23B-046 (100) MINTZ,LEVIN,COHN,FERRIS,GLOVSKY AND POPEO,P.C.
VIA FACSIMILE
Mr. Anthony Patillo
August 21, 2003
Page 2
If you have any questions, or need any additional information,please call me at
617-348-4865.
I very much appreciate your attention to this request.
Very truly yours,
MINTZ, LEVIN, COHN,FERRIS,
GLOVSKY and POPEO, P.C.
M. Daria Niewenhous
MDN:j am
cc: Edith Peter
LIT 1415732v1
MIN'I"Z LEVIN Boston
CoHNFEM Washington One Finan cial Center
S Reston Boston,Massachusetts 02111
617 542 6000
New York 617 542 2241 fax
GLovsKY,A,T'\D New Hawn wwm mintZ.com
L os A ngeles
POPEO PC London
M. Dacia Niewenhous
Direct dial 617.348-4865
nzirueuenhous@n,a'ntz.com
August 21, 2003
Via Facsimile
Mr. Anthony Patillo
Building Commissioner
City of Northampton
212 Main Street
Northampton, MA
Re: Cooley-Dickinson Hospital, 30 Locust Street,Northampton
Dear Mr. Patillo:
As we discussed by telephone this morning, this firm represents Cooley-Dickinson
Hospital with respect to the preparation of a filing with the Department of Public Health. The
filing requires the Hospital to enclose a letter(or other form of official determination) from the
Northampton Building Department that states that the use of the Hospital's premises as a hospital
is permitted, either as being in a medical or other zone where it is a permitted use, or as
grandfathered, as the case may be.
Please consider this correspondence as a request for such a letter. Also, please let me
know if there is a fee involved and I will arrange for prompt payment. The letter or
determination may be addressed to Edith Peter, Chief Financial Officer, at Cooley-Dickinson
Hospital, 30 Locust Street. I would very much appreciate it if you would mail the letter to Ms.
Peter and send a copy to me by fax at 617/542-2241. Please put my name on the fax cover
sheet. As I mentioned, the hospital plans to file early in the second week of September, so your
prompt assistance is very much appreciated.
Nov 03 03 10: 08a p, 3
. w
XES______r-
10. Do any signs exist on the property? NO.
IF YES,describe size,type and location:
Are there any proposed changes to or additions of suns intended for the property?YES NO
IF YES,describe size,type and location:
11. ALL INFOR "XON MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
.LACK OP INFORMATION: T: —ice t. ba filled in
by the RujigUng, nwpastment
Required I
Existing Propose.d By Zoning
Lot size
Frontage
Setbacks
-side L• R: L: R•
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of :Parking Spaces
# of Loading Docks
Fill:
t
V02-ume--& location}
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my k(noowwledge.
DA'Z'E: November 3 , 2003 AppLXCANT's SIGNATURgi) /� I
MOTE: Issuanoe of a zoning permit sloes not relieve an applicant's burden to oompjy with Atli
zoning requiraments and obtain all required pe,rrnits frorn the Board of Health, Qoimeervation
iCommission, Department of Public Works and other applicable permit granting authorities.
FILE #
Nov 03 03
lo 2
File-�No.
. ''_._0,1 So
--
ZONING PERM.ZTr APPLXCATXON (§10. 2)
PLr,ASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Daria Niewenhous , Esq.
Mintz Levin et al.
Address: One Financial Center Telephone: (617) 348-4865
Boston, MA 02111
2. Owner of Property: Cooley-Dickinson Hospital , Inc.
30 Locust Street (413) 582-2243 Edith Peter
t-
Address: Norhampt-on _ MA Telephone: CFO
3. Status of Applicant: Owner Contract Purchaser Lessee
___A_Other(explain): AttojZney for 03an P r
4. Job Location: 30 Locust Street — Northampt:on, Mme_
Parcel Id: Zoning Map# d4 3 �3 Parcel#-�& District(s):�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property Hospital
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
In connec ion with a filing with the Massachusetts Department
of Public . Health, the Hospital requires a letter or other official
documentation that the use of the premises as a hospital is permitted.
Please see attached.-
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the(allowing Z questions may be obtained by checking with the Building Dept or Planning Department piles.
8. Has a Special Permit/Vadance/Finding ever been issued for/on the site?
NO DONT KNOW 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#
9. Does the site contain a brook,body of water or wetlands? NO 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)
UNTZ LEvIN M. Daria Niewenhous
CoHN FE'"`-s Direct dial 617 348 4865
V LV V sK 1 AND Fax:617 542 2241
POPEO PC mniewenbous@mintz.com
Oj 0v-- 3 ) ;� 3
CCO ip
J ,
a i n
File#MP-2004-0050
APPLICANT/CONTACT PERSON NIEWENHOUS DARIA
ADDRESS/PHONE ONE FINANCIAL CENTER (617)542-6000
PROPERTY LOCATION 30 LOCUST ST
MAP 23B PARCEL 046 001 ZONE M
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM LLED OUT
Fee Paid D
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-HOSPITAL USE IS PERMITTED
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildiniz Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FO,J,LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9R54ATION PRESENTED:
Approved Additional permits required(see below)
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 C scion
L 2O
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.
T;S MP-2004-0050
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: x9098
Map:
Lot:
Block:- - ZONING PERMIT
Permit: ZONING PERMIT APPLI APPLICATION PERMIT
,Category: Zoning Permit
Permit# MP-2004-0050 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2004-0766 _
Est. Cost: $0.00 Contractor: License:
Fee: $15.00 —Homeowner as Contractor
--- --* --
#of Fixtures: Owner: COOLEY DICKINSON HOSPITAL INC
Applicant: NIEWENHOUS DARIA
AT. 30 LOCUST ST
ISSUED ON: 12-Nov-2003 AMENDED ON: EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
ZPA-HOSPITAL USE IS PERMITTED
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Zoning Permit Application REC-2004-001431 04-Nov-03 190750 $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS®2003 Des Lauriers Municipal Solutions,Inc.