29-104 (3) �(11N I PT
r°asaa.oy N o.Of
Alteration.._...._____( )
Plans must be filed with the Building Inspector, Repair-__._ ( )
Repainting....-_-___.�( )
before a permit will be granted, Removal............
_...._.....( )
Application for a Permit to Place or Maintain a Sign
or other Advertising Device
(Application to be filled out in ink or typewritten)
FEE... .... PAGE....... PLOT.........
Northampton, Mass............... ...........
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME
r
1. LOCATION, STREET and No K(.
Z. Owner's name.. �V i
3. Owner's address-----_._......_...
4. Maker's name......
_...-...._.
5. Maker's address....._...._.........
._.
6. Erector's name..... _.
r�
7 Erector's address_.
SIGN KIND OF SIGN
1. Sign will be (check one) illurrunated..._._.... non-illuminated..... (Designate)
2. Will sign obstruct a fire escape, window or door?___...._.... Marquee..................................
3. Lower edge will be....._.._.__ ft Projecting_ __..._....._............_
_ __._ _....ms. above the public way.
4. Upper edge will be____..-........it ._._..._.....ins. above the public way.
Roof__.
5. Height_...._.._.....ft.._....... _.....ius. Width_............ ins. Temporary...__.........._............
6. Face area----_.._... sq. ft. Wall....._........._..._.......................
7. Inner edge will be__.____._ins from the building or pole. Ground__.........._._..._...._.........
8. Outer edge will be_..._...__._ins. from the building or pole. Other.............__......................
9. Face of'building or pole is_.._....__.ins. back from the street line.
10. Sign will project_ -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._._..._..._....___ ._..._.... Face_........._....._..._.
13. Estimate cost...............
The undersigned certifies that the above statements are true to the
best of his knowledge and belief. / J
%Signature of Owner or Agent)
NOTE: In order that this application may be accepted, the data called for above must be set forth
C'T.F.ART.V on,i -Pgrr.T.V
10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property/?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be filled in
by the Bui7Aing Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
Parking spaces
f %f Loading Docks
Fill:
':(vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
y,
is true and accurate to the best of my knowled e.
DATE: �,I -� �_ - ��:-
APPLICANT,s SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an appl nt' burden to comply with ��t
zoning requirements and obtain all required permits from rd of Health, Con$ervation..
Commission, Department of Publio Works and other applioa le permit granting authorities.-,
FILE I
OCT 2 File No.
/ q t
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: rCy�� lC c � �ICFi'n�� ��s. Telephone: ' liA,r �_. S � - r� 7t
2. Owner of Property:
e Cam^
P
Address: `��., ' C -: c-�-- Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): 77
4. Job Location: `�9c�is
Parcel Id: Zoning Map#�:�'L� Parcel# `r District(
(TO BE FILLED IN BY THE 6UILDING DEPARTMENT) tf
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Y CJ
f
7. Attached Plans: Sketch Plan 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 DON'T KNOW V 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 1/ 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)
FILE
!/�
V� 2
APPLICANT/CONTACT PERSON: G, / �12CAE
ADDRESS/PHONE:
PROPERTY L CATION: fit
MAP P CEL: ZONE It f�f
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Pnid
1Rjiildin2 Permit Filled nnt
Gam`'
New Cnnctrnrtinn
�U.
6 r
ArrPCCnry StrnctnrP
Rni_ ld na Plane Tnrinded-
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability_ Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservation Co mission
Gs
Signature of Buil bate
NOTE:Issuance of at zoning permit does not relieve an applicant's burden to oompty with all
zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other appiioable permit granting authorities. —
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