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18D-026 (9)32-60592 Northampton CDJR 1 55 Damon Road I Northampton, MA 01060 CH RYS LiR "'"' n DODGE Jeep».o..�.SIGN DETAIL 5'-11 1/2" F 23 5/8" Jeep 28 3/4" 9 SERIES JEEP Square Footage 14.28 ft2 Manufacturing Details 5"deep aluminum cabinets, silver returns White acrylic faces w/ 1st surface green vinyl leaving 1/8" white perimeter LED internal illumination, AgilightTuffRayz LEDs 1-60 W - 0.63 amps Advance Ballast Colors Green PMS 371 White Silver 14 uity/state/Glp: - -- - - ---- . --- The Commonwealth of Massachusetts ft Department of Industrial Accidents Type of project (required): Office of Investigations -=� 1 Congress Street, Suite 100 employees (full and/or part-time)* 2.'El 1 a n a sole proprietor or pa;mer- Boston, MA 02114-2017 r- www.mass.gov/dia Workers' Compepsation Insurance Affida`r`itc Builders/Contractors/Electricians/Plumbers At pli&nt fTnformation ' 1 Please Print Legibly 9. ❑ Building addition [No workers' comp. insurance required.] Name (Business/Organization/individual): CALLAHAN SIGN, LLC Address: 117 UNION ST P.O.BOX 744 DTTTCrTrT T) TRA 1M0.9 � Mq) LAq—SQgl uity/state/Glp: - -- - - ---- . --- - - - - - Phone##: ' - Are you sin employer? Check the appropriate box: Type of project (required): 1. ElI am a employer with 5 4. ❑ 1 am a general contractor and 1 have hired 6. ❑New construction employees (full and/or part-time)* 2.'El 1 a n a sole proprietor or pa;mer- the sub -contractors listed on the attached sheet. , 7. ❑ Remodeling ship and have no employees These sub -contractors have f g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance required.] comp. insurance.* 5• ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. o workers' com y � p• right of exemption per MGL 12.❑ Roof repairs insurance required.) t c. 152, §1(4), and we have no 13•® Other sign employees. [No workers' comp. insurance required.) *Any applicant that checks box 41 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. Contractors 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. Travelers Indemity CO Insurance Company Name: Policy # or Self -ins. Lic. #: 6KUB-5B74571A Expiration Date: 12/19/2013 Job Site Address: 55 DAMON ROAD City/State/Zip: NORTHAMPTON, MA 01060 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 undeg the pains and penalties of perjury that the information provided above is true and correct: James P. I Callahan 1natPt/19/2013 —5931 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. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Page 2 of 3 11. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. 12. SEE ATTACHED SITE PLAN This column to be filled in by the Buildino Department. : 13. Certification: ) hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 2/19/2013 APPLICANT'S SIGNATURE �/ ES P. CALLAHAN 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 Existing Proposed Required b� Zoning Lot Size Frontage Front: Setbacks: Side: L: R: L: R: Rear": Building Height t Bldg Square Footage % Open Space: (Lot area minus bldg and Paved parking) # of Parking Spaces # of Loading Docks Fill: (volume a location) 13. Certification: ) hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 2/19/2013 APPLICANT'S SIGNATURE �/ ES P. CALLAHAN 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 Page 1 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION 0300 ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION CALLl�HAN. SI LLC —" TAMEST P. CALLAHAN 1. Name of Applicant: - Address: 117 UNION ST PTTT FIELD. MA 01201 Telephone: 413-443-5931 2. Owner of Property: ROBERT S. THOMAS Address: 55 DAMON ROAD Telephone: FAX 2032880233 3. Status of Applicant: _Owner _Contract Purchaser _Lessee XOther(explain): SIGN CONTRACTOR 4. Job Location: 55 DAMON ROAD NORTHAMPTON, MA 01060 " Parcel ID: Zoning Map # parcel # District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: USED PREVIOUSLY AS FORD DEALERSHIP NOW CHRYSLER DODGE JEEP RAM 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary) SEE ATTACHED DRAWINGS:INSTALL ONE PYLON (8'X12')SSIGN, INSTALL DEALER NAME LETTERS, INSTALL (1) DODGE BADGEI,, INSTALL (1) JEEP BADGE, INSTALL (1) RAM BADGE, INSTALL (1) MOPAR AND INSTALL (1) CHRYSLER BADGE 7. Attached Plans: X Sketch Plan X Site Plan Engineered/Surveyed Plans 8. Has a Special Permit/Variance/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 X 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: REMOVAL OF EXISTING SIGNAGE EXEPT "customer Are there any proposed changes to, or additions of, signs intended for the property? YES X NO IF YES: Describe the size, type and location: SEE ABOVE FOR THE ADDITION OF NEW SIGNAGE if TRIJ of Nort4amptan a � lnssttrlfizsrtts �i Lu DEPARTMENT OF BUILDING INSPECTIONSLLl 212 Main Street e Municipal Building s w���c�cc Northampton, MA 01060 INSPECTOR Application for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee QP�13 7G� (Application to be filled out in ink or typewritten) Number 1 Plans must be filed with the Building Inspector Erection..................(X ) before a permit will be granted. Alteration .................( ) Repair .....................( ) Repainting ...............( ) Removal ..................( ) FEE........ PAGE........ PLOT....... � Northampton, Mass. ..........FEBR..U..A....RY ... 19 ..........20.1.3 To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. NORTHAMPTON......CHRYSLER.......DODGE ..JEEP .................. RAM ...... BUSINESSNAME............................................................... 1. Location, Street and No. 55 DAMON ROAD NORTHAMPTON., . MA ..................... 2. Owner's name ROBEB-T...S.— TROMAS........................................................................... 3. Owner's address ...55 DAMON ROAD........................................................................... P 4. Maker's name .... ..................RINCIPLE........USA ... INC ............................................................................ 5. Maker's address 2.035 LAKESIDE CENTRE WAY #250 KNOXVILLE, TN 37922 ............................................. . CALLAHAN SIGN, LLC 6. Erector's name............................................................ 7. Erector's address .... . 117 UNION ST PITTSFIELD, MA 01201 ..................... .................................................... SIGN KIND OF SIGN JEEP (Designate) 1. Sign will be (check one) illuminated X..... Non -illuminated ....... 2. Will sign obstruct a fire escape, window or door? Y....... 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 ......ft..? ins Width A ... ft11,..�s Temporary ............. 6. Face area A t.94. ft. Wall .X .................. 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� AoT�r ppole. Face ACRYLIC 12. Of what material will sign be constructed? FrameA?,L!r?INUM. •. ...... ....................... 13. Estimated cost $... 3.x000.......... The undersigned certifies that the above statements are true to t e best of his knowledge and belief. t� ............... (Signature of Owner or Agent) JAMtS P. CALLAHAN File # BP -2013-0769 APPLICANT/CONTACT PERSON CALLAHAN SIGN COMPANY ADDRESS/PHONE P O Box 526 PITTSFIELD (413) 443-5931 PROPERTY LOCATION 55 DAMON RD MAP 18D PARCEL 026 001 ZONE GIO00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvpeof Construction: ERECT ILLUM WALL SIGN - JEEP 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 INFORMATION, PRESENTED: Approved VAdditional 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 UNDE : -7' 7 Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Septic Approval Board of Health Water Availability Sewer Availability 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 rx— Z,-ZQ ignature 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.