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Page 2 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 Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage
2tDS
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. •
DATE:J? IQ ( 1 2 — APPLICANT'S SIGNATURE i _ /
4
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
)
1. Name of Applicant: { j= ( I `13r� 1
D [_ . P — — — - -- —
Address:1 _-9 1 r�S� 1P�nn 1 )71)33 Telephone:S1it 'l - 16 Z-
2. Owner of Property: C -,r4__ �
Address:� IPra K.bl. 0s -4A Ut_SitfTelephone:_
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): k0._014 _.-
4. Job Location: ' 1(r��
Parcel ID: Zoning Map # _ Parcel # _ District(s) ! _._
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property:_ 2s. • _
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
( I t u VrLP e_ _ Ia A •t t 5 I
7. Attached Plans: }L _Sketch Plan Site Plan Engineered /Surveyed Plans
8. Has a Special PermitNariance /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 V 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 x DON'T KNOW
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
r
IF YES: Describe the size, type and location: 7Nrrr i
Are there any proposed changes to, or additions of, signs intended for the property? YES V
IF YES: Describe the size, type and location: ___
//o,„ M ,� (.ilj of Norlluimp - ton
i �. j . ',Hass 1ritusrti$ ti sY �G
r
s- ` DI�PARTAI 0/ BUILDING INSPECTIONS" �4 . b
�"`' !., 212 Main Jtr eel. • Municipal Building s , ..,., i s�r
Northampton, MA 01060
i \H F('TO 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 . 4p_ 1 3 r 6 2
Plans must be tiled with the Building Inspector Erection ( )
before a permit will be granted. Alteration ( )
Repair ( )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. , .—L &erAl -:.1.. ..20.1
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME ...��(4—b M.. /VC�.P� .? t - 04!1 '-\
.`
1. Location, Street and No. 6. .t... 6 i sal ,? .L
2. Owner's name ..x.0,4. -- h RTC. C4. e - .0
. 6
3. Owner's address .1 ", �. -" (c I� .3... c�L�R.ii. re o l:. r.u4�-t,(. .0134- t
4. Maker's name .. 1, k,,,,e.e un� C
5. Maker's address ... mea ,(( h-)
6. Erector's name .. (1X it'x �l 0 W
.r
7. Erector's address 1.2,0...2.4...q ..... 0....c,... (,,,.,..A.).`./...L
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated k Non - illuminated
2. Will sign obstruct a fir escane, window or door? ...,1V.0 Marquee
3. Lower edge will be ; 1 ft. 1 .ins above the public way. Projecting
4. Upper edge will be /S ins above the public way. Roof
5. Height .1..ft. -.ins Width .171..ft..S.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 .,l s s ibs 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 Pau' Face. 11...)
13. Estimated cost $i 4oiO
The undersigned certifies that the above statements are true to the best of his knowledge and belief.
(•ij. nature of Owner or Agent)
File # BP- 2013 -0667
APPLICANT /CONTACT PERSON SAXTON SIGN CORP
ADDRESS/PHONE 1320 Route 9 Castleton (518) 732 -7704 (102)
PROPERTY LOCATION 968 BRIDGE RD
MAP 18D PARCEL 027 001 ZONE HB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid �±
Building Permit Filled out `/,'11 % - 7 p b
Fee Paid
Typeof Construction: ERECT ILLUM GROUND SIGN - FORD
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
// J2 113
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 18D Lot027 Zone HB(100)/
Massachusetts Date issued 4/5/2013 0:00:00
Inspector of Buildings Permit # BP- 2013 -0667
Permit Fee$30.00
SIGN PERMIT
Business FORD
Address 968 BRIDGE RD
Applicant InstallerSAXTON SIGN CORP
Applicant Installer Address 1320 Route 9
Work Description ERECT ILLUM GROUND SIGN - FORD
Estimated Cost $12000.00
Building Department
Approval by: