38A-110 (3) A m BEALS A, B E N A H L S IN +THOMAS TRANSMITTAL
Reservoir Corporate Center F 508.366.4391
144 Turnpike Road mail @btiweb.com I www.btiweb.com
Southborough, MA01772 -2104 Regional Office: Plymouth, MA
To: Building Commissioners Office Date: September 6, 2012
City of Northampton Job #: 1700.19
212 Main Street Project: Assisted Living Facility
Northampton, MA 01060
Attention: Louis Hasbrouck Via: FedEx
WE ARE SENDING YOU:
❑ Attached ❑ Under Separate Cover
❑ Original Mylar ❑ Report
❑ Sepia Mylar ❑ Change Order
❑ Letter ® Application
❑ Specifications ❑ Compact Disk(s)
❑ Plans ❑ Other:
❑ Shop Drawings ❑ Other:
No. of Copies Date Number Description
1 9/6/12 1 Zoning Permit Application
1 9/5/12 2 Site Plan- Christopher Heights Assisted Living Facility
1 9/6/12 3 Check - $15 filing fee
THESE ARE TRANSMITTED AS CHECKED BELOW:
• For Approval ❑ Preliminary
❑ For Your Use ❑ Unchecked
❑ As Requested ❑ Revised
❑ For Review & Comment ❑ Final Plans
NOTES:
cc:
Transmitted By: David A. Johnson
Received By: Date:
700.19TR001
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 NO
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 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 Lot 110 - 29,326 Lot 110 - 54,080
Lot 112 - 82,374 Lot 112 - 57,621
Frontage Lot 110 - 553.07' Lot 110 - 579.04'
Lot 112 - 618.42' Lot 112 - 592.06'
Setbacks Front N/A 1.0'
Side L: N/A R: N/A L: 12 R: -- L: R:
Rear N/A 30.9'
Building Height
N/A 3 Stories
Building Square Footage
0 54,000 s.f.
% Open Space: (lot area
minus building & paved N/A Not Required
parking
# of Parking Spaces
0 30
# of Loading Docks
0 1 loading area
Fill: TED
(volume & location) N/A
13. Certification: I hereby certify that the information contained herein Is true and accurate to the best of
my knowledge.
Date: September 6, 2012 Applicant's Signature. v "%--
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
requirements and obtain alI required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
WADocumentsVOILMSi original \building- IuspectoiNaning- Permit - Application- paaive.dac 5f412004
i
v;p - ! 2012
DEFT. OF EU,LGING INSPECTIONS
NORTHAMPTON MA010611 / _ 3
File No,
ZONING PER T APPLICATION (1O.2)
Please type or print all information and return this form to the Building
Inspector's Office with the $15 filing (check or money order) payable to the
City ofNorthampton
1. Name of Applicant :. The Grantham Group, LLC
Address: 99 Pleasant Street, Marlborough, MA 01752 Telephone: 508- 281 -8001
2. Owner of Property: Hospital Hill Development, LLC, c/o MassDevelopment
Address: 160 Federal Street Bo .. ua .7 a Telephone: 800 -445 -8030
3. Status of Applicant: Owner Contract Purchaser x Lessee Other (explain)
4. Job Location: 0 village Hill Road
Parcel Id: Zoning Maps sex Parcel# 110, 112 District(s): PV, SG_s overlay
In Elm Street District. In Central 'Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property: vacant - Lot 110
Existing vacant building - Lot 112
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary);
Construction of a 58,000 s.f. Assisted Living Facility with associated site work
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?
2003 Original
NO DON'T KNOW YES x IF YES, date issued: 2009 - Amended
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES x
IF YES: enter Book Page and /or Document #
9.Does the site contain a brook, body of water or wetlands? NO x DON'T 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: lDacumentsWO RMSlnriginnl\Buitding- Inspecmi \Zoning- Permit - Application- pussive.dac 8/4/2004
File # MP- 2013 -0032
APPLICANT /CONTACT PERSON Beals & Thomas
ADDRESS/PHONE Reservoir Corp. Ctr. (508) 366 -0560 Q p7,,' At ON RC_
PROPERTY LOCATION VILLAGE HILL RD
MAP 38A PARCEL 110 001 ZONE PV(100) /SG b(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid /7' ," YI AC
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 58,000 SQ FT ASSISTED LIVING FACILITY W/ ASSOCIATED SITE WORK
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 PRESENTED:
Approved VAdditional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER : § %Y1 3 5 11 , 3
Intermediate ProjectPlan 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
G% ? " /' � /1
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.