23B-046 (208) ZONING .
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
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IV. IDENTIFICATION - To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
I'
Owner or Cooley Dickinson 30 Locust St 01060 584-4090
Lessee Hospital
n r f r Builder's N xc1J -t
1. r i �� �''�. CJ� _��� f �<}� If�--a_ ../ r� �. License No. J
Contractor
� I?21Z,
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.
Sign tur f applicant Address Application date
30 Locust St. 4/30/87
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD - For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check Obttaitned 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
Building e �y 19 7 Use Group
Permit issued V{i(/�+ 7 IF Building Fire Grading
Permit Fee $ (vS Jv�[_J .0 V
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved
Drain Tile $
Plan Review Fee $
TITLE
„ CITY OF NORTHAMPTON
.� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
$ e
Pa B ���
,yT g Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
1 ZONING URB-2
AT (LOCATION) 30 Locust Street (Cooley Dickinson Hospital) DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING CROSS STREET) iCROSS STREET)
LOT
12.6 acres
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking” most recent use m
M
1 [7] New building Residential Nonresidential
20 Addition(1/ residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any, 13 Two or more Family — Enter 19 Church, other religious
in Part D, number of units— — — —
3 Alteration (SSee e 2 above) —)- 20 Industrial
14 Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — 22 �� Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) ❑
16 Carport 24 n Office, bank, professional
60 Moving (relocation)
17 Other — Speci/y 25 Public utility
7 D Foundation only
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 [# Private (individual, corporation, 28 ❑ Tonks, towers
nonprofit institution, etc.) 29❑ Other — Specify
9 0 Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, 128,000 school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical....................... 52,000
Relocation of Hospital Recovery Room and
b. Plumbing ...................... 14 000
new Surgical Day Care area.
c. Heating, air conditioning.......... 17,000
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ 211 ,000
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts 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 1
30❑ Masonry (wall bearing) 40:K{ Public or private company 48. Number of stories..............
31 Wood frame 41 El Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior 4 050
32 Structural steel dimensions .....................
33 X: Reinforced concrete H. TYPE OF WATER SUPPLY
Kr l Public or private company 50. Total land area, sq. ft. 12•.6•ac. 548,856
34 0 Other — Specify 42
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 E5� Gas Will there be central air 52. Outdoors........................ 570
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 [a Yes 45 ( No 53. Number of bedrooms..............
38 Coal
39 Other — Specify wood Will there be an elevotorP Full..........
54. Number of
46 F� Yes 47 In No bathrooms Partial........
DEPT:OF BUILDING INSPECTIONS BUILDING �O
a 212 Main Street 'Q 5 '
Northampton, MA 01060 PERMIT as
23B - 46 VALIDATION
DATE April 2Q 19 PIT NO. 241
APPLICANT F.J. Mac Innis ADDRESS 3(�ozcu�s StreERMet
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alteration (_) STORY Hospital NUMBER OF
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) DWELLING UNITS
AT (LOCATION) 30 Locust Street/Cooley Dickinson Hospital ZONING URB
DISTR ICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit of relocate hospital recovery room and new surgical day care area
VOLUME 4.050 sQ. ft. ESTIMATED COST $ 211 ,000.00 FEEMIT $ 580.00
(CUBIC/SQUARE FEET)
OWNER Cooley Dickinson Hospital (J/,��► Gr"�� /} '
ADDRESS 30 Locust Street BYILDIN�^
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