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C O N S U L T I N G
October 25, 2013
City of Northampton
Puchalski Municipal Building
212 Main Street
Northampton,MA 01060
Attn: Mr.Louis Hasbrouck Cumberland Farms
Building Commissioner V0389/Store 0129
53 Main Street
Florence,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 53 Main 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#2254 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.
Si erely,
1104 1
Carolyn A. '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
umergard _u
A R
July 15.010
To Whom It May Concrarm.
villa annd farms, Inc.. -with a usual vac of business- in F t gharn
M s cii&ua ri T does ie aby ^ ;Zr" CAROLYN F tea' €GEC r
rs�`�t �F � s.�'f to apply
for and .represent Cumberland e!ian aiaz Inc_ in Tirol: of arw e; 'sic3`on& for zaqui as
,pal isFiis am agpmvals for LED PRICE PANELS at our
station :i cludincr. but not ilrni ? aprerh-lc before any co anroental agemy at
Gsnerat r sr.�- or public- =tear L r.Adre s n suc i C onVrn ontimpc =vemerrc of
Cumbadand Fate rei faclivies.
?in:be*acid Farms Group of Cor aeries=
"�.
fl TC
Piar sing Dcwartment Manager
COMMONWEALTH OF MASSACI-ILIS:.-77TS
inDLESEX COUNT
Stih....r.+ri bei `vtaarn before-ma-tile 15th day-of uiy 2010 LS Manny G iva'ras n
o .Z
known to ma.
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∎=7 "7s r• Notar y.?UDfl LL:�:1 ce tif:L{i.:ts7.s p,,,' �i&Con r isa ion :Expires.:` i0?
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Page 2 of 3
11. ALL INFORMATION MUST BE COMPLETED;PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
12. gt4�C.-EX/S7//( c %� iee a er i9/ `+r' 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: /t0 02 /i3 APPLICANTS SIGNATUR;
NOTE:Issuance of a zoning permit does not relieve an applicants 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
/� p, PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: e4eaty,<, +� Ieits,
Address: I ) '-4S';/ /yj 49/&66 Telephone: 77V -027SY
2. Owner of Property: GVV
O !S/,8i 6?tek. .6L--,4),e/221/4s.
Address: .�/72[�isf A22£ x .Q
C -7r1
Telephone:62'�
0/7�
3. Status of Applicant: Owner Contract Purchaser Lessee
XOther(explain): /a 6 �Pty �-] a 0 c 7-' /� p /�y
4. Job Location:_ ,6-7,3 /77/9//t6 6'�/e 1C� / j FW.C.� /�.-�&iW C. /)7�
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: X/%S.//N/< C',4 5" c 7 Q 77C/(/J
ezWvg,ilh.v ,e- .577),e
6. Description of Proposed Use/Work/Project/Occupation:(Use additional sheets if necessary) y�5
///U57,9/.-L ITV M. /� 7 'i " 194 rie;e4 ,�✓ C/
W///c/ 77Y5 I x/6-7-1/2(.1 X 6 /-e" l.E D p,€/ ?'
. � /NS 91 (Z) Nei )
7. Attached Plans: x Sketch Plan Site Plan Engineered/Surveyed Plan(
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?�7
NO DON'T KNOW YES X IF YES,date issued: o20/
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES )e
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 X ,Date issued
10. Do any signs exist on the property? YES X NO V j ,p ` ,
IF YES: Describe the size,type and location: /9 . .(;k /S r//(./ �� � /fee/22/=//v
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 17 l-w e
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DEPARTMENT OF BUILDING INSPECTIONS
X
212 Main Street • Municipal Building
s'fris. -1,ox'
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee
...37
(Application to be filled out in ink or typewritten) Number •--g
Plans must be filed with the Building Inspector Erection ( .)
before a permit will be wanted.
Alteration ?()
Repair )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. /C/-j2 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 0-0/7784--Eicii.9A-4eD 1-77 74 7 I 17•7 loS /I Alit Ca
1. Location, Street and No. 67 Y 192/17/1/ S7 &7"-- 1-7-1)/e47-/Vek7/-)Z49
.9-
2. Owner's name C t;ti) 4-.7-7A: 1-.9A/D /-72S //tie ,
re;0_)5.->A0z.; "A./(2- 4FA:v<2. .7
3. Owner's address"—A? /4/64,-/,9-.11-2,./?-7/9 e27.2-7‘''''' 2
4. Makers name.884:-.6 /9.,Q ir.L., ZA,5,42
5. Maker's address
6. Erectors name -\722A/4-75 f
,..,- .6--...7 a i:e(._s ,,-;z7 777....:s-7,-.
7. Erector's address ....i5.9.0g;e4/120 ,,e, -/22/7` .C-V
SIGN KIND OF SIGN
‘
(Designate)
1. Sign will be(check one illuminated .A... Non-illumipgt9d
2. Will sign obstruct a firscape,window or door? ./VC„e) Marquee
3. Lower edge will be .:-. ..ft ins above the public way. Projecting
4. Upper edge will .6..ft ins above the public way. Roof
5. Height../...ft. ...ins Width 2..ft / ins
,ioe
Temporary
6. Face area .. sq.ft. Wall
7. Inner edge will be ins from the building or pole.,t ',9 Ground
8. Outer edge will be ins from the building or pole.4/1,9 Other.2.-.E.0..P1-)1VPt,(/
9. Face of building or pole is ins back from the sire,t line././/g 7-6. 7.1. /e7e, 7r- //di ,, ,,7•—•
10. Sign will project ins beyond the street line.eir//19 se/A tt,c r v/..)-yer" ./27/1-2, /7' •
11. Sign will extend ft ins above the building orictoy/ti - --"'" „
12. Of what material will sian be constructed? Frame .›. .,. . .......... Face r"•(-1,(577a
13. Estimated cost $. (.i .1'‘)-e)The undersigned undersigned certifies that the above statements ar e to th:d ••-st o , • -e e and belief.
aft
t) if
if
(Sig .: ure of Owner or Agent)
File#BP-2014-0551
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508) 853-1167
PROPERTY LOCATION 53 MAIN ST-FLORENCE-CUMBERLAND FARMS
MAP 17C PARCEL 197 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out a� 03 Cj
Fee Paid
0�.f)
Typeof Construction: ERECT ILLUM LED PUMP TOPPER W/SMARTPAY 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 OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
I RMATION 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
C76" o ttic - J6 /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 17C Lot197 Zone GB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0551
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 53 MAIN ST - FLORENCE - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM LED PUMP TOPPER W/SMARTPAY
ALTERNATOR
Estimated Cost $800.00
Building Department
Approval by:
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DEPARTMENT OF BUILDING INSPECTIONS �� a
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:___ °` 212 Main Street • Municipal Building sNjy 3,o<\
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee ,�01 LI 66b
(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
Repair )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. /G/: -y 20.13
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME ('0 in 8 Ex-1 ,41, A7t.-#9J.-s../,/ ....
1. Location, Street and No. 6.7\3 /72'Qr/✓ 'S re % T: /'kLwk/t/oe ,9
2. Owner's name C Gr 772 8.A X L-19I4/D
F
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3. Owner's address�-/'/A/a/: . i72,./22 . /9A
4. Maker's name.151.6.4E ?&.1...�, t/
5. Maker's address
6. Erector's name �. 6-S 4 /`/e'9/
7. Erector's address ..j9. i. �.� ",C,,.. 2. p'' .�6 ea 7
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated X.. Non-illumi t d
2. Will sign obstruct a firtescape, window or door? . C1 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 ../...ft. .ins Width c2..ft / ins Temporary
6. Face area .. sq.ft. Wall
7. Inner edge will be ins from the building or pole./ //9* Ground
8. Outer edge will be ins from the building or pole.4///9 Other.Lf ..2Un2,1i (/
9. Face of building or pole is ins back from the str t line.// 7-6)1:'/�iE� 1
10. Sign will project ins beyond the street line..91/9 t ,Q t',
it_ Sign will extend ft ins above the building o e,�{�4 P /e �A
12. Of what material will s��a structed? Frame . :J i.47-... Face <5. .
13. Estimated cost $....&VC"(VO /ieT.9i6
The undersigned certifies that the above statements a t
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e to t )behi, dge and belief.
, , s„rte' .,
0
(Sig nature of Owner or Agent)
,,
File#BP-2014-0550
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508)853-1167
PROPERTY LOCATION 53 MAIN ST-FLORENCE-CUMBERLAND FARMS
MAP 17C PARCEL 197 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT /,e ��
Fee Paid (�`�
Building Permit Filled out
Fee Paid
Typeof Construction: ERECT ILLUM LED PUMP TOPPER W/SMARTPAY 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 LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN RMATION 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
olition DAL P O
VV
10/3/ 1( 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 17C Lot197 Zone GB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0550
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 53 MAIN ST - FLORENCE - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM LED PUMP TOPPER W/SMARTPAY
ALTERNATOR
Estimated Cost $800.00
Building Department
Approval by:
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IT DEPARTMENT OF BUILDING INSPECTIONS y� a
212 Main Street • Municipal Building s-PA. To,"
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee 20'u� cda
(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
Repair ( )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. /C/c2. V 20 � '
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME (-1'Qm S1'.Ex .09,4 /`?-,„j ' / f /
1. Location, Street and No. 6-;:i m/Q 7/V /-% T F E 'e /71,4
2. Owner's name(.1-t;f) W./ 7C ii-.19 D - de/7 ,- - //c C
if `,/f/6-7/�- ,27,. /r�7 .;% .,�..-
3. Owner's address�J�=/`? .. ._ ,/'.�°
4. Maker's name.&E X..-E 9 7:1,, 1-1-..5/677
5. Maker's address
6. Erector's name.\17)..1 _,S 10/</
7. Erector's address ..X? - f,.&2e9 .)/ ee)
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated .X.. Non-illumin ted
2. Will sign obstruct a fire escape,window or door? .,,r( ‘l 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 ft.'..ins Width 1..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. Other A, //
9. Face of building or pole is ins back from the street line. t`,5
10. Sign will project ins beyond the street line. X,r _/L/
11. Sign will extend ft ins above the building or pole.
12. Of what material will sig�n b-yey constructed? Frame 2 7,9L Face )O2,9 �/-'�• �
13. Estimated cost $....;: 1-. CIO
The undersigned certifies that the above statements ar: . e to the best • his ••wledge and belief.
I
1
• (Sig' ure of Owner or Agent)
File#BP-2014-0549
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508)853-1167
PROPERTY LOCATION 53 MAIN ST-FLORENCE-CUMBERLAND FARMS
MAP 17C PARCEL 197 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �V C'l �3 v
Fee Paid J �t
Typeof Construction: ERECT ILLUM SMARTPAY 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
FORMATION 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
;" //t az /40//7
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 17C Lot197 Zone GB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0549
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 53 MAIN ST - FLORENCE - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM SMARTPAY ALTERNATOR ON
CANOPY
Estimated Cost $500.00
Building Department
Approval by:
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pi DEPARTMENT OF BUILDING INSPECTIONS .s�� li a
212 Main Street • Municipal Building X41 DN'```
Northampton, MA 01060
INSPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee
Number ,iq-5 Y0
(Application to be filled out in ink or typewritten) l
Plans must be filed with the Building Inspector Erection
before a permit will be granted. Alteration (X))
Repair ( )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. 0/02'T 20..13
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME 0'0 M S,'1eX-1Q, f� �19�- •,, �,./4/.0 .. /�y
1. Location, Street and No. .. .4•Y 129/9/ S /I61ET '" ale-I6/1 C.�iGi g
2. Owner's name C In Si,C L,9N D /- -✓) a ./ /C
' . •
3. Owner's address
/lit J p'.. /..r.� .i,/2
4. Maker's name.8.6.4E /?iel . 41
5. Maker's address
6. Erector's name 44/ J f_,,� �
7. Erector's address ., ?I ,..c.6.. ,r ✓12 .f-V 6c' 9
SIGN KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated .X..Non-illuminated
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 above the public way. Roof
5. Height ft. '..ins Width '..ft.5?.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. Other
9. Face of building or pole is ins back 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 si n b constructed? Frame 4791- Face '5�/����
13. Estimated cost $....i..i app
The undersigned certifies that the above statements ar: e to the best • his ••wied•e and belief.
(Sig!.ture of Owner or Agent)
File#BP-2014-0548
APPLICANT/CONTACT PERSON CAROLYN A PARKER CONSULTING
ADDRESS/PHONE 3 LORION AVE WORCESTER (508)853-1167
PROPERTY LOCATION 53 MAIN ST-FLORENCE-CUMBERLAND FARMS
MAP 17C PARCEL 197 001 ZONE GB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out Z, l r �j 3 O
Fee Paid 77��
Typeof Construction:_ERECT ILLUM SMARTPAY 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
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IlORMATION PRESENTED:
VV 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
Demoli ion D(. ao
X0613
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 17C Lot197 Zone GB(100)/
Massachusetts Date issued 11/1/2013 0:00:00
Inspector of Buildings Permit # BP-2014-0548
Permit Fee$30.00
SIGN PERMIT
Business CUMBERLAND FARMS
Address 53 MAIN ST - FLORENCE - CUMBERLAND FARMS
Applicant InstallerCAROLYN A PARKER CONSULTING
Applicant Installer Address 3 LORION AVE
Work Description ERECT ILLUM SMARTPAY ALTERNATOR ON
CANOPY
Estimated Cost $500.00
Building Department
Approval by: