33 NEW DERBY ST - BUILDING INSPECTION 09/01/2012 12:27 9787418509 THE UPS STORE PAGE 01/01
FROM : UITRL SIGNS "THOhE NO. 4ug. Fit 2012 12.56PM Pl
Permit Number
APPLICATION .FOR•PE"IT To IERECT A SIGN
\ f� NOTE:19UILOING PERIM MUST BE OBTAINGO BEFORE SIGN In ERECTBa
Location,OwneMhip and Detail Must Be Con*ct,Coropleta, and Legible
&:ticm,MassedhuseRa
Date
To the BuWng InsImctai
rnA underolgned hereby applleo for a permit to . ett, a AlW, a Ropair at sign on the following de cribed buddings:
3 ��2 W D Q r b S'C, ^ ^Ram Areal a NonEntre
CmrldOr
o bfiC Di d o Ndte
\O G 0.1
Tela h" qn N . @.?,Aodrese
• 1 RCor
V OV1 dr7f
Telephone
E-mall caa j t �,� -. Haw many busmassas ale!n the b
lr a 0Qrjx"a body,name
of;;=odfeor I _ _
'\1 P..uilding linear feet
Carretrlaueorr gPs Ucanea 'pr ArArlva�'a Space( M--Ttarle inew feet
A Mae 42 %Q now feet
T e e AIV34S'--k
E•m+a V rr t W wn _r..-- a Sign oemer a sign Erector u Oil=
MUM
S n2 anJ�—
a UrfaCB .._'..._._ a Surface o aUn'alaa '•�•_."•."_...�y
o RlghtAngla t09W1ding a RightAngte to Building u Right Angle to Bulling
a FM Staruding a Free Shinding u Free Silencing
a Awning gy ming o Awning
o P�rtaWe L4 Frem�Lg ri c ether(3pWIM ) o Other(spcoly)
ha(sptsclty)
91 n Materials Ito '91gn im— l¢ds
Sign Dimensiona ign 6imenMons Sign menslbns
Sign Area t Aten Sign Area
X R R so R
Sign Height(if free stand'stg) Sign Height(if free SW ng) -Egan Height fir tree standing)
EgUmsted Cost of Not Work
a 4{ lb.q
Type 919n Aral Togo Ranloved7 70wW�o
a surhros —sq R a yes uno
a Right Angle to BWhthtg —,aC ft a yes a noo Free SWOing ,_,,,,•_Sq R o yes o no Authorized Represen
o Awning aq R o yes ono
o Other(seedy) N� '3 1 sq R VYva n no ---.
ProfrBrty Owner
Flervqrly&Community Lmelopmeht Doparbnarlt Fnstorlrnl Commission
I rl r' I\ A n Building Inepe or _—._.•..._.__,___.. .
�r��[[rr . .�. v .L wean
AUG 0 6 2012
DEPT. OF PLkNNIr1O&