25C-084 (9) No
JAN 2 4 2�0
! Erection._..........._.___( )
Alteration__._..............( )
'4 Repair ( )
Plans must be filed with the Building Inspector, Repainting....._._..........( )
before a permit will be granted, Removal...._.................
( )
Tits of 'Naart4amptan, 'ffia55.
Application for a Permit to Place or Maintain a Sign
or other Advertising Device
(Application to be filled out in ink or typewritten)
FEE:.......... PAGE.......... PLO"r..........
aoo c
Northampton, Mass..............................L.. 2a....................9:...........
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device, or marquee.
BUSINESS NAME.............f .�:N.......Ll� ss (F....LEU A.F
1. LOCATION, STREET and No. ................ .......
. 2. Owner's name....._.. ...........o F ... .................
3. Owner's N_.... .....................................................................................................................
_.
4. Maker's name.. . _......_...................................................._.................
5. Maker's address..........................................................................................................._....................................................._.......................
6. Erector's name....._... jd ........ t.........................................................
................ . ^... .... ..................._........................................_...
7. Erector's address..........._......................_................
SIGN KIND OF SIGN
1. Sign will be (check one) illuminated..................non-illuminated......X....... (Designate)
2. Will sign obstruct a fire escape, window or door?..... .2.....
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......I.....ft.........0.....ins. Width........ .....ft._..Q..........ins.
Temporary................._.........._..
6. Face area.....L a._sq. ft. Wall..........._...._...._................_.....
7. Inner edge will be.....NA...ins from the building or pole.
Ground.................._........._--
8. Outer edge will be..N.R.....ins.from the building or pole.
Other......rr.6� ......S1.G�
9. Face of building or pole is.-.L8....ins.back from the street line.
10. Sign will project...N.A...-ins.beyond the street line.
11. Sign will extend.. -J_A ....ft...._.........._ins.above the building or pole.
12. Of what material will sign be constructed? Frame....._.�.�....N� .... Face... �.�••��.••••••••-•
13. Estimate cost.l qP. 500
The undersigned certifies that the above statements are true to the
best of his knowledge and belief.
(Signatu of Owner or Agent)mM M
NOTE:In order that this application may be accepted, the data called for above must be set forth
CLEARLY and FULLY.
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JAN
2 9 201
D � a DEPT OF BUILDING INSPECTIONS
NORTHAMPTON,MA 01060
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10. Do any signs ebst on the property? YES NO v/
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES ✓ NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This ccl== to be filled in
by the Bcildiag Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks ---fmnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
#t of Loading Docks
Fill:
{vol-ume--& 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: laeunnoe of a zoning permit does not relieve an mppijo4khrs den to nply wit"74111
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other appiioable permit granting authorities.
FILE #
JAN 2 4 2000
File No.
4_1 Al 1 ::
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE =E OR P=T ALL INFORMATION
1. Name of Applicant: LA�_ iE-_ LaA.COLD F:_
Address: 2:7 Pt> Ld Aj Ki —C--E Telephone- C?o e&—C 0
2. Owner of Property: 0 LZ�7 M P
2) MA4 E_'_�ME
Address:—, 2 J� EET Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
/Other(explain):
4. Job Location:
Parcel Id: Zoning Map# '46—e— Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property EL:D�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
UO CIAA
_M&xE7 OV= (J SE:_
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 Perm it/Va dance/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
__V-' 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)
File#BP-2000-0670
APPLICANT/CONTACT PERSON NORTHAMPTON LASSIE LEAGUE
ADDRESS/PHONE 275 MAIN ST Lucy 586-2016 ext 119
ST
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid t d
Typeof Construction: ERECT(25)3'X 4'SIGNS W/SPONSOR'S NAMEg INFO AROUND FENCE
New Construction
Non Structural interior renovations
Addition to Existin¢ -
Accessory Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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
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.