30C-049 (3) File #BP-2022-1204
APPLICANT/CONTACT PERSON:BRIAN CAMPEDELLI
223 CARDINAL WAY FLORENCE, MA 01062(413)539-3685
PROPERTY LOCATION 506 FLORENCE RD
MAP:LOT 30C-049-001 ZONE
• THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $75.00
Type of Construction: DEMO HOME AND OTHER STRUCTURES
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
1uilding Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
•
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION JRE SE NT E D:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:*
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed_
Other Perm its Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Perm it from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
01\16L N. N' i.q t • ;I 1/209,
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 Masstichusetts
y, r - Board of Building Regulations and Standards FOR
I Massachusetts State Building Code, 780 CMR MUNICIPEALITY
y:
C" /aiilding Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
N _ One-or Two-Family Dwelling
IA c\r This Sectio For Official Use Only
BuNing Pew Number: Date Applied:
�z
U
E 7(:_13ti ding(Wfic al(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 11.2 Assessors Map& Parcel Numbers
Se? 6 Flair., . PA ikbeihill 0` 9
1.1a Is this an accepted street?yes umber
1.3 Zoning Information: +l 43
up4iP Zoning District Proposed Use15..ct.." � ) .
me
(ft)
V"
1.5 Building Setbacks(ft)
Front Yard [Rear Yard
Required Provided Provided
1.6 Wat Supply: (M.G.L c.40,§54) 1 posal System:
Public 11 Private❑ ` 1 site disposal system 0
SE(
2.1 Owner'of Record: Ale-.
Name(Print)
J
(3 s8(-#J 6. 1oce4,.4144.,1r4.._
No.and Street Telephone f mail Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied LI Repairs(s) 0 Alteration(s) ❑ Addition ❑
Demolition lef Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work': D dkw- .1
ode SD(o-F(ose„, tik-
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 Cost (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees 4 1116 ;
Suppression)
wily Check No. 1heck Amount: Cash Amount:
6. Total Project Cost: $ d OP --.-, 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS DgZ` th
(
rt �w.ctL.tI I
License Number Ex ira ion Dee
Name of CSL Holder
i List CSL Type(see below)
tiZ 3 ( (At A0-1
No.and Street Type Description
f(ett..ft. M Pr V 0I 6.,Z (� 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
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
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 Issuance of the building permit.
Signed Affidavit Attached? Yes 0 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
to act on my behalf, in all matters relative to work authorized by this building permit application.
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 applicatio is true and accurate to the best of my knowledge and understanding.
infr
4 7 11:2
Print w 's or Au orize Ag is Name(Electronic Signature) at
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 arbitra,ion
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"
i
City of Northampton
cr X)f-f- w ,?,.,
.. �� Massachusetts t�
III % DEPARTMENT OF BUILDING INSPECTIONS % . :'
},� f' 212 Main Street • Municipal Building J� •,tea
Northampton, MA 01060 tf.i', {3,,aN'\"
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: J4/ p/6 01
i
The debris will be transported by:
Name of Hauler: Qov6 </l/ --77c/r /v
77
Signature of Applicant: Date: g Z.
7
It
The Commonwealth of Massachusetts
x _;= Department of Industrial Accidents
_`11 1 Congress Street,Suite 100
°4 _ Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): t+-._ ,�0 (1
Address: 2-23 .,.4Q
City/State/Zip: Ti K 1 tM# O( aG Z Phone#:_ 4 f 13 -fig--44-7-I
Are you an employer?Check the appropriate box: Type of project(required):
l.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling
any capacity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
9. '®-Demolition
10❑Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.Q Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
p
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
I.Homeowners 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. 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. !77
Insurance Company Name: VoLAi1 T1Vl ft.�/ - -
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
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$,,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 der the pains and penalties of perju . hat the information provided above is true and correct
Signature: d Date: 7 2( /? '.'i_
-
Phone#: L/'( —Set, 74
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.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
September Lane Labs, INC.
P. O. BOX 275
Beacon Falls, CT 06403
203-668-8533
04/21/2122
WORK PERFORMED BY:
Baystate Contracting Services, INC.
352 Albany Street
Springfield, MA 01105
Attn: James Beaudry
Project NO: 506-FR-FM
506 Florence Road
Florence, MA
The asbestos abatement project is considered completed because the
post-abatement re-occupancy criteria for the asbestos abatement have
been satisfied.
On April 20, 2022, a Licensed Project Monitor conducted a visual
inspection and collected PCM Final Clearance air sample. No visible
debris was found in the containment.
The air sample collected in the abatement work area was below the lev
specified in Federal and MASS Regulations, 0.010 f/cc.
Attached are EMSL's PCM Air Clearance analysis results.
ABATED ACM:
Kitchen Drywall and Joint Compound
Roofing Shingles _-
ero
MA Li 041931
°nationaignd INVOICE
National Grid
Non-Utility Billing
300 Erie Blvd. West
Syracuse NY 13202
(315) 428-31 10
Invoice Number: 5001 15447
Invoice Date: 12/09/2021
Customer Number: 400030872
SHERRY TAYLOR Due Date: 03/09/2022
25 Edwards Sq Work Order: 10030505132
Northampton MA 01060-3219
Line Description Quantity UOM Unit Amt Net Amount
Please make this payment promptly to ensure your job progresses in a timely manner.
Costs associated with temp service at 506 Florence Rd, Florence, MA
If paying by wire: Wire Payment: JPMorgan Chase, Bank Routing Number
(ABA): 021000021, Credit: National Grid USA, Bank Acct. Number:
777149618. Please include invoice(s) with payment
If you have any questions about this invoice, please contact DONNA MCGUIRE
10 Non Utility Billing Line Item 1 .000 EA 240.00 $240.00
Sub Total : � � 240.00
Total Taxes : / 0.00
TOTAL AMOUNT DUE: l4 $240.00 )
Prices are subject to change after 90 days
ACH Payments (Banking Information) up to $99,999 can be made for a One Time Fee through
Speedpay at https://internet.speedpay.com/nationalgrid. Credit/Debit Card Payments can be made in
five (5) $1 ,000 Increments for Invoices up to $5,000, at a fee per Transaction, through Speedpay,
by selecting Add Card in the Payment Form at https://internet.speedpay.com/nationalgrid
BUILDING DEPARTMENT
DEMOLITION PERMIT SIGN-OFF SHEET
Date: /7,112-1'
Address: 5 0 o r-4 (L- 1/. pe- PM Building Use:
Owner: Phone: 'H Ste— L
Owner's Address:
UTILITY CUT 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 peen removed or sealed and plugged in a
safe manner.
Eversource (Gas) ! 0 1
Signature Title
National Grid (Electric) 340_
Signature Title
DPW (Water) _
Signature Title
DPW (Sewer) l(�
Signature Title
DPW (Storm water)
rar _ act( Title
- ,�,
DPW (Tree Warde 6L f c- '-V— ' Ye w, a l
Signature Title
DPW Director
Signature Title
Historic Comm. Review
Signature Title
September Lane Labs, INC.
P. O. BOX 275 Beacon Falls, CT 06403 203-668-8533
Private Client Project Monitoring Agreement
CLIENT:
ADDRESS: )(e, �/ a
CITY:
STATE/ZIP CODE: V
Client will retain September Lane Labs, INC. to perform a
Final Visual Inspection and Collect Final Clearance Air
Sample(s) if applicable.
Check One:
_ Final Visual Inspection $225.00
_ PCM Final Clearance — 1 Cassette $300.00
PCM Final Clearance — 2 - 4 Cassettes $350.00
SIGNATURE:
DATE:
Payment in form of check to SLL, INC. will be made available day of
services.
