06-016 (8) tii DEPT. OP,SUILDING INSPECTIONS BUILDING D goof TN-�
"--'- Northampton,MA 01060 PERMIT v- G/G/ � ,,)
6 - 16$50 ,E ��yMQ4,. VALIDATiDN
DATE May12 o29-044‘k .RM'TWttidJVr cro5
APPLICANT John Chakalos ADDRESS U!
010.) 'STREET) ICONTR'$ LICENSEI
PERMIT TO Foundation Only ) ) STORY Nursing Home NOF
NUMBBERIMOUNITS
/TYPE OF IMPROVEMENT INROPOUEO VIE)
Haydenville Road ZONING Ji(
AT(LOCATION) DISTRICT
(Aga WNW/
BETWEEN AND
ICROIA 1TREETI (CROIF 1TRCET)
4OT
SUBDIWSION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE NY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS CA FOUNDATION
{TtPE)
REMARKS; permit for the foundation only for a new nursing home
Per ZBA Approval
AREA ORERMIT(� 200,000.00 P $ 800.00
VOLUME ESTIMATED COST $ FE£
IOVEanOUARt FEET) ,E
OWNER Same as Applicant V� , T //
NUILDINCI 'IY lI A(�7�''ynbFE
ADDRESS Same as Applicant's BY Cv
UNITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY
s4.^-[�J, • CITY OF NORTHAMPTON
MASSACHUSETTS
Aw
-4't ;e.41: !I OFFICE of the INSPECTOR of BUILDINGS
0
fr.o.. %.9 /G $ .S�
= � Page 6 Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR
BUILDING PERMIT
z
IMPORTANT — Applicant tocomplete oil itemsin
Iin sections: I, II, III, IV, and IX. O
AT (LOCATION) �0. y9'/p /✓ D i/l✓ L� ZONING (i�
( DISTRICT(
LOCATION (NO.) (STREET/
OF BETWEEN AND
BUILDING {CROSS STREET) ICR055 STREET)
or /d 4
SUBDIVISION LOT BLOCK LOT
IA
II. TYPE AND COST OF BUILDING — All applicants complete Ports A - D -I
A
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
-♦
1 New building Residential Nonresidential
2I I Addition((I residential, enter number 121 I One family 18 Li Amusement, recreational
of new housing units added, if any, 13 T• wo or more family - Enter 19 Church, other religious
Part si) ❑ ��
number ofunits---- -i 20 [11 Industrial
3 IT Alteration (nee 2 above) 14 ❑ T• ransient hotel, motel, 21 I - ] Parking
4 I Repair, replacement or dormitory - Gnrer number
garage
5 I I Wrecking (II multifamily • ideruial, of unit., y 22 ]- 1 Service station, repairgarage
enter number of units w building in 15 Ti Garage 23 [ Hospital, institutional
Part D 13)
16 'E) Carport 241ri Office, bank. professional
6 -n y ing (relocation)
FaandaKan only 17 C Other - Specify 25r P• ublic utility
26I i S• chool, library, other educational
B. OWNERSHIP s 27 I] Stores, mercantile
0 ✓I/Pr1v a (individual, corporation, j 28 r I Tanks, towers
nonprofit institution etc.) �OC/Ne(Ct �e Cr 29 H_I O• ther - Specify,Ne*n5"2
•
9 Public(Federal, State, or
C. l
COST ac government) ( �t�s) n Nonresidential detail proposed useof buildings, e.g., food
e processing plant,pmachine shop, laundry building at hospital, elementary
10. Cost of improvement $ ZOO,e O C. school, secondary school, college, parochial school, parking garage for
department[store, rental office building, office building atindustrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use,
in the above test ,/
o. Electrical D/�(.�_'_�_ein��
b. Plumbing
c. Heating, air conditioning
d. Other (elevator, etc ) - -
11. TOTAL COST OF IMPROVEMENT b vb0,4,60--
W. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Ports E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL, TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 Fri Masonry (.wall bearing) 40 Ei Public o private company `2 Number of stories �_
v ❑ woad framePrivate (septictank, 49. Total square feetal floor
41 ank, etc.) all floors, based on exterior
32 Ia"Structural steel dimensions
33 E l Reinforced concrete H. TYPE OF WATER SUPPLY
34 FT Other - Specify 42 I Public or private company 50. Total land area, sq. ft
—
43HiPrivate (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL Si. Enclosed
35 L--_ Gos Will there be central air 52. Outdoors
361yl,,//Oil conditioning'
./ L. RESIDENTIAL BUILDINGS ONLY
37 L'i Electricity 44 •vl Yes 45 No 53. Number of bedrooms
38 ly I Coal
3911 Other- Specify Will there be on elevator' { Full
54. Ynnber of -
46 iU- Yes 47 - I No bathrooms
Partial
IV. IDENTIFICATION - To be completed by oil applicants .-
n /Nome Mailing address — ,Number, Street, city, and State ZIP code Tel. No.
I. a.i4bu Pi[ kt/ah .c 0,-,-446.k --.1,-k- LIC-4-015/i Ail' o efS G Yltr
Lessee
JJ
Builder s
z.
License No.
Contractor
+7/1h
Architect or /A0. �.¢, fdied JD A. It-AP J74- Y9"
f
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature al applicant Address Lour N�/54 Appli cotion date
4? /i L Ca 24.41 /..
.4 , �.� Nom- 7�n"
te—
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD - For office use
Plans Review Required Check Plan Review Date Pions Date Plans Notes
quire Fee Started By Approved By
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
•
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
•
OTHER _ OTHER
VII. VALIDATION
Building 5/ FOR DEPARTMENT USE ONLY
Permit number
Buildingf�^ ' I Use Group
Permit issued 1 I \3. h-� t 3- ` 19__
BuildingQ4 on
Fire Grading
Permit Fee $ LSae i `- Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:. -•.
Drain Tile $ W nO. ar
Plan Review Fee $ +/
TITLE
NOTES and Data - (For department use)
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VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN - For Applicant Use
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DEPARTMENT OP BUILDING INSPECTIONS4/
INSPECTOR 212 Main Street ' Municipal Building 4,
Northampton, Mass. 01060 " —'
William A. Nimohay
To: Mayor Musante, Kathy Fallon, Larry Smith, and Paul Hadsal
From: William A. Nimohay, Building Commissioner W O 'C'4 1/cer
Date: May 12, 1988
Subject: Foundation & Building Permit for Nursing Home, Haydenville Rd.
This is to update you that a foundation permit was issued to the new nursing
home which will be located on Haydenville Rd., Northampton. In no way does
this mean that the building permit will be issued until all the requirements
for the permit will be satisfied. Please be advised that such documents must
be presented to this office at the time of the request for the building permit.
Wetlands and Department of Public Works requirments are attached for your in-
formation.
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