216 N KING ZPA 2019-09-26 File#MP-2020-0014
APPLICANT/CONTACT PERSON RANDALL GERALD F
ADDRESS/PHONE BOX 623
PROPERTY LOCATION 216 NORTH KING ST
MAP 18 PARCEL 007 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
T)Teof Construction: ZPA-RENO EXISTING SPACE TO USE AS A MMI-CAL MARIJUANA DISPENSARY
New Construction
Non Structural interior renovations
Addition to Existine
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
INFORMATION PRENTED:
Approved VAdditional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § �' b
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD P RMIT REQUIRED UNDER: § �- 3 7Q r?UrtDj
t�l7
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
1 b7
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.
*Variances are granted only to those.applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.
E �IVED
File No.
-
K�INGPERMITAPPLICATION(§10.2)
type or print all information and return this form to the Building
nrpT^:If1Esp�ctor's.Office with the $30 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: Life Essence, Inc.d/b/a Trulieve
Address: 56 Canal Street, Holyoke, MA 01040 Telephone: (678) 749-9726
2. Owner of Property: Gerald F. Randall
Address: P.O. Box 623, Williamsburg, MA 01096 Telephone: 413 - S7 5- 0111
3. Status of Applicant: Owner Contract Purchaser Lessee X Other (explain)
4. Job Location: 216 North King Street, rear portion of existing building
Parcel Id: Zoning Map# l Parcel# C0District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: dual use tenants. Major tenant is Valley Motor Sports.
Zoning Permit is for new tenant, Life Essence, Inc. d/b/a Trulieve, for Medical Marijuana Dispensary
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Renovation of existing space for use as a Medical Marijuana Dispensary. Leased space is approximately 3,800
square feet. exterior improvements are minimal, and are related to landscape and lighting.
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 DON'T KNOW YES X Finding IF YES, date issued: February 28, 2002
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES X
IF YES: enter Book 6646 Page 332 and/or Document# 992214991
9.Does the site contain a brook, body of water or wetlands? NO X DON'T 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
10. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: existing pylon sign located at frontage of property
Supported by two poles. Size is approximately Tx 6', 8' high
Are there any proposed changes to or additions of signs intended for the property? YES X NO
IF YES, describe size, type and location: new sign face within existing sign frame
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 X
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
67,814 SF 67,814 SF
Frontage
290 Feet 290 Feet
Setbacks Front 76-5" 76'-5"
Side L: 51.5' R: 31.15' L: 51.5' R: 31.15' L: R:
Rear 41.4' 41.4'
Building Height 16' +/- 16' +/-
Building Square Footage 15,181 SF
15,181 SF
Open Space: (lot area
minus building £t paved 23.2%
parking
#of Parking Spaces
42 42
#of Loading Docks
1 1
Fill:
(volume It location) none none
13. Certification: I hereby certify that the information contained here' s true d accurate to the best of
my knowledge.
Date: G( l Applicant's Signature
NOTE:Issuance of a zoning permit does not reliev a pplic nt's burden to comply with all zoning
requirements and obtain all required permits from the oard 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-Permit-Application-passive.doc 8/4/2004