07-045 (5) BP-2023-0294
284 NORTH FARMS RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
07-045-001 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-2023-0294 PERMISSION IS HEREBY GRANTED TO:
Project# DEMO 2023 Contractor: License:
ASSOCIATED BUILDING
Est. Cost: 20000 WRECKERS INC 062382
Const.Class: Exp.Date: 10/31/2023
Use Group: Owner: LINDA OLBRIS
Lot Size (sq.ft.)
Zoning: WSP Applicant: ASSOCIATED BUILDING WRECKERS INC
Applicant Address Phone: Insurance:
352 ALBANY ST (413)732-3179 WCA154516521
SPRINGFIELD, MA 01105
ISSUED ON: 03/31/2023
TO PERFORM THE FOLLOWING WORK:
DEMO HOUSE
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: i,
d
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
File #BP-2023-0294
APPLICANT/CONTACT PERSON:ASSOCIATED BUILDING WRECKERS INC
352 ALBANY ST SPRINGFIELD, MA 01105 (413)732-3179
PROPERTY LOCATION 284 NORTH FARMS RD
MAP:LOT 07-045-001 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 HOUSE
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
INFORMATIONPRESENTED:
Approved! AIMNonal permits required filiniallirr
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition De/7r
istisrtilL `fit, 3 )(/
/ /
Signature of Building Officia 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.
i "-ic,--- av
/ " Q v ,,_,-,-. , _ ,
AR 7 ,
9 2023 , The Commonwealth of Massachusetts
I. Board of Building Regulations and Standards FOR
is �ui
MUNICIPALITY
<n/ Board
State Building Code, 780 CMR
Hgnil,r Ngp._ , USE
BtiiltY4it •Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
lb";Permit Number: aWC Date Applied:
BuildingOfficial(Print Name) ‘,9
( Si afore -- e
>
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
284 North Farms Road 07-045-001
1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Residential 21, 7680
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
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: /
Public fib Private 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Linda Olbris Chicopee, MA 01020
Name(Print) City,State,ZIP
15 Langevine Street Apt. 1L (347)337-7907 lolbris@gmail.com
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction ❑ Existing Building I Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition Accessory Bldg. 0 Number of Units 1w Other 0 Specify:
Brief Description of Proposed Work': Machine demolition of single-family house including slab and
foundations. Use water for dust control via tanker. Live load debris onto ABW trailers
for disposal at licensed facility. Backfill to surrounding grade.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 20, 000 1. Building Permit Fee: $ Indicate how fee is determined:
2. Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
Check No.1.11I (fl heck Amount: P Cash Amount:
6. Total Project Cost: $ 20, 000
0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
Andrew Mirkin License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
352 Albany Street
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
Springfield, MA 01105 R Restricted I&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
(413) 732-3179 demo@buildingwreckers.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC-169969 8/24/2023
Associated Building Wreckers, Inc. HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
352 Albany Street ABWinc@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 IssuJce 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 Associated Building Wreckers, Inc.
to act on my behalf,in all matters relative to work authorized by this building permit application.
Linda Olbris 3/3/2023
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, President, Associated Building Wreckers, Inc. 3/3/2023
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.aov/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"
City of Northampton
(--
i'1�,
'f, Massachusetts
k ' '1 DEPARTMENT OF BUILDING INSPECTIONS - 1:::.!.) .1
ilv, p 212 Main Street • Municipal Building
\—,4 - - Northampton, MA 01060 ti
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: .;SA Hauling & Recycling, 120 Old Boston Road, Wilbraham, MA
The debris will be transported by:
Name of Hauler: Associated Building Wreckers, Inc.
0
Signature of Applicant: A.A.... Date:
Andrew Mirkin, President
_ The Commonwealth of Massachusetts
I*_;: �l. Department of Industrial Accidents
t• =7i(1r= b 1 Congress Street,Suite 100
_'l != 7. Boston, M 4 02114-2017
.. 4.-.. www mass.go►'/dia
— 1%urkers'( ompensation Insurance Aflidat,it: Builders0('ontractorsfElectricians/Plumbers.
1'O BE:FILED WITH I HE:PERM ITIM:At!TH(1R1'i .
Annlicant Information Please Print l esibly
Name(uusrne,„(kparnratwn Individual): Associated Building Wreckers, Inc.
Address: 352 Albany Street
City/State/Zip: Springfield, MA 01105 phone#: (913) 732-3179s
Are you an employer?Cheek die appropriate hut: Type of project(required):
t.eft am a employer with 30 employees(lull miter part-time l.• 7. 0 New construction
2D I am a wk proprietor of partnership and hate nu employees ticking fur me m K. aRemodeling
any capacity.(Nu war►ers'comp.insurance required.)
9. EiaDemolition
30 I am a homeirw net doing all work myself.(Nu aortas'comp.insurance regwnd.J'
10 CI Building addition
4.0 I am a lwmeovnet and will be hiring contractors to conduct all work on my pperty. I will
m-r artsurc that all contracture either hate workers'compensation insurance or an sole 11.0 Electrical repairs or additions
proprwtons a ith no employees
12.0 Plumbing repairs or additions
>D I am a general contractor and I bare hired the sub euntractota listed on the attached sheet. 130 Roof repairs
Them:subcontractors lute employees and have worker'cusp.insurance.,
6.0 We are a corporation and lb officers hate exercised then nght of esenptwn pet NCI c. I4.0Othrt
152.¢I14).and we hate nu employees.Nu workers'comp.insurance required.J
•Any applicant that clucks but PI must also fill out the section below skating their a orkers'compensation polio information.
*Ilomeoaners who submit dos atfrakrtit indicating they arc doing all aork and then hire outside contractors must submit a new atlidat it rnd,eatmg such
:Contractors that cheek this hoc must attached an additional sheet shifting the name of the sub-contractors and state whether or not those entities hate
employees. II tin•sub-cuntractura hate eemployoes.they must preside their workers'catnip pokey number.
/ant an employer that is prodding worberr'compensation insurance for my employees. Below Ls the policy and Job site
in fornnetion.
Insurance Company Name: Great Divide Insurance Company
Policy#or Self-ins.Lic.#: WCA1545165-22 Expiration Date: 2/1/2024
Job Site Address: 284 North Farms Road City'Statelip: Florence, MA 01062
Attach a copy of the workers'compensation policy declaration page(showing the policy somber and expiradsa date).
Failure to secure coverage as required under MGL c. 152,*25A is a criminal violation punishable by a tine up to S1,500.00
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 thylvi later. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage vcr ucat on-
I do herebyc4erti 'under e pai s and penalties of perjury that the information provider!uha 'e•is true and correct.
Signature: /\\ Andrew Mirkin, President Date 3/3/2023
Thorn,::: (913) 732-3179
Official use only. Du nut write in this area. to hi.I ample fed by cite or town official
( its or Town: Permit/license#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City r Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
( untact Person: Phone#:
Griha (/Geieadi 0//ka4T/i.[/( /
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
ASSOCIATED BUILDING WRECKERS, INC. Registration: 89969
352 ALBANY ST. Ex
Expiration 08/2412023
SPRINGFIELD, MA 01056
Update Address and Return Card.
SCA 1 as 20M-05/17
./J t149t)PAAP1/FeW/ tt 4 ks10,PARPftvt ion
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Corporation before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
169969 08/24/2023 00 Washington Street -Suite 710
ASSOCIATED BUILDING WRECKERS,INC. ost n,MA 02118
ANDREW H.MIRKIN
352 ALBANY ST.
SPRINGFIELD,MA 01056 Not without signature
Undersecretary
Commonwealth of Massachusetts
ItDivision of Occupational Licensure
Board of Building Relu Iations and Standards
Const, lott Svisor
.{
CS-062382 spires: 10/31/2023
ANDREW H MIRKIN a
299 TANGLEWOOD DR
LONGMEADOW MA 01106
Commissioner 1;I' � m
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.govldpl
THE COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT
DEPARTMENT OF LABOR STANDARDS
19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114
•
ASBESTOS CONTRACTOR LICENSE
ASSOCIATED BUILDING WRECKERS,INC.
352 ALBANY STREET
SPRINGFIELD MA 01105
LICENSE: AC000898 EXPIRES: Friday,August 18,2023
IN ACCORDANCE WITH MGL CH. 149 §6B AND 453 CMR 6.04
THIS CERI'lk'ICATE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS TO THE
CONTRACTOR ABOVE FOR THE PURPOSE OF ENTERING
INTO OR ENGAGING IN ASBESTOS WORK.
THIS LICENSE IS VALID FOR A PERIOD OF ONE(1)YEAR.
L FLANAGA CTOR
•
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.
ASSOCIATED BUILDING WRECKERS,INC.
352 ALBANY STREET
SPRINGFIELD,MA 01105
(DIG SAFE SYSTEM, INC - MA) 02/09/2023 15:29:03
-HK11 -MC
*** INTERNET TICKET ***
***** REGULAR *****
TIME..15:29 DATE..02/09/2023
REQUEST NO. . .20230606466
STATE MASSACHUSETTS
MUNICIPALITY NORTHAMPTON
ADDRESS..284
STREET...NORTH FARMS RD
NEAREST CROSS STREET 1..000NTRY WAY
DEMOLITION OF HOUSE ON PROPERTY INCLUDING FOUNDATIONS AND WALKWAYS
NATURE OF WORK..DEMOLITION
EXTENT OF WORK
STREET TO HOUSE
AREA IS PREMARKED..YES
START DATE 02/14/2023 START TIME..15:45
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
Service Area USLtXTY1M(5) Contact Alternate Contact EmergMICy Contact
COMCAST-WESTERN CABLE TV USIC LOC
MA (800)778-9140
HF1I
*Principal
NATIONAL GRID ELECTRIC USIC LOC
ELECTRIC-MASS ELEC (800)778-9140
r,4 C
*Principal
This Dig Safe ticket expires on:03/11/2023
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.
nationaigrid
55 Bearfoot Rd
Northborough MA 01532
Nov 7th, 2022
RE: Service Removal for Building Demolition
284 N Farms Rd
Florence, MA
To Whom It May Concern,
This letter is to confirm that,per your request, National Grid has confirmed the electrical meter#
(25047278) and service have been removed from 284 N Farms Rd, Florence, MA
The work was processed on work request#30705988.
If you have any questions or need further assistance, please feel free to contact Andrea Hache@
508-691-6552.
Sincerely,
X..Anou,wiWai
Andrea Heche
Customer Connections Representative
MyConnections NE
nationaigrid
EVERS=URCE
December 14, 2022
John Jeffress
Demolition Coordinator
Associated Building Wreckers, Inc.
Re: 284 N Farms Rd Northampton, MA
To Whom It May Concern:
This is to inform you that there is no Eversource Gas Service at 284 N
Farms Rd Northampton, MA.
Sincerely,
Jared Co Clete
Operations Manager
Springfield, MA
Eversource Gas
(pp Dan Heggie Operations Supervisor)
John Jeffress
From: Romito,Jeff <Jeff_Romito@comcast.com>
Sent: Monday, December 12, 2022 2:09 PM
To: John Jeffress
Subject: RE: Demolition Disconnect Request - 284 North Farms Road, Florence, MA
All set
From:John Jeffress<demo@buildingwreckers.com>
Sent:Thursday, December 8, 2022 1:42 PM
To: Romito,Jeff<Jeff_Romito@cable.comcast.com>
Subject: [EXTERNAL] Demolition Disconnect Request-284 North Farms Road, Florence, MA
Good afternoon-
Attached please find our request to disconnect services at 284 North Farms Road in Florence.The house is scheduled for
demolition.
Thank you in advance for your time.
John Jeffress
Demolition Coordinator
Associated Building Wreckers, Inc.
(413)732-3179
www.buildingwreckers.com
A:W
ASLOC,A;CV NM OMO wNS COINS
1
verizon1
NYS-NE OSP CENTER
1-866-686-1195
nys-ne.osp.center.verizon.com
John Jeffress
December 23, 2022
RE: Facility Removal for Demolition
This Letter confirms that Verizon's facilities have been disconnected and
removed from the address below.
284 North Farms Rd
Florence, MA
Thank you,
Lynn Stickney
OSP Engineer
A f r,
/1///i/p'S Wyl, I ir 7'-if.-/-')/(1 .,/ . / H-ei/-)(•;;; Alt_7/1/ L'- '
CLEAN-SEPTICS Name:- / 2) ( /1 L � /-}' 4'„-'.
P.O. Box 394, Ludlow, MA 01056•office@cleanseptics.com C.
Ludlow 583-2138•cleansepticsinc@gmail.com
•
Toll Free 833-583-2138•FAX 413-589-1140
1;
A. Facility Information Phone#
}) f_7 � i � {�� t/,� ter`
1. System Location: / .01/ �``I ` f �'t
I /J / j(
,7 1 'j !, I' if + l tl r' , I. ......J / / i - ..
/
f ✓ f
Address / , f I
r
MASS
City/Town / State Zip Code
///' 4-,, .,1''
'
2. Pumping Fee -� < Open Dig Fee
3. CCLS Bacteria - C•( / t - /i//� 14-14-; -r?`
4. Extra Labor / /IF! , ft , % /fi '. 5 f <,1/ - t ,�
5. Comments ,'/ i 0(4. -7 / 4 / e':t ;°L,,rd F f i`I: ! ; C '' i 9, 1 7 , J
;-
NI) This i our Dill;€iJease remit. Total Due •1\ E 7 4—j`
1' ). , \ OL' i_. '''''''' ' ". '
B. Pumping Rec rtl., f ?C,
g ' ,.a� -•
1. Date of Pumping k--- - / - 2. Quantity Pumped: ❑ 1000(gal.) 0 1500(gal.)
3. Component: 0 Cesspool(s) ❑ Septic Tank D Tight Tank 0 Two Compartment Tank
0 Other(describe):
4. Effluent Tee Filter Present? 0 Yes 0 No If yes, was it cleaned? 0 Yes 0 No
5. Observed condition of component pumped kr) , ;' ,. c.
i' -‘' 't.) \ (.N WV'\\ -' OM C( 1.--- iist i6. System Pumped By: �.
- l �
/t_ A /;_ '� ORANGE YELLOW/SILVER MACK
Name uncee ^IcC 1 2 3 4 5
CLEAN SEPTICS, INC. 7
Company /►�A
°1141(17 •
7. Location where contents were disposed:
BONDI'S ISLAND, INDIAN ORCHARD, MASSACHUSET
W e l' 1 ) ci v5 k a- „� I.�
Signature of Hauler Customer#
I: 417
Signature of receiving Facility(or attached facility receipt) Invoice#
r11eTAMCP rnPV la Record• Page 3
September Lane Labs, INC.
P. O. Box 275 Beacon Falls, CT 06403 203-668-8533
12/17/2022
Associated Building Wreckers, INC.
352 Albany Street
Springfield, MA 01105
RE: 284 North Farm Road
Florence,MA
ASBESTOS SURVEY
September Lane Labs, INC. conducted a pre-demolition asbestos inspection of the residence located at 284 North Farm Road in Florence, MA
Massachusetts Licensed Asbestos Inspector- Marco Carralero -AI#900719 EXPIRATION 03/01/2023
42 samples were taken of 20 building materials suspected of containing asbestos.
Samples numbers, descriptions, locations, condition, and approximate quantities of asbestos-containing materials are listed below.
2A-B Gold Linoleum Main Level 27% Chrysotile 320 SQ. FT. Deteriorating
3A-C Joint Compound** Main Level** <1% Chrysotile** 1,500 SQ. FT.** Deteriorating
4A-B Panel Adhesive Walls 7% Chrysotile 1,100 SQ. FT. Intact
13A-B Duct Paper Insulation Basement** 40% Chrysotile 50 SQ. FT.** Deteriorating
19A-B Flashing Mastic Back Roofs** 7% Chrysotile 200 LN. FT. Intact
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.
(3)OSHA and Disposal Regulations apply for Joint Compound<1%Chrysotile
(4)Duct Paper Insulation is located in the back basement directly beneath the living room.
(5)Flashing Mastic is on all roofs except the new front of house pitched asphaltic shingled roof.
EMSL Analytical, Inc. EMSL Order: 242205966
Customer ID: SLL78
165 Gracey Avenue Meriden,CT 06451
Customer PO:
Tel/Fax:(203)284-5948/(203)284-5978
http://www.EMSL corn I wallingfordlab@emsl cornProject ID:
Attention: Marco Carralero Phone: (203)668-8533
September Lane Labs Inc Fax:
83 September Lane Received Date: 12/13/2022 2:25 PM
Beacon Falls, CT 06403 Analysis Date: 12/15/2022- 12/16/2022
Collected Date: 12/13/2022
Project: 284 NORTH FARM ROAD FLORENCE
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
1A Red linoleum Red/Black 15%Cellulose 85%Non-fibrous(Other) None Detected
Fibrous
242205966-0001 Homogeneous
This is a composite result of both vinyl and backing layer
1 B Red linoleum Red/Black 30%Cellulose 55%Non-fibrous(Other) None Detected
Fibrous 15%Synthetic
242205966-0002 Homogeneous
This is a composite result of both vinyl and backing layer.
2A Gold pebble linoleum Brown/Gray 73%Non-fibrous(Other) 27% Chrysotile
Fibrous
242205966-0003 Homogeneous
This is a composite result of both vinyl and backing layer
2B Gold pebble linoleum Positive Stop(Not Analyzed)
242205966-0004
3A Joint compound Tan 100%Non-fibrous(Other) <1%Chrysotile
Non-Fibrous
242205966-0005 Homogeneous
° <1% Chrysotile
3B Joint compound Tan 100/°Non-fibrous(Other) ry
Non-Fibrous
242205966-0006 Homogeneous
3C Joint compound Tan 100%Non-fibrous(Other) el%Chrysotile
Non-Fibrous
242205966-0007 Homogeneous
4A Panel adhesive Brown 93%Non-fibrous(Other) 7% Chrysotile
Non-Fibrous
242205966-0008 Homogeneous
4B Panel adhesive Positive Stop(Not Analyzed)
242205966-0009
5A Drywall painted Gray 5%Cellulose 95%Non-fibrous(Other) None Detected
Non-Fibrous
242205966-0010 Homogeneous
5B Drywall painted Gray 3%Cellulose 97%Non-fibrous(Other) None Detected
Non-Fibrous
242205966-0011 Homogeneous
6A Grey linoleum Brown/Gray 10%Cellulose 90%Non-fibrous(Other) None Detected
Fibrous
242205966-0012 Homogeneous
This is a composite result of both vinyl and backing layer
6B Grey linoleum Brown/Black 30%Cellulose 55%Non-fibrous(Other) None Detected
Fibrous 15%Synthetic
242205966-0013 Homogeneous
This is a composite result of both vinyl and backing layer.
7A Insulation paper Brown/Black/Silver 35%Cellulose 57%Non-fibrous(Other) None Detected
Fibrous 8%Min.Wool
242205966-0014 Homogeneous
Initial report from:12/16/2022 12:46:29
ASB PLM 0008 0001-1.78 Printed: 12/16/2022 12:46 PM Page 1 of 3
EMSLEMSL Order: 242205966
Analytical, Inc.
Customer ID: SLL78
165 Gracey Avenue Meriden,CT 06451
Customer PO:
.. Tel/Fax:(203)284-5948/(203)284-5978
http://www.EMSL.com/wallingfordlab@emsl.com Project ID:
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
7B Insulation paper Brown/Black/Silver 60%Cellulose 30%Non-fibrous(Other) None Detected
Fibrous 10%Glass
242205966-0015 Homogeneous
8A Bathroom linoleum Brown/Beige 5%Cellulose 85%Non-fibrous(Other) None Detected
Fibrous 10%Glass
242205966-0016 Homogeneous
This is a composite result of both vinyl and backing layer
8B Bathroom linoleum Brown/Tan 5%Cellulose 85%Non-fibrous(Other) None Detected
Fibrous 10%Glass
242205966-0017 Homogeneous
This is a composite result of both vinyl and backing layer.
9A 1x1 ceiling tiles Brown 70%Cellulose 30%Non-fibrous(Other) None Detected
Fibrous
242205966-0018 Homogeneous
9B 1x1 ceiling tiles Brown 85%Cellulose 15%Non-fibrous(Other) None Detected
Fibrous
242205966-0019 Homogeneous
10A Tub adhesive gold Tan 100%Non-fibrous(Other) None Detected
Non-Fibrous
242205966-0020 Homogeneous
10B Tub adhesive gold Tan 100%Non-fibrous(Other) None Detected
Non-Fibrous
242205966-0021 Homogeneous
11A Basement window Gray/White 100%Non-fibrous(Other) None Detected
glazing Non-Fibrous
242205966-0022 Homogeneous
11 B Basement window White 100%Non-fibrous(Other) None Detected
glazing Non-Fibrous
242205966-0023 Homogeneous
12A Chimney flue patch Gray/Black 7%Quartz None Detected
Non-Fibrous 93%Non-fibrous(Other)
242205966-0024 Homogeneous
12B Chimney flue patch Gray 8%Quartz None Detected
Non-Fibrous 92%Non-fibrous(Other)
242205966-0025 Homogeneous
13A Duct paper insulation Gray 40%Cellulose 20%Non-fibrous(Other) 40%Chrysotile
in basement below Fibrous
242205966-0026 living room back room Homogeneous
13B Duct paper insulation Positive Stop(Not Analyzed)
in basement below
242205966-0027 living room back room
13C Duct paper insulation Positive Stop(Not Analyzed)
in basement below
242205966-0028 living room back room
14A Chimney mudd Tan 4%Quartz None Detected
Non-Fibrous 96%Non-fibrous(Other)
242205966-0029 Homogeneous
14B Chimney mudd Tan 5%Quartz None Detected
Non-Fibrous 95%Non-fibrous(Other)
242205966-0030 Homogeneous
15A Exterior-6 pane shed Gray/Tan/White 100%Non-fibrous(Other) None Detected
window glazing Non-Fibrous
242205966-0031 Homogeneous
15B Exterior-6 pane shed Gray 100%Non-fibrous(Other) None Detected
window glazing Non-Fibrous
242205966-0032 Homogeneous
Initial report from:12/16/2022 12:46:29
ASH Pt M 0008 0001 1 78 Printed:12/16/2022 12:46 PM Page 2 of 3
EMSL Analytical, Inc. EMSL Order: 242205966
Customer ID: SLL78
165 Gracey Avenue Meriden,CT 06451
Customer PO:
Tel/Fax:(203)284-5948/(203)284-5978
http:/lwww EMSL corn/wallingfordlab@emsl cornProject ID:
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
16A Exterior-roof felt Black 65°/Cellulose 35%Non-fibrous(Other) None Detected
Fibrous
242205966-0033 Homogeneous
16B Exterior-roof felt Black 50%Cellulose 50%Non-fibrous(Other) None Detected
Non-Fibrous
242205966-0034 Homogeneous
17A Exterior-asphaltic Black 20%Glass 5%Quartz None Detected
shingle Fibrous 75%Non-fibrous(Other)
242205966-0035 Homogeneous
17B Exterior-asphaltic Black 15%Glass 5%Quartz None Detected
shingle Fibrous 80%Non-fibrous(Other)
242205966-0036 Homogeneous
18A Exterior-back shed Black 25%Cellulose 3%Quartz None Detected
rolled roofing Fibrous 5%Glass 67%Non-fibrous(Other)
242205966-0037 Homogeneous
18B Exterior-back shed Black 25%Cellulose 5%Quartz None Detected
rolled roofing Fibrous 6%Glass 64%Non-fibrous(Other)
242205966-0038 Homogeneous
19A Exterior-back roof Black 10%Cellulose 3%Quartz 7%Chrysotile
flashing mastic Fibrous 80%Non-fibrous(Other)
242205966-0039 Homogeneous
19B Exterior-back roof Positive Stop(Not Analyzed)
flashing mastic
242205966-0040
20A Exterior-roof vapor Black 60%Cellulose 30%Non-fibrous(Other) None Detected
barrier Fibrous 10%Synthetic
242205966-0041 Homogeneous
20B Exterior-roof vapor Black 55%Cellulose 35%Non-fibrous(Other) None Detected
barrier Fibrous 10%Synthetic
242205966-0042 Homogeneous
-1444-
Analyst(s)
Halley Rangel(19) Danny Sandhu,Asbestos Laboratory Manager
Leslie Tetrick(18) 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.Meriden,CT NVLAP Lab Code 200700-0,
Initial report from:12/16/2022 12:46:29 ,
ASB PLM 0008 0001-1,78 Printed: 12/16/2022 12:46 PM Page 3 of 3
Massachusetts Department of Environmental Protection 100379545
BWP AQ 04 (ANF-001) Asbestos Project#
Asbestos Notification Form r Project Revision
(— Project Cancellation
A. Asbestos Abatement Description
1. Facility Location:
RESIDENTIAL HOUSE 284 NORTH FARMS ROAD
Instructions 1.All a.Name of Facility b.Street Address
sections of this form NORTHAMPTON
must be completed in MA 01062 3473377907
order to comply with c.City/Town d.State e.Zip Code f.Telephone
MassDEP notification LINDA OLBRIS OWNER
requirements of 310
CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title
Department of Labor Worksite Location: MAIN FLOOR,BASEMENT,&ROOF
Standards(DLS)
notification i.Building Name,Wing,Floor,Room,etc.
requirements of 453 2. Is the facility occupied? f a.Yes 1;7 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 r 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 BUILDING 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 1—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.
1/31/2023 2/3/2023
a.Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY)
7:OOAM-3:30PM N/A
c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday
11. What type of project is this?
1t7 a.Demolition r b.Renovation r c.Repair r d.Other-Please Specify:
Revised: 11/13/2013 Page 1 of 4
Massachusetts 04 Depa(Artment of001)Environmental Protection 100379545
BWP AQ NF-
Asbestos Project#
"41111
Asbestos Notification Form r Project Revision
1,
r Project Cancellation
A.Asbestos Abatement Description: (cont.)
12.Abatement procedures(check all that apply):
r a.Glove Bag r b.Encapsulation r c.Enclosure r d.Disposal Only (v e.Cleanup
I f.Full Containment r g.Other-Please Specify:
13.Job is being conducted: FT a.Indoors P b.Outdoors
14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or
encapsulated:
200 1470
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 50 i. Other-Please Specify:
1.Lin.Ft. 2.Sq.Ft.
j.Insulating Cement LINO,ADHESIVE,MASTIC 200 1420
1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft.
15. Describe the decontamination system(s)to be used:
REMOTE AND CONTIGUOUS 3 STAGE DECON UNIT 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):
THOROUGHLY 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 r a.Yes Ff b.No
project?
Revised: 11/13/2013 Page 2 of 4
Massachusetts Department of Environmental Protection 100379545
L
BWP AQ 04 (ANF-001) Asbestos Project#
Asbestos Notification Form 1— Project Revision
f Project Cancellation
B. Facility Description
1. Current or prior use of facility: RESIDE
2. Is the facility owner-occupied residential with 4 units or less? f- a.Yes l b.No
3 LINDA OLBRIS 15 LANGEVIN STREET#1 L
a.Facility Owner Name b.Address
pHICOPEE MA 01020 3473377907
c.City/Town d.State e.Zip Code f.Telephone
4 LINDA OLBRIS 15 LANGEVIN STREET#1 L
a.Name of Facility Owner's On-Site Manager b.Address
CHCOPEE MA 01029 3473377907
c.City/Town d.State e.Zip Code f.Telephone
5 ASSOCIATED BUILDING WRECKERS INC 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 CO.
g.Contractor's Worker's Compensation Insurer
WCA1545165-21 2/1/2023
h.Policy# i.Expiration Date(MM/DD/YYYY)
6. What is the size of this facility? 1588 1
a.Square Feet b.#of Floors
Note:Temporary storage of Asbestos C. Asbestos Transportation & Disposal
containing waste 1. Transporter of asbestos-containing waste material from site of generation:
material is only
allowed at the place f• a. Directly to Landfill or r b.To Temporary Storage Location/Transfer Station
of business of a DLS
licensed Asbestos
contractor or a transfer ASSOCIATED BUILDING WRECKERS,INC. 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 173 PICKERING STREET
a.Name of Transporter b.Address
PORTLAND CT 06480 8603421022
c.City/Town d.State e.Zip Code f.Telephone
Revised: 11/13/2013 Page 3 of 4
Massachusetts Department of Environmental Protection 100379545
BWP AQ 04 (ANF-001) Asbestos Project#
Asbestos Notification Form E 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 173 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 ROAD
c.Address
WAYNESBURG CH 44688 3308663435
d.City/Town e.State f.Zip Code g.Telephone
Note:Contractor must
sign this form for DLS
notification purposes D. Certification
ANDREW MIRKIN ANDREW MIRKIN
"I certify that I have personally 1.Name 2.Authorized Signature
examined the foregoing and am PRESCENT1/17/2023
familiar with the information
contained in this document and 3.Position/Title 4.Date(MM/DD/Y YY)
all attachments and that, based 4137323179 ASSOCIATED BUILDING WRECKERS,I
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."
Revised: 11/13/2013 Page 4 of 4
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: DEMOCOORD
Transaction ID: 1480834
Document: AQ 04 - Asbestos Removal Notification Form ANF-001
Size of File: 231.33K
Status of Transaction: In Process
Date and Time Created: 1/17/2023:10:24:26 AM
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.
[NIMassachusetts Department of Environmental Protection
BWP AQ 04 (ANF-001) PreForm
Asbestos Notification Form
✓ This is a revision to an existing form.
Project ID for existing form to be revised:
✓ 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.
t� None of the above conditions apply,generate a new form.
Revised: 11/13/2013 Page 1 of 1
September Lane Labs, INC.
P. O. BOX 275 Beacon Falls, CT 06403
203-668-8533 Septemberlanelabs( gmail.com
02/06/2023
Linda Olbris
#1 L
15 Langevin Street
Chicopee, MA 01020
Associated Building Wreckers, INC.
352 Albany Street
Springfield, MA 01105
Attn: Fred VanDerhoff
Project NO: 284-NFR-FM
284 North Farms 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 February 6th, 2023, a Licensed Project Monitor conducted a visual
inspection and collected PCM Final Clearance air samples. No visible
debris was found in the containment.
The air samples collected in the abatement work areas were below the
level specified in Federal and MASS Regulations, 0.010 f/cc.
Attached are EMSL's PCM Air Clearance analysis results.
ABATED ACM:
Exterior Flashing Mastic
Duct Paper Insulation
Panel Adhesive
Linoleum Flooring
Marco Carralero
MA License # AM041931
EMSL Analytical, Inc. EMSL Order: 242300548
Customer ID: SLL78
41110„ 165 Gracey Avenue Meriden,CT 06451 Customer PO:
Tel/Fax: (203)284-5948/(203)284-5978 Project ID:
;ttp://www.EMSL.com/wallingtordlab@emsl.corn
Attention: Marco Carralero Phone: (203)668-8533
September Lane Labs Inc Fax:
83 September Lane Received Date: 02/06/2023 03:55 PM
Beacon Falls, CT 06403 Analysis Date: 02/06/2023
Collected Date: 02/06/2023
Project: 284-NFR-FM/284 NORTH FARMS 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/min' Fibers/cc Notes
B-01 BLANK FIELD 02/06/2023 Field Blank
242300548-0001 Not Analyzed
B-02 BLANK FIELD 02/06/2023 Field Blank
Not Analyzed
242300548-0002
03 BASEMENT 02/C6/2023 1317.5 10.5 100 0.0020 13 4 0.0039
242300548-0003
04 KITCHEN 02/06/2023 1302 7 100 0.0021 6 92 0.0026
242300548-0004
05 BEDROOM 02/06/2023 1302 18 100 0.0021 22.9 0,0068
242300548-0005
The results reported have been blank corrected as applicable.
Analysl(s).
Shannon Halloran PCM 3
Danny Sandhu,Asbestos Laboratory Manager
or other Approved Signatory
EMSL maintains liability Witted Io cosi 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.wehout written approval by EMSL EMSL hears no responsibility for sample collectron 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 wdhtn quality control crdena and met method specificalions unless otherwise noted.Limit of
detection is 7 fibers/aim?.Fiber counts outside the recommended fiber density range of the method(100.1300 Umm?)have greater than optimal variability and are probably blotted.Field blank results,when available,are
used to blank correct results.NIOSH 7400 requires field blanks be submitted al a rate of 10%.with a minmum of per set Measurement of uncertartay available upon request.The results in this report meet as
requirements of the NELAC standards unless otherwise noted Intro-taboralory Si values:5-20 fibers-0.32,21-50 fibers.0.26.51-100 fibers=0.16 inter-laboratory Sr values(Average of EMSL round robin date)
035
Samples analyzed by EMSL Analytical,Inc Meriden CT C7 PH-0322 MA AA000I91 RI AAL-10BT3.VT AL357101,NYS FLAP 12063
Initial report from.C2/07/2023 09.05 AM
Y ' RESIDENTIAL PROPERTY RECORD CARD 2023 Null I MAW'I ON
lit division
Situs:284 NORTH FARMS RD Map ID:07-045-001 Class:Single Family Residence Card: 1 of 1 Printed:December 23,2022
OLBRIS LINDA Living Units 1 •
15 LANGEVINE ST APT 1L Neighborhood 17 T,, It
CHICOPEE MA 01020 Alternate Id
Vol/Pg 13237/161
District
Zoning 4 _
Class Residential DTP .k
. i
Type Size Influence Factors Influence% Value Assessed Appraised Cost Income
Primary Sf SF 21,780 99,520 Land 99,500 99,500 99,500 0 93,300
Building 174,700 174,700 187,400 0 168,000
Total 274,200 274,200 286,900 0 261,300
Manual Override Reason
Base Date of Value 2023
Value Flag MARKET APPROACH Effective Date of Value 1/1/2022
Total Acres: .5 Gross Building:
Spot: Location:
Date ID Entry Code Source Date Issued Number Price Purpose %Complete
09/08/20 JA Not At Home Other
11/05/99 MC Unimproved Convert From Univers
Transfer Date Price Type Validity Deed Reference Deed Type Grantee
04/17/19 125,000 Land+Bldg Family Sale 13237/160 Quit Claim OLBRIS L
l' Y I e t RESIDENTIAL PROPERTY RECORD CARD 2023 NORTHAMPTON
Situs:284 NORTH FARMS RD Parcel Id:07-045-001 Class: Single Family Residence Card: 1 of 1 Printed:December 23, 2022
Dwelling I{ tjon
II IC Code Description —
A Main Builaini
B 10 1SFR -
Style Cape Year Built 1939 1: ,t C 10 1SFR i£';
Story height 1 Eff Year Built 1970 D 14 FUE 21E
Year Remodeled 11 a 12 EFP
--
Attic Full-Fin F 12 EFP
2E
Exterior Walls Frame Amenities - -
Masonry Trim x
Color Natural In-law Apt No 1- 11 J
16 E It-
i_ Basement _
1�
Basement Full #Car Bsmt Gar -
FBLA Size x FBLA Type _,--
Rec Rm Size x Rec Rm Type 2E „
Heating&G Fireplaces
Heat Type Basic Stacks
Fuel Type Oil Openings 22 - 22
System Type Warm Air Pre-Fab
E
Room Detail
Bedrooms 3 Full Baths 1 ._
Family Rooms Half Baths
Kitchens 1 Extra Fixtures L. _ Outbuilding Data
Total Rooms 5
Kitchen Type Bath Type Type Size 1 Size 2 Area Qty Yr Blt Grade Condition Value
itchen Remod No Bath Remod No
AdjustmetInt vs Ext Same Unfinished Area
hedral Ceiling x Unheated Area
Grade&Depreciation -
Grade C+ Market Adj
Condition Average Functional
CDU GOOD Economic
Cost&Design 0 %Good Ovr
%Complete111111, _
Dwelling Computations I Condominium/Mobile Home Information
Base Price 127,471 %Good 75 Complex Name
Plumbing %Good Override Condo Model
Basement 0 Functional
Heating o Economic Unit Number
Attic 21,766 %Complete Unit Level Unit Location
Other Features 0 C&D Factor Unit Parking Unit View
Adj Factor 1 Model(MH) Model Make(MH)
Subtotal 149,240 Additions 75,460
Ground Floor Area 550
Total Living Area 1,405 Dwelling Value 187,390 Comparable Sales Summary
Parcel ID Sale Date Sale Price TLA Style Yr Built Grade
36-205-001 01-APR-20 545,000 3,139 3 1992 A-
Building Notes '' 13-101-001 21-MAY-20 535,000 2,518 3 2000 A-
- 36-227-001 12-JUN-20 520,000 2,592 5 1985 B+
30A-085-001 23-SEP-21 710,000 2,680 7 1985 B+
36-315-001 17-JUN-20 479,500 2,086 7 2003 B+
-1,'' ukCIct 3) 30)c 3
* 10441315 cor P-4014 of
I than n ntg "
s, 9
+MAMA• CITY of NORTHAMPTON
_` ,��� PUBLIC HEALTH DEPARTMENT
� Public Health Director-Merridith O'Lea?)',RS
1 c�� Municipal Building-212 Main Street-Northampton,MA 01060
Phone(413)587-1214-Fax(413)587-1221 PLilcueataL
http://www.northamptonma.gov/245/Health Prevent.Promote.Protect.
WITNESS OF EXTERMINATION
Date ` r• .-3 Time C` rZ. y-\
Property Owner: Linda Olbris
Property Address: 289 North Farms Road, Florence, MA
Exterminator:
Company: Braman Termite & Pest Elimination
Company Address: 147 Almgren Drive, Agawam, MA
Rodenticide/Chemicals Applied C L .4 r"c--( -h 1 G )C ce A -#+ 1 :a H S -2+7 q
Reason for Extermination:
Comments: - \a C e G <. 4.- : , c,r r Lk E�-, •-‘-- Y'S Ct .v 34 c',�--D L r- S
LA).‘ A--A-, L--i 7\ LL.C_S C,-Or VDc...t '`7e .^ 3e_u , (--e: C rr \_),;\‘.1
s., �c ti--\0 -, st
•
[hereby certify, under the pains and penalties of perjury,that Ito 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.
❑ City Water ❑ Well C'Septic System
If a plicable C3'Y s ❑ NoA- kidritti,V0 _.6Z'--, )--/ /,"
, , �
Board o Health Representative ignatu a ofExterminator
*Demolition best practices relating to fugitive dust and debris must be adhered to in accordance
with MGL Chapter 111, Section 122.
rir
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.
Braman Termite&Pest Elimination Service Inspection Report
BRAMAN P.O. Box 368 Detailed Service Report #2381562
Agawam, MA 01001-0368
Termite c;' Pest Elimination 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
covcD if e MA-24352 41
Not Available John Calabrese Time In: 2/16/2023 08:45 AM Terms: NET 30
Time Out: 2/16/2023 09:32 AM
Order# Service Description Quantity Unit Cost Amount
2381562 Rodent Service 1.00 $325.00 $325.00
SubTotal: $325.00
Tax: $0.00
Total: $325.00
Amount Due: $325.00
Service Comments
Order Instructions: (Arrive Anytime)Rodent Abatement for 284 North Farms Road,Florence,MA(No interior access).
PO 255
Please fill out Northampton Witness of Extermination and return to Kim in the office.
Tech Comment: Complete inspection and treatment for rodents.Placed 8 exterior rodent bait stations around exterior of home.Thank you for choosing Braman for
your pest control needs.
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 32.000 Each Baiting N/A
N/A 0.0050 32.000 Ounces N/A
Target Pests:Mouse
Areas Applied:Exterior
Pest SummaryWith Without Total Device Exceptions
QuantityDevice Summary umma ry Activity Activity Inspected Replaced Removed Skipped
None Noted None Noted
Additional pest findings may have been observed.Please see conditions and comments for more details.
Area Inspections
Area Inspected Pest Findings Time
111 River St N Adams 8:07 AM
111 River St N Adams-> Interior 8:07 AM
284 North Farms Rd. 9:15 AM
284 North Farms Rd.->Exterior 9:15 AM
Printed: 2/17/2023 Page: 1/2
I
Braman Termite&Pest Elimination Service Inspection Report
BR/1MAN P.O. Box 368 Detailed Service Report #2381562
Agawam, MA 01001-0368
'Termite u' Pest 'f fimnial i ,N 800-338-6757
Area Inspections
Area Inspected Pest Findings Time
Device Inspection Details
Area Device Name Device Type Activity Pest Findings Time
None Noted None
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
284 North Farms Rd.->Exterior 32.0000 Each 32.0000 Ounces John Calabrese 09:15 AM
Weather: 0°,0 MPH
Printed: 2/17/2023 Page: 2/2