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18D-055 (11) 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 Front: Setbacks: Side: L: R: L: Rear: Building Height Bldg Square Footage % Open Space: (Lot area minus bldg and ` Paved parking) Z- 7- # of Parking Spac s # of Loa ' g Docks F" : (volume&location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. 4 DATE.(O-�"'�7-5—l J 5 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 3 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING PERMIT APPLICATION . ,QQ PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: W Address: 3 Ue—a"e$ T>C Telephone: 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) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: n b L l r-� t'�S-e- 6. Description of Proposed UseNVork/Project/Occupation: (Use additional sheets if necessary) rb(e 0f) ZZ�Yl- 611 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 DON'T KNOW YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW y 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 10. Do any signs exist on the property? YES ✓ NO IF YES: Describe the size, pe and location: Are there any proposed changes to,or additions of,signs intended for the property? YES V NO IF YES: Describe the size,type and location: ��✓ Page 2 of 3 City of Northampton axis., sjr Massachusetts �w qtr 1 DEPARTMENT OF BUILDXATG INSPECTIONS 212 Main Street • Municipal Building ..-�►�'pr" Northampton, MA 01060 INSPECTOR Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee /�Pd679-9/ (Application to be filled out in ink or typewritten) Number .l`................. ` r Erection.................. ) Plans must be filed with the Building Inspector [� I_ C�� Il� I� Alteration................( ) �i —� before a permit will be granted. � � - ( t Repair.....................( ) Repainting IL VM 2 5 2015 , � p g...............( ) i;.../ Removal..................( ) Electric, Plumbing Uas!nspectio E........PAGE........PLOT_.... Northamntort, MA 01060 Northampton, Mass. ...............................20..... To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME .... I �e-� t�� 1. Location, Street and No. .............................................................................................. 2. Owner's name ............................................................................ 3. Owner's address .. .. "`^`�5 ... ....1....... ...`�.....�... ... �.�� 4. Maker's name ....... �..` '.y.......Gmvx.�,...... ...................I..............I............... 5. Maker's address �T l7"` P '� . ................... ...................................................................................... 6. Erector's name .......................................................................................................... 7. Erector's address ....................................................................................................... SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ....... Non-illuminated ....... 2. Will sign obstruct a fire escape, window or door? ......... Marquee ............... 3. Lower edge will be ......ft........ins above the public way. Projecting .............. 4. Upper ge wi be ......ft.......�!!3 above the public way. Roof ...E,l"............ 5. Height .. t. .ins WidthLl4...ft.0...ins Temporary............. 6. Face are .. ...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 .......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© l 12. Of what material wi si n be constructed? Frame .......... MM 13. Estimated The undersigned certifies that the above statements are t to the best of his knowledge and belief. 4A.., ..... ... ................ of Owner or, gent) (Signature Page 1 of 3 File#BP-2015-0891 APPLICANT/CONTACT PERSON BEWRY OWEN ADDRESS/PHONE 38 GREENLEAVES DR HADLEY01035 (413)387-0600 Q PROPERTY LOCATION 141 D DAMON RD MAP 18D PARCEL 055 001 ZONE GB(100)/URA(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out job Fee Paid 1 . Typeof Construction: COVER EXISTING SIGN -MT ZION DELIVERANCE TEMPLE 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 ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON irF,65RMATION PRESENTED: H a U 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 . .. .. ,.,ti._.....,X 112-11 SignatureFof 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 Lot055 Zone GB(100)/URA(0)/ Massachusetts Date issued 4/6/2015 0:00:00 Inspector of Buildings Permit # BP-2015-0891 Permit Fee$30.00 SIGN PERMIT Business MT ZION DELIVERANCE TEMPLE Address 141D DAMON RD Applicant InstallerBEWRY OWEN Applicant Installer Address 38 GREENLEAVES DR HADLEY MA 01035 Work Description COVER EXISTING SIGN - MT ZION DELIVERANCE TEMPLE Estimated Cost $600.00 Building Department Approval by: