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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 i 5
#of Loading Docks
,,,,e
Fill: (volume&location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
ATE: �'�' `�►PPLICANT'S SIGNATURE �f _-
V
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 3of3
4
.
Page 1 of 3
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
ame of Applicant: C.,l Z et v) Y \ ( v 1.-e__-
Address: ?4 ML .V1 \- ' CO■--1 01" Telephone: (41) $3t. l g SC
Owner of Property: ..S a CAL v 4N ‘1
Address: Telephone: 3) q,1 /�U Q 9
3. Status of Applicant: Owner Contract Purchaser "' Lessee
_Other(explain): C
Job Location: 1 S1✓X LQ CA; Ar ea
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
Existing Use of Structure/Property: +N QD QS0vM
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
0 4 f'YS ca. 0... -k, - e.
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 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 issued
10. o any signs exist on the property? YES "' NO
7
IF YES: Describe the size,type and location: a )c 3 \ \\,,,..,„..,41/4A--( 0(
w, - .\ 0-c \�\\SA.\4 CJ.\0 o,i e c•0o4'
Aere any proposed changes to,or additions of,signs intended for the property? YES/ NO
( e.,..Q cA,Lebt ES: Describe the size,type and location: �� C `"c�i^�i ANC( �'
D-1 Nurtilnmpto-u
t t ,+f .assnrtfusetts
. ' + ;l ` SEP 2 5 2013 s
DEPART NT OF BUILDING INSPECTIONS c.
21�
M.in Street • Municipal Building Ssfkr 3o\`‘�1
Electric,Plumbing&Gas Inspections orthampton, MA 01060
INSPECTOR nl;rt•a • ' on• •,o
so
•r a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee
BP-/// 7°2
(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. 20
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME ...O.frW. r.5iL .. 1 r -9
1. Location, Street and No. J \ f..VOA
2. Owner's name 7 & L. C b c
3. Owner's address 31* Mt \` \-0e-S "NC I/T-Vkt\ U0L1
4. Maker's name 'p prn/t1t' 600H1-3
5. Maker's address Q 10 O' ei ..fJ.l.,..!✓
6. Erector's name .P!2 4.-..C,;M4PNtk J
7. Erector's address(0 6Nt711-' .511 tT AST f1 J'"- MA
SIGN KIND OF SIGN
/ (Designate)
1. Sign will be(check one) illuminated ...V.. Non-illuminated
2. Will sign obstruct a fire escape, window or door? .140... Marquee
3. Lower edge will be ..7..ft.. ...ins above the public way. Projecting
4. Upper edge will be .(AA ins above the public way. Roof
5. Height .3..ft ins Width, :t.ft ins Temporary
6. Face area .:12...sq. ft. Wall
7. Inner edge will be .0...ins from the building or pole. Ground
8. Outer edge will be .10..ins from the building or pole. Other
9. Face of building or ole is Vt7..ins back from the street line.
10. Sign will project ...gins beyond the street line.
11. Sign will extend ...Q.ft ins above the building or pole. ii��
12. Of what material will sign be constructed? Frame ...Q�i,^I�.ikt f t
.... Face.. . GAl4'6Q tcf,'f`-
13. Estimated cost $.... 0.0
The undersigned certifies that the above statements are tr to the bes• his knowledge and belief.
(Signat re o Owner or Agent)
411
File#BP-2014-0372
APPLICANT/CONTACT PERSON COLE ELIZABETH J
ADDRESS/PHONE 34 MAIN RD WESTHAMPTON (413)531-7858 O
PROPERTY LOCATION 59 SERVICE CTR RD
MAP 32C PARCEL 133 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid Zig 3
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE ILLUM WALL SIGN-UNIVERSAL HEALTH&FITNESS
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:
L.A'pproved 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
CA- /
//2/k)
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 Lot133 Zone GB(100)/
Massachusetts Date issued 9/30/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0372
Permit Fee$30.00
SIGN PERMIT
Business UNIVERSAL HEALTH & FITNESS
Address 59 SERVICE CTR RD
Applicant InstallerCOLE ELIZABETH J
Applicant Installer Address
Work Description REPLACE ILLUM WALL SIGN - UNIVERSAL
HEALTH & FITNESS
Estimated Cost $900.00
Building Department
Approval by: