16 NEW DERBY ST - BUILDING INSPECTION - -- Permit Number —8
APPLICATION FOR PERMIT TO ERECT A SIGN
NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
� t1) �1a Location, Ownership and Detail Must Be Correct, Complete, and Legible
spy^ Salem, Massachusetts 12 A/I
To the Building Inspector:
Date
The undersigned hereby applies for a permit to ❑ Erect, o Alter, ❑ Repair a sign on the following described buildings:
Street Address --Toning District
❑ Urban Renewal Area o Entrance Corridor
eW G tr C-C' ❑ Historic District ❑ None
C ca V '
Telephone cr?) 44 _ 2jCD U 01 1 floor
YI'1 G�rG 1 c..
F'AV L moNTEFt%o 2" floor a
Address 25 PPLE %f R17 6jq4!qy4 3 floor
Telephone (a)} 0213. : 6J g 4 floor
E-mail P N40 N`{ EKO rop L/vC, COAA How many businesses are in the building?
If a corporate body, name Frontage
of re onsible officer
ERANTON 1:Z0SAF%10 Building 45 linear feet
Construction Sup's License No C I Applicant's Space(if multi-tenant) 1 ( linear feet
Address 2 1 flyl Property linear feet
Telephone 2 I O' 1 .Gj cl?�Q I Mail Sign Permit to
E-mail 6P%0 A RIV 1 cj µt7TUA IL Sign Owner a Sign Erector o Other:
SI n 1 Si n 2 Sign 3
V'Surface ❑ Surface ❑ Surface
❑ Right Angle to Building ❑ Right Angle to Building ❑ Right Angle to Building
❑ Free Standing ❑ Free Standing ❑ Free Standing
❑Awning ❑Awning ❑Awning
❑ Portable(A-Frame) ❑ Portable(A-Frame) I ❑ Portable(A-Frame)
❑ Other(specify) m(Other(specify) r ui uW . ' (,WS ❑ Other(specify)
Sign M riots Sign Materials ''// j"A
n Materials
V r 5 G�GIS
Sign Dimensions , Sign Dimensions ,r n Dimensions
2V H x Gc� w IV H K 6o w
Sign Area ' Sign Area n Area
s ft s ft
Sign Height(if free standing) Sign Height(if free standing) n Height(if free standing)
Estimated Cost of Net Work
$ 1, sueExisting Signs
Type Sign Area To Be Removed? Si• Owq0I
❑ Surface sq ft ❑ yes ❑ no
❑ Right Angle to Building sq ft ❑yes o no
❑ Free Standing sq it ❑ yes a no Sign Owners Authorized Representative
❑Awning sq ft ❑yes ❑ no
a Other(specify) sq ft ❑yes ❑ no
RropyAY Ow
Internal Review
Planning& Community Development Department Historical Commission
Approval
Building I spector
OW24110,.v