24 NEW DERBY ST - BUILDING INSPECTION (10) "« Permit Numb
r
APPLICATION FOR PERMIT TO ERECT A SIGN
NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
1 Location, Ownership and Detail Must Be Correct, Complete, and Legible
Salem,Massachusetts
Date
To the Building Inspector: /
The undersigned hereby applies for a permit to d Erect, ❑Alter, ❑Repair a sign on the following described buildings:
DistrictStreet
ZLI• Urban Renewal Area ❑Entrance Corridor
o Historic District ❑None
• C:f" o(' Use of Building
Telephone 1� floor
• Ht q NON 2" floor
Address —QG Q 3 floor
Use of
Telephone 77-4 — &, 3_ 9 y7 4 floor
E-mail -E fyq��,� (,U � How many businesses are in the bHE]
uilding?
If a corporate body,name
of res onsible officer Frontage
'ZAA-L a3 Building linear feet
Construction Sup's License No Applicant's Space(if multi-tenant) linear feet
. Address Property linear feet
Telephone Mail Sign Permit to
E-mail ❑Sign Owner u Sign Erector o Other:
posed Signs (If more than three signs are proposed. attach additional sheets)
Sign 1 Si n 2 Sign 3
o Surface ❑Surface is Surface
❑ Right Angle to Building ❑ Right Angle to Building ❑Right Angle to Building
❑ Free Standing u Free Standing ❑Free Standing
❑Awning ❑Awning ❑Awning
❑ Port le(A-Frame ❑Portable(A-Frame) o Portable(A-Frame)
er(specify) / O ❑Other(specify) ❑Other(specify)
Si M tena ^^ Sign Materials Sign Materials
6!/ 1 -C 1000Ct QI
Sign DimeQts ,,- Sign Dimensions Sign Dimensions
Sign Area
�Ll Sign Area Sign Area
s its Its It
Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ 0 o
v
Existing Signs
Type Sign Area To Be Removed? Sign
❑Surface - sq ft ❑yes ❑no
❑ Right Angle to Building sq it ❑yes ❑no
❑Free Standing sq It ❑yes ❑no Sign Ownertothodzed Representative
❑Awning sq ft ❑yes ❑no
•Other(specify) sq it u yes ❑no
Property Owner
internal Review
\81aroing&Community Development Department Historical Commission
Approval
Building Inspector
ae/zano re.