Loading...
31B-239 (5) City of Northampton Map 3 1 B Lot239 Zone CB(100)/ Massachusetts Date issued 12/13/2018 0:00:00 Inspector of Buildings Permit # BP-2019-0696 Permit Fee$100.00 SIGN PERMIT Business Address 60 KING ST Applicant InstallerPROSIGN Applicant Installer Address 110 FORGE RIVER PARKWAY Work Description ILLUMINATED SIGN - OTHER PYLON - CREATIVE IMAGING GROUP*NOTE - LIGHTING MUST MEET CITY LIGHTING STANDARDS** Estimated Cost $3500.00 Building Department Approval by: ctlt ck Ffle#BP-2019.0696 APPLICANT/CONTACT PERSON PROSIGN ADDRESS/PHONE 110 FORGE RIVER PARKWAY RAYNHAM PROPERTY LOCATION 60 KING ST MAP 3 I PARCEL 239 001 ZONE C8000V THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST EN OSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildine Permit Filled out Fee Paid lypeof Construction: ILLUMINATED SIGN-OTHER PYLONATIVE IMAGING GROUP New Construction A16(E— I.jGjdlNCx MUST J►n.ECT- CBTy L(4fqIN4. 4*VWr#WE- 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 INF99MATION 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 / d 1Z 2 SignatXb 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. Titq of Xort4amptan � :J ���.•, sus ..'' sic eel :r �It188t1P�1t8Pn8 mow ' �_ <<� �- A. I tt N: 1 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 rnr�l r'roi� Application for a Permit to Place or Maintain a Sign Sidewalk Sign, Marquee or other Advertising Device (ja (� (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..(w. � PLOT..... � C'r� 31 R ECI VED yam' Northampton, Mass. ........ ...... ........ To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or m que . DEC 1 0 2018 BUSINESS NAME ...�ta. �.X11:)....................................................... ........... CC DERT OF BUILDING INSPECTIONS 1. Location, Street and No. . ...���n�...ut f e�+ NORTHAMPTON,MA 01060 2. Owner's name ......�.Aian.................................................................... 3. Owner's address ....3ffCt..,..I ��'k�l!�14�'LY .QS .�N1Q............ 4. Maker's name .. .CC'Cat1�/'.....lNKL9d).9.....6caulp..c...l(.)C9................................ 5. Maker's address .R.Q.,. BOY...0D _40.,...�C.'�'te ....0.,4 0 6. Erector's name .V.fi.0...(�19c\....I....� 4Z1.ICE'_ ...LLC..............nn...�................ 7. Erector's address .��0...f or .e. ..P !� ... ..,. Q 11h4�n(1 t.1v.� .... -767 vV_ SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated Z. Non-illuminated ....... 2. Will sign obstruct a fire escape, window or door? .140.. Marquee ...t......... 3. Lower edge will be I.O..'A..O..ins above the public way. Projecting .............. 4. Upper edge will be I.b A........ins above the public way. Roof ..................... 5. Height .0..ft.2,..ins Width .8...ft.l'hJns Temporary............. 6. Face areaSO..sq. ft. Wall ..................... 7. Inner edge will be9$:".ins from the building or pole. Sidewalk.................... 8. Outer edge will be I "..ins from the building or pole. Other..X.."... .QAA J.N 9. Face of building or pole is .ins back from the street line. 10. Sign will project .0...ins beyond the street line. 11. Sign will extend A0A ..2—ins above the building or pole. 12. Of what material will stagn��be constructed? Frame 0.(Q r_.X7MU.(Y.1... Face..lC)Q. ........ 13. Estimated cost $3!X) )..-DEQ The undersigned certifies that the above statements are true to the best of his knowledge and belief. (Signature of Owner or Agent) Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING PERMIT APPLICATION n PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant:�' nnn- -tini«r h Address:k-S- �C-JMMJ- S.E' S U 1� 1 Telephone: c��s 2. Owner of Property: _2.Qn0C)g' "cin Q Address: M K If-)Q c� �r� � y � Q �� rTelephone: S� '���-S 2,a Hi1 3. Statu of Applicant: Owner Contract Purchaser Lessee 7Other(explain): 4. Job Location: ( P Lc i rte\ �Sfi f r c-* Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: cxv� 6. Description of Proposed Use/Work/Project/Occupation:(Use additional sheets if necessary) V x Ccn rye 1 IS tNy-1 111OWSWUM I\x0noctl ort.'N pncc C Y1m�d C.W-16 \n S-tCcU 1 c 4y� do Ili 10 � �C� �In 7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ✓ DON'T KNOW YES IF YES,date issued: IF YES: Was the permit 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 DON'T KNOW YES IF YES: Hasa 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: t/i A q vu (M4 00 Dott (.0 1 If y Of) L'(m- "Z�Q' \j I - Are there any proposed changes to,or additions of,signs intended for the property? YES NO_Z IF YES: Describe the size,type and location: 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 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. DATEJ21� I I 'QD APPLICANT'S SIGNATUR nona-2 r ct,-A Applicant's E-mailAddress (re uir ) 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. Page 3 of 3 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: L (a f f t The debris will be transported by: ? xcc(f E- - L Ac. The debris will be received by: Building permit number: Name of Permit Applicant 12 � Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations d 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Pro Sign Service _ Address: 110 Forge River Parkway City/State/Zip: Raynham, MA 02767 Phone #: 508-339-5289 Are you an employer? Check the appropriate box: . I am a general contractor and I Type of project(required): 4 1.0 I am a employer with 5 ❑ g employees (full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' y p �'• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.� Other Signs 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: Morse insurance Agency Inc. Policy#or Self-ins. Lic. #: 7PJUB7H69099317 Expiration Date: 09/23/19 Job Site Address: City/State/Zip:V VQLn� ►Kq 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 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: A4,%4' Nd1d Dat e: f 2 Phone#: 5089446499 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 Creative Imaging Group TM Sign pr*JW approval.shN►t November 28,2018 <,, i rojecf Name: King St Convenience 80 King St.Northampton-MA Q10g0 SpeoMcatlons j New Road Sign artwork and digital price signs using 97.25"w x 74"Tall(50.00 Sq ft per side) Rebrand pumps(7.5 Square feet per pump) 4-Toppers 48"x 5' 4-Bases:42 X 20 4 ly Current g 2.. Approvals: Y j AW Owner name(printed) K �` i Owner address ` i © City State Zip Date Page: 3 CREATIVE IMAGING GROUP, INC. P.O. Box 6540 PURCHASE ORDER: 20233995 Scarborough ME 04070 Order Date: 10/29/2018 Ship Date:12/27/2018 Phone: (207)883-2999 Fax: (207)883-2992 Client PO: TED FABIAN Consultant: CMI DB1 CM1 Chuck McCatherin Ship Via: None Manufacturer Information Prev.Job: Quote: Phone: (774)2184602 Fax: ()Order Class: NEW E-Mail: signs@prosignservice.com (003258) NORTHHAMPT V To: (000948) S ATTN:KING ST CON\MNIENCE E H FABIAN NORTHHAMPTON MA N Pro Sign Service LLC 1 60 KING ST D 110 Forge River Pkwy p NORTHHAMPTON MA 01060 O Raynham MA 02767 T R O QUANTITY UNIT ITEM 8 DESCRIPTION UNIT COST EXTENSION 1 EA11 INSTALL Installation 3,500.00 3,500.00 Onsite installation with Bucket Truck for Canopy and Pumps Graphics Installation.See PDF designs for details to support the following: PUMPS -Remove pump numbers,install vinyl on pump bases and pump headers -Place plain white vinyl on sides of pump domes -Wrap graphics for base -Paint base of poles and protection hoop and cement pad face ROAD SIGN -Remove interior retainers,mount 3 digital price changers -Refresh cabinet and pole with brown paint -Leave vent space between Price LED and lens as appropriate and space allows -Set up price signs to red,test and provide to manager Pictures,please PO Instructions:For questions about this order,please contact the Customer Service Rep assigned. Please mail invoices to: P O Box 6540 Scarborough,ME 04070 Continued On Next Page>>> • jog w f' im mono r� '�► rp �, Member • - Regular Super KING STREET OPEN je CONVENIENCE 24 hours & SMOKE SHOP '~ 4/ TIM u � ..a I �� t S»13'y. M11l++ F r _. 4-Mt 1 ._ i rz y �w of, {~+,��„� °•^ I^