64 Grove StreetOwner signature Permit Nimber
�+..C°� APPLICATION FOR PERMIT TO ERECT A SIGN
P m
NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legib
Salem, Massac iusetts
To the Building Inspector:
Date
The undersigned hereby applies for a permit to -i Erect, Alter, u Repair a sign on the following describep buildings:
Ll a Urban Renewal Area c Entrance Corridor
S-�r �n�wr,a� Historic District w14"one
PropertyU�e of Building
Telephone (Q 0 15 floor
Owner:Sign e.14-h V e. AS 2r floor �,
Address 3 NAu di -. �f wood 3`' floor �+
Telephone _ 5 A 4 floor
E-mail 51�Yr g How many business s are in the building?
If a corporate body, name Frontage 0
of res onsible officer
Sign Erector: Name Ae_�l Building linear feet
Construction Sup's License No Applicant's Space (if ulti-tenant) linear feet
Address 3 Property linear feet
Telephone 1 .rL - t lWL Mail Sign Permit to
E-mail M ign Owner L3 Sig Erector c Other.
two
7nnrSi n 2Si n 3
-i Surface r_ Surface
❑ Right Angle to Building �j Right Angle to Building c Right Angle to Building
.agree Standing c Free Standing c Free Standi g
❑Awning ii Awning c Awning
n Portable (A-Frame) -1 Portable(A-Frame) r Portable(AFrame)
Other(specify) zi Other(specify) a: Other(spec fy)
Sign Materials, Sign Materials Sign Material
_
Sign Dimensions u'��X 1r Sign Dimensions Sign Dimensi ns
Sign Area 1 Sign Area Sign Area
'�•"1' s ft so ft s ft
sign Height(if free standing) Sign Height(if free standing) Sign Height(i free standing)
n
Estimated Cost of Net Work
Existing' Signs
Type Area To Be Removed? Sign O n
Sign
7
❑Surface r �"5sq ft c yes ❑no
:i Right Angle to Building sq ft yes no
Free Standing sq ft r- yes n no Sign Owner's Authorized epresentative
Awning sq ft c yes :-i no
❑Other(specify) sq ft ::: yes -j no
Property Owner
Planning&Community Developrnent Department Historical Com ission
7
Building Inspector
08/24/10 rev