22B-040 (14) File 9 MP-2019-0031
APPLICANT/CONTACT PERSON JONATHAN GURFEIN
ADDRESS/PHONE 98 MORNINGSIDE DR (413)270-2395
PROPERTY LOCATION 221 PINE ST
MAP 22B PARCEL 040 001 ZONE SKI 15)/WP(I 15)/WSP(l)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
LOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildina Permit Filled out ,
Fee Paid OPERARoN w�t;l$T
Typeof Construction: ZPA-CANNABIS PROD -GROW ONLY
New Construction /-t c-G- samwirz u 0 E Lr
Non Structural interior renovations
Addition to Existinp,
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
INFO,RMATION PRESENTED:
_A/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
Cog 10 t z t v
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.
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o o File No. Yyl qJ�r
ZONING PERMIT APPLICATION 01 o.2)
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oF,-oPle stype or print all information and return this form to the Building
omwec 6V� Office with the $30 filing fee (check or money order)payable to the
o� ITS City of Northampton
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N Name of A plicant: 11
ress: Mts�/t1 kA ��,1 d - lfelephone:
2. Owner of Property: �rvs wo/ S &rs '9 s
Address: 01211 (pl�— S Y'�"e�—�, �/d/u'fCJ�— Telephone: l3
3. Status of Applicant: Owner Contract Purchaser Lessees Other (explain)
4. Job Location: "211 P1� 5�'�-t- . FlOP4- — M/d -
Parcel Id: Zoning Map# 'Aa;�� Parcel# 0 q District(s):
In Elm Street District In Central Business District
TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: 4 C6,slG
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
C.h✓��� I S C O U t,�r-� �d W O h
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed
RECEIVED !i
8. Has a Special Permit/Variance/Finding ever been issued for/on the site? f
NO DONT KNOW K YES IF YES, date issued: OCT _ q 018
IF YES: Was the permit recorded at the Registry of Deeds?
DEPT.OF BUILDING INSPECTIONS
NO DONT KNOW YES NORTHAMPTON.MA 01060
IF YES: enter Book Page 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:
(Form Continues On Other Side)
W:\Docu ilding-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
1 � - 17h -2 v'�
Are there any proposed changes to or additions of signs intended for the property? YES NO X
IF YES, describe size, type and location:
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 column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
%Open Space: (lot area
minus building ft paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume it location) 1-10
13. Certification: I hereby certify that the information contained herein i ru a rate to the best of
my knowledge.
Date: Applicant's Signature i
f
NOTE:Issuance of a zoning permit does not relieve an appleurden to comply with all zoning
requirements and obtain all required permits from B and of Health,Conservation Commission,
Historic and Architectural Boards,Department of P lie;Nyorks and other applicable permit granting
authorities.
it
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive. c/` 8/4/2004