112 NORTH ST - BUILDING INSPECTION (3) Permit Number
f �0 APPLICATION FOR PERMIT TO ERECT A SIGN
� �Aa
51 NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
11t a Location, Ownership and Detail Must Be Correct, Complete, and Legible
Salem, Massachusetts yb 7/
Nita
To the Building Inspector:
The undersigned hereby applies for a permit to ❑ Erect, ❑Alter, ❑Repair a sign on the following described buildings:
Street Address Zoning District
17 �.. 1, ❑ Urban Renewal Area Entrance Corridor
(/VI , ❑Historic District /❑ None
&� Okgco L' kv 5 Use of Building
Telephone -7/0 oor
• OG C w1/�� S 2 floor 2
Address VC7�jy7�S T Ljv( 3 floor
Telephone -7c1 _ 73a 4 floor
E-mail How many businesses are in the building?
If a corporate body, name Frontage
of responsible officer
Building �e - linear feet
Consbucbon Sup's License No Applicant's Space(if mul I-tenant) near feet
Address Property 3 P. „linear feet
Telephone Mail Sign Permit to..,
E-mail Sign Owner o Sign Erector o Other:
�W (If rnore'than three signs are proposed, attach additional sheets)
Sign 1 Si n 2 SI n 3
❑ Surface o Surface ❑Surface
❑ Right Angle to Building ❑ Right Angle to Building ❑Right Angle to Building
• Free Standing ❑ Free Standing o Free Standing
•Awning AR ❑Awning ❑Awning
ortable(A-Frame) ❑ Portable(A-Frame) ❑ Portable(A-Frame)
Other(specify) - o Other(specify) ❑Other(specify)
Sign Mate ials Sign Materials Sign Materials
f P•a c X, S
Sig Dimensions Sign Dimensions Sign Dimensions
5
Sign Area Sign Area Sign Area
,,, X sq ft s ft sq It
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ / C) 69 0 0
Existing Signs Signatures
Type Sign Area To Be Removed? Sign r
a Surface sq It o yes a no
Right Angle to Building sq ft o yes o
gree Standing sq ft ❑yes �o Sign Owner's Authorized Representative
caning sq it ❑yes
Other(specify) sq ft ❑yes ❑no
Property Owner
Internal Review
PlanTnp&Community Oevelopment Department Historical Commission
Approval
Building In§pector
08124/10 rev
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