86 JACKSON STREET, SIGN, BPA 17-193 Permit Number
APPLICATION FOR PERMIT TO ERECT A SIGN
NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legible
Salem,Massachusetts
Date
To the Building Inspector:
The undersigned hereby applies for a permit to airect, ❑Alter, ❑Repair a sign on the following described buildings:
Street Address Zoning District
❑Urban Renewal Area ❑Entrance Corridor
I ❑Historic District ^one
fUse of Building
�. Telephone 7 7 1-floor
• • 2 floor
Address S 3ra floor
Telephone 4n floor
E-mail How many businesses are in the building?
If a corporate body,name Frontage
of respionsible officer
• Building linear feet
Cons uclion Sup's License No Applicant's Space(if multi-tenant) linear feet
Address Property linear feet
Telephone Mail Sign Permit to
E-mail f7gi56 Owner ❑Sign Erector ❑Other:
Proposedmore - signs
Si n1 S n2
Sign 3
Surface dSurface ❑Surface
❑Right Angle to Building ❑Right Angle to Building ❑Right Angle to Building
❑Free Standing ❑Free Standing ❑Free Standing
❑Awning ❑Awning ❑Awning
❑Portable(A-Frame) ❑ Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) ❑Other(specify) ❑Other(specify)
Sign Materials 1- Sign Materials Sign Materials
Sign Dimensions \/N� Sign Dimensions Sign Dimensions
13
Sign Area l� sq ft s ft Sign Area Sign Area
sq ft
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$
Existing Signs Signatures
Type Sign Area To Be Removed? Sign Own
s/Surface A-t6 sq ft ❑yes Vno x
❑ Right Angle to Building a sq ft ❑yes r(no
❑Free Standing sq ft ❑yes ❑no Sign Owner's Authorized Representative
❑Awning sq ft ❑yes ❑no
❑Other(specify) sq ft ❑yes ❑no
Property er
Internal Review
Planning&Communityevelopment Department Historical Commission
Approval
311i
Building Inspector
08/24/10 rev