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31D-142 (9) Zone CB(l City of Northampton Map 3 1 D Lot 142 Zo e C ( ) Massachusetts Date issued 2/18/2020 0:00:00 Inspector of Buildings Permit # BP-2020-0905 Permit Fee$60.00 SIGN PERMIT Business Address 175 MAIN ST - TU BANK Applicant InstallerSAXTON SIGN CORP Applicant lnstaller Address 1320 Route 9 Work Description NON ILLUMIATED AWNING SIGN Estimated Cost $2200.00 Building Department Approval by: File#BP-2020-0905 APPLICANT/CONTACT PERS N SAXTON SIGN CORP ADDRESS/PHONE 1320 Route 9 Castleton (518)732-7704(102) PROPERTY LOCATION 175 N AIN ST-TD BANK MAP 31 D PARCEL 142 001 Z 3NE CB 100 / THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildina Permit Filled out Fee Paid Typeof Construction: NON ILL MIATED AWNING SIGN New Construction Non Structural interior renovations Addition to Existin Accesso 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 PRESENTE Approved Additional ermits required(see below) PLANNING BOARD P RMIT 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 Con ervation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay O4— / L2 1 ?,A 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 I hose applicants who meet the strict standards of MGL 40A.Contact Office of Planning& Development form re information. Titij of Xiart4ampton ''' ,+Alttssttrllusetts a��S S. -�c,� %• _, K DEPARTMENT OF BUILDING INSPECTIONS �,t+ 212 Main Street • Municipal Building yrs...... Northampton, MA 01060 Application for a Permit to Place or Maintain a Sign Sidewalk Sign, Marquee or other Advertising Device (Application to be filled out in ink or typewritten) Number A$.�. .. .. 20-�O y . .... ... Plans must be filed with the Buildin ,Ins e'tor 'V�� Erection..................( ) before a permit will be granted. Alteration.................( ) FEB / Repair.....................( ) 2020 Repainting...............( ) moval..................( ) DFaTOF 30d �4L _No�reUrLDINGr 1 E ..PAGE........PLOT....... �' HAMr'70 Nq crroNS N,r,� °s0 ortthmpton, Mass. ...............................20..... a'S2'I To the Building Commissioner: Application for a permit to place or maintain a`)sign or other advertising device, or marquee. BUSINESS NAME .. .... `.......................................................................... 1. Location, Street and No. ..`�. ...1.'.!�L1.11...1�4............................................................ 2. Owner's name .-).-t1 !".....pb ... .....�..))................................................................ 3. Owner's address . ../. .. Cl-►J�.--T.......YJO l U 4. Maker's name ....�P.lJn.......................... .7................................................ 5. Maker's address ..J.}�� ..�7.. .....� �r gin...... 1�,-1-...IcW3 ............................... 6. Erector's name ... ........................................................................ 7. Erector's address ,1.3��.....t'.-i-.9.....Cc s-�� -fU^ 0'" 1 R%:30.......................... ............ .......... .. SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated -... Non-illuminated. 2. Will sign obstruct a fire escape, window or door? ... Marquee ............... 3. Lower edge will be .......ft........ins above the public way. Projecting .............. 4. Upper edge will be ....A........ins abpve the public way. Roof ..................... 5. Height ..V.'.ft.(4'..ins Width14....ff,......ins Temporary........... 6. Face area J*.e sq. ft. Wall 7. Inner edge will be ......ins from the building or pole. Sidew Ik.................... 8. Outer edge will be .......ins from the building or pole. Others ................. 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 or pole. 12. Of what material ' si n be opstructed? Frame ...�1� X.............. Face.t. *'c�1 ^.✓�l s. 13. Estimated cost $ ' S. .l a�3�, The undersigned certifies that the above statements are t e to est is knowledge and belief. ........ ................. ...... .. ...... ( nature of 0 ner or nt) Page 1 of 3 Site Name: Northampton Property ID: 3710 Address: 175 Main St. City/ST: Northampton, MA N06 Existing Signage: Awning Overall:3'-3"Tall 25'-0"Wide TBD Deep Square Footage:81.25 sq.ft. "gr rr Y n ORIGINAL PHOTOGRAPH COMPOSITE PHOTOGRAPH with PROPOSED SIGNAGE SPECIAL CONDITIONS Technical Survey Required prior to manufacture. C Q D Im �L (profile varies) FRONT VIEW SIDE VIEW NTS NTS ACE STYLE Technical Survey FLEX FABRIC Dimensions FACE❑ ❑ TD-A.RF TBD sq.ft. rrACHMENT Existing awning to be recovered like for like materials. I • 08-28-19-JP PG-9 Site Name: Northampton Property ID: 3710 Address: 175 Main St. City/ST: Northampton, MA E04 Existing Signage: Illuminated Directional Overall:3'-11"Tall 3'-1"Wide TBD Deep Square Footage: 12.08 sq.ft. ORIGINAL PHOTOGRAPH-SIDE A COMPOSITE PHOTOGRAPH with PROPOSED SIGNAGE SPECIAL CONDITIONS Turn off power at breaker,cap off existing 2 1/: power,and replace with new directional 2 Ii/,$- 8 s/,$8 15hs 1'-8 1h" 2: 4'-6" 21 V��c 2'-9 1/2" park ENTER SIDE A SIDE VIEW SIDE B TD-D.0004-X scale-1/2"=l'-o" 4.33 sq.ft. Non-illuminated painted directional sign with film decorated sign face.Aluminum tube frame and aluminum sheet construction.Sign to be painted to match:PMS 5535#MP62874V1.0(Satin Finish).Sign face first surface film 3M 5000 Scotchlite Reflective White Vinyl and 3M IJ680-10 Scotchlite Reflective Film(InkJet Digital)to match Matthews Pantone 361 with 3M MCS approved ORIGINAL PHOTOGRAPH-SIDE B Iinkjet inks. 'C,��.' REV-12-20-19-BRG PG-7 Site Name: Northampton Property ID: 3710 ' Address: 175 Main St. City/ST: Northampton, MA • . _ - E05 Existing Signage: _ Illuminated Directional Overall:T-11"Tall S-1"Wide TBD Deep Square Footage: 12.08 sq.ft. s a ORIGINAL PHOTOGRAPH-SIDE A COMPOSITE PHOTOGRAPH with PROPOSED SIGNAGE SPECIAL CONDITIONS Turn off power at breaker,cap off existing zo }}z I I power,and replace with new directional z sns 8 5/,s 1'-8'12 2Z 4'-6" 2'-9 1/z„ SIDE A SIDE VIEW SIDE B TD-D.0004-X scale-1/2"=1'-0" 4.33 sq.ft. Non-illuminated painted directional sign with film decorated sign face.Aluminum tube frame and aluminum sheet construction.Sign to be painted to match:PMS 5535#MP62874V1.0(Satin Finish).Sign face first surface film 3M 5000 Scotchlite Reflective White Vinyl and 3M IJ680-10 Scotchlite Reflective Film(InkJet Digital)to match Matthews Pantone 361 with 3M MCS approved ORIGINAL PHOTOGRAPH-SIDE B I inkjet inks. 'r,��i REV-12-20.19-BRG PG-8 Site Name: Northampton Property ID: 3710 - Address: 175 Main St. City/ST: Northampton, MA` W XZ T Bank Bank 7D Bank wo TO Open 7 Days Open 7 Days Open 7 Days - E01 / Side A / East E01 / Side B / West E02 / Side A / East E03 / Side A / West ENTER E04 / Side A / East E04 / Side B / West E05 / Side A / West E05 / Side B / East I 4s N06 / Side AT f East •MOW: ' 08-28-19-JP PG-10 RINGING DESIGN r0 RFAVTV To Whom It May Concern: I, Steven Prouse , acting as authorized agent of the Owner of the subject property hereby authorize Saxton Signs to act on my behalf in all matters relative to work authorized by these building and/or sign permit applications for the property listed at 175 Main St., Northampton, MA 01060 All work done by said contractors will meet or exceed code requirements and meet NEC standards. Owner/Authorized Agent: Signature-.- 130 ignature: 130 Pinnacle Point Court,Suite 109,Columbia,SC 29223 Phone: 803.790.2121 www.rnageresourcegroup.corn 2598 E Sunrise Blvd.,Suite 210-A.Ft.Lauderdale,FL 33304 Florida Registration: F03000005018 841 Prudential Drive. 12 floor.Jacksonville,FL 32207 Bank America's Most Convenient Bank, TD Bank, N.A. 17000 Horizon Way Mail Stop: NJ5-005-105 Mount Laurel, NJ 08054 T:(856)470-3983 Vicki,Svlvester td,com AUTHORIZATION LETTER February 27, 2019 To Whom It May Concern: Please allow this letter to serve as authorization for employees of Image Resource Group to act on behalf of TD Bank N.A n the filing of any applications for required permits and/or approvals for the Signage Renovation Work of the TD Bank N.A owned facility. This would include, but is not limited to, signing any owner signature application, appearing before any governmental agency at general meetings or public hearings addressing the signage at the facilities and, if necessary, recording any such decisions. Should you have any questions, please do not hesitate to contact me directly at (856) 470-3983. Sincerely, Vicki Sylvester TD Bank N.A. - Officer cc: File Steven Prouse— Image Resource Group EVema M.Cornish lic,State of New Jersey ission No.2181623 xpires October 30,20 Site Name: Northampton Property ID: 3710 Address: 175 Main St. City/ST: Northampton, MA zz ago Ira j0F, % • 1=9 M&rrrC Site Plan 08-28-19-JP PG-3 E05i " E04 4 , E03 JIM NO6 •r P E02 _1 XNI 71 1: /100�`-gsx NYSIF New York State Insurance Fund 199 CHURCH STREET,NEW YORK,N.Y. 10007-1100 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^AAAAA 141670108 SAXTON CORPORATION OF ALBANY 1320 RTE 9 a f CASTLETON NY 12033 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER SAXTON CORPORATION OF ALBANY CITY OF NORTHAMPTON 1320 RTE 9 212 MAIN STREET CASTLETON NY 12033 NORTHAMPTON MA 01060 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G 813 625-1 784881 11/01/2019 TO 11/01/2020 2/6/2020 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 813 625-1, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING ?9231 ACOREN DATE(MM/DONYM `� CERTIFICATE OF LIABILITY INSURANCE 2/6/2020 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 pollcy(les)must have ADDITIONAL INSURED provisions or 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 NAME: Connie O'Brien Arthur J.Gallagher Risk Management Services, Inc. PHONE 518-869-3535 AX No):518-869-3580 677 Broadway 4th Floor Albany NY 12207 ADDE-MRESS: Connie OBrien@ajg.com INSURERS AFFORDING COVERAGE NAIC S INSURER A:Selective Insurance Company Of SC 19259 INSURED SAXTCOR-01 INSURER B:ShelterPoint Life Insurance Company 81434 Saxton Corporation of Albany 1320 Route 9 INSURERC: Castleton On Hudson NY 12033 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1288469384 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY S 2139450 1/1/2020 1/1/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED__ CLAIMS-MADE rx-1 OCCUR PREMISES Ea occurrence $500,000 MED EXP Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICYPRO- FI LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ A AUTOMOBILE S 2139450 1/1/2020 1/1/2021 COM BINEDSINGLE LIMIT $1,000,000 Ea acddant X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIREDX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per aoddent $ A X UMBRELLALL48 X OCCUR S 2139450 1/1/2020 1/1/2021 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED I X I RETENTION I $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I ER _ ANYPROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ _ K es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Disability DBL-44433 1/1/2020 1/1/2021 A Leased&Rented S 2139450 1/1/2020 1/1/2021 $150,000 $1,000 DED Installation Floater $100,000 $1,000 DED DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more apace is required) Additional Insured Forms as required by written contract:CA 78 09NY 01 16, CG 7921 01 14 and CG 73 00 01 16. Sign erection,repair&manufacturing. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton 212 Main Street AUTHORIZED REPRESENTATIVE Northampton, MA 01060 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - BLANKET BASIS COMMERCIAL UMBRELLA LIABILITY CXL 456 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE PART The following is added to Paragraph M. Transfer Of Rights Of Recovery Against Others To Us under SECTION IV— CONDITIONS: We will waive any right of recovery we may have against a person or organization because of payments we make for "bodily injury" or "property damage" arising out of "your work" done under a written contract or written agreement and included in the "products-completed operations hazard". This waiver applies only if, in that same written contract or agreement, you have agreed: 1. To waive any right of recovery against that person or organization; or 2. To include such person or organization as an additional insured on an "underlying policy"; or 3. To assume the liability of that person or organization and that written contract or agreement qualifies as an insured contract; and 4. The"underlying insurance" contains a substantially similar waiver of recovery rights. This endorsement applies only if the"bodily injury" or"property damage" occurs subsequent to all parties' execution of the written contract or written agreement. Copyright, 2013 Selective Insurance Company of America. All rights reserved. CXL 456 10 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1 INSURED'S COPY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS , COMPLETED OPERATIONS - AUTOMATIC STATUS IIVHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU COMMERCIAL GENERAL LIABILITY " ' CG 79 21 01 10 THIS ENDORSEMENT CI ANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II — WHO IS AN INSURED is amended to This insurance does not apply to: include as an additional insured any person or organi- zation whom you have agreed in a written contract or "Bodily injury", "property damage" or"personal written agreement to add as an additional insured on and advertising injury" arising out of the your policy. Such person or organization is an addi- rendering of, or the failure to render, any pro- tional insured only with respect to liability for "bodily fessional architectural, engineering or injury" or "property damage" caused, in whole or in surveying services, including: part, by "your work" performed for that additional 1 The re a rovin or failingre- insured and included in the "products-completed ( � p parin g' pp g' operations hazard", pare or approve, maps, shop drawings,to pre- insured opinions, reports, surveys, field orders, B. With respect to the insurance afforded to these addi- change orders or drawings and specifica- tional insureds, the following additional exclusions tions; or apply: (2) Supervisory, inspection, architectural or engineering activities. This coverage shall be excess with respect to the person or organization included as an additional insured by its provisions; any other valid and collectible insurance that person or organization has shall be primary with respect to this insurance, unless this coverage is required to be primary and/or not contributory in the contract or agreement referred to above. Copyright, 2009 Selective Insurance Company of America. All rights reserved. CG 79 21 01 10 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ElitePacc General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 OONY 01 16 SUMMARY OF COVERAGES (including index) This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. Refer to the actual endorsement (Pages 3-through-8) for changes affecting your insurance protection. DESCRIPTION PAGE FOUND Additional Insureds - Primary and Non-Contributory Provision Page 6 Blanket Additional Insureds -As Required By Contract Page 5 Broad Form Vendors Coverage Page 6 Damage To Premises Rented To You (Including Fire, Lightning or Explosion) Page 3 Electronic Data Liability ($100,000) Page 4 Employee Definition Amended Page 7 Employees As Insureds Modified Page 5 Incidental Malpractice Exclusion modified Page 6 Knowledge of Occurrence, Claim, Suit or Loss Page 6 Liberalization Clause Page 7 Newly Formed or Acquired Organizations Page 5 Non-Owned Aircraft Page 3 Non-Owned Watercraft (under 60 feet) Page 3 Not-for-profit Members - as additional insureds Page 4 Products Amendment (Medical Payments) Page 4 Supplementary Payments Amended - Bail Bonds ($5,000) and Loss of Earnings ($1,000) Page 4 Unintentional Failure to Disclose Hazards Page 7 Waiver of Transfer of Rights of Recovery (subrogation) Page 7 When Two or More Coverage Parts of this Policy Apply to a Loss Page 3 Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 THIS PAGE IS INTENTIONALLY LEFT BLANK. Copyright, 2015 Selective Insurances Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 ElitePac(` General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 OONY 01 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if(a) two or more Coverage Parts of this policy, or(b) two or more forms or endorsements within the same Coverage Part apply to a loss, the coverage provision(s) with the broadest language will apply, unless specifically stated otherwise within the particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. COVERAGES -Amendments (6) Any aircraft, not owned or operated by any insured, which is hired, chartered or loaned with SECTION I - COVERAGE A BODILY INJURY AND a paid crew. However, if the insured has any PROPERTY DAMAGE LIABILITY other valid and collectible insurance for "bodily EXCLUSIONS injury" or "property damage" that would be cov- Non-Owned Aircraft, Auto or Watercraft ered under this provision, or on any other basis, this coverage is then excess, and subject to A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Condition 4. Other Insurance, b. Excess Watercraft under COVERAGE A BODILY INJURY Insurance under SECTION IV - COMMERCIAL AND PROPERTY DAMAGE LIABILITY, 2. Exclu- GENERAL LIABILITY CONDITIONS. sions is deleted in its entirety and replaced with the Damage To Premises Rented to You following: (2) A watercraft you do not own that is: A. The last paragraph of Paragraph 2. Exclusions under COVERAGE A BODILY INJURY AND PROP- (a) Less than 26 feet long and not being used to ERTY DAMAGE is deleted in its entirety and re- carry persons or property for a charge; or placed with the following: (b) At least 26 feet, but less than 60 feet long, Exclusions c. through n. do not apply to damage by and not being used to carry persons or fire, lightning or explosion to premises rented to you property for a charge. Any person is an or temporarily occupied by you with the permission insured who uses or is responsible for the of the owner. A separate limit of insurance applies to use of such watercraft with your expressed this coverage as described in SECTION III - LIMITS or implied consent. However, if the insured OF INSURANCE. has any other valid and collectible insurance B. Paragraph 6. under SECTION III - LIMITS OF for "bodily injury" or "property damage" that INSURANCE is deleted in its entirety and replaced would be covered under this provision, or on with the following: any other basis, this coverage is then excess, and subject to Condition 4. Other 6. Subject to Paragraph 5. above, the most we will Insurance, b. Excess Insurance under pay under COVERAGE A for damages because SECTION IV - COMMERCIAL GENERAL of"property damage" to any one premises, while LIABILITY CONDITIONS. rented to you, or in the case of damage caused B. The following is added to Exclusion g. Aircraft, by fire, lightning or explosion, while rented to you Auto Or Watercraft under COVERAGE A BODILY or temporarily occupied by you with permission INJURY AND PROPERTY DAMAGE LIABILITY, 2. of the owner, for all such damage caused by fire, Exclusions: lightning or explosion proximately caused by the same event, whether such damage results from This exclusion does not apply to: fire, lightning or explosion or any combination of the three, is the amount shown in the Declara- tions for the Damage To Premises Rented To You Limit. Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8 C. Paragraph a. of Definition 9. "Insured contract" under a. Any Insured SECTION V - DEFINITIONS is deleted in its entirety To any insured. and replaced with the following: This exclusion does not apply to: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises (1) "Not-for-profit members"; that indemnifies any person or organization for (2) "Golfing facility" members who are not paid a damage by fire, lightning or explosion to fee, salary, or other compensation; or premises while rented to you or temporarily (3) "Volunteer workers". occupied by you with the permission of the owner is not an "insured contract"; This exclusion exception does not apply if COVERAGE Electronic Data Liability C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. A. Exclusion p. Access or Disclosure Of Confidential Product Amendment Or Personal Information And Date-related Liability under COVERAGE A BODILY INJURY Exclusion f. Products-Completed Operations Hazard AND PROPERTY DAMAGE LIABILITY, 2. Exclu- under COVERAGE C MEDICAL PAYMENTS, 2. Exclu- sions is deleted in its entirety and replaced by the sions is deleted in its entirety and replaced with the following: following: p. Access or Disclosure Of Confidential Or f. Products-Completed Operations Hazard Personal Information And Date-related Liab- Included within the "products-completed operations ility hazard". Damages arising out of: This exclusion does not apply to "your products" sold (1) Any access to or disclosure of any person's for use or consumption on your premises, while such or organization's confidential or personal products are still on your premises. information, including patents, trade secrets, This exclusion exception, does not apply if COVERAGE processing methods, customer lists, finan- C MEDICAL PAYMENTS is excluded by another cial information, credit card information or endorsement to this Coverage Part. any other type of nonpublic information; or SECTION I - SUPPLEMENTARY PAYMENTS - (2) The loss of, loss of use of, damage to, COVERAGES A AND B corruption of, inability to access, or inability Expenses For Bail Bonds And Loss Of Earnings to manipulate "electronic data" that does not result from physical injury to tangible A. Subparagraph 1.b. under SUPPLEMENTARY property. PAYMENTS - COVERAGES A AND B is deleted in This exclusion applies even if damages are its entirety and replaced with the following: claimed for notification costs, credit monitoring b. Up to $5,000 for cost of bail bonds required expenses, forensic expenses, public relations because of accidents or traffic law violations expenses or any other loss, cost or expense arising out of the use of any vehicle to which incurred by you or others arising out of that Bodily Injury Liability Coverage applies. We do which is described in Paragraph (1) or (2) not have to furnish these bonds. above. B. Subparagraph 1.d. under SUPPLEMENTARY B. The following paragraph is added to SECTION III - PAYMENTS - COVERAGES A AND B is deleted in LIMITS OF INSURANCE: its entirety and replaced with the following: Subject to 5. above, the most we will pay under d. All reasonable expenses incurred by the insured COVERAGE A for "property damage" because of all at our request to assist us in the investigation or loss of "electronic data" arising out of any one defense of the claim or "suit", including actual "occurrence" is a sub-limit of$100,000. loss of earnings up to $1,000 a day because of SECTION I - COVERAGE C MEDICAL PAYMENTS time off from work. EXCLUSIONS SECTION II -WHO IS AN INSURED -Amendments Any Insured Amendment Not-for-Profit Organization Members Exclusion a. Any Insured under COVERAGE C The following paragraph is added to SECTION II - WHO MEDICAL PAYMENTS, 2. Exclusions is deleted in its IS AN INSURED: entirety and replaced with the following: If you are an organization other than a partnership, joint venture, or a limited liability company, and you are a not- for-profit organization, the following are included as additional insureds: Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 I. Your officials; to "your work" only, for the period of time 2. Your trustees; described above, for your liability arising out of the conduct of any partnership or joint venture of 3. Your members; which you are or were a member, even if that 4. Your board members; partnership or joint venture is not shown as a 5. Your commission members; Named Insured. However, this provision only applies if you maintain or maintained an interest 6. Your agency members; of at least fifty percent in that partnership or joint 7. Your insurance managers; venture for the period of that partnership or joint 8. Your elective or appointed officers; and venture. 9. Your"not-for-profit members". This provision does not apply to any partnership or joint venture that has been dissolved or otherwise ceased to However only with respect to their liability for your function for more than thirty-six months. activities or activities they perform on your behalf. With respect to the insurance provided by this provision, Employees As Insureds Modified Newly Formed or Acquired Organizations, the A. Subparagraph 2.a.(1)(a) under SECTION II - WHO following is added to SECTION IV - COMMERCIAL IS AN INSURED does not apply to "bodily injury" to GENERAL LIABILITY, Paragraph 4. Other Insurance, a "temporary worker" caused by a co-"employee" Subparagraph b. Excess Insurance: who is not a "temporary worker". The insurance provided by this provision, Newly Formed B. Subparagraph 2.a.(2) under SECTION II - WHO IS or Acquired Organizations, is excess over any other AN INSURED does not apply to "property damage" valid and collectible insurance available to the insured, to the property of a "temporary worker" or "volunteer whether primary, excess, contingent or on any other worker" caused by a co-"employee" who is not a basis. "temporary worker" or"volunteer worker". (All other provisions of this section remain unchanged). C. Subparagraph 2.a.(1)(d) under SECTION II - WHO Blanket Additional Insureds - As Required By IS AN INSURED does not apply to "bodily injury" Contract caused by cardio-pulmonary resuscitation or first aid A. Subject to the Primary and Non-Contributory services administered by a co-"employee". provision set forth in this endorsement, SECTION II - With respect to this provision only, Subparagraph (1) of WHO IS AN INSURED is amended to include as an Exclusion 2.e. Employer's Liability under SECTION I - additional insured any person or organization whom COVERAGES, COVERAGE A BODILY INJURY AND you have agreed in a written contract, written PROPERTY DAMAGE LIABILITY does not apply but agreement or written permit that such person or only for the benefit of the co-"employee" described organization be added as an additional insured on above. your policy. Such person or organization is an This provision does not apply to any claims covered additional insured only with respect to liability for under Worker's Compensation insurance. "bodily injury" or "property damage" or "personal and Newly Formed Or Acquired Organizations advertising injury" caused, in whole or in part, by: A. Subparagraph 3.a. under SECTION II - WHO IS AN 1. Your ongoing operations, "your product", or INSURED is deleted in its entirety and replaced with premises owned or used by you; the following: With respect to the insurance afforded to these additional insureds, the following additional a. Coverage under this provision is afforded only exclusion applies: until the 180th day after you acquire or form the organization or the end of the policy period, This insurance does not apply to: whichever is earlier. However, COVERAGE A "Bodily injury", "property damage" or "personal does not apply to "bodily injury" or "property and advertising injury" arising out of the damage" that occurred before you acquired or rendering of, or the failure to render, any formed the organization. professional architectural, engineering or B. The following paragraph is added to SECTION II surveying services by or for you, including: -WHO IS AN INSURED, Paragraph 3: a. The preparing, approving, or failing to If you are engaged in the business of con- prepare or approve, maps, shop drawings, struction of dwellings three stories or less in opinions, reports, surveys, field orders, height, or other buildings three stories or less in change orders or drawings and specifi- height and less than 25,000 square feet in area, cations; and you will also be an insured with respect Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 b. Supervisory, inspection, architectural or d. Repackaging, unless unpacked solely for the engineering activities. purpose of inspection, demonstration, testing, or This exclusion applies even if the claims against the substitution of parts under instructions from any insured allege negligence or other wrong- the manufacturer, and then repackaged in the doing in the supervision, hiring, employment, original container; training or monitoring of others by that insured, if e. Any failure to make such inspections, adjust- the "occurrence" which caused the "bodily injury" ments, tests or servicing as the vendor has or "property damage", or the offense which agreed to make or normally undertakes to make caused the "personal and advertising injury", in the usual course of business in connection involved the rendering of, or failure to render, with the sale of the product; or any professional architectural, engineering or f. Products which, after distribution or sale by you, surveying services. have been labeled or re-labeled or used as a 2. Your maintenance, operation or use of equip- container, part of ingredient of any other thing or ment, other than aircraft, "auto" or watercraft, substance by or for the vendor; however this rented or leased to you by such person or insurance does not apply to any insured person organization. A person or organization's status or organization, from who you have acquired as an additional insured under this endorsement such products, or any ingredient, part or ends when their contract, or agreement with you container, entering into, accompanying or for such rented or leased equipment ends. With containing such products. respect to the insurance afforded to these The provisions of this coverage extension do not apply additional insureds, this insurance does not unless the written contract or written agreement has apply to any "occurrence" which takes place been executed (executed means signed by the named after the rental agreement or equipment lease insured) prior to the "bodily injury" or"property damage". expires. The provisions of this coverage extension do not Incidental Malpractice apply unless the written contract or written agree- Subparagraph 2.a.(1)(d) under SECTION II - WHO IS ment has been executed (executed means signed by AN INSURED is deleted in its entirety and replaced with the named insured) or written permit issued prior to the following: the "bodily injury" or "property damage" or "personal (d) Arising out of his or her providing or failing to provide and advertising injury". professional health care services. This does not Broad Form Vendors Coverage apply to nurses, emergency medical technicians or Subject to the Primary and Non-Contributory provision paramedics if you are not in the business oroccupation of providing any such professional set forth in this endorsement, SECTION II - WHO IS AN services. INSURED is amended to include as an additional insured any person or organization (referred to below as This provision does not apply if you are a Social Service vendor) whom you have agreed in a written contract or or Senior Living risk. written agreement to add as an additional insured on SECTION IV - COMMERCIAL GENERAL LIABILITY your policy. Such person or organization is an additional CONDITIONS -Amendments insured only with respect to "bodily injury" or "property Knowledge Of Occurrence, Claim, Suit Or Loss damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's The following is added to Paragraph 2. Duties in the business, however the insurance afforded the vendor Event of Occurrence, Offense, Claim or Suit under does not apply to: SECTION IV - COMMERCIAL GENERAL LIABILITY a. "Bodily injury" or"property damage" for which the CONDITIONS: vendor is obligated to pay damages by reason of The requirements under this paragraph do not apply until the assumption of liability in a contract or after the "occurrence" or offense is known to: agreement; however this exclusion does not 1. You, if you are an individual; apply to liability for damages that the vendor 2 A partner, if you are a partnership; would have in the absence of the contract or agreement; 3. An "executive officer" or insurance manager, if you b. Any express warranty unauthorized by you; are a corporation; c. Any physical or chemical change in the product 4. Your members, managers or insurance manager, if made intentionally by the vendor; you are a limited liability company; or Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 5. Your elected or appointed officials, officers, 3. You have assumed the liability of that person or members, trustees, board members, commission organization in that same contract, and it is an members, agency members, or your administrator or "insured contract". your insurance manager if you are an organization The section above only applies to that person or other than a partnership, joint venture, or limited organization identified above, and only if the "bodily liability company. injury" or "property damage" occurs subsequent to the Primary and Non-Contributory Provision execution of the written contract or written agreement. The following is added to Paragraph 4. Other Liberalization Insurance, b. Excess Insurance under SECTION IV - The following condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance shall be excess with respect to any If we revise this Coverage Part to provide more coverage person or organization included as an additional insured without additional premium charge, subject to our filed under this policy, any other insurance that person or company rules, your policy will automatically provide the organization has shall be primary with respect to this additional coverage as of the day the revision is effective insurance, unless: in your state. (1) The additional insured is a Named Insured under SECTION V - DEFINITIONS such other insurance; (2) You have agreed in a written contract, written Electronic Data agreement or written permit to include that additional The following definition is added to SECTION V - insured on your General Liability policy on a primary DEFINITIONS: and/or non-contributory basis; and "Electronic data" means information, facts or programs (3) The written contract or written agreement has been stored as or on, created or used on, or transmitted to or executed (executed means signed by the named from computer software, including systems and applica- insured) or written permit issued prior to the "bodily tions software, hard or floppy disks, CD-ROMS, tapes, injury" or "property damage" or "personal and drives, cell, data processing devices or any other media advertising injury". which are used with electronically controlled equipment. Unintentional Failure To Disclose Hazards For the purpose of the Electronic Data Liability coverage provided by this endorsement, Definition 17. "Property The following is added to Paragraph 6. Representations under SECTION IV - COMMERCIAL GENERAL damage" is deleted in its entirety and replaced by the LIABILITY CONDITIONS: following: However, if you should unintentionally fail to disclose any 17. "Property damage" means: existing hazards in your representations to us at the a. Physical injury to tangible property, including all inception date of the policy, or during the policy period in resulting loss of use of that property. All such connection with any additional hazards, we shall not loss of use shall be deemed to occur at the time deny coverage under this Coverage Part based upon of the physical injury that caused it; or such failure to disclose hazards. b. Loss of, loss of use of, damage to, corruption of, Waiver Of Transfer Of Rights Of Recovery inability to access, or inability to properly manipulate "electronic data", resulting from The following is added to Paragraph 8. Transfer of physical injury to tangible property. All such loss Rights Of Recovery Against Others To Us under SECTION IV - COMMERCIAL GENERAL LIABILITY of "electronic data" shall be deemed to occur at CONDITIONS: the time of the "occurrence" that caused it. For the purpose of the Electronic Data Liability coverage We will waive any right of recovery we may have against provided by this endorsement, "electronic data" is not a person or organization because of payments we make tangible property. for"bodily injury" or"property damage" arising out of your ongoing operations or "your work" done under a written Employee Amendment contract or written agreement and included in the Definition 5. "Employee" under SECTION V - 11 prod ucts-completed operations hazard", if: DEFINITIONS is deleted in its entirety and replaced by 1. You have agreed to waive any right of recovery the following: against that person or organization in a written 5. "Employee" includes a "leased worker", or a contract or written agreement; "temporary worker". If you are a School, "Employee" 2. Such person or organization is an additional insured also includes a student teacher. on your policy; or Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 Golfing Facility The following definition is added to SECTION V - DEFINITIONS: "Golfing facility" means a golf course, golf club, driving range, or miniature golf course. Not-for-profit Member The following definition is added to SECTION V - DEFINITIONS: "Not-for-profit member" means a person who is a member of a not-for-profit organization, including clubs and churches, who receives no financial or other compensation. I I Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 OONY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 ElitePac`, Commercial Automobile Extension COMMERCIAL AUTO CA 78 09NY 01 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by the endorsement. AMENDMENTS TO SECTION II - LIABILITY COVER- An "employee" of yours is an "insured" while operating AGE an "auto" hired or rented under a contract or agreement If this policy provides Auto Liability coverage for Owned in that "employee's" name with your permission, while Autos, the following extensions are applicable accord- performing duties related to the conduct of your ingly: business. NEWLY ACQUIRED OR FORMED ORGANIZATIONS BLANKET ADDITIONAL INSUREDS The following is added to SECTION II, A.1. - Who Is An The following is added to SECTION II, A.1. - Who Is An Insured: Insured: Any organization you newly acquire or form, other than a Any person or organization with whom you agreed in a partnership,joint venture or limited liability company over written contract, written agreement or written permit to which you maintain ownership or majority interest, will add as an additional "insured" on your policy is an addi- qualify as a Named Insured if there is no similar insur- tional "insured". Such person or organization is an ance available to that organization. However: additional "insured" only with respect to your ownership, maintenance or use of a covered "auto". This coverage 1. Coverage under this provision is afforded only until shall be primary and non-contributory with respect to the the 180th day after you acquire or form the organiza- additional "insured". This provision only applies if: tion or the end of the policy period, whichever is earlier; 1. It is required in the written contract, written agree- ment or written permit identified in this section; 2. Coverage does not apply to "bodily injury" or "property damage" resulting from an "accident" that 2. It is permitted by law; and occurred before you acquired or formed the organi- 3. The written contract or written agreement has been zation. executed or written permit issued prior to the "bodily No person or organization is an "insured" with respect to injury" or"property damage". the conduct of any current or past partnership, joint EXPENSES FOR BAIL BONDS AND LOSS OF venture or limited liability company that is not shown as EARNINGS a Named Insured in the Declarations. Paragraphs (2) and (4) of SECTION II, A.2.a. - LIMITED LIABILITY COMPANIES Supplementary Payments are deleted in their entirety The following is added to SECTION II, A.I. -Who Is An and replaced with the following: Insured: (2) Up to the Limit of Insurance shown on the ElitePac If you are a limited liability company, your members and Schedule for the cost of bail bonds (including bonds managers are "insureds" while using a covered "auto" for related traffic law violations) required because of you don't own, hire or borrow during the course of their an "accident" covered under this policy. We do not duties for you. have to furnish these bonds. EMPLOYEES AS INSUREDS (4) All reasonable expenses incurred by the "insured" at our request. This includes actual loss of earnings If this policy provides Auto Liability coverage for Non- because of time off from work, which we will pay up Owned Autos, the following is added to SECTION II, to the Limit of Insurance shown on the ElitePac A.1. -Who Is An Insured: Schedule. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. Copyright, 2015 Selective Insurance Company of America. All rights reserved. CA 78 09NY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 EMPLOYEE INDEMNIFICATION AND EMPLOYER'S ADDITIONAL TRANSPORTATION EXPENSES LIABILITY AMENDMENT SECTION III, AA.a. - Transportation Expenses is The following is added to SECTION II, B.4. - Exclusions deleted in its entirety and replaced with the following: This exclusion does not apply to a "volunteer worker" We will pay up to the maximum Limit of Insurance shown who is not entitled to workers compensation, disability or on the ElitePac Schedule for temporary transportation unemployment compensation benefits. expenses that you incur because of any "loss" to a cov- FELLOW EMPLOYEE COVERAGE ered "auto", but only if the covered "auto" carries the coverages and meets the requirements described in 1. The Fellow Employee Exclusion, SECTION II, B.5. - is or 2. below: deleted in its entirety. 1. We will pay temporary transportation expenses for CARE, CUSTODY OR CONTROL AMENDMENT total theft of a covered "auto". We will only pay for The following is added to SECTION II, B.6. - such expenses incurred during the period beginning Exclusions: 24 hours after the theft and ending, regardless of the This exclusion does not apply to property owned by policy's expiration, when the covered "auto" is anyone other than an "insured", subject to the following: returned to use or we pay for its "loss". 1. The most we will pay under this exception for any 2. For "loss" other than total theft of a covered "auto" one "accident" is the Limit of Insurance stated in the under Comprehensive or Specified Causes of Loss ElitePac Schedule; and Coverage, or for any "loss" under Collision Coverage to a covered "auto", we will only pay for those tem- 2. A per "accident" deductible as stated in the ElitePac porary transportation expenses incurred during the Schedule applies to this exception. policy period beginning 24 hours after the "loss" and AMENDMENTS TO SECTION III - PHYSICAL ending, regardless of the policy's expiration, with the DAMAGE COVERAGE lesser of the number of days reasonably required to If this policy provides Comprehensive, Specified Causes repair or replace the covered "auto" or 30 days. of Loss or Collision coverage, the following extensions Paragraph 2. of this extension does not apply while are applicable for those "autos" for which Comprehen- there are spare or reserve "autos" available to you sive, Specified Causes of Loss or Collision coverage is for your operations. purchased: This coverage extension does not apply to Emergency TOWING AND LABOR Services Organizations, Governmental Entities and SECTION III, A.2. - Towing is deleted in its entirety and Schools. replaced with the following: HIRED AUTO PHYSICAL DAMAGE COVERAGE We will pay all reasonable towing and labor costs up to The following is added to SECTION III, A.4. - Coverage the maximum Limit of Insurance shown on the ElitePac Extensions: Schedule per tow each time a covered "Private Passen- Physical Damage coverage is hereby extended to apply ger Auto", "Social Service Van or Bus" or "Light Truck" is to Physical Damage "loss" to "autos" leased, hired, disabled and up to the maximum Limit of Insurance per rented or borrowed without a driver. We will provide cov- tow each time a covered "Medium Truck", "Heavy Truck" erage equal to the broadest coverage available to any or"Extra Heavy Truck" is disabled. covered "auto" shown in the Declarations. But, the most For labor charges to be eligible for reimbursement the we will pay for "loss" to each "auto" under this coverage labor must be performed at the place of disablement. extension is the lesser of.- This f:This coverage extension does not apply to Emergency 1. The Limit of Insurance stated in the ElitePac Services Organizations and Governmental Entities. Schedule; or GLASS BREAKAGE DEDUCTIBLE 2. The actual cash value of the damaged or stolen The following is added to SECTION III, A.3. - Glass property as of the time of the "loss"; or Breakage - Hitting A Bird Or Animal - Falling Objects 3. The actual cost of repairing or replacing the dam- or Missiles: aged or stolen property with other property of like If damaged glass is repaired rather than replaced, no kind and quality. A part is of like kind and quality deductible will apply for such repair. This extension does when it is of equal or better condition than the pre- not apply to Emergency Services Organizations and accident part. We will use the original equipment Governmental Entities. from the manufacturer when: Copyright, 2015 Selective Insurance Company of America. All rights reserved. CA 78 09NY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 5 (a) The operational safety of the vehicle might PERSONAL EFFECTS otherwise be impaired; The following is added to SECTION III, A.4. - Coverage (b) Reasonable and diligent efforts to locate the Extensions: appropriate rebuilt, aftermarket or used part If this policy provides Comprehensive Coverage for a have been unsuccessful; or covered "auto" you own and that covered "auto" is (c) A new original equipment part of like kind stolen, we will pay up to the Limit of Insurance shown on and quality is available and will result in the the ElitePac Schedule, without application of a deducti- lowest overall repair cost. ble, for lost personal effects that were in the covered For each leased, hired, rented or borrowed "auto" our "auto" at the time of theft. Personal effects do not include obligation to pay "losses" will be reduced by a deductible jewelry, tools, money, or securities. This coverage is equal to the highest deductible applicable to any owned excess over any other collectible insurance. "auto" for that coverage. No deductible will be applied to AIRBAG COVERAGE "losses" caused by fire or lightning. The following is added to SECTION III, B.3.a. - HIRED AUTO LOSS OF USE COVERAGE Exclusions: The following is added to SECTION III, AA. - Coverage Mechanical breakdown does not include the accidental Extensions: discharge of an airbag. We will pay expenses for which you are legally responsi- This coverage extension does not apply to Emergency ble to pay up to the Limit of Insurance shown on the Services Organizations and Governmental Entities. ElitePac Schedule per "accident" for loss of use of a EXPANDED AUDIO, VISUAL, AND DATA ELEC- leased, hired, rented or borrowed "auto" if it results from TRONIC EQUIPMENT COVERAGE an "accident". This coverage extension does not apply to Schools. SECTION III, B.4. - Exclusions AUTO LOAN/LEASE GAP COVERAGE (Not Applica- This exclusion does not apply to the following: ble in New York) 1. Global positioning systems; The following is added to SECTION III, A.4. - Coverage 2. "Telematic devices"; or Extensions: 3. Electronic equipment that reproduces, receives or In the event of a total "loss" to a covered "auto" we will transmits audio, visual or data signals and accesso- pay any unpaid amount due on the lease or loan for a ries used with such equipment, provided such covered "auto", less: equipment is: 1. The amount paid under the Physical Damage Cover- a. Permanently installed in or upon the covered age Section of the policy; and "auto" at the time of the "loss"; 2. Any: b. Removable from a housing unit that is perma- nently installed in the covered "auto" at the time a. Overdue lease/loan payments at the time of of the of "loss"; c. Designed to be solely operated by use of power b. Financial penalties imposed under a lease for from the "auto's" electrical system; or excessive use, abnormal wear and tear, high mileage or similar charges; d. Designed to be used solely in or upon the covered "auto". c. Security deposits not refunded by the lessor or financial institution; A deductible of $50 will apply to each covered "loss" of d. Costs for extended warranties, credit life, health, such equipment. accident, or disability insurance purchased with COMPREHENSIVE DEDUCTIBLE - LOCATION the loan or lease; and TRACKING DEVICE e. Carry-over balances from previous leases or The following is added to SECTION III, D. - Deductible: loans. Any Comprehensive Coverage Deductible shown in the You are responsible for the deductible applicable to the Declarations higher than $50 is hereby reduced to $50 "loss" for the covered "auto". for"loss" caused by theft if the "auto" is equipped with an This extension only applies if the lessor or financial "auto" location tracking device and that device aided in institution is an additional "insured" under this Coverage the recovery of the "auto". Form. Copyright, 2015 Selective Insurance Company of America. All rights reserved. CA 78 09NY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5 PHYSICAL DAMAGE LIMIT OF INSURANCE MULTIPLE DEDUCTIBLES SECTION III, C. - Limit Of Insurance is deleted in its The following is added to SECTION IV, A. - Loss entirety and replaced with the following: Conditions: The most we will pay for a "loss" in any one "accident" is If a "loss" from one event involves two or more covered the lesser of: "autos" and coverage under Comprehensive, Collision, 1. The actual cash value of the damaged or stolen or Specified Causes of Loss applies, only the highest property as of the time of the "loss"; or applicable deductible will be applied. 2. The cost of repairing or replacing the damaged or CONCEALMENT, MISREPRESENTATION OR FRAUD stolen property with other property of like kind and The following is added to SECTION IV, B.2. - quality. Concealment, Misrepresentation Or Fraud: This coverage extension does not apply to Emergency If you should unintentionally fail to disclose any existing Services Organizations and Governmental Entities. hazards in your representations to us prior to the incep- AMENDMENTS TO SECTION IV - BUSINESS AUTO tion date of the policy or during the policy period in con- CONDITIONS nection with any newly discovered hazards, we will not DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT deny coverage under this Coverage Form based upon such failure. OR LOSS SECTION IV, B. 5. Other Insurance Condition, The following is added to SECTION IV, A.2.a. - Duties Paragraph 5.b. is deleted in its entirety and replaced by In The Event Of Accident, Claim, Suit Or Loss: the following: The notice requirements for reporting "accident" claim, For Hired Auto Physical Damage Coverage, the follow- "suit" or "loss" information to us, including provisions re- ing are deemed to be covered "autos"' you own: lated to the subsequent investigation of such "accident", claim, "suit" or "loss" do not apply until the "accident", 1. Any covered "auto" you lease, hire, rent, or borrow; claim, "suit" or"loss" is known to: and 1. You, if you are an individual; 2. Any covered "auto" hired or rented by your "employee" under a contract or agreement in that 2. A partner, if you are a partnership; "employee's" name, with your permission, while 3. An executive officer or insurance manager, if you performing duties related to the conduct of your are a corporation; business. 4. Your members, managers or insurance manager, if However, any "auto" that is leased, hired, rented or you are a limited liability company; borrowed with a driver is not a covered "auto". 5. Your elected or appointed officials, trustees, board This coverage extension does not apply to Emergency members or your insurance manager, if you are an Services Organizations and Governmental Entities. organization other than a partnership, joint venture POLICY PERIOD, COVERAGE TERRITORY or limited liability company. SECTION IV, B.7. - Policy Period, Coverage Territory But, this section does not amend the provisions relating is deleted in its entirety and replaced with the following: to notification of police or protection or examination of the property that was subject to the "loss". Under this Coverage Form, we cover "accidents" and "losses" occurring: WAIVER OF SUBROGATION a. During the policy period shown in the Declarations; SECTION IV, A.S. - Transfer Of Rights Of Recovery and Against Others To Us is deleted in its entirety and replaced with the following: b. Within the "Coverage Territory". We waive any right of recovery we may have against We also cover "loss" to or "accidents" involving a cov- any person or organization because of payments we ered "auto" while being transported between any of make for "bodily injury" or "property damage" resulting these places. from the ownership, maintenance or use of a covered "auto" but only when you have assumed liability for such "bodily injury" or "property damage" in an "insured con- tract". In all other circumstances, if a person or organiza- tion to or for whom we make payment under this Cover- age Form has rights to recover damages from another, those rights are transferred to us. Copyright, 2015 Selective Insurance Company of America. All rights reserved. CA 78 09NY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 5 TWO OR MORE COVERAGE FORMS OR POLICIES EXTRA HEAVY TRUCK ISSUED BY US - DEDUCTIBLES "Extra Heavy Truck" means a truck with a gross vehicle The following is added to SECTION IV, B.8. - Two Or weight rating of 45,001 pounds or more. More Coverage Forms Or Policies Issued By Us: HEAVY TRUCK If a "loss" covered under this Coverage Part also in- "Heavy Truck" means a truck with a gross vehicle weight volves a "loss" to other property resulting from the same rating of 20,001 pounds to 45,000 pounds. occurrence of "loss" or damage that is covered under this policy or another policy issued by us or any member LIGHT TRUCK company of ours, only the highest applicable deductible "Light Truck" means a truck with a gross vehicle weight will be applied. rating of 10,000 pounds or less. A minimum deductible of $50 will apply to each covered MEDIUM TRUCK "loss" unless it is a Collision "loss" for a "private passen- "Medium Truck" means a truck with a gross vehicle ger auto". For a "private passenger auto", a minimum weight rating of 10,001 pounds to 20,000 pounds. deductible of$100 for Collision will apply to each "loss". PRIVATE PASSENGER AUTO AMENDMENTS TO SECTION V - DEFINITIONS BODILY INJURY INCLUDING MENTAL ANGUISH (Not "Private Passenger Auto" means a four-wheel "auto" of Applicable in New York) the private passenger or station wagon type. A pickup, panel truck or van not used for business is included The definition of bodily injury is deleted in its entirety and within the definition of a "private passenger auto". replaced by the following: SOCIAL SERVICE VAN OR BUS "Bodily injury" means bodily injury, sickness, or disease "Social Service Van or Bus" means a van or bus used by sustained by a person, including death resulting from a government entity, civic, charitable or social service any of these. "Bodily injury" includes mental anguish organization to provide transportation to clients inci- resulting from bodily injury, sickness or disease sus- dental to the social services sponsored by the organiza- tained by a person. tion, including special trips and outings. ADDITIONS TO SECTION V - DEFINITIONS TELEMATIC DEVICE COVERAGE TERRITORY "Telematic Device" includes devices designed for the "Coverage Territory" means: collection and dissemination of data for the purpose of 1. The United States of America (including its territories monitoring vehicle and/or driver performance. This in- and possessions), Canada and Puerto Rico; and cludes Global Positioning System technology, wireless safety communications and automatic driving assistance 2. Anywhere in the world, except for any country or systems, all integrated with computers and mobile com- jurisdiction that is subject to trade or other economic munications technology in automotive navigation sys- sanction or embargo by the United States of tems. America, if a covered "auto" is leased, hired, rented, or borrowed without a driver for a period of 30 days VOLUNTEER WORKER or less, and the insured's responsibility to pay "Volunteer worker" means a person who performs busi- "damages" is determined in a "suit" on the merits in ness duties for you, for no financial or other compensa- and under the substantive law of the United States tion. of America (including its territories and possessions), Puerto Rico, or Canada, or in a settlement we agree to. If we are prevented by law, or otherwise, from defending the "insured" in a "suit" brought in a location described in Paragraph 2. above, the insured will conduct a defense of that "suit". We will reimburse the "insured" for the rea- sonable and necessary expenses incurred for the defense of any such "suit" seeking damages to which this insurance applies, and that we would have paid had we been able to exercise our right and duty to defend. Copyright, 2015 Selective Insurance Company of America. All rights reserved. CA 78 09NY 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5 ,I City of Northampt n Map 31 D Lot 142 Zone CB(100)/ Massachusetts Date issued 2/18/2020 0:00:00 Inspector of Buildings Permit # BP-2020-0902 j Permit Fee$60.00 SIGN PERMIT Business Address 175 MAIN ST - TD BANK Applicant Installer AXTON SIGN CORP Applicant Installer Address 1320 Route 9 Work Description ILLUMINATED WALL SIGN - TD BANK Estimated Cost $2200.00 Building Department Approval by: CX" File#BP-2020-0902 APPLICANT/CONTACT PERS:)N SAXTON SIGN CORP ADDRESS/PHONE 1320 Route 9 Castleton (518)732-7704(102) PROPERTY LOCATION 175 N AIN ST-TD BANK MAP 31 D PARCEL 142 001 ZONE CB 100 / THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinsz Permit Filled out Fee Paid Tvpeof Construction:_ILLUMINATED WALL SIGN-TD BANK New Construction Non Structural interior rev ovations Addition to Existing Accesso Structure Buildina Plans Included: Owner/Statement or Lice se 3 set f Plans/Plot Plan THE OLLOWING ACTION AS BEEN TAKEN ON THIS APPLICATION BASED ON IN RMATION PRESENTE Approved Additional ermits required(see below) PLANNING BOARD P RMIT 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 PER IT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from D W 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 Dela Signature of Building Official Date Note: Issuance of a Zoning per it does not relieve a applicant's burden to comply with all Zoning requirements and obtain all re uired permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only tothose applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. <SIti ..r,ir THIJ of Xvrt4ampton ,� ' , ;x `r� +ARttssttrlfusrtts �� 5-��•~�f4G w l= DEPARTMENT OF BUILDING INSPECTIONS s 212 Main Street • Municipal Building Northampton, MA 01060 INSPECTOR Application for a Permit to Place or Maintain a Sign Sidewalk Sign, Marquee or other Advertising Devic ,e5 ZO q Z (Application,to be j'led! or typewritten) Number ..................... Plans must be filed with the Building Inspector � Erection..................( ) before a permit will be granted. Alteration.................( ) FEBc Repair.....................( ) 2020 Repainting...............( ) A_p Rv-inval..................( ) T QF 13U �( `*•,npTHq% ONG�NSP� F o f U AGE3.�..:PLOT.. N.41Aq otoCTNg Nortpt Mass. ...............................20..... I..1 To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESSNAME ... .L/...l.X .n. ............................................................................... 1. Location, Street and No. ............................................................. 2. Owner's name .... ......................... 3. Owner's address ..�.I.S... .� ....�1........... VU.�..U.. ........... ................................... 4. Maker's name ......:!.<. :?<.. n...................................................................................... 3 � a ,�: 5. Maker's address ......... ....i�....(...... .0 ,,... . . ......... . .L.......... .. . ..................... 6. Erector's name ....J.CISx�................................ .......... ........................ 7. Erector's address .... . . .......�I ... ......CS).,5 � )`:.... .y\..... �� '.� SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ....... Non-illuminated ....... 2. Will sign obstruct a fire escape, window or door? P?. ... Marquee ............... 3. Lower edge will be .... .ft........ins above the public way. Projecting .............. 4. Upper edge will be ....k.ft........ins above the public way. Roof ..................... 5. Height ......ft..0.ins Width l.J,..ft.Q..ins Temp ar ............. 6. Face are44'.Tsq. ft. Wall . .............. 7. Inner edge will be ..... ins from the building or pole. Sidewalk.................... 8. Outer edge will be .......ins from the building or pole. Other......................... 9. Face of building or pollis .......ins back from the street line. 10. Sign will project .......ins beyond the street line. 11. Sign will extend .......ft .......ins above the building or pole. 12. Of what material wA I sIgn be constructed? Frame .. .< ?f............... Face..uOK-.oe.".......... 13. Estimated cost $.!.! Ci-)-q.cz 1A n The undersigned certifies that the above statements are true to the of his knowledge and belief. . ....... ........ ...... ................... tgna Own r or A nt) Page 1 of 3 131 Site Name: Northampton Property ID: 3710 Address: 175 Main St. City/ST: Northampton, MA E03 Existing Signage: Illuminated Wall Sign _ Overall:2'-0"Tall 12'-10"Wide TBD Deep Square Footage:25.67 sq.ft. ORIGINAL PHOTOGRAPH COMPOSITE PHOTOGRAPH with PROPOSED SIGNAGE SPECIAL CONDITIONS No Special Conditions. 12'-10" 1" 2'-2 7/8"— 2'-0" FRONT VIEW Scale-3/8"=1'-0" TDB-CRP-24X154 25.67 sq.ft. Breakformed.125"thk Aluminum cabinet painted Matthews Paint-MP65220 R165605 V-1.3-Satin. Vinyl to be 3M 7725-10 Scotchcal White Vinyl applied to the first surface.Mounted with appropriate aluminum angle all hardware painted to match. I • r a• REV-12-20-19-BRG PG-6 City of Northampt n Map 3 1 D Lot 142 Zone CB(100)/ Massachusetts Date issued 2/18/2020 0:00:00 Inspector of Buildings Permit # BP-2020-0904 Permit Fee$100.00 SIGN PERMIT Business Address 175 MAIN ST - TD BANK Applicant InstallerSAXTON SIGN CORP Applicant Installer Address 1320 Route 9 Work Description NON-ILLUMINATED GROUND SIGN Estimated Cost $2200.00 Building Department Approval by: File#BP-2020-0904 APPLICANT/CONTACT PERS N SAXTON SIGN CORP ADDRESS/PHONE 1320 Route 9 Castleton (518)732-7704(102) PROPERTY LOCATION 175 ry AIN ST-TD BANk MAP 3 ID PARCEL 142 001 Z NE CB 100 / THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOS EQUIRED DATE ZONING FORM FILLED OUT _ Fee Paid Building Permit Filled out Fee Paid T eofConstruction: NON-ILLUMINATED GROUND SIGN 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 F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional ermits required(see below) PLANNING BOARD P RMIT 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 PER IT REQUIRED UNDER: § Finding Special Permit Variance* Received& Re orded 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 Dela Zlr 31 Zd Signature of But ding Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all re uired 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 form re information. � . r � _ "� � � _ .. fi,. � � '. ,;\ � _ - _ _. 1 .. �1 -. �. I � .% .�r�:. i ,. � i-- '1. / \. _ i .. � � i .. � # /, .. r � . �" �4°; • � �. .. - _ .. +�„�.";� - � 'r �' -; ,. �: i ' .� - TitU of Nort4ampton ,+ARttssttrt�usrtts �� s- ��'''�4� DEPARTMENT OF BUILDING INSPECTIONS m 212 Main Street • Municipal Building Northampton, MA 01060 INSPECTOR Application for a Permit to Place or Maintain a Sign Sidewalk Sign, Marquee or other Advertising De% �J! / (Applicdti. tobe,filled out in ink or typewritten) Number ... a�.. "'~ t ........... P ��'''1� Plans must be filed with the Building Inspector. L \.� Erection.... ( ) before a permit will be granted. `— Alteration.................( ) Repair.....................( ) Repainting...............( ) dna Removal... qRemoval..................( ) c4 Z— No �Ft��t FEE66...PAGE........PLOT....... T yAItI CT,oMg p, C. o�oAbhha pton, Mass. ...............................20..... To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME ...ID......... v .K.......................................................................... 1. Location, Street and No. . l`� 4'.A.cl-./k...�S .............................................................. 2. Owner's name ....ta RNEN.....XL ............1.......1................................................... 3. Owner's address ...D5 ....!'..CA.t11..„ .....i..�V.(`r !ACX. .................................... c 4. Maker's name .. ............................................................................. 5. Maker's address .. tb.....t? �,......1. LotiefQln-....t.!V.. !.....otw............. 6. Erector's name ........ T ...p,a! ........................................................................... 7. Erector's address .... .....C-,&54!,pT ...!. .1........1a033.................... SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ....... Non-illuminated ...... 2. Will sign obstruct a fire escape, window or door? ......... Marquee ............... 3. Lower edge will be .Q..ft..Q...ins above the public way. Projecting .............. 4. Upper edge will be ..�..ft��...ins above the public way. Roof ..................... 5. Height .5....ft.1�G.ins Width ft......ins Temporary............. 6. Face area :D:-�sq. ft. Wall ..................... 7. Inner edge will be ......ins from the building or pole. Sidewalk.................... 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 or pole. 12. Of what material will sign be c s ru ted? Frame ..At.* fh.............. Face.u.e)>W............ 13. Estimated cost $Xo: The undersigned certifies that the above statements are true of his kn edge and belief. ....... ........ ........ ..... ......... .. . ........... f Own or Agent) Page 1 of 3 Site Name: Northampton Property ID: 3710 Address: 175 Main St. City/ST: Northampton, MA E01 F ■ Existing Signage: z -- - D/F Non-Illuminated Monument Overall:5'-2"Tall 5'-2"Wide TBD Deep Square lot — _ Footage:26.69 sq.ft. C - .a ORIGINAL PHOTOGRAPH COMPOSITE PHOTOGRAPH with PROPOSED SIGNAGE SPECIAL CONDITIONS 7'-2 1/4"Cut Size No Special Conditions. 6'-11'V.0. 4'-81/2" 5'-1 t/4" Cut Size 4'-10" V.O. 4'-2 112 FRONT VIEW MFG NOTE SCaI@-1/2rr_�r_�rr ........ ----- --- Any seams in inyl to be located at bottom of T TDB-RP-FS.0003 Qty 2 37.2 sq.ft. C`ossbar .177"thk Makrolon sl#7328(1354)polycarbonate.Background to be 3M 3632-6513 Translucent Dark Green Vinyl applied to first surface.Logo to be 3M 3630-5741 TD Light Green Translucent Vinyl laminated with 3M 3660M applied to the first surface.Copy to be dropped out to illuminate white. I • r i REV-12-20-19-BRG PG-4 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: L S Address: Telephone: 1, �S -a 0Q 2. Owner of Property: ,)I-- piaJJ1r— Address: D S Ma i,1 '5-1 A-,;)ku Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee _Other(explain): 4. Job Location: Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE//BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: f��IC 6. Description oaf/Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) l =�-�ti r Y._ fP—r (' I��. cx � iS I >lR S c ✓l L{,"/ �I ,c,t� Cur azatt 1 d¢n LA!�2 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: 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 ,I IF YES: Describe the size,type and location: Alrin�C/Il — Are there any proposed changes to,or additions of,signs intended for the property? YES_ NO IF YES: Describe the size,type and location: CA(' [' kn 'cc'i'i fain LI 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. DATE: ° �(J APPLICANT'S SIGNATURE Applicant's Email Address (required) 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 Map 3 1 D Lot 142 Zone CB(100)/ Massachusetts l Date issued 2/18/2020 0:00:00 Inspector of Buildings Permit # BP-2020-0903 Permit Fee$60.00 SIGN PERMIT Business Address 175 MAIN ST - TD BANK Applicant InstallerSAXTON SIGN CORP Applicant Installer Address 1320 Route 9 Work Description ILLUMINATED WALL SIGN - TD BANK Estimated Cost $2200.00 Building Department Approval by: cXd" File# BP-2020-0903 APPLICANT/CONTACT PERSON SAXTON SIGN CORP ADDRESS/PHONE 1320 Route 9 Castleton (518)732-7704(102) PROPERTY LOCATION 175 MAIN ST-TD BANK MAP 3 1 D PARCEL 142 001 ZONE CB(100)/ I THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildina Permit Filled out- Fee utF e Paid Typeof Construction: ILLUMINATED WALL SIGN -TD BANK New Construction Non Structural interior re ovations Addition to Existin Accessoa Structure Buildina Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 Dela I IZD Signature of Building Official i 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 tothose applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. -- Tits of Xort4amplon DEPARTMENT OF BUILDING INSPECTIONS yam: a 212 Main Street a Municipal Building Northampton, MA 01060 INSPECTOR Application for a Permit to Place or Maintain a Sign Sidewalk Sign, Marquee or other Advertising Device �I ' (Applica on to be filled out in ink or typewritten) Number .6e...'�... v Plans must be filed with the Building Inspector / Erection..................( ) before a permit will be granted. i ED Alteration.................( ) Repair.....................( ) Repainting...............( ) FE9 ' 20� Removal...... . . EE! UV f 1 C4Z V` ...PAGE'.�.......PLOT....... nF NOAT F et1ItOwn IMSA M RAMP?nN. q or� mpt n, Mass. 20..... To the Building Commissioner: � Application for a permit to place or maintain a`sign or other advertising device, or marquee. d l BUSINESSNAME .. .... (, ........................................................................ 1. Location, Street and No. C...i'.!cu.A...!�r ............................................................ 2. Owner's name . .1. 1/!".....1. ....................................................................... 3. Owner's address .��.J.... U.i1�.-� .......�`!Q. .�U ........................................................... 4. Maker's name .::?.Ct`tTQ.ri....�>.()n............................................................................ 5. Maker's address ..j.50,k.�J7..C1..... (C!l7ya ...... ...1.aO ............................... 6. Erector's name ...�.)CLA):�...e,-. ............................... .......... .... . 7. Erector's address 1.3dz.....1V.9.....Co,5VAfbr A i41 ....... T..... ........ . . ......................... SIGNKIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ...... Non-illuminated ....... 2. Will sign obstruct a fire escape, window or door? .0..0... Marquee ............... 3. Lower edge will be ......ft........ins above the public way. Projecting .............. 4. Upper ed�..99e will be ......ft........ins ab ve the public way. Roof ..................... 5. Height ../...ft.u..ins Width�...ft. ..ins Temporary............. 6. Face area AVc1sq. ft. Wall .. ................ 7. Inner edge will be ......ins from the building or pole. Sidew Ik. .................. 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 or pole. 12. Of what material VAi �vl slo structed? Frame ...At_v»a.............. Face.Lt.-c lt!1............ 13. Estimated cost $. . � The undersigned certifies that the above statements are t e to est is knowledge and belief. ........ ................. ...... . ( nature of O ner or nt) Page 1 of 3 Site Name: Northampton Property ID: 3710 Address: 175 Main St. City/ST: Northampton, MA E02 Existing Signage: Illuminated Channel Letters Overall:2'-2"Tall 7'-4"Wide TBD Deep Square • Footage:15.89 sq.ft. • canl Open 7 Days • • ORIGINAL PHOTOGRAPH COMPOSITE PHOTOGRAPH with PROPOSED SIGNAGE SPECIAL CONDITIONS No Special Conditions. B A i = NOTE:NO WORK TO BE DONE ON LETTERS-RETAIN AS IS L- ED D FRONT VIEW NTS-TYPICAL VIEW B IC Technical Survey 2'- 2 3/8" 2'- 5 1/2" 4'- 5" 6 1/4" Dimensions TDB-CRP-CL .177" Thk W7328 White Acrylic Face with Translucent Light Green Vinyl Applied First Surface Of Face. "TD"Dropped Out To Show White.Entire Face To Be Laminated With 3M Overlaminate Vinyl.1"trim cap adheared to face,trim cap and hardware MEpainted Light Green.I� a REV-12-20-19-BRG PG-5