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Aug 19 15 10: 39a WhiteStone - Go Graphix 413-525-9941 p. 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 and accurate to the best
of my knowledge.
DATE: $ — 11-7-015 APPLICANT'S SIGNATURE Ganes.
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
Aug 19 15 10: 39a WhiteStone - Go Graphix 413-525-9941 p. 2
THIS FORM IS PART OF THE SIGN PERMIT APPLICATION
File No.
ZONING PERMIT APPLICATION
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: EJ11& 1140 S
Address: FOP.f.E P._�XW", F"I!4Xl.1N. Mkelephone: `I r7 ' X033^gyp$
2. Owner of Property: IMATT ma D woo 610 3
Address. Telephone:
3. Status of Applicant:_Owner _Contract Purchaser Lessee
_,Other(explain):
4. Job Location:_ 11% [WJ:J- -CT,, N b93-N AMM N ,MA
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: S A
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 PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOW K YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW X YES
IF YES: Enter: Bock Page - and/or Document#
9. 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 'C NO
IF YES: Describe the size, type and location: 12�51ST1N!r CA2,0U ND SI 6 TR0&rJ_
_Pi�RYJ RAr L o r iFps l KF_
Are there any proposed changes to, or additions of,signs intended for the property? YES NO
IF YES: Describe the size,type and location_ (tfP( }tF. OC O N6-- C%QAVH IL&I 2 S IDES
Page 2 of 3
Aug 19 15 10: 38 eStone - Go Graphix 413-525-9941 p. 1
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`DI;PARId9GN7' Gl' LfU1LUING INSI'L;'CI'IONS
- '
rte. r 212 Main &reel_ • Municipal Building !,s. ,,
� � Northampton, MA 01060 ti "
1� :>,r,c'rart 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..................( )
before a permit will be granted. Alteration.................( X)(34WHIC.
Repair.....................(A )laALLAST-
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 NSW. >~NCANQ 'c Rq�ME 'T...•ACCESS
1. Location, Street and No. -�.S4i.....c0, 'L'`...;�!7......................
2. Owner's name ..I►:1AT.r...MAC.DO.N.ALD................................................................ ...
3. Owner's address ........................................................................................................
4. Maker's name ..GHQ....CRA! H]&.................................................................................
5. Maker's address .31....9$.V.M N....PEZ.a....F..A T....L..O.IJIr !tF.ADbW
6. Erector's name .09-----GAA-PHI.�C............. ..
.............................................................
7. Erector's address 3. .......8£NTah/....�?�.r...... /aSr....i.ON..G.M +�Qw.�..... t4.........
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated Non-illuminated .......
2. Will sign obstruct a fire escape, window or door? ..NC)... Marquee ...............
3. Lower edge will be ......ft........ins above the public way. NIA Projecting ..............
4. Upper edge will be ......ft........ins above the public way. t41A Roof .....................
5. Height ......ft......ins Width ......ft......ins E-ttSTIN(r Temporary.............
6. Face area .......sq. ft. f:)gsT(tJCr Wall .....................
7. Inner edge will be ......ins from the building or pole.ext;TiNCr Ground ......?4.......
8_ Outer edge will be .......ins from the building or pole. EXLSTIti - Other ...................
9. Face of building or pole is .......ins back from the street line.anST04-
10. Sign will project .......ins beyond the street line.f.y4ST CN
11. Sign will extend .......ft .......ins above the building or pole.4XJ3 ft4&-
12. Of what material will sign be constructed? Frame ....AW N.Y.t! MMr .. Face...4A ........
13. Estimated cost $....1STS...........
The undersigned certifies that the above statements are true to the best of his knowledge and belief,
(SignaIur f Owner or Agent)
Page 1 of 3
File 9 BP-2016-0203
APPLICANT/CONTACT PERSON NEW ENGLAND TREATMENT ACCESS
ADDRESS/PHONE 45 ORCHARD RD SWAMPSCOTT01907(617) 838-2168 Q
PROPERTY LOCATION 118 CONZ ST
MAP 39A PARCEL 020 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid O 73�3 07M
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE GRAPHICS ON GROUND SIGN NEW ENGLAND TREATMENT ACCESS
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
INFO TION PRESENTED:
pproved 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
e e
ature 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 39A Lot020 Zone GB(100)/
Massachusetts Date issued 8/24/2015 0:00:00
Inspector of Buildings Permit # BP-2016-0203
Permit Fee$100.00
SIGN PERMIT
Business NEW ENGLAND TREATMENT ACCESS
Address 118 CONZ ST
Applicant InstallerNEW ENGLAND TREATMENT ACCESS
Applicant Installer Address
Work Description REPLACE GRAPHICS ON GROUND SIGN NEW
ENGLAND TREATMENT ACCESS
Estimated Cost $1375.00
Building, Department
Approval by: