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11. ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
12. This column to be filled in by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage
Front:
Setbacks:
Side: L: R: L: R:
Rear:
Building Height
Bldg Square
Footage
% Open Space:
(Lot area minus bldg 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 /ILE.
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
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INF@RMATION
1. Name of Ap licant: \.) R i t� ` q. 6.
111
Address: M q ` C' \ ' t Telephone: 413 2;•1553
2. Owner of Property: M(X&A(O An el to
� [[����� oto 4 5 1.3 18
Address: 12- 1.-4(1%( Q L.41, tick 422 Mk Telephone: 17 Sa
3. Status of Applicant: Owner Contract Purchaser Lessee
_Other(explain):
4. Job Location: C \Z 1 h .2-A--
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure / Property: Al WARCit'G t tltdtlia s Cln-lei 16.'r-.
6. Description of Propos d Use/Work /Project/Occupation: (Use additional sheets if nece ary) ,
1 � \ \ I1t ►NA T' a � ,� h
a
7. Attached Plans: Sketch Plan 17 Site Plan Engineered /Surveyed Plans
8. Has a Special PermitNariance/Finding ever been issued for /on the site? VYES NO DON'T KNOW IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW V YES
IF YES: Enter: Book Page and /or Document #
9. Does the site contain a brook, body of water or wetlands? NO t,/ 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 iss ed •
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 1/ NO
C7 I `
IF YES: Describe the size, type and location: ` ,
I b nod`) (ilk whit) (� ( PO Q <S)
al 4 , 2 KA 0 1 141 ovqr d. n
Page 2 of 3
City of Northampton
asr+aMNro S'. s
f Massachusetts 4 5ti
F.: * G
nF) . j W t dud st
! if p 1 DEPARTMENT OF BUILDING INSPECTIONS ?' a i i b
'r'
$
^' i, 212 Main Street • Municipal Building y.
yr.r Northampton, MA 01060 ,fry° ° ''
u Application for a Permit to Place or Maintain a Sign
INSPECTOR �� g ,,
Or other Advertising Device, or Marquee /J° jV y
(Application to be filled out in ink or typewritten) Number ..
Plans must be filed with the Building Inspector ,, Erection V
before a permit will be granted. _. - -_'. ' Alteration - ( )
Repair ( )
iAY 2 1 L010 Repainting ( )
Removal ( )
J FEE _ PAGE PLOT.......
iS
Northamp Mds. ..`?. ..gQ 20/0
To the Building Commissioner:
Application for a permit to place or aintain a sign or other advertising device, or marquee.
BUSINESS NAME v Q \`Z ,......... I,\k-i . 1J. e/A., ek ,
1. Location, Street and No C \ ........ . 91.1 f "y
2. Owner's name Mo00 ArliQU to
3. Owner's address 12• L a d s Slippei L1,1 L ( MA- 01(135
4. Maker's name MZ kA) Eil, . .. .Y} t .�.... jl-K
5. Maker's address ...... 6 a.., 4 , e.. \ ............: :.*
6. Erector's name 1 V e,. .....1.-- -'Irt.. t5:Y -1DI �J ` hs
7. Erector's address 6a% �.}., �-- "Q r'.
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated Non -illu I ated
2. Will sign obstruct a 're escape, window or door? . .� Marquee
3. Lower edge will be ..o.ft... above the public way. Projecting
4. Upper e .e will be 2 t..ft...(a..ins above the public way. Roof
5. Height ..ft. e.ins Width .. `.ft ins Temporary
6. Face area .A. `".sq. ft. Wall
7. Inner edge will be . ins from the building or pole. Ground
8. Outer edge will be ins f om the building or pole. Other
9. Face of building or pole isp,.V.ins back from the street line.
10. Sign will project ins beyond the street line.
11. Sign will extend ft""` - ' ins above the building oriNle. ; / r
12. Of what material will sign be constructed? Frame ...J.1..M..h.4l,Yr)... Face... fl1.14.117..41.A
13. Estimated cost $...
The undersigned certifies that the above statements are o t best o his nowle • - , n ® belief.
(Signature of Owner o • ` t)
li
Page 1 of 3
File # BP- 2010 -1047
APPLICANT /CONTACT PERSON NEW ENGLAND SIGNS INC
ADDRESS/PHONE 628 Center St CHICOPEE (413) 594 -2131
PROPERTY LOCATION 98 MAIN ST
MAP 32C PARCEL 015 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out r/
Fee Paid �? [o
Typeof Construction: ERECT WALL SIGN - VALLEY AYURVEDA
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 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
S - /z 7/ I c
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 Map 32C Lot015 Zone CB(10Q /
Massachusetts Date issued 6/2/2010 0:00:00
Inspector of Buildings Permit # BP -2010 -1047
Permit Fee$30.00
SIGN PERMIT
Business VALLEY AYURVEDA
Address 98 MAIN ST
Applicant Installer NEW ENGLAND SIGNS INC
Applicant Installer Address 628 Center St
Work Description ERECT WALL SIGN - VALLEY AYURVEDA
Estimated Cost $400.00
Building Department
Approval by: