39A-039 WWTP Sign permitCity of NorthamptonCity of NorthamptonCity of NorthamptonCity of Northampton
MassachusettsMassachusettsMassachusettsMassachusetts
DEPARTMENT OF BUILDIDEPARTMENT OF BUILDIDEPARTMENT OF BUILDIDEPARTMENT OF BUILDING INSPECTIONSNG INSPECTIONSNG INSPECTIONSNG INSPECTIONS
212 Main Street 212 Main Street 212 Main Street 212 Main Street ● Municipal BuildingMunicipal BuildingMunicipal BuildingMunicipal Building
Northampton, MA 01060Northampton, MA 01060Northampton, MA 01060Northampton, 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………………...( )
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 ………………………………………………………………………………………...
1. Location, Street and No. ………………………………………………………………………………….
2. Owner’s name ……………………………………………………………………………………………..
3. Owner’s address …………………………………………………………………………………………..
4. Maker’s name …………………………………………………………………………………….............
5. Maker’s address ………………………………………………………………………………….............
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 ……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. 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…………………..
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)
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THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No._____________
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:______________________________________________________________________________
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:__________________________________________________________________
_________________________________________________________________________________________________________
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______ NO______
IF YES: Describe the size, type and location:_______________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Are there any proposed changes to, or additions of, signs intended for the property? YES______ NO______
IF YES: Describe the size, type and location:_______________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
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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:
Rear:
L: R:
L: R:
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:__________________ APPLICANT’S SIGNATURE__________________________________
NOTE: Issuance of a zoning permit does not relieve an applicant’s buNOTE: Issuance of a zoning permit does not relieve an applicant’s buNOTE: Issuance of a zoning permit does not relieve an applicant’s buNOTE: Issuance of a zoning permit does not relieve an applicant’s burden to comply with all zoningrden to comply with all zoningrden to comply with all zoningrden to comply with all zoning
Requirements and obtain all required permits from the Board of Health, Conservation Commission,Requirements and obtain all required permits from the Board of Health, Conservation Commission,Requirements and obtain all required permits from the Board of Health, Conservation Commission,Requirements and obtain all required permits from the Board of Health, Conservation Commission,
Department of Public Works and other applicable permit granting authorities.Department of Public Works and other applicable permit granting authorities.Department of Public Works and other applicable permit granting authorities.Department of Public Works and other applicable permit granting authorities.
FILE #____________________FILE #____________________FILE #____________________FILE #____________________
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