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05-001 (2) City of Northampton Massachusetts Date issued 7/17/2009 0:00:00 Inspector of Buildings Permit # BP- 2010 -0038 Permit Fee$30.00 SIGN PERMIT Business THE OVERLOOK HEALTH CENTER AT NORTHAMPTON Applicant Installer NORTHROAD WOOD SIGNS Applicant Installer Address 203 OLD REVOLUTIOARY ROAD Work Description INSTALL GROUND SIGN 22 SO FT - THE OVERLOOK HEALTH CENTER AT NORTHAMPTON Estimated Cost $6000.00 Building Department Approval by: r � File # BP- 2010 -0038 APPLICANT /CONTACT PERSON HAMPSHIRE COUNTY LTC FACILITY ADDRESS/PHONE RIVER RD LEEDS PROPERTY LOCATION RIVER RD MAP 05 PARCEL 001 001 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: INSTALL GROUND SIGN 22 SO FT 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 INF ATION 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 z0 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. No r Plans ) ans must be filed with the Building Inspector, Repair- Repainting ( ) before a permit will be granted, Remov ) crlwftlj'C�,, Application for a Permit to Place or Maintain - a Sign or. other Advertising Device (Application to be filled out in inlr or written) PAGE.......... PLOT .......... Northampton, Mass. � 19 To the Building Commissioner: Application for a permit to place or main a sign o�r1 other advertising 4evice, or marquee. BUS1NlrSS NAME..l. 6' R, !G,K . F-, G� .4..�' T.IL � � 1. LOC kTION, STREET and No. --- 4L z- R1 y"a r'C y _ ... .._ .-. 2. Owner's nam oI G ft L 54'S 3. Owner's addr ; �'L /� OA G 4. Maker's uamP ti�9 5. Maker's addr 2-4 till) & ✓o ilneff 6. Erector's name 7. Erector's addr -- SIGN KIND OF SIGN (pftignate ) 1. Sign will be (check one) illuminate - - - - -- -n on ill ted j 2. Will sign obstruct a fire escape, window or door? Projecting S. Lower edge will be at. ins above the public way. 1'r ecti 4. Upper edg will b ____ _»izs. above the public way. Roof S. Height y� ft ;,,.. Wid th �- � --l�s T emporary ._"._._..'..._ 6. Face area ft. Wa 7. Inner edge will b +ra from the building or pole. Ground.—..... g p 1r� from the building or pole- S. Outer edg will. b g Oth 9. Face of building or le C ins back from the street line. 10. Sign, will prof ins. beyond the sheet line. 11. Sign, will exten ft ��' ice above the building or pole. e- 12. Of what mateAal will sign be constructed? Frain UAf1,Yv1 ^ Face_:. � _ 13. Estimate cost..�/A The undersigned certifies that the above stat is are a A e best of his knowledge and belief; 7._ (S n re of Owner or Agent) NOTE: orderthatthis application =ay be' "accepted; the data called for above must be set forth � o CLEARLY and FULLY, TOOZ ZLZTL92CTV %Vd LZ :60 600Z /ZO /LO THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. Z ONING PERMIT APPLICA.T r0N (S10.2) P LEASE TYPE .OR PP= ALL =ORMArroN 1. Name of Applicant 7 Address: L� 3 oLl) a ��yOt. ✓�7 aH f !� : - Teleph`on 2. Owner of Property: Address: U� /t'��Soi�' iC- /t� f . 1�ft't Tti� Telephone: 5 �3 T� 3.. Status of Applicant: Owner Contract Purchaser Lessee ,Other (explain): 4. Job Location: 2- 7 z— _j) . Parcel Id: Zoning Map# Parcel# 9 District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Frosting Use of Structure/Property 6. Description of Proposed Use /WorklProject/Occupation: (Use additional sheets if necessary): 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 Deparnnent Files, 8. Has a Special Permf /Vadance/Finding ever been issued for/on the site? NO DONT KNOW 'c YES 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 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) Z000 ZLZTLSSCTV %Va L9:60 60OZ /Zo /LO i 10, Do any signs east on the property? YES NO IF YES, describe sae, type and location: l �i �'fr T A F E t C ' /2 Are there any proposed changes to or Wfflons of signs intended for the property/? YES NO 7� IF YES, describe size, type and location: 11. ALL INFORKATIOX MUST BB COMPLETED, or pM TT CAN ' BE DEFIED DUX TO LACK OF =ORHMXOX . alts mz� to �. fiZZ.�d ,� �' �' Peel yw�f w 9 DspasGmeat Required I Existing Proposed, By Zoning Lot size Frontage Setbacks fmat - side L: Et :� L: R: • rear Bullding height Bldg Square fpotage QAOpen Space: '.(Lot area minus bldg zpavod parkSng) # of tpar' idng spaces # of .Loading Docks Fill: Z vo1 - & 30cation) 13. Certification: S hereby certify that the In f naatiis coata:iniid herein is 'true and accurate to the best of y- brio ed j ©m MWE: �-c'C 1r.P�'LICANT's SIGNp RE NOTES 01- at d'son ng permit doe* hot relieve ah app opnYa burden to comply eolith ail zgning ressgc+lretreants and obtain all required parmltm ftam tha Board of •kealth. ConmervotiOn Commisslon. Dapartneent atPubtlo - WO - i'Uw - and*"o- ier'appiloablo permit granting mutharitiaa. ..- - •-- - - ..................... --- --• - FILE . # £OOIn ZLZTL92£T6 %V3 LZ :60 600Z /ZO /LO n C) N N ' U W OB ,, r.r 000 b O O O y ! UUU . U n O • Cj x �.. W, y o • R io US "s �! � f r✓ v Nrn - n CN W - h iwX� x ; �J-- b O 0) (M(00) - O U � n 3 N c •'" c0 H Co ca O ° 'a a r c ( J) cu O U \ O� c C ( D Cn w Cu ...U�cv o V c am 0" SSE � =Oo W mccuaU)o ���.��� Ca � > >cuoma) ' O�O�n.mcn Filc: Datc: Northroad Wood Signs &, Sign Graphics Drawn for: 203 Old Revolutionary Road, Temple, New Hampshire 03084 Copyright 2009 Northroad Wood Signs. This design is the property of Approved by: Datc: Northroad Signs. It may not be copied or distributed without permission. O w i a v s o� v s 4i w w y r� F g¢Wi S xµ�(v P � r ad AW .* OP w e ,v , Filc: Datc: Northroad Wood Signs Sign Graphics Drawn f o r: 203 Old Revolutionary Road, Temple, New Hampshire 03084 Copyright 2009 Northroad Wood Signs. This design is the property of pprovC y: atC: Northroad Signs. It may not he copied or distrihutcd without permission.