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39-063 (20) City of Northampton Map:Lot 39-063-001 Massachusetts Date issued 11/30/2021 Inspector of Buildings Permit # BP-2021-2197 Permit Fee $100.00 SIGN PERMIT Business Address 8 ATWOOD DR Applicant Installer AGNOLI SIGN CO INC Applicant Installer Address P 0 BOX 1055, SPRINGFIELD, MA 01105 Work Description ILLUMINATED GROUND SIGN -EMC Estimated Cost $40000 Building Department Approval by: II y . )� . NFcO' G1-17uNG7 s'cc. File #BP-2021-2197 S ;pZ,RD � UGRA�Mtry(� APPLICANT/CONTACT PERSON:AGNOLI SIGN CO INC P O BOX 1055 SPRINGFIELD, MA 01 105(413)732-5111 PROPERTY LOCATION 8 ATWOOD DR MAP:LOT 39-063-001 ZONE �r - ���0� NITS THIS SECTION FOR OFFICIAL USE ONLY: N I' i t t M 70O NITS' PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Ago Fee Paid $100.00 Type of Construction: ILLUMINATED GROUND SIGN - EMC l New Construction Non Structural 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 INFJORMATION PRESENTED: / Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Perm it With Site Plan Major Project: Site Plan AND/OR Special Perm it With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Perm its Required: Curb Cut from DPW Wa ter 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 rr r ► . . 11/ /30 a 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 standardsofMGL 40A.Contact Office of Planning&Development for more information. City of Northampton ,.,NA ro s.S .'"'. s Massachusetts �,i�.,' , c g ;� 4. DEPARTMENT OF BUILDING INSPECTIONS t.j. 4' 212 Main Street . Municipal Building � . `�'� �''� Northampton, MA 01060 sr ��- ��0 Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee (Application to be filled out in ink or typewritten) Number B P - I I`� • 7 Plans must be filed with the Building Inspector Erection ( ) before a permit will be granted. Alteration ( v) Repair ( ) Repainting ( ) Removal ( ))FEE •".V— PAGE. 3(1 PLOT" ',Northampton, Mass. ...1J.o.f.ec Q ad.203A. Application for a permitr� to place or maintain a sign or other advertising device, or marquee BUSINESS NAME ...`-�A.o.olo6...PrSe..s.Qc)p.\....1 �C po 1. Location, Street and No. C6i...t"1Atoca6..bYN.Q. 2. Owner's name .. e\i.e.1.0 7('f)eo:V...0 G- 3. Owner's address ....1Q30_5\ver..3A...0t-A.c....R:s000n....To A...0.100.1 4. Maker's name 1/450Qi.i 313()...ea. Inc. • 5. Maker's address I�o:BOX....10.5.5 6.c i.er18a..m:A...0.00.1- I o.O.55 6. Erector's name Anoa,..5\ 0....ao•..toc.. 7. Erector's address . b c x...14. .b ti.,?p'ci.00.�8... .'A...cAloi - 10.5.5... J SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated / Non-illuminated 2. Will sign obstruct a fire escape, window or door? .. .U... Marquee 3. Lower edge will be ft ...ins above the public way. Projecting 4. Upper edge will be ft ...ins above the public way. Roof 5. Height 3 ft..a..ins Width .AL)..ft...c#.ins Temporary 6. Face area3q.J:-.sq. ft. Wall 7. Inner edge will be ins from the building or pole. Ground ✓ 8. Outer edge will be ins from the building or pole. Other 9. Face of building or pole is ins back from the street line. 10. Sign will project ... ...ins beyond the street line. 11. Sign will extend .. ...ft ins above the building or pole. 12. Of what material will sign be constructed? Frame do“") Face..1.eXGC1 13. Estimated cost $ 1-40,Oco..cD The undersigned certifies that the above statements are true to the best of his knowledge and belief. (Signature of Owner or Agent) Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING (INFORMATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: (\QC')O\i 3 c' �(rc• �(�C Address: 1�(-) X \05P) Sp(I0 t;e\C�, (`tlA0"0i- `OTelephone: I-413 - 3 - 5 2. Owner of Property: ---0Qqp\oMPCI (.\S3c C:• C O ool Address: AC) `,S\VPC S\• ,k C. (a�n�cm, rnA Telephone: /-I 34 ao 3. Status of Applicant: Owner Contract Purchaser Lessee ✓Other(explain): ago Cne "CZc 1C15\Ci c 4. Job Location: I-I r&i oc \ My Q, Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: C:f�cY)Ccle(i c Q\ \xc Pc4,\I 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) ' (41]Ce e1tg\-cc1C� IOU:0 ecb wP O�. UOL IQ Si6eck fik n S�JC1 (Yr\ n C �au p��J ,ee 9•c c1P-n;\s rAeckcomr meczo.,se nenAoc-5 ,o. C\1c \ c s-\c hecK - In e,c 54i; 7. Attached Plans: c/ Sketch Plan Site Plan Engineered/Surveyed Plans CA> 7e+' 8. Has a Special PermitNariance/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 IF YES: Describe the size,type and location: C )('55k 43 S C1f c.\on _1•,s(-) iz Ah b c-k( i Vacs . Are there any proposed changes to, or additions of,(signs intended for the property? YES / NO IF YES: Describe the size,type and location: P CILQ P�l�4c,C1 CCYk CY'\a 4 \cc 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:(for sign)Side: L: R: L: R: Rear: Building Height Facade Square Footage # of Parking Spaces 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 11 I , 1 APPLICANT'S SIGNATURE 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 gnoli ign Company Inc. AGNOU AGN COMPANY,INC OPTION 2 A.1 722 WORTHINGTON STREET - - — 120" SPRINGFIELD,MA 07105 TEL.(413)732-5111 EXISTING PROPOSED i- CUSTOMER: • „ w DEVELOPMENT F- ASSOCIATES -# 630 SILVER ST/UNIT 3C w :: AGAWAM,MA -^ _. _,,, 11. I ti LOCATION. i '... �r I -- Millk ATWOOD 2X-SINGLE FACED ELECTRONIC MESSAGE CENTERS ATWOOD PROFESSIONAL - ProfeuionalCnmpus CAMPUS CABINET:47"X 120" 8 ATWOOD DRIVE .;5.:_. '"` Ar" ; V.O.:36"X 1 08" NORTHAMPTON,MA STORE#: `'•,, ,. #000 1 ` .. A_2 CONTACT: no. -...L.1,. - ::-y. ••.. /'1�= ..- TRAVIS WARD SALES PERSON: . ---#N. .-- -Am. - - AT WOOD DESIGNER: ' M Professional Campus BRIAN ORIG DATE: 0-29-20 78 1/2" REV.DATE: 07-13-20LRV 05-24-21 ADL 2X-LEXAN FACES FOR DOUBLE FACED PYLON 09-09.21LRV WITH TRANS SLATE GREY VINYL SCALE. NTS NOT FOR PRODUCTION THIS DESIGN IS THE EXCLUSIVE PROPERTY OF AGNOLI SIGN COMPANY INCORPORATED A AND ALL RIGHTS TO RS USE D-MISC/DEVELOPMENT ASSOCIATES.PLT OR V REPRODUCTION ARE RESERVED DEVELOPMENT ASSOCIATES-8 ATWOOD DR-NORTHAMPTON, MA.CDR AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) ,..../ 6/21/2021 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 policy(ies) 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 The Dowd Agencies, LLC PHONE Suzanne R.Mlinarcik FAX 14 Bobala Road tax.No.Ext):413-437-1042 (A/c,No):413-437-1442 Holyoke MA 01040 E-MAIL ADDRESS: smlinarcik©dovad.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Middlesex Insurance Company 23434 INSURED INSURER B: Agnoli Sign Co., Inc. 722 Worthington Street INSURERC: PO Box 1055 INSURER13: Springfield MA 01101-1055 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER:1802862557 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY A0130589003 6/21/2021 6/21/2022 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X ' OCCUR PREMISES(Eaoccurrence) $500,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY X JEC X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ A ,AUTOMOBILE LIABILITY A0130589004 6/21/2021 6/21/2022 COMaccBINidenqED SINGLE LIMIT $1,000,000 (Ea ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURYaccident) AUTOS ONLY X AUTOS (Per $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR A0130589006 6/21/2021 6/21/2022 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X , RETENTION$n $ A WORKERS COMPENSATION A0130589005 6/21/2021 6/21/2022 X ;MUTE EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTIONIf s, N under E.L.DISEASE-POLICY LIMIT $1,000,000 OF OPERATIONS below i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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. Evidence of Insurance AUTHORIZED REPRESENTATIVE rASOI:API)* ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations s _? �! Lafayette City Center _` w = 2 Avenue de Lafayette, Boston, MA 02111-1750 ": www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Agnoli Sign Company, Inc. Address: 722 Worthington Street/PO Box 1055 City/State/Zip Springfield,MA 01101-1055 Phone #:413-732-51111 , Are you an employer? Check the appropriate box: Type of project(required): 1.Q I am a employer with 28 4. 0 I am a general contractor and 1 employees (full and/or part-time).* have hired the sub contractors 6. 0 New construction listed on the attached sheet. 7. 0 Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. El Demolition workingfor me in anycapacity. employees and have workers' p h 9. 0 Building addition [No workers' comp. insurance comp. insurance. t required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Middlesex Insurance Company Policy#or Self-ins. Lie. #:A0130589005 Expiration Date: 06-21-22 Job Site Address: City/State/Zip: 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 der the ain nd penalties of perjury that the information provided above is true and correct. Signature: Date: 413-732-5111 Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): lDBoard of Health 20 Building Department 30CityITown Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.EjOther Contact Person: Phone#: Commonwealth of Massachusetts Division of Professional Licensure Board of Budding Regulations and Standards Const\watit t'Supprvtsor CS-113467 spires:03/15/2023 JOHN G MACCORMICK 281 PINEWOOD DRIVE LONGMEADOW MA 01106 \ f()ft\ Commissioner /L -: ir"'""{- Construction Supervisor Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet (991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call (617)727-3200 or visit www.mass.govldpl