analysis by TEM, utilizing ELAP-198.4 TEM Method for Identifying and Quantifying Asbestos in NOB Bulk Samples. Conclusions and Recommendations No ACMs were identified during GEC's sampling. Any suspect ACMs that are discovered during building • demolition that is not included in this report should be assumed to contain asbestos until further bulk sampling and analysis is performed. GEC appreciates the opportunity to work with you on this important project. If you have any questions regarding this report, please contact us at (413) 341-3418. Sincerely, Green Environmental Consulting, Inc AL' III- Adam Lesko President Attachments: 1 Laboratory Report and Chain-of-Custody Page 2 of 2 Attachment 1 Laboratory Report and Chain-of-Custody EMSL Analytical, Inc. EMSL Order: 042119193 Customer ID: GECL78 EMSL 200 Route 130 North Cinnaminson,NJ 08077 Customer PO: Tel/Fax:(800)220-3675/(856)786-5974 ,- http://www.EMSL.com/cinnasblab@EMSL.com Project ID: Attention: Reports Phone: (413)341-3418 Green Environmental Consulting, Inc. Fax: (413)341-3419 180 Pleasant St Received Date: 08/02/2021 9:00 AM 2nd Floor, Suite 213 Analysis Date: 08/03/2021 -08/07/2021 Easthampton, MA 01027 Collected Date: Project: 26 Northern Ave., Northampton Garage NESHAP/03225/26 Northern Avenue, Northampton, MA 01060 Test Report:Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized Light Microscopy Non-Asbestos Asbestos Sample Description Appearance %Fibrous %Non-Fibrous %Type 03225-01A Garage-Sub Siding Black 20%Cellulose 80%Non-fibrous(Other) None Detected Paper-Black Fibrous 042119193-0001 Homogeneous 03225-01 B Garage-Sub Siding Black 20%Cellulose 80%Non-fibrous(Other) None Detected Paper-Black Fibrous 042119193-0002 Homogeneous 03225-02A Garage-Storm White 100%Non-fibrous(Other) None Detected Window Caulk Non-Fibrous 042119193-0003 Homogeneous 03225-02B Garage-Storm White 100%Non-fibrous(Other) None Detected Window Caulk Non-Fibrous 042119193-0004 Homogeneous 03225-03A Garage-Garage Gray/Black 20%Cellulose 80%Non-fibrous(Other) None Detected Roof Shingle Non-Fibrous 042119193-0005 Heterogeneous 03225-03B Garage-Garage Gray/Black 20%Cellulose 80%Non-fibrous(Other) None Detected Roof Shingle Fibrous 042119193-0006 Homogeneous 03225-04A Garage-Garage Black 20%Cellulose 80%Non-fibrous(Other) None Detected Roof Paper Fibrous 042119193-0007 Homogeneous 03225-04B Garage-Garage Black 20%Cellulose 80%Non-fibrous(Other) None Detected Roof Paper Fibrous 042119193-0008 Homogeneous 03225-05A Shed-Shed Rolled Black 25%Cellulose 75%Non-fibrous(Other) None Detected Roof Shingle Fibrous 042119193-0009 Heterogeneous 03225-05B Shed-Shed Rolled Black 25%Cellulose 75%Non-fibrous(Other) None Detected Roof Shingle Fibrous 042119193-0010 Homogeneous 03225-06A Shed-Shed Rolled Black 30%Cellulose 70%Non-fibrous(Other) None Detected Roof Paper Fibrous 042119193-0011 Homogeneous 03225-06B Shed-Shed Rolled Black 30%Cellulose 70%Non-fibrous(Other) None Detected Roof Paper Fibrous 042119193-0012 Homogeneous Initial report from:08/07/2021 07:25:04 ALB_PLM_00>98 0001- I 78 Printed:8/7/2021 7:25 AM Page 1 of 2 EMSL Analytical, Inc. EMSL Order: 042119193 EMSL. 200 Route 130 North Cinnaminson,NJ 08077 Customer ID: GECL78 Customer PO: Tel/Fax:(800)220-3675/(856)786-5974 http://www.EMSL.com/cinnasblab@EMSL.com Project ID: Analyst(s) /671/144/() Brian Kibelstis(5) Samantha Rundstrom,Laboratory Manager Nancy Stetter(7) or Other Approved Signatory EMSL maintains liability limited to cost of analysis.Interpretation and use of test results are the responsibility of the client.This report relates only to the samples reported above,and may not be reproduced,except in full,without written approval by EMSL.EMSL bears no responsibility for sample collection activities or analytical method limitations.The report reflects the samples as received. Results are generated from the field sampling data(sampling volumes and areas,locations,etc.)provided by the client on the Chain of Custody.Samples are within quality control criteria and met method specifications unless otherwise noted.The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR(previously EPA 600/M4-82-020"Interim Method") but augmented with procedures outlined in the 1993("final")version of the method. This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP.NIST or any agency of the federal government.Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis.Unless requested by the client,building materials manufactured with multiple layers(i.e.linoleum,wallboard,etc.)are reported as a single sample.Estimation of uncertainty is available on request. Samples analyzed by EMSL Analytical,Inc.Cinnaminson,NJ NVLAP Lab Code 101048-0,AIHA-LAP,LLC-IHLAP Lab 100194,NJ DEP 03036,PA ID#68-00367,LA#04127 Initial report from:08/07/2021 07:25:04 ASB_PLM_0008_0001-1.78 Printed:8/7/2021 7:25 AM Page 2 of 2 0zdezzo: 042119193 Page lofl Analysis Type: ` Asbestos Chain of Custody � l� pLM �7����� � ' — Turnaround Time: 96*our Green Environmental Consulting, Inc 180 Pleasant Street-Suite 2l3 Easthampton. wAOlO27 Phone/Fax Project Info: F Send Results To: Project Name: Results to: 2O Northern Ave. Northampton Garage NESHAP ems|reportsoa9ecenvi/ozum Project Number: Invoice to: 03225 adann, gecenv.,o.com Project Address Comments/Special Instructions: 2G Northern Avenue Northampton, MA0lO6O ` � Sample Number Sample Location Sample Description - 03225'0lA Garage Sub Siding Paper (B|acW ` ^.` 0322S-018 Garage Sub Siding Paper (B|ack) �o 03225'02A Garage Storm Window Caulk _ 03225'02B Garage Storm Window Caulk 03225-03A Garage Garage Roof Shingle 03225'03B Garage Garage Roof Shingle 03225'04A Gamgo Garage Roof Paper | 03225'048 Garage Garage Roof Paper 03225-O5A Shed Shed Rolled Roof Shingle 03225'05B Shed Shed Rolled Roof Shingle 03225-05A Shed Shed Rolled Roof Paper 03225'06B Shed Shed Rolled Roof Paper Sampled By: Date� RecexvedBy� me Relinquished By� Date/Time: Received in Lab By: Date/Time: / \ > � � ~1 7/��� / �"°