31B-281 (6) KeithBrickDesign 413.519.9390
EXISTING PROPOSED
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S['ECI.ALISTS
586 -5002 I
SINGLE FACE ,PAINTED 1/2" THICK PVC PANEL
Sign 4 ENTRANCE SIGN
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.
, s-
DATE: — <fi' / ) 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
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
• File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: `tit € VeSA IZU ()
Address: 1 c .s ()V L 1 C 5 r NOV1V Telephone: E(d
2. Owner of Property: C Ore-625S a U C- &-(c�1Q C ,
Address: 0 (!'t '-b' c ", NO (A-0 Telephone: 5Q - S Z
3. Status of Applicant: Owner Contract Purchaser XLessee
__Other(explain):
4. Job Location: OP OLsc31A, I,. G SZ
Parcel ID: Zoning Map # ? b Parcel # ? O ( District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property: 0111_ G( I -Q,C✓\ o r-1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
c Cot D C
7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans
8. Has a Special Permit/Variance /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 X 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
10. Do any signs exist on the property? YES y NO
IF YES: Describe the size, type and location: r vs + ci ' 0 V.
(s )/ v1.eN' / c () LA 01 v■
Are there any proposed changes to, or additions of, signs intended for the property? YES \kr NO
IF YES: Describe the size, type and location: e e 21... i
b �x 15 r1 V 1 `� 5 (c J G�S
Page 2 of 3
7 City of Northampton �(�y
.� �
Massachusetts
.
) L ' e ',1'1,` DEPARTIV:NT OF BUILDING INSPECTIONS 1
212 Main Street • Municipal Building ,ys, N.
:z4,.."';'. u Northampton, MA 01060 a{•
Application for a Permit to Place or Maintain a Si
INSPECTOR pp Sign
� g
Or other Advertising Device, or Marquee
(Application to be filled out in ink or • -wri ten) Number ,� P. / . 3.31/
Plans must be filed with the Building Inspector RECEIVED Erection (x )
before a permit will be granted. Alteration (
r SEP (7 IN Repair ( )
Repainting (
I. Removal (
—. of euiwi INSP
/01 FEE PAGE PLOT
Northampton, Mass. I k" 20. Z
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME l`+ qr 6 4 4 t0.7 ' .J ...lit 5 (U� J PAZ i Pcl t T
1 . Location, Street and No..... S - f s : : . rV 1 0 L 4 . k C — S te, l" O ( - 1 , ANI i Zi
2. Owner's name n;) lee- 1 t s S eU 9 q l . v'. v f
3. Owner's address ��- 5 t • ) 12 r- 4. t.' V'n'&'
4. Maker's name 1C,--k +-( l C LL D 5 , / w
5. Maker's address 9 -a , Mct ( ST . (/J j( (v A,/Lu 051 tJt44- 0 Lo
6. Erector's name l0
7. Erector's address
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated Non - illuminated ...
2. Will sign obstruct a fire escaape, window or door? . V.P. . Marquee
3. Lower edge will be. ins above the public way. Projecting
4. Upper edge will be -1 1t -Fins above the public way. Roof
5. Height .a:.ft.. Width ,?.`.ft. � e.ins Temporary
6. Face area ..� ft. Wall X
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 4 ins back from the street line.
10. Sign will project ...?.:ins beyond the street line.
11. Sign will extend ." ...ins above the building or .
12. Of what material will sign be constructed? Frame t°" e_- Face r C---
13. Estimated cost $ ..... ... `�
The undersigned certifies that the above statements are tr e to the best of his knowledge and belief.
t 1L c
(Signature of Owner or Agent)
Page 1 of 3
File # BP- 2013 -0311
APPLICANT /CONTACT PERSON KEITH BRICK DESIGN
ADDRESS/PHONE 9 EAST MAIN ST WILLIAMSBURG (413) 519 -9390 Q
PROPERTY LOCATION 86 MASONIC ST - 50 CENTER ST
MAP 31B PARCEL 281 001 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 `7 �� n
Fee Paid J✓
Typeof Construction: ERECT NON ILLUM WALL SIGN - NORTHAMPTON VISION SPECIALISTS
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
/?..A11
Signature of Building Official Date
g g
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 31B Lot281 Zone CB(100)/
Massachusetts Date issued 9/21/2012 0:00:00
Inspector of Buildings Permit # BP- 2013 -0311
Permit Fee$30.00
SIGN PERMIT
Business NORTHAMPTON VISION SPECIALISTS
Address 86 MASONIC ST - 50 CENTER ST
Applicant InstallerKEITH BRICK DESIGN
Applicant Installer Address 9 EAST MAIN ST
Work Description ERECT NON ILLUM WALL SIGN - NORTHAMPTON
VISION SPECIALISTS
Estimated Cost $375.00
Building Department
Approval by: