23D-107 (18) 1- DEPT. FILE COPY
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BUILDING
` PERMIT
VALIDATION
DATE June 2, 19 77 PERMIT NO. 198
APPLICANT Pioneer Valley Nursling Home ADDRESS .48 Elm Street
NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Storage Shed ( ) STORY Storage DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING ��
AT (LOCATION) 54'8 Elm Street DISTRICT ifBB
(NO.) (STREET)
m BETWEEN Federal St. AND Elm St-
VD (CROSS STREET) (CROSS STREET)
rn
O LOT
m SUBDIVISION LOT BLOCK SIZE
a
O O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE _ USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
D:
o
REMARKS: Nursing Home - Storage Shed A' X A' X 11'
AREA OR VOLUME ESTIMATED COST $ 200.00 FEEMIT 10.00
(CUBIC/SQUARE FEET) 1
OWNER Pioneer Valley Nnrsing Home eu
,E4 ADDRESS 548 Elm Street, Northampton B -
(Affidavit on reverse side of application to be completed by authorized agent of owner)
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
•
F AJJCJJVKJ GVYT
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BUILDING
PERMIT VALIDATION
•
DATE Juno 2, is PERMIT NO. 1/15
APPLICANT Firneirner Y:•`4*17 ADDRESS R1 'atreet
NO.) STREET) (CONTR'S LICENSE)
PERMIT TO a NUMBER OF
( ) STORY 1'+� DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. _- PROPoseD USE)
ZONING g�
AT (LOCATION) 903 �'.l. St DISTRICT uAa
(NO.) (STREET)
a BETWEEN federal 2t, AND tia .'t'•
O (CROSS STREET) (CROSS STREET)
a
4 LOT
m SUBDIVISION LOT BLOCK SIZE
a
U O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
co
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
cc
LL REMARKS: Altaing r zitswato a• x st, A. Is.
•
AREA OR VOLUME ESTIMATED COST $ •W FEE
9 18.00
�r (CUBIC/SQUARE FEET)
OWNER BURS DEP.l.
BY i'/.1 r �ADDRESS
CERTIFICATE ISSUED
DATE
BUILDING PERMIT -
CERTIFICATE OF OCCUPANCY
�!
DATE J 2, 19 77 PERMIT NO. 't93
APPLICANT Pte .IFr Vollay Nutiting *Pia ADDRESS Ike Rijn ^a
0.) STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO .nti O STORY V DWELLING UNITS
(TYPE F IMPROVEMENT) NO. ROPOSED USE)
����ccc ZONING
AT (LOCATION) Sim S DISTRICT WM
NO.) (STREET)
m BETWEEN radaral St i AND J St_
0 (CROSS STREET) (CROSS STREET)
n LOT
a) SUBDIVISION LOT BLOCK SIZE
a
U O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
E (TYPE)
re
0 REMARKS: ihnItirtig ___ — ctosimes 43* X 8' X 8'
i{ rl 1_+V , 7 K=.l #1 aii 1 7 illt fii tr1 KE si c 2 oil 9
AREA OR :1111 p,;1'1��111 :IIII ;1111( ;IIII t1111 Si �T orr�A;'111:1i ;IIII :IIII( ;11111t,ay
VOLUME • 2 1i1 •7ci ';W1 ' W X 11: C S •G •-r1 'El 't�-T1 `-�1 'lIII 's.,II 'El?1
(CUBIC/SQUARE FEET) �'•• �-^' �l1�Ni, - ' ^
NW :MI :1111 :MI :1111 :IIII IIII FY111 NW NW '1111 Mar :1111 ;Illllr IIII :1111
O`1:T I bTTI Id TT Ida-11io•T711 A"rT1 iY I,b'TTI U'TTI !t T.TI IO.TTI A'. IbrTI o•17?I
OWNER TO BE P.SjD ON PREMI S`
ADDRESS SE'A'4%..... '-1) .•'✓DRY IBC P,. . ..e CATS
• DEPARTMENTAL APPROVAL FOR CERTIFICATE
of OCCUPANCY and COMPLIANCE
To be filled in by each division indicated hereon
upon completion of its final inspection.
BUILDINGS Permit No.
Approved by Date
Remarks
PLUMBING Permit No.
Approved by Date
Remarks
ELECTRICAL Permit No.
Approved by Date
Remarks
OTHER Permit No.
Approved by Date
Remarks
OTHER Permit No.
Approved by Date
Remarks
Tr- r /O
VIII. ZONING PLAN EXAMINERS NOTES \ �O�`+'e.) II
/ ,. Cat of a #1l lit tatt
)0 1.••el
[assachnsetfs
DISTRICT ��' � �;
am� ,.,�y:'
C .
(Office of the 31nsprctor of iguilbings
USE APPLICATION FOR
Page 3 Plot /0 7 ZONING PERMIT AND
BUILDING PERMIT
FRONT YARD •
IMPORTANT — Applicant to complete all items in sections: 1, I1, Ill, IV, and IX. Z
O
SIDE YARD SIDE YARD /! /x E L ZONING /,$
I. AT (LOCATION) Sly.$ —" �r DISTRIC�
LOCATION (NO.) (STREET)
REAR YARD OF BETWEEN FE DERCA L S7.1 AND EL 1.v � + /
NOTES BUILDING (CROSS STREET (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — Al! applicants complete Parts A — D Xi
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 rNew building Residential Nonresidential
2 I I Addition(If residential, enter number 12 % one family 18 I Amusement, recreational
of new housing units added, if any,
IX. SITE OR PLOT PLAN — For Applicant Use in Part D, 13) 13 o or more family — E ter 19 I Church, other religious
PP nu •er of units— — — —yr. 20 I Industrial
. 3 I Alteration (See 2 above)
hrolsr.: : ::• 14 I I Trans nt mo -I, 21 Parking garage
�••■ lNNN■q. 4 [1 Re air, replacement P P or dorm toryhotel, ter number
1 l: 1NNpgrrNN■rrl of unit --- --- — . , 22 I Service station, repair garage
l : •l 5 I I Wrecking (If multifamily residential,
is of
number of units in building in 15 n Garage 23 Hospital, institutional
ute:..1...11 l: i : Part D, 13) 16 I I Carport 24 I Office, bank, professional
Ni N.■ N.Ogi - P
11::::::::: 6 I Moving (relocation)
NNq : 17 Ix Other — y_ 25 I Public utility
I. = 7I Foundation only I.
oas 26 I School, library, other educational
•■■ ■N.:.l : :eis _ 1....$NN.1 : B. OWNERSHIP .� 27 [ ] Stores, mercantile
i■.. l•:::::::::•:e•••:•: less: : = e:::e:l::::i ■ _ 28 I Tanks, towers
! 8 I� Private (individual, corporation,
WO..i='..N.eiri=O�1 : _ ri ._ !_'_ = nonprofit institution, etc.) 29 VI Other — Specify
1::: : : :..1 1 :suss: . _ l 9 [ I Public (Federal, State, or
:$::a: lrei.p::11.\i ■..eii.l■.q■1:: local government) NftnkStv04 b484M.£
a•:::NNl�::::Ni:�:! N: a.. :
e = ! ; ...■u2• :: C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food
■■. N i..■. :.
°\ :N: ■N■ :: ..1 processing plant, machine shop, laundry building at hospital, elementary
�_:=■■■\:..sues=...! 1 • NN. ■■: school, secondary school, college, parochial school, parking garage for,
N:■i.N..N■.: : ! : 10. Cost of improvement $ 20 0
1 .: department store, rental office building, office building of industrial plant.
: 1..■l.., _ he: l To be installed but not included If use of existing building is being changed, enter proposed use.
I =r in the above cost t t
\■ r■ a. Electrical 2 /^ Q 1/
m. N.::i:::: N: Cm.....r\i■r: S s N..■r ._11jmrua.'., - Ll L. \_ V ), Z P[k VJ S 4 1, $::::1:.1\N.■. ■! Ni:s: \ ■ ■• b. Plumbing �`JJ`_ _ (/� ,�j �� �•
4
::ase■\Ngi.:a.::l:l:=.■i..::::::•:/i1 : : s _ :..N.: Fer S ice _ O, �r 4Ar�I MN
a..:■■: ■:1 .al=.e:s:e�•rrqq l :_ i.:..Ns$1 ._• .. •:: :_:,a• 1 =:C:l::`:,rlN\r �.leN.e N\• slsN : ■N.N. c. Heating, air conditioning
N. lr.Niiii.r.ii. a::\■e...\..qN.q.N...In ! ::rrN:■sue! : s♦ : 11 1
t:�l. =••1lN•rrs : sr. l...l■.s s .s l ! l s :: s:: s \-oa S. It-•+tn�r• a c9 i\S tr v C O v%
•.■. N■■/N■■suss■.N..N \N. \Nrr■NNi.N■.■N■■\suss■\■■■■
N N. N NNN q.e ..e N. \N■Neq■i.N.gN \. .i.■.
ji !!l: :$lr N#: r::: r.:! • IHN ■■: Nl • : :• •:••.r ■llnllu\■: Nlll::ll. N. a d. Other (elevator, etc.) , •
alai......■:\.ii.!■...i:.riess:s.rs:a.N:l ! .■ l $s :l:i\■!■l
;6!ll••1:a.mMOS a.o..s •.•$..i Ni$r$:::1•re! =Ni■: 1. \ Hie:eissaaa.•::s:1::: _ l:: _�� 11. TOTAL COST OF IMPROVEMENT $ 20 O
sr !: 11=1...11.■5.:.\..#i1.il.l! ••• s ::$_..i.■.!e$$$s ESSI $$?$$::9$$$$:'�.r$:ms :N■.N:...l
'.a,..a.a!::$•!imposts $8lee 1i$.......... l rl=■$..i■ .1:m1! •r•rll1.•1 s•: !■.er0\r.l:SUMO......:" " """:MO III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
1�1. ■..\ N. . qq • .r.N.. O. \tun\ ■■.
ms
71
"•_•••!$•••!••l$•i••l••:'t•!•i•=':: .: ;$ $ :! !_ for wrecking, complete only Part J, for all others skip to IV. D
i,....i ..i .alai i.i ..■EN i. . .■..■r.ii.:iN ..N. ..■qi.N...Ni.N■..N■..\.i..ii\...■.■■
" •••1:::!!!$$'�'="'z!S'"!=$ a ;•••:. Us...sill!■.l■■1■■:tell. :a:•.aa.••.sa.as 'r'�'�!'�!............: al E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS t7
:l::•■.•:■s:• i..i..il m
i i ::.i..l:l:■q. Li : 1•! l ! 1■r.q.N..■\.1C.! !
i�#l::l:::••ell::1:: : I. \!::l:sal11111 le • ■.la.SI! 1 30 L J Masonry (wall bearing) 40 I I Public or private company 48. Number of stories
"11:0i$ liil::i$$$li$$$$$ $l.i..1$...:! 1 : :ma eel 1• :.Hee .:.:'i■se = 31 Wood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area,
i$ __....=....rrr•.rrr. NUN . ■N.N ■■■....■..■r .\.•u ..■ all floors, based on exterior
1 $r$$$$■N$ $: lrl$:l:s::ill$$N.1 : : 1N. N$ :•.::r !!r N:.. ■ : p■ ls e : i I
\i ..N i!_!.._Nisere • _ _ . ■:Ni::.N■$ll.r :: u:, ■.l .!• 32 Structural steel dimensions
ii�$ •$sr$1 l: :i=:: i$i..ale.: ! : : :111:5:::::$$i:::::::N1�::l::::::: r$::: !:emo•!r:'r qm::. I I H. TYPE OF WATER SUPPLY
ii 33 Reinforced concrete
:i.: a::.$::l$.ill■i.11.li..e ee� 1 I.• ..n..e !••! =:e• =■r■• ■.....$!•! :::::1...:: 34 n Other — Specify 42 I—I Public or private company 50. Total land area, sq. ft.
l$f lS�ll.Welitral$$a$$$$e$$iiid eee$see: :•• •! lei s:::1' :N.:..::::NNi:. .! lqq$�1$li$l::::Pagelle.11q.■:••i$l:::•iu 43 I I Private (well, cistern) K. PARKINGROF OFF-STREET
pfl !� ! ■r■li \Ne1::. N■ :Jr l !.
$ • •:$$1$$$1$la$$el$!$ i111:$ $:$•i$!:$:: ••1$•:l.l' �� �!•! lees :a! $:$„$'$ N;. q e !$$$:l•assessairgls $�l•1:$o.less#.sell F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed r
al....s l . l.s. :.. 1# .aloe. O
;1i :a=es! =::.III$$.=$$� ;$a.I$$$ =::::ei$$$i:::.:: `I..r....N■.i■else::.„.:1•h.....1..110111s$e 11:11$ _:::::::i$ ll::l:1:1■Ni.1 I I —4
i$$iiel$ei$ .7\e:1$.1::...e: l : : $ : :N::::!1l11:iii .■.1.•.■il.ii.l.i..l 35 Gas Will there be central air 52. Outdoors
! • ! s •1 1.ii=!••lei 1':i:• ! ' .iN•.• iN.i .N ■..iN..i.■ .■.■ ■..■ e..i ... ■.. ■■ ■. I I conditioning? L. RESIDENTIAL BUILDINGS ONLY
i$ $$ :• '$e ii' $r•rll••:•11••! lass: :Nq:\Ni:rlll!!1llN.: i.elll•:e ells$$$!.!:llsserr : 36 Oil
i e ale.. llli� le Lieilleellime 1 1=....1.■rlll:il Il=/i. ll lhlrlri•.l$lnar 1.nriihe11=■■ir■llNN.::::1:::::1:: 37 11 Electricity 44 I I Yes 45 I I No 53. Number of bedrooms
$ .. ..$$$e$... i$ s$1 i.s . 1 .r= :!.•las\•.■ ... :.$..iW l3.l OITI:•�.i:•ulll $is•i$::s:=$!Min N, i1.e.■■..i\!1■:..1. 38 I coal
•$ i $$$$$ � \ :• •!l ! •:lal.i:li $. a ..l:i��t "MOB
■ • .'Ni■.l ... :!e••l:el••!q�:! \■q ■Ml•:le•i.iNl�
: ehe$:$$i . sa ue$$:e pill i$ele...se...$l. e ! aeii.:ee...i:.■i:e:ii. ei.i:l : $l. : :: —
$ui#u:##ei##u#a II!!:#;##;i##i#oases... hall::s:...s.,lase/lisill✓El:mad= $ !r_'6ili:i.elrli!ll: lailiiing..tragar:lgr....:::::: 39 n Other — Specify Will there be an elevator? 1 Full
54. Number of
mitrintO Me 46 I I Yes 47 7 No bathrooms
Partial
IV. IDENTIFICATION — To be completed by all applicants ,
Name Mailing address — Number, street, rir., am/ State ZIP code Tel. jilo.
1 OK.l .AZ /ALLLy NOTES and Data — (For department use)
Owner or VJURs1 ) G pd.E 8, ELM. S_I (V-O`� K{ 1 •0•0 — e 60 58 tDo
Lessee
MIAVIA reINOOVCr 14VOtO, 0%060 Builder's
2. TOKYO A SPA CZ NI. 51 LtL•LY ST. v oc 3 tWcTr rt SS • License No.
Contractor
3.
Architect or -
—
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 of applicant Address Application date
r At_ SI U t.L.` 5T FL0 2E'CE M+asr,
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes •
9 Fee Started y Approved y
BUILDING
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date
Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtai ed 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
Permit number 198 •
Building
Permit issued June 2, 19 77
Building
Permit Fee $ 10.00
Certificate of Occupancya
Appro
avo410
Drain Tile
Plan Review Fee S—
LOCAL INSPT IfR
TITLE