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23B-046 (204) v Date Filed File No. ZONING PERMIT APPLICATION Zoning Ordinance Section 10.2 1. Name of Applicant: THE COOLEY DICKINSON HOSPITAL INC. Address: 30 LOCUST STREET Telephone: qg2-2000 2 . Owner of Property: THE COOLEY DICKINSON HOSPITAL INC Address: 30 LOCUST STREET Telephone: �SR2-2ppp 3 . Status of Applicant: XX Owner Contract Purchaser Lessee Other (explain: ) 0 4 . Parcel Identification: Zoning Map Sheet# Parcel# Zoning District(s) 30 LOCUST STREET nStreet Address 5 . Compliance with Zoning: Existing Proposed Use of Structure/Property 6,to i r2o Toa DoT Size of Structure (sq. ft. ) 360 5Q.FT. Building height 9' 0" Building Coverage v Setbacks - front G' - side N/ 13so 5 - rear N/A az/ Lot Size N/A Frontage N/A 0 %Floor Area Ratio N/A Open Space N/A Parking Spaces NONE REQUIRED Loading Spaces NONE REQUIRED Signs NONE REQUIRED ' Fill (volume & location) NONE REQUIRED 0 6 . Narrative Description of Proposed Work/Proiect: (Use additional sheets if necessary) PORTABLE BUILDING (MODULAR) - FOR USE AS AN INDEPENDENT BUILDING BETWEEN SOUTH WING AND RECEIVING AREA TO BE USED AS A SMOKING AREA FOR PERSONNEL. INDEPENDENT OF HOSPITAL MAIN BUILDINGS 7 . Attached Plans: XX Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my/knowledge. Date: AUGUST 6, 1990 Applicant's Signature: THIS SECTION FOR OFFICIAL USE ONLY — — — - — — — `= — — — — — — — Approved as presented Denied as presented Reason for Denial: Signature of Building Inspector Date COMMONWEALTH I OF MASSACHUSETTS I i EXPIRATION DATE 06/30/1991 I 7 1;�� RESTRICTIONS NONE SS 4 029 .35-3930 iPHOTO(BLASTING OPR ONLY) FEE: y (ry� 1 00.00 HEIGHT: DOB: 10/ 19/194 THIS DOCUMENT MUST BE CARRIED ON THE PERSON OF THE HOLDER WHEN ENGAG OTHERS -RIGHT THUMB PRINT ED IN THIS OCCUPATION I 20OM-2.87.81429 j 1 DEPARTMENT OF PUBLIC SAFETY 1010 COMMONWEALTH AVE. BOSTON,MASS.02215 EFFECTIVE DATE LIC-NO. ° .7 6 f30 11 038243 0 91035 NOT VALID UNTIL SIGNED Y LICENS E ANO OFFICIALLY STAMPED OR SIG TU/R OF T' IOMMIS NNEER f A SIGNATURE OF LICENSEE /i • .a!�� A' ��J� COMMISSIONER I i J i ti f . I _ G 1O U l I h G I Q A V � I C iI I Oct I It NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE MaSTING CONDITIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plans,in duplicate,mustbe filed with this application before apermitwill be granted,oneof which,upon issuance of the permit shall be kept at the site during the progress of the work. New...............F-1 zz Addition........❑ No.................—D, Zone..................., Type..................., Mapel?.,J......... Parcel....,. Alterations....El Repair............❑ CITY OF NORTHAMPTON Demolition....❑ MASSACHUSETTS Application for other than a Dwelling Permit (To be filled out in ink OR on a typewriter) To the Building Inspector: Date... -7d.)1.1 .................19 9 Application for a permit is hereb made according to the following:— 1 1. Location,Street and No...... .A..�.�.tJ.S.�......�/.... �..l�.d�.�f.9.��.C.Z.J.1... �.�V l0� b �7 2. Nearest cross street....... .17.......................................................................................... Lot No.....�............ 3. Owner's name.�..��,��:es..�1.GY.�.'.:.�.S.Uh..C�..��! u Address.�C�..�-�!?.Cc.?�� �.......�..11l.all��� 4. Architect's name..., Address........... .............................................. ............................................ . 5. Builder's name.�2fl. ,.4:.: .�sm.. ..T ..���, Address............................................................. 6. Use of building,Prese t.......A)..Q.2J..,s............ Proposed......................................................................... 7. Building fronts on how many Streets?..................................................................................................................... 8. Is building in fire district?......................................................................................................................................... 9. Size of building,Width in ft...........LZ........., Length in ft.........3.p........... Height in ft.......................... 10. Distance of building from Street Line J��.Gr..> left lot line.'3.210 right lot line.J.3.2!Trear lot fine...5(6 U 11. Type of construction(check one):1—A.......... 1—B.......... 1--C.......... II.......... III.......... IV.......... V.......... Stories B 1 2 3 4 5 6 7 Roof Story heights in ft. Thickn's of walls in ins. Material of walls Material of floor/roof Design live load Design dead load Occupancy or Use No.of persons/families No.of stairs \dj._ (' 12. Soil under footing is.... j.� .t/1sL1.0 ....(�.F:.�....1�.� 13. Depth of footing below grade.......J..l.................... ft. Will piles be used?......, .................. 14. Area of entire building(Present plus new)...�1..�a.U.... .:..J`.f......................................................... sq.ft. 15. Type of roof—flat......t .......,pitched................... Mater�il of roof covering........l..lZ :!..................... 16. No.of elevators.....::�.. Method of heating�.lxl�t et�t................................. Fuel................................. 17. Are live loads noted on drawings?....11 Q.. Are all other structural conditions noted on drawings?,�................... 18. Building lll a is) i d ith rinkl rs? .... )tGh sp' er al ?f.... /..�1.............. 19. Is buildinito be used as a factory,workshop or mercantile or other establisfiment employing 10 or more persons? ............................................. ?1.......................................................................................................................... 20. Is building to be used as an office building,dormitory,hotel,family hotel,apartment or boarding house,lodging house or tenement house having 8 or more rooms above the second story?............ . 6.................................. 21. How many exits(per floor)to street?......�....W.... ............................................................................................... 22. Is building a"Place of assembly"as defined by the General Laws?........�l�..t�................................................... 23. Will building conform to the General Laws?...}`.�.e.5...........Building and Zoning Ordinances?....... `e 5...... 24. If a garage,distance from nearest building?....... ........................ 25. If an addition,alteration or demolition,when was building erected?.......................:J.q...................................... 26. Estimated costs:— The undersigned certifies atthe above state nts tru o thebest General$........... . ( .... of e kn g owled e d V61ief. Plumbing......................................... Gas Piping....................................... Signat of owner,arIc gi neer Sprinklers........................................ WRITTEN DISCRIPTION OF WORK TO BE DONE Heating (Use blank half of reverse side,if necessary) Electric............................................ ............................................................................................................... Other............4 ........ ............................................................................................................... Total$.......r- .. ? ' ...... ..........C......................................................................................... 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