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File N BP-2019-0008
APPLICANT/CONTACT PERSON FEDER hL HEATH
ADDRESS/PHONEI500 NORTH BOLTOtRD JACKSONVILLE
PROPERTY LOCATION 54 EASTHAMPT-, N RD-RACING MART
MAP 38C PARCEL 075 001 ZONE SC(83,!GI(15)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
OSED REQUIRED DATE
ZONING FORM FILLED OUT EN
CI
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstruction: NEW CANAPY SIGN
New Construction
Non Structural interior renovations
Addition to Existing
Accesso 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 Pldd AND/OR Special Permit With Site Plan
Major Project: Site Platy AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: 750--7- (JA)
Finding Special Permit V 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
/" — ' rs (a
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.
Titi3 of Xart4amptott
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I e
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street. a Municipal Building
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Sidewalk Sign, Marquee or other Advertising Device Q
(Application to be filled out in ink or tWewrltten) Number .....§.0.
=E ]
ldl a Ins eclor Erection............_....(Alteration............Repair.....................(Repainting.........�,�NA� RemovalEE�.�...PAGE�.[`C.PLOTp76 Northampton, Mass. 20.....
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME ... '?ACING._./IMAe..7..._FEL,$........................._................. _.....
1. Location, Street and Na. ..J'~... .. 4-5r1NA/VPrO,.,. lt�..177:.....................................
2. Owner's name .. 4,5.. .LL,C...
3. Owners address ..,��.lP....�AST...GM.9LN...Sc.....LlUE3T6a.ccy...Ar(L;....QL.i-d'L...
4. Maker's name .../'COsr .t.. EA.rH..................................................................
5. Maker's address .IU.G../1�a47N... ,TAN..PQ!.....)A.CJ�Sav✓/GCG�....%X... 7�/E6
6. Erector's name .... X�4.T[[VG._,.5.<.4.!J....................................................................
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? ./✓.G.. Marquee ......✓........
3. Lower edge will be ......ft........ins above the public way. Projecting ..............
4. Upper edge will be ......ft........ins above the public way. Roof .....................
5. Height ......ft......ins Width ......ft......ins Temporary.............
6. Face area .......sq. ft. Wall .....................
7. Inner edge will be ......ins from the building or pole. Sidewalk....................
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.......................
13. Estimated cost $........................
The undersigned certifies that the above statements are true to the best of his knowledge and belief.
(Signature of Owner or Agent)
Page 1 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 Buill Department
Existing Proposed Required by
Zoning
Lot Size 1P 9�
,Acire.5
Frontage
Front:
Setbacks:
Side: L: R: L: R:
Rear:
Building Height
Bldg Square
Footage
% Open Space:
(Lot area minus bldg and
Paved packing)
#of Parking Spaces
#of Loading Docks
Fill: (volumes location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: 7�jP APPLICANT'S SIGNATURE
SKS /-4,�) VMA// . (2CM
Applicant's Email Address (required)
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.
Page 3 of 3
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