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22B-041 (5) Sinks Mop sink • 3'x2' 2'x2' I 6' I Bathroom • H Office /storage I`s 4-4,- - 14.5' _ I \____ Cold Steam = Fridge table table 2'x3' • 2'x4' 'x3' — i 3' Prep table • Electric A-► 2 .4---� 5 stove 2.5'x3' 31 1441 Hand washing 3' Baked goods 3 ' Counter 12' i • ► Sink 1'x1' f -► 41-40 4 ► 7' 4' 4' Deli case 1.5'i H 1 2' Cash 1 2' F► - register 4---10 • 6' 6' i — • ► Shelves 4-'00 Fresh produce Fresh produce 56' 28' . 28' 16' 16' • i i r Tables i / \ I . Entrance A 2' 4 4' 6' 4--► 5' -...,,,,,,, j 30' 4 ► Michael Kaynes ' Fresh produce, deli and more... 176 Pine Street Florence, Ma 01062 i 10. •Do any signs exist on the property? YES ✓ NO IF YES, describe size, type and location: • Are there any proposed changes to or additions of signs intended for the prope r YES / NO IF YES, describe size, type and location: Lurie G��1 11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan of development that will disturb over 1 acre? YES NO 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 coizann reserved for use by the Building EXIST'I11TG PROPOSED "° "'�" Frontage Setbacks Front Side L• R: L: R: • Rear Building Height Building Square Footage =' • % Open Space: (lot area minus building ft paved of Parking Spaces # of Loading Docks (volume Ft location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: l / ed'AD 9 . Applicant's Signature .�.t PP ' � � J . NOTE: Issuance Issnce of a zonlg permit does not relieve an applicant's burden to comply with zoning requirements an obtain all required permits from the Board of Health, Conserva Comm Hist oric and Architectural-Boards, Department of Public Works and other applicable permit granting authorities. W: 1Decuments1FORMS1oriDnallBnii riinp- Inspcctor,Zoning- Pamit- Application- passive.doc 8/4/2004 '/° /b 4' , _maw,.. :m,....:..�,...,..+sru.v i:.. _ Please type or print 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 ofNorthampton 1. Name of Applicant: / L/e/ �i'�ZL�� Address: 3,2 </312CK SIW F AvE • SOu- �J Telephone: ' x- / /3/ »'9(757 2. Owner of Property: � /9 /Yit T/ in ' &4) J &kJ Address: 17 /' /NF S77 Rzioir,E_ (4 / Telephone: Y/. (.56 0 9 1 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) 4. Job Location: /`71' P)tif S / F1',CIC 'tiG� st . ...--'. .ate i •"°' 1. ..� '^' -,�� - ,.s�,, _ _ -mac. �+�a.. mac- - _- �._ - ems• - ��.,� �.we� e,..�- �c ,.�s:7 � x reZ - - 1 1 77 -,� ..'" : _ t£7 R'5 -rte eE"i`� �Y ... YEA -e - - � 5 Existing Use of Structure /Properly: Em ( y 6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary): • 7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans 8. Hasa Special Permit /Variance /Finding ever been issued for /on the site? • NO DONT KNOW ' YES IF YES, date issued 1FYES; - - V as the permit recorded at the Registfy Deeds? NO DONT KNOW YES IF YES: enter Book Pa e and /or Document # • 9.Does the site contain a brook, body of water or wetlands? NO 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: fF orm- t=orstinees -0n ether-Side)' W :1Documents WORMS \onginaABuilding- Inspector\Zoning- Permit- Application- passive.doc 8/4/2004 • File # MP- 2010 -0036 APPLICANT /CONTACT PERSON AVEZZIE KERRY ADDRESS/PHONE 32 BERKSHIRE AVE (413) 569 -9657 0 PROPERTY LOCI `T O 174,PINE ST MAP 22B PARC , " I5I t o 'r iq »t THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE CONING FO' FILLED OUT ee • al. Building Permit Filled out Fee Paid Tvpeof Construction: ZPA - FRESH PRODUCE, DELI 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 INFVRMATION 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 irlAvfe. 76 ZONING BOARD PERMIT REQUIRED UNDER: § S2 Finding Special Permit Variance* 7' 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 Permit DPW Storm Water Management / //r 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.