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18-005 (19) City of Northampton Map 18 Lot005 Zone Massachusetts Date issued 6/10/2021 0:00:00 Inspector of Buildings Permit # BP-2021-1476 Permit Fee$100.00 SIGN PERMIT Business Address 245 NORTH KING ST Applicant InstallerSIGNARAMA Applicant Installer Address 879 BOSTON RD Work Description REFACE ILLUMINATED GROUND SIGN Estimated Cost $3673.00 Building Department Approval by: Z —0 File#BP-2021-1476 APPLICANT/CONTACT PERSON SIGNARAMA ADDRESS/PHONE 879 BOSTON RD SPRINGFIELD (413)731-9213 PROPERTY LOCATION 245 NORTH KING ST MAP 18 PARCEL 005 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REFACE ILLUMINATED GROUND S GN 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 INN ORMATION PRESENTED: �"[ Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay it& 6 (07A, Sig ture 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. .7#1Co.- City of Northampton a,HAMpT a. #o J., o,�` SAS,...�......SICJ �" L, Massachusetts ��% S- �� g ,) yi ;l R 4'i (fit �'-It DEPARTMENT OF BUILDING INSPECTIONS Dt x ..'1,; 4, 212 Main Street • Municipal Building Off` :C'' - t,r.'' Northampton, MA 01060 f W. `,‘0 -- Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee 00 _d,l /`/7C' (Application to be filled out in ink or typewritten) Number . C!' Plans must be filed with the Building Inspector Erection ( ) before a permit will be granted. Alteration ( ) Repair ( ) Repainting ( ) it (Removal ( ,) F E1( PAGE., ...PLOT.V.` 6 Northampton, Mass. ):..;Jilt 1 202..1 Application for a permit to place or maintain a sign or other advertising device, or marquee BUSINESS NAME /OorTh1pk... Tr-805 M 1 5,5 liebNi 1. Location, Street and No. M5 N. eota 2. Owner's name ....tt4�� '- C) L 4- € f I!9 C 3. Owner's address 5 Two ,All `�D' (,,E, «-d. M.. 010y 4. Maker's name Sk V)J'9i v3 l _ - r ^ ` Li 5. Maker's address e 761 8 Ito... c 14,,/ tj l ' I / C)t(< I 6. Erector's name . 1.�. YLICI'11114 7. Erector's address BOSien Rb - .S.11.. CE..l...<.'.(.4 0 1 SIGN KIND OF SIGN `, (Designate) 1. Sign will be (check one) illuminated .K.. Non-illumi 3 ed 2. Will sign obstruct a fire esc e, window or door? Marquee 3. Lower edge will be .. ..ins above the public way. Projecting 4. Upper edge will be ..l ..ft... in above the public way. Roof 5. Height .D. Ins Width .//2ft ins Temporary 6. Face area . sq. ft. Wall 7. Inner edge will be ..c2i from the building or pole. Ground ... 2��t'1`tc. 8. Outer edge will be -,ins from the building or pole. Other 9. Face of building or pole is ../.Qns back from the street line. 10. Sign will project .0..ins beyond the street line. 11. Sign will extend 0 ft (,2 ins above the buildingor ple. (� 12. Of hat material will slap,b e constructed? Frame . I Vi'+�1'n 0'1 Face P©kCb4" 13. Estimated cost $. > ' . . .3 The undersigned certifies that the above statements are true to the best of his knowled e and belief. sada444 / (Signature of Owner or Agent) Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING (INFORMATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: [ `7 iC 1�P IBC 14 I A oi/I - 4 Y' It/i d 5V Address: sr 1 GC�J�j1/4.0 J �/414 U((Olephone: "1j 13 —13 I -9 2 ( 3 2. Owner of Property: (ILXIIVK, /7V1{ L } 51/\ I� I f9 C �- u Address: J TU 7 M 1 I� (4)• Lt LA re v '4/3 T1f4elephone: 7 13 5v5 3. Status of Applicant: Owner Contract Purchaser Lessee kOther(explain): )'cS41 1-10 4x't` -' Cool+'( c -)c 4. Job Location: 2 45 �, k/ l� . /1/044mplan Al/4 0(OfG•.o Parcel ID: Zoning Map# �� Parcel# �5 District(s) (TO BE ILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: My I tIp k 05 z _ ( vici ,1/4 v ci('#4 L 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) gtct;a h i, �bc if - i bek) Oy-c. . 7. Attached Plans: &Sketch Plan Site Plan Engineered/Surveyed Plans 8. Has a Special PermitNariance/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 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 X NO p � IF YES: Describe the size,type and location: r)(i )+1\' GZC)11`J 5 I 11 6 K (t! A). G11/Lc5� Are there any proposed changes to, or additions of, signs intended for the property? YES YES/ K NO ,-� IF YES: Describe the size,type and location: 11� i[ 'L( t5f i 6 2c .3 Ld 211 . ►rYYt._ . 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 I O(oriCr 5AjO Frontage ti Z�C�F.F- 5 t1 rY\ Front: ih Setbacks:(for sign)Side: L: (00 R: R: Rear: Building Height 2C7 Facade Square Footage 5 c # of Parking Spaces Lf 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 47) Jcj/zi APPLICANT'S SIGNATURE adavm 1 ` CQ-6 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 „slo.H.,,,,,,,, • . ..,_ ✓ Date = Hov . :**; Ilk. ,�* 1 , .a a t +r ar. . '_ ORTHAMPTON :*:: raasaaissisa 4...f., 1 d r _ - - IMPORTANT:Please reveiw attached proof for size,layout and content.Colors in proof are not representative of the finished product due to individual monitor settings. Upon output we use the CMYK or RGB color values supplied in the file.If a color match is required,a Pantone(PMS)color number must be provided with the artwork.Please reply to this email for approval or any changes.Your approval aknowledges that the proof is correct and that we may proceed with production. 879 Boston Rd.* Springfield MA,01103 * 413-731-9213 FAIL 413-731-9175 * design@mass-signs.com c This design and drawing submitted for your review and Name: Company: --41 Sig approval is the exclusive property of BpneranO Phone: Fax: E-mail: v .,way to grow you,business. It may not be reproduced,copied,exhibited or utilized for any purpose,in part or in whole by any individual Comments: 1 without written consent of ttmq File: Date: J The Commonwealth of Massachusetts =-*-= Department of Industrial Accidents t Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: " i G 6 -PC c., (0+1C -- r1 . Address: 0 7-CA City/State/Zip: 5prfti fIb) M11 Oil(1 Phone#: 4 /3- 73)- g 213 Are you an employer? Check the appropriate box: Business Type(required): 1.[1 I am a employer with 3 employees (full and/ 5. ❑ Retail or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7_ ❑ Office and/or Sales(incl. real estate, auto,etc.) employees working for me in any capacity. [No workers' comp. insurance required] 8. Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.E.Manufacturing no employees. [No workers' comp. insurance required]** 11.0 Health Care 4.❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance req.] 12.121 Other 51�Y1s *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees./Below is the policy information. Insurance Company Name: I l� I/1 C1L 'lrE r15c>rAl1cE `fj,n-pi4r -f Insurer's Address: One. 14 pr y: P��}zi% p ('� L 15f j City/State/Zip: c c- cr ., CT (Xc:, Policy#or Self ins. Lic. # 76, 1A)F.6 AC3315 Expiration Date: 12/2 3 /2. 1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains an pe allies of perjury that the information provided bo a is true and correct Signature: friit Date: 4i 9L/ Phone#: cm --73/— 72I3 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4. Licensing Board 5.Selectmen's Office 6. Other Contact Person: Phone#: www.mess.gov/dia