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Page 2 of 3
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
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
Page 1 of 3
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
P C
1. Name of Applicant:
C `� �3 (� (}c is .
r_,
Address: l X . Ic'\3 Telephone: L)i? i3 - 5 I t
2. Owner of Property:_ 0/i ) el.fe,si8lry4k. P,), LL.
Address: lc.5:; k-' yk /Cx ACY%,,'c n, tf� c■C'Gi Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
/Other(explain): tn`5\(-MP.
4. Job Location: a3 f c..s;C.m05C1
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)
•nOe cs.j,(kPc non 1\omcy---,‘43A ricouc &c -\ J7 \-1Th
�flnC l4
6,(0(C kte v C) per- c3'c;k-
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:
fiD crA 1( .3 CP
is -9 2013
oaCNAMPTD.. V t of Wort1 amptnn
Electric, fu rr -,/ !„ ,Y,k" ,,s 2S�.... sic,,
e
j A`
f!,.. i /4 DEPARTMENT OF BUILDING INSPECTIONS 1.,I`
212 Main street • Municipal Building ssN1' N1N
Northampton, MA 01060
l\.--l'IC''rOi; Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee ip � %./�
(Application to be filled out in ink or typewritten) Number .
Plans must be filed with the Building Inspector Erection ( ✓)
before a permit will be granted. Alteration ( )
Repair ( )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. 'J3/ i 2 20
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME K10% VhCA )P3.0:1.../...I.-.(.1.11...7w 3 .tnCt`....t e..f11.tPC
1. Location, Street and No c c2.....A\t.c ....4Jr:NE„
2. Owner's name .. CS X bc.!t.t...i ret,v ceAS 1`4,∎1;IA P_4'LIs, (.-L-`
3. Owner's address L43 5:I\' c 3\-...I..00, .:.fie A cQ c m. •l"lfl o.iC>Gk...
4. Maker's name jt"•C.A*1 5,E3>7 Cc>...NM-
.av ~ :. . �c.1ca35....Jp-: >`1(�.(Nloi- P55
5. Maker's address .:. a.ts,.C�i.. � . ..� . �l;.l`c�...,.Qld.,... ..
6. Erector's name . _ `SY�.v._S'rr f7 C-c. tS1C• _ - , v
laa..t �I�+CJCt.} c:)...3A.:.. &yC.�Q`J-5... i,"1s .48,.HA.cuoi-lo``35
7. Erector's address .. U
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one) illuminated Non-illuminated ...L.
2. Will sign obstruct a fire escape, window or door? ..14.0... Marquee
3. Lower edge will be ft ins above the public way. Projecting
4. Upper edge will be ft ins aboyv the public way. Roof
5. Height ft., tins Width ft lr ins Temporary
6. Face area ..)...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 ..I.$.!•frs back from the street line.
10. Sign will project 0 ins beyond the street line.
11. Sign will extend ft Li ins above the building or pole.
12. Of what material will sign be constructed? Frame ... • Face..O\cX'h•
13. Estimated cost $..(g) -.CZ...
The undersigned certifies that the above statements are true to the best of his knowledge and belief.
itev."69 -II,IA\%-3
nature of Owner or Agent)
c: 1 it 5
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(t 1 1"ts r.,,,pk. 1.' cit"“is 04
ii20.1-- i•j.,,,,_,
City of Northampton Map 39 Lot060 Zone
Massachusetts Date issued 7/16/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0012
Permit Fee$30.00
SIGN PERMIT
Business NORTHAMPTON/ I 91 PROFESSIONAL CARE
Address 22 ATWOOD DR
Applicant InstallerAGNOLI SIGN CO INC
Applicant Installer Address P 0 BOX 1055
Work Description ERECT ILLUM GROUND SIGN W/TENANT
DIRECTORY - NORTHAMPTON/I91 PROFESSIONAL CARE
Estimated Cost $6500.00
Building Department
Approval by: