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24B-089 (2) 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 ac rate to the best of my knowledge. � f ATE: C 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 1. Name of Applicant: k '(-6, B u C—c—e 1 Address: Telephone: 2. Owner of Property: �- Address: Telephone: 3. Status of Applicant:,Owner _Contract Purchaser _Lessee ,Other(explain): 4. Job Location: Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: g!4_-Aj-ajr ,— _ 6. Description of Proposed Use/WorklProjecUOccupation:(Use additional sheets if necessary) 'g::S'&yj L 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 V NO / T IF YES: Describe the size,type and location: (7 i Vl l 0 �c Are there any proposed changes to,or additions of,signs intended for the property? YES V NO IF YES: Describe the size,type and location: D 1101" '2 le V E6 4n P14 L4t__R l �'J L . 2 9 2015 4� � ���,;��;'-�:� �Ulttssarffusrtts •� ctions t DEPARTMENT OF BUILDING INSPECTIONS 212 Main street • Municipal Building Northampton, MA 01060 INSPECTOR Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee 1.7 (Application to be Oiled out in Ink or typewritten) Number . Plans must be fled with the Buildina inspector Erection..................( ) before a permit will be aranted 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. .�.IA. z ..� 51 ..Kv.V!n ............ BUSINESS NAME �,}{..�:.�° .�:,'.�.•••• '" //__ 4 1. Location, Street and No. ........,... .1;l I AC) l7 6., . .......................... .� ...?........................................ 2. Owner's name ....... �.:�•.o�.......�...... 3. Owner's address ...... .......API.................. r7t7 4. Maker's name ..... .. . ......L.. .� rl�....... j.. .. ...:. �-r�- .°................... 5. Maker's address ....... .......' ......)A.-..w.\(....... t l l �►� C�t�3�e l f 6. Erector's name ......�,.%.' ...•.... . .. . ..L"t................................................ r 7. Erector's address ......... ......................................................................... SIGN KIND OF SIGN • / (Designate) 1. Sign will be(check one)illuminated ..Y.. Non-illuminated ....... 2. Will sign obstruct a fire esc pe,window or door? .../vP Marquee ............... 3. Lower edge will be .7 .ft.... ins above the public way. Projecting .............. 4. Upper edge will be �..'�� .ft.... ..ins above the public way. Roof..................... 5. Height .5..ft...1-r:ins Width .-.7..ft..(a.ins Temporary............. 6. Face area�.J.sq.ft Wall ..................... 7. Inner edge will be .✓IJJ\ins from the building or pole. Ground .....)- ........ 8. Outer edge will be :i.E.ins from the building or pole. Other ................... 9. Face of building or pole is 3k"Tns back from the street line. 3Z FT 10. Sign will project .Z...ins beyond the street line. 11. Sign will extend ..Q..ft .......ins above the building or pole- 12. Of what material will sign be constructed? Frame .... (.5}tIVV k Face....G^.E7KJwA 13. Estimated cost $... .j.O:M--0•• The undersigned certifies that the above statements are true to the best is knowledge and belief. (Signature of Owner or Agent) PON- File#BP-2016-0107 APPLICANT/CONTACT PERSON CHEN HAO ADDRESS/PHONE 261 KING ST NORTHAMPTON01060 PROPERTY LOCATION 261 KING ST-SAKURA/VEGAN PALATE MAP 24B PARCEL 089 001 ZONE HB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ADD NAME TO EXISTING GROUND SIGN-VEGAN PALATE 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: 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 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 24B Lot089 Zone HB(100)/ Massachusetts Date issued 8/11/2015 0:00:00 Inspector of Buildings Permit # BP-2016-0107 Permit Fee$100.00 SIGN PERMIT Business SAKURANEGAN PALATE Address 261 KING ST - SAKURA/VEGAN PALATE Applicant InstallerCHEN HAO Applicant Installer Address Work Description ADD NAME TO EXISTING GROUND SIGN - VEGAN PALATE Estimated Cost $2000.00 Building Department Approval by: