23B-046 (99) COOLED DICKINSON HOSPITAL
DARTM'UTH—HITCHCOCK ALLIANCE
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To: Terry Reynolds—Huntley&Associates P.C.
CC: File TRO/Barr&Barr
From Juanita M.Forsythe—Project Manager
Date 10/22/03
Re: and Medical Records Bldg—Site Plan Permit
Please find provided in this memorandum authorization to file the initial site plan permit for the
Medical Record Laboratory Building.
Cooley Dickinson Hospital is granting the authorization for Huntley and Associates Engineers to
proceed with the application for permit to the City of Northampton for the Zoning Permit Application
associated solely with the Laboratory and Medical Records building.
If there are any questions regarding this authorization please contact Juanita M.Forsythe at 413-586-
7878. Thank you.
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10. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: A sign is located at the main entrance indicating the hospital and o
related hospital facilities.
Are there any proposed changes to or additions of signs intended for the property? YES NO X
IF YES, describe size, type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQVIUD 11V:
Lot Size ?
1,018,427 SF 1,018,427 SF
Frontage
2,658' 2,658' ,',
Setbacks Front 127'
127'
Side L: 308' R: 42' L: 308' R: 26'
L:
Rear 187' 187'
Building Height 80'
80' r
Building Square Footage 392,000 SF
404,500 SF "
3
%Open Space: (lot area 49% 49% I�
minus building Et paved parking Q
#of Parking Spaces
788 789
#of Loading Docks 1 dock/2 bays 1 dock/2 bays
Fill: 1,160 CY off-site disp
(volume Ft location)
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: /0Z2//_03 Applicant's Signature
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NOTE:Issuance of a zoning permit does not relieve an appli cant'-,burden o compl�with all zoning
requirements and obtain all required permits from the Board of Health,Conservation Commission,
Historic and Architectural Boards,Department of Public Works and other applicable permit
granting authorities.
OOO.pdf
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' File No. Ql
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Please type or print all information and return this form to the Building
Inspector's Office with the$io.filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: Huntley Associates,P.C.
Address: 30 Industrial Drive East,Northampton, MA Telephone: (413) 584-7444
2. Owner of Property: Cooley Dickinson Hospital
Address:30 Locust Street,Northampton,MA Telephone: (413) 582-2313
3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain)Agent
4. Job Location: 30 Locust Street,Northampton
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5. Existing Use of Structure/Property: The area to be developed is currently a ten space parking area for lab ~
vehicle parking and grassed area.
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
The project consists of construction of a 12,500 SF modular medical records/lab building and a 10 space
parking area to replace 10 parking spaces displaced by the modular building.
7. Attached Plans: Sketch Plan Site Plan X Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON7 KNOW X 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 X DONT 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)
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File#MP-2004-0041
APPLICANT/CONTACT PERSON HUNTLEY ASSOCIATES PC
ADDRESS/PHONE 30 INDUSTRIAL DR EAST (413)584-7444
PROPj6 e� , , ST .
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM ILLED OUT
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Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-CONSTRUCT 12.500 SF MODULAR BLDG& 10 SPACE PARKING AREA
New Construction
Non Structural interior renovations
Addition to Existing
AccessoKy Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site PlanA��
Major Project:VSite Plan AND/OR Special Permit with Site Plan ®,ca c-7T
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 Co ssion
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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.