=TATE SIVIat INC
352 Albany Street,Springfield,Massachusetts 0110
Tel: (413)781-0820/(800)448-2822
Fax:(413)734-6224
May 3,2021
Industrial Hygienist Firms Recommend
September Lane Labs
Contact: Marco Carralero
83 September Lane Beacon Beacon Falls Ct.
Cell: (203) 668-8533
E-Mail: septemberlanelabs(° mail.com
Project Monitor DLS Certification #AM041931
Asbestos Analytical Lab #AA000191
Green Environmental Consulting LLC
Contact: Adam Lesko
180 Pleasant Street Suite# 213
Easthampton, Ma 01027
Cell: (413) 695-5875
E-Mail: alesko@gecenviro.com
Project Monitor DLS Certification # AM071610
Asbestos Analytical Lab # AA000242
ATC Group Services LLC
Contact: Brian Williams (413) 781-0070
73 William Franks Drive
West Springfield, Ma.
E-Mail: brian.williams@atcgs.com
Project Monitor DLS Certification #AM000095
Asbestos Analytical Lab # AA000005
Project Monitor May 3,2021
Myrjt COMAC11NG SERVICES, IN 1 E-MAILED
352 Albany Street,Springfield,Massachusetts 01105 -- / / �G�L
Tel:(413)781-0820/(800)448-2822 —1/2 `t' - .-.
Fax:(413)734-6224
www.baystalecontractin .com
AA/EOE
January 26,2022
Sam and Sherry Taylor
25 Edwards Square
Northampton,MA 01060
For the sum of$10.850.00,we agree to perform the following asbestos abatement work at 506 Florence Road in Florence.Mas-.chusetts.
Asbestos Abatement work includes:
1. Removal of approximately 704 S.F.of joint compound walls located in the kitchen, I"floor back hallway.
2. Removal of 8 S.F.of sink undercoating located in the kitchen.
3. Removal of 85 S.F.of glazing on windows located at front/back of house la floor fix window&6 ea.in back.
4. Removal of 20 S.F.of old furnace located in the basement.
5. Removal of 1 ea.275-gallon oil tank with 10 gallons of product located in the basement.
6. Removal of 2 S.F.of black mastic located on the exterior meter box.
7. Removal of 225 S.F.of 3 ea.layers of rolled roofing located on shed#3.
8. Removal of 375 S.F.of 1 ea.layer of rolled roofing located on shed#4.
Our methods of removal include:
1. Work is done in a cocoon type work area.
2. HEPA vacuum work area.
3. Use of Profo-Bags.
4. Brand method of negative air pressure and HEPA filtering work area(4 times per hour)
5. Wet removal.
6. Brush all surfaces and wipe clean.
7. Encapsulent agent on all surfaces.
8. Compliance concerning all local,state,and federal agency required by law notifications.
9. Proper disposal and transportation of asbestos to an EPA authorized dumpsite.
Our standards meet all EPA,DOS,DEP and OSHA requirements for asbestos abatement. We are licensed and fully insured.
Sam and Sherry Taylor shall be responsible for:
1. Removing all moveable objects from work area prior to start of work.
2. Making pre-payment of 50%prior to Baystate Contracting Services,Inc.filing the required State notification with Dep: ent of
Environmental Protection(DEP),which has a ten(10)working day waiting period,with the balance due in full upon c.mpletion.
3. To arrange and pay for Visual Inspection and Air Test by an Independent Industrial Hygienist.See attached sh.•t.
Note: Due to the use of tape,spray adhesive,staples,etc.to meet compliance with applicable asbestos removal State regulati.ns,Baystate
Contracting Services,Inc.cannot be held liable for damages to surfaces in the work area.
Sam and Sherry Taylor acknowledge that they are the owner of the property and are not in bankruptcy or petitioning for bankrup cy.
Any balance that becomes past due for any reason will be charged a service charge of 1.5%per month,18%annually.If it should becom necessary to turn
This account ovcrl r collection,the billed party agrees to pay all collection costs,plus reasonable attomey's fees incurred.
DISCLAIM{'`R: This contract is only val' 'f the Owner acknowledges and has disclosed any and all violations or orders placed on the . .perry by any
Governmental agency(if any exists). ; a act any violations exist and any work has been done by Baystate Contacting Services,Inc.,B:ystate can stop
further work upon discovery of su v' lations and the owner will be responsible for costs of labor and materials associated with the wo executed.
The li ility of :ystate Contntictin_Services,Inc.begins and ends with the contracted work only.Asbestos in the building not covered y this contract is not
the re sibili of Baysta Contr•1ting Services,Inc.
BAN TAT: CONTRA T G S'R CES,INC. Agreed a Accepted by:
James Be.udry,Estimator ,''Sa`m and Sherry Taylo PVIr jam:to
c
N:\Msword\ASBESTOS contracts\20221506 Florence Road,Florence,MA..doc
September Lane Labs, INC.
P. O. BOX 275
Beacon Falls, CT 06403
203-668-8533
04/21/2022
WORK PERFORMED BY:
Baystate Contracting Services, INC.
352 Albany Street
Springfield, MA 01105
Attn: James Beaudry
Project NO: 506-FR-FM
506 Florence Road
Florence, MA
The asbestos abatement project is considered completed because the
post-abatement re-occupancy criteria for the asbestos abatement have
been satisfied.
On April 20, 2022, a Licensed Project Monitor conducted a visual
inspection and collected PCM Final Clearance air sample. No visible
debris was found in the containment.
The air sample collected in the abatement work area was below the level
specified in Federal and MASS Regulations, 0.010 f/cc.
Attached are EMSL's PCM Air Clearance analysis results.
ABATED ACM:
Kitchen Drywall and Joint Compound
Roofing Shingles /
• . ro
MA Li _ -� '4'041 ' 31
EMSL Analytical, Inc. EMSL Order: 242201856
Customer ID: SLL78
165 Gracey Avenue Meriden,CT 06451 Customer PO:
Tel/Fax: (203)284-5948/(203)284-5978 Project ID:
http://www.EMSL.com/wallingfordlab@emsl.com
Attention: Marco Carralero Phone: (203)668-8533
September Lane Labs Inc Fax:
83 September Lane Received Date: 04/20/2022 03:35 PM
Beacon Falls, CT 06403 Analysis Date: 04/20/2022
Collected Date: 04/20/2022
Project: 506-FR-FM/506 FLORENCE ROAD FLORENCE, MA
Test Report: Fiber Count by Phase Contrast Microscopy (PCM), NIOSH 7400 Method -A Rules,
Revision 3, Issue 3, 6/15/2019
LOD
Sample Location Sample Date Volume(L) Fibers Fields (fib/cc) Fibers/mm' Fibers/cc Notes
B-01 BLANK LOT 04/20/2022 Field Blank
Not Analyzed
242201856-0001
01 IN KITCHEN 04/20/2022 1318 5.5 100 0.0020 7.01 0.0021
242201856-0002
The results reported have been blank corrected as applicable.
Analyst(s):
Danny Sandhu PCM 1 Danny Sandhu,Asbestos Laboratory Manager
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.Limit of detection is 7
fiberslmm'.Fiber counts outside the recommended fiber density range of the method(100-1300 f/mm')have greater than optimal variability and are probably biased.Field blank results,when available,are used to blank
correct results.NIOSH 7400 requires field blanks be submitted at a rate of 10%,with a minimum of 2 per set.Measurement of uncertainty available upon request.The results in this report meet at requirements of the
NELAC standards unless otherwise noted.!Mrs-laboratory Sr values:5-20 fibers=0.35,21-50 fibers=0.15,51-100 fibers=0.17.Inter-laboratory Sr values(Average of EMSL round robin data)=0.34.
Samples analyzed by EMSL Analytical,Inc.Meriden.CT CT PH-0322,MAAA000191,RI AAL-108T3,VT AL357101,NYS ELAP 12063
Initial report from:04/20/2022 05:06 PM
Printed 04/20/202205:08PM .7_NoSig_0003_0001 Page 1 of 1
EMSL Analytical, Inc. EMSL Order:,242201856
Customer ID: SLL78
EMSL 165 Gracey Avenue Meriden,CT 06451 Customer PO:
Tel/Fax:(203)284-5948/(203)284-5978 Project ID:
•� http://www.EMSL.com/wallingfordlab@emsl.com
Attention: Marco Carralero Phone: (203)668-8533
September Lane Labs Inc Fax:
83 September Lane Received Date: 04/20/2022 03:35 PM
Beacon Falls, CT 06403 Analysis Date: 04/20/2022
Collected Date: 04/20/2022
Project: 506-FR-FM/506 FLORENCE ROAD FLORENCE, MA
Test Report: Fiber Count by Phase Contrast Microscopy (PCM), NIOSH 7400 Method -A Rules,
Revision 3, Issue 3, 6/15/2019
LOD
Sample Location Sample Date Volume(L) Fibers Fields (fib/cc) Fibers/mma Fibers/cc Notes
B-01 BLANK LOT 04/20/2022 Field Blank
Not Analyzed
242201856-0001
01 IN KITCHEN • 04/20/2022 1318 5.5 100 0.0020 7.01 0.0021
242201856-0002
The results reported have been blank corrected as applicable.
Analyst(s):
Danny Sandhu PCM 1 Danny Sandhu,Asbestos Laboratory Manager
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.Limit of detection is 7
fiberslmm'.Fiber counts outside the recommended fiber density range of the method(100-1300 f/mm')have greater than optimal variability and are probably biased.Field blank results,when available,are used to blank
correct results.NIOSH 7400 requires held blanks be submitted at a rate of 10%,with a minimum of 2 per set.Measurement of uncertainty available upon request.The results in this report meet at requirements of the
NELAC standards unless otherwise noted.Infra-laboratory Sr values:5-20 fibers=0.35,21-50 fibers=0.15.51-100 fibers=0.17.Inter-laboratory Sr values(Average of EMSL round robin data).0.34.
Samples analyzed by EMSL Analytical,Inc.Meriden,CT CT PH-0322,MAAA000191,RI AAL-108T3,VT AL357101,NYS ELAP 12063
Initial report from:04/20/2022 05:06 PM
Printed 04/20/2022 05:06 PM SB PCP✓, NoSict OUO OU01 - Page 1 of 1
6/6/22,3:29 PM Mail-Samuel Taylor-Outlook
Re: 506 Florence Rd Demolition
David Sparks <davidsparks@northamptonma.gov>
Mon 12/20/2021 8:52 AM
To:Samuel Taylor <samtaylorl @hotmail.com>
Hi Sam, do you expect to use the water service again for a new house? If so we ask that your demo
contractor not hook the service during demolition. If this is not possible we will require the service be
cut off outside the foundation so it won't be pulled out of the water main. If you don't plan on reusing
the service we will require it be cut off at the main. Let me know what your plan is.
Thanks
On Fri, Dec 17, 2021 at 12:18 PM Samuel Taylor <samtaylorl @hotmail.com> wrote:
Hello,
My name is Sam Taylor. We are trying to get the permit completed for a demolition of 506
Florence Rd. I need to get a sign off for the demolition to start. I had the water turned off at the
road earlier so that there wouldn't be any freezing problems this winter. Is there anything else I
need to have done to get your signature.
Thanks Sam Taylor
413-588-7421
Sent from Mail for Windows
David Sparks
Water Superintendent
City of Northampton
413-587-1097
https://outlook.live.com/mail/0/deeptink?Print 1/1
INVENTORY FORM B CONTINUATION SHEET [NORTHAMPTON ] [546 FLORENCE ROAD]
MASSACHUSETTS HISTORICAL COMMISSION Area(s) Form No.
