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18-004 (3) f , II I �I �, �. �2 \ \ » . ' \\ . . . � . � 7 < . � i r- I i it !� I �� I II �II i I � � s `. 7��., "� ���- �.� a'��, � � � , . � z � � t � �� � � � t � �� THE FOLLOWING AUTHORIZATIONS MUST BE OBTAINED BEFORE SUBMITTING THE APPLICATION TO THE OUTDOOR ADVERTISING DIVISION 711 CMR 3,06(1)(e): Each application shall contain the following certification which must be signed by a duly authorized official of the city/town no earlier than 60 days before the filing of the application under 711 CMR 3.05. 1 hereby certify that the subject sign is (check applicable bog): NOT IN CONFORMITY WITH F-1 IN CONFORMITY WITH NOT SUBJECT T O 0 AUTHORIZED BY A SPECIAL PERMIT/VARIANCE FROM F] Protected by specific provisions which"grandfathers"off-premises signs in the applicable Ordinance/By-Laws of the City/Town of. The location of the sign is in an area zoned: The subject sign(s)is(are)as of this date standing at the location on the reverse of this application: YES or NO Name&Title of City/Town Official (Please Print) Telephone Signature of City/Town Official Date 711 CMR 3.06(1)(f): Each application shall contain the following certification which must be signed by a duly authorized official of the Massachusetts Highway Department no earlier than 30 days before the filing of the application under 711 CMR 3.05. I hereby certify that the subject sign is (check applicable bog): NOT IN CONFORMITY WITH THE PROVISIONS OF M.G.L.CHAPTER 93D F7 IN CONFORMITY WITH THE PROVISIONS OF M.G.L.CHAPTER 93D F1 NOT SUBJECT TO THE PROVISIONS OF M.G.L.CHAPTER 93D If subject to M.G.L. Chapter 93D,the subject sign is: IN CONFORMITY WITH APPLICABLE MUNICIPAL ORDINANCES OR BY-LAWS NOT IN CONFORMITY WITH APPLICABLE MUNICIPAL ORDINANCES OR BY-LAWS. It has been maintained in violation since (date) Name&Title of MHD Official (Please Print) Comments Signature of MHD Official Date 711 GMR 3.03(2)(d) The Board reserves the right,after notice and opportunity for hearing,to revoke for cause any permit at any time. Without Limitation,any violation of any provision of 711 CMR 3.00,any violation of any provision of any permit or license,and any submission of false,misleading or deceptive information in any application or in response to any information request by the Board, by any Board member or by the Executive Director shall constitute grounds for revocation of any permit as well as for imposition of any other penalty provided by law. r THE COMMONWEALTH OF MASSACHUSETTS .4 Executive Office of Transportation and Construction Massachusetts Highway Department Outdoor Advertising Division Ten Park.Plaza,Room 7362, Boston, MA 02116-3973 Outdoor Advertising Board (617)973-7867 (617)973-8404- Fax APPLICATION FOR PERMIT TO LOCATE OUTDOOR ADVERTISING New Permit# Approved: Tri-vision: Application is hereby made to erect and maintain an advertising device in accordance with the rules and regulations under provisions of M.G.L.Chapter 93,Section 29 and 711 CMR 3.011 et.seq.at the following location. I certify that to the best of my knowledge and belief the information set forth in this application is true and complete. PLEASE PRINT OR TYPE THE FOLLOWING INFORMATj Applicant Name: :D 4 t.o K& � L a 3 2,C 9- Rg 7L '"; R 7'E Address: ASS IYOR T H f: f ilk 6- 6-1 (Street address must be included) City/Town NO P.f l-� R rn P m6 eJ State MA Zip 01 ,060 Phone#: (q 13 ) 6-8L" ,3 3 33 Contact: b fl Y i_D - I(A L 0 A161- Authorized Signature: Date: /6-o 3`0.57 YOU MUST COMPLETE ONE APPLICAP9FOR EACH ADVERTISING FACE INCOMPLETE APPLICATIONS WIL-L BE RETURN-ED 1. EXACT LOCATION OF PROPOSED ADVERTISING SIGN a. Street and number AK5 NORTH I H G Route#(If applicable) l-, 5. -5410 City/Town 1V 0 R+b PM PT0jl� i b. Name of Road sign is intended to face /1 T e s s t l Q 1 IO r►� l��/1 6 6- 5T bQ b,�® c. Distance from the road on which the sign is located,to nearest edge of sign 18 ft. d. Distance from the road the sign is intended to face to nearest edge of sign 19 ft. e. Check one: on Wall? On Roof? on Ground? f. Does sign presently exist? (5 or NO: If Yes,when was it built? /9L3 ; Was it ever permitted? YES or NO If yes,give date permit was issued and permit# (ifknown) ft NkfVWW lb j2R4?5e/7f L�wln g. Sign faces: N S X_ E _ W 2. DIMENSION OF SIGN(do not include any extensions or cutouts) LENGTH Sol feet inches: HEIGHT Re feet inches: DEPTH feet inches HEIGHT from ground to Top of Sign A 0 feet inches HEIGHT from roof to top of sign(if applicable) tj/`g _feet inches HEIGHT above road sign is intended to face to top of sign—Ai/ feet inches 3. CONSTRUCTION OF SIGN Materials T j 't Woo _;Number of upright supports THE FOLLOWING AUTHORIZATIONS MUST BE OBTAINED BEFORE SUBMITTING THE APPLICATION TO THE OUTDOOR ADVERTISING DIVISION 711 CMR 3.06(1)(e): Each application shall contain the following certification which must be signed by a duly autho7zed official of the city/town no earlier than 60 days before the filing of the application under 711 CMR 3.05. I hereby certify that the subject sign is (check applicable boa): NOT INCONFORMITY WITH F] IN CONFORMITY WITH 7 NOT SUBJECT TO AUTHORIZED BY A SPECIAL PERMITNARIANCE FROM Protected by specific provisions which"grandfathers"off-premises signs in the applicable OrdinancelBy-Lawis of the City/Town of: The location of the sign is in an area zoned: The subject sign(s)is(are)as of this date standing at the location on the reverse of this application: YES or NO Name&Title of City/Town Official (Please Print) Telephone Signature of City/Town Official Date 711 CMR 3.06(1)(f): Each application shall contain the following certification which must be signed by a duly authorized official of the Massachusetts Highway Department no earlier than 30 days before the filing of the application under 711 CMR 3.05. 1 hereby certify that the subject sign is (check applicable box): 17 NOT IN CONFORMITY WITH THE PROVISIONS OF M.G.L.CHAPTER 93D F7 1N CONFORMITY WITH THE PROVISIONS OF M.G.L.CHAPTER 93D NOT SUBJECT TO THE PROVISIONS OF M.G.L.CHAPTER 93D If subject to M.G.L. Chapter 93D,the subject sign is: IN CONFORMITY WITH APPLICABLE MUNICIPAL ORDINANCES OR BY-LAWS NOT W CONFORMITY WITH APPLICABLE MUNICIPAL ORDINANCES OR BY-LAWS. It has been maintained in violation since (date) Name&Title of MHD Official (Please Print) Comments Signature of MHD Official Date 711 CMR 3.03(2)(d) The Board reserves the right,after notice and opportunity for hearing,to revoke for cause any permit at any time. Without Limitation,any vlohdion of any provision of 711 CMR 3.00,any violation of any provision of any permit or license,and any submission of false,misleading or deceptive information in any application or in response to any information request by the Board, by any Board member or by the Executive Director shall constitute grounds for revocation of any permit as well as for imposition of any other penalty provided by law. ate- THE COMMONWEALTH OF MASSACHUSETTS Executive Office of Transportation and Construction Massachusetts Highway Department Outdoor Advertising Division Ten Park Plaza,Room 7362, Boston,MA 02116-3973 Outdoor Advertising Board (617)973-7867 (617)973-8404-Fax APPLICATION FOR PERMIT TO LOCATE OUTDOOR ADVERTISING New ^_ Permit# Approved: Fri-vision: Application is hereby made to erect and maintain an advertising device in accordance with the rules and regulations under provisions of M.G.L.Chapter 93,Section 29 and 711 CMR 3.00 et.seq.at the following location. I certify that to the best of my knowledge and belief the information set forth in this application is true and complete. PLEASE PRINT OR TYPE THE FOLLCOWING INFORMATION Applicant Name: ��[lC/J� li f� Q � P,68 L c ;r l4?L- Address• x85 A(6&H-, k 1 NG-- 64 /l (Street address must be included) City/Town ND R H l7'!/�Td�� State M� Zip Phone#: ( q13 Contact: 16 W l A/c" Authorized Signature: Date: f 0-cl 3-0 5 YOU MUST COMPLETE ONE APPLICA N FOR EACH ADVERTISING FACE INCOMPLETE APPLICA IONS WILL BE RETURNED 1. EXACT LOCATION OF PROPOSED ADVERTISING SIGN j a. Street and number a?c�J~ IVo�z#1 6/y&N& :S-�- Route#(If applicable) tC'S 1�/ City/Town IVO l��A /q !Y7 pT©l\ b. Name of Road sign is intended to face 1V e5 54 /O RM 4 1 NG ✓l Ja L 7 � ) c. Distance from the road on which the sign is located,to nearest edge of sign ft. d. Distance from the road the sign is intended to face to nearest edge of sign ft. e. Check one: op.Wall? On Roof? on Ground? _ L Does sign presently exist? YE or NO: If Yes,when was it built? /94 3 Was it ever permitted? YE or NO If yes,give date permit was issued and permit# (if known) qP, g. Sign faces: N X _ S E . W 2. DIMENSION OF SIGN(do not include any extensions or cutouts) LENGTH---j,- feet inches: HEIGHT _feet inches: DEPTH feet_ inches HEIGHT from ground to Top of Sign e feet_—,inches HEIGHT from roof to top of sign(if applicable) N feet inches HEIGHT above road sign is intended to face to top of sign--,�Z-t](—feet inches 3. CONSTRUCTION OF SIGN E�J�Materials f woo d _;Number of upright supports Y File#BP-2006-0406 APPLICANT/CONTACT PERSON DULONG DAVID I&PAUL A LABBEE ADDRESS/PHONE 189 PANTRY RD HATFIELD PROPERTY LOCATION 285 NORTH KING ST MAP 18 PARCEL 004 001 ZONE SR 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 face of existing sign 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 F L LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9RMATION 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 Commi ion 7 Zao 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.