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10. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: Main Entrance and Driveway Entrance Signs
located where the subect signs of these as •lications are to be located.
These signs are replacement
Are there any proposed changes to or additions of signs intended for the property? YES X NO
IF YES, describe size, type and location: Re • la cement
LI. „, ALL INPORMATION MUST BE COPEPLE'TED, or PERMIT CAN BE WEIVIF na TO
X.ACX OF niroRwirioN.
Ellia CO Um= to be fillact
_ by taw SaileeLog Depastsst=t
i Required
• Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus tadg
&paved parking)
# of 'Parking spaces
- - -
r of Loading Docks
Fill:
volnme -a- location)
”
1
13. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
April 11, 2012
DATE: APPLICAMTS SIGNATURE
IMOTE1 hosuatetca of zoning perratt aloe* not rolievo &ii applicator= burden to comply with ail
zoning reqPireirsents and obtain all required permit= from the Board of Health. Canneinration
Cotrimisation, Deportment sot Pubillo ocermit cAutNchritiosa.
-------
FILE I —
C0OL ZLZILfic.M Via LZ:60 600Z/MLO
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION (§1.0 2)
przASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Northroad Wood Signs
Addr es 203 Old Revolutionary Rd., Temple, NH 03,Weiihone: 603 - 924 -9330
2. Owner of Pia a Deaconess Abundant Life Communities
P �
80 Deaconess Rd. Concord, MA 01742 " 978 369 - 5151
Address: Telaphone:
3. Status of Applicant: Owner X Contract Purchaser Lessee
Other (explain):
4. Job Location- 25 / 37 Coles Meadow Road, Northampton
Parcel Id: Zoning Map# Parcel District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property Senior Living Residence
6. Description of Proposed Use/Work/Project/Occupaton: (Use additional sheets if necessary):
same
7. Attached Plans: X Sketch Plan X Site Plan Engineered/Surveyed Plans
Answers to the Wowing 2 questions may be obi ined by checking with the Building Dept or Planning Department Files,
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 at the Registry of Deeds?
NO - DONT KNOW YES
IF YES: enter Book Page and/or Document #
9. Does the site contain a brook, body of water or wetlands? NO DONT KNOW X , 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)
ZOO[P] ZLZTLBSCT1' 11'd 1.Z:60 800ZiZ0'L0
NO
Erection ( )
Alteration ( )
Plans must be filed with the Building Inspector, Repair ( )
Repainting -- - - - - -- ( )
before a permit will be granted, Removal ( )
TitO err Nurthamptmt, AU555.
ear
Application for a Permit to Place or Maintairra Sign
or other Advertising Device
(Application to be filled oat in itak or typewritten)
FEE PAGE PLOT
Northemptori, m ass., April 11, 2012 19__ .
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device. or marquee.
BUSINESS NAME Rockridge Retirement Community
1. LOC.A.TION, STREET and No. _25 / 37 Coles Meadow Road
2. Owner's name . Deaconess Abundant Life Communities
3. Owner's addr• . 80 Deaconess Road, Concord, Massachusetts 01742
4. Maker's name Northroad Wood Signs
5. Maker's addr 203 Old Revolutionary Rd., Temple, New Hampshire 03084
ess..._. - ---.-
6. Erector's name same
7. Erector's address —
SIGN KIND OF SIGN
esignate
I. Sign will be (check one) illuminated X non - illuminated _ (p)
2. Will sign obstruct a fire escape, window or door? no Marquee
3. Lower edge will be n/a ft. inq. above the public way.
4. Upper edge will b n e - / ...ft.
;n-% above the public way. Foot """'
S. Height 5 .ft- 2 i 4. Width 0 ft 2 {i luding posts) Temporary______—......
6. Face area 25 . sq. ft.
W afl
7. Inner edge will be n/a inA from the building or pole. Ground._ X
8. Outer edge will l be n/ a . in-s. from the building or pole_ Other
9. Face of building or pole is n/a ills. back from the s-eet line.
10. Sign will project— ins beyond the street line.
11. Sign will extend.. r ft .ins. above the building or pole.
Aluminum -clad MDC, Treated Timbers, PVC Trim,
12. C)t what material will sign be constructed? ¢ a
$7 phenolic impregnated c F uF, High Density
I 3. Estimate cost �
i�oiy`ta`reti ianG i 'v`c^i1l'i , , .r' '
The undersigned certifies that the above statements are true to the � - "
best of his knowledge and belief.
(Si gnature of Owner or Agent)
NOTE: la order that this application ttay the data railed for above must be set forth Pa m w
CLEARLY and FULLY.
T0001 ZL7.IL9cCI YV.4 L7.:Rn 81)n7i7(Jtn
File # BP- 2012 -0900
APPLICANT /CONTACT PERSON NORTHROAD WOOD SIGNS
ADDRESS /PHONE 203 OLD REVOLUTIONARY ROAD TEMPLE (603) 924 -9330 O
PROPERTY LOCATION 25 COLES MEADOW RD
MAP 13 PARCEL 073 001 ZONE
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 c/
Typeof Construction: REPLACE GROUNDS SIGNS - ROCKRIDGE RETIREMENT COMMUNITY
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
INFORMATION PRESENTED:
Approved I/ Additional penults 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: § 50 '7 Z (M)
Finding Special Permit v" 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
/ 6141 't f ' 66 1 4,010totiC 4 /4 Vh
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 Office of
Planning & Development for more information.