220 MORRISSEY BOULEVARD,BOSTON,MASSACHUSETTS 02125
NTH.445
Recommended for listing in the National Register of Historic Places.
If checked,you must attach a completed National Register Criteria Statement form.
Use as much space as necessary to complete the following entries, allowing text to flow onto additional continuation sheets.
ARCHITECTURAL DESCRIPTION:
Describe architectural features. Evaluate the characteristics of this building in terms of other buildings within the community.
This is a one-and-a-half story house with a side-gable roof to which is attached a front-gable. In the angle of the two sections of
house is a tower. A porch traverses the front-gabled section. It rests on columns and has a brick stoop. The vinyl siding and
window replacements obscure any details of architectural significance.
HISTORICAL NARRATIVE
Discuss the history of the building. Explain its associations with local(or state)history. Include uses of the building, and the role(s)the
owners/occupants played within the community.
From Form B of 1980: "Florence Road, originally known as South Street, first appears on the 1854 Hampshire Co. Map as a
connecting route between Florence and Easthampton. The road begins at a junction with West Street (now Ryan Road) at the
middle crossing of the Mill River in Florence, and heads south to a junction with Easthampton Road (now Wilson Road) near the
Easthampton line. Only a few farms were scattered along this road until the 20th century and more particularly after the Second
World War, when suburban development lined this street with houses."
BIBLIOGRAPHY and/or REFERENCES
Beers, F. W. County Atlas of Hampshire Massachusetts, New York, 1873.
Hales, John G. Plan of the Town or Northampton in the County of Hampshire, 1831.
Miller, D. L. Atlas of the City of Northampton and Town of Easthampton, Hampshire County, Massachusetts, Philadelphia, 1895.
Walker, George H. and Company. Atlas of Northampton City, Massachusetts, Boston, 1884.
Walling, Henry F. Map of Hampshire County, Massachusetts, New York, 1860.
Continuation sheet I
6/6/22,3:29 PM Mail-Samuel Taylor-Outlook
Re: 506 Florence Rd Demolition
David Sparks <davidsparks@northamptonma.gov>
Mon 12/20/2021 8:52 AM
To:Samuel Taylor <samtaylorl @hotmail.com>
Hi Sam, do you expect to use the water service again for a new house? If so we ask that your demo
contractor not hook the service during demolition. If this is not possible we will require the service be
cut off outside the foundation so it won't be pulled out of the water main. If you don't plan on reusing
the service we will require it be cut off at the main. Let me know what your plan is.
Thanks
On Fri, Dec 17, 2021 at 12:18 PM Samuel Taylor <samtaylorl @hotmail.com> wrote:
Hello,
My name is Sam Taylor. We are trying to get the permit completed for a demolition of 506
Florence Rd. I need to get a sign off for the demolition to start. I had the water turned off at the
road earlier so that there wouldn't be any freezing problems this winter. Is there anything else I
need to have done to get your signature.
Thanks Sam Taylor
413-588-7421
Sent from Mail for Windows
David Sparks
Water Superintendent
City of Northampton
413-587-1097
https://outlook.live.com/mail/0/deeplink?Print 1/1
aoPTH;r�,o� CITY of NORTHAMPTON
` r PUBLIC HEALTH DEPARTMENT
Public Health Director Merridith O'Leary, RS
Municipal Building 212 Main Street -Northampton, MA 01060
Phone(413)587-1214 Fax(413)587-1221 Public
PHealth
YIJBR:
http: www northamptonma.gov.245`Health Prevent.Promote Protect
WITNESS OF EXTERMINATION
Date Time
Property Owner:
Property Address:
Exterminator:
Company:
Company Address:
Rodenticide/Chemicals Applied
Reason for Extermination: � y frAw-- t✓ SO 6 F/co
Comments:
I hereby certify, under the pains and penalties of perjury, that I to the best of my knowledge
and belief, have applied the above noted pesticide in accordance with M.G.L. Chapter 132B
and any other applicable law or regulation.
0 City Water 0 Well 0 Septic System �`-'�
If applicable DYes 0 No
Board of Health Representative Signature of Extermin•tor
*Demolition best practices relating to fugitive dust and debris must be adhered to in accordance
with MGL Chapter 111, Section 122.
RULES AND REGULATIONS FOR EXTERMINATION FOR
RODENTS IN BUILDINGS TO BE DEMOLISHED
The Board of Health has adopted the following Rules and Regulations to be conducted before
demolition of property:
1. A licensed and professional exterminator active in the business must be hired to perform
the extermination of the building(s) to be demolished.
2. The Board of Health must be notified of the date and time of the extermination so that a
Sanitarian can be present for inspecting and witnessing.
3. A fast acting rodent poison must first be used in sufficient quantity and bait stations
to be adequately accessible to the rodents.
48 hours after this baiting, an anti-coagulating type or other effective rodenticide
must be used and allowed to be present for 72 hours before demolition can
begin. This is a total five (5) day treatment.
The poison should be checked by the exterminator at sufficient intervals in order
to replace bait stations which are consumed. Sufficient data must be supplied to
the department on the rodenticide used to satisfy the Board of Health of its
effectiveness.
TEMAN
MIN` MINUTEMAN 'EST CONTR L
90 CONZ STREET, NORTHAMPTON, MA 01060 • (413) 586-1009 • (800) 586- 009
PEST CONTROL SERVICE AGREEMENT
Date: A, Rep: ,/
SERVICE LOCATION DIRECTIONS to SERVICE LOCATION
Name
. � . /, j/(.
Street "' ,+ /
City �% State Zip
?//(+Gf Q/G 4 D
Day Phone a" Evening Phone 1Cell Phone
Email Address
BILLING INFORMATION 111 SAME AS ABOVE JOB INSTRUCTIONS/COMMENTS
Name ❑Need to call ahead 24 hours before service.
Street �!
City State Zip ?/9/ r...(J77 /704j_) 44/ 6./e/e d,e
Day Phone Evening Phone Cell Phone
Email Address/0- `r,;,°,)4 , ./:.d7O"
QUOTATION !-1. �..... .,c /�✓✓� ..� I^ - l'!11
Initial Service Fee (c.o.d.) $ `-:- /�C J t
Initial Service Fee (billed) $ 6,1v1,410V yr' ,+a+y.�� �.+
fir+/ 4 / ." /',C J ✓'
Monthly Acct. (c.o.d.) $
Monthly Acct. (billed) $ .'J �fv�'v ,& '• 0A- •"/'//e •
Termite/WBI Treatment Fee$ i
PRICE QUOTED EFFECTIVE FOR 60 DAYS /
",
Signature + Date
ANNUAL EXTERIOR HOME SERVICE CONTRACT FOR CARPENTER ANTS
Minuteman recommends seasonal exterior treatments to help prevent carpenter ants from infesting your home. The treatments will
start in the early spring and end late summer/early fall. This program will automatically renew annually, but you may cancel at any
time by giving us a thirty-day written notice. Price subject to change after one year.
Per-Treatment Cost$
AREAS OF APPLICATION
House Q Garage El Barn •
Q Shed I]Pool Area ❑Other
Please allow ample time for the treatments to do their work. For this reason, it is important that the customer wait 30 days from the
initial service for any re-treatment to be performed. (Rain will not affect the results of your exterior treatment.)
Although Minuteman Pest Control Co., Inc. provides the most up to date materials and methods,this Agreement is not a guarantee or warranty
as to the absence of wood destroying insects. Minuteman is not responsible for wood destroying insects that may be behind obstructed areas or
in locations where there is a moisture problem. It should be understood that some degree of damage, including hidden damage, may be present.
Signature Date
WHITE-Office Copy • Yellow-Return Copy • Pink-Customer Copy