sign app 10-7-16 City of Northampton Map 11C Lot054 Zone HB(100)/
Massachusetts Date issued 10/7/2016 0:00:00
Inspector of Buildings Permit # BP-2017-0445
Permit Fee$100.00
SIGN PERMIT
Business
Address 430 NORTH MAIN ST - SUNOCO
Applicant InstallerGRAPHIC IMPACT SIGNS INC
Applicant Installer Address 575 DALTON AVENUE
Work Description REFACE EXISTING GROUND SIGN WITH
ILLUMINATED SIGN FOR GAS PRICES
*light levels must meet zoning standards 350-12.2
Estimated Cost $2500.00
Building Department
Approval by:
‘,0\0:1
File#BP-2017-0445
APPLICANT/CONTACT PERSON GRAPHIC IMPACT SIGNS INC IA
O
ADDRESS/PHONE 575 DALTON AVENUE PITTSFIELD (413)443-0034 1 140
O g6 1,5PROPERTY LOCATION 430 NORTH MAIN ST-SUNOCO / �i
MAP 11C PARCEL 054 001 ZONE HB(100)/ �1 ` NW))
THIS SECTION FOR OFFICIAL USE ONLY: C5V- ,
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ---------,
Buddingee d °V C ,�1 -q
Permit Filled out f �fTJ
Fee Paid f ���jjj i
Tvpeof Construction: REFACE EXISTINZROUND SIGN WITH ILLUMINATED SIGN FOR GAS PRICES
9a Lt( Hr LEVELS ' cr 1e Zo 14 i,vc1 sa-t-A0 Mus 3SO-6Z. 2-
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 FOLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO 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
o /41/7/q.
Signature of BuildingOfficial Date
g
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.
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F-- D,, DEPARTMENT OF BUILDING INSPECTIONSs
LLI U m , .t. o
cc O o¢ 212 Main Street • Municipal Building r 1.
z Northampton, MA 01060
LU
a I SPECTOR Application for a Permit to Place or Maintain a Sign
Or other Advertising Device, or Marquee , -9y $f(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 (X )
Repair ( )
Repainting ( )
Removal ( )
FEE PAGE PLOT
Northampton, Mass. OCMPEK 4 20.6
To the Building Commissioner:
Application for a permit to place or maintain a sign or other advertising device,or marquee.
BUSINESS NAME 5.0JJOCQ - SUKNMANI IOC.
1. Location, Street and No. `t50 k.QI?-T.l-j..Mh{N SWIM-
2.
W -2. Owner's name KOLL°INOE-1Z, G GH - 5%*14MMMI INC.
3. Owner's address I{30 NorzT MM N STtZ� T I l..EeD5 d IYIA
4. Maker's name G( Pd-ttC- IMPf C.T 5(61,3S i INC.
5. Maker's address 575 pert-fbJ isNENuEi Pc1TTFIEW, MA 01201
6. Erector's name G 'PH(G (1 ? C-T $j JS E (NC.
7. Erector's address S'75 DM-Told AV ENUE LEI AAA_ 012.01
SIGN &EFAC.E EX STMG) KIND OF SIGN
(Designate)
1. Sign will be(check one)illuminated ✓ Non-illuminated
2. Will sign obstruct a fire escape, window or door? NO Marquee
3. Lower edge will be 6 ft.:b....ins above the public way. EXfS17A. Projecting
4. Upper edge will be .LP..ft 0 ins above the public way.E7cYST74IG Roof
5. Height .3..ft..6..ins Width .5...ft..1...ins Temporary
6. Face area .1$ sq.ft. Wall
7. Inner edge will be.-.$...ins from the building or pole. Ground v'
8. Outer edge will be .Get..ins from the building or pole. Other
9. Face of building or pole is .1(5...ins back from the street line.
10. Sign will project .- ..ins beyond the street line.
11. Sign will extend ...$...ft .:0-...ins above the building or pole. EXI5T1 JG
12. Of what material will sign be constructed? Frame Elcts 1 Face PtUiM I..)VA.Z-PLASTIC.
13. Estimated cost $ Z500-
The undersigned certifies that the above statements ar- e to.. i-.1.! his knowledge and belief.
y Si.•a . e • yiner or Agent)
Existing
1 _ I
ainififisit.-..'
....... .L IF:
"L1
, graphic
—
3'6'2' impact
1.5"deep alum.fabricated pan faces...painted Sunoco Red...designed to fit 2.1- .1 signs
into existing sign cabinet I 3/4"retainer system...new white LED modules 9
tes
behind product description verbage
existing 8"deep aluminum fabricated
internally illuminated sign cabinet 800.458.7376
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fax 413.443.0034
Sri a•x......on,.••..(•M
4 61.25" 4. gisigns.com
1 roulered"Regular Self'text with Watchhre 12"tall character red LED F
white acrylic backup..whlte LED " ••�•A�++l/77
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gas price module i mechanically fastened Proposed
ilium.behind to back of tate I ----- '
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T • Sales Rep: J.Rend
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'---• d. Job Name: FL Roberts
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_ tr^r. �` .4 •,, Job Location:Leeds,MA
• °i•tal — -A!'�'—_. .1 Sheet: t of 1
R e g u l a .•. ... •.•1,: 1 i Date: 7/8/16
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• �n FL Roberts Sunoco
N • 430 North Main St.
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+�� Leeds MA
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. roistered"Diesel Self"text with Watchfire 12-tall character green LED
yellow acrylic backup..while LED gas price nodule(mechanically fastened ;;'.;�:n"•* ''W•"
ilium.behind to back of face I f a Mw°,,ti.M.`rw•e.;va
t r r �8q ! , ''Ji4smw•.;i. *\\�.� � ,..;.7.....,
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Re-Face Existing 3 Product Gas Price Sign to 2 Product LED Gas Price Sign 1 1/4'=1 -0'
A�D9 CERTIFICATE OF LIABILITY INSURANCE DATE(MMD D,'YYYY)
g/23/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Adrianne M. Grover, AAI, CIC, AIRS, CISR CPIW
NAME:
Berkshire insurance Group, Inc. PHONE( 413)447-7376 I ASIC.No,toms)699-3918
43 East Street ADDREESS:agrover€berkshireinsurancegroup.cos
PO Box 4889 IJSURER(S)AFFORDING COVERAGE I NAIC I _
Pittsfield MA 01202 INSURERA All America Insurance Company 20222
INSURED INSURER B Central Mutual Insurance Co _20230 -
Graphic Impact Signs, Inc. INSURER CAIG Specialty Ins. Co.
575 Dalton Avenue INSURERD:
INSURER E: — _
Pittsfield MA 01201 INSURER F:
COVERAGES CERTIFICATE NUMBER2016-2017 Master REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LIR 1 TYPE OF INSURANCE Q WVBDR POLICY NUMBER (MMOD POLICY
(MF MDYD/YYYY)„ UMITS
•
1 X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000
A CLAIMS-MADE B OCCUR PREMSES Ea€otcu ante) S 300,000
CLP977872110 8/19/2016 8/19/2017 MED EXP(Any one person) S 5,000.
PERSONAL&ADVINJURY 6 1,000,000
GEWL AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ 2,000,000-
R POLICY 4, CaT fl LOC PRODUCTS-COMP/OP AGO $ 2,004,000
OTHER: S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMB s 1,000,000•
(Ea accident)
B ANY AUTO BODILY INJURY(Per person) $
AALL UTOOIS?ED x ACCEDULED BAP977873310 8/19/2016 8/19/2017 BODILY INJURY(Per accident) S
HIRED AUTOS X NON-CANNED PROPERTY DAMAGE $
AUTOS (Per accident)
5
X UMBRELLA UAB 8 OCCUR EACH OCCURRENCE $ 6,000,000,
B
EXCESS LAB CLAIMS-MADE AGGREGATE $ 6,000,000.
DED X RETENTIONS 0 CXS977873410 8/19/2016 8/19/2017 $
WORKERS COMPENSATION X
AND EMPLOYERS'LIABILITY STATUTE ER
_
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N/A EL.EACH ACCIDENT $ 1,000,000_
OFFICC (Mandatory In ER EXCLUDED? N WC005849357 8/19/2016 8/19/2017 ' E.L.DISEASE-EA EMPLOYEE $ 1 000 000
(Mandatory In NH) _
If yes,descrbe under
DESCRIPTION OF OPERATIONS below , E.L.DISEASE-POLICY LIMIT E 1,000,000.
DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101 Additional Remarks Schedule,may be attached If more space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Office of Building Inspector ACCORDANCE WITH THE POLICY PROVISIONS.
Municipal Building
212 Main Street AUTHORIZED REPRESENTATIVE
Northampton, MA 01060 �� �at><�L
A Grover/AGROVE A 'a '
0 1888-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025 r7ctm,.'