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18D-026 (6)32-60592 Northampton CDJR 1 55 Damon Road I Northampton, MA 01060 CHRYSLER pamGE JeepSIGN DETAIL L _________________________________ Chrysler Silver (Metallic) Trimcap Black Day/Night Vinyl ------------------------------; 18"LETTERSET Square Footage 28.4 ft' Usage Chrysler and Jeep Only Dealerships a Any combination of Chrysler, Dodge, Jeep and Ram Description it Construction: Channel Letters w/ Plex. Face Color: Black � Electrical LED Illumination [G 32-60592 Northampton CDJR 1 55 Damon Road I Northampton, MA 01060 o 0 o rsE Jeep RAM'WW ELEVATIONS Mullions and other wall accents to be painted Pelican Gray. Building to be painted Pelican Gray. Available wall area for badges to be verified in field prior to installation. The Commonwealth of Massachusetts Department of Industrial Accidents I X71 '--:✓l Office of Investigations =� I' I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Comp"satipn Insurance Affidavit: Builders/Contractors/Electricions/Plumbers Appyican't Information ` 4 ' 4 Please Print Lelzibly Name (Business/Organization/Individual): CALLAHAN SIGN, LLC Address: 117 UNION ST P.O.BOX 744 City/State/Zip: PITTSFIELD, MA 10202 phone #: (413) 443-5931 Are you an employer? Check the appropriate boa: 1. [J 1 am a employer with 5 4. ❑ I am a general contractor and 1 employees (full an&or part-time).* , have hired the sub -contractors ` 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 4 ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp, insurance required.) t employees and have workers' comp. insurance.*. ❑ We are a corporation and its officers have exercised their right of exemption per MGL C. 152, §1(4), and we have no employees. [Noworkers' comD. insurance reouired.l Type of project (required): 6. [] New construction 7. ❑ Remodeling t 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I LE] Plumbing repairs or additions 12.❑ Roof repairs 13.91 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 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. Travelers Indemity CO Insurance Company Name: Policy # or Self -ins. Lic. 4: 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 cert undthe wins a� nd penalties orperjury that the information provided above is true and correct James P. Callahan ID,t,P/19/2013 413)VW43-5931 Official use only. Do not write in this area, to be completed by city or town official City. or Town: Perm itfLicense # 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 tha Ruildinn nannrtmant 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 2/19/2013 APPLICANTS SIGNATURE 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 Required by Zoning Lot Size Frontage Front: Setbacks: Side: + L: R: L: R: ' r M ' Rear: 4 Y 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: 2/19/2013 APPLICANTS SIGNATURE 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 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 SIGN, LLC'— JAMES+ P. CALLA$AN Address: 117 UNION ST PTTTSFIELD, 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 r � " Parcel ID: Zoning Map # Parcel # bistrict(s) , (TO BE FILLED IN BY THE BUILDING 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 EXEPT "customer 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 RECD:` ..� of Nort4am.pton 2 0 2013 1Rttssttrllugrtts �° ''`� P , FBUI �i;oG i-JSY'cCT DEPARTMENT OF BUILDING INSPECTIONS y� e THAMPTON, MA 010E 212 Main Street . Municipal Building Northampton, MA 01060 INSPECTOR 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) Numberew._/ .l. , � .,?� E� Plans must be filed with the Buildina Inspector before a permit will be granted To the Building Commissioner: Erection..................(X ) Alteration .................( ) Repair .....................( ) Repainting ...............( ) Removal ..................( ) FEE........ PAGE........ PLOT....... Northampton, Mass. FEBRUARY 19 20.13 Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME ..NORTHAMPTON CHRYSLER DODGE JEEP RAM ................................................................................... 1. Location, Street and No. 55 DAMON ROAD NORTHAMPTON, MA .......................................... 2. Owner's name .... ROBERT ,S._ THOMAS ..................................................................................... 3. Owner's address .55 DAMON ROAD ....................................................................................... 4. Maker's name ....PRINCIPLE USA INC ............................................I............................ 5. Maker's address .2.035 LAKESIDE CENTRE WAY #250 KNOXVILLE, TN 37922 ..................................................................I................. 6. Erector's name ., CALLAHAN SIGN, LLC .............................................................................................. 7. Erector's address ... 117 UNION ST PITTSFIELD, MA 01201 ............................................................................ SIGN KIND OF SIGN 1. Sign will be (check one) illuminated X..... Non -illuminated ....... (uesignate) NORTHAMPTON 2. Will sign obstruct a fire escape, window or door? ....X.... 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.IS.ins Width ..?-. ftlJ... iWs8 Temporary 6. Face area � .-Aq. ft. Wall ..X . 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 r 12. Of what material wi si��lObe constructed? Frame�o.. vhum ePLEX ...... Fac ....................... 13. Estimated cost $..... ................. The undersigned certifies that the above statements are true to,1he best of his knowledge and belief. ....................................... (Sign ure of Owner or Agent) JAME� P. CALLAHAN qK File # BP -2013-0766 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(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiny, Permit Filled out Fee Paid T_yneof Construction:_ ERECT ILLUM WALL SIGN - NORTHAMPTON 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 INFO JRMATION PRESENTED: /Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Major Project: Site Plan AND/OR ZONING BOARD PERMIT REQUIRED UNDER: §_ Finding Special Permit Special Permit With Site Plan Special Permit With Site Plan 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 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 18D Lot026 Zone GI(100)/ Massachusetts Date issued 2/26/2013 0:00:00 Inspector of Buildings Permit # BP -2013-0766 Permit Fee$30.00 SIGN PERMIT Business NORTHAMPTON Address 55 DAMON RD Applicant InstallerCALLAHAN SIGN COMPANY Applicant Installer Address P O Box 526 Work Description ERECT ILLUM WALL SIGN - NORTHAMPTON Estimated Cost $4000.00 Building Department Approval by: