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Sign permit App 2012-09-20 File # BP-20 13-0313 APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING ADDRESSIPHONE 3 LORION AVE WORCESTER (508) 853-1167 PROPERTY LOCATION 138 KING ST -CUMBERLAND FARMS MAP 31B PARCEL 038 001 ZONE HB(IOO)/. THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Pennit Filled out Fee Paid TypeofConstruction: REMOVE PRICE SIGN FROM POLE & INSTALL LED PRICE ON CANOPY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets ofPlans /Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION .,u:SENTED: _ _ Approved _V_ AAddditional pennits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ __________ Intermediate Project___Site Plan AND/OR _ _ __Special Pennit With Site Plan Major Project Site Plan AND/OR Special Pennit With Site Plan WNING BOARD PERMIT REQUIRED UNDER: §---=3-'!:j<.....O_-_1_ 1_L.----.::(...:....fI't_)-r-_ Finding _ _ ___ Special pennit __V'--____ Variance*____ ___Received & Recorded at Registry of Deeds ProofEnclosed_____ __Other Pennits Required: ___Curb Cut from DPW ___Water Availability ___Sewer Availability ___Septic Approval Board of Health ____Well Water Potability Board of Health ___Pennit from Conservation Commission ___Pennit from CB Architecture Committee ___ Pennit from Elm Street Commission ____Pennit DPW Storm Water Management ___Demolition Delay S;gnaUrr'~Offi,ia! (yY Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain an 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 ofMGL 40A. Contact Office of Planning & Development for more information. QJ;Uy nf Nnrl1ynmptn DEPARTMENT OF BUIWING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 RECEIVEDSEP 19. i i ~~g.~ :$: .,,: w,;_. r:;,'i; J'.rbv >,_:/,11;; " ..JJ: Li Application for a Permit to Place or Maintain a Sign -q-r 7INSPECTOR Or other Advertising Device, or Marquee L3fJ /3 -3,3 (AppUcation to be filled out in ink or typewritten) Number ..................... Plans must be filed with the Building Inspector before a permit will be granted. To the Building Commissioner: Erection ..... ............ .C><) Alteration............... .. ( ) Repair.....................( ) Repainting...............( ) Removal. .... ....... ...... ( ) FEE ... .. ... PAGE .... ....PLOT ...... . Northampton, Mass . ........ 2--::1"1!.........20.4Appli cation for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME ....t!i!.I1?8.Eg.iLll../Z?....E./.1l?!1?u...................... . 1. Location, Street and No . ../.3.2......Ki#...G.....S:T~E..Z... ..................... . . 2. Owner's name .(!J/.m.¢!~g./.v.:f.lY..D..EI1.If::..I2l..S............... ............. . 3. Owner's addressl()()..'~f! ~s.:IA/.G...8.i.Al.q...F£8../l?IN.q#fl~QJ~ ~/7t)~ 4. Maker's name .FE12.£i2.B..~....H.ER..TI:I............ ................................._.. 5. Maker's address /£)~.M...Z1.()I..:-:Tl!.~.. J?!(JK~AI.V(t.t4..T.X· I7S '?6t 6. Erector's name .#...!-/..S /G.N& ................................................................... . 7. Erector's address lpt!.. r!.?:P.. .. :.p§.~I.?Y.£4-..LlJAl Z!.O/V.?:?£.efi.3)j",tV#~ 0'3062 SIGN 1. Sign will be (check one) illuminated .X.. Non-illuminated ....... 2. Will sign obstr~ct a ~~esc2fe,. window or door? (.V.o... f. 3. Lower edge Will be/.v.. .fL.~...lns above the public way. V4. Upper e:te ~~be!.'l.ft...v...ins, above the public way. -t;L5. Height }..~.ins Width .. ~.ft..t?..ins 6. Face area .. ..sq. ft. 7. Inner edge will be ..... .ins from the building or pole. N/J4 8. Outer edg~ ~ill be .. ..... ~ns fro~ the building or pole.AI/.19 KIND OF SIGN (Designate) Marquee .. .......... .. . Projecting .............. Roof ..................... Temporarr.............. Wall .......X .......... Ground ................ Other ....... ,. .·· ·· ··· t·.~L7rJE/l"7"'\ 9. F~ce o! bUlI~mg or 'po.le IS .......InS back from the street line. It./{Yr.l9~0 # It? V~·..,,"" 10. Sign Will project .. il..ms b~ond the street line. C//';Vlf)pyj::;llse-/~ 11. Sign will extend .. C2rt ...q.ins above the building orPole. 12. Of~hat material will _siW!>~COllst[ucted? Frame ~/.l.g-r..t9:.L... Face.PL/t<:S.17C 13. Estimated cost $.. /.::5.CX/..!.CJO The undernigned certmes that the above st3ternenffi ~:e.;,~t.~~~~:hiS~ ~-6:neror Agent) Page 1 of3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. _____ ZONING PERMIT APPLlCA1"ION PlEASE TYPE OR PRINT ALl INFORMATION 1. 2. 3. Status of Applicant: _Owner _Contract Purchaser _Lessee ~Other(eXPlaln): HG'EALr Fa£-()t(}A/&e. 4. Job Location: /3~ K/AlG ST~Ei/ParcelID: Zoning Map # Parcel # District(s)C-___________ (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: GflS ST8 //CJ,A//et?NVg Al/EN'c..eSTO,e§ , 6. Description of Proposed UseIWorkIProjectlOccupation: (Use additional sheets if necessary) SOmE us £-REmoVE £x/u'r/N-·G ~~x~/Y;£/(~£ SiGAI .. PR£J//2 L/G#T P4LE. /NcST8J..L (02) 7. Attached Plans: LSketCh Plan ASite Plan __Engineered/Surveyed Plans 8. Has a Special PenniWariancelFinding ever been issued for/on the site? NO__ DON'T KNOWX YES__ IF YES, date issued:, ________ IF YES: Was the pennit recorded at the Registry of Deeds? NO__ DON'T KNOW~ YES__ IF YES: Enter: Book,___ 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 penni! 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, type and location: uJliLL SiGAl ¥ ; X102' tJ tiER :.D{)O,e... CFPBNEL ..If 'X~' tJN CIt/JLJI?Y .ECJOE Are there any proposed changes to, or additions of, signs intended for the property? YES~NO__ IF YES: Describe the size, type and location: IAI0'TB LL (p2) c2!"'~" X 6 t..{) It ();N6"'Le S/Z)E'D ~£D PIG/C6 (SiGAlV"'. t:J/J5 ON IC/teJI 0/D £' ZJF {!8)Jt)PY· F8svG. • Page 2 of3 11. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. 12. This column to be filled in by the BuildJrlg Deoartmenl Existing Proposed Required by Zonina Lot Size Frontage Setbacks: Front: Side: Rear: L: R: L: R: 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:_______________ APPLICANrS SIGNATURE.________________ NOTE: Issuance of a zoning penn it does not relieve an applicanfs burden to comply with all zoning Requirements and obtain all required pennits from the Board of Health, Conservation Commission. Department of Public Works and other applicable pennit granting authorities. FILE#_______ Page 30f3 -------File # BP-20 13-0314 APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING ADDRESSIPHONE 3 LORION AVE WORCESTER (508) 853-1167 PROPERTY LOCATION 138 KING ST -CUMBERLAND FARMS MAP 31B PARCEL 038 001 ZONE HB(100)! THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid TypeofConstruction: REMOVE PRICE SIGN FROM POLE & INSTALL LED PRICE ON CANOPY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets ofPlans /Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION P~SENTED: __Approved ~dditionalpermits 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 WNING BOARD PERMIT REQUIRED UNDER: §-----"3c.;:,5:....o".6~--l1~,=Z:J,.-{-'....:M-=--)+-_ Finding Special Permit /' Variance* ___Received & Recorded at Registry of Deeds ProofEnclosed_____ ___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 L ILdJSignfmr~uilding Official 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 ofMGL 40A. Contact Office of Plarming & Development for more information. • " ...'-'&::I V C:U SEP I 9 2012 ffiity nf Nnrllplmpinu J,\assadluseUs DEPARTMENT OF BUILDING INSPECTIONS 212 Main StreeL • Municipal Building Northampton, MA 01060 Application for a Permit to Place or Maintain a Sign INSPECTOR Or ~~p~!.u~~::~:i~~n~~~:V::~)Mar~~~:rO.@..~J~.1!.~ Plans must be filed with the Building Inspector Erection.................. C><) before a permit will be granted. Alteration ................. ( ) Repair.....................( ) Repainting ............... ( ) Removal. ...... .. ......... ( ) FEE ........ PAGE .... .... PLOT .. .... . Northampton, Mass . .... .. .i.--:.11!'.........20.4To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME .... t!JI..I!?B.E'g.~AI"O'.... E.t9.!/{(lJ.u....................... . 3. a V", ~/L,' STPe-pr1. Location, Street and No.../.-.. a ...... ./.... If.v. ..'>Z ...... ... .~.. . ~....... ... ...................... 2. Owner's name l!J/m. . .¢!/Ii.g.!v.flYD..E./1.tf::I2l..'-S:..... ........................ 3. Owner's addresslti.t!..C.~!?~SIN.G...8,(V4.. F,e.R.I7JIAlq/~/J-/J2. QJ~ tJ/7cJ~ 4. Maker's name ..£E.12££,B..t........II:.ER..TI:I............... ................................ .. 5. Maker's address 16Z)t!./0..21.O'~T2?~.. J.7!.(!K~N..V(t.&4. .7X 17S?6d, 6. Erector's name. AlII ..SiGNS.......................... ............................................ . 7. Erector's address .1d1...()/.d)...p..e.£.R:y..R.~..£.t!&.??(!.A!..??~.ee~AI)I 0306.. KIND OF SIGN IfSIGN (Designate) U 1. Sign will be (check one) illuminated .J< .. Non-illuminated ....... I 2. Will sign obstruct a ry,21-escqpe. window or door? No... Marquee .............. . 3. Lower edge will be/a7... ft .. q ...ins above the public way. ~~ P .k roJect'mg .............. 4. Upper ~e~~be/........ft.. . .. iZab~e the public way. -r;/--Roof ................... .. 5. Height -;~.ins Width ....ft......ins TemporalY ........... .. 6. Face area .~ ..sq. ft. Wall ....... X .......... 7. Inner edge will be ..... .ins from the building or pole. N/~ Ground ................ 8. Outer edg~ Y:'ill be ....... ~ns fro~ the building or pole.N/.19 Other ... ......... ... ..•. ~./l' 9. F?ce o~ bUlI~mg orpO.le IS .......ms back from the street line. /N6T/9~ 0# t!J f,/s;eA{ff/7"D 10. S~gn w~1I project .. q.ms b~?nd the street line. C#~L)pyj::;llse../,t9 11. Sign Will extend .. at ...~.Ins above the building oIPole. ." 12. Of~hat material will ,si.9.D!>~co'lsY:.ucted? Frame ~/.I.&7./9:.~... Face.P.4&.S:,l7.C 13. Estimated cost $../~.O£I.~.CP The undersigned certifies that the above statements are true t Page 1 of3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No._____ ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT AlL INFORMATION 1. 2. 3. Status of Applicant: _ Owner _Contract Purchaser _Lessee l\.-0ther(eXPlain): nGEALT EtJ,e Ot(}A./e:te. 4. Job Location: /38' K./A/G .sT/2...l?',lIiT'"' Parcel ID: Zoning Map # Parcel # District(s) _ _ _________ _ (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of StructurelProperty: G,flS STf}//0;(//e~NVffN/6NC£STo,e§ , 6. Description of Proposed UseIWork/ProjectJOccupation: (Use additional sheets if necessary) SOmE uSE -REmoVE £XIS'/"'-/NcZ ~;X 1b' y?/2/~E S/GAJ ·PRLJ//2 LIGHT'poLE: IALoT8i..L (sj) 7. Attached Plans: XSketch Plan XSite Plan __Engineered/Surveyed Plans 8. Has a Special PenniWariance/Finding ever been issued for/on the site? NO__ DON'T KNOWX YES _ _ IF YES, date issued:,_____ ___ IF YES: Was the pennit recorded at the Registry of Deeds? NO__ DON'T KNOWX 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 pennit 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, type and location: wilLi.. SIGAl ¥ ; X102,' tJ VffK V{)Oe CFPBNE L 4-'x-r; I tJN CIlA.lLJI?Y .PLJOE Are there any proposed changes to, or additions of, signs intended for the property? YES~ NO__ IF YES: Describe the size, type and location: IN<)TIJ LL (p2) c:2 ~~ ,-; X 6 !() 'I <51A16'LE S/2)eD ~£D PRXAlS 6lGAirS. c)AJ5 DN /C/teH SID£' !JF effAft)PY' F/}SV,9.• 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 Buiklino Department Existing Proposed Required by Zoning Lot Size Frontage Front: Setbacks: Side: Rear: L: R: L: R: 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. APPLICANrS SIGNATURE ~~ NOTE: Issuance of a zoning permit does not relieve an applicanfs 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 of3 ~gHDD LED p,e/C,£ S/6/V 7D ~II/JOPY F;;,SJ~//J S c;{);O£ _ mRIlJrlNN SIGN It"/_ tFx/.2'J<J/fLL SIGN _ rnI9IN"TRIN SlGN"'c2. -I.j'X(p1 cr-SIGAl _ R£moV£ SIGArP3 .-/:/){A/' PRIcE SIGJJ #4> -/NS/8Li-62) 7700 AiEtU ,2JIc/' >< 0'-6" J,£D PR.IC/£ S/G/.JS'. (JNE ~N £/-1~1I 0/0£ {)F 'THE Ok egNi)PY F/1S'~/&. 21-611 X61 1 Product Price Face w/18" ABLE 49" LED Cabinet .... ._--._ . .. .. ---:-----------.J 2B 3/4" 29 SIB" (.12S thick backing) PRODUCT PANELS 72" CABINET ROUTED COPY WI 1/2" CLEAR ACRYLIC PUSHED THRU LETIERS70 SIB" FACE W/1ST SURFACE VINYL PRODUCT TO BE ILLUMINATED BY LED'S CARDINAL -RED 3630-S3 1.090 ALUMINUM ROUTED METAL FACEREGULAR M' WHITE r r 1g" x4S"f-LIJ TAXLIJ U a:;WINDOW OPENING 1 c:::~ ~ cc _ INCLUDED ~<C Co UU ;n Cl C") C'l b 00 LIJI I -' LI N TAX INCLUDED SIDE VIEW1ST SURFACE VINYL RED 3630-S3 FJOO N""'" Xxl01116/CF105206 1).« 04,01.10 9't!-f'\.\;........::;,.. '" OI'..··f' ·· .J"TI'""~ r Trm, UIIQfll.l\ df""'III~~ .......u~r~ h ,-" Revision 1: Was 7215/16" wide Cabinet, 719/16' Face. 1212/10 asl ........ "./dan HU'.' ' 1.<.'"",j",,,,. I~ ~~'KItd .n pdi( 0( ... ~·f:rA'1J·~OIW: ·C:~"s!lFEDERAL pl,.n11lOO plOJorlReyision 2' added led callout. 02.14.11 as! . . ClA;t t~~ .--.1 (( 1" . t~bt'!'....,l.IA:\',~·!.J,~~l ~III) ..f~rAl Revision 3 red was geranium red. 03.01.11 as! """ ': .'-q. JuaOlta Beetge rOf'l~ , ,, rr.'l"'llf;II,·r U (I.'fo..::::Q~Ci:oI":,Jrl.~ .(~-AlI('':'''~(''"\:I'''';:OI' t,w,..-,..~" HEATH ••..'thOu: l')t: ·.·.'tl ltf'IIRevision 4: remd UNLEADED. 07.06.11 ast c",-,> mC S IGN CO MPAN Y ~·w....~-lr"'I'\If1*-~~ r (' r m t 1 ~ I (I" C)'cumb~lgnd Farms ~-IlI·n.J .~·l,-..-.w'lII · h.n.:4 '::....... . i);-poI -o.;.~_""-l t'.:.otr" -f4. n::,r~~!. www Ft!1erOJ\.linth.com Fr tJ(,.,,1 Il rcl : 11 'i'\I'Otrn~~ ~•. -.•. •' . u.,,~,-· ..,.... Cr ' :\~~~~,~~;,~~t~t~:: ISOD North BOlton' JacJuonvlUe, TtlrO)5 75766 CC"ltnll.i1l t laC (903/5B9·Z100· f'ax19031 589 · 2101 ,~.II' IJIj'IJ\I' 'I,"Building auallry Sfgnol~ sance 1901' ~d~3I:~; ,. , .00('1" " ~._.-... " ........3 .(".G'''. ~. ~I 1-0:1 .. , 1 ""''''-''''''\9' F~ 1 70 '/6' '''''E 1 1/2" II :ve" )( ,000 "'AL HIt«iE 6" La. "'" ,,,. j.....L,.. S 6'r-f ~ ~ 1 ~!.::';~" ~ ~ 1 104 ' /2" ,~r U \ " /2· 2 1/"" CABINET DETAIL SCAU, 3/'"."-0" :~9~J~O:~3 i~· :~~:.o:x~~:. 0 &: t.Dc!/!::~: LID ~__ """""' NO, CF2026SF_ 1LD 8J•••_RAL ... HIlATH SIGN COMPANY 1000 No IIOLlON, JIoOCSOtNIIU.L 1X 1&7. (iOJ) e.-Z100 o iII[O TO __To. AU. CAU.OU1'1 ro~ ~ 2'6'x6' SF 1 PROD LED SIGN copied Ot reproduced without the permlnk>n of Federal Heoth ~n Compony LLC or it, authoriud og."t. C METAl fACE PUSH THRU COPY fL\ u • ......, r.:J:;:.. UCtIIICAlID un "......., \8VlHIf....... ~~..:ro:t:':::.::. 01 ,31.11 'Jolt NO, 110.23 D,HALL DAAWN BY: ASf 6' ~ ~":"';i>' '/>'1"M2071 .... nLLL" I---(2) 72 9/1.' (2) 29 5/8' Ir'~ WI ~ IL. ~" /4' "-J' , J' , J/16' !oJ.. ....LE 2"~HOLECTRS. MOIA'lTING HOLES prw;w PMeynra to WH ..., IfIUD rstCOHO OUSJ -DPOItItt C. co.ftWiT 'IImt 1rMncww. a.J»IO mce WIlJ STa.JCW1tD5 ~~.:,.~,",,"ACCRIft·~~::'t.W.) .......,.., lIl'''''U'fCfY'IJPC$ PNn CMMT, SICIIn • ACT~MIPS I ,'!' AWSH. ~_(I)20 ~1f1lJIIOR:,"" ¥Q."IS _ 120 c.-m £XIDtIOR rACtl .wi( 1:ZO-lf4& CMICT D.T1JaCII c.<rM«T1 1M'( ~ I DATE (MMlDDNYVY)ACORD' CERTIFICATE OF LIABILITY INSURANCE 1212112011~ THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER NAlC#INSURERS AFFORDING COVERAGE Peerless InsuranceINSURER A: INSURERB: INSURERC: INSURER D: Obrey Insurance Agency, Inc. 1 E Commons Drive Unit 27 Londonderry NH 03053 INSURED INDABA HOLDINGS INC DBA NH SIGNS 60 OLD DERRY RD LONDONDERRY NH 03053 I INSURERE: THE POLICIESOF INSURANCE LISTED BELOWHAVE BEEN ISSUEDTOTHEINSURED NAMEDABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS CERnFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~i: ~~~ TVP" n~ , ... ,. 'D,.,r" POLICY NUMBER b~}J;~Y EFFECTIVE ~!ykCY EXPIRATION LIMITS ~ERALLIABIlITY EACH OCCURRENCE $ 1,000,000 A ~5MMERCIAlGENERAL LIABILITY CBP8335183 10/05/2011 10/05/2012 2~r9,,~D $ 100,000 r--CUlIMS MADE [!] OCCUR MED EXP IAnv one oarson) $ 5,000 PERSONAL & mv INJURY $ 1,000,000 r-GENERAL AGGREGATE $ 2,000,000 r-rill.AGGREfl L~MIT APPnPER PRODUCTS -COMP/OP AGG $ 2,000,000 X POLICY :I~ LOC ~OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A ....!. I'o'lY AUTO BA8803961 10/05/2011 10/05/2012 (Ea aCCident) -ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (per person) --HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) --PROPERTY DAMAGE (Per acCident) $ ~GELIABILITY AUTO ONLY -EA ACCIDENT $ I'o'lY AlITO OTHER ll-II\N EAACC $ AUTO ONLY: AGG $ ~ESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 A X OCCUR D ClAIMS MADE CU8806761 10/05/2011 10/05/2012 AGGREGATE $ $4DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION I;;::~vS!~}):!-" IX IO~ AND EMPLOYERS' LIABILITY YINA ANY PROPRIETORJPARTM:RIEXEClfTIVE D WC4465680 10/05/2011 1010512012 E.L. EACH ACCIDENT $ 500,000 OFFICERIMEM8ER EXCLUDED? (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ 500,000 If yes, describe under $ 500,000SPECIAl PROVISIONS below E.L. DISEASE -POLICY LIMIT OlliER DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS COVERAGES CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAlL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGEr.rTS OR REPRESENTATlVES. AUTHORIZED REPRESEr.rTATlVE I ACORD 25 (2009/01) @1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD July 15,2010 To VI/hom It May Concern: Cumberland Farms, Inc.. IJ'Jith a usual place of business in Framingham. Massachusetts, does hereby authorize CAROLYN A. PARKER CONSULTING to apply for and represent Cumberland Farms, Inc. in fiiing of any applications for required permits andlor approvals for the LEO PRtCE PANELS at our storeiself-service gas station including, but not limited to. appearing before any governmental agency at general meetings or public hearing addressing such constructionlimprovement of Cumberfand Farms retail facilities. Cumberland Farms Gulf Group of Companies. Manny Paiva tJ Planning Department Manager COMMONWEALTH OF MASSACHUSETTS MIDDLESEX COUNTY Subscribed and swom to before me this 15mday-of July 2010 by Manny Paiva who is personaf/y known to me. Cumber-lima Gulf Group cf Com~iel; 100 Crossing BouI=an:i, F=inghil!Jl,M:\ 01702 50B-ZT0-i 40{) CAROLYN A. PARKER CONSULTING September 16, 2012 City of Northampton Puchalski Municipal Building 212 Main Street Northampton, MA 01060 Attn: Mr. Louis Hasbrouck Cumberland Farms Building Commissioner V0535/Store 0145 138 King Street Northampton, MA 0 I060 Delivery: Regular mail Dear Mr. Hasbrouck, Enclosed please find (2) two Applications for Permit to Place a Sign, (2) two Zoning Permit Applications, (1) one Site Photo showing all existing site signage and (I) one detail of the LED single sided price panel by Federal Heath for the proposed sign modifications for the site located at 138 King Street, Northampton, MA. Cumberland Farms, Inc. the owner ofthe property wishes to remove the existing 6'-0" x 4'-0" price sign from the existing light pole and install (2) two new 2'-6" x 6'-0" single sided LED price signs, one on each side of the existing overhead canopy fascia. They will maintain the existing 4'-0" x6' -0" CF sign installed on top of the canopy. The zone that we are in, Entrance Business (EB), does not allow a pylon sign without a variance from the Zoning Board of Appeals, which Carolyn Misch states we are very unlikely to get, hence the reason for this proposed style sign. The contractor scheduled for this site is NH Signs, 60 Old Derry Road, Londonderry, NH, a copy of their Worker's Compensation Insurance is enclosed. Also enclosed please fmd an Agent for Owner Authorization letter, allowing me to obtain the permits on behalf of Cumberland Farms. An electrical permit will be obtained by a licensed electrician prior to the price sign installation. Lastly, I am enclosing check #1941 in the amount $60.00 for the Sign Permit fees ($30.00 x 2). Ifyou have any questions while reviewing the proposed changes please call me at (774) 239-2781 to discuss. Thank you in advance for your time in helping to expedite this matter. Cc: Cumberland Farms File SPECIALIZING IN THE PETROLEUM INDUSTRY Project lvfanagement, Permit E)..peditillg, Drafting o· Fire Suppression Pfan 3 Lorion Avenue, Worcester, MA 01606 • Tel: 508-508-853-J 167 • Fax: 508-853-J 176 • Cell: 774-239-2781 • capconsulting@verizon.net