06-039 File # MP- 2012 -0018
APPLICANT /CONTACT PERSON ETHEREDGE & STEUER, P.C.
ADDRESS/PHONE 64 GOTHIC ST (413) 584 -1600 ()
PROPERTY LOCATION 331 HAYDENVILLE RD
MAP 06 PARCEL 039 001 ZONE SR(100)J
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT 1 41 441 AC
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 70 BEDRM ASSISTED LIVING RES& 20 BED MEMORY CARE
New Construction
Non Structural interior 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
INFORMATION PRESJ
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project : Site Plan AND /OR SS c' I Permit with Site Plan
Major Project: Site Plan AND /OR Special Permit with Site Plan j,57U AIT "- 50 -00+
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
Signature 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 the Office of
Planning & Development for more information.
File No.
ease type or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: Chakalos Investments, Inc.
Address: 52 Overlook Drive Windsor CT 06095 Telephone: (860)688 -5994
2. owner of Property: Chakalos Investments, Inc.
Address: 52 Overlook Drive Windsor CT 06095 Telephone: (860)688 -5994
3. Status of Applicant: Owner _ Contract Purchaser X Lessee Other (explain)
4. Job Location: 331 Haydenville Road Northampton, MA 01060
k t x
Parcel It Parcel# Distt�s)
_-
5. Existing Use of Structure/ Property Residence
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
Zoe Life Senior Retirement Community, Berkshire Facili
70 Bedroom Assisted Living Residence & 20 Bed Memory Care Unit.
7. Attached Plans: Sketch Plan Site Plan X Engineered/ Surveyed Plans
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO X DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and /or Document#
9.Does the site contain a brook, body of water or wetlands? NO X DONT KNOW YES
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)
W:\Documents\FORMS\original \Building- InspectorlZoning- Permit - Application- passive.doc 8/42004
10. Do any signs exist on the property? YES NO X
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES X NO
IF YES, describe size, type and location: New signs will be added at the street entrance & the at the buildings
front entry. Approximate sizes: 4' -0" High X 5' -0" Wide.
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 wilt disturb over 1 acre? YES X NO
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 457,794 S.F. 457,794 S.F.
10.51 Acres 10.51 Acres
Frontage
247.17 Feet 247.17 Feet
Setbacks Front 56 Feet 264 Feet
Side L• 42 Feet R: 83 Feet L: 67 Feet R: 94 Feet L: R:
Rear 1230 Feet 754 Feet
Building Height < 35 Feet
35 Feet
Building Square Footage 1,325 S.F.
28,695 S.F.
% Open Space: (lot area
minus building Et paved 98.8% 79.7%
parkin
# of Parking Spaces
Unknown 74 Spaces
# of Loading Docks
0 1 Loading Dock
Fill' volume l3 location) Unknown Balanced Cut & Fill
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge. alkl<,t6s
22 v .
Date: t la LO 1 / Applicant's Signature of % 4�/?y
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.
IA':\ Documents \FORMS\original \Bu ilding- inspector\7.on ing- Permit - Application- passive.doc 8/4/2004
Etheredge & Steuer, r.c.
ATTORNEYS AT LAW
64 GOTHIC STREET
NORTHAMPTON, MASSACHUSETTS 01060
EDWARD D. ETHEREDGE (413) 584 -1600 FAX (413) 585 -8406
SHELLEY STEUER" ed@noholaw.com
ss@noholaw.com
WHEATLY R. GULMI- LANDY' wheatly@noholaw.com
'Also Admitted in New York
'Also Admitted in California
August 10, 2011
Louis Hasbrouck, Building Commissioner
City of Northampton
212 Main Street
Northampton, MA 01060
Re: Chakalos Investments, Inc. (Zoe Life)
ZPA 331 Haydenville Road
Dear Louis:
I enclose:
1. Zoning Permit Application with attached Site Plan (2 pages);
2. Check in the amount of $15.00.
Please let me know if you require anything further.
Very truly yours,
Edward D. Etheredge
EDE /kap
Encs.
cc: client
Tsomides Associates