24B-046 (16) t
1
I
pp
lz , p c
29
t
n,.
3 tip{ } tj
gj
Al
3 3.
f
t t 1 r !
y�1
al.
e
3 ;14
I {
f
im
ic
9� {I
age
Y$ r}
rr
N yr
Y k
4�Rt _
p
NC, sc�. FT.
S2- 516-ly 56k. FT-.
G�.I i p I e-mp 1?C aG-f zU 11 n 1 A!a �---�!
10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location: - i_ TT-
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location: C 4 C v T -®v T' Le TTC 2 5. rC)
a [-- 13Zr;l-PIlvG- - 5 e G ArTAc4o5 n 5le- E 7-c.4-
ZZ. ALL XNFORMATION MUST BE COMPLETED, or PERITIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Tlsis colam¢ to bs fiZ3ad it
by the I Ba13.d ag D=A=±�—t
Required l
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R�
- rear
Building height
Bldg Square footage
%Open Space:
O area Minus bidg
&Pared Paz*il2gi
# of Parking spaces
f of Loading Docks
Fill:
{voZ-ume-& location)
Z3 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowZed
DA'Z'E: � O q APPLICANT's SIGN�.TU
NOTE: lssusnoe a a'zoning permit does not relieve a appliomnrm bear en to ¢iy �:tf iii
zoning requirements and obtain all required permits from the Board of Health, 0ohServtstion
Commission. Department of iPubno Works and other applioable permit granting ac:thoritCoa.
FILE IF
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
r ZONING PERMIT APPLICATION (§10 .
PLEASE =Z OR P=T ALL DTFOP—MAT10Y
1. Name of Applicant:
Address: 54 Gc/L 5T 5T. iv,
Y
2. Owner of Property: �C 2 r2 12� fv D`1 1'✓1 S 5% 2
Address: Telephoner U�
3. Status of Applicant: Owner Contract Purchaser Lessee
"Other(explain): kytiCrL
4. Job Location: °I (+(LL-01V
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property_13(15/AIC-5 5 /j,5 ✓ 6;rArl
5. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if.necessary):
_ l�-T°7'✓�C'r� C v T—D v T �L=TTG2 S ?'U ?"l�� �/LO�rU f�/3 f//L/�/if/�
Sa✓C— ��-r i�4-L't-� S(GET�/�
7. Attached Plans: Sketch Plan Site Plan. Engineered/Surveyed Plans
Answers lathe following 2 questions may be obtained by checking with the Suflding Dept or Planning Department Files.
8. Has a Special PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOIAI 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 KN01/+! YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON 0 i HER SIDS
No.,11TAte)
y
Erection
Alteration—( )
'Plans must be filed with the Building Inspector, Repair ( )
Repainting ( )
before a permit will be granted, 1 11, Remova—
A—
Application for a Permit to .Place or Maintain a Sign
g
or other Advertising Device
(Application to be filled out in ink or typewritten)
FEE.......... PAGE............... PLOT..........
Northampton, Mass.,_4 �0_�_
To the Building Commissioner:
Application for a permit to place or maintain a sign or/other advertising device, or marquee.
BUSINESS NAME.. .... Cr�!vr�I�.l"`'..�. �'................
1. LOCATION, STREET and No. C ✓-1 2 L-0/L/ 2 V
2.- Owner's name f E 2 tE K LTv o K I'1't S S i IF tZ
3. Owner's addres___ r � �
4. Maker's name 12 K tG 13(/S 144-`1 S ( Cr.v S
5. Maker's address W C—sr S7 we--5? /j 4 rFl C<_Q rn V4 O to ff
6. Erector's name---!Z(C IL US 1-1 e'-( S/C/tI�5
7. Erector's address SE-Y W C=ST ST,
(;(,�� T/��7 T1�/C �-/�;�'Y!✓� �l�
SIGN / KIND OF SIGN
1. Sign will be (check one.) illuminated non-illuminated §/J (Designate)
2. Will sign obstruct a fire escape, window or door? NO Marquee
3. Lower edge will be 2- ft. I ins.above the public way. Projecting
4. Upper edge will be.�ft. '_..ins.above the public way. Roof_
5. Height.. .funs. Width_ft__4r_ins. Temporary//
6. Face are i .S q ft Wa1L.1G�� _.
7. Inner edge will be_ 6 in from the building or pole. Ground
8. Outer edge will.be 2" in from the building or pole_ Other_
9. Face of building or pole is L. back from the street line.
10. Sign will proj eci .ins.beyond the street line.
11. Sign will extend__w_Q_ft. Ca _.ins.above the building or pole.
12. Of what material will sign be constructed? Frame 4614 5LLC.._._ Face PZ-1 Sr/C
13. Estimate cost...............
The undersigned certifies that the above statements are true t the
best of his knowledge and belief.
(Signature of Owner or ;ent7
-NOTE:-In orderthat th.is application maybe accepted; the data called for above must be set forth ?-
.___._ PAyjs.SAOP
-- ---------_.—_---_ -----_.._ ,
File#BP-2009-0829
APPLICANT/CONTACT PERSON RICK BUSHEY SIGNS
ADDRESS/PHONE 54 WEST ST WEST HATFIELD (413)247-0182
PROPERTY LOCA'T'ION 39 CARLON DR
MAP 24B PARCEL 046 001 ZONE HB(l00)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TyReof Construction: ERECT NON-ILLUM WALL SIGN WELLNESS CENTER
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 AC ION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION FOLLOWING
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 (,lam an
ZONING BOARD PERMIT REQUIRED UNDER: § -�,t & ° '
Finding Special Permit Variance* 'oek ; 1 F
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
z 9
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.