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that it fully nIIM tler.11rntrlhelt 10cs�- It q }�
tilt. Inyout of a.•lid areas. area•
,MICHAEL G. SISSII14LJ r w �
t 1rn. �llta►'na1t�R,;•nrPr^x4'ulte t
area tocwhtcll`it hasaceesso cn n
pew/ ALMER HUWLEY.JR. a ASSOCIATES. INC.
SURVEYORS • EWOKENS • ►LM0105
JR a Its KCASMT ATRItr '
.. NORTHAMPTON. MASS.
J96•AId•L1�3 ,
• Z 37r1 1
DatQ 1998 at._•:r�'ctack>1nd. m..iteed.ened and
. , WAN
400
t +aR'THAM P IDN "VIA. Am
eroAIL
3�t"k
u
'Gravel Medicine, Inc.
369 Pleasant Street
Northampton, NIA 01064
Ova nei- Stuart hose, MD
413-5,`i4-0381
Sign Design for Millbank Place Office complex. This sign is to be located in front of
369 Pleasant Street office building in the front portion of the lawn toward the road.
Our building is part of the Office Complex.
n roe
10. Do any signs exist o the property?rty? YES NO
IF YES,describe size,type and location:_ ���` "� �"t3 c"' G
l l v--e, L A�er>A—y
Are there any proposed changes to or additions of signs intended for the property?YES NO y�
IF YES,describe size,type and location:
40
11. ALL XNFORMATIOA MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO��
LACK OF INFORMATION.
2Zsia co1—t to b, filzsd is
by the iii-l':U,g Deprrrmeat
Required I
�
.. i
�iiSa.��..�y Proposed By Z-fiiiirig
Lot size
Frontage
Setbacks front
side L: R•
L: R:
- rear
Building height
Bldg Square footage
%Open Space:
--Lot areas rius bldg
&PEved Far---'ng!
#: of -Parking spaces
f of Loading Docks
Fill:
{vol-Lime-& location)
'13 . Certification: I hereby certify that the infor-mation contained herein
is true and accurate to the best of my knowledge.
DATE: �' �'� � APPLICANT's SIGNp.TUR.� ���
NOSE: =f m =oning permit doe!c not reiieYe an applioanrn burden to oompty
zoninfl requlrimments and obtain all required permits from the Board of Hemlth, Cch'- serv4stion
Commisslon. Department of Public Works and other applioable permtt arentiny nuthorKlea.
FILE #
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
Fi 1 e No.
ZONING PERMIT APPL.IGATXON (§10 . 2)
PLEASE TYPE OR P=T ALL INFORMATION
1. Name of Applicant: C5-T--(r%A C?T— a
Address: Telephone: L
2. Owner of Property: ;
Address: ._ � Telephone: � "1'- 26 To
3.. Status of Applicant: Owner Contra Purchaser Lessee
Other(explain): f
4. Job Location: R/ c' Aa,� ST U°r r�►''�" a
Parcel id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) 1
S, Existing Use of Structure/Property t��=' ► �'� �'` ��
8, Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if riecessary):
C—, c> P T' � o i�-C&—
KxfA y-
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 PermitMariance/Finding ever been issued for/on the site?
NO LZ DON?KNO A 1 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 COfv`iINUEs ON OTrIER SIDE)
s e
Erection ( )
Alteration ( )
'Pla.ns must be filed with the Binding Inspector, Repair ( )
'`';•y - A Repainting before a permit will be granted, "` Removal- ( )
Application for a Permit to Place or Maintain a Sign
g
or other Advertising Device 6 �
(Application to be filled out in ink or typewritten))
FEE............ PAGE.......... PLOT..........
Northampton, Mass.,_ 61,4 ..19.
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME...... . 4i,, V L 1 C i'N P-.'.0
._ ....... ..
.........................
1. LOCATION, S No. �
2.' Owner's name- i C. 03 Cz--r
3. Owner's addre5 —Pro�
4. Maker's name__ Tb y'C to p i- [U L-
5. Maker's address
6. Erector's name. ors °
7. Erector's addrPQ. —ery-11 Z _
SIGN KIND OF SIGN
(Designate)
I. Sign will be (check one) illuminated non-illriminated
2. Will sign obstruct a fire escape, window or door? t-40 _ Marquee
3. Lower edge will be ft. ina.above the public way, Projecting
4. Upper edge will be------ft.--ins.above the public way. Roof _
5. Height..... ins. Width Temporary _
6. Face area-5--sq. ft. I%.V V)ray. Wall`
7. Inner edge will be— in from the building or pole. Ground-
8. Outer edge will_be ns.from the building or pole• Other.__.._-.____- _
9. Face of building or pole is__l- _ins.back from the street line- ve-
10. Sign will prof ect 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... ✓c/a ...w... _ Faee_ �.��2 �
13. Estimate cost...�. .r
The undersigned certifies that the above statemen�re true to the
best of his knowledge and belief. 4 R-V-2
(Signature of Owner or Agent)
NOTE:In order thstthis the data called for above must be set forth PRf P
File#BP-2009-0904
APPLICANT/CONTACT PERSON ROSE STUART R
ADDRESS/PHONE 30 PROSPECT AVE NORTHAMPTON (413)584-2670 Q
PIOR ` " . ST
j&6 ,g"9Z4 THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
T},eof Construction: ERECT NON-ILLUM GROUND SIGN-TRAVEL MEDICINE INC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildin Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING AC ION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION P ENTED:
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 UND : § . b
�� G 2e�w� �`LCo�✓
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed Y-
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 Coni nittee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
Signature of Building Official ate
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.