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10, Do any signs exist on the property? YES X _ No
IF YES, describe size, type and location: M ain Entrance and Driveway Entrance Signs
located where the sub'ect sins of these a• elications are to be located.
These signs are replacement sie ns.
Are there any proposed changes to or additions of signs intended for the property? YES X NO
IF YES, describe size, type anti iocation: Replacement
11. ALL INFORMATION MUST BE COMPLETED, or MUM' CM BE DENIED DUE TO
LACIC OF INFORMATION
mi.* an lARIMI. to by fi2Zad ii
by Me Thrliditeg Deparittusat
Required
• Existing Proposed By Zoning
Lot size
Frontage
Setbacks z_freinf
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of "Parking Spaces
of Loading Docks _
4 volume -& location)
13. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
April 11, 2012
DATE IIFPLICAMT SIGNATURE
PP.crrel bkokuartz,ft =t zoning persnit doe* not relieve /MI ilapplInalnirsc biz oonsplY tw.fr-FF MU
zoning requiroments and obtain all required permits from the Board of Henan, Conservation
Commission, 13eportmettt or 1Publio r itillie.r . otapliosiblo permit arnntinb authorities; .
" " • - FILE f
OOtj I1.8SCIt YTid LZ:60 600Z/Z0iL0
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No. n
ZONING PE T APPLICATION 0 ICATION ( .2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant Northroad Wood Signs
Addr ess 203 Old Revolutionary Rd., Temple, NH 03pecgoone: 603 -924 -9330
2. Owner of Pro a Deaconess Abundant Life Communities
pity:
Address: Deaconess Rd. Concord, MA 01742 Telephone: 978-369 -5151
3. Status of Applicant: Owner 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/Occupation: (Use additional sheets if necessary):
same
7. Attached Plans: — X Sketch Plan X Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained 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 issued;
(FORM CONTINUES ON OTHER SIDE)
Z 00 j ZLZTLBSCTr IVd LZ:60 600Z/Z0/L0
No
Erection_ ( )
' v==
Alteration—__( )
Plums must be filed with the Building Inspector, Repair .( )
B.epainting. ( )
before a permit will be granted, Removal - ( )
r it 1tmptort,
•
4 - - • for a Permit to Place or Maintain - a a Sign
or other Advertising Device
APR 18 2n
(APP lictioi to be filled out in ink or typewritten)
DEFT Or FY -: FEE PAGE.......... PLOT
NCR`!
Nortbamptorz, Mass., April 11, 2012
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device. or marquee.
sLSI.'.FSS NAME Rockridge Retirement Community
1. LOCATION, STREET and No 25137 Coles Meadow Road
2 O h mtme. Deaconess Abundant Life Communities
3. Owner's address 80 Deaconess Road, Concord, Massachusetts 01742 _
4. Maker's mule Northroad Wood Signs
5. Maker's addr- - 203 Old Revolutionary Rd., Temple, New Hampshire 03084
6. Erector's na„m Same
7. Erector's address______._ _ . - •—
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated X - non illuminated .
2. Will sign obstruct a bre escape, window or door? no Marquee
n /a f projecting
3. Lower edge will be t _ , ins. a th public way.
4. Upper edge will be._ i ... ins above the public way. Roof
5. H 6 .ft 4 mR, w i d th 5 uding posts) Temporary___—_
-- ._...— .._...
B Wan
6. Face are', 14 sq. ft. X
7. Inner edge will be n/a its from the building or pole. Ground
8. Outer edge will be n /a .. iris. from the building or pole- 4thar
9. Face of building or pole is n/a ins. back from the svt eat line.
r
10. Sign will p ro j ect n " a ire beyond the street line.
11. Sign, will extend_ n/a ft its. above the building or pole.
A luminum -clad MD4 Treated Timbers, PVC Trim,
12. Of what material will sign be constructed Frartib ¢ ac
$3 000 henolic impregnated N High Density
,
13_ intimate cost Polyurethane Foam ' / -
The undersigned certifies that the above statements are true to the \-
best of his knowledge and belief -.'
(Signature of Owner or Aleut)
NOTE: 7.n order that this application =ay - be - accepted, the dam railed for above must be set forth % daZib
CLEARLY and FILLY.
T 0 0 Oil 7.LZTLRSCT - 'FV4 LZ:RO Rnoz /7n, in
File # BP- 2012 -0899
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 _
Fee Paid
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 PJtESENTED:
Approved V 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: § 3.ro '7° ' CM�
Finding Special Permit L- 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
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 Iv1GL 40A. Contact Office of
Planning & Development for more information.