22B-041 (21) City of Northampton Map 22B Lot041 Zone NB(100)/
Massachusetts Date issued 5/16/2016 0:00:00
Inspector of Buildings Permit # BP-2016-1316
Permit Fee$60.00
SIGN PERMIT
Business ASCENDANCE INNER WORLD ARTS
Address 176 PINE ST - ASCENDANCE INNER WORLD ARTS
Applicant InstallerBOYD DYLAN
Applicant Installer Address 192 PINE ST FLORENCE
Work Description INSTALL ILLUM WALL SIGN - ASCENDANCE
INNER WORLD ARTS
Estimated Cost $7000.00
Building Department
Approval by:
File#BP-2016-1316
APPLICANT/CONTACT PERSON BOYD DYLAN
ADDRESS/PHONE 192 PINE ST FLORENCE01062(617)767-1757 Q
PROPERTY LOCATION 176 PINE ST-ASCENDANCE INNER WORLD ARTS
MAP 22B PARCEL 041 001 ZONE NB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid ITYT V(40
Building Permit Filled out
Fee Paid Lr1
Tyneof Construction:_INSTALL ILLUM WALL SIGN-ASCENDANCE INNER WOR*9 ARTS
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
INFQRMATION PRESENTED:
/Approved 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: §_
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 l 71
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.
- City of Northampton
R� ���' _ j Massachusetts
�� . .
ZWEUT OF BDIt+DING INSPECTIONS
r 12 Main Street • Municipal Building 'b
Northampton, MA 01060 ay1
INSPECTO Appligation € r Permit.to Place.or Maintain a-Sign
DEPT.OFBUV
NORvertlsing Device, or Marquee
(Application to be filled out in ink or typewritten) Number .....................
Plans must be filed with the Building Inspector Erection..................( )
before a permit will be granted. Alteration.................( )
Repair................... .( )
Repainting...............( )
4zernovaL.................( )
FEE........PAGE........PLOT.......
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 ......!::Se �N"-,e- W ot-L'> �� u,(,
...........................................................>.....................
i� �X12 �wu - Et.0 wu IV- U t o(,"L
Location, et and No. ................. ............ .. ......................
................................
2. Owner's name .....P\ ...?i.
3. Owners address ��ti o4i...C,6Lr " 1�� l-�uv�t~K ��- NA oto 5U
' ...... ........... .,..............6. ..........................................
4. Maker's name .............................................................................................................
5. Wiaker's address ..........................................................................................................
6. Erector's name ..........................................................................................................
7. Erector's address .......................................................................................................
SIGN KIND OF SIGN
(Qesia�
1. Skp wA be(check one)Xan ed ..�.. Abra,i�ed.......
2. Will sign obstruct a fire escape, window or door? ... Marquee ...............
3. Lower edge will be .l:'t.ft... ?..ins above the public way. Projecting ..............
4. Upper edge will be .J.5.ft....6 :ins above the public way. Roof .....................
5. Height .. .ft.:3mins Width .2�ft. ..ins Temporary
6. Face area q. ft. Wall . .,?.4...........
7. Inner edge will be .:2 .ins from the building or pole. Ground ................
8. Outer edge will be ..(o...ins from the building or pole. Other ...................
9. Face of building or pore is .......ins back from the street line.
10. Sign will project A..ins beyond the street line.
11. Sign will extend ..PA .R.-ins above the building or pol`e..
12. Of what material will sign be constructed? Frame '1 ...... Face....���! `..s S
13. Estimated cost $.....�tj1?........
The undersigned certifies that the above statements are tr=to the t of his knowledge nd belief.
. . . . .... ........
(Sign t re of Owner or Agent)
Page 1 of 3
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
1. NaM of AAOC-aa IVIOL" WcW Avnp i,,L-(-
I(I Z
Address: W 60 Telephone: 6
2. Owner of Property; PQV" Fr'w%�j L C
Address: P6 XJL-Stf�ttll VXA- 016RPTelephone: `10-, 3-7-3 - S/54�-
3. Status of Applicant—Owner Contract Purchaser Lessee
__Other(explain):
i q
4. Job Location: G 5`
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: \Joj-ctk-�
6. Description of Proposed Use/Work/Project/Occupation:(Use additional sheets if necessary)
7. Attached Plans: Sketch Plan Site Man —Ermineeft-dfSwveyed Piwis
8. Has a Special Permit/Variance/Finding ever been Issued for/on the site?
NO DONT KNOW 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_I)L DONT KNOW YES
IF YES: Has a permit been,or need to be,obtained from the Conservation Commission?
Needs tobe obtaineO_ Obtained Date issued
10. Do any signs exist on the property? YES NO
IF YES: Describe the size,type and location:
Are there any proposed changes to,or additions of,signs intended for the property?' YES P40—Y
IF YES: Describe the size,type and location:
PaVe 2 of 3
11. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
12. This column to be filed to by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage to 2,,c S
Front:
Setbacks:
Side: L: R• L: R:
Rear:
Building+ieight 1 i
Bldg Square
Footage
%opea Space:
(int aea•rnir"Wg 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: 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
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