23B-046 (149) >
Ic
t=
>
LO 1C, �4
Z rn
Z
>
Z
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 584-4022 Alterations
NORTHAMPTON, MASS. June 5, -19 97 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a Garage
1. Location 30 Locust Street - 4TH Floor Lot No.
2. Owner's name Cooley Dickinson Hospital Address 30 Locust Street, Northampton, MA
3. Builder's nameAquadro & Cerruti- Joint Venture Address Texas Road, Northampton, MA
Mass.Construction Supervisor's License No. CS-069206 Expiration Date 8/11/2000
4. Addition N/A
5. Alteration Renovation of existing 4th floor for ICU/CCU & Telemetry
6. New Porch N/A
7. Is existing building to be demolished? No
8. Repair after the fire N/A
9. Garage N/A No.of cars Size
10. Method of heating Steam
11. Distance to lot lines
12. Type of roof Existing EPDM
13. Siding house
14. Estimated CoSL- + $ 1 ,300,000.00
The undersigned cert' " at the above statements are true to the best of his, her
knowledge and bedef.
44
Signature of respons b!e app! ant
Remarks
.}i
10. Do any signs exist on the property? YES NO �' yt"
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. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col=a to be filled in
by the Hni.lding Department
I Required
Existing Proposed By Zoning
Lot size 4.L t tJT0L'0P-
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking%
pf "Parking Spaces
f of Loading Docks
Fill:
_(vol-ume--& location)
13 . Certification: I hereby certify that the in ormation contained herein
G is true and accurate to the best of my k owl
e ge.
DATE: j U vjc APPLICANT's SIGNATU
NOTE: lasuanoe of as zoning permit does not relieve n plioant's burden t mply v✓it""'all
zoning requirements and obtain all required perms rom the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities,
FILE #
AV 5 OR
Ef'T
0 F 8(!rC!??t� o Fi 1 e No.
G�.3
-ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Zlatc a-t e-L) ' ( . -OM
Address:_ l�tfq-S sa 4-c>. Telephone:
2. Owner of Property: eons-C-y 0(eK "0056..) 43'Pr7-#+ L- ,—Wc- ,
Address: ?Vp Z-O(f C. ±T- /te,EG?- Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
--Other(explain): Zo ►.J tiT���Tz�.� � r�G-
4. Job Location: 4 g` FL Uo +
Parcel ld: Zoning Map# 5251 Parcel#I& District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property f/lll C-01 CR [, cAq—
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
//CEDrc�� �R-21✓ � .sou/�cu >:.. c=G�'o�c�7��
7. Attached Plans:sLmcrreV Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Vadance/Finding ever been issued for/on the site?
NO DON'T 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)
FM 5 M7 FILE
APPLIC /Cz NTAQ�PERSON:
0 Pt of 80 ADD
WS-8F F 11 � 1
PROPERTY LOCATION:
MAP__,— �,�_ PARCEL: ZONE
THIS SECTION FOR.DFFICIAL USE O cx
PER HT APPLICATION CHECKMS3 7
ENCLO
ZONING FORM M,TFD 0111
FP7� Paid �`" vn
Q__
t/
THE
OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
/Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
!Permit from Conse t' n Commiss' n
Signature of Building ector Date
NOTE:Issuance of at zoning permit does not relieve an applicant's burden to oompty with ail
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Pubiio Works and other applioable permit granting authoritlas.
V
z
g. o
o
z oR d �y y ►r�
w o 'd
° °o � K
b7 OD
0.
(6F; ° �' C y
n ... r� oy
° rt
�+, r x N
c c� q. E � > b
bd o g �.(IQ o n
�. B 5 R o a
o � � = � x,d o
A � 't Q, d
co n
ft 0
r � • n � � n
w o 0 < ' c 0
5 ° o o CD p
0 y g � rt
rt
C
C� o p
C/1 0
tz 00)
0 0
�"� o � a c o• o ° o
BE
Crl r 5 o� o ►ti v v, \ 7d
F-y ��• J W tJ •t-+ ^
5 T I i 5 l I r o g � o g o
5 ►rJ •b 7d � A N 3 n g.
o tz
Cm
CD
O yu
� . CD
H• o O
b �
n
CD
dF