136 CANAL STREET_SIGN PERMIT_JACKSON HEWITTCity of Salem Sign Permit Application Worksheet
Zoning (res/non-res)I
Entrance Corridor (Y/N)Y
Lot frontage 187 feet
Building or tenant frontage 140 feet
# of businesses on site 1
Bldng dist from street center <100 feet
Multiplier 1
Building and Blade Signs
maximum area permitted 140.00 sq ft
total proposed sign area 14.00 sq ft
Sign 1 14.00
Sign length 84.00 inches
height 24.00 inches
sign 2
length 0.00 inches
height 0.00 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
height 0.00 inches
Freestanding Signs not applicable
maximum area permitted 32.50 sq ft (per side)
maximum # of signs permitted 1 signs
maximum height permitted 12.50 ft tall
sign 1
existing sign area sq ft
length inches
height inches
Application meets standards set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes
Acrylic letters stud mounted to sign face. The sign face projects 3 inches
from the building. It is externally illuminated with an LED downlit light.
27-Jan-21
Jackson Hewitt
132-134 Canal Street
BCommonwealth of Massachusetts
City of Salem
120 Washington St, 3rd Floor Salem, MA 01970 (978) 745-9595 x5641
Permit No. SP-21-3
FEE PAID: 55
DATE ISSUED: February 10, 2021 PERMIT TO BUILD SIGN Expiration Date: August 10, 2021
This certifies
that:
Ed Juralewicz
has permission to erect a
sign(s) on :136 CANAL STREET Map/Lot #: 33-0008-0
Detailed as
follows:Sign #1: Wall Sign,
Contractor Name: Brian Chipman
DBA: Metro Sign & Awning
Installer: Metro Sign & Awning ,Contractor License No: CS-089645
Building Official : Issued Date: February 10, 2021
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. The Building Official may grant one or
more extensions not to exceed six months each upon written request.
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
All construction, alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the
completion of the same.
HIC #:
Restrictions:
4/9/26, 11:18 AM about:blank
about:blank 1/2
BBuilding plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
4/9/26, 11:18 AM about:blank
about:blank 2/2
This design/drawing is copyrighted: 2021 Metro Sign & Awning, Inc. No part of this drawing may be reproduced, copied or exhibited in any fashion without written consent from Metro Sign & Awning, Inc.
DWG. DATE:
Rev1:
Rev2:
Rev3:
Sales:
EJ
Design:
EJ
Pmgr:
PR
Drawing #
Customer/Job Location:
P & S Tax Prep Partners
136 Canal St Salem, MA 21-2166-2
2.09.2021
N OT E S
Work Order:
EXISTING SIGN
BY OTHERS
Quantity: 1
E X IS T I N G
RELEASE TO PRODUCTION:
Sign Sq Ftg:
Fonts:
Date
File Name:P & S Tax Prep Partners_Jackson Hewitt_Salem_CLS_2166_2876.cdr
Rev4:
Rev5:
Rev6:
EXISTING PANEL IN AN EXISTING PYLON
REQUIRED BY THE CITY OF SALEM
PLANNING DEPARTMENT TO BE
INCLUDED ON THE SIGN PERMIT
APPLICATION.
DO NOT FABRICATE
12’’ x 81’’ existing tenant panel
N o t e s
Release to Production:
Work Order:
This design/drawing is copyrighted: 2020 Metro Sign & Awning, Inc. No part of this drawing may be reproduced, copied or exhibited in any fashion without written consent from Metro Sign & Awning, Inc.
Approved
Approved As Noted xDateApproval:DWG. DATE: 10/29/20
Rev.1
Rev.2
Rev.3 File Name:
Sales.:Design:P.Mgr.:
Drawing #:
Customer/Job Location:
W W W .M E T R O S I G N .N E T F A X : 9 7 8 .8 5 1 .2 0 2 2 P H O N E : 9 7 8 .8 5 1 .2 4 2 4 1 7 0 L O R U M S T R E E T , T E W K S B U R Y M A 0 1 8 7 6
20-2166-r3
COLOR KEY
Loc. 1
Ed Juralewicz
JOB:
2166
EJ PRP & S Tax Prep Partners
132 Canal St Salem MA
INTERNALLY ILLUMINATED
WALL SIGN
QUANTITY: 1
A. Pan Sign: 24’’ x 84’’ x 3’’ Wall
Sign. .080 aluminum face painted
to match 3M 3630-57 Olympic
Blue. 1/2’’ thick acrylic graphics
painted white and black. Stud
mounted flush to face.
B. External lighting:
Two Oona Slim Wall Washer 48P
mounted above sign. One
H60W-PPS524V HanleyLED
60W 24V Power Supply inside
right end of pan.
Electrical feed and tie in by others
Mounting: Fasten with lag bolts
or equivalent into studs.
3530-57 Olympic Blue Satin
3635-222 Black Satin
Sign Sq Ftg. 14 sf
P & S Tax Prep Partners_Jackson Hewitt_Salem_CLS_2166
2
4
”
84”
changed to wall cabinet
EXTERNALLY ILLUMINATED PAN WALL SIGN
NOT TO SCALE
EXISTING PROPOSED
12/2 changed background color
12/11 pan sign external illum
A
B
24
"
3”Building Wall
Aluminum Tube Frame
1/8" thick
AL Face
(bleed edges)
AL angle (@ top
& bottom)
1/4"-20 Fastener
3/8" x 4" Lag Bolts
4 @ top & 4 @ bottom
1”
1/2" FLAT CUT OUT
ACRYLIC LETTERS
STUD MOUNTED
TO SIGN FACE.
Studs are threaded into
face with adhesive.
S I D E V I E W
I N S TA L L D E TA I L
LED Strip Light
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
www.mass.gov/dia
Workers’ Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):______________________________________________________
Address:__________________________________________________________________________
City/State/Zip:_____________________________ Phone #:________________________________
*Any applicant that checks box #1 must also fill out the section below showing their workers’ compensation policy information.
†Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
‡Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees, they must provide their workers’ comp. policy number.
I am an employer that is providing workers’ compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:____________________________________________________________________________
Policy # or Self-ins. Lic. #:__________________________________________ Expiration Date:____________________
Job Site Address: City/State/Zip:______________________
Attach a copy of the workers’ compensation policy declaration page (showing the policy number and expiration date).
Failure to secure 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 statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone #:
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: ___________________________________ Permit/License #_________________________________
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other ______________________________
Contact Person:_________________________________________ Phone #:_________________________________
Type of project (required):
7. New construction
8. Remodeling
9. Demolition
10 Building addition
11. Electrical repairs or additions
12. Plumbing repairs or additions
13. Roof repairs
14. Other____________________
1. I am a employer with _________employees (full and/or part-time).*
2. I am a sole proprietor or partnership and have no employees working for me in
any capacity. [No workers’ comp. insurance required.]
3. I am a homeowner doing all work myself. [No workers’ comp. insurance required.]
†
4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers’ compensation insurance or are sole
proprietors with no employees.
5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employees and have workers’ comp. insurance.‡
6. We are a corporation and its officers have exercised their right of exemption per MGL c.
152, §1(4), and we have no employees. [No workers’ comp. insurance required.]
Are you an employer? Check the appropriate box:
Information and Instructions
Massachusetts General Laws chapter 152 requires all 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 employer is defined as “an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments 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 not produced acceptable evidence of compliance with the insurance coverage required.”
Additionally, MGL chapter 152, §25C(7) states “Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority.”
Applicants
Please fill out the workers’ compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, 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 Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial 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 license 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 will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under “Job Site Address” the applicant should write “all locations in ______(city or
town).” A copy of the affidavit 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 future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit.
The Department’s address, telephone and fax number:
The Commonwealth of Massachusetts
Department 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
www.mass.gov/diaRevised 02-23-15