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11. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
12. This oolum to be filled in by
the Building
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. A
DATE: ` � a -K APPLICANT'S SIGNATURE — 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 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 f- 61 I
1. Name of Applicant: II �S - iM A LLQ �4 A ��'r� � �`�9+fa�rl��a''� MA '
Address: �U 1' cX� Pje � S(, Telephone: q13- 5-250( - `tq/7
2. Owner of Property: l ma l 1 ootitk
Address: GeA; M,'ti (21 lvtofvv1-� /� e phone: 6,03 - 0421— DG O
3. Status of Applicant:XOwner Contract Purchaser Lessee
_Other(explain):
4. Job Location: 0
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: �e 11 16 l t�nW�l-e (�I�ydv Cki
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
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 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/4 NO 1
IF YES: Describe the size,type and location: 6�e Le-L,
Are there any proposed changes to, or additions of,signs intended for the property? YES NO
IF YES: Describe the size,type and location:
D
Qt of Northampton
51s R. s�G
iiC,Fiumpm9 MA 01
Massachusetts
orthampto c
Y f1 UJ,
DA PA/ TMiVtT OR SU/ZO/NG /NSPFCNONS
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
(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.....................(XV)
Repainting...............( )
Removal..................( )
FEE........PAGE........PLOT.......
r�
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 ...4..J.....—.j..J OA...i.LLC
I.............................................................................
1. Location, Street and No. .......7 �1. �A
2. Owner's name .........AIfrQ��...4.t?nt.&.4e.......................................................................
?, tmi�k 2� AJIWfdyl- Aj N Q37 3
3. Owner's address . .......... ........d ............................ ......f................................
4. Maker's name .....°.�L� ...�? '(s'
... .................................................................
5. Maker's address ..1k...C..`�. ,, exc.,... ......4Q a
. . .. ....................................................
6. Erector's name ......e�?-..MA LLL
.
.. ......... ........../......N OV
.............................
f./f I d Qw�? ................................
7. Erector's address ..... �... . ..�I
....S. . ........... ........................................
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated ....... Non-illuminated .. ..
2. Will sign obstruct a fire escap,e, window or door? ..N.O... Marquee ...............
3. Lower edge will be ......ft...��"ins above the public way. Projecting ..............
4. Upper edge will be ......ft.fl$..ins above the public way. Roof .....................
5. Height ......ft.. . .ins Width ......ft.Wins Temporary.............
6. Face area .j. ..sq. ft. Wall .....................
7. Inner edge will be ...k..ins from the building or pole. Per
8. Outer edge will be ...r...ins from the building or pole. ~'�'"^�
9. Face of building or pole is 11.0.ins back from the street line.
10. Sign will project . .ins beyond the street line.
11. Sign will extend ..`&.ft .. Sins above the building or pole.
12. Of what material will sign be constructed? Frame ;AkkVMA1J.A.k Face.....L.'`...............
13. Estimated cost $.... &.10.....
The undersigned certifies that the above statements are true t the be of his kn wledge and belief.
S re f Owner or Agent)
File# BP-2016-0239
APPLICANT/CONTACT PERSON CS-MA LLC
ADDRESS/PHONE 2420 BOSTON RD WILBRAHAM01095
PROPERTY LOCATION 40 HATFIELD ST
MAP 17D PARCEL 032 001 ZONE URB(100)/WP(2)/
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: REPLACE GROUND SIGN PANEL-CONSTRUCTION SERVICE_
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildina Plans Included• —
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF RMATION 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
?bb
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 17D Lot032 Zone
URB(100)/WP(2)/
Massachusetts Date issued 9/9/2015 0:00:00
Inspector of Buildings Permit # BP-2016-0239
Permit Fee$100.00
SIGN PERMIT
Business CONSTRUCTION SERVICE
Address 40 HATFIELD ST
Applicant InstallerCS-MA LLC
Applicant Installer Address
Work Description REPLACE GROUND SIGN PANEL - CONSTRUCTION
SERVICE
Estimated Cost $15000.00
Building Department
Approval bv: