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23D-107 (24) s� \ DEPT. OF BUILDING INSPECTIONS BUILDING ZO /� /� +_t , -H. 212 Main Street 04 ,$ , '✓ C� Northampton, MA 01060 PERMIT 23D - 107 VALIDATION DATE November 18, 19 86 PERMIT NO. - 6/ APPLICANT Pioneer Valley Nursing HomeADDRESS 548 Elm Street owner IRO.) (STREET) (CONTR'S LICENSE) Nurs i n PERMIT TO New Building ( ) STORY q Home/Shed NUMBER OFDWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 548 Elm St. DISTRICT URB (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE R FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for the construction of a new auxilary shed AREA OR 96 sq. ft. 500.00 PERMIT 10.00 VOLUME ESTIMATED COST $ FEE $ (CUBIC/SQUARE FEET) - �-� r � OWNER Same as Applicant BUILDI 'f kl, "'' ADDRESS BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY APPLICANT COPY • PINK - ASSESSORS COPY pINTSNp • i - CITY OF NORTHAMPTON MASSACHUSETTS VII1. ZONING PLAN EXAMINERS NOTES A �� ♦„�, )6.1A, . Ili�• i'-7.:!a OFFICE of the INSPECTOR of BUILDINGS DISTRICT > L13 1. P IO t�` � Page e� �J ZONINGCATION FOR USE INSPECTOR PERMIT AND BUILDING PERMIT FRONT YARD Z IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. O SIDE YARD SIDE YARD ) ' C 7/ - ZONINGYWI. AT (LOCATION) DISTRI REAR YARD LOCATION (NO.) (STREET) OF BETWEEN AND NOTES BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING - All applicants complete Parts A — D -a Xl A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m m 1 New building Residential Nonresidential 2 N Addition(II residential, enter number 12 I One family 18 I I Amusement, recreational of new housing units added, if any, in Past D, 13) 13 I I Two or more family - Enter 19 L__I Church, other religious IX. SITE OR PLOT PLAN - For Applicant Use number of units- - - - -> 20 I I Industrial • 3 I I Alteration (See 2 above) n.= ! •N=N7, : 14 I I Transient hotel, motel, 21 Li Parking garage .! r.N■•Nrii::'f-w■), 4 I Repair, replacement or dormitory — Enter number i::l:=riN•■•i••!i�■= !••■■•:• i ......N..... •■'r„mow..“ rg of units - -.� 22 L—I Service station, repair garage I■•..=•!: i:•�•••• :::•_:U•' U a: �•u-:Gi•ICOMM = 5 I I number amslinrbui�d:'ngan 15 I I Garage 23 I Hospital, institutional teas.■ NN•NN■.• 'r�ir•!::••N:••.. •�_ !�•=' :NN■■r••. •:•••_ • •as'U- N■ ■ �i Part D, 13) 24 Office, bank, professional rfl....ifl•■••■Siiiit=::!••■.: i•=i::� :• •■::■'ea::ii•G=: �•••_■! :l::� = 6 I Moving (relocation) 16 I I Carport I MVO _ _ ....U.:!• ••■•'i :''�I:�::!'� ■•!.s..s:::! .ii....l.s:ari,..i�_-_-_~•::ii =■r: ir•'rii =::: I I y 17 I I Other - Specify 25 I Public utility :::::i::::::::'■■•:•:ii::ai:: •�- •• •rf■tN1 •p•u.N• u 7 Foundation only N�ning•�::: ■■ • : Cp-'�f erne: •rms=•rs•:s••rreaa u ■ : 26 I School, library, other educational ! • i N ::• ■ yy. ■r•.u.. ....aA :•r/.■ s••�l q.:::�.{: ■■:::NO N•■seas•■!N•■■�....../ ,l ■N=■■•. f• n.lein .Ns!•U:.N..I:11:ii:l.. .,,_I ,_ '.•.•r ,r B. OWNERSHIP 27 Stores, mercantile ii.u...=l =� .s .s.=■N•■.N 1.......,N••N NN.=i:OOrs:iii ii: �•N• N:■•••i■u :•, ly l p 2g Tanks, towers ea:s■ •■ : .N ■f:ea•NlN:iN•NrlN.rr:NV.�1 +.,.••J' ::■r■■■N•••t 8 yr ' Private (individual, car oration, •::.•:: :: i•••r s..nf•-..•.•AY. ...ILI :r nonprofit institution, etc.) 29 I Other - Specify imeaseami VOSOMSOMI al::::N ■:Of:l:lSfa:::::l:::IIi:immommenue i ■r. '•:! =■i�• •■ufa '"' ••.•{■ • 9 I I Public (Federal, State, or �• !��s N... .sU_NN Nrea•KAfI•N■::r: local government) ii••N•NOVSMr#i:::=:OG:::•'•""':::_'.'. N................................... ■••■■ =.Nr:i=*•x =•�•! • •! :::: Nonresidential — Describe in detail proposed use of buildings, e.g., food •N-_ •ii. ••N :sear C. COST (Omit cents) ••■■■■■• pp•• ■::::: L•:•■•:•:■:::•:: ... g .. y r, processingplant, machine shop, laundrybuildingat hospital, elementary ••N:::■■�::N: iis.'a!s 11i;6p=11,' ::::pis•N'•••••'•N'•••"s:N.f••.....::N•••••II\■■■N••.f.■.tea = 10. Cost of improvement $ P.gparochial school, P v� school, secondaryschool, college, parking garage for. •■f.■• NN■•• N•r=i•='■=■•fs::•iN•� Ito department store, rental office building, office building at industrial plant. ••::: •••• •'•i•ri ':•::•i:: ::::'■••!:�:i•N!•.••.N■g _III, �l••: To be installed but not included If use of existing building is being changed, enter proposed use. :Up: ••.n:•:is�ia::::.p•:::s. • i:•:' ■N■ ■■ qq� Ik in the above cost jj�/�/� /� nun /:•:M:::••UN..N•• .N•N!=•SN)N•s•:S ■� ��,N: a. Electrical I L�/ �� /l Q /'// —/�//}�/) 1... N: N.!■••Nl:�l:::f1N•rt■•Nr�i•■•rN.■■■■■• N 3 I : r n.. /��-I12":4-‘2444-60 el K �r _• e 7 i:siaasi:a:::! U•Ij.•N•N•:a::a:ii ! S: :•N•••N••.••■••••■.•:•'•: ! : •• ■• b. Plumbing ! (i�./ '•NII N: ......'• N : ii:• .u..me u...u.........:••lu::=:: N■•■■••■•■•■■�■N■•■::.::::: c. Heating, conditioning / U . . . g, air • NNu• uu 13�iiiui U•ii ::ii� ::as! !'••N.::::IB:::::■.••..■■..r•..•r•a a I' d. Other (elevator, etc.) V:::�•: sass h::l: :::::::::•.•: : ! S '�=■ . •■• !:s ::::::::S=:..::::: :!=••S.3 _.. •.. !� : ar•.:V: ! C 11. TOTAL COST OF IMPROVEMENT $ y�©"` iiN ■ SSS: .N.' =•:a•:•. :NU..0..r • ...N •:: _!=: N.. .:•::•iNS•:r: iz••ss.•:•:i :.N.N:! III. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, complete Parts E — L; Si:::::�:�� s ___ ____ _ .!• :i:::::........N.:::::! ••r=!� !_ :•t�::=ii ....:::. for wrecking, complete only Part J, for all others skip to IV. ■s.■■SS••:::ii.•••. ! aii•:a.s..s.s■■ss •: i s: s :S'5==::::i": • i::r • . • . •■"'•" ': 'S::I N.• : E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS ::isls:si:a=i::. : •i:: r:•:lea;•:•: : ::! _::: :: . : a asa r ! :N.� :::■:NN:•:nfri� _ _ _ _ : 48. Number of stories !u i:: :: ISS:: __ .B_ •f=! .i'UU:!=:::::!■• i•::sis ! _ '�I Q 30 I Masonry (wall bearing) 40 I I Public or private company 49. Total square feet of floor area, .. ...i... . . ..ii.i:Nsi:s.......:... . :::: :s::: : : : : 31 I -I Wood frame 41 I I Private (septic tank, etc.) all floors, based on exterior _n ! ii: i _ _ : ! =S :••'_■:!=•=!i=•:�•:�:• 32 I I Structural steel dimensions ii 'SSB :USa i ::: l:S:::: • .. N ■■._.•:' •. ii■ ■N ■. sa .. . .. ...s...�� :•■• • a.. ! =!O•.: ..•..■:.••■=.■Sr••!.•! H. TYPE OF WATER SUPPLY • • •N•••■N•N• •• • N Nr ! N ■ •i .N•■ ■•■• ::.• :: • N■ • se: _ _U� ..:: • 33 I Reinforced concrete 1: : ��� :: !• :• r••'•N• N/•■:'. •• •U •:: .: ■■ ! ':!! ••::■ ■ ....ISM ■ .• ■ea • 50. Total land area, sq. ft. : :U !!!! :: ! !: :! : :i :S: . N ! ! ::::i•:...1.: ...a•.•IU..!=::! =■•N■ 11'iiiri: r S!'::' :Sal: _..__•■__ ::NU N■ NU=:� :I:•: ■ N =■N.=..._. 34 I I Other — Specify - 42 I I Public or private company ' • :•i : : i ■•.. ": ••'••'"• ■ '• :.S.:S .■ •:•. • • ..■ .. .■ ■•....::! 43 I I Private (well, cistern) K. NUMBER OF OFF-STREET : i :sii :a! i'ii Ni■N •• ::■•:S N•::::•::•:..•:■ NN S I::rr::• N •.! w PARKING SPACES :.I ■Npii ! i! ::: I Hi:: '•• •i;:• ..•=•N.:.•:■.N.Nr.Nri':'IM:alf:s :•N.l:i:•::f_:•::::::_:• is • ! ;;g !:: ,a : • + ass ! ::: =i:as::::::: a: =i ii:::ils•'s 's•=..$•lS s" _' i t}Y' ■ !' :l: :i . '• : ■ ■ .• ■•:: • • NN F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed =' � RM-1 , i ���i assui ii :::::i•sii•Ni■r:::::::ss::::::::: a..•Ns: as:aaass.s....:...............maim! �r- N . . . ...N■■■••N ..■... .. r■ ... I.+,? t.'i+i ��i Giiii•iiiiiiP4 file ,. r • -i-iii� = i •si=i is. !=::::i::i ::g=iilR :i: i .I r�= = 35 I I GosWill there becentral air52. Outdoors tas :■.. .+t 1 : :■ • •• sass • ■ conditioning? � . ` + f • `••�• + z ' } + } { �• • ;�:� sas::as : ::i=s=:isi :u _'• as a:::als:sa: ! 36 I I OilL. RESIDENTIAL BUILDINGS ONLY .. z ) f t ■ :� iii i' ia:s'•":'::'•s:'::::: 37 I— I Electricity 44 Yes 45 N o � :ifi�Ill{+ 1 fZ1 .. t} + al i i;iii=•� S ii:iaa:�is:: : • : �� -. 53. Number of bedrooms • ! ttt } 1 T ti f t 11 I-*.}7j'._'�}. t l,'NCN'; :.i ■N•jry■j• ■ r ■N N■• ■ N �j��......N■N• ii ... .... ..555*55 h ;tit tor. ....ill: i f 'r i- •5UUS - a1 ?.�\a•UU ::lSl a:m� = ■■USB•U III ilillaa=�U:.•.• I 38 I I Cool -- t sear - y ■■M•�■ N YYY • ■ • NN SU • NN N■N 39 I I Other - Specify Will there be an elevators Full .+,+.. .... .1.. sass: I U! t _ AIM_ r f +f s l tl ela:: ::sas.�uii■t !�!all:Nes•: :NN:•NNl 54. Number of 46 L I Yes 47 L I No bathrooms NE 4P Partial P I . - IV. IDENTIFICATION — To be completed by all applicants /� /� Name Mailing address — Cumber, street, city, and State ZIP code Tel. No. 0 t//1� 2 ..7)61�y Siege `r �VJ NOTES and Data — (For department use) Owner or V(������ Siege ���/ �/ Lessee ges..s"� Builder's "L. t (� License No. Contractor �y __� f� 3. �!/D.f�I_!C. 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 ap ca� Address Application dote / 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 ate 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 FOR DEPARTMENT USE ONLY Permit number 9 Bui lding "i I ✓ /Tr 19 Use Group _ . Permit issued [�W Building / Fire Grading Permit Fee L �� $ Live Loading Certificate of Occupancy $ Occupancy Load App by: Drain Tile $ Plan Review Fee $ TITLE