25A-179 (25) File #9
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APPLICANT/CONTACT PERSON:INSA INC
35 CENTER ST CHICOPEE, MA 01013(413)231-4450
PROPERTY LOCATION 29 INDUSTRIAL DR - EAST
MAP:LOT 25A-179-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $30.00
Type of Construction: ZPA -MANUFACTURING &PROCESSING OF CANABIS
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure}
Building Plans Included: �,Vr
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON J.A
INFORMATION PRESENTED:
1/ / •
Approved Additional permits required (see below) `
PLANNING BOARD PERMIT REQUIRED UNDER:§ I• P
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR SpecialPermit 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 WaterAvailability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Perm it from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
,Wier Va7 ),
Si ature 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, ConservationCommission, 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 Office of
Planning&Development for more information.
1;14Iz1 � JAN 2 7 2022 I g
O File No.
ZONING PERMIT APPLICATION (?Y o.2) ;c iE;rs
Please type or print all information and return this form to the Building
Inspector's Office with the $30 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant:_ ;!`J • S • A , �-�-1`�C
Address: 5- ,,i"rti+-t t` T}f Lt r (loco tt4 �7Te ephone: `'/i ? - 23 1-44 To
t
2. Owner of Property: S S n v S'C t 4+, t T`i V tL-
Address: 3 ( '1 d 114." S t sit. 3 o 7 Telephone:
3. Status of Applicant: Owner Contract Purchaser )< Lessee -i� Other (explain)
4. Job Location: 2-4'1 n o...),St C:14.1 \ (' t F4,11- ?3 o /�i"l"��,�r i ('1 A
Parcel Id: Zoning Map# j��l_.. 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: .1&n4.'*Q4(,‘c" W 1\ '�^� Prix xf
b. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
A k'�vr1/\ ?rottsi 1n� Ce^,`0\ () S
e r,n,5 ()fin U ct- j"t .,,,. -�<4. r( r 11 *^Sc ''cro., L' CC
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 X. YES IF YES, date issued:
IF YES: Was the permit recorded att,/the Registry of Deeds?
NO DONT KNOW h YES
IF YES: enter Book Page `/ and/or Document it
9.Does the site contain a brook, body of water or wetlands? NO 1( 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:A Documents\FORMS\onginailluilding-Inspector,Zoning-Pcniiit-Application-passivc.doc 81412004
10. Do any signs exist on the property? `` YES X NO (�
IF YES, describe size, type and location: V •.)"0 `n 's� "`''
S � S \ e-- J
Are there any proposed changes to or additions of signs intended for the property? YES IBC NO
IF YES, describe size, type and location: (-t 1.t,.A. At'. e 4 S m 3 Ay W S t oc.4te tM
11. Witt 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
j-ih,,r 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 a paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 1-25-22 . Applicant's Signature ' 'yallaff '
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.
WADocwuenis\FOR141Swiginai\i3uilding-InspectorZoning-Permit-Application-passive.dcx 8/4/2004
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