32C-137 (15) .;
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File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: JOH-(J ��1 6
�,�1
Address: d 7q W 63T S �' jo-J n T_ ��VT 1r``ttJ1'�lephone:
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):
(f0 BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property C) F=-�P_-LL
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
V_
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOl1' 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:
(FORM CONTINUES ON OTHER SIDE)
10. Do any signs exist on the property/? YES NO 1C
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES LL�_ NO
IF YES,describe size,type and location: 7 40'r
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cclamm to be filled in
by the 8aildinq Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&paved parking)
# of -Parking Spaces
#r of Loading Docks
Fill:
volume--& location)
13 . Certification: I hereby certify that the information obtained herein
is true
q and accurate to the best of my know
le ffj
D71TE: � ZS CSI APPLICANT's SIGNATURE
NOTE: 11"uaktfoe of a zoning permit does not relieve an ap oanYs u en to comply With ail
zoning requirements and obtain all required permits fro the Board of Health, Conservtation
�Commisslon, Department of Publio Works and other ap liooble permit granting authorities.
FILE if
r Erectiofi. -•�-»..........( )
_ Alteration'......-- ----( )
Repair............................
( )
Plans must be filed with the Building Inspector, APR 2 3 2003 Repainting....................
( )
before a permit will be granted, Removal.....-......_...........
( )
,` tia R t
Application fora Permit to Place or Maintain a Sign
or other Advertlsing DevIce
(Application to be filled out in ink or typewritten)
1 F:t.. ...... PAGE.......... PLO-f......
....
Northampton, A4 ass.............:1. .. .9...................19............
F ..
To the Building Commissioner:
Application for a permit to place or maintain a sign or oLlter advertising device, or marquee.
BUSINESS NAME........ N
1. LOCATION, STREET and No. ..... � ....^N-1
Joy �2.rr�z
2. Owner's name..........................................................................................................................................................................................................
�z (�C, Lc��►� C�. ...�.���.........�Vo...................................................................
3. Owner's address.............<................................. . ................... . �
4. ?Maker's name.................. ?.��.G..�.� ....�(.G.�` S...................................:.........................................................................................
5. Maker's address........./..�.�1.....1A1�:1�� ..5.�...�....�! ��`! 1..�-a.��.. ...f..1�^.r�...... �..t.�..V........................
G. Erector's name................. ..... J .......
_ __... ... .....................................................................
. . . .... ........................................
r. Erector's address.......................................................................................................... ....... .....__.....................
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated..................non-illuminated.�... ...
2. \gill sign obstruct a fire escape, window or door".................
Projecting..................................
3. Lower edge will be.....-.&.....ft. ......:7�......ins. above the public way.
Roof.................................................
4. Upper edge will be...../4......ft. ..................ins. above the public way..
Temporary.................................
5. Height........�f.....ft...............ins. Width..................ft-.................ins.
. S 1- Wall.......✓.......................................
G. Face area..................sq. ft. L 6- _f
Ground..........................................
7. Inner edge will be.....b.-.....ins from the building or pole.
Other..............................................
8. Outer edge will be......./.........ins. from the building or pole.
9. Face of building oi�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 b constructed . Frame...A <:....^t..�..N.k..?:....... ...................
13. Lstrnlate cost...S37/(-&Z) 1 7S /3 ?2 /
The undersigned certifies that the above statements are true to th�/
best of his knowledge and belief. r �'
_ .....................
( i t rc of O �'ur or Abent)
NOTE: In order that this application may be accepted, the data called for above must be set forth
CLEARLY and FULLY.
R
File#BP-2003-0901
APPLICANT/CONTACT PERSON Seigel Signs
ADDRESS/PHONE 113 Linseed Rd (413)247-5986
PROPERTY LOCATION 395 PLEASANT ST
MAP 32C PARCEL 137 001 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
I Permit Filled out
Fee Paid 7 2&Z; Z35—
Typeof Construction: ERECT(2)NON-ILLUM FRONT WALL SIGNS-NORTHAMPTON WELLNESS
CENTER
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: § /I �
Finding Special Permit �/� Variance* 71'z �r/ fflCpC�6J/
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 C mmission
6
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.