Zoning Permit 23B-046 (289) File #36
APPLICANT/CONTACT PERSON:COOLEY DICKINSON HOSPITAL I
30 LOCUST ST NORTHAMPTON, MA 01060
PROPERTY LOCATION 30 LOCUST ST
MAP:LOT 23B-046-001 ZONE
THIS SECTION FOR OFFICIAL USE 0 Y:
PERMIT APPLICATION CHECKLIS
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $30.00
Type of Construction: ZPA -7,650 ADDITION ON EAST SIDE OF BUILDING
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved V Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§. II.S
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: X 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 Delay
t Zriel 6/ ' 7d 3
Sign.i;Lure of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
RECEIVED
JUN - 6 2023 File No. �Q C�i# l qLc $. 10
n- ZONING PERMIT APPLICATION (§i o.2)
T
�i '„�,�eaee�. `or plrint all information and return this form to the Building
Inspector's Office with the $30 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: Cooley Dickinson Hospital
Address: 30 Locust Street, Northampton, MA 01060 _ _ Telephone: (413) 582-2000
2. Owner of Property: Cooley Dickinson Hospital
Address: 30 Locust Street, Northampton, MA 01060 Telephone: (413) 582-2000
3. Status of Applicant: Owner X Contract Purchaser Lessee Other (explain)
4. Job Location: 30 Locust Street, Northampton, MA 01060
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: Hospital Building 'A' and ambulance parking area.
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Approximately 7,650 sf of building expansion on the east side of Building 'A'. Removal and
replacement of paved drive aisle and concrete sidewalks. Removal and replacement of
paved ambulance parking area. Addition of new storm structures and piping.
7. Attached Plans: Sketch Plan Site Plan X Engineered/Surveyed Plans X
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW X YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
NOT WITHIN
9.Does the site contain a brook, body of water or wetlands? NO PROJECT DON'T KNOW YES
Wetlands exist on site but are approximately 330 feet south of this project limit of work.
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
8-41 g 0A ,
W:\Documents\FORMS\origina]\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
10. Do any signs exist on the property? YES X NO �1
IF YES, describe size, type and location:
There are only small directional and parking signs within the limit of work.
Are there any proposed changes to or additions of signs intended for the property? YES NO X
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO X
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size 30.419 AC 30.419 AC
Lot 23B-046-001 Only
Frontage 1,253 FT 1,253 FT
Locust& North Elm St Only
Setbacks Front 99'-Surgery Bldg to Locust St 87'-New Canopy to N. Elm St.
Side L: 42' R: 66' L: 42' R: 66' L: R:
Rear 704'-Elm St. 704'- Elm St.
Building Height
Unknown Less Than Existing
Building Square Footage
APPROX. 179,500 SF APPROX. 187,150 SF
Open Space: (lot area
minus building it paved NO CHANGE ► NO CHANGE
parking
#of Parking Spaces
NO CHANGE ► NO CHANGE
#of Loading Docks
NO CHANGE ► NO CHANGE
Fill: NO CHANGE ► NO CHANGE
(volume a location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 06/4/2023 Applicant's Signature r t 5'eau4,
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards,Department of Public Works and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004