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24B-069 (3) 176.0" graphic hic U4.0" 28.0" IMP signs 20.0" aluminum fabricated decorative sign gn cap 800.458.2376 ...painted to match ESB green aluminum fabricated sign cabinet wl CAM routered 3.443.0034 aluminum sign faces...1/2"thick push-thru acrylic copy/ lo go faced with translucent green and grey vinyl film gisigns.com Internal white LED module Illumination alum.fabricated trim painted Sales Rep: M.Brazeau to match ESB green IS Name: ESB Bank Is Location:Northampton, co aluminum fabricated base shroud.... eet: I of 8 faux stucco painted finish Date:: 8/27/i5 to match Gobi Desert 710C-3 Job 1 12"thick raised PVC address,,, Scale: as noted pamted to match duronodic bronze Drawn by: LH ESB Bank A 297 King Street 297 KING STREET Northampton, MA Rev 9/1/15 CLIENT aMttNlUlE DaiE —T1. r 7=1 111 ci- impact -� signs tr 800.458.2376 fax 413.443.0034 �� „�dA1nrigisign s.com rAVI • . jo j ' Sales Rep: M.Brazeau � 4 - Job Name: ESB Bank I yy ?°� JOb Location:Northampton.M :�,,�� *• "-=- � � t- ? ��asthampton • � Y, .,... ,. Job#: s � � v � • Scale: as noted . Savings uwww,r D aPPgOVEDABNOTED CLIENT 81 aN�TURE dlE L� '\ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Graphic Impact Signs, Inc. Address: 575 Dalton Aveenue City/State/Zip: Pittsfield, MA. 01201 Phone #: 800-458-2376 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 16 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3711 am a homeowner doing all work myself. [No workers'comp.insurance required.]f 10❑ Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 14.DOther Signs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no 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 hire outside contractors must submit a new affidavit indicating such. (Contractors 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 sub-contractors 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: Granite State Insurance Company Policy#or Self-ins. Lic.#: WC 005849357 Expiration Date: 08/19/2016 Job Site Address: -?q7 Al/1-5 City/State/Zip:Arr, Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: (1�c-�� G��w�L Date: 1!- "/"J Phone#: 800-458-2376 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 Building Department. Existing Proposed Required by Zoning Lot Size Frontage t/ Front: j 1 S� Setbacks: Side: L: R: L: R: Rear: ✓ Building Height v/ Bldg Square Footage %Open Space: (Lot area minus bldg and Paved parking) #of Parking Spaces #of Loading Docks Fill: (volume&location) A f / 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. ) DATE: APPLICANT'S SIGNATURE��/c c�, 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: G 6A n ki ll_ l•►,d 4;1t_�tl;S, (N Address: ✓ td Telephone: C�a. 0Q -+l S-1 2. Owner of Property: E ics�r d t;us Address: F( L-cLL�L S'{-' c,+-" rto,-,"*.,c-,t" Telephone: 3 3. Status of Applicant:_Owner _Contract Purchaser _Lessee I/ Other(explain):--J d b vt Ic(c 2 n t/a//erc. 445 ,.i— 4. Job Location: �2 C/ 7 k� St. Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: vac;s k- 6. Des(c�riptio/n of Proposed Use/Work/Project/Occupation:(Use additional sheets if necessary) T GPI[ P 'eaGl�sJ/i1�y lh crnvn�,.( s c L)" CK-4 r5 h) AIVYr�irvv,.. �r.�riCz -c1 pa Frn.h a I l4 r ("i l,.j" Let)11 7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans + 1y tym rZer��E2�r+s 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW__L YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW f 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 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 v-' NO IF/YES: Describe the size,type and location: L!ti @ -Sr�r c t,"e c -R c { (c.�.t_ t t r e- acv 6-1 Are there any proposed changes to,or additions of,signs intended for the property? YES V NO_ IF YES: Describe the size,type and location: it). , 6 v .��c- a7z�-,u�r �, rj"-" t--0\ of Xort4ampton ric( _ DL'PAR7MI;NT 01' BUILDING INSPFC7IONS .r 212 Main Street • M()�tcipal Building NorLharnpton, MA 01060 z 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 Buildinq Inspector Erection..................( ) before a permit will be granted. Alteration.................(�Q Repair.....................( ) Repainting...............( ) Removal..................( ) FEE........PAGE........PLOT....... Northampton, Mass. �f l...c�....20?$— ............... .. .. To the Building Commissioner: WJ Application for a permit to place or maintain a sign or other advertising device,or marquee. BUSINESS NAME ..... f/}i�S.... ............................. 1. Location, Street and No. ..x.1..7....�.t NJ....S !4. .r.............................................. 2. Owner's name ..... S- 4................................................................ t- 3. Owner's address .. <.. Vic! t .. ............p<.?.r: ................................. 4. Maker's name ... N..�J1�!C ...�rn�7.G�.c.f.... .t /vs.?..�N�........................................... 5. Maker's address .....e,T#.I�<,( r...!tt!`�....04?:°.1......... 6. Erector's name ........ ... 1!4n! -................................................................................ 7. Erector's address .. ................................................................................................... SIGN KIND OF SIGN (Designate) 1. Sign will be(check one) illuminated ....... Non-illuminated ....... 2. Will sign obstruct a fire escape, window or door? ..ol.VO. Marquee ............... 3. Lower edge will be .Q..ft...t? ..ins above the public way. Projecting .............. 4. Upper edge will be J 3..ft...Q...ins above the public way. Roof ..................... 5. Height . ..ft.y...ins Width ./.�-ft.d..ins Temporary............. 6. Face area .8'1...sq.ft. Wall ..................... 7. Inner edge will be ......ins from the building 9F pele v 114- Ground ........►r.. 8. Outer edge will be .......ins from the building orb Other ................... 9. Face of building or pole is ..P 7ins back from the street line. 10. Sign will project C)...ins beyond the street line. 11. Sign will extend ..O..ft .......ins above the building or pole. 12. Of what material will sign be constructed? Frame .....�.��.......... Face......4t��1`'`! 13. Estimated cost $.... The undersigned certifies that the above statements are true to the best of his knowledge and belief. ` ....... �....4.� ... `/0 . (Signature of Owner or ent) I�—�- �� File#BP-2016-0348 WHAT m' c �<o �G APPLICANT/CONTACT PERSON GRAPHIC IMPACT SIGNS INC ���{ ADDRESS/PHONE 575 DALTON AVENUE PITTSFIELD01201 (413)443-0034 AS V+r'k PROPERTY LOCATION 297 KING ST-EASTHAMPTON SAVINGS BANK MAP 24B PARCEL 069 001 ZONE HB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT :54 TIVO Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REPLACE ILLUM MONUMENT SIGN -EASTHAMPTON_SAVINGS BANK New Construction Non Structural interior renovations Addition to Existing- Accessory Structure Buildiniz Plans Included• - Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION PRESENTED: l/ 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 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 24B Lot069 Zone HB(100)/ Massachusetts Date issued 9/30/2015 0:00:00 Inspector of Buildings Permit # BP-2016-0348 Permit Fee$100.00 SIGN PERMIT Business EASTHAMPTON SAVINGS BANK Address 297 KING ST - EASTHAMPTON SAVINGS BANK Applicant InstallerGRAPHIC IMPACT SIGNS INC Applicant Installer Address 575 DALTON AVENUE Work Description REPLACE ILLUM MONUMENT SIGN - EASTHAMPTON SAVINGS BANK Estimated Cost $18160.00 Building Department Approval by: