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18D-055 (6) _ _ M' ' f '.,.. . «,.w 5ww rte-•=- 1 • 1 , • si.unaurW 1t.rnnuNINM l 59175/785 11b 14N1 - ~ Slav 1VItavw a3xlw r,A �/ nsIi f ni f Ndlllzv89 .... , ____ ..___ _ _____ ir ----- "BEEP . , I . , k W 1 ., , I rna, +I J eI 1 i • r 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: ! V C( is APPLICANT'S SIGNATURE t ' 0 �1 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: 74(r� qs Gaff Address: Pi T I 4 J4 EQ � Sg1Ly/01/1 4 Telephone: 1 -1/ 7 S ( 5 . R' /// 2. Owner of Property: f{G-f/141 Yy P% - r e Address: / 8 . o r ex etifO 1811 G�sI1,44t- ,,Telephone: / / 2 S� ? — 15 - T © 3. Status of Applicant: Owner �/ Contract Purchaser V Lessee Other(explain): /� 4. Job Location: /F").."2— 4 e " . 0 / 1 bet Parcel ID: Zoning Map # Parcel # District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure /Property: 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 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 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 Titq of NnrtI imphun r ,ter assattjusitts ,." r � , C, ' * r; DEPARTMENT OF BUILDING INSPECTIONS `� a`+ 212 Main Street • Municipal Building te ,, 4 Northampton, MA 01060 Irry 1 ->‘. INi'i,c'r0R Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee 4( p i 3 ygs (Application to be filled out in ink or typewritten) Number/v Plans must be filed with the Building Inspector Erection ( ) before a permit will be granted. Alteration ( ) Repair ( ) Repainting ( ) Removal ( ) FEE PAGE PLOT Northampton, Mass. 20 To the Building Commissioner: Application for a permit to place or maintain a sign or other advertisin device, or marquee. BUSINESS NAME ka Hi 41 oK Q.<. .a1 ki 1. Location, Street and No....! 37- 4 Al:cR."1. ,l d.� .... 2. Owner's name .....ha.rw.t . C. / �Q e 3. Owner's address ......y... !k . t .... f"G,-e �. ‘7 4.1 e.27 It .. Ai :ft 4. Maker's name f V 17 1.ci" �� iki libl 5 5. Maker's address �I � ! r 6. Erector's name .... 4.{{er (e, 7. Erector's address SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated Non - illuminated .. 2. Will sign obstruct a fire escape, window or door? . Marquee 3. Lower edge will be ft ins above the public way. Projecting 4. Upper edge will be ft .ins above the public way. Roof 5. Height ft.30.ins Width (.0 ft ins Temporary 6. Face area Z.5 .sq. ft. Wall 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 ins back from the street line. 10. Sign will project ins beyond the street line. 11. Sign will extend ft ins above the building or pole. Pi 45 r, 12. Of what material will sign be constructed? Frame Face 13. Estimated cost $ 4 /00 The undersigned certifies that the above statements are true o he best of his k wledge and belief. (Signature of Own o Agent) Page 1 of 3 . ,m,),„2.cQ ( / / I Z t , City of Northampton Map 18D Lot055 Zone GB(100) /URA(0)/ Massachusetts Date issued 10/9/2012 0:00:00 Inspector of Buildings Permit # BP- 2013 -0395 Permit Fee$30.00 SIGN PERMIT Business TEAMLINK NORTHAMPTON — BRAZILIAN JIU JITSU Address 137 DAMON RD Applicant InstallerGOMES THOMAS Applicant Installer Address Work Description ERECT FRONT ROOF SIGN - BRAZILIAN JIU JITSU Estimated Cost $400.00 Building Department Approval by: