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10D-019 167 Main Leeds Demo App--- --- File # BP-2016-0014 APPLICANT/CONTACT PERSON ASSOCIATED BUILDING WRECKERS INC ADDRESSIPHONE 352 ALBANY ST SPRlNGFIELDO11 05 (413) 732-3179 PROPERTY LOCATION 167 MAIN ST MAP 10D PARCEL 019 001 ZONE URBOOO)! THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out , S'71Z 1 ;;-i1­ Fee Paid TypeofConstruction: DEMOLISH HOUSE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 063282 3 sets ofPlans I Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: __Approved __Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ __________ Intermediate Project_...__Site Plan ANDIOR ____Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: ~____.__~__ Findin~____ Special Permit, ________ Variance"'____ -::--:--~Received & Recorded at Registry of Deeds ProofEnclosed__.__ __Other Permits Required: Curb Cut from DPW ___Water Availability ___Sewer Availability ___Septic Approval Board ofHealth ____Well Water Potability Board ofHealth Permit from Conservation Commission Permit from CB Architecture Committee --~ ___,Permit from Elm Street Commission __-,Demolition Delay ~~~_,Permit DPW Storm Water Management Signature ofBuilding 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 ofHealth, Conservation Commission, Department of public works and other applicable permit granting authorities. '" Variances are granted only to those applicants who meet the strict standards ofMGL 40A. Contact Office of Planning & Development for more information. .. R CEIVED 08/04/2013 09:52 .E 14136042000 From: Moses D. Miller 2015-07-0420:29:50(GM!) To: Mike Page 4 of 4 City of Northampton Building Department . 212 Main Street . Room 100 L.J.!~!:l!r~~~~=.l~2rrnJ:lrnf\trl.n MA01060 24Q Fa)(41~•.p,a7w1272.' .. CONSTRUCT, AI.TER,REPAIR,RENOVATE OR DEMOLISH AONJ; OR TWO .' ". seCTION ...SITE INFORMATION 1 1.1 fropertyAddress: .;" .... 7blullcUo,ntobe ~'!IpIQte~.by.offl~e.,. '. !1w!ap .•• '" ';<.).d~j. '.....>.:: ",.',:;' ,', :~~,i .. ,U~"1 HQ.ln~+'. l..~S.~.O\()Ga·· lZ0~~., .' ... , . .o,wdll~JJlstrlj)t"".,.,...........-:-__ r--"...,.,....,.,..______________....ll..!E1m::::.;. st.Distflct "."',.E.M,'!I~~,,, .. r';'<'',. r'-'~"'" '. .. 'seCTION 2 .. PROPERTYOWNERSHIP/AUTIiORIZED AGENT' " . . -.. , 2,10w'nel' of Reoord; Moses Miller 2.2 AuthmiZ'l d Aaent '(413)7; 2-~ 79 (4l3)132-'3l79. '. -. '.' Name (PriIVI)'W.· .A . Current MaiUIlQ A~lI; __--..;;;..,-.--...;;---:::=;J-3o".\""""::::=""'/~..,.,.."..---_~_ ··.;..<4_13...;.)_73_2_"3_17_9--:-______....-_-,.-.--__- Signarure ............... . r,lephOn& '.. SECTION 3 ~ ESTIMATED CONsmYCIlON cgm . . '. Item 1. Building .' 2. EI~rlcal 3. Plumbing ".Mechanical (HVAO) 5. Fire Protection '. 6. Total =(1 +2" 3 +4+5) '. 'Estimated COlit(OolJars)10 be comoreted bv oermit applicant .'Official Use Only, . . ". '. '. ". (a) Sl!ildlll9 PellJlltFee . J. . j ! • (b) Estimated Total Cost of . . Constroclion fromJ!'it BUn(11)Q PSll'l1't, File.. ". ,A L. Check Number This Section For OffIcial Use Onlv Dale 1(lfi6 Issued:,___--,..,--_____________ Buldil1IJ Commisslonell(nspector of Buirqfngll Dale ' .. RECEIVED 08/04/2013 09:52 To: Mike Page 1 of 4 2015-07-0420:29.:50 (GMT) 14136042000 From: Moses D. Miller . ... _.', Section 4. ZONING AlllnformatlQll AI"it B.e Completed, Permit Can B.e DenIed DYe Tolntomplete Information -' .E'ldsting prQP9lied .' Requited by Zoning . '-. This eoluinn IQ be fillejUn. bY.'. .'Building1);pal1n)ent . Lot Size [0.8 Acres I I II I Frontage I II .11 I Se.tba6;ks 'J:~on! .-. c:J -C] CJ'-­-' . ,Side .. L:c=J'R:c=J L:CJR:! .... , CJ ····CJ ~~ ~"'~ CJ CJ c:J .. ,.~ " "' Bldlding Heigh~ " c:J:c::J 'C] Bldg. Sql.lW'e Footage CJ CJ % c:J CJ -', 'CJ Open Space Footage I:::=J :[::::~ % CJ CJ CJ "<'. (Lot area minils l>ldg & paved parkiru!:) ·····CJ ··CJ '. '. r:::::J# ofParking Spaces <­ Fin: . . .. . __(volumc&Locatioo) I A. ··.···Has l1)Sp~C;ial Petmjttvarlante/Findihgev~r be~n issued~or/on the $fta? .. ' -. '''."... NO .0 ." .' .' DON'T KNOW@) .', ~ YESO:: ': •... lFYES,date lSSlJed:1 I,"" ..... ...... . '. _ lfYES: . Was the.permitrecor:dedat the Registry. of.Deeds? NOO . : .. DONT KNOW @ . '. YES 0 .. w~~.~l 1'~ I and/or • D.Qcumenul,:-,"":". .....-,....,......_.....-rl] '!3~ ·.poes .tbesitecontain a brook,bQdyofwaterQrwetland~ NOO . DONT Kt'lOW ~..YES '. 0, . " "...... ", "':", fF .VES. IlaS a perl'l;lit been or need to .be obtain~d from tlte ~onse,ry<ltipn Comrnisslonl . Needs to b~obtainedQ . .obtained . 0 ','Da~eIS$U~d:""I----- ,ff .' . C" . DQ any sfgnsexlst 00 tile. property? YES o ·NO ..@ . IFY~S"describ~size,t¥pe and lQ~atlon:~L..~~",-,---c--"""",,-,--~,,,,,,,,,,,,,,,,,,_""""'_~____-J1 o..Are there any propo$e4 cbanges. to !;Ir aQdt~iQnsof signs intended for the property? . YESQ ··.·NQ·@·· ,IFYES~ describe size type 'andlocation:1 " ~ J't 'E,. Will the con!!truction activity:disturb (i;tearing, grading. excavatlon. or filling) over 1:acre or Isit partofacpmmori plan thallNill disturb ~V$r 1~Cre?Y~s.O NQ €)." ........ .... .,.. .'..... '...•........... . IF YES. t~en a NQrtI)ampton Storm W~ter Management P.el11.l1t from the PPVIf iSll!quire.d•. ­ RECEIVED 08/04/2013 09:52 2015-07-0420:29:50 (GMT) . 14136042000 From: M,oses D. Miller To: Mike Page 3 of4 .SECTION 5. DESCRleTION OF PROPOSEI1WORK(check allaeellcable) Replacelllent Wi!1dQW~ Alteratlon(s) 0 Roofing 0 Or O.()OI'S .0 .... . L ___-,-,~__L---_-----..",-,; Siding 1CI1 Other [ClIAccesso!y Bldg. 0 D~moIitlQn . . 0. NewSigns (CJ] Dl1cks ·IC1 . Blier [)eseripUon of ProposedWQrk: Compldc _lill••orli"~!\"lrCd ilnIdu".lSIlll<l""lol..,,,,lnhobitabl.d •• to .,.".., • .(..11'1 fi1\l) '. '.' Adding neWbedro~m~Ves ~NP . •.... . . Alleration of exi~og pedrQom~Yes_No Attached Narrative . . . . .: Renovating unfinished basement _._._.Yes __·_No Plans AttacIJed Ron -Sh.ee! . . 6a~'lf Nei.v houseand liradditiontoexlsting housinq.complete thefoilqwins{ .,"-. a.Use ofb!ljlding: Qnefamily ___ b. .Numbero! ro.()ms In ~<ilI* family unit.~.__~-.,._ Number .of Bathrooms,_---­ ~llltbere.l'I :!l<u<lge attached1.__........, . d.PfC.PQsed.~quare fQotage ofnel/l Q51nsirullll\)!l....,._,·_--_-_~OimfmsJQI111_~_____.,..-_~__...,­ e•. Number.olstories?~._'~~___.,......_-__---: f•.. Method .ofl)eatitlg?"".____-_:--,..,-,.-:---Fireplaces orWo()cI~t01/es ··Nl,lmblill'afell,*, -,--'.. . . g. ·EnergyC.oll(?ervatlQI'l Cof'!1plja!l~. . ..Massi::be:ckEnel9Y Compl~~tormalt~ed?"..._...,....,..,..,..~_ h. Type of construction DemolitioJl. j. ..Is conslr\lc:tiO/1 ~ll1ln 100 .f!: ofwetrands?_ ve.s.. _._._·_·. MQ, IS~,r;rStructio.n wJthln1QOyr.f1.oo.~plain _,_.._.Ve~~N.Q . j. ·.Depthof baseme(ltor cellar. floor below flni~hed9rade _,...,_..,..,.-..,.--____­ k. Will buil(l\ng CQnform to the Builcling and Zoning regulali{)nl!? . _~~.Yes_._._.,_No.. I. Septic Tank'--::' 'Cily.Sewer.~ . Private well _._ •._". GllyViater Supply L SECTION 7a • OWNE~AUTHORIZArION..TO Bl'! COMPLETED WHEN OWNERS AGENT OR CONTRACTORAPpl.le~ FO,! BUI1.DiNG PERMIT I, .J·k1O~a;i~g::!II:..;;Iit!"'Y..lI!:!:J,.\1,\~)l'iliIe~.,.___-:-_.....,._~:--_~....,..,:--..,.....-.--....,..-:-.....-:-_...,·"aSO'lVner QUhe s!.Ibject . pmpe.1ty . . ~erebYa!Jlhoril!e Ae.15C$\~ bt\t\~~~.«!I\c.~ ..... to act on .mY behalr, 1n all matters relative to WOt!iM.hDri~d by this builqing pemilt application.' ...... #~ ··+:I.-Zo,:C I, t\M(\ilul Mi(j;.tv\ . . as OwnerJAuthoiimd '..... Agent ~erebY"ecla(e ti)a! .thestatemenls andJllfon:na\ion on tl:l.e foregolngapplic;'ltiQll ~re trofl, !ilnd accvra\e,to.the b!asl of my ~Il()W!edge and bebef. . . . '. .' ..... . ",. . . 1 RECEIVED 08/04/2013 09:52 To: Mike PaQe2of4. 2015-07-04 20:29:50 (~MT) 14136042000 From: Moses D. Miller " "",-:'. SECTION 8 -CONSTRUCTION SERVICES .. a~1 licensed ConsyroctionSupervlsor: NotAppncabl~O . . . me of Lic&nse HD do. : ~-b\(t>.§ '" '~~.. Ob'Z.l\fJ'2. Uce~et/JJmber" ".. Number' . ~~~~~~W~~~s.~_ .' 812.5\"2.0\'bExpl!'a.UonOate. '. > .SE.CTION 10-WQRKIi;RS'COMPENSATION INSURANCE AFFiDAVIT (MoO.t. c.162, §.25C(S)) '1 Worker.; Compensation IO$l,lnll\C6 affld~vjlmllst.j)e coI!lPIf;Ie4 and 6vbmitted with thi;r ilP'plicallon: .Failure ~PJ9vide this. a(f1dallillM.lI result In the denial of the issuance of the building permit .. . .' . ...' ..... . ... : .·.• li~Hom~·OWllerEiemptionJ .'. '•. Ihecurrent exemption (or "homeownem" Was extended t~l~clude Own~r-oeeupled DWellings ofone (1) or .two(2) {amili~ .and to allow:such home<lwncJ" to engage lUlindividua} fur hire whl;)iloes.l,lotpossess Ii li!lCnse,.provided tbat tbepwner'ads .assupervisor. CMR 7BO, Sixtb Edition Sedilln 108.3;5.1 •. ' ". '" ',' .Definition ofHomeowner: Person (s)who. own aparcel of land on which he/she resides or ln1endstoreslde. on which there is. oris intended .to. b~, ao.ne or two. family dwelling, atIIlcbcd or deta¢hed $WclUres accessorylO .!l.u.ch US!! andlorJann '. struC!l\res. A person wbo constructs more tban one homeloJ! two-yeAi"' periodshalJ nut be considered'allOnieowger, . spcta "h.pmeowner" shallsubmittolhe BUilding OffiCial, on a form acceptable t() the BulldingOfficiaJa that belsl!e shall be responsible: for all such wo rk performed under tbe huilding nermlt. .' .. ... . ......... ...... . . 'A~actitW Construction Supervisor your presence on fhejob site 'VIjIJ be required ·from.time totlme.doo)g:\md UpoJl . .~omplelionofthQ work f"r whi~hthis pennitis i~sueQ.·· . '..'. .... . . . . . .. '... ,Also be advised. lhlllwlth'referenceto Chapter 1$2 (Workers' Compensation)lIIldChlIpt~r lS3(LhllJUity.ofEmployers to .'.. Employees for injuries not resulting inDeath) ofthe Massachusetts Oen.~1 LaWli.Annotaled"you moy be liahlefofpa:SOn.(S) '.. 'yOU ltire: to perfurmworkJorrOll under this pennI!;. -. ...' ". . '. .. . ". 'Theunde~lgned /lhOl:neowner!t~l1ifl~and.lI,'lSuQU:s resPQllsi~Pity for c\>mp!iaru;e'\Vith the SW.ll,Bullding Code,City of . Northwnpton OrdinlU1ces,$l~teJI!ld L~ZoDinB Laws find StateofMilSsachuseU$ O\lll~ ~:aW$AnnQU!!ed~ .... . . • '" ' . ." " '. ,',,' " '-". . '. . ':.. The Commonwealth ofMassachusetts Department ofIndustrial Accidents Office ofInvestigations 1 Congress Street, Suite 100 Boston,.MA 02114-2017 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/ContractorslElectricianslPlumbers Applicant Information Please Print Legibly Name (BusinessfOrganizationlIndividual): ASSOCIATED BUILDING WRECKERS, INC ""T,"""" 352 ALBANY STREET City/State/Zip: SPRINGFIELD, MA 01105 Phone 413-732-3179 Are you an employer? Check the appropriate box: 1. [j] I am a employer with 32 employees (full and/or part-time).* 2.0 I am a sole proprietor or partner­ ship and have no employees working for me in any capacity. [No workers' compo insurance required.] 3. 0 I am a homeowner doing all work myself. [No workers' compo insurance required.] t 4. 0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers' compo insurance) 5. 0 We are a corporation and its officers have exercised their right of exemption per MGL C. 152, §1(4), and we have no employees. [No workers' compo insurance required.] Type of project (required): 6. D New construction 7. 0 Remodeling 8. II] Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roofrepairs 13.0 Other________ *Any applicant that checks box #1must also fill out the section below showing their workers' compensation policy information. t 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 ofthe sub-contractors and state whether or not those entities have employees. lithe sub-contractors have employees, they must provide their workers' compo policy number. I am an employer tit at is providing workers' compensation insurance for my employees. Below is tlte policy andjob site information. GREAT DIVIDE INSURANCE COMPANY Insurance Company 02/01/2016Policy # or Self-ins. Lie. ._W_C_A_1....5_4_5_1_6_5_13___________ Expiration Job Site vvv._1_6_7_M_a_in_S_tr_e_et___________City/State/Zip: Leeds, MA 01053 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. l52 can lead to the imposition ofcriminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fme of up to $250.00 a day again the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of e IA:tI surance coverage verification. I do Itereby certi pains andpenalties ofperjury that the information provided above is true and correct. Si nature: Date: Phone #: ('" \!».,5Z·3 ,.." Official use only. Do not write in tit is area, to be completed by city or town official. City or Town: PermitlLicense # ______________ Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. CitylTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.0ther ____________ Contact Person: Phone #: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: ife,"l )...\o.'\n $'d1"'ee.+ (\....eed.s.) The debris will be transported by: Af.Sc:rlo.+a:\ 'Su:\6\~ ~C".:t", The debris will be received by: ~~W ~c.&.\-! kC!A..\~ (\,o,.\,S\,kl4) Building permit number: _____________ plicant As~&;\d.t,~\N~.~ Signature of Permit Applicant RECEIVED 06/05/2013 09:05 05/05/2015 03:02pm OVERLOOK EAST 14135851069 #950 Page 03/03 nationalgrid 40 Sylvan Rd Waltham MA 02451 May 4, 2015 Mr. Moses Miller 57 Main st. Haydenville, MA 01039 EMAIL: mosesmi1l@gmall.com RE: Service RemoYal for Building Demolition Dear Mr. MJUer: This letter is to confirm. per your request, that there is no service andlor meter(s) located at 167 Main St., Leeds, MA 01053 as of 514/15. Ifyou have any questions or need further assistance, please feel free to contact me at {5081357-460S. Sincerely, AnnMarie Estrella Customer Fulflllment Fax: I-S88-266-8()'H Phone: 1-5Q8-357-4UQ1 annmarie.estrella@nationalgrid.com nationalg rid Ref: WR.!¥19330219 {-----' 1 ('1 "" ,J) ,UrnDla "Jas j of 1\1assaCiTLLset fs A NiSource Company 995 Belmont Street Brockton, MA 02301 Date: April 30, 2015 To Whom It May Concern: The address listed below has had the gas service(s) disconnected and is now ready for demolition. ADDRESS: 167 Main St TOWN: Leeds STATE: Massachusetts Sincerely, Lisa Buckley Integration Center Columbia Gas Of Massachusetts 508-580-0100 Ext 1293 FROM: VerizollEngineering 146 Leland SI. FIr.2 Frfllllillghalll, Ma. 01702 UE: 167 (vjain St, Northampton, t1A This letter is to inform YOll thal the VeriZOll services involving 167 Main St, NOl1hamptoIl, MA have been disconnected. Thank YOll, Lisa Donovan CClllral ElIgjll~('rillg 508-820-3533 Page 1 of 1 MichaelOrr From: Romito, Jeff [Jeff_Romito@cable.comcast.com] Sent: Saturday, April 18, 2015 7:27 AM To: demo coordinator Subject: RE: Request for Disconnection of Service.:. 167 Main Street .1\11 set From: demo coordinator [mailto:demo@buildingwreckers.com] Sent: Friday, April 17,201510:26 AM To: Romito, Jeff Subject: Request for Disconnection of Service -167 Main Street Good Morning Jeff, Attached you will find a request for the disconnection of cable service at 167 Main Street in Northampton. Please let me know if you have any questions, or need any additional information. \ Thank you, Michael Orr Associated Building Wreckers Demolition Coordinator 352 Albany Street Springfield, MA Telephone: (413) 732-3179 Fax: (413) 734-6224 Demo@buildingwreckers.com AA II"'\A/I""\A1 r­ CITY Of NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS I LOCUST STREET NORTHAMPTON, MA 01060 413-587-1570 FAX413-587-1576 Ecl\vard S Huntley. P.E. DircL'IOr February 4, 2015 Louis Hasbrouck, Building Inspector Municipal Office Annex 212 Main Street Northampton, Ma 01060 Dear Mr. Hasbrouck: The water service at #167 Main Street Leeds has been disconnected from the city water supply and the water meter has been removed from the premises as of February 4,2015. Please contact me if you have any questions. ~ l gory R. Nuttelman Superintendent of Water Cc: Ncd Huntley, Director ofPublic Works Jim Laurila, City Engineer Commonwealth of Massachusetts Executive Office of Energy & Environmental Affairs Department of Environmental Protection Western Regional Office· 436 Dwight; Street, Springfield MA 01103 -413·784·1100 Charles D. Baker Matthew A. Beaton Governor Secretary Karyn E. Polito Martin Suuberg Lieutenant Governor Commissioner Moses Miller 167 Main Street Leeds, MA 01053 Re: Non~Traditional Asbestos Abatement Work Practipe Fire Damaged Building Demolition 167 Main Street, Leeds Approval Number: WNT15022 Dear Mr. Miller: MassDEP Western Regional Office is in receipt ofyour application and attached work plan for the use ofNon~Traditional Asbestos Abatement Work Practices ("NTWP" or "work plan"). The work plan, submitted by your consultant, requests that your contractors be allowed to demolish the building . without removing the asbestos materials prior to demolition. This request is based on the building having been 'significantly damaged by fIre rendering it unsafe to enter for any traditional asbestos inspections or removal operations. The remaining structure and debris pile shall be removed by hydraulic excavators and all materials shall be disposed of as Asbestos~ Containing Waste Material ("ACWM"). Your application to use NTWP' s at the referenced site is APPROVED with the following conditions: 1. By perfOlming work pursuant to this NTWP, the owner and his contractors, subcontractors and consultants acknowledge and agree that failure to strictly comply with all ofthe submitted work plan provisions and conditions contained in this Approval'may result in immediate revocation ofthis NTWP and that all parties may be subject to enforcement action by MassDEP. 2. If the instrument ofpayment, used to.pay the applicable fee for this NTWP, fails to be honored by the issuing financial-institution, the NTWP shall be considered incomplete as ofthe date it was submitted and void. All parties involved in the operations shall be subject to enforcement action for failing to obtain an NTWP prior to performing such activity at the Site. 3. The owner has designated certain contractors to perform work at the Site pursuant to this work plan. These designees cannot be changed and this Approval is not transferrable. This Information Is available ill alternate format. Call Michelle Waters·Ekanem, Diversity Director, at 817·292·5151. TTY# MueRelay Service 1·B00-439·2370 MassDEP WabsllIJ; www.mass.gov/dep Printed on Recycled Paper Non-Traditional Asbestos Abatement Work Plan Approval Number: WNT15022 167 Main Street Leeds,MA Page 2 4. All contractors performing asbestOs handling shall have cmrent and valid notific~tions for the duration ofthe work. In the event MassDEP is notified by any financial institution that any applicable notification fee is not valid, then all work at the Site shall stop. The contractor who failed to pay the notification fee shall be subject to enforcement action by MassDEP for failing to notifY prior to performing asbestqs abatement activities. Work shall not resume until all notifications and notification fees are determined to be valid. 5. Contractors and consultants shall not use any work or monitoring practices which are not . specifically listed in the work plan, this Approval or the MassDEP asbestos regulations, 310 CMR 7.15. 6. All contractors and subcontractors shall comply with all safety requirements, directives and instructions issued by city, state and federal health, safety and building inspectors. Failure to comply with such directives shall immediately result in immediate halt to all work at the Site and potential revocation ofthis NTWP; . 7. No work pursuant to this 'NTWP shall commence unless the asbestos project monitor ("APM") is at the Site and all air monitoring stations, both perimeter and employee monitoring, are in :full operation. 8. All documentation regarding air monitoring methodologies, collection procedures, calibration records and analysis results, as well as visual inspections reports, waste disposal records, site log books,.visitor sign in logs, notices ofviolation, cease and desist orders and MassDEP . notifications shall be·kept on Site for inspection by MassDEP and all other federal, state and local governmental agency personnel during the asbestos demolition and bulk loading operation. 9. Copies ofall ofthe Site records and documentation are to be supplied to the MassDEP by the owner, and each and every contractor, subcontractor and consultant upon request or within thirty (30) days ofcompletion ofthe work ifnot requested earlier. All submittals to MassDEP shall be accompanied by a completed Certification Statement, attached as the last page 'ofilis document. 10. This work plan does not negate the responsibility ofthe owners, the contractors, subcontractors and consultants from complying with all other applicable federal, state and local laws or regulations. 11. This work plan applies specifically to the asbestos demolition, clean-up and bulk loading at 167 Main Street in Leeds, MA. This work plan does not apply to any past or future demolition or asbestos handling operations at the Site. All other MassDEP regulations are in effect for the duration ofthis asbestos demolition and bulk loading operation. 12. The property owner shall ensure that a representative of each contractor, subcontractor and. consultant, involved in this project, reoeive a copy ofall parts ofthe NTWP including this Non~Traditional Asbestos Abatement Work Plan Approval Number: WNT15022 167 Main Street Leeds, MA Page" 3 Approval. A copy ofthe application, work plan and Approval shall be kept at the Site for the . duration ofthe project. 13. Should unforeseen Site conditions require changes to any ofthe procedures in this work plan, the applicant may request an amendment or addendum to the NTWP. Any request for changes shall be made to MassDEP inwriting, None ofthe added or amended conditions shall be utilized at the Site until the request has been reviewed and Approved by MassDEP. 14. Should asbestos become released, the owner, his contractors, subcontractors and consultants shall be held responsible for any subsequent abatement ofthe release and may be subject to enforcement action by the MassDEP. 15. MassDEP may, at its sole discretion, revoke this NTWP ifviolations ofthe regulations or any noncompliance with the submitted work plan, occur. 16. This Approval and NTWP are not intended and should not be relied upon to create rights or defenses, implied or otherwise, in any third parties, enforceable at law or in equity, by any person in any future litigation. MassDEP does not assume any liability in association with the performance of any activity inaccordance with this NTWP. " . 17. This NTWP is valid for ninety (90) days after the date it is signed by MassDEP ("the effective date"). Tills NTWP shall expire at the start of the ninety~fust (91st) day. If activities are "to continue past the 90 day expiration date then the MassDEP shall be notified in writing at least ten (10) days in advance, specifically, on or before the eightieth (80th) day. Continuance ofthe work under the provisions of the NTWP shall be the sole determination and' approval of MassDEP. . Date:._(P-f'!-=-;r~6/..:..,;.~C,-----itft-;.~~~4/4AtLL Marc Simpson . Permitting Section Chief . Bureau ofAir and Waste Western Regional Office attachment Non-Traditional Asbestos Abatement Work Plan Approval Number: WNT15022 167 Main Street Leeds,MA Page 4 NON-TRADITIONAL ASBESTOS ABATEMENT WORK PLAN SUBMITTAL CERTIFICATION All documentation submitted pursuant to the terms ofthis work plan shall comply With 310 CMR 7.01 (2)(a) Accurate Submittal to the Department which states: "No person shall make any false, inaccurate, incomplete, or misleading statements in any application, record, repOlt, plan, design, statement or document which that person submits to the Department pursuant to M.O.L. c. 111, §§ 1~2A through 142M, M.G.L. c. 111, § 150A, c. 21H, or 310 CMR 7.00 et seq." Finally, I certifY that I am authorized by the property owner or the :firm I represent to sign this foon. All information must be printed legibly or typed. Name:,-------_________Signed: ____________Date:,____ Entity Name, Address and Telephone Number: _________________ MassDEP Notification Number(s): _____________________ MassDEPNTWP Approval Number: ____________________ List ofAttachments: 650 Dwight Street, #1337 (Holyoke, MA 01041 TEL: 413~221~8233 ( FAX: a66-423~63558lJ?RBES www.forbeswheeler.comr~(>;"': i'\THEELER .' .f! Members: AIHA I ASTM , ... ~. Asbestos • Lead Paint. Mold/Fungi. EH&S Training .. Indoor Air Quality. Industrial Hygiene .Hazardous Materials May 28, 2015 ~ ':!: z: '0's! ~ Mr. Robert Shultz Massachusetts Department ofEnviromnental Protection (DEP) Bureau of Waste Prevention :::0 ·0 .t..) .!h !:5 .~ jf~ a:~ i!J j Westem Region 436 Dwight Street Springfield, MA 01103 RE: Asbestos Removal Work Plan Application for Non-Traditional Asbestos Abatement Work Practice Approval Demolition ofEntire Bui1dinglFire~Damaged Building Debris, as Special Waste 167 Main Street, Leeds, MA 01053 ' Dear Mr. Shultz: On behalf of the demolition contractor for the building owner (Moses Miller, 167 Main Street, Leeds, MA 01053), Forbes & Wheeler is requesting review and approval ofthe following Non-Trnditio+Ud Work Plan ("NTWP"), in association with the attached BWP AQ 36 (Application for Non-Traditional Asbestos Abatement Work Practice Approval), requesting that the facility owner's contractor be allowed to demolish the entire building located at 167 Main Street, Leeds, MA 01053, without first removing the asbestos. The building has been damaged by fire, and is declared as unsafe for human occupancy or use by the local building authority. Therefore, an asbestos survey cannot be conducted. Both mabIe and non~ mabIe asbestos"containing materials (ACM) are assmned to exist within the building materials. To the best ofmy knowledge, no asbestos survey was conducted prior to the fire. Therefore, the owner requests that the assumed asbestos materials be allowed to remain in place during demolition and be bulk loaded for disposal as asbestos waste. I have developed specific alternative work practices which shall be implemented by aU contractors, sub·contractors and consultants, to ensure that "no release of asbestos to the ambient air space during the demolition and bulk loading operation" occurs. These altemate work practices include maintaining adequate wetness as required, by water runoff control, full time third party oversight, representative perimeter, and ambient air monitoring, fuU time asbestos contractors and other requirements listed below during the remaining asbestos demolition and bulk loading operation. By performing wOl'k: pursuant to this NTWP, the owners and their contractors, subcontractors and consultants acknowledge and agree that failure to strictly comply with all of the work plan provisions and conditions stated herein may result in immediate revocation of this NTWP by the MassDEP and subsequent enforcement action by MassDEP. Forbes & Wheeler Non-Traditional Work Plan 167 Main Street, Leeds, MA 01053 Page 2 The specific sections of the MassDEP asbestos regulation, 310 CMR 7.15, to which these Non-Traditional Work Practices will apply are: 310 CMR 7.15(4) -SUlvey Reports 310 CMR 7.15(5). -Requires the removal and disposal of any ACM in accordance with 310 CMR 7.15, prior to conducting any demolition and/or any renovation thereof~ and removal or encapsulation any friable ACM that has been or will be exposed or created as a result of any demolition or renovation. 310 CMR 7.15(7)(c)1.-6. -Work Area Preparation Requirements. 310 CMR 7.15(7)(e) -Work Area Ventilation System requirements. 310 CMR 7.15(7)(f13.a. -c. -Requires prompt cleanup of all asbestos waste and removal from the worksite on a daily basis, and that said asbestos-containing waste materials be sealed into leak-tight containers such as bags, drums or wrapped in poly sheeting following removal. 310 CMR 7.l5(15)(b) -Packaging Requirements for ACWM into leak tight containers. 310 CMR 7.15(16)(b) Transpo11 of ACWM in Totally Enclosed Vehicles. The foHowing conditions and work practices shall be strictly followed during the course of the asbestos demolition and bulk loading operation: 1. The asbestos abatement contractor ("AAC") shall submit a completed notification ("ANF-OOl") fOlin to the MassDEP database at least ten (10) working days prior to the start of any work pursuant to this NTWP. All applicable notification fees shall be paid. The notification shall comply with all parts of MassDEP regulation 310 CMR 7.15(6), including acceptance by MassDEP. Failure to submit a properly completed notification form may result in the notification being rejected by MassDEP. Rejected notifications may be resubmitted within 30 days, however, the 10 working day notification period must be observed each time a rejected notification fOlm is resubmitted. Each and every asbestos contractor and subcontractor who perfOlms work at the Site shall submit an individual ANF-OOI in the manner described above. 2. The demolition contractor ("DC") shall submit a separate ANF-OOI to the MassDEP database at least ten (10) working days prior to the start of any work pursuant to this NTWP. AU applicable notification fees shall be paid. The notification shall comply with all pads of MassDEP regulation 310 CMR 7.15(6), including acceptance by MassDEP. Failure to submit a properly completed notification form may result in the notification being rejected by MassDEP. Rejected notifications may be resubmitted within 30 days, however, the 10 working day notification period must be observed each time a rejected notification form is resubmitted. Each and every demolition contractor and subcontractor who performs asbestos handling at the Site shall submit an individual ANF-OOI in the manner described above. 3. The Asbestos Monitoring Finn ("AMF") perfomIing work subject to this NTWP shall designate an employee, who holds a current and valid license issued by the Massachusetts Division of Labor Standards ("MADLS") as an Asbestos Project Monitor ("APM") to pelfonn aU duties of Forbes & Wheeler Non-Traditional Work Plan 167 Main Street, Leeds, MA 01053 Page 3 the APM pursuant to this NTWP. Prior to the start of any work subject to this NTWP, the APM shall review each and every asbestos notification (and applicable revisions) prior to commencing any work. 4. Prior to the start of any work subject to this NTWP, the APM shall review all aspects of this NTWP with each contractor, subcontractor and consultant. A written record of each entity attending the review shall be kept by the APM conducting the review and submitted to MassDEP at least one (1) working day and in accordance with Condition number 28 below. S. All contractors and subcontractors shall comply with all safety requirements, directives and instructions issued by City, State and Federal health, safety and building inspectors. Failure to comply with such directives may immediately result in the revocation of this NTWP by the MassDEP. 6. A regulated work area shall be established using asbestos warning signs and asbestos batner tape and physical barriers to prohibit unauthorized access into the work area during the asbestos demolition and bulk loading operation. 7. The AAC and every asbestos contractor and subcontractor working at the Site shall hold a current and valid license issued by the MADLS. The AAC shall be on site at all times during the asbestos demolition and bulk loading operation. The employees of each and every asbestos contractor shall also hold current and valid licenses issued by the MADLS as either asbestos workers and or asbestos supervisors. At least one (1) asbestos supervisor shall be on site for each four (4) workers. The AAe shall ensure all ofthe following: a) that the co-mingled asbestos and demolition waste material will be treated as Asbestos­ Containing Waste Material ("ACWM") and thoroughly wetted with runended water prior to handling and kept wet at an times during handling, b) that all of the roll-off dumpsters, truck waste containers, are properly lined as described in thisNTWP, c) that all ofthe A CWM is properly containerized as described in this NTWP, by sealing the liners over the top of each load, labeling the outermost liner and ensuring that the loads are covered prior to transport from the Site, d) that no water leaks fl.'om the vehicles dW'ing transport to the landfill, e) that the ACWM is properly tracked with MassDEP and USEPA required Waste Shipment records ("WSR's"), effective 1-1-15. 1) that all ACWM is disposed of properly in accordance with all local, State and Federal regulations regarding the transport and disposal ofasbestos wastes. g) that the exterior of all vehicles leaving the Site are properly cleaned and free of any debris generated at the Site. 8. Lat'ge capacity frre hoses (minimum nominal inside diruneter of 1-1/2 inches) shall be used during an pbases of the demolition and ACWM loading operations to eliminate dust generation and Forbes & Wheeler Non-Traditional Work Plan 167 Main Street, Leeds, MA 01053 Page 4 ensure adequate wetting of ACWM. A venturi or similar mixing system shall be affixed to the hose such that a surfactant is applied to the ACWM prior to handling. Alternatively, the surfactant may be applied by a separate system. Surfactant must be appJied to the ACWM at the beginning of each day's work, after which water that is not amended may be used for wetting purposes. Hookups to a municipal fire hydrant and/or water tankers are required to meet this standard. The water tank trailer or truck, if used, shaH be a minimum of 3,000 gallons. Garden hoses are not acceptable. If a water tank is used, it shall be equipped with a gas-powered centrifugal pump capable of discharging water at a minimum of 140 gpm, with enough pressure capable to reach all areas and heights ofthe building and the work. 9. Water runoff control shall be used to capture any water runoff from the site. If the water is collected into a lined collection pit then following all demolition and cleanup operations the liner shall be removed and disposed ofas asbestos waste and three (3) inches of soil shall be excavated from the pit and disposed of as ACWM. Asbestos-contaminated water must pass through filters capable of capturing and containing particles greater than or equal to five (5) microns in size, before disposal to a sanitary sewer is permitted. Hay bales, silt fences, fiber rolls, fiber logs, and straw wattles are not acceptable for water runoff control. 10. The DC shall use equipment of sufficient size to ensure a controlled demolition operation and prevent an uncontrolled collapse. All equipment and personnel associated with the asbestos demolition and ACWM buJk loading operation shall be fully decontaminated on a daily basis and before being released to other service. At a minimum, the equipment operators shall be trained in accordance with the standards fOl" Asbestos-Associated Project Workers described in 453 CMR 6.00, or trained and certified pursuant to any other necessary training described in 453 CMR 6.00 as determined by inspectors of the Springfield, MADLS office. Copies of said training and licenses shall be kept at the Site at all times for review by MassDEP personnel and shall be submitted with the requisite documentation listed in Condition 28 below. 11. An APM holding a current and valid license issued by the MADLS shall perfonn perimeter air monitoring of the ambient air around the circumference of the work area. This perimeter air monitoring shall be performed on a continuous basis during the asbestos demolition and ACWM bulk loading operations until the start of the visual inspection required pursuant to 310 CMR 7.15(8). Attention shall be paid to the downwind sector as wen as to all adjacent properties, streets and walkways to ensure that the circlunferential monitoring points coincide with these sensitive receptors. The consultant shall have a minimum of four (4) air monitoring stations to accomplish adequate monitoring between the Site and all of the sensitive receptors. The AMF is responsible to ensure that the APM performs the sample collection in compliance with all parts of theNTWP. 12. AU perimeter air samples shall be conected at a minimum flow rate of eight to sixteen liters per minute (8.0 to 16.0 Ipm). Each sample shall col1ect a minimum volume of 1100 liters of air, except under special circumstances (such as low volwne due to sudden end of working day) acceptable to MassDEP and which shall be noted by the APM either on the air sample data sheet or site log. Perimeter air samples shall be collected in the general breathing zone. which for the purposes of this NTWP is between 48 and 72 inches above ground leve1. Each air sample's start and stop flow rate shall be measured by a device (rotometer) that has been calibrated to a primary standard within six (6) months ofuse at the Site. A copy of the calibration records for each such measurement device (rotometer) shall be provided to MassDEP at least one (l) working day prior to the start of any activity pursuant to this NTWP. All air filter cassettes shall be changed as Forbes & Wheeler Non-Traditional Wode Plan 167 Main Street, Leeds, MA 01053 Page 5 necessary to prevent particulate overloading. Each air filter cassette shaH have the soot and stop time and associated start and stop flow rates recorded in the consultant's Site log or air sampling data sheet. Air monitoring series which repeatedly reveal samples that are overloaded with particulate and cannot be analyzed may be considered to be in noncompliance with the terms of NTWP Approval and MassDEP Air Quality regulations. Any noncompliance may result in the revocation of this NTWP and subsequent enforcement action by MassDEP. The AAC shall provide four (4) sources of one hundred ten volt alternating current (I JOv AC) such that MassDEP personnel may set up monitoring pumps at any area around the perimeter of the site. These power sources shall be protected by ground-fault circuit interrupters (OFCl's). The AAC shall also provide sufficient power cords meeting OSHA requirements for use by MassDEP personnel. 13. Analyses ofthe perimeter air samples shall be performed within one hour ofcollection and a copy ofthese results shan be provided to the APM and each contractor working at the Site, so that real time corrections in the work practices can be made. If the air monitoring results exceed one ­ one hundredth fiber per cubic centimeter (0.010 Vcc) of air, then all work shall stop. The work methods shall be evaluated by the Asbestos Project Monitor in consultation with the AMF, Asbestos Project Designer, Asbestos Site Supervisor and the demolition site supervisor prior to continuing any further work. MassDEP shall be notified by telephone by close ofbusiness (5:00 p.m.) on that same day of the air monitoring exceedance and the updated emission control procedures. If the airborne fiber concentrations reach or exceed fifteen thousandths fibers per cubic centimeter (0.0]5 Vee) of air, then work shall stop and MassDEP shall be notified of the exceedance by telephone within two (2) hours. 14. Each and every contractor and subcontractor performing asbestos handling related work at the Site pursuant to this NTWP shall perform employee air monitoring, this is not to be confused with OSHA personal air monitoring requirements. The pump shall be operated at a minimum of 2.0 liters of air per minute and each sample shall collect a minimum of 275 liters of ai1". The employee air samples shall be located in the worker's breathing zone, which for the purposes of this NTWP is twelve inches (12") from the nose and mouth. Flow rates are to be measured by a device (rotometer) that has been calibrated to a primary standard within six (6) months of use at the site. A copy ofthe calibration records for each such measurement device (rotometer) shan be provided to MassDEP at least one (I) working day prior to the start of any work. The start and stop times and associated flow rates are to be recorded in each contractor's site log book. At least one in four workers, or one for each assigned job duty, shall wear a personal air monitoring pump. This includes supervisors, ground crew in the asbestos work area, ground crew outside the asbestos work area, asbestos removers, and equipment operators as appropriate. The employee air monitoring shall be performed ona continuous basis during all asbestos handling operations. If work stoppages are expected to exceed 30 minutes, such as lunch breaks or wait times for dumpster delivery or equipment repair, then each monitor shall be shut off and the flow rate and time recorded. When work recommences and the unit is re-started, the re-start time and flow rate shaH be recorded. Employee air monitoring shall be performed until such time as the visual inspection pursuant to 310 CMR 7.15(8) is conducted. The AAe and DC are also required to ensure that employee monitoring is performed on their own employees and on the employees of all subcontractors, and that it is performed in compliance with the tenns ofthe NTWP, 15. Analyses results of the employee air samples shall be provided to the APM by each contractor and subcontractor each morning prior to beginning any work on every day except the first day of work. Jfthe air monitoring results exceed one -one hundredth fiber per cubic centimeter {O.OlO Forbes & Wheeler Non-Traditional Work Plan 167 Main Street, Leeds, MA 01053 Page 6 f/cc) of air, then work shall not commence and MassDEP shall be notified ofthe exceedance by telephone within two (2) hours for evaluation of the work practices. Results for each sample shall be repol1ed separately, time weighted average (TWA) calculations of the employee air samples are not acceptable for the purposes ofthis NTWP. 16. Analysis of both perimeter and employee air samples shall be performed by personnel who are properly trained in accordance with the NIOSH 582 or 582 equivalent method, are successful participants in the American Industrial Hygiene Association's Asbestos Analytical Registry (AlHA's AAR). are considered proficient with the most recent "PAT" rounds, or alternatively. who are employees of a laboratory, which is licensed by the Commonwealth to perform such analysis and which is accredited with either the AIHA or National Voluntary Laboratory Accreditation Program (NVLAP) as appropriate. 17. No asbestos-related activities or asbestos removal work pursuant to this NTWP shall commence unless the APM is at the Site and all air monitoring stations, both perimeter and employee air monitoring, are in full operation. Acknowledgement that the air monitoring is in operation shall be recorded in the site logs or field sampling data sheets of the APM each day the air monitoring is being perfOlmed. 18. All of the co-mingled asbestos demolition debris shall be disposed of as ACWM. This material shall be thoroughly wetted with amended water prior to the start of work each day and kept wet during demolition and loading operations until bulk loaded. All asbestos waste shall be "live loaded" into roll-offs or dump trucks that have been lined with a minimum of two (2) ten-mil (0.010 inch thick) pre-formed polyethylene ("'poly") liners. These liners shall be of sufficient size and installed in such a manner so that the top flaps will overlap and so that they can be sealed across the top of the load. During loading operations proper placards shall be displayed pursuant to 40 CFR Part 61. After sealing the exterior liner, it shall be properly labeled in accordance with 310 CMR 7.15. None of the asbestos waste shall remain on the gl'Ound or in a dumpster or truck in an uncovered state overnight. For the purposes of the NTWP "live-loaded" means placed into the lined roll-off or dump truck as it is produced and not accumulated or stockpiled. 19. The asbestos-contaminated building rubble shall be maintained in large sections during demolition and not crushed or compacted in any way. The loading operator may "heelwdown" once on each bucket of ACWM deposited into the roll-off or dump truck to level the load in order to prevent uncontrolled shifting during transport. Sharp building components that are to be bulk loaded may tear the poly liners. If it is determined that tearing of the liners cannot be prevented, then the contractol'S shall place 3/8 inch thick (nominal thickness) plywood sheets inside the 1'011­ off or dump truck, between the liners and the waste, to prevent tears to the poly. This plywood shall then be disposed of as ACWM with the load. 20. The ACWM shall not be otherwise crushed or compacted by hydraulic or other means. Large metal components such as un-insulated steel I-beams and large sections of uncoated concrete walls or floors, that are to be recycled, shall be washed and thoroughly decontaminated. Following decontamination each such large component shall be visually inspected by the APM. A list of these components and the results of each visual inspection thereof shall be recorded in the APM's Site log book. All clean masonry material that is to be removed for recycling shall be handled in accordance with all applicable local and state regulations including those at the following MassDEP Solid Waste Division's website link describing the proper handling of asphalt, brick and concrete resulting :from demolition activities. Forbes & Wheeler Non-Traditional Work Plan 167 Main Street, Leeds, MA 01053 Page 7 lilll):llwww.mass.gov/eeaiagenciesimassdeplrecycle/l'educe/using-or-processing-asphalt­ pavement-brick-ang-concrete-.htmI 21. All heating system components or other building components for which there are no asbestos abatement records or inspection results shall be treated as "suspected" to have been covered or coated with asbestos shall be segregated to a remote area of the Site, wetted with amended water and covered with at least one layer of six-mil (0.006 inch) thick poly sheeting that is secured to the ground. These components shall be tested for asbestos materials prior to abatement within a full containment structure with REP A filtered work area ventilation. Alternatively such components may be considered covered or coated with asbestos materials and abated without testing in accordance with the provisions of310 CMR 7.15. The AMP is responsible for ensuring that the APM perfonns thorough visual inspections of each such containment as described in 310 CMR 7.15(8). No heating system components or insulated structural building components are subiect to the bulk loading or alternative handling grocedures of this NTWP unless tested, and shall be segregated to a remote isolated work area on the Site ot isolated and contained in-place for subsequent stripping and removal of the friable ACMs. Clearance Air monitoring pursuant to 453 CMR 6.l4(5)(b) shall be conducted inside ofthese isolated work areas. 22. If it is necessary to leave a partial1y filled asbestos waste roll-off or huck at the Site overnight, then it shall be wetted, covered and secured. 23. The asbestos contractor shall establish a loading area beneath and around the waste loading areas and the excavator swing zone and/or crane machine swing zone, which is to be kept :free of visible debris and cleaned between loads to prevent trucks fonn accumulating ACWM in or in the tires. Installation one layer ofsix mil poly on top of one layer ofreinforced six-mil poly sheeting may speed cleanup as the top layer of poly could be removed and replaced between loads to maintain the clean loading area. Alternatively, one layer of a W thick waterproof asphalt sheeting or a W' thick Ethylene Propylene Diene Monomer (EPDM) liner may be used, and be cleaned at the end of each working day. Poly sheeting shall be disposed of as ACWM at the end ofeach working day. 24. ACWM shall not be stockpiled and shall not be crushed or compacted. If by unforeseen occurrence all ACWM generated during a particular work day is not loaded prior to the end ofthe shift, due to a delay in waste transport vehicle or rol1~off availability, then the asbestos waste shall be wetted and covered with at least one-layer ofsix-mil poly sheeting that has been secured to the ground. This ACWM shall then be loaded the following day or the first day of project recommencement, prior to the commencement of any further demolition operations. The poly covers shall likewise be disposed of as ACWM and not stored or reused. 25. The contractors shall ensure that no water leaks ft'om the trailer truck containers or roll-off dumpsters or any other permitted waste receptacles during transport to the landfill, and that the ACWM is covered at all times dwing transport. The trucks or roll-off dumpsters shall be in good condition with no holes or rusted out areas and with tailgates, which close tightly and are lockable. USDOT Class 9 placards shall be afflXed to the exterior ofeach dumpster or truck prior to transport. 26. Following the completion of the removal of all of the bulk ACWM but prior to any further excavation or backfiUing operations, the asbestos contractor shall collect, for disposal, all Forbes & Wheeler Non-Traditional Work Plan 167 Main Street, Leeds, MA 01053 Page 8 remaining waste, small debris and detritus accumulated around the Site or on the slab or in the cellar hole (if any). This material shall be collected with wet methods utilizing either HEPA vacuums or squeegees and shovels or picked up by hand. Dry sweeping shall not be employed. The remaining asbestos or asbestos-contaminated materials shall then be sealed into leak-tight and properly labeled containers for disposal as ACWM. 27. Following the bulk loading operation and cleanup of all remnant or suspected ACWM, but prior to any continued Site work, excavation or backfilling, a fmal visual inspection shall be performed by the APM and AAC Site Supervisor and DC Site Supervisor to ensure that no remnant asbestos, co-mingled asbestos demolition debris, asbestos-contaminated water or any other suspected ACWM remains on any slab or in any cellar hole, on the ground around the work site, at the loading site, as well as any other area at the Site. The results of this inspection shall be recorded in the individual's respective Site logs. 28. All documentation regarding air monitoring collection and analysis results, as well as visual inspection reports, waste disposal records, contractor and consultant site logs, visitor sign in logs, notices of violation, cease and desist orders and MassDEP notifications shall be kept on Site for inspection by MassDEP and all other Federal, State and local governmental agency personnel during the asbestos demolition and bulk loading operation. Copies of all of the Site records and documentation are to be supplied to the MassDEP by the property owner, and each and every consultant, asbestos contractor and subcontractor upon request or within thirty (30) days of completion of the work if not requested earlier. Each submittal shall be accompanied by an original signed copy ofthe last page ofthe MassDEP approval letter. 29. This work plan does not negate the responsibility of the property owner, the contractors, subcontractors and consultants from complying with all other applicable Federal, State and local regulations. ' 30. This work plan applies specifically to the asbestos bulk loading ofthe structure and debris located at 167 Main Street) Leeds, MA 01053. This work plan does not apply to any past or future demolition or asbestos handling operations at the Site. All other MassDEP regulations are in effect for the duration ofthis asbestos demolition and bulk loading operation. 31. The property owner or the APM shall distribute copies of this work plan to each entity involved with the project. A copy ofthis work plan shall be kept at the Site for the duration ofthe project. 32. Should unforeseen Site conditions require changes to any ofthe procedures in this work plan, the undersigned Asbestos Project Designer may request an amendment or addendum to the NTWP. Any request for changes shall be made by the undersigned Asbestos Project Designer to MassDEP in writing. None of the added or amended conditions shall be utilized at the Site until the request has been reviewed and accepted by MassDEP and a written approval issued. 33. Should asbestos become released, property owners, their contractors, and subcontractors may be subject to enforcement action by the MassDEP, and may be held responsible for any subsequent abatement ofthe release. 34. The MassDEP may, at their sole discretion, revoke this NTWP. Forbes & Wheeler Non-Traditional Work Plan ]67 Main Street, Leeds, MA 01053 Page 9 35. The NTWP is intended solely as guidance for the property owners in the conduct of the subject asbestos removal activities. 36. This NTWP is valid for ninety (90) days after it is approved by MassDEP and shall be deemed expired at the start of the ninety-first (91·t) day. If activities are to continue past the 90 day expiration date then the MassDEP shall be notified in wllting at least ten (10) days in advance, specifically, on 01' before the eightieth (80~ day. Continuance of the work under the provisions of the NTWP shall be the sole detennination and approval ofMassDEP. Sincerely, AIfL#~Ste7~W.NiV Asbestos Project Designer MA License No. AD071139 413-221-8233 Forbes & Wheeler Massachusetts Department of Environmental Protection Bureau of Waste Prevention BWP AQ 36 Application for Non-Traditional Asbestos Abatement Work Practice Approval Important: When completing forms on a computer, use only the tab key 10 move your , cursor· do not use the return kay. ~ ~ --.-----------------~-------------------A. Work Site Information Facility Fire-dam~=e=_d:::_H:.::o_=_us;:;;.;;e~~_:__---_______________._______ Facility Name or Site Description J67 Main Street Facility Address Leeds Cityffown Owner Moses Miller Owner Name 167 Main Street OWner Address Leeds CitytTo""-w-n--­ (413) 6Q!i-0094 Telephone Number Applicant Address......--'---- Leeds CityfTown (413) 69..§~0094 Telephone Number MA 01053 ZIPCode---'--­State MA 01053 State ZIP Code unknown ---------"..--Email Address Applicant ~ 0 Check hera if same as Owner and skip to next section. Otherwise, complete fields below. Moses Miller Applicant Name 167 Main Street MA State Email Address B. Project Information Asbestos Abatement Project Designer Step~en W. NieQ. _________.__ Name 650 Dwight Street, #1337 Address Hol}!-=-:okc:.;:e,--_ CityfTown 413~221~8233 Telephone-N7'u::..:m7b-er------------­ Asbestos Abatement Contractor Ba:ystate Contracting Services, Inc. Contractor Name ~.~2 Albany Street Address Springfielg'--____________ CitylTown 413-781~O;;;..;8=2c=_O___________ Telephone Number AD071139 Department ofLabor Standards (OLS) Contractor Ucense Number MA 01041 Slate ZIP Code sniec@forbeswheeler!c;=:.::o:.:.:m"'--_,______ Email Address ACOOOO21 Department of Labor Standards (DLS) Contractor MA 011~O=5________ State ZIP Code Demo@buildingwreckers.co"1___, ___, Email Address BWP AQ 36 -Applicalion for Approval of Non-Traditional Asbestos Abatement Work Practice Approval -Page 1 of 3 7/14 Massachusetts Department of Environmental Protection Bureau of Waste Prevention BWP AQ 36 Application for Non~Traditional Asbestos Abatement Work Practice Approval B. Project Information (continued) Demolition Contractor (If Applicable) Associated Building Wreckers,lng=-, ___, Contractor Name 352 Albany Street Address ..§eringfield MA 01105 CityfTown State ZIP Code 413-781-0820 Demo@buildingwreckers.com Telephone Number Email Address CIrcumstances -Check the appropriate box(es) to indicate why a Non-Traditional Asbestos Abatement Work Practice Approval is needed. o Facility is being demolished under a state or local government order because it is structurally unsound and in danger of imminent collapse. (Please attach a copy of the order to your work plan proposal.) o Asbestos Containing Material (ACM) or Asbestos Containing Waste Material (ACWM) was not accessible for testing, therefore not discovered until after demolition began and, as a result, cannot be safely removed. o Abatement activity is being conducted as part of an emergency renovation operation. o Asbestos abatement activjty is being conducted to clean up and decontaminate a facility or portion of a facility where: o Previous asbestos abatement activities were not conducted in compliance with 310 CMR 7.15. o ACM deterioration, if not immediately attended to, would present a safety or public health hazard. o Wetting during a facility renovation would unavoidably damage eqUipment or present a safety hazard. !81 The project requires bulk loading of ACM and/or ACWM. List the requirements of 310 CMR 7,15 that you are unable to comply with and explain why: 310CMR 7.15(4); 310 CMR 7.15(5); 310 CMR 7.15(7}{c)1.-6; 310 CMR 7.15(7){a); 310 CMR 7.15(7)(f)3.a. -c.; 310 CMR 7.15(15){b); 310 CMR 7.1S(16)(b). Building is fire-damaged, has been deemed as unsafe for human occupancy or use by the local building authority, and is unsafe for .!nspection pr conventio!l."",a=l..;::ac:csb::..e:...:s:..;.to,,-,s,--,r:..;:e=m=o:..;.v..:..:al,-,-._____________ --_..------------,---------­---~,--- Other Project Details Types & Amounts of ACM Requiring Non-Traditional Work Practice(s): !81 Friable 650 CY !81 Non-Friable same ~~~~~~~~~~~.Quantity In Cubic Meters (Cubic Yards) Quantity In Cubic Meters (Cubic Yards) Location(s) of ACM in the Facility: Entire building assum~d to oontain asbestos. -40' x 30' rectangular area building footprint, 1-1/2 story BWP AQ 36 -Application for Approval of Non-TradItional Asbestos Abatement Work Practice Approval -Page 2 of:3 7114 Massachusetts Department of Environmental Protection Bureau of Waste Prevention BWP AQ 36 Application for Non-Traditional Asbestos Abatement Work Practice Approval C. Certification "I certify that I have personally examined the foregoing and am familiar with the information contained in this document and all attachments and that, based on my inquiry of those SignatUre SteRhen W. Niecindividuals immediately responsible for obtaining the Printed Nameinformation. I believe that the information is true, accurate, Project Designerand complete. I am aware that there are significant Titlepenalties for submitting false information, including possible fines and imprisonment. I am aware that this 05/2812015 permit application or notification shall not be deemed valid Date (MMlDDIYYYY) unless payment of the applicable fee is made." D. Submission of Application Note: MassDEP review will begin only after your submissions have been received at both locations. STEP 1: Submit Fee Payment Send the materials below to the P.O. box address below to: MassDEP P.O. Box 4062 Boston, MA 02211 t:8I A copy of this completed and signed form. t:8I Fee payment of $600 (check or money order payable to "Commonwealth of Massachusetts"). The following entities are exempt from this fee: • CIties, towns, counties or districts of the Commonwealth • Federally recognized Indian tribe housing authorities • Municipal housing authorities • The Massachusetts Bay Transportation Authority (MBTA) Entities that are exempt from the fee must stilI submit a copy of this completed and signed form, without payment, to the P.O. box above. STEP 2: Submit Application Send the following materials to the appropriate MassDEP Regional Office*, Attention: Asbestos Section: 181 This original completed and signed form. 181 A copy of the check or money order from Step 1. 1:81 Your proposed work: plan, describing work practices. duration and schedule. The proposal must: • Include signature of the Asbestos Project Designer who prepared it. • Demonstrate that the deviations from 310 CMR 7.15 and alternatives proposed will not cause any vIsible emissions to the outside air or pose significant risk to public health, safety or the environment. 181 All supporting documentation. *Find the MassDEP Regional Office for the community where this work will be done: http://www,mass.gov/eea/agencies/massdep/aboutl contactsl 8WP AQ 36 -Applicatfon for Approval of Non-Traditional Asbestos Abatement Work Prectice Approval· Page 3 of 3 7/14 ~':'''--'."''';"",~~-.--. ':'."" . . .' ~' , . ',' .. , ..... ASSOCIATJ;D. Qu'!I1PJN~::WaeCK.ERS, .INC~ ", .,:,peOPl~!,$:~NJTEDBAN.t '. , .', .' . "3"'1',:·:·S'::9''.8'~O·· ':::­. .... ··~352ALBANY..ST. "." . . ' .. :~ :'·::~~~1\9[1~~~::1cr~~I~..'.".>::.: .:,:':: , '"<": ·::·€l~~!·1~~~;~:a~:eb1105 :,::.. ./~::" ....::.~./.bAT~·:.:.::::·:·:». :·6~,~9~:~~:~. :·'.;...·,A~OUNT ,;.';:~:;: . . .....;. ..' .:'05(Q51:?015::; : .,.·:31(i~~Q :: ..$~()O~OO ...................~...;.............;~...::~;..;...~......~..I~....~~~;~UU1~E~AND xX 1100 DOLL~ ••.•.•.•..• PAY.. . .... ", ..... '.' ....:\. .... .. ,-.. , ..... "" -.;' ," '", " ........ "'.: I : ":'","{ ".' >,:,..._,:::>.: .', '..' .-<.....~ " .:.....,<:....:.:;.; ::::· ...::.:: .... '... :i .• :'·.·:\:.::.:, .. ·.·:·:, '....:..... "": ..•• '. TO THE ORDER Of . / ~7 Massachusetts Department ofEnvironmental Protection Bureau of Waste Prevention • Air Quality 100219680BWPAQ06 Asbestos Project Number # Notification Prior to Construction or Demolition Instructions: 1. All sections of this form must be completed in order to comply with the Department of Environmental Protection notification requirements of 31 0 CMR7.09. 2. Submit Original Form To: Commonwealth of A. Applicability A Construction or Demolition operation of an industrial. commercial. or institutional building, or residential building with 20 or more units is regulated by the Department of Environmental Protection (MassDEP). Bureau of Waste Prevention. Air Quality Division. under Regulations 310 CMR 7.09. Notification of Construction or Demolition operations is required under 310 CMR 7.09 (2) ten (10) working days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. Is this a fee exempt notification (city. town. district. municipal housing authority. state facility. owneroccupied residential property of four units or less)? Is this a fee exempt notification (city, town, district, municipal housing authority, state facility, owner-occupied residential property offour units or less)? ('7 Yes r No Type ofNotification: r Revision ofan Existing Form r Cancellation of Project 1. Blanket Permit Project Approval, ifapplicable: Approval 10 # 2. Non-Traditional Asbestos Abatement Work Practice Approval, if applicable: Approval 10 # B. General Project Description 1. Facility Information: FIRE DAMAGED SINGLE FAMILY RESIDENCE 167 MAIN STREET Name of facility NORll-IAMPTON MA Street Address 010530000 4136950094 CitylTown MOSES MILLER State Zip Code OIJInIIER Telephone Massachusetts P.O. Box 4062 Boston, MA 02211 Facility Contact Person 4136950094 Facility Contact Person Telephone Contact Person TItle demo@buildingwreckers.com Facility Contact Person Email Facility Size: 2000 2 Square Feet Number of Floors Was the facility built prior to 1980? FYes rNo Describe the current or prior use of the facility: ARE DAMAGED RESIDENTIAL STRUCTURE Is the facility a residential facility? ('7 Yes rNo If yes, how many units? 1 2. Facility Owner: MOSES MILlER 167 MAIN STREET Facility Owner Name Address LEEDS (NORll-IAMPTON) MA 010530000 4136950094 CitylTown State Zip Code Telephone MOSES MILlER 167 MAIN STREET On-Site Manager/Owner Representative Address Leeds (Northampton) MA 01053 4136950094 CitylTown State Zip Code Telephone Revised: 03/17/2014 Page lof3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention· Air Quality iLj_\ ..••. .... ' . . , ,. "; BWPAQ06 Notification Prior to Construction or Demolition Asbestos Project Number #j B. General Project Description (continued) 3. General Contractor: ASSOCIATED BUILDING WRECKERS 352 ALBANY STREET Name Address SPRINGFIELD MA 011050000 4137323179 CityfTown State Zip Code Telephone ANDREW MIRKIN 4137323179 General Statement: If asbestos is found during a Construction or Demolition operation, all responsible parties must comply with 310 CMR 7,00,7,09,7.15, and Chapter21E of the General Laws of General Contractor's On-site Manager/Foreman Telephone C. General Construction or Demolition Description I. Construction or demolition contractor: ASSOCIATED BUILDING WRECKERS 352 ALBANY STREET Contractor Name Address SPRINGFIELD MA 011050000 4137323179 CityfTown State Zip Code Telephone ANDREW MIRKIN 4137323179 the Commonwealth, This would include, but would not bw limited to, filing an asbestos removal notification with the Department and/or a notice of release/threat of release of a hazardous substance to the Department, if applicable, Construction and Demolition On-site Manager Telephone 2. Licensed Contractor Supervisor: ANDREW MIRKIN CS-062382 Supervisor Name License Number 3. Is the entire facility to be demolished? 4. Describe the area(s) to be demolished: ENTIRE STRUClURE MassDEP Use Only 5. If this a construction project, describe the building(s) or addition(s) to be constructed: N/ADate Received 6. If this is a demolition or renovation project, were the structure(s) surveyed for the presence of Asbestos-Containing Material (ACM)? P"Yes INo 7. Was asbestos containing material (ACM) found? If a survey was conducted, who conducted the survey? ASSUMED (FIRE DAMAGED NIA P" Yes INo Name Department of Labor Standards Certification Number Revised: 03/1712014 Page 2 of3 Massachusetts Department of Environmental Protection Bureau ofWaste Prevention· Air Quality 1100219680BWPAQ06 Notification Prior to Construction or Demolition Asbestos Project Number # C. General Construction or Demolition Description (continued) The Asbestos Abatement Notification Number for this TBD address is: -------....,.....----------­ This project r Construction J7 Demolition is: 5/18/2015 8/3112015 Project Star! Date (MMIDDIVVYY) Project End Date (MMIDDIYYYY) 8. For demolition and construction projects, Indicate dust suppression techniques to be used r Seeding J7 Wetting r Covering r Paving r Shrouding r Other -SpecifY: 9. For Emergency Demolition Operations, who is the MassDEP official who evaluated the emergency? Name of MassDEP Official TiHe Date of Authorization (MMlDDIYYYY) D. Certification "I certify that I have personally examined the foregoing and am familiar with the information contained in this document and all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the information is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment. The undersigned hereby states, under the penalties of perjury, that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made: MassDEP Waiver Number ANDREWMIRKIN Print Name ANDREWMIRKIN Authorized Signature PRESIDENT PositionlTitie ASSOClAlED BUILDING WRECKERS Representing 51412015 Date (MM/DDIYYYY) UNKNOWN P.E.# Revised: 03/1712014 Page 3 00 eDEP -MassDEP's OnlineFiling System Page 1 of 1 MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System Username:DEMOCOORD Nickname: DEM01 eDEP Forms ~ My Profile ~ Help Notifications l Receipt j Signature Receipt Summary/Receipt Co. [ print receipt Your submission is complete. Thank you for using DEP's online reporting system. You can select "My eDEP" to see a list of your transactions. DEP Transaction ID: 739225 Date and Time Submitted: 5/4/2015 11 :50:03 AM Other Email : DEP Transaction ID: 739225 Date and Time Submitted: 5/4/2015 11 :50:03 AM Other Email : Form Name: AQ 06 -Construction/Demolition Notification Form Name: AQ 06 -Construction/Demolition Notification Payment Information DEP code Date Amount ($) Payment Detail MyeDEP MassDEP Home I Contact I Privacy Policy MassDEP's Online Filing System ver.12.14.3.0© 2015 MassDEP Ir)·c~..i Massachusetts Department of EnVironm:ntal 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: 739225 Document: AQ 06· Construction/Demolition Notification Size of File: 217.S2K Status of Transaction: In Process Date and Time Created: 5/4/2015:11:51:11 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. Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality BWPAQ06 Notification Prior to Construction or Demolition I This is a revision to an existing fonn. Project ill for existing fonn to be revised: I This job is being conducted under a Blanket Pennit MassDEP assigned Blanket Authorization ill: Ir------­ I This job is being conducted under a Non Traditional Abatement Work Practice Pennit. MassDEP assigned Non Traditional Work Practice Authorization ill: I ~ None ofthe above conditions apply, generate a new fonn. Revised: 11113/2013 Page 1 ofl DIG SAFE SYSTEM, INC. -Renew Existing Ticket Page 1 of2 II Request Number: 20152600525 Date 06/22/2015 Time 07:25 Ilatitude: longitude: I IState: MASSACHUSETTS Municipality: NORTHAMPTON Address {Intersection: 167 MAIN STREET INearest Cross Street 1: ARCH ST Nearest Cross Street 2: .1 Additional Information: il I I I I INature Of Work: DEMOLITION I Area Of Work: STREET TO BUILDING Area Is Premarked: Y Start Date: 06/26/2015 Start Time: 09:00 I~MICHAEL Title: Return Call: IPhone#: 413-732-3179 FaX#: Alt. Phone#: I Email Address: Contractor: ASSOCIATED BUILDING WRECKERS, INC IAddress: 352 ALBANY STREET City: SPRINGFIELD State: MA Zip: 01105 IExcavator Doing Work: I I Member Utility List IICode II Abbreviation II Name II~I COMCAS COMCAST -SOUTH BURLINGTON IIEJI FBRTEC FIBERTECH NETWORKS -MA IM114 II MATECH II MASSACHUSETTS TECHNOLOGY PARK CORP §]I NGRDEL II NATIONAL GRID ELECTRIC-MASS ELEC ~I MCI IIMCIIIEJI ONTARG ON TARGET LOCATING IIEJI VERIZN VERIZON II~II VERIZN VERIZON WB II BRKGAS II BERKSHIRE GAS IIEJI CMAGAS COLUMBIA GAS OF MASSACHUSETTS • There may be non-member utilities in the area that you need to notify. ,. Northampton, MA: Residential Property Record Card Page 1 of2 Northampton, MA Residential Property Record Card [ Back to Search Results 1 [ Start a New Search ][ Help with Printing] Search For Properties ParcelID Name Street Name IMAIN ST vi Search II Reset ParcellD Card Map-Block-Lot Location Zoning State Class Acres 100-019-001 1 167 MAIN ST 101 ­n/a 0.800 Owner Information Property Picture Miller Moses 0 [ No Picture Available] 167 Main St Leeds MA 01053 Deed Information Book/page: 9943/8 Sale Date: 2009/08/24 Dwelling Information Living Units: 1 Style: Conventional Story Height: 1.5 Exterior Wall: Alum/Vlnyl Attic Living: None Basement: Full Year Built: 1860 Ground Floor Area: 750 UnfiniShed BSMT Area: 750 Fin BSMT Living: n/a Tot Living Area: 1312 Rec Room: 1 x 400 Tot Rooms: 6 Bedrooms: 3 Full Baths: 2 Half Baths: 0 Mas Fire Place n/a Frame Fire Place n/a Heating Type: Basic Valuation Land: $93,700 Building: $125,800 Total: $219,500 Sales History Document No Date Price Type Validity n/a 2009/08/24 $268,000 Land + Bldg 0 n/a 1995/02/01 $75,000 Land + Bldg Permit History Date Purpose Price 2004/10/22 12 X 12 SUNROOM $19,000 Out Building Information Type Qty Year Size1 SIze2 Garage-Wd/Cb 1 1964 1 380 Northampton, MA : Residential Property Record Card Page 2 of2 Pool-Prefab Plastic Liner 1 1995 16 36 Sketch DescriptorIArea A:1.5Fr/B 750 sqft 12 12 B:EFP1!'"ood Dec~4 144 sqflEFP12 12 @) C:Wood Deck@) 168 sqfl 12 12 D:Wood Deck30 56 sqft 1.5FI/B25 25@ 30 , A 4 .D I .. 41 Notice The information delivered through this on-line database is provided In the spirit of open access to government information and is intended as an enhanced service and convenience for citizens of Northampton, MA. The providers of this database: CLT, Big Room StudiOS, and Northampton, MA assume no liability for any error or omission in the information provided here. Currently All Values Are Finalized For Fiscal Yr 201S. Comments regarding this service should be directed to: Isarafin@northamptonassessor.u5 167 Main Street Page 1 of 1 http://maps.massgis.state.ma.us/temp/OL_MORIS~rintl1435576966.1169254762.html 0612912015