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10. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: Roadside #1: 6x8; #2: 8x1 2
#1! Real estai temporary "available" sign
#2: Dealership sigt'I. Now blank.
AJhso, there i an "D sign that will be li red when NSC is open.
Are t ere any proposed c anges to or 1 Ions o gns intended for the proper y.
IF YES, describe size, type and location: Paintedgsign oaanmmwwi ndow /overhead door,
11. Will the construction activity disturb (clear ng , g ad iin g e o o v e r 7 a c r e o is pa at a c o m mon
plan of development that will disturb over 1 acre? YES NO X no construction.
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. 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 REQUIRED BY
ZONING
Lot Size
5ii 1 1 f ff Game
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height •
20' same
Building Square Footage
14,000 same
% Open Space: (lot area
minus building & paved
parking 0 same
# of Parking Spaces
80 same
# of Loading Docks
none same
Fill:
(volume & location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 7 ( f ( Applicant's Signature F7 •
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply 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.
W:\ Documents\ FORMS\ original\ Building- Inspector\Zoning- Pennit- Application- passive.doc 8/4/2004
� 1 It
�n I
SEP - 1 2010 P // -S�
i File No.
N NG PERMIT APPLICATION (§10.2)
Please`'ype- orPrint all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: Northampton Survival Center, Inc.
Address: 265 Prospect St. , Northampton Telephone: 413-586-6564
2. Owner of Property: Double Duck, LLC (Cahillane )
Address: 384 South St. , Northampton Telephone: 413-575-6142
3. Status of Applicant: Owner Contract Purchaser Lessee X Other (explain)
4. Job Location: 375 South Str - k • , . n • • IP - n . • - • - ' • .
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property: marketplace.
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
Use:
Nutritional education, food pantry storage and distribution,
and office administration.
7. Attached Plans: Sketch Plan X Site Plan Engineered /Surveyed Plans
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DONT KNOW YES X IF YES, date issued: 5 / 2 7 / 2 0 0 9
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW X 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)
W: \Documents \FORMS \original \Building- Inspector\Zoning - Permit- Application- passive.doc 8/4/2004
File # MP- 2011 -0031 r
APPLICANT /CONTACT PERSON NORTHAMPTON SURVIVAL CENTER
ADDRESS/PHONE 265 PROSEPCT ST (413) 586 -6564 0
PROPERTY • TON' "K.T
r4M 3:C PARk O -tJ ?1 ' • ;`r+ ' e 00 //WP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
FNING FO FILLED OUT 0.9 9 -
Fee Pai
Building Permit Filled out
Fee Paid
Tvpeof Construction: ZPA - SURVIVAL CENTER TEMPORARY LOCATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory 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
INFQRMATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER : §
Intermediate Project : Site Plan AND /OR Special Permit with Site Plan
Major Project: Site Plan AND /OR Special Permit with Site Plan
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 Commission Permit DPW Storm Water Management
�.. _ .►�..�� OP
5 Q
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.