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122 WASHINGTON ST - BUILDING INSPECTION (2) bu ` _ . _ � � _ T _�_ .— - : _ f _ _ _ _ _ Commonwealth of ��Iassachusetts ` V�r� c,�v� �� Slieet ��[etal Permit M. L. �,1 i� . � u:��: �r�l iL('��o � �O i��,,,�� r: ----- —.. _ _- .� 8 �' r� °� listim:uc� Job C'ost S � � Pcrnut t��e: �'7 � G�=- 3q �'6 S3 Pl:msSubmiU�J: YF.S��p Plansftc�icwc�l: 1'ES NO_____ � — — mo�s�. �N�s-�_ �t� � �3usine,s I.icensr;t n��,i��„� t.�«�„� � C 5 — Q q � 2Z,�} }—. 13usincss Infi�rnuuion: I'roperty O�vncr/Job L u c a t i o n I n t i�r ma t i u n: i Namc: p�nit� �� . (� 1�(Ai�O� IV:nne: � U �„��,. Y`n�,c �n,e.C" = n(�,nr. Strrcr. - � 0 a � � �'�"� 5trcet: � ��- �`'C�1h(�'�'cn rj,C, �(7� � City/fuwn: La �1i-G�i 1'L,(�, � City/Cown: Sa�Yti i Y`n'�1 1'ciephone: � � � y `L�'(o � � 3 0 0 Telepho� : �J a 8 `I'� ' D d S 7i t'Iwt�� LD. reyuired/Copy oFPhoto LD. attached: YES � NO J-I / :�I-1-unrrstrictcd liccnse x„rn��in:a o ;n o- � rn a > J-2/ Ji-2-restricicd N d�vcllings 3-storics or Icss and commcrcial up to t 0,000 sy. ft. / 2-sturi�ur la�� = Rc�iclential: i-2 familY_ Multi-famil '� a� '` Y,�_ Condu/ "1'ownhouses_ Other �'� CommercinL• OFtice Retail V —�' �q � — _ [ndustrial _ Educational ____ op .c [nstitutionai Other � �'�^ — — cn Square Footage: undcr I l).00p sq. ft._ ��vcr 10,00U sq. tt._ Number uf Ssnrtes: Shect metal work to he complcted: New �Vork: J _ ltenovation: I(VAC_ i�tetal Watcr.hrd Ruufing_ Kitdien fl.rhaust Sy�tem� ��fcta� C'hinmcy i V�nts_ Air 13alancing _ I'ruvi�l�dctail��i Jcscriptiun uf wurk N be doite: �� C_xl�(4`�`' I�`,�'�l ,� 'l,/� `��'j�(J � ��__ �"0 ��' G� (� - --_ ..--_ __.___------ ---___ _ _ I�n r�� -1, z \ � • � � INSURANCE COVERAGE: I i have a current liabili insuronca policy or ils equivalent which meets the requirements ot M.G.L. Ch. 112 Ves❑ No❑ If you have checked Yee, fndiwte the rype o/coverage by checking the appropriate box beiow: I Other type of indemnity ❑ Bond ❑ A liability insurance policy ❑ OWNER'S INSURANCE WA��E�d that marsit nattuhe lon thfs permit appl catlon waives his require9menquired by Chapter 112 of the Massachusetts GeneralLaws, Y 9 Check One Only ��/// / �� // � -- ---'--. Owner ❑ Agent ❑ i� -.., v Signature of Owner or Owner's Agent By chucking thls box�.I heraby certify t�at a�l of the detalls and Informatlon I hava submittad(o�entered)regarding thla applleatlon are true and � In compllancaewlth allf partlnent provlslon of the'Maasachusetb Buliding Code aind Chapt�2 of the GeneralnLawsued lor thle appll�atlon wlll be . Duct inspectlon requlred prlor to Insulation Instal�atlon: YES__NO__ Pro��ress Insucctions Comments Dat� —__-- --------- Fin�l li��!1 Commznts [):i W TYVe of Ucense: I � �Y .. �Master � � � � ❑ue ❑hiaster-Reslncted I _ i i;r;,ro.rn______--- ❑.lourneyperson Signature of Licensee ` � ��-----�--�� I pernut�_f — Journe person-RestriUed � ❑ Y License Numbec � roa i . .—--- ' ..--------�--- � � ----_.---- ChBck al�:�"�.,� m�-'�iil ; I � 3 °� (�� i �'., i inspuclor Si9naluro of Pcrmit Approval .__. � �i., I . _ ._—___-_—_ __-- __——.—.__' . � ' _. _._ . . . � _ _ \ �_ _ _ . �� Massachusetts - Department of PublicSafety Board of Building Regulations and Standards . � ConsG�uchun Superriror t,�`+� ,.:: � Llcense CS-091228 �s �� ' �,.i'.� . Y� ,. . . DANIEL J OBOY�,$ -- •.'� � � � . . . 2SACHEMST : � NO READING 11� 01� ' ��' � - � � N ; ^ �Z /� "a�::�` \� . . I �,�..-� �.f� „ '�� ` Expiration Commissioner , O6l02/2016 ; � ,' t�, �� =CQ` COMMON',WEALTHtOF�MqSSAZ."1M , , e USE:1`TS �' e � , �. = � � BOARD QE. , . . . , SHEE�'. ME'FqL WORK€RS �ti ' I SS,UE$ TME FOLLOWP�1"G"L I CENS'�:; �' AS"A MASTER, U�}R�STRICTED+ � > � �� '` � ' �� ; CS V;�NTILATIiON INC n � ' '� '�� " DANI �L J a BOYLE ,� f, {� � � CS VENT1LATf:ON INC,:` °.Y \`, , a �a � � � � �7 A��f310N ST `" � ' � „ ` '' � ; � WAIC'EF t E�LQ MA 0':1880 28CJ7 4 � • � ..��?8:/16 �� ' ' Az�R � `-- --- T �� ,� - � __——i . ' r , ��\ Nor-4-8 4/6/2016 8:28:51 AM PAGE 2/002 Fax Server """� { CERTlFICATE OF LIABILITY INSURANCE oarErMrarnomvri T - � 'tIFICATE IS 155UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RICXTS UPDM 7NE CER7IFICATE NO�DER. 7HIS ' GER7IFICATEDOESNOTAFFIRMATIVELYORNEGATNELYAMEND,EX7ENDORALTERTNECOVERAGEAFFORDEDBYTHEPOLICIE56ELOW. THIS CERTIFICATE OF iNSURANCE DOES NOT CONSTITUTE A CONTftACT BETWEEN 7HE ISSUING INSURER(S),AUTMDRIZED REPRESENTATNE U TH R C O IMPORTANT.Ifthe certifieate holder is an ADDITONAL INSURED,the poltcy(icsj must be endorsed. If SUBROGATION IS WAIVED,subjed to he 4erms and wndRbns oi the polity,certain policies may reqWre and ertdorsement R sfatemen}on this certficate tloes not conTer rights to e cert�cate hoWer irt lieu of sach endorsement s. ' - PRODUGEA � CONTAGT , NAME HUB IN'[F;RNAT[ONAL NE � • . . ... axoN6 vnx 224 BAf.I.ARDV AC,E 5T ., . Uvc,wo.Exry: (arc,ao}: EfdNL WII.MINGTON,MA DI887 nouaEss: � , 2B227 INSVRER(SyA�PoROWGCOV6RAli6 NAIC# �ry5�m INSURERA: TRAVELQ25INDBMNLFYCOMPANYOFAMHRlCA C S VENTII,ATfON INC � INsuqERe: I IN6UNERC:••�• - �I INSVRER O: �' 34 BROADWAY ST wsuaErt E WA[�FfELD,MA OI880 INSUkERF: � COYB2AOE3 CENTFlGATENUMBER: REVlBIONNVMBER: TOC9tTIFYFHATTNEPOLlG1ESOFN511 l%TECBELOtlfNAVEBEENISSUmTOTX£WSUR�NPE�ABOVEPORTNEPOLlCYPpUODINOICNTm. NOTWITHSTN�BlG ANY REpUIREM�IT�TERM OR CONU1f10H OP ANY COIITMLi OR OTMER�OG�ASIl�WRX RESPBT TO WMICH TMIB C6RIPIGFiE I64Y BE RSU�OR M1NV PHtTAOI 1ME IH9YRNNGE AFFOAO�BT THE POL8;IE5 06CF�8ID HEHEBI IS SYBJ�T TO ALL THE TEPM1D�QGWSIONS ANO CONORIONS OF SUCN POLCI�L08iS SN9NM MHY NAVE B@T1 RmUGFD HY PAm ClAMS. N�t pOOSUB POUGYEFFUAi6 POLICYWDATE LTR TYPEOFBiSIIRANCE L R PoLG'lNUMBER �MAlOO\YYYYY (��riWl � L0.1T9 GEPIERALLIABILIT` ACHOCCURRENCE , g COMMERCIAL GENERAL LIABI�ITY ' � CLAIMSMADE (xCUR. AAIAGETOREMED S � EMISES(EB ncauence , D EXP(My one person) $ " RSONALBADVINJURY S � OEN'L AGGREGATE Lt�IIT PPPLIEB PERI Nq2qL AGGREGATE $ POLICY OPROJECT�LOC ODUCTS-COMP/0PAG0 S i �AUTOMoeILEl.i/1BWTY COMBINEDSINq.E S � AM'AUiO LIb11T{EB eceiCer[) ALLOWNEDAlff05 BQOILYINJURY $ S SC#�IX1LE AVTQS (PetpereonJ { HIREDAVTOS �DILYINJURY S � NON-OWNED A�OS (Pu eCcitleM) � PROPERTYDAMAGE S {PefdCGtlNit) } UMBRELLAUAB OCCUR �NOCWRRENCE S i EXCESS LIRB CL41M5-MADE -� AGGRE^uATE S � DEDUCTIBLE g i RE7ENTION$ $ � � A WORI(E0.'9COMPENSA7IONAfm � WCSiAMORV OfHER ? FmPLOY6R'S W61LIN Y/N U&2EY22325-75 052020'15 052d20�8 LIMIiS i IwrPRopERirowPu2rNER/Ex'cCtf1'rvE �NlA ELEACHACCIDENT S y,000,00p � (Mmitlmary�NMREJtcLU0ED4 E.LDISEASE-EAEMPLOYEE $ 7��p�000 � pves,aescnbawder E.L�I6EABE-�LICYLIMR $ 1,000,000 ' OESCRIPTiON OF DPERAT�ONS below I DESCRIPTION OF OPERAliONbllOCA710NSNt7dICLESIRE4TRIG7ION9/�EqAL 17EM5 � � THLS RBPLaCES ANY PRIOR CERT[FICA'15 iSSDHDT0771e CE{tTff[CA1'6F[OIDIDt AFf�ECTINC WQRKh'RS COMP COVERAGE. � I ! I CERTIFICATE HOLDER CANCELLATION j � THEUGLYMUGDINER SXOUIDANYOFil1EA90VEDE5CRIBmPOLICIESBECpNCELLEO � ! �22WA$I-tINGTO?dSTjZg.'[' B�ORETXE6XPIRA710NDAlE7HEREAF�NOTCEWW.BEOEI.NERED Z IN ACCORDANCE NAIH hiE POLJCY PROVISIONS. E �!"YR'� V"'�"l�e:"4r F AU7NOR�REPREBENT �Y6 € SAIEM,MA 01970 ..�2... � t ACOR�25(2070105) TheACORD name and loga are registeretl marks dACORD 789B-2tl'IOACARQ CORPORATION. AII rights reserveC. } « 's i ! ` • .� - �_ _-- � _ __ , � � The Conzmonwealth nfMassachusetts Department of Industrial Accidents ;l � ` �'� 1 Congress Street, Suite 100 � � - � Boston, MA 02114-2017 www.mass.gov/dia �S'ockers' Compensation Insurance Aftidavit:Builders/Contractors/Electricians/Plumbers. � - TO BE FILED WITH THE PERNIITTING AUTHORITY. � Applicant InTormation ` ` I y Please Priut LeQiblv 1V3Iri0 (Business/Organiza[ion/Individual): �J V�'il 'K�� (� Address: 3`}' I (b .N � Ciry/State/Zip: � � `�1� Phone #: � 8� ' Z'`� f' �3 0 d Are ou an employcr?Check the appropriatc box: Type of projeC[(required): 1. 1 am a employer with¢�employees(full a�d/or part-[ime).* ]. NBw ConStCUChOn � ❑ 2.�i am a sole prop�ietor or partnership and have no employees working for me in $. �$emOdZ�i11g aoy capacity.(No workers'bomp.insurance required.] 3.�1 am a homeowner doing all work myselC[No workers'comp.insurance required.J 1 9. ❑ Demolition 7 0 ❑Building addition. 4.❑I am a homeowner and will be hiring contractors[o conduct all work on my property. I will e�sure that all conhactors ei[her have workers'compensation insurance or are sole 1 I.�Electrica]repairs or additions propr�erors w;m�o empioyees. 12.�Plumbing repairs or additions 5. 1 am a general con[ractor and I have hired the subconhactors lisred on[he attached sheet. ❑ 13.�Roof repairs These sub-conhactors have employees and have workers'comp.insurance.i ,,_,/ r 1' - 6.�We are a corporation and its officers have exercised their right of exemption per MGL c. �4.V I Othe��--1� 1"".,,(��1� �,4 152,§I(4),and we have�o employeea[No workers'comp.insurance required.] � �,1 �[,� 'Any applicant tha[checks box#1 mus[also fill out the section below showing their workers'compensation policy inf ation. t Homeowners who submit[his affidavit indicating they are doing all work and then hire outside convacrors must submit a new affidavit indicating such. �Contractors that check[his box must attached an additional shee�showing the name ofthe sub-con[racrors and state whe[her or not those entities have employees. Ifthe sub-contracmrs have employees,they must provide Iheir workers'comp.policy number. � I mn an employer tha[is providing workers'coinpensation insurance for my employees. Below is the policy and job si[e information. � ^ , � Insurance Company Name: ��'• ,SG� . ��1�V14�. . Policy#or Self-ins.Lic.#: '_\r� I �O� . Ex iration Date: � v d� � Z �� . ,..V� �y�l.�;��},(� �t Job Site Address �� 4City ta[e/Zip: (1 Attach a copy of the wo 'compe ation policy declaratiou page(showing the policy uumber and xpiration date). Failure to sewre coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this sffitement may be forwarded to the Office of Investigations of the DIA for insurance ,. coverage verification. I do hereby cer[ify under thepains and pena[ties of perjury that[he information provided above is true and cnrreet. Si ature: "'" • � r O I �" Date: /^ �` . ��I� Phone#� �_�, �"'� �^ ' � 0 - Official use oaly. Do not write in this area,to be compfeted by eity or town oJficial. �� . � City or Town: PermiULicense# Issuing Authority(circle one): 1.Board of Health 2.Building Depar[men[ 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector � 6. O[her Contact Person: Phone#: . Information and Instructions ". Massachusetts General Laws chapter 152 requires al]employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written:' An emp[nyer is defined as"an individual,partnership,association,corporation or other]egal entity,or any two or more of[he foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased employer,or the � receiver or trustee of an individual,parMership,association or other]egal entity,employing employees. However the owner of a dwelling house having not more than three aparhnents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer" MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has no[produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)sffites"Neither the commonwealth nor any of its political subdivisions shal] enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of[his chapter have bee�presented to the contrac[ing authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-con[ractor(s)name(s),address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Parinerships(LLP)with no employees other than the members or parMers,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Deparhnent of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the afiidavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Department of . Indushial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should�enter their � � � self-insurance]icense number on the appropriate line. - City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which wil]be used as a reference number. In addition,an applicant " that must submit multiple permit/license applica[ions in any given year,need only submit one a�davit indicating c�rrenf � � policy information(if necessary)and under`7ob Site Address"the applicant should write"all locatio�s in (city or town)."A copy of the affidavi[that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for futuce permits or licenses. A new affidavit must be filled out each year.Where a home ovmer or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or perntit to burn leaves etc.)said person is NOT required to complete fhis afHdavit. The DepartmenYs address,[elephone and faac number: � The Commonwealth of Massachusetts Deparhnent of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia - ' - -- - Cl'TY OF SALEIV� 1VIASSA(�i[J�E T75- , Bc�.an�cDErat�rrr � � 120 WAstm�TG'rorvS7REET,3mFioOR 1h�(978)7459595 � FAX(978)740-9B46 xn�Fxr AyDRiSODLL MRYOR , 75�AsST.P�xRE Drn�cn�oa rt�acrxo�at�'r/si�nnaG a�ssr�s Construction Debris Disposa/Affidavit (required for all demolition and,.renovation work)� In accordance with the sixth edition of the State Building Code, 780 CMR, Section 111.5 Debris, � and the provisions of MGL c40, S 54; Building Permit�1 is issued with the condition that the debris resuking from this work shail be dfsposed of in a properly licensed waste deposit facility as defined by MGL c 111, S i50A. The debris will be transported by: �5 ��, 'c�, c., � , (name of hauler) The debris will be disposed of in: . GS ^ �l ,I �k, �, , � r� (name of facility) 3 �" T� �� .u��'Llc�� 1 �I �a (address of facility) � 1� .� - �',� (�.,...._ Signature of ap licant � f�� 4-, ?�� : Date ., ` "°`T,- Commonwealth of Massachusetts ;� � �� ; � q City of Salem �, �� m 120 Washington St,3rtl Floor Salem,MA 01970(978)745-9595 u5641 `��' \ Retum card to Building Division for Certifieate of Occupancy �� - �� Perm it No. B-16-354 P E R M I T T O B U I L D � FEE PAID: $77.00 DATE ISSUED: 4121/2016 � � This certifies that PEABODY BLOCK, LLC C/O RCG LLC has permission to erect, alter, or demolish a building 120-b1dg2_WASHINGTON STREET Map/Lot: 3500040 ' ��. as follows: Other Building Permit � SHEET METAL PERMIT FOR THE UGLY MUG @ 122 WASHINGTON ST.: ! EXTEND EXISTING KITCHEN EXHAUST HOOD TO MEET CODE. Contractor Name: r DANIEL J. O'BOYLE DBA: C S VENTILATION INC � � Contractor License No: CS-091228 � ! � 4/21/2016 ` � Building Official .� • Date I I This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced wRhin si�ths after issuance.The Building Official may grant one or more extensions not ro exceed six mi nths each upon written request � �� . '. All work authorized by this permit shali contorm to the approved application and the approved construction documents for which this permit has been grented. � � ! � � � All constmction,alteretions and changes of use of any��buildin9 and structures shall be in compliance with the local zoning by-laws and codes. �� 1 ' � � This permit shall be displayed in a location clearly visitile from access street or road and shall be maintained open for public inspecGon for the entire duration of the work until the completion of the same. I ' � ' �,, 1 The Certificate of Occupancy will not be issued until a�l applicable signatures by the Building and Fire Officials are provided on this;permit. �..��C#: . 'P�rsons contracling wi[h unregistered contractors do not have access to Ihe guare�fund'(as se[forth in MGL c.142A). '' i / ' r Restrictions: - . Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. ' REVISIflC�S 61f f��,J I�oOD ��C'�`v�I rs C-j- gp�`'�'',`C�� 6��1tn1C-r '6� � ��I � �2�-+/. � �Ey��N L , . �u� , C� —c�" �7 � �ZG��,-) �,� C�. � � o:;� X2��C}{� n -0 _ ( I l p',t�'�{}� � � � `�. �� " �1� t�� xs �"c�� 5-�� - 3 G � � � �-� wi�il� (�,�-p� _ — LI� -� 000 No� �S; � � � � � � ��I��c� � � � , � � � I/ 1 G S�, �J� ��--�-- �`�°�?� ��'=—L_ �tK P L�' W i t�l} L-�.�=�o� p � � � K- �� (� � �D�-}—I 0 tJ 6�.�4 SS, � tl� �,.—�Er�C.-�' �'GQi=. �'r� � M � ,� , � (� 01� P.DD � �P�, `"-I G�, 1 J ,� . fi,n�� I � �1/� . C I N��E:N�� .ri--i'_ �v h��',� h1��{-{�r.�;��-�.. c�� :.�:�::� . 1-�-� � K—� '��-� �1�� DDI�10�I � �� :yq�.`' = j'-�'� � Q <<�r� � � � I U L-�o� �� I rz,�-'`��FZ�=SSf a� o �s�� . � � � U� � � � � � � i. � �) � � �v� � -�c3 �jc;�;.�,�ar,T �F;� � �1Gt��': �c� �s4/J I t —{�� 4ti�,�a: U� ��2'�"'� � i ' �� .__ � _ . ', .� L}o�D � � ��`�� s�� 'U �l�i�i�lG( �� ? � � ---�"--- � - - {�,t� ,a�, �, �f <*"^��J — ^c---� c� l� N�J — 7 ' —s �� . � o � � — {� �o '� � i _.. _ _ L� � _ ,� ' S � - �--- - ._� _ _.:,�_ -�v u�3�0 „�. � � � . _ ' U��}1" �I�� _��-- '�—� � �_ ��' ,tf� � � �� ' � �—� �2�1� � �c� �� l< i� '��'1 � � - E�u, �� CT� „- �� , [� ,_____,___,__�'-� � � p, , � � ,. , �E�-I�iA:;C,-�) �, �Q��.DG: Lt7 :;ol , olw�E,�i�y ��r _• ", � � ' �I ZZ��I � , r � �� v � \ fi��'N t �' �- _ � � ' e`'SnT„��Tn i io. . � � �Z �2 �(�i�.=. �� fj '-'----'--- --- N� :V�".1J i �rt r'�? 7 T ^�h C::'.�i J - ., _— .:�_ --- ,L' ,,. ..� �'-- �J D �i L_'� ., y ��.J� ��'rR^l.n Gr)LEI v F-�^n•r c--�-- I . . . 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Commonwealth of Massachusetts a "e� � :;�,' ., �. , ° � � �: Citv of S�alem . � : � F y � l � - . - - . - 120 Washington St,3rd Floor Salem,MA 01970(978)7459595 x5841 � � � � ` '�. ' , .. � � . � . . ,. . . , . � Return card to Buliding Divisba for CeRificate of Occupancy. . � . -�� ` ` � . Permit No. B-16-355� = p E RM I T TO B U I:L D � FEE PAID: $0:00 DATE ISSUED: 21 2016 . y� , n ' „ This certifies that GORILLA PRINTING � ° has permission to erect, alter or demolish a building,�_ ,,2g NORMAN STREET� Map/Lot: 260450-0 as follows: Sigms ; SIGN PERMIT�AS APPROVED FOR: GOLD DUST GALL'ERY , 1 �- � ; � Contractor Name: � ,._ „� _ � � �+, i DBA: , � � � � . . Contractor License No: 1 � s � 9 ,� f . ; . ,. } "` a2vsoas ' ` � Building Offici �' Date _ � � � � This permitshall be deemetl atiandoned and invalid unless tha work authorized by this pertnk is commenced wkhin sfz months a8er issuance.The Building OKciel- . � � � , may grent one.or more extensions not W exceed six.moMhs each upon written request \, - . � � � �, � �� All work authorized by this�permd shall conform to the approved application and Ne approved consWction documeMs for whic�is permR has�been granted. ' � � . . ' � .. . ,� ..., � . . . All construction,.alteretlons and�chenges ot use of aay buiWing and swctures shell be in compliance with the local zoning by-lews end codes. � � This permit shall be displayed in a Iocation cleaAy visiti e from access street or road and shall be maiMained open for public inspection for the enHre duration ot the , . � �� work until the compleUon of the same. .. . �� r . l. , 0 a �The Certificate of Occupancy will rrot 6e issued untll all applicable signatures by the Building and Fire Officials.�are provided on ihis pertnft � � - • � , . . i . _-�. . .. ,,,:., _. ...-.r'f _. . - . s � �HIG#: ' + � . 'Persans contracdng with unrepistered contractors do not ha�e access ta the guereMy nd"(as set forth'�In MGL cA 42A). � � � � Restrictions: ' ` � ,f� , . � � i �•�' { — ' ..r.. ..}.+�..�.R ... . .. ..._ T ' d� . m � � „ mm {Building plans are to be available on site. � 4 y All Permit Cards are the property of the PROPERTY OWNER. ' ' _,:. , , City of Salem Sign Permit Application Worksheet . ,,,; a��{VEO ��`c,p�,�j10P�AL SERViCG5 ��-ma�-�e . �j q � 49 coia o�se cauery =291b `APF1 � 28 Norman Street � Zoning(res/non-res) - 65 I /1 Entrence Corddor(Y/N) N V� Lot frontage n/a feet � Building or tenant fronWge 25 (less than 25) �!1 #of businesses on site Multiple �i � Bldng dist from street center <100 feet �� Multiplier t � 1 maximum area permiHed 25.00 sq ft � total proposed sign area 29.18 sq ft � sign 7 length 90.00 inches height 24.00 inches sign 2 length 43.00 inches height 47.50 inches sign 3 length 0.00 inches height 0.00 inches sign 4 length 0.00 inches height 0.00 inches sign 5 length 0.00 inches hei ht 0.00 inches maximum area permitted , 0.00 sq ft(per side) � maximum#of signs pertnitted 0 signs maximum height permitted 0.00 ft tall sign 1 proposed sign area 0.00 sq ft length 0.00 inches height 0.00 inches proposed sign height 0.00 ft sign 2 proposed sign area 0.00 sq k length 0.00 inches height 0.00 inches '� . ro osed si n hei ht k Application meets guidelines set forth in[he Salem Sign Ordinance yes Recommend approval yes v � Permit Number .. �� "�,, � — APPLIGATION.FOR IaERMIT TO EI2ECT A SIGN ' . ��'�.. � NUTE:BtlfIQING PERMtIT MUST BE OBTAlNED BEF4RE SIGN IS ERECTEQ �`; `,��:»� r , LocaGon, Ownership and Detaii Must Be Correct, Complete, and tegibie ,r�`'1 Saiem,Massacfiusetu 3 �� L �-^- . DaYe < -Ta the Suild�ng inspector: The uc�ders"r.�}ned het�tiy appties far.a permii to :a Erect r;AI[er, ;-�: Repair a sign an the#o8owing descnbed buildings: - . e � ` � �� . r Urban Renewai Area :.Ent!ance�Comidor � i � �!) :� YI c5'�i 5�f.t!��_ ,�'i�i'� ..,�.._ . ' -.;Historic DisVicf _ �,Nane . _ . ..�__ . .� . �� s .. �� _ -� �d�vv-(�rr'�� " ' " ' ' F . Teieptwne � Z' � tfle�i �f t floor _��-iJt1�.. � T_.. .. e � 1!. . � � - ._.. ��a.floor `..�..----- . - Kn�il� ltiel �.��d`�u f _�.�._..__—___ ___.. � .. . - � RtldrEss �7 � j 3 ofl or ,..` `. � B /1.�7V�'YiGYl.��I SSUv�� _._------ _._�_. j � ��Teieptione � '7 7i3 'J � ��fiooc --��-�-�------- -- e-mai� 1 How many businesses are in Fhe truikling? ! ll a eoiporate body, name Z . vf reSoonsibfs oflx:er � _ _.__._..�..--...._.__.—.-_ . �� 1 - , � ��Building . . ... . iinear(ea ' �a4�-i 15..� �Fg�-i rS�-i �at�' +, �'� I � Appficanfs Space(if multftenan4) finearfee --- -.._. - --� - ; , . '- linea.r�tee -.�.,._.��.�� Address�_[`-��._.�"�"'��iE�^' Property . . . Z-�' - �� ----�-� �. �. . � - Telephone � ��.$} $�{�" '�� _ I .. j E-mail t Sign Owner c$iprs Erectar a Oiher. ��n 1 • i Sign T --------- . . S n 3- . . . . ; �Surface -�-_T�{C Surface pLSurface � c;�RighE Angle to Buiiding � ��Right Angle to Building :�Right A�te to Buiidirx,� ; �-Free Standing i :;Free Standing . � c Eree�Ste'nding •�Awning � -1 Awning � e AtmuTg . , .. . + �-;�PoRatrie (A-Preme) f �:a Portable (A-Frame} u Portebte(A-�Frarr�) ; _:;Other{specity) . I �a Other(specifyi ��Othee(s{n3df�} � .' . , Sign Materiafs ` ` ` a � Y � � Sign Materiais V ` � � � Sign-Materials �f� t . ' V i d ��^� j Sigr.Dimensions ( �i�t/.� Sign Dimensions g �� SigrrOimensions tf `r � �� X�� -�-- ---- --- Z 2 Z.�€ �x � Si nk Area — �� ! 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