OCEAN CHIROPRACTOR 76 Lafayette Street
Ocean Chiropractor
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MITTS' It! OJPLICAT= :c S`T TO == FILED WITH THE
APPLICAT1017 !'.UST Bc Su- c _:??D'. 0 F TE FLANNING
LANNII;G cr. - - -
t_ Correct C-mpiete
:«•P-. Lcca_ ion, C•.nersnia , and -_ - ._ccc cired for ery ion.andag Leei :.le c_o
a 9�r-Ct Sign
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Sales, ' •zsszchusetts -i Z-7
10 THE WILDING I !iSFECiOR:
tit to �`-tettAlter , Repair
The undersicned �
=•erebY applies fpermit a , —
<_ icn on t`e fotle•,aina described building:
I qrAZA =orino/District ] �J
Location and No. - I^u L
;;ane of Property Owner IY1,111,UrI!\l
';ame of Sian Owner C'�
Address
If Owner is a corporate body nave of responsible officer
Name of Licensed Sion ,Erector G _ Salem
Address C
„l LRNToJI��� —1(L0-� License No.
,
1st Floor 3rd-Floor
Use of Building: /2nd Floor 4th Floor
Te of Sion: ✓ Surface, Right Anales to duildina , Free Standing,
YP
Other (specify)��P��� Ta .ttj`�� 111 � Height:
Sion t.ateriz �/
I
g `JPly G�I 'rWJ Sion Area SF
Sion Dinensigns 1
Sign Area SF
Existing Sians : Surface: Sign Area SF
Richt Angles: Sign Area SF
Free-Standing Sign Area SF
Other
' Sian Area SF
Signs to be Removed: Type
FT Property FT
Frontage: Building I0� —
Name and Address of Signature ofpOwner„
Insurance Company:
Signature of Owners Authorized R resentative
Address
Estimated Los G� Telephone
of New Worki
APPROVALS: _ ---
T T
Jim lily(
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NEW ACCOUNTPAY TO /
ORDER OFEi-
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4- ,.U-ARS
BAN OF BOSTON
FOR
+1:01100039101: 733 44975u� -�-