23B-046 (215) ZONING •
DISTRICT
USE
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, ami State ZIP code Tel. No.
Owner or
Lessee
Builder's
2.
License No.
Contractor /�
3.Architect or ,3 !/I/• �iAZ�—Cc>✓d�IC� /14QGt[ /- �•Yr .4G t1uJA�. �3/JS:1'.
Engineer 4-r-mW AA&
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 f applicant Address Application date
ejLtp��� , 6 sr �r-7 /�6t ry/A, 7--
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
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 p FOR DEPARTMENT USE ONLY
Permit number 33 D
Building.
Use Group
Permit issued 199d
Building Fire Grading
Permit Fee $ C
Live Loading
Certificate of Occupancy $ Occupancy Load
o d by:
Drain Tile $
Plan Review Fee $
TITLE
;o CITY OF NORTHAMPTON
9� *� MASSACHUSETTS
r •
OFFICE of the INSPECTOR of BUILDINGS
"' Page 3 4 Plot 7� APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
Jr (��7 /n Al Z O N I N G
&0 �dc6/JT /• Al 2T1JJ,1I"� r0A � // . DISTRICT
AT (LOCATION)
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK _ SIZE
N
11. 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 w building Residential Nonresidential
2;�ddition(If residential, enter number 12 ❑ One Family 18 ❑ Amusement, recreational
new housing units added, if any,
in Part D, 13) Be LC-R 13 ❑ Two or more family - Enter 19 ❑J Church, other religious
number of units- - - - --> 20 ❑� Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
❑ of units ------- - --� 22 ❑ ervice station, repair garage
5 Wrecking (l/multifamily residential, -
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13) ❑
16 Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation)
7 ❑ Foundation only 17 [:-] Other - Speci/y _ 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
B Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution. etc.) 29 ❑ Other - Specify
9 ❑ 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,,,,,,,,,,,,,,,, L9U school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
7'o be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical..................... ,&j1L2)1AJ(. WILL 9CUS'45 {1iit�Q .6WIZ41-- 6 8"Lfe_
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............. //N-T��v7
11. TOTAL COST OF IMPROVEMENT $ .4&ViOCO �J / SJ y X 7�1
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 /
30 ❑ Masonry (wall bearing) 404?IoPublic or private company 48. Number of stories..............
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior 79s�
32 Q Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY �Cnts
34 ❑ Other - Specify 42 Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
conditioning?
36 Oil �_._/ L. RESIDENTIAL BUILDINGS ONLY
37 �� Electricity 44 ❑ Yes 4S16-No 53. Number of bedrooms..............
38 ❑ Coal ,A'
39 ❑ Other - Specify WOOO Will there be an elevator? Full.......... -
54. Number of
46 C] Yes 47 E;'OtN o bathrooms
Partial.......
DEPARTMENT OF BUILDING INSPECTIONS
212 MAIN STREET BUILDING 'q �� / �`
NORTHAMPTON, MA. 01060 PERMIT QIL
23B - 46 - ` VALIDATION
DATE July 17, 19 Al PERMIT NO. 13A
APPLICANT RnhPrt Hall P.F_ ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO AdAi ti o (1_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO, (PR OSED USE)
ZONING
AT (LOCATION) if) jnrticY DISTRICT .URA
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
44 70
BUILDING IS TO BE {}S FT. WIDE BY 7�5 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Building will bouce x�voA 'hurajug boijer system to pzGvide atiasm for heating
entire hospital buildings. Structural steel, wood heat,
(��' Addition to boiler room
AREA OR VOLUME 7..955 ESTIMATED COST $ 200,000 FEE MIT $00.00
(CUBIC/SQUARE FEET)
OWNER Cooley Dickinson Hoepitstl BUILDI
ADDRESS BY
j
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY