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18D-028 (2)
City of Northampton Map:Lot 18D-028-001 Massachusetts Date issued 04/20/2023 Inspector of Buildings Permit # BP-2023-0491 Permit Fee $60.00 SIGN PERMIT Business Address 8 NORTH KING ST Applicant Installer AGNOLI SIGN CO INC Applicant Installer Address P 0 BOX 1055, SPRINGFIELD, MA 01105 Work Description NON - ILLUMINATED WALL SIGN WEBBER & GRINNELL -B Estimated Cost $10200 Building Department Approval by: Jonathan Flagg z—Ok File #BP-2023-0491 APPLICANT/CONTACT PERSON:AGNOLI SIGN CO INC P O BOX 1055 SPRINGFIELD, MA 01105(413)732-5111 PROPERTY LOCATION 8 NORTH KING ST MAP:LOT 18D-028-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $60.00 Type of Construction: NON -ILLUMINATED WALL SIGN WEBBER& GRINNELL -B New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan Driveway Grade% THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: XApproved 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 I ' Fla /1 64 1.04) a Signat re of Building Official � Date 1 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 •f Planning&Development for more information. City of Northampton e .c ?.:7 „o2m... . ,. Massachusetts $ . . A.,. i. *I toe. t .4, . . , r 41 DEPARTMENT OF BUILDING INSPECTIONS S 1-; ...c 212 Main Street • Municipal Building ,..., -I, ..• Northampton, MA 01060 jsikPY 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) Numbe Plans must be filed with the Building Inspector Erection ( ) before a permit will be granted Alteration ( i#) Repair ( ) Repainting ( ) tii emoval 9 ( FEE PAGESS...PLOT..0. , c, tt, Northampton, Mass. ...Apr).).....Lb 20 Application for a permit to place or maintain a sign or other advertising device, or marquee BUSINESS NAME (:)e.. b.t).e.C.... 1. Location, Street and No. '1)8 .3-kr.e.e-A 2. Owner's name 1.42\JE.bber A 8G.01).E.11 3. Owner's address ......Z...PNICA".kb....1iQ3...31, t ).Q f.-}.-‘narn.q.ton....fi).o..a 4. Maker's name (4,5 ac.q. Co• \oc... c, 5. Maker's address 6. Erector's name m C' 7. Erector's address ...E0...Zi.DA. I 00.J...op.,-.-1 osc?i.68,..fr.B....c._. .w.).............. SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated Non-illuminated ../... 2. Will sign obstruct a fire escape, window or door? ..N.Q.. 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 .A..ft..o..ins Width ..11..ft..0..ins Temporary 6. Face area 54ADtq. ft. Wall )4 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 iole is ins back from the street line. 10. Sign will project ..4..ins beyond the street line. 11. Sign will extend ..d„ft ins above the building or pole. 12. Of what material will sign be constructed? Frame 13. Estimated cost The undersigned certifies that the above statements are true to the best of his knowledge and 1:elief. CP.1,4-6-4, (Signat e f wner or Agent) Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION i3(-) Q File No. ZONING (INFORMATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant:"' A3(i)\ 3 CI L,�- 'C1c - li Address: -) ,X It)5 Sc akTi, MA O1101 Telephone: 4l3• 1- -5\1\ 2. Owner of Property: (�Q 1)6,0er } t2r Me 0 • 1 6\OLDO Address: <6 1ck i ' Y;,n3 S A• 1�pc*nC�'t1Qkn. (gyp, Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee _ZOther(explain): 5i5c) 1o,3\-Qclec I ec 4. Job Location: O 1..1pc-Vh 1 ,( a rP e A Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) /n 5. Existing Use of Structure/Property: ( .pcmecet(A / S',nPSS 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) (bn-l\ociy,cxaen1 ?4 G cylne1 pa, e c k \i►n i N epeceie per1P15- Sep. 5Ke4Caf 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 / 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: 10O•,Aom;n -Aczke\ bi_sM\ n 5,6 oc bi\c: 'Rep‘ac;c e�;;��;c t;:�kln reW Are there any proposed changes to, or additions of,signs intended for the property? YES ./ NO IF YES: Describe the size,type and location: 14L.,5 j; OC) }'ctilk (10A. jidej b:xkl-,(") cepleiP_ ex;; fics L Th net ne e hec kn SA--e. 5e.c \SekChe . J Page 2 of 3 S►sn 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 1•0g1 Acw3 1.041 Pcct Frontage 3• Front: Setbacks:(for sign)Side: L: R: L: R: Rear: Building Height 141 Façade 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: II APPLICANT'S SIGNATURE C1.1 1,41C, 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 • The Commonwealth of Massachusetts Department of Industrial Accidents =s Na Office of Investigations _'4I'a G1 I. :�r�_ Lafayette City Center 'j'� 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 #:413-732-5111 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 20 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs 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' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t tk>meowners who submit this affidavit indicating they arc 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 joh site information. Insurance Company Name: Middlesex Insurance Company Policy# or Self-ins. Lic. #:A0130589005 Expiration Date:06/21/23 Job Site Address: 4v ) �j17Yk City/State/Zip: , . ,i 4„,,.+,01 A Attach a copy of the workers' compensation policy declaration page(showing the policy number and expir,tion 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 OR 9 ER 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 0 ce of Investigations of the DIA for insurance coverage verification. I do hereby certi nd he ains and penalties of perjury that the infOrmation provided above is true and correct. Signature: Date: M\ l \ 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): 1❑Board of Health 2❑Building Department 3❑City/Town Clerk 4:111 Electrical Inspector 5F1'lutnbing Inspector 6.(—]Other __.---- T--_. 1 Ct,ntaet Person. I'houe DATE(MMIDDIYYYY) AC 0 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 (AIC,No,Ext):413-437-1042 (A/c,No 413-437-1442 Holyoke MA 01040 ADDRESS: smlinarcik©dowd.com INSURERS)AFFORDING COVERAGE _ NAICN INSURER A:Middlesex Insurance Company 23434 INSURED INSURER B: Agnoli Sign Co., Inc. INSURERC: 722 Worthington Street PO 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 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. IN5R TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD W (M, VD' POLICY NUMBER (MM/DD/YYYY) MIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY A0130589003 6/21/2022 6/21/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO j CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $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 JECT X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY A0130589004 6/21/2022 6/21/2023 COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE S AUTOS ONLY _ AUTOS ONLY (Per accident) S A X UMBRELLA LIAB X OCCUR A0130589006 6/21/2022 6/21/2023 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION S D $ A WORKERS COMPENSATION A0130589005 6/21/2022 6/21/2023 X ;MUTE AND EMPLOYERS'LIABILITY STATUTE ER YIN ANYPROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? 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 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD EXISTING PROPOSED Anis Webber f�, WEBBER& , �o�E grinnell AUTO GRINNELL pl�� AINSTANCE BUSINESS i Ili ljb-- iii A "' ® . ijo s . ,,... i i 4,, 4 1.g,'—441144• - . ,06'"ifi111 Mk • IR "pis. 1111 , \ -4•04 , .,.i.� ,� a n KKI 132" 104" r *- 112" - - 116" WEBBER& _ '-,? A GRINNELL HOME AUTO BUSINESS izv.,, JRi- COPY: 1/2" PVC PAINTED BLACK & PMS 2995C BACKER: PAINTED GREY (P172-11 C) BACKER: PAINTED GREY (P172-11C) COPY: 1/2" PVC PAINTED WHITE BOTTOM PANEL: PAINTED TO MATCH 2995C BOTTOM PANEL: PAINTED TO MATCH 2995C HP WHITE VINYL ORIG. DATE:1 2-27-22 REV. DATE:01 16-23V REV. DATE:00 00-00 ORDER# gnoll REV. DATE:01-04-23 W REV. DATE:02-23-23V REV. DATE:00-00-00 w MISC/wEBBER&GRINNELL NORTHAMPTON, MA-8 NORTH STREET.PLT 00000 ign Company REV. DATE:01-Ob-23 W REV. DATE:04-17 23V REV. DATE:00-00-00 WEBBER&GRINNELL NORTHAMPTON, MA-8 NORTH STREET.CDR Inc. CUSTOMER: LOCATION: CONTACT: SALESPERSON: PROJECT MANAGER: THIS DESIGN IS THE EXCLUSIVE PAGE: AGNOLI SIGN COMPANY,INC. APPROVED PROPERTY OF AGNOLI SIGN WEBBER&GRINNELL WEBBER&GRINNELL HARRY HARRY ELECTRIC SIGN COMPANY INCORPORATED 722 WORTHINGTON STREET REYNOLDS WHALEN — AND AU.RIGHTS TO ITS USE SPRINGFIELD,MA 01105 8 NORTH STREET 8 NORTH STREET DESIGNER: SCALE: µ :,, »- ,�_ �«�, TEL.(413)732-5111 NORTHAMPTON,MA NORTHAMPTON, MA LANCE 0"=1 '-0" RELEASE DATE: 00-00-23 -T-5.5 �mWC e G.ci.=:rr° r-sK OR REPRODUCTION ARE xsre�rcn.�lxuvwv�cor sw RESERVED