10B-089 (2) File#MP-2016-0106
APPLICANT/CONTACT PERSON TENNYSON LISA BETH
ADDRESS/PHONE P O BOX 203 (413)584-7646 0
PROPERTY LOCATION 225 MAIN ST
MAP IOB PARCEL 089 001 ZONE URB(100)/WP(571/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ' ,,
Fee Paid w1 / ,,
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Typeof Construction: Non-illuminated wall sign 11../3- Wv61-e3k w--
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
( ir - 62316
Signature of Building Official Dat I
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 the Office of
Planning&Development for more information.
r (!Hlu of Northampton
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ix• r.. DEPARTMENT OG /RUO,D/NG INSPLEPP/oAS cl
�" 212 M am S rec1 • Municipal Buildlnp �'%'q V.-)CVS
Sorl.hsmpton, MA 01060
IAHl'C(-rolt Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee
(Application to be tilled out in ink or typewritten) Number
Plans must be filed with the Building Inspector Erection ( )
before a Dermic will be granted. Alteration ( )
Repair ( )
Repainting (K,)
Removal ( )
FEE PAGE PLOT
Nortnumpton, Macs. ........L/.22 20./4
To the Building Commissioner:
Application for a permit to place or maintain a sign(-or other advertising device, or marquee.
BUSINESS NAME 11/6/14.E. ....S.74aw
I. Location, Street and Na 221 /11&(1.1/4) ir- Na Nd
2. Owner's name _.A E.BIR.RI9.....WEE IQ
3. Owner's address 22-.S MMPtu 5. Nd ro
JiM. Sig DUEIL 7¢l; _7E E_ .(!
4. Maker's name -7-9/ ......... � � . .
il. . X 7 G �( tt1') owl ��nau�sx6u.,
5. Maker's address ....,... .. .
00 AC
6. Erector's name
N/f
7. Erector's address FC/4
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated Non-illuminated .4..e<-
2. Will sign obstruct a fire escape, window or door? ..446. Marquee
3. Lower edge will be ft ins above the public way. ti Projecting
4. Upper edge will be ft ins above the public way. Roof
5. Height .....ft.yO...ins Width ..Af..ft..U.ins Temporary
6. Face area 2Y6..sq. ft. Wall __X
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 orpole is .ka..ins back from the street line.
10. Sign will project ..QJ..ins beyond the street line.
11. Sign will extend ..D...ft ins above the building or pole.
12. Of what material will sign be constructed? Frame VAr Face Pig://D
13. Estimated cost $..S110
The undersigned certifies that the above statements are tree to the best of his knowledge and belief.
/ i
l (Signature of Owner cr Agent)
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