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18D-026 (10)CMRYS LAR LIOOGE Jeep. 9 SERIES RAM BADGE Square Footage 5.4 ft2 32-60592 1 Northampton CD1R 1 55 Damon Road I Northampton, MA 01060 8'-10 1/2" Manufacturing Details 5" deep aluminum cabinets, black returns Formed prismatic acrylic face w/ 1 st surface mirror finish & 2nd surface vinyl details Illumination LED internal illumination, Ventex VenBrite VL -W1 00 (1) VLP100-120 LED Driver -0.50 Amps Colors Black Process Black Silver 15 9 SERIES RAM LETTERS Square Footage 5.73 ft2 Manufacturing Details 5"deep aluminum cabinets, black returns White acrylic faces w/ 1 st surface black perforated vinyl leaving 1/8"white perimeter Illumination LED internal illumination, Ventex VenBrite VL -W100 (1) VLP100-120 LED Driver -0.50 Amps Colors Black Process Black Silver Name (Business/Organization/Individual): CALLAHAN SIGN, LLC Address: 117 UNION ST P.O.BOX 744 PTTTgFTFT.D _ MA 1 ngng (411) 441-5911 t✓lty/Jtate/z.lp: The Commonwealth of Massachusetts Are you an employer? Check the appropriate bog: Department of Industrial Accidents 4. ❑ I am a general contractor and 1 Office of Investigations have hired the sub -contractors y listed on the attached sheet. 1 Congress Street, Suite 100 These sub -contractors have Boston, MA 02114-2017 ------- www.mass.gov/dia Workers' CoMp,ensation Insurance Affidavit: Builders/Contractors/Eiectricians/Plumbers �Api fica'tit'Information , i"' Please Print Le ibly Name (Business/Organization/Individual): CALLAHAN SIGN, LLC Address: 117 UNION ST P.O.BOX 744 PTTTgFTFT.D _ MA 1 ngng (411) 441-5911 t✓lty/Jtate/z.lp: YhOne V: Are you an employer? Check the appropriate bog: X❑ I am a employer with 5 4. ❑ I am a general contractor and 1 employees (full and/or part-time).* ❑ 1 am s sole proprietor or, partner-, have hired the sub -contractors y listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.'. required.] 5• ❑ We are a corporation and its ❑ 1 am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolitions 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 Roof repairs 13.9) Other sign *Any applicant that checks box ill 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 subcontractors 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. Travelers Indemity CO Insurance Company Name: Policy # or Self -ins. Lic. #: 6KUB-5B74571A Expiration Date: 12/19/2013 Job Site Address: 55 DAMON ROAD City/State/Zip: NORTHAMPTON, MA 01060 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 certiundep the pains and penalties of perjury that the information provided above is true and correct James P. Callahan—IDat,P/19/2013 —5931 Official use only. Do not write in this area, to be completed by city or town ofciaL 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. SEE ATTACHED SITE PLAN This column to be filled in by the Buildino Department. 13. Certification:.) hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 2/19/2013 APPLICANT'S SIGNATURE �� Ar, ES P. CALLAHAN 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 , Existing Proposed _ Re' aired b9i a Zoning Lot Size Frontage , Front: Setbacks: Side: L: R: L: R: Yx « 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:.) hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 2/19/2013 APPLICANT'S SIGNATURE �� Ar, ES P. CALLAHAN 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 , 91 9 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: CALLAHAN. 5S� N, LLC —i JAMES P. CALLAHAN Address: 117 UNTON ST PITTSFIELD, MA 01201 Telephone: 413-443-5931 2. Owner of Property: ROBERT S. THOMAS Address: 55 DAMON ROAD Telephone: FAX 2032880233 3. Status of Applicant: _Owner _Contract Purchaser _Lessee XOther(explain): SIGN CONTRACTOR 4. Job Location: 55 DAMON ROAD NORTHAMPTON, MA 01060 a e Parcl ID: Zoning Map # Nrcel # ' « District(s) « + (TO BE FILLED IN BY THE BUILD:NG DEPARTMENT) , 5. Existing Use of Structure/Property: USED PREVIOUSLY AS FORD DEALERSHIP NOW CHRYSLER DODGE JEEP RAM 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) SEE ATTACHED DRAWINGS:INSTALL ONE PYLON (8'X12')SIGN, INSTALL DEALER NAME LETTERS, INSTALL (1) DODGE BADGEi,,, INSTALL (1) JEEP BADGE, INSTALL (1) RAM BADGE, INSTALL (1) MOPAR AND INSTALL (1) CHRYSLER BADGE 7. Attached Plans: X Sketch Plan X Site Plan Engineered/Surveyed Plans 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW X 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 X 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_ NO IF YES: Describe the size, type and location: REMOVAL OF EXISTING SIGNAGE E) EPT "customer parking" 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: SEE ABOVE FOR THE ADDITION OF NEW SIGNAGE 4 t off�rik�:m}�kan ,5 ��-• :..5,� `'' �iRussufiltzsPlls ss�^j ?� Ca UJ DEPARTMENT OF BUILDING INSPECTIONS Lw 212 Main Street • Muni ci010 wilding X Northampton, Application for a Permit to Place or Maintain a Sign i \P> cTol� Or other Advertising Device, or Marquee-? _. _ ,aft �. (Application to be filled out in ink or typewritten) Number .............. Erection._ ........ (X ) Plans must be filed with the Buiidincl Inspector Alteration ..............•••( ( ) Repair ..................... ) beforeyrmit will be granted. Repainting... •• ( ) Removal ..................( ) FEE........ PAGE........ PLOT....... FEBRUARY 19 ...... 2o.i.3 Northampton, Mass- ................ . To the Building Commissioner: or maintain a sign or other advertising device, or marquee. Application for a permit to place NORTHAMPTON CHRYSLER DODGE JEEP R� ...........I ................. BUSINESS NAME .......... 1. 2. 3. 4. 5. NORTHAMPTON ..................................... Location, Street and No. 55., DAMON ROAD .................. Owner's name ......ROM S t.. THOMAS................... .............................................. Owner's address ...55..DAMON„ ROAD..................................................................... PRINCIPLE USA INC..................................................................... Maker's name ................ ... .................... . 22 2035 LAY, SIDE, WAY,. ��250 KNOXVILLE,., TN 379.,...,,,, Maker's address ................ g. Erector's name 7. Erector's address CALLAHAN SIGN �...LLC....................... ........... .- 117 UNION ST PITTSFIELD,...MA•1201 .............................. SIGN KIND OF SIGN (Designate) RAM 1. Sign will be {check one) illuminated X..... Non -illuminated ....... 2. Will sign obstruct a fire escape, window or door? .. Marquee ..... • • • • • • • • • • ublic wa Projecting ... • • • • • • • • • 3. Lower edge will be ...... ft..... ... ins above the p y' Roof ..................... er edge will be ......ft ........ ins above the public way. )fem ora 4. Upp .. lOtr� total (see drawing P ry•."""" 5. Height ......ft. � 8.ins Width ......ft......' Wall .X .................. g. Face area 11,•]x, ft.Ground ................ 7. Inner edge will be ......ins from the building or pole. Other ................... g, Outer edge will be .......ins from the building or pole. g. Face of building or pole is .......ins back from the street line. 10. Sign will project .......ins beyond the street line. ole. 11. Sign will extend .......ft .......ins above the building or p Face ... AGRYLIC....... 12. Of what material will sign be constructed? Frame •ALUMINUM° °' 13. Estimated cost $•1+•:•00-• ....""' e best of his knowledge and belief. The undersigned certifies that the above statements are true tQ tk r............................. lgnature of Owner or Agent) AAMES p. CALLAHAN File # BP -2013-0770 APPLICANT/CONTACT PERSON CALLAHAN SIGN COMPANY ADDRESS/PHONE P O Box 526 PITTSFIELD (413) 443-5931 PROPERTY LOCATION 55 DAMON RD MAP 18D PARCEL 026 001 ZONE GI(100V THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ERECT ILLUM WALL SIGN - RAM 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 INFORMATION P SENTED: 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 § 3,23- 7, Z- Fmdmg p 7` S ecial Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Septic Approval Board of Health Water Availability Sewer Availability Permit from Conservation Commission Well Water Potability Board of Health Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 2 VZ< 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.