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31B-272 (12) Page 2 of 3 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: 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 an accurate to the best of my knowledge. DATE:%` A 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 Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Safe Passage, Inc. Address: 43 Center Street, Ste 304, Northampton 010Qphone: 413-586-1125 2. Owner of Property: Address: Telephone: 3. Status of Applicant:_Owner _Contract Purchaser Lessee X Other(explain): 4. Job Location: corner of Maid and King Streets (courthouse), Northampton MA 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) hang a banner promoting the Hot Chocolate Run on the courthouse fence, facing King St., between 11/16/15-12/5/15. 7. Attached Plans: X 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 X 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# 0. Does the site contain a brook,body of water or wetlands? NO X 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 X IF YES: Describe the size,type and location: Are there any proposed changes to,or additions of,signs intended for the property? YES NO X IF YES: Describe the size,type and location: I it 3 it of Xart4amptan j c, Piurnu'in3&Gas Inspections w. North--'npturr MA 01060 _ �tt188Mf�li$Pt�B � 1� DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 l� l>r,crol Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee (Application to be filled out in ink or typewritten) Number ..................... Plans must be filed with the Building Inspector Erection..................( ) / t/ before a permit will be granted. Alteration................. Repair.....................( ) /f 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 ....... Hampshire Council of.Governments. . ... ..... ........... ..................................... 1. Location, Street and No. ....Corner of Main and King Streets, Northampton 2. Owner's name ........................................................................................................... 3. Owner's address ........................................................................................................ 4. Maker's name ............................................................................................................. 5. Maker's address .......................................................................................................... 6. Erector's name .......Safe Passage,.Inc..................................................................... 43 Center Street, Suite 304, Northampton MA 7. Erector's address ....................................................................................................... SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ....... Non-illurrilated ...X.. 2. Will sign obstruct a fire escape, window or door? ....0... 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 ..3..ft......ins Width ...14ft......ins Temporary.....X...... 6. Face area ...42sq. 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 ...Banner..... 9. Face of building or pole is .......inslback 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 be constructed? Frame ..nip................. Face...vinyl.............. 13. Estimated cost $........................ The undersigned certifies that the above statements are true the be of kno edge and belief. ........ .. (Signature of 0 er or Agent) File# BP-2016-0130 APPLICANT/CONTACT PERSON SAFE PASSAGE INC ADDRESS/PHONE 43 CENTER ST 4304 NORTHAMPTON01060(413)586-1125 Q PROPERTY LOCATION 99 MAIN ST-COURTHOUSE MAP 31 B PARCEL 272 001 ZONE CB(100) 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: TEMPORARY BANNER 11/16/15-12/5/15-HOT CHOCOLATE RUN 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 INF MATION 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 c:Z-4iS 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. City of Northampton Map 3 1 B Lot272 Zone CB(100)/ Massachusetts Date issued 8/6/2015 0:00:00 Inspector of Buildings Permit # BP-2016-0130 Permit Fee$30.00 SIGN PERMIT Business HOT CHOCOLATE RUN Address 99 MAIN ST - COURTHOUSE Applicant InstallerSAFE PASSAGE INC Applicant Installer Address Work Description TEMPORARY BANNER 11/16/15-12/5/15 - HOT CHOCOLATE RUN Estimated Cost Building Department Approval by: