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32C-057 (3) File #BP-2023-1587 l� r APPLICANT/CONTACT PERSON:AGNOLI SIGN CO INC / J )J6 k`r 0,Kr P O BOX 1055 SPRINGFIELD, MA 01105 (413)732-5111 OW P n� PROPERTY LOCATION 125 PLEASANT ST PEK MAP:LOT 32C-057-001 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 SIGN -NOTCH 8 GRILLE --A-I/O GJ/;l/�] 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: _ 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 t � /9/ S Si 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. City of Northampton ��z5•y s �`c``�G F % Massachusetts N 9y b o�� r� INSPECTIONS �1- r ?/y ""' OF BUILDING IN Building sVP( :0t DEPARTMENT Municipal C.- Street • b 212 Main ton M p1p60 ding a Sign 7 i 1l;tF r Northampton, 1J Application fora Permit to Place or MMntain a -�- 3 'f � ,,% Device, Number ............ •° - . p �privertising ewritten) Or ot� �, �-txa- _ . _, i (Application t' ) (ADP �8��� �. Erection..............•....( -- Alteration............. in I Repair.....................( ) ainting•••••••••"•"( P1 r i il�d h h NOV 8 �023 Removal............. • t �t f4Yg�t II be .PAGE........PLOT....... nFa' .1 i OOLONG lNSPEC710NS ? FE S� O CO NORTHAMP70N,MA�)�p60 ` 11 v 2 Northampton, Mass. ......aLea1 =;.... . •. or other advertising deice, or marquee place or maintain a sign device, . ermitto .••�•-••• '• Application for a p . BUSINESS NAME ......... •' Street and No. ......................... .. 1. Location, va- .Q:tt10�....................................................... . ...... 2. Owner's name ........ CC 5c,..� ... ..... 3. Owner's address Maker's name ........ .. a.61... 4. VA 5 Maker's address 7.14).• jr :.i. '................ . 6 Erector's name .• t OF SIGN �,�...1C?'�`-�•.. . KIND 7 Erector's address ••• (Designate) SIGN . Non-illuminated . ..... Marquee ............... check one)illuminated .••••• nJ at • projecting 2. 1 Sign will be ( e,window or door? . way. Roof ..• 3 Will e sign edge will a fire escape,ins above the p way. Temporary oProjecting ..-• '•:i will be .►Q•ft.. 3 Lower ft . ,...ins above the publicWall ••••••'•�„" 4. Upper edge will be�s�.•Width .�..ft.` ...ins Ground ..f...•....'.' 5 Height .�j..it.3tos or pole. a! �;q,ft. Other 6. Face area�� ins from the building or pole. 7 Outer edge will bee .• ins from the building edge will ••••••• ins back from the street line. 8• orpole is ....... i n�l.l 9. Face of building ins beyond the street line. or pole. Face...�� ��••�V 1d Sign will project • ins above the building r pole. ;.C'tl�m� sign be constructed? Frame . 11. Sign will extend •wil• it belief. 12. Of what material will a� f his knowledge and 13. Estimated cost certifies •• ..................belief. The undersigned certifies .,. P that the above statements are true to the b s .. t e of Owner or Agent) {Sign Page 1 of 2 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING (INFORMATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: A3 S',gn e- Address: ,y (U`-0 Jpr'►faelcl. ►npv pitA Telephone: 14 3 - 5111 2. Owner of Property:w(1%on 5cA•,p n Address: 1a5 `N\er`c [).C)t t lat-() ). MA Telephone: Lt13 - '-A(o I • (o'#sa 3. Status of Applicant: Owner Contract Purchaser Lessee .LOther(explain): 3-3c) meg\pc- I \(15k(.1?c 4. Job Location: J 5 p, 1 eaxnV c3C ee Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: C.cencc -6(1\ ?rOPPc • C-P5kn,it-cnC-4 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) rive evc; a1 ?crperk .i ` cP3-0.)ccr' 4. ► le,,s [\rma cJ 1)e..3 5il.CNS cpc re-s}(' rno • eu-Ivan Pat s;3nciKse 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 y 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: L`Xle ( (iN-Pc Nc y 5;3n ()ear cxCic' 1p1, oND (`�ti(1;�,r� ��; N�c��l 1ek�e�cm oc� r�c`�, prRick,cJ V ,Jn R eoWonce Vo(crel_ ,45 ( c Are there any proposed changes to,or additions of,signs intended for the property? YES / NO IF YES: Describe the size,type and location: 1Ofl}(11 fit;p ( 2) �emppfCci S;T3 Doc. Ckjd.ie: rimy nc•NCt op P)c;3 1.0 ‘cLc-ccc.j S; . 10 n I I b(1 e1(13}+n�' try: nene .. Page 2 of 3 V 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: ti )c:.L 3 APPLICANT'S SIGNATURE a° 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 / 1 ACORO) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 6/15/2023 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 NAME: The Dowd Agencies, LLC PHONE Catherine Palazzo FAX 14 Bobala Road IA/C,No.EXO:413-437-1042 _ (A/c,No):413-437-1442 Holyoke MA 01040 ADDRESS: cpalazzo(gdowd.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 INSURERD: Springfield MA 01101-1055 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:1343537788 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 �gp WVD _ POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDD/riri) (MMlDD/YYYY) A X COMMERCIAL GENERAL LIABILITY A0130589003 6/21/2023 6/21/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $5,000 PERSONAL BADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY X jRC7 X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY A0130589004 6/21/2023 6/21/2024 COMBINED SINGLE LIMIT $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 $ AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR A0130589006 6/21/2023 6/21/2024 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTIONS n $ A WORKERS COMPENSATION A0130589005 6/21/2023 6/21/2024 X ;MUTE Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N NIA (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 94 ©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 a_•-• --@ Office of Investigations '' MS . Lafayette City Center 4—Oil 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 22 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2.Ill I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' P ty 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t 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' 13.2/Other 8;0rry,ed 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. Lic. #: A0130589005 Expiration Date: 06/21/2024 Job Site Address: la Fj �l PO r l A- Sk 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify ').der i e 1'ins and penalties of perjury that the information provided above is true and correct. Signature: , �1 Date: 1 J/$ I()C�a3 • 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): I❑Board of Health 2❑Building Department 3❑City/Town Clerk 4.1:]Electrical Inspector 517lk'1umbing Inspector 6.❑Other Contact Person: Phone#: 1 722 Worthington Street P.O.Box 1055 Agnoli Sign Co. Springfield,MA 01101-1055 (413)732-5111 fax(413)787-2169 Memo To: City of Northampton, MA—Building Dept. From: Amanda Pfeffer RE: Notch 8 Grille—125A Pleasant Street Date: 11/8/2023 Enclosed are the sign permit applications for the two(2)proposed temporary signs and the new face on the existing awning.I have enclosed the sketch along with check#1003 in the amount of$220.00 for these applications.Can you please review and process the applications?Please let me know if you need any additional information or have any questions and or comments.I have enclosed a self-addressed,self-stamped envelope for the permits to be mailed to us upon completion. 1 ..41:.‘':::. t,,,k \ .. ,es, ,,.....'",17,../,, Att.44 - ,...., ,,,,.. , ,,,,g0.,./ ....la, ' t I , f 'll':::.‘''' .4:4'1'6: 1 I F• a , . N®TCIISGRJLLE ;r� 7. - a STEAK•SEAFOOD •COCKTAILS ` ,�' NEW LEXAN FACE FOR EXISTING AWNING '� ,� ` �.4 ' ' : �ME `, Ili,' LAMINATED/PRINTED VINYL 00SEVELT 0OM t � t SCREWED TO EXISTING FRAME THROUGH FACE UNION STATION r I } E C fe,.f ;- 'L 0 GUNNE� 11E@ECK:61 x 100 , DD.DRINK.MUSIC.• 45) '_ ''e . ,13Al __ S!,CE 1897- 4,, r_ it ;W; - - :It �§{� f -! i ho RIG, DATE: I I_ _2 _2_13AM_ + 1- 1 'APPROVAL: DJOBS/UMISC/UNION STATION - NORTHAMPTON, MA - 125A PLEASANT ST..PLT REV. DATE: 1 1 -6-23AM ❑APPROVED REV. DATE: 11 8 23AM DATE CDR/UNION STATION - NORTHAMPTON, MA - 125A PLEAS ST.CDR CUSTOMER: LOCATION: CONTACT: ❑APPROVED AS NOTED SALESPERSON: PROJECT MANAGER: THIS DESIGN S THE EXCLUSIVE DATE: NOT FOR PRODUCTION APPROVED PROPERTY INCORPLI SIGN AWNING AGNOLI SIGN COMPANY, INC. UNION STATION UNION STATION JEREMIAH HARRY HARRY ELECTRIC SIGN COMPANY INCORPORATED 722 WORTHINGTON STREET ❑REVISE & RE-SUBMIT AND All RIGHTS TO IIS USE 125A PLEASANT ST 125A PLEASANT ST STORE#: DESIGNER: "'��„,1„°`OtPBf1NSiA`"°1N FACE SPRINGFIELD, MA 01105 DATE �wew,„IMI„,saea.ial0000nel„a.b OR REPRODUCTION ARE TEL (413)732-5111 NORTHAMPTON, MA NORTHAMPTON, MA ADAM NOT FOR PRODUCTION i uw° ` w 4Mal r'N RESERVED