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VALLEY SWIM SCHOOL
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NORTHAMPTON, MASSACHUSETTS
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THE CAA SCHOOL FOR THE DEW
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SOALE: = 30'
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HER17'AGE SURI"EYS, INC.
.RE fS'7F PFD PFOFFSSIONAw LANiD SORVFYOP��
C0,14f0f HIGHWAY & CLARie c,7PFFT
POST 0FRcF sox
SOUTHAMPTON, MASSACHUSi;77S
413) 527-3650
LIN U
BLIC,
.........
TBM 3
Historic Round Hill Summit
Proposed new sign location&dimensions:
- Use existing sign location
- Use existing sign dimensions
- 4'x8'sign
- Right post (from driveway): 9.5'from main street curb, 9.5'from driveway curb
- Left post (from driveway): 13.5'from main street curb, 9.5' from driveway curb
Page 2 of 3
11. ALL INFORMATION MUST BE COMPLETED, 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: k 2io / 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: nL a, bi%,�'C 4 �5�-�`L A----,0:R s &ILL %uXw ,t L-L C_ ,
Address: 3 33 `L✓v\ 551RY °F- lJ. SeAtO °(`2L0 Telephone: I k,` 3 -at-k,
r.r"N ,a?
2. Owner of Property: yl_, -sc
Address: `rd Qoit-sn ttl[-L -"; 1,JaX91k,\^b Telephone: (4 _7,_7)L_Q
^_10k mL'V(FZ�,
3. Status of Applicant: V--'Owner Contract Purchaser Lessee
_Other(explain):
4. Job Location: t3 VS,
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: uc`11�t °•�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
7. Attached Plans: Sketch Plan Site Plan `e Engineered/Surveyed Plans
8. Has a Special PermitNariance/Finding ever been issued for/on the site?
NO Z"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 ✓en 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: Sew LA-0-
Are there any proposed changes to,or additions of,signs intended for the property? YES NO
IF YES: Describe the size,type and location:
_ �IRMg8Mr�1T8P�t8 ��� �
3 DEPARTMENT OF BUILDING INSPECTIONS
//�������� 212 Main Street • Municipal Building +art
is tYJ.7 Northampton, MA 01060
L__ , , Application for a Permit to Place or Maintain a Sign
Elects 11\�PEC�OR pp i
Or other Advertising Device, or Marquee
(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 ... ......r! q..,....1-l-C..................
1. Location, Street and No. ..............................................................................................
2. Owner's name ......"''?tx.........f�`? ...............................................................
!`=.L! 1...5' !Z�"t' ....t,�►`�?�...��°��NCrt�t�.!�J......... . chi 6'^�
3. Owner's address ...•���
4. Maker's name ..... .A........ .. ...... ...............
5. Maker's address ....7..1e................ .......i-.-ND••••
6. Erector's name ..........................................................................................................
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 Wit...O.Jns above the public way. Projecting ..............
4. Upper ed�9 a will be ..`(..ft....c"�Jns above the public way. Roof .....................
5. Height .Y.Jt.C�Jns Width .`:{..ft..D.ins Temporary.............
6. Face area J.e.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.
12. Of what material will sign be constructed? Frame ....... Face... !Z.....
13. Estimated cost $..../,�.� .:......
The undersigned certifies that the above statements are true to the best of his knowledge and belief.
.. ..............................
(Signat e of Owner or Agent)
File#BP-2016-0220
APPLICANT/CONTACT PERSON HEBERT MAX
ADDRESS/PHONE 333 ELM ST WEST SPRINGFIELD01089(413) 896-3018 Q
PROPERTY LOCATION 46 ROUND HILL RD
MAP 31 B PARCEL 004 001 ZONE URCaQU
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid r .,-
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE GROUND SIGN-HISTORIC ROUND HILL SUMMIT
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 ,V 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: § 3 4O — T' Z- C � ` ro,
Finding Special Permit h 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
vzp,ermit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
Signature of Building Of icial 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.