MH BONACORSO INSURANCE AGENCY 15 Front Street
MH Bonacorso Insurance Agency
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APPLICATION FOR PERMIT TO ERECT A SIGN
t �v %u Salem, Massachusetts 6 — 19
PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
APPLICATION MUST BE SUBMITTED TO THE BUILDING INSPECTOR WITH STAMPED APPROVAL
FROM THE SALEM REDEVELOPMENT AUTHORITY.
TO THE BUILDING INSPECTOR:
The undersigned hereby applies for a permit to Erect,
Alter, Repair a sign on the following described
building.
s
Location I_5F jentu i cp" Zoning/District
Name of Property Owner 4,/ e_,4cA L d YM i i:Y T- lL U S --r-
Name
Name of Sign Owner /�I H +3owAC8125o = 1y.5ue A)y
Address 15 r (Law i 5 1, 5,9/,eM, 111�1.
If Owner is a corporation, name of responsible Officer
Name of Licensed Sign Erector SA), e K1 slow COM W 4+v 4
Address C 4 A 14ry i Salem License No. 117
Use of Building: 1st Floor 3rd Floor
/ 2nd Floor 4th Floor
Type of Sign: 7/ Surface )Llr-� Right Angles to Building
h A- Free Standing _ Other ( ) Height:
Sign Materials : 4;y 0 n
Sign Dimensions : l9 X z Sign Area .3 SF
Existing SignsSur Lu e o 0 Sign Area '37 SF
Ight Angles : A.' 14 Sign Area SF
Free-Standing: Sign Area SF
Other: Sign Area SF
Signs to be removed: Type N1A Sign Area SF
Frontage: Building _ F erty 3 your FT
jj
Signature of Owner` "�
Name & Address of Address ;b`���t� d
Insurance Company:
Telephone
Estimated Cost of New Work: la S C c
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EXPLANATION AMOUNT 53-179/113
M.H. BONACORSO INSURANCE AGENCY
15 FRONT STREET 1003
\� SALEM, MA 01970
CHECK
PAY `
DOLLARS AMOUNT
DATE I TO THE ORDER OF DESCRIPTION I CHECK NO.
/00 3 $ do
Eastern Bank LYNN.MA
11'0070003111 1:0LL3017981: 09 7766 711'