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11. ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
12. This column to be filled in by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage
Front:
Setbacks:
Side: L: R: L: R:
Rear:
Building Height
Bldg Square
Footage
% Open Space:
(Lot area minus bldg and
Paved parking)
# of Parking Spaces
# of Loading Docks
Fill: (volume & location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: ll 1 1 I ( I APPLICANT'S SIGNATURE -
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,
Department of Public Works and other applicable permit granting authorities.
FILE #
Page 3 of 3
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant 3M ObZ.c.oLr- ? ,R So..) 4
Address: - CO+•Z— Telephone: \ I i' ' SV1 ' WI
2. Owner of Property: ( a `J`?'`w tC -ti, 1 0.2_
Address: 2A (" NcS�'MR Si FLT Pik 0 ∎c L LL Telephone: L (i 3 S17 , o&
3. Status of Applicant: Owner Contract Purchaser Lessee
_Other(explain): 1 G 60g v J
4. Job Location: 2 -9 ( DIAZ - S( tZvt �"a < . ,L4 0106 _
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property: CD t'r't ce
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
P 2 50 5 \(r c� S S� z_
L V(tib
7. Attached Plans: _ ) Sketch Plan _ Site Plan Engineered /Surveyed Plans
8. Has a Special PermitNariance /Finding ever been issued for /on the site?
NO DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: Enter: Book Page and/or Document #
9. Does the site contain a brook, body of water or wetlands? NO 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
10. Do any signs exist on the property? YES ✓ NO
IF YES: Describe the size, type and location: r
L) — 2 — S ti)0 , 1 i ? ,At -LL) t 0 1
Are there any proposed changes to, or additions of, signs intended for the property? YES NO
- S
IF YES: Describe the size, type and location: 12 y SO w�-C- Sl � t 2- ts)i_
(A=.: lC0 /j , c>J St°)
Page 2 of 3
City of Northampton
� Massachusetts 1{
7 DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building r• b�.
" °r __ Northampton, MA 01060 771
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee , 1p ash c
(Application to be filled out in ink or typewritten) Number
Plans must be filed with the Building InspQctor RECEIVED Erection ( )
before a permit will be granted. Alteration ( )
Repair ( )
NOV 2 8 2011 I Repainting ( )
Removal ( )
O of BUILDING; PECTIONS FEE PAGE PLOT
NORTHAMPTON, INSPECTIONS MA 01060 `
■ Northampton, Mass. 20.....
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME SER-v` (cNe
1. Location, Street and No. 2-c1.(0 Jvo tiWz..t4 5( iZcl't-c,2E i O,UX'L
2. Owner's name 6eJ - t — ( ja-'.q,-7 OF- 1U Svt4 ,Lkt L(.2..
3. Owner's address )a Co 0 Uiv(- r' 1U p' bG L
4. Maker's name Ta L 5 «' A i_s,,,,i
5. Maker's address T Cc > - ' Z K.) 0 1C , ta ' 6 ` csGu
6. Erector's name ,,fi„v
7. Erector's address
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated Non - illuminated
2. Will sign obstruct a fire escape, window or door? 'A Marquee
3. Lower edge will be /P ft ins above the public way. Projecting
4. Upper edge will be ..! L.ft - ins above the public way. Roof
5. Height ft 5O ins Width ft I 2 -ins Temporary ....
6. Face area A, 1r sq. ft. Wall
7. Inner edge will be ins from the building or pole. Ground
8. Outer edge will be 1 ins from the building or pole. Other
9. Face of building or pole is 10 ' - lin back from the street line.
10. Sign will project r .ins beyond the street line.
11. Sign will extend — ft " ins above the building or pole.
12. Of what material will sign be constructed? Frame ...t3 t- `'' Face 4- t-u -1 -4- ..
13. Estimated cost $ - 7oo
The undersigned certifies that the above statements are true to the best of his knowledge and belief.
(Signature of Owner or Agent)
Page 1 of 3
File # BP- 2012 -0506 e� "11
7 Q47/
APPLICANT /CONTACT PERSON PORCUPINE SIGNS 162- -
v
ADDRESS/PHONE 78 CONZ ST ( #REAR) NORTHAMPTON (413) 584 -4501 S
PROPERTY LOCATION 296 NONOTUCK ST MAP 22B PARCEL 043 001 ZONE GI(100) / /WP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
6'
Fee Paid I)
Tvpeof Construction: ERECT NON -ILLUM PROJECTING SIGN - TAPESTRY HEALTH
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
INFO ATION PRESENTED:
pproved Additional pe rmits required (see below) P 3C0 -7 3
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
Demolition Delay
l I 2 /i
Signs a 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 Office of
Planning & Development for more information.
City of Northampton Map 22B Lot043 Zone GI(100) / /WP
Massachusetts Date issued 12/1/2011 0:00:00
Inspector of Buildings Permit # BP -2012 -0506
Permit Fee$30.00
SIGN PERMIT
Business TAPESTRY HEALTH
Address 296 NONOTUCK ST
Applicant InstallerPORCUPINE SIGNS
Applicant Installer Address 78 CONZ ST ( #REAR)
Work Description ERECT NON -ILLUM PROJECTING SIGN -
TAPESTRY HEALTH
Estimated Cost $700.00
Building Department
Approval by: