32A-143 (4) 7
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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:
Sider 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:—6 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
4
File No.
ZONING PERMIT APPLICATION
Cn PLEASE TYp�OR PRINT ALL INFORMATION
1. Name of Applicant: ! K a'1 GI`' f/�"�rYI G�'1� /"� ��7
` l�� ` I-3 -)�� �-)W
Address: ! " ��//J � ,i����- !�a 4��'Telephone:
2. Owner of Property: <X&tTn,
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:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary)
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: CeJ L r�
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW v 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 V/ NO p
IF YES: Describe the size,type and location: oC /'"�/l0
Are there any proposed changes to,or additions of,signs intended for the property? YES y NO
IF YES: Describe the size,type and location: L'S/N G-5 S kj�m C
Page 2 of 3
City of Northampton
5
t �
Massachusetts .,
DL OF SUSLDING INSPECTIONS
' s 17N1 2 206 21 � n Street • Municipal Building
«t orthampton, MA 01060 ,jib@
INSPECTOR Elect-#'12 n i6As ermit to Place or Maintain a Sign
Northa ertlslr! Device, car Marquee
g � y��y,, i
(Application to be tilled out in ink or typewritten) Number .�il...............
Plans must be filed with the Building Inspector Erection..................( )
before a permit will be granted. Alteration.................( )
Repair.....................( )
Repainting...............( )
Removal..................( )
FEE........PAGE........PLOT.......
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 ... .�.!t t ? 'Pr�'Y`.:T•�I.. .....!��� ....
.V....
1. Location, Street and aN�o. ...........
//''. ...............................f......:..
2. Owner's name Y. .....� i�- 11 `
f
3. Owner's address ...... .... ........ .......... .'`......U..............................
4. Maker's name ... j SPY° ! 7...`. ....� ..................................
5. Maker's address .....:�2)..... ...... (...../.... d�f .....! .� ..U.�(1Z,
6. Erector's name ..........................................................................................................
7. Erector's address .......................................................................................................
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated ....... Non-illumirlaled ..
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 ed a will be ......ft........ins above the public way. Roof .....................
5. Height .ft......ins Width I.f;ft......ins Temporary....
6. Face area .F� .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 ,,2,6.ft .......ins above the building or pole.
12. Of what material will sign be constructed? Frame ... ........ Face....!.....�...........
13. Estimated cost' $...... ?.0.:!0....
The undersigned certifies that the above statements are true to the best of his kn. ledge and belief.
..... ............. .....5er ...................
(Signature of O or Agent)
Page 1 of 3
File#BP-2015-1162
APPLICANT/CONTACT PERSON FERNANDEZ-NIEVES FRANCISCA
ADDRESS/PHONE 40 MAIN ST UNIT 102 FLORENCE01062(413)727-8761
PROPERTY LOCATION 40 MAIN ST-UNIT 102
MAP 32A PARCEL 143 001 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction:_REPLACE NON-ILLUM WALL SIGN-SIMPLY SERENITY FRANKI'S
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
C2�
Signature of Buildmg 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 32A Lot143 Zone CB
Massachusetts Date issued 5/28/2015 0:00:00
Inspector of Buildings Permit # BP-2015-1162
Permit Fee$30.00
SIGN PERMIT
Business SIMPLY SERENITYATRANKI'S
Address 40 MAIN ST - UNIT 102
Applicant InstallerFERNANDEZ-NIEVES FRANCISCA
Applicant Installer Address
Work Description REPLACE NON-ILLUM WALL SIGN - SIMPLY
SERENITY (a, FRANKI'S
Estimated Cost $500.00
Building Department
Approval by: