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17A-270 (2) THIS FORM IS PART OF THE SIGN PERMIT APPLICATION • File No. ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: "N\s - ( ca , Address: 3 (3 V\4(4j L- ' Sr 5p _i) ( Telephone("( \ 730C 13 4 0 2. Owner of Property: Sa Address: 3 (3 r r 5r 10 Z._j) Telephone: t( �� 7j,3 3. Status of ApplicannOwner Contract Purchaser Lessee Other(explain): 4. Job Location: \\,, � talc( ((Wei— Parcel ID: Zoning Map # Parcel # District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure /Property: — O c eiL,4 - 14'(-- op b 6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary) 7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans 8. Has a Special PermitNariance /Finding ever been issued for /on the site? NO DON'T KNOW 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 DONT KNOW YES IF YES: Has a permit been, or need to be, obtained from the Conservation Commission? Needs to be obtained 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 NO IF YES: Describe the size, type and location: Page 2 of 3 S P star �T r City of Northampton Massachusetts +,:� ':� 9.� i pl t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building p s i ' `, Northampton, MA 01060 V K. INSPECTOR MM Sign R Application for a Permit to Place or Maintain a Si Or other Advertising Device, or Marquee Q J (Application to be filled out in ink or typewritten) Number .4 1! ,1. d. . �.W Plans must be filed with the Bu" ••• •_.:.- ,:,:...: , � Erection ( ) before a permit will be granted. 0 E10/ i- D Alteration ( ) Repair ..( ) JUL � � " Repainting ( ) I � _ Removal ( ) DEPT. OF BUILDING ;NSF FEE PAGE /!,LOT ?O NORTHAMPTON, MA 01060 Northampton, Mass. 20 To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAMES 1.V 1. Location, Street and No. 1 v' L 4 '1 9M4-+ :ei. MUSS O(Q . 2. Owner's name .. t -t.S5.4 3. Owner's address .3 if.3 , iL- , -St' 51) G9. 4. Maker's name ....5 .( ...l 5. Maker's address r ‘:2„, ,'4..0.t1( o !� C 6. Erector's name e ..5. kct/t 7. Erector's address 50.. a-5 0e11e= SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated Non - illuminated 2. Will sign obstruct a fire escape, window or door? 04 O Marquee —3- Lower edge will be ft ins above the public way. Projecting -4-° tipper edge will be ft ins above the public way. Roof 5. Heightt...ft..l.4..ins Width ft.lLins Temporary... 6. Face area . JA �ssq. ft. Wall . ... . _ 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. o "E(2.'O _.-40: Sign will project ins beyond the street line. 4t Sign will extend ft ins above the building or pole. 12. Of what material will sign be constructed? Frame Face °? G ' 13. Estimated cost $...QQ ` u The undersigned certifies that the above statements are true to the best of his knowledge and belief. (Signature of Owner or Agent) Page 1 of 3 , File # BP- 2012 -0084 APPLICANT /CONTACT PERSON MAPLE HEIGHTS REALTY TRUST rZ©d•-11 ADDRESS/PHONE 313 MAPLE ST SPRINGFIELD (43) 732 -1343 0 PROPERTY LOCATION 110 OAK ST MAP 17A PARCEL 270 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out <5 V Fee Paid Typeof Construction: ERECT NON -ILLUM WALL SIGN - MAPLE HEIGHTS REALTY TRUST 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 INFO ION 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 moli ion Del 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. l■ • • City of Northampton Map 17A Lot270 Zone URB(100)/ Massachusetts Date issued 7/28/2011 0:00:00 Inspector of Buildings Permit # BP- 2012 -0084 Permit Fee$30.00 SIGN PERMIT Business MAPLE HEIGHTS REALTY TRUST Address 110 OAK ST Applicant Installer MAPLE HEIGHTS REALTY TRUST Applicant Installer Address Work Description ERECT NON -ILLUM WALL SIGN - MAPLE HEIGHTS REALTY TRUST Estimated Cost $300.00 Building Department Approval by: