31B-038 (3) Fe a y 4'4,.:
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CONSULTING
October 25,2013
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 01060
Delivery: Regular mail
Dear Mr. Hasbrouck,
Enclosed please find(4)four Applications for Permit to Place a Sign,(1)one Zoning Permit Application,
and necessary detail drawings of the"Smart Pay"Alternator for the 2'-6"x 6'-0" sign and the LED Pump
Toppers with alternator for the proposed sign modifications for the site located at 134 King Street,
Florence, MA. Cumberland Farms, Inc.the owner of the property has recently initiated a Smart Pay
program which allows customers to received ten cents off a gallon of gas if they are a member. There are
(2)two existing 2'-6"x 6'-0" LED price signs on the existing overhead canopy. Cumberland wishes to
install a new 6"x 56"alternator placard within the existing 2'-6"high x 6'-0"wide LED price panel,
allowing the sign and prices to alternate from the"Smart Pay Member"price to the"Non-Member"price.
We will also install (2)two new LED Pump Toppers with alternator on the existing duel dispensers. Per
your comments we will have both the price sign and pump toppers alternate every 30 seconds.
The contractor for the project is Jones&Frank,358 Wilbraham Road, Palmer,MA a copy of their
Worker's Compensation Insurance is enclosed.Also enclosed please find an Agent for Owner
Authorization letter from both the Owner and Cumberland Farms,allowing me to obtain the permits on
their behalf. An electrical permit will be obtained by a licensed electrician prior to the alternator
installation.
Lastly, I am enclosing check#2255 in the amount$120.00 for the Sign Permit fees($30.00 x 4).If you
find everything is in order please return the permits to me in the self-addressed stamped envelope.If you
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.
S erely,
Carolyn A.i'arker
Cc: Cumberland Farms
File
SPECIALIZING IN THE PETROLEUM INDUSTRY
Project Management,Permit Expediting,Drafting&Fire Suppression Plans
3 Lorion Avenue,Worcester, MA 01606 • Tel: 508-853-1167• Fax: 508-853-1176 • Cell: 774-239-2781 • capconsulting @verizon.net
The Commonwealth of Massachusetts
�.` Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,M4 02111
y� — ,j,,,�
www.mass.govl ia�
Workers'Compensation Insurance Affidavit: Bul Jders/ContractoralElectrieians1Plumbers
Applicant Information Please Print Legibly RaillV,
Name(Business/organization/Individual): 3 Ac r,�v i St�-io i L.L C c�. 3-ones A
Address: 3L/ Wi 1 ji'rikQtt& 6Y
Ci /State/Zip: % � 4_n b ft. Phone#: 3. : -6 3
Are you an employer?Cheek the appropriate boar. Type of prided(required):
1.0 I am a employer with 4. 0 I am a general contractor and I •
employees(fulland/or part-time)." have hired the sub-contractors 6. ❑New emelluelion
2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees • Thew sub-contractors have 8. 0 Demolition
working for me in any capacity. employees workers' 9. 0 Building addition
[No workers'comp.insurance p.
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself.[No workers'comp. rigid of GL
12.0
insurance Roof repairs
required.]t c.152,§1(4),exemption d we have no 13.0 Other
employees.[No workers'
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hie outside contractors most submit a new affidavit indicating such.
IContractoss that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. (�
Insurance Company Name: V e\ FS, �ItlL°irf i D� Ct
Policy#or Self-ins.Lie.#: U t `'f 1 tp 119 Expiration Date: Jar,b l e2
Job Site Address: 53 /)3n/ T Imo. &- City/State/Zip: oe&&1 J7/
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy ofthis statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cer#f.Yt ,, / j
, kepis and � „ of perjury that the information provided above is tr t
ueand correct.
#: y3--cRO
O,icial use on Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle on*
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
1
kesc‘fiff:
Jay
15,2010
o =9ft Kt M Cc -+ .n:
Cumberland -,rr - Ina., --Tel-X7. a usual -;✓'ace of business Fir .Framingham,
kiIassacu ,;few i sr b i o "ter CAROL Y PARKER C 8UL _ . b apply
i4' and r r,-'.�cr Gsir rbsri Femme sno_ in tiring of any at" .icauon,s for raw:mad
L_wi and r a^- triv for the LED PRICE PANELS at our
et-stroll ictuciag, but nct .1Fi: '_ appearino before any gcver � scy at
asneFCl or public- hearing addressing c h s rr ortRmpravcmrt
Cf
Cumber n 3 :'arms ret fact-es
• • Cumberland Farms a Gul 3 Q D of Companies,
1 j{t j..�.
Manny a ve
:=7.: !Z: "'Amager
COMitt ONW�F�_.AEIH OF M=r.- SAcHUSE`_ 1 SS
DLESE:C-OUNTY
i1c'+d aid swim F.""}. ir3�re-""t v-�LST= lc; day al July 20113 by Manny PeiVS who is
pvtso affy _lOtt i
fir'#Pub im - 13,411
-...
w �C,Ci s`�mvI�sTS- C-�3 3±r *r�5 NO"t 8 uz PUDH ': ;a iris-n -tea,
Zia :010-'Ms=
16.n?pan y Commission sion xpii cc_
t"-.-.:_.�-'+.?iris%•rte i•.s' i: .i = .
Jul • :'�i 41.V
•
Page 2 of 3
11. ALL INFORMATION MUST BE COMPLETED:PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
12. gjc,�C.,, x/6—�/'7/(f e� ,9/'`/ This column to be filled in by
the Budding 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: /Ct102'Y/(.3 APPLICANTS SIGNATUR: .!A�.L_.�� 1411,r
l
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 (2,-091 &)4�/4/
e—e..Div �v.� n .775/ --235? -0275V
Address: dC�t�/E'('1 �s ;/ r J72/? Vii/ � Telephone:
2. Owner of Property: 4)/22,84' /t/.1 /giE?/Zk5 -7
Address:A/F'-.� if/G/y� 2-7 2 Tele hone:.�2) "/ )°✓7"OC)
3. Status of Applicant: Owner Contract Purchaser p
ik_Other(explain): f-6 / /
4. Job Location: 3 /� k/i`y G S ✓/�- �G /
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: .EX✓+S///-/0 C7,4 2.1..i' 3 d9 T/CA/ S
6. Description of Proposed Use/Work/Project/Occupation:(Use additional sheets if necessary)
w//iv 77/5 ,C X 4 3 T/A J ", X( 'e ,6D
�'/C�/(/• /ills✓/ia. (z) N61 ) /9.e_.7- /.E..i7 T''U'M1J
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plan�� � ��
8. Has a Special PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOW YES_X IF YES,date issued: e 1-1 f ..
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES V.
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 permit been,or need to be,obtained from the Conservation Commission?
Needs to be obtained Obtained ,Date issued
X 10. Do any signs exist on the property? YES /� NO ,!^
IF YES: Describe the size,type and location: f�I(-+C.. X /S .77 A/ y � ie/6/2 AI AJ
Are there any proposed changes to,or additions of,signs intended for the property? YES x NO
IF YES: Describe the size,type and location: /9 171 /J vv--/ !G'4 �-
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` ari -.' DEPARTMENT OF BUILDING INSPECTIONS 16f c,�:'
_ 212 Main Street • Municipal Building ss,�ti. „ol�.�.
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee
(Application to be f fled out In ink or typewritten) Number P`/ ' 7
Plans must be filed with the Building Inspector Erection ( )
before a permit will be granted. Alteration ( )
Repair )
Repainting ( )
Removal ( )
FEE PAGE / PLOT
Northampton, Mass. /0/c2 9 20.13
To the Building Commissioner.
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME C V m 8 / / < ) 7t?/,7 ./4/</....
1. Location, Street and No./ 3 ,9/
' /s/ ,y `Y .%.6,-
2. Owner's name C L•'/298/7-77/2.,L iQAJ D , .. -/;' .. ' /A/le •
3. Owner's address./=1�' /4f7-1:,.. - -.a � 2 /7.1' e://'..7
4. Maker's name. ' +. E /9,9 45/2
5. Maker's address
6. Erector's name e S ,/Q/ l/�
7. Erector's address ., '.r .�20 .yee,s %?, /C%( ,:�
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated .X... Non-illumiptd
2. Will sign obstruct a fiA;,escape, window or door? Marquee
3. Lower edge will be P? .f. ins above the public way. Projecting
4. Upper edge wilbe t' ft ins abo a the public way. Roof
5. Height../..flp..ins Width :Z.ft / ins Temporary
6. Face area ,..sq.ft. Wall
7. Inner edge will be ins from the building or pole,,kl//? Ground
8. Outer edge will be .......ins from the building or pole. /t/49 (' OtherL / i'� i P
9. Face of building or pole is ins back from the street line./( J j7/2,3,ev // /2J,41,,e_,-7-10. Sign will project ins beyond the street line./41/ p,41)/ "/9,C_T.&/eA//9 7.2 e
11. Sign will extend ft ins above the building or pole.
12. Of what material will On be constructed? Frame e 2.eere .- L.. Face)''-9 S'77e
13. Estimated cost $.... C2r..426
The undersigned certifies that the above statements ae to i.e best of hiswled a and belief.
C.:�l7k.4 ' 09IJ21&
(Si.(ature of Owner or Agent)
File#BP-2014-0547
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508) 853-1167
PROPERTY LOCATION 134 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
Building Permit Filled out cC- *3°
Fee Paid J
Typeof Construction: ERECT ILLUM LED PUMP TOPPER W/SMART PAY ALTERNATOR
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
INF9RMATION 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
9 ,a t�G�hr '71/4303 Si nature o"f Building Official Date
Signature
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 31B Lot038 Zone HB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0547
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 134 KING ST - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM LED PUMP TOPPER W/SMART PAY
ALTERNATOR
Estimated Cost $800.00
Building Department
Approval by:
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DEPARTMENT OF BUILDING INSPECTIONS J 1 .z.-
,..z.s.
-.:::::jf—ri• 212 Main Street • Municipal Building
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee
Agy0/V-596,
(Application to be filled out in ink or typewritten) Number.,k.<
Plans must be.filed. with the uildin Ins ector
Erection ( )
b ore i_a__.A.miti.__k12m.k_win d.
Alteration ‹)
Repair p )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. /0/42 9 20.43
To the Building Commissioner
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME (1t1 1,771474","-i..... 9A: ?-'.) / /)7, ,-- Ai 1/
,-- —d,„,-- ...,. ... ...„..-
1. Location, Street and No. 13 /-1A/( :--;- / "---43.7:-7
_
2. Owner's name''.-7-I;",r),;("If/7 7"-/Z- -(:- / /',.'
..."Aei .::--;
3. Owner's address../..----74:-?-"'927-7/...>:((.1-;'. , -42-;- /77/9 (--„--./;
4. Maker's name.8..etc:4.n:- /-:..:77,p,
5. Maker's address
/- - 7,
6. Erector's name *\/2").A( ...,715 ,,,---/H . .
Z(../.(j."-iri,:(2;1- XX. .,-)7" . e,7
7. Erector's address .41!:-`4.6?:.,te'22,4'....-:,C,.„., 02,9 C.,:',/ '47 9
SIGN
KIND OF SIGN
,,,.
(Designate)
1. Sign will be(check one)illuminated .A.,..Non-illum)vd
a
2. Will sign obstruct a gescape,window or door? Marquee
3. Lower edge will be Pr .ft. ins above the public way. Projecting
4. Upper edge wig be (c, ft ins aboye the public way. Roof
5. Height../..ftP..ins Width . 2...ft / ins Temporary
6. Face area cie.....sq.ft.
Wall
7. Inner edge will be ins from the building or pole //,Q Ground
8. Outer edge will be ins from the building or pole. ,v49 Other A‘...6-17 Pe)S1-
9. Face of building or pole is ins back from the street line./4- 0,,,.. ,c--,E) v_...,// 1,V.,- -/
10. Sign will project ins beyond the street line././//P- ,,,.,4iy -, /9,L7-,6-/e.A./.e9
11. Sign will extend ft ins above the building or pole.
12. Of what material will§ign be constructed? Frame f224:-.z..-:-:,9.4. Face' 4-19 5'77C
13. Estimated cost
The undersigned certifies that the above statements are e to th z .e s t o •'s k : edg and belief.
(Sign-i re of Owner or Agent)
File#BP-2014-0546
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508)853-1167
PROPERTY LOCATION 134 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
Building Permit Filled out "go- 4)
Fee Paid
Typeof Construction: ERECT LED PUMP TOPPER W/SMART PAY ALTERNATOR
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 ATION 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
/0/3///3
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 31B Lot038 Zone HB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0546
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 134 KING ST - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT LED PUMP TOPPER W/SMART PAY
ALTERNATOR
Estimated Cost $800.00
Building Department
Approval by:
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- - DEPARTMENT OF BUILDING INSPECTIONS sue, fr
212 Main Street. • Municipal Building ss1,x. ,,,t�'`c
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee gi p u
(Application to be filled out in Ink or typewritten) Number l" d<
Plans must be filed with the Building Inspector Erection ( )
before a permit will be granted- Alteration ( )
Repair ( )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. /C'/. I/ 20 (-3)
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME 0'0 m8 " -'x-- A-/ , =, ,a/-- ;% f.'
1. Location, Street and No.A39 /c'/'V6 S f ,ef .6-7--
2. Owner's name C 1)in 8 €j ii--%1t/D ,. .9":•472, ..- 4" •
3- Owner's address/-. /Ai,C; .f- � /7/9 /!
4. Maker's name.8 E /9/9 �, 411'.5,Q
5. Maker's address
6. Erector's name e ../ /E7/OA
... 15 L.c. i Bid x/;42 `.5 i.
7. Erector's address -." �c' � ,,ee}••fj„�j7 67 6 ee, 5
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated 1(,... Non-illumin d
2. Will sign obstruct a fire escape,window or door? . a Marquee
3. Lower edge will be ft. ins above the public way. Projecting
4. Upper edge will be ft ins,abo e the public way. Roof
5. Height ft-4...ins Width ..'ff.-ft. .ins Temporary
6. Face area 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. r( Other,X j1
9. Face of building or pole is ins back from the street line. 'k,1%f7 ,9, r" )0�i`,/
10. Sign will project ins beyond the street line. ,,A r-,��?�(.//Q- jt,.°
11. Sign will extend ft ins above the building or ppojl3- _
12. Of what material will l�n�be o�nstructed? Frame %[/4 r''9A Face/) 9`577 ,�,E"2j
13. Estimated cost $ '-X& "L
The undersigned certifies that the above statements
r-0.i
e to the est of his kn edge nd belief.
4.
(Sign ure of Owner or Agent)
File#BP-2014-0545
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508)853-1167
PROPERTY LOCATION 134 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 /
Building Permit Filled out ,2076•4 403a
Fee Paid
Typeof Construction:_ERECT ILLUM SMART PAY ALTERNATOR ON CANOPY
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
T FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I ORMATION 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 /
--—--"ct VA;I a //c.v a ,01,t,G 1 f 3/ 11
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 31B Lot038 Zone HB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0545
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 134 KING ST - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM SMART PAY ALTERNATOR ON
CANOPY
Estimated Cost $500.00
Building Department
Approval by:
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DEPARTMENT OF BUILDING INSPECTIONS sJ! a
212 Main Street • Municipal Building fsl • g.,-50�
Northampton, MA 01060
INSPECTOR 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.I.(
Plans must be filed with the Building Inspector Erection (
before a permit will be granted. Alteration (
Repair (
Repainting (
Removal (
FEE PAGE PLOT
Northampton, Mass. /0/02 V 20.-/3
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME 0'O mek- '..ci9Ato A ..-/?2.,, j.,/w
1. Location, Street and NoJ;3/14 /CM/Q S T /ET
2. Owner's name L 1.)/fl 8,4,X L I /D f- �'z7AS Y --/(V C
•
/c-y. 's,J//v C-V-2:›
3. Owner's address/-.:-......e:' /4/.a.i/. ., �-/-.r.�- --e`!
4. Maker's name.86.4—.-E /. /9 rey, 1/1/4_,5,47
5. Maker's address ,--
6. Erector's name t>, d6Y f ..'-/0
7. Erector's address . .6.Yi2? re,f-.&..z 9 c /6 7
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated A... Non-illumin9yd
2. Will sign obstruct a fire escape,window or door? .../Y.41 Marquee
3. Lower edge will be ft ins above the public way. Projecting
4. Upper edge will be ft inspboxe the public way. Roof
5. Height ft.Ca,-.ins Width ..'%.-ft. .ins Temporary
6. Face area 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. rt OtherX lj
9. Face of building or pole is ins back from the street line. 27,Q )0Q
10. Sign will project ins beyond the street line. f9 X- re.eit.//-
11. Sign will extend ft ins above the building or pole,.
12. Of what material will�ssi n��be�o istructed? Frame /.IJ T'9A Face P� 7f e/A-#6.Z)
13. Estimated cost $ � >
The undersigned certifies that the above statements a e to the est of • %op edge and belief.
' tir-Lbl.....,
(Sign ure of Owner or Agent)
File#BP-2014-0544
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508) 853-1167
PROPERTY LOCATION 134 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
Building Permit Filled out ,�
Fee Paid ��J `�
Typeof Construction: ERECT ILLUM SMART PAY ALTERNATOR ON CANOPY
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
TH OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I ORMATION 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
:— " if4a &t.Ac,-.L /oar g
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 31B Lot038 Zone HB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0544
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 134 KING ST - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM SMART PAY ALTERNATOR ON
CANOPY
Estimated Cost $500.00
Building Department
Approval by: