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17A-270 (3) City of Northampton O � rtahKH _ _._. f 0,c! c . Massachusetts s�'� DEPARTl OF BUILDING INSPECTIONS j Zg ' -� 212 Main Street • Municipal Building ` \111, .b I Northampton, MA 01060 3�"31�0 INSPECTOR Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee " _1 (Application to be filled out in ink or typewritten) Number . XI Plans must be filed with the Building Inspector Erection ( ) before a permit will be granted. Alteration ( ) RECEIVED Repair ( ) Repainting ( ) Removal ( ) JUL 25 all FEE PAGE PLOT DEPT. OF BUILDING INSPECTIONS NORTHAMPTON, MA 01060 Northampton, Mass. 20..... To the Building ,,n nr1Issloner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME N t\cd\-' 6 4e0- �' 1. Location, Street and No. ...1. "iS6 OW.4-- 2. Owner's nameT . SQ 3. Owner's address .. .. kG .(, .,.J 53 • • k .0. it 1. s' 4. Maker's name S' i ( C--4 TA 5. Maker's address ..... 1 i(>;' d- 6. Erector's name S . ......... (\')...:Qc(3,;ue . 7. Erector's address :_? C GL..b.. SIGN KIND OF SIGN '' !' - ,„r (Designate) 1. Sign will be (check one) illuminated Non - illuminated ' 2. Will sign obstruct a fire escape, window or door? ..C, Q. .. Marquee 3. L.-- -•• : - .. l .:: _ • _ - Projecting 4. :•- _ : :- :._ - .- Roof _ 5. Height . 1, . ins Width .. 4 ..ft ins Temporary 7 -6. Face area ;1/4'..sq. ft. 1 a all 7. I- .. : -.- ' fejt Ground. 8. e . - • • • r. , ..:. -. Other 9. Face of building or pole is .\ _ ;. ac from the street line. 10. S' = ' • - _ - ...' - - - line. 12. Of what material will sign be constructed? Frame 1.,00.0(.... Face.. .1,1...):3c4 13. Estimated cost $ t t 000 The undersigned certifies that the above statements are true to the best of his knowledge and belief. c. -- ( jkl.A04- r Y x I (Sign ure of Owner or Agent) de_r1S43a V f Page 1 of 3 } r a'a6 m' r6 s6 d - GI ; f , '' 1, 111 1 L.. ... 1 f J f t t .pz �;,. ' z ,., ,: r. •� �° - _mow ._ DNS, .r _ ✓ �-- 3 3 LI } ,. {( *00 -, , ., ~' W a' , f 1 t~ 1 ; n } ' t { r o f f { !+ it . � j 11 t ' ., f t .} /a' /6 4N/ /9'96 dO1 ' ' ,I ` } __.. x -- �.._ � - i Ii. . i I i ,i i _ 1 0 , '41111111 ii g � i f t ; Lb 9307 /jVc? maple Height Investments 313 Maple Street S pringfield, MA 01105 7/0/4 1 ( 4 - cceizd l p(dii )7(cr 04/4$1.- Rirexe,5-A(Lati, riv,14 (6,ve,eut S Qems,e,. siAlkoet6?,(44 11. ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. s(etd 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: 1 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 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 3of3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: C \"\\LI k, E 0 / U St Address: 13 1, (f " Telephone: dk '3 1 J 4 I� 2. Owner of Property: �( V° O Address: 3 (� V 1A <c � j � -(� Telephone: /'( �,) 73,4 (3 3. Status of Applicant: Owner Contract Purchaser Lessee _Other(explain): 4. Job Location: t, c1 0 }�(M 5J E C'�Z G° V\Ar t. 5 of 04 Parcel ID: Zoning Map # Parcel # District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure /Property: - l 6. Descriptian,_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 DONT KNOW YES IF YES, date issued: IF YES: Wa a permit recorded at the Registry of Deeds? NO DON'T MOW YES IF YES: Enter: Book `� Page and/or Docume• • 9. Does the site contain a brook, body' 'of,water or wetlands? • DONT KNOW YES IF YES: Has a permit been, or need to be; opt.• ed from the Conservation Commission? Needs to be obtained Obt ' ed ` N , Date issued 10. Do any signs exist on the prop ? YES NOS_ IF YES: Describe the ' e, type and location: Are the any proposed changes to, or additions of, signs intended for the property? Y €S NO IF ES: Describe the size, type and location: y. Page 2 of 3 4 File # BP- 2012 -0085 APPLICANT /CONTACT PERSON MAPLE HEIGHTS REALTY TRUST /( ADDRESS /PHONE 313 MAPLE ST SPRINGFIELD (413) 732 -1343 0 PROPERTY LOCATION 110 OAK ST D cca A MAP 17A PARCEL 270 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out b�� ��,r� Fee Paid ,J V Typeof Construction:_ERECT NON -ILLUM GROUND SIGN - MAPLE HEIGHTS REALTY TRUST 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 _ 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 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.