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24B-047 (2) File #BP-2022-1120 zJ� IZ APPLICANT/CONTACT PERSON:AGNOLI SIGN CO INC P 0 BOX 1055 SPRINGFIELD, MA 01105(413)732-5111 PROPERTY LOCATION 300 KING ST MAP:LOT 24B-047-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $100.00 Type of Construction: INSTALL NEW ILLUMINATED DOUBLE SIDED COMPANY NAME GROUND SIGN 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 U FORMATION PRESENTED: J 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 SpecialPermit 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 Ava liability Septic ApprovalBoard 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 41/ Q ' I" s�� !/'� a� Sig Iature 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. asn i3 -r-Py(Oc> City of Northampton 4' c�, % :, Massachusetts ���s icy% .; ti. ' L. 0- '.Y { r�i -11_,_-: DEPARTMENT OF BUILDING INSPECTIONS 4 .e '. y 212 Main Street • Municipal Building yJ6. a�s� + Northampton, MA 01060 .cy.,._ 3�� z Application for a Permit to Place or Maintain a Sign _) Or other Advertising Device, or Marquee rz� Ti (Application to be filled out in ink or typewritten) Number W 12--)1Lo Plans must be filed with the Building Inspector Erection ( v1 before a permit will be granted. Alteration Repair ( ) Repainting Removal ( ) FEE PAGE I PLOT.2 Q'O'7—O D / I Northampton, Mass. 41 1- 20a&.. Application for a permit to place or maintain a sign or other advertising device, or marquee BUSINESS NAME Deca.r.LJe.0......COMpOCI 1. Location, Street and No. �y ...A......\<11-)3... re-. 2. Owner's name C.OD.l Y'4... .0.11 :� �ru :1 3. Owner's address .....�#...0..Z0x.,... 3 # .cY,p ,.m ..0.lCAcA 4. Maker's name 5.Opki ai3n...Cc, knc.. 5. Maker's address . 0.. X U`J. V...I .... . r.t . :�.ela... R...C:l.to\...1.265 6. Erector's name ..t'. 1 CX1( pj.iC�'{�.. ):..inc, (� 1 , . 7. Erector's address ^O. C...10 5.... ri.(�C ti.61. Pi...C�1.101.-.i4,J6 V SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ..f.. Non-illuminated 2. Will sign obstruct a fire escape, window or door? ..W.c;.. Marquee 3. Lower edge will be .`Z..ft..C,>....ins above the public way. Projecting 4. Upper edge will be .IR..ft.. 1....ins above the public way. Roof 5. Height M...ft.c..ins Width .5..ft.4...ins Temporary 6. Face area : CU..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 isl.��:Liffi back from the street line. 10. Sign will project . )..ins beyond the street line. 11. Sign will extend ...C ..ft ins above the building or pole. 12. Of what material will sign be constructed? Frame ...Oluco L m... Face..1 On 13. Estimated cost $....(2Ic.DO•..c ... The undersigned certifies that the above statements are true to the best of his knowledge and •elief. e .4 -t- (Signatu e o 1 Owner or Agent) Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING (INFORMATION (n� PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: r,3Unl; 3i Ca. it7r • Address: Pfl )OS,j ih PA(, (Y)A C) 1(-)\ Telephone: -13- -, 1 t 2. Owner of Property: Con( Pa k A ' Ir�,S� Address: PC) -7ti. b3t4 , roc; Telephone: (DOi--44;7'cQ 10a 3. Statustu of Applicant: Owner Contract Purchaser Lessee ' Other(explain): 3te'0 '( nKer (Ale( 4. Job Location: 30oPt ` SkY PP-} Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: COmmPrc O\ - c €1 0_,nmpc.n3 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) 1•IPL_b 1I\ONY\("VAC . (Able, act crl j c S'\J Co pet SY)ek*h 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 J 1 IF YES: Describe the size,type and location: l- i 11 0c'c r4PC 1 La `l Ss nc) enAcncyc, -I-o bo-,Id-,n . Are there any proposed changes to,or additions of, signs intended for the property?.! YES NO ^�^ IF YES: Describe the size,type and location: J PL (i.� l e ;C '� l(U('n c Cal d scovc i-cc-k c hc),Id C3 c 5Ke h• 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 51Pa Q.51 '1G Frontage Front: Setbacks:(for sign)Side: I mo" L: R: I.3 60` L: R: 1 ` Rear: alp)' aWO Building Height 15 15i Façade Square Footage (00 # of Parking Spaces 13. Certification: I hereby certify that the information contained herein is true and accurate t. the best of my knowledge. DATE: 011 1('(1 APPLICANT'S SIGNATURE ,C) , t ' NOTE: Issuance of a zoning permit does not relieve an applicant 's burden to comply with all -oning Requirements and obtain all required permits from the Board of Health, Conservation Commiss on, Department of Public Works and other applicable permit granting authorities. FILE # Page 3 of 3 DATE(MMIDD/YYYY) A C R EP CERTIFICATE OF LIABILITY INSURANCE 6/27/2022 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 (A/C,No,Ext):413-437-1042 (NC,Nob 413-437-1442 Holyoke MA 01040 ADDRESS: smlinarcik@dowd.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Middlesex Insurance Company 23434 INSURED INSURER B: Agnoli Sign Co., Inc. IN8URERC: 722 Worthington Street P0 Box 1055 INSURERD: Springfield MA 01101-1055 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:824472810 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR`HE 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 INSD WVD POLICY NUMBER (MMIDD/YYYY) IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY A0130589003 6/21/2022 6/21/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY X JECOT- X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY A0130589004 6/21/2022 6/21/2023 COMaccident)BINED SINGLE LIMIT $1,000,000 (Ea ANY AUTO BODILY INJURY(Per person) $ OWNED x SCHEDULED BODILY INJURY(Per accident $ AUTOS ONLY AUTOS X HIRED x NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR A0130589006 6/21/2022 8/21/2023 EACH OCCURRENCE $5,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X I RETENTION S n $ A WORKERS COMPENSATION A0130589005 6/21/2022 6/21/2023 X ;MUTE EMPLOYERS'LIABILITY YIN 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 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/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 ©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 '' _'ice _f'9• Lafayette City Center 2Avenue de Lafayette, Boston, MA 02111-1750 "t 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 #:413-732-5111 Are you an employer? Check the appropriate box: Type of project(req fired): 1.Q i am a employer with 20 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub contractors 6. ❑ New constructs in 2.❑ i am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5• ❑ We are a corporation and its 10.❑ Electrical repai s or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repai s or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' I3.0 Other comp. insurance required.] *Any applicant that checks box it 1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit find eating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those ent ties 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 a djob site information. Insurance Company Name: Middlesex Insurance Company j Policy#or Self-ins. Lic. #:A0130589005 Expiration Date:06/21/23 Job Site Address: 3C C) 'j\m a City/State/Zip: ► • '.•s,.ta1 ..A Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi ation date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal .enalties of a tine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK OR PER and a fine i of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the 0 'ice of Investigations of the DIA for insurance coverage verification. 1 do hereby certi '�W5the ,ains and penalties of perjury that the information provided above is true and co rect. 1 l Si mature: „j ' Date: t Phone#: 413-7.2-51 1 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): n ID Board of Health 20 Building Department 3flCity/Town Clerk 4.0 Electrical Inspector 5.1111umbing Inspector 6.0Other• Contact Person: Phone#: 60" -4- 2„ L 1 1iou' c- — ' H Co 0 Dead River Dead River' , 1 1 ,� Company t Company I I Propane • Heating Oil Propane 4 Heating Oil I ► 24-Hour Service 24-Hour Service 4 I I 'I i i 1 I I I I sai 300A 1 I 1 1 3QQA HP WHITE VINYL I 1 . BOTH SIDES I Iri,,,:,,,,' y 1 1 N 1 1 SIDE VIEW x -. a 1 I I __. . I II o I II I I I I I 1 I I I , I 6" STEEL POST 4, 1 1 `�c aC ;A .4*11. ,` •,. . ` • l I I I I "- ':k14.v'A 4a1 ', A I I I I 1 4'l ' ' DOUBLE SIDED ILLUMINATED SIGN 8"" ' ' ' ' TRANS VINYL: TOMATO RED & DELFT BLUE 11 11 1 1 1 1 CABINET & SKIRT PAINTED BLACK I I I I I I I I u I---I eREVORIG. DATE:08-08-22 REV. DATE:08-23-22V REV. DATE:00-00-00 D-MISC/DEAD RIVER COMPANY-300 A KING STREET-NORTHAMPTON, MA.PLT ORDER# gf011 . DATE:08-11-22V REV. DATE:00-00-00 REV. DATE:00-00-00 00000 1gn Company REV. DATE:08-22-22V REV. DATE:00-00-00 REV DATE:00-00-00 DEAD RIVER COMPANY-300 A KING STREET-NORTHAMPTON, MA.CDR Inc. CUSTOMER: LOCATION: CONTACT: SALESPERSON: PROJECT MANAGER: THIS DESIGN IS THE EXCLUSIVE PAGE: APPROVED PROPERTY OF AGNOLI SIGN AGNOLI SIGN COMPANY,INC. DEAE RIVER COMPANY DEAD RIVER COMPANY HARRY HARRY ELECTRIC SIGN COMPANY INCORPORATED 722 WORTHINGTON STREET ERIN BEST - SPRINGFIELD,MA 01105 300 A KING STREET 300 A KING STREET DESIGNER: SCALE: „_,A. _<„K max,_ AND ALL RIGHTS TO ITS USE TEL.(413)732-5111 NORTHAMPTON,MA NORTHAMPTON, MA LANCE 0"=1'-0" RELEASE DATE: 00-00-22 w=, ,}:om= ��WA„ ° u�o�:` OR RE R°°R ""RE