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4 CANAL STREET - SIGN PERMIT
4 Canal Street Domino's Commonwealth of Massachusetts f �+ Citv of Salem 120 Washington St.3rd Floor Salem,MA 01970(978)745-9595 x5641 Return card to Building Division for Certificate of Occupancy Permit B-15-1242 PERMIT T O BUILD FEE PAID:: $0$0.00 DATE ISSUED: 11/19/2015 This certifies that BARLO SIGNS has permission to erect, alter, or demolish a building 4 CANAL STREET Map/Lot: 340478-0 as follows: Signs SIGN PERMIT AS APPROVED FOR: DOMINO'S Contractor Name: DBA: Contractor License No: e� j/h2+ 11/19/2015 Building Offici I Date 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. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. HIC#: Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A), Restrictions: Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. City of Salem Sign Permit Application Worksheet RECEIVED ECTIONAL S, 9-Nov-15 Domino's ^ (` 4 Canal Street Zoning(res/non-res) B5 Entrance Corridor(Y/N) Y Lot frontage(2 frontages) 318 feet Building or tenant frontage 136 feet(combined) � y� #of businesses on site 1 V/ Bldng dist from street center <100 feet Multiplier 1 Building and Blade Signs CQmaximum area permitted 137.00 sq ft total proposed sign area 58.06 sq ft sign 1 Domino Logo Front Sign length 38.00 inches height 20.00 inches sign 2 Front Sign Type face length 142.50 inches height 24.00 inches sign 3 Domino Logo Front length 38.00 inches height 20.00 inches sign 4 Side Sign Type Face length 142.50 inches height 24.00 inches sign 5 length 0.00 inches height 0.00 inches Freestanding Signs maximum area permitted 32.50 sq it(per side) maximum#of signs permitted 1 signs maximum height permitted 12.50 ft tall sign 1 proposed sign area 11.28 sq ft length 56.00 inches height 29.00 inches proposed sign height 15.11 ft(approx) sign 2 proposed sign area 0.00 sq ft length 0.00 inches height 0.00 inches propos d sign height ft Application meets standards set forth in the Salem Sign Ordinance Yes Recommend approval Yes All building signage will be externally illuminated. Freestanding sign will be installed on existing poll. 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 O11/06/15 Salem, Massachusetts Date To the Building Inspector: The undersigned hereby applies for a permit to a Erect, ig Alter, ❑Repair a sign on the following described buildings: ZoningStreet Address District 4 Canal St ❑Urban Renewal Area 2,Lntrance Corridor ❑Historic District ❑None 7corporate David Jenks hone6179084413 1 Floor Restaurant David Jenks 2 floor ress 4 Canal St Salem MA 3 floor hone 6179084413 4 floor -mail How many businesses are in the building? 1 ame Frontage of responsible officer Barlo Signs Building 28'and 90' linear feet Construction Sups License No Applicant's Space(if multi-tenant) linear feet Address Qr�fli 2&w Nff p Property linear feet Telephone Y(A9 - ZZ-f-54P 7 4 A-333 E-mail •_eM;kr o - ❑Sign Owner Ne8ignErector n Other: Sioposed Signs(If more than three signs are proposed,attach additiona;sheets) gn I Sign 2 1 Sign 3 Surface @(Surface ❑Surface ❑Right Angle to Building Right Angle to Building ❑Right Angle to Building ❑Free Standing Free Standing q(Free Standing ❑Awning E:Awning ❑Awning ❑Portable(A-Frame) r Portable(A-Frame) ❑Portable(A-Frame) i Other(specify) c Other(specify) ❑Other(specify) REPLACE CAB. SAME POLE Sign Materials BEA PLEXI Sign Materials BEA PLEXI Sign Materials BEA LEXAN Sign Dimensions (A)3'3"X 15'7" Sign Dimensions TY X 15'T, Sign Dimensions 2'5"X 47" Sign Area 50.7 s it Sign Area 50.7 sq ft Sign Area 25 sq ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free.standing) NO CHANGE Estimated Cost of Net Work $ 18,000 Existing Signs Type Sign Area To Be Removed? Sign Owner XSurface sq ft dyes -no Authorization Enclosed Right Angle to Building sq ft ❑yes = no X Free Standing 26"2!$q ft 5,yes -no Signwn �s uthonzed Representative �Awning sq ft �yes -no Barlo Signs-Jenn Robichaud XOther(specify) Replace Cabinet sq ft ❑yes no Existing Pylon Abo Prop Owner Au rization Enclosed internal Review PI ing&Community Development Department Historical Commission Building Inspector -. . 5+ /./. /frS— ,Irs,fdG& COff MUNlly DE-VELOPWOT Department of Industrial Accidents y _ � ✓'P Inv�Ch�izntys . 1 1 Congress Street,Suite 166 _ Boston,MA 02114-2017 www.mass.gov/dia =_ ._ r�-s,� P;ensato�lnsuratce-itla�t. � tiders%�ontrxctoxs�ElectracaansfPlam'<�b - -�_ - --- Amplicant`Information �^. Please Print Le23biv Name(Business/Orgamzation/IndividiW): �dfeoa Address- j5e 61z.CS26t, c('` - City/State/Zip: ��,f®x! /�� d dei°S/ Phone#: ®3 ��a•a6f C �� Are yqu an employer?Check t appropriate tion: Q✓ 4. I am a general contractor and I Type of project(required): 1. I am a employer with ;G� ❑ g 6. El New construction employees(ftill and/or part:time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' comp.[No workers' comp.insurance co insurance.$ 9. []Building addition required.] 5. [� We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their. 11.❑Plumbing repairs or additions myself,[No workers' comp; right of exemption per MGL 12.❑ Roof repairs. insurance required]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other' comp.insurance'required.] *Any applicavtYbat checks box#1 must also fill out ffie section below showmgtheir workers'compevsatioapolicy.information. t Homeowners who submit thisatTtdavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that Check this boz must aftaclted av additional shcet showiag the varve of the sub-contrAbtors and We Whether of not these entities have ' aruployees.df the s¢b,contractofs haveeinplCyees,they tuuet provide their workers'corilp.policy number. - �- I ain an employer that is providing workers'compeitSatiotr in's»ra»ce for my employees: Below h the policy and job site infot»eaHon. Insttrance(,omgany Name:. Policy#or Self-ms..�Me.#:- V" 000717 Expiration Date: ® b Job Site Address: 41/1111)? City/State/Lip: 9�© Attach a copy,of the workers'compensation policy declaration page(showing the Policyriumber and expiration date). Failure to secure coVeragb as required under Section 25A of MGL c. 152 can lead to the imposition of criutigal penalties:of 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. Be advised that a copy of this statement maybe forwarded to the Office of . Investigations of the DIA for insurance coverage verification. r I do hereby cerd tinder tJte pains and a aloes ofperiva that the in ormation provided ab ye is true and correct j SiEuature: Phone#: Ifd3 o0` Z'2`3� L 3 °j) Official use only. Do not write in this area,to be completed by eity;ortom official' City or Town: P ermit/License# Issuing Authority(circle one): 1:Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b.,Other. . utaet]Person: --hone fiRAPLO SIGNS PROPERTY OWNER AUTHORIZATION MUST BE SIGNED BY OWNER OF PROPERTY (This verifies that you are authorizing Barlo Signs to submit an application for permits ON BEHALF OF the owner of the property.) As owner of 4 Canal St Sale MA (Fill in Property Address) I hereby authorize Jennifer Robichaud or as an authorized representative of Barlo Signs of Hudson, N.H., to APPLY FOR SIGN PERMITS for this site. hereby authorize Jenn Robichaud or Authorized Representative of Barlo Signs of Hudson, N.H., to APPEAR BEFORE THE PLANNING WARD and/or SIGN REVIEW BOARD and/or the ZBA for this site. Property Owner's Signature: Printed Name: jl'1-U � nirLS Address: Phone number: L(W 3 We cannot apply for permits or hearings until we receive your authorization. Please FAX this completed & signed form to 603-882-7680, attn: Bill Barnard and MAIL ORIGINAL to Barlo Signs, 158 Greeley Street, Hudson, NH 03051. If you have any questions, please call meat 1-800-227-5674 ext. 347 THANK YOU! Date: September 23, 2015 Reference JOB NAME: Domino's Salem MA Job No: #3774 C:\Users\David\HppData\Local\Microsoft\Windows\Tenporary Internet Files\Content.Outlmk\JA5DG7(IH\POA Property Owner's Authorization 11.6.09.doc. Rev11.6.09 ,6:,_ ON RPM, `i 0Domines law I CURRENT SIGN ELEVATION I SCALE 3116'=1'-T PROPOSED SIGN ELEVATION I SCALE 3116'=I'-0' ISd'r: 3.3' 1'REVERSE CUT WHITE OUTLINE _ LIGHTINGANGLED REFLECTOR rTOCK BRACKETSLACK 2'X6"ALUMTUBEI rMAXSIRGNE 3MIN STROKE \/ PTM FASCIA TBl11 11-10 h' ITEM A- Ii)SET OF NON-ILLUMINATED CHANNEL LETTERS WI RACEWAY&GOOSENECK LIGHTING SCALE 112'=1'-0" JOB#. 1 1' JM Nem,:DOMINO'S 1• r 1• RaeewoY:2X6 ALUMINUM RECTANGULAR TUBE Dem [ommem L"aaliw: 4Cenal Street,Belem MA :.g FLINCOCaDROFC11 1 ITEM MANUFACTURE d INSTALL Letter Face:3L16'WHITEPLEX nno�o UUM,.TLO.M v BARN I-1e PENEEO GOOGFNEOK s.ksW I1 SET OF NON-ILLUMINATED CHANNEL LETTERB WI ORn'KETaC:ORFOR u�mv - — 'gfiwif4,dieLRiixnml R�CEWAYflG005ENECK LIGHTING LetterTrim:1'BLUE OFT I vn+ TM Ialel FalanlaD.itla Leno,Ramm:.040 CHEVRON BLUE BEA(COIL STOCK) -- T-le REnSFDGOO!iEK" tManm. a'. 11-515 r"s meooxnsen SITE SURVEY REQUIRED. BRncNET FOR OPTION t ornsrwam eotsTNE eamo woue it.- REMOVE OPTIONS peal n:MG8 Dem:ll-B Sign Aru:So)SF tt6 REPLACE PYLON ' nm L.,face:X16"WHITE FLEX wl En'rre.a Dare'. wa in ArlwvdP ❑Yes■No PAmva Avail: ■Yes Dee ■REO66A33 ADD HEIGHTS fay6rtvun: Date: �Yewalrnur¢' w: ttfi MAKE J REMOVEALL ■INTENBEBLOE 3a30.tD OPTIONS Sher Deter u,wm. Belem MA 150fi1466BJ Sipe Depaamm: Carp SPN3Avail: ■Yes Nu Lagu Trim:1-WHITE @aker. Otte: Logo Ramco: ,040 WHITE BEA Im d uvn Data: B-1 S06-14668 SHEET 1.0 GOOSENECKS/ RACEWAY BY BARLO HUDSON 15-7 z LETTERS/LOGO BY BARLOMEX GOOSENECK UGHTING BY BARLO HUDSON LIGHT FIXTURES WHITE OUTLINE OUTLINE RSE CUT- -_---_ ELECTRICAL CONDIUT W - J-BOX AND RACEWAY BLACK LL, d _GOOSE NECK LIGHTING m ',� � � - i /� ,� N / (EXACT DIMS TBD PER SITE SURVEY) 9fR i NEW 1.5°ANGLE BRACKETS OTY(4) PTM MANSARD ROOFF I. 2'X6--ALUMTUBE rµAy STRgIE TNINSIPOKE "M FASCN T80 1r-1p S• —W/1 BO%wf ALUM / PLATE(8'SQ x.25') i IGCALE TEEM A NON-ILLUMINATED CHANNEL LETTERS W/RACEWAY 8 GOOSENECK LIGHTING THIS BRACKET TD BE LEFT LONGAND FIELD CUT G'-1G 114° LOGO T V-3- LETTERS SCALE 112'=1' CHEW LETRR.108 Job Name.DOMINO'S .aims I Leca.... IN S' Le0.Plan&ovided:. Loc.Plan Provided-Ya= LNo mRem L"im. 4Canal Street.Salem MA Amp 20 Drain Hole,: ■r - iNo Working He All d:vESD Boq: ❑Yes ON. Mea &.MOIMGB UL Locaflimt_Ter■NA NdCn.,T ds Base men Req: ❑Yes LT No OSua limn.. sd..n°v BARN taabruy2lYmyal�i vglage 120 Fan Mo ■'lc.Moon TUJIT Spatial Velide Type:— eln I.,Rnq: LIYes ❑No f-lo-nµ >ti� TM I®la&llarfupming"e U.L — DVemiphl Rey:❑Ye,❑No p: Stpn I.,Req: ❑Yes ON. — '."divedr ecywelarz mtstlle Dail 11615 uP ras—mo-n'll. Bed McCJNa MCEr.]ta.an Ta:.090 Access to 5'n: .Imere❑E%Mle i �OYes ON. pesi n. GB 0ete:llS pO6°s��emu uorn�nw .remua muxnraevvaneuuma Sultade Loce6m:A Wet DnmP gory em anv ms>.euwavwweurnrvas Height SP Winn Behind Wal:— Fun Detail Roq: ❑1'es ONO En'neem : -Darn: Nolen- Rearms:MaL:— Tb:.lHo Dapth:5- Gaw SPace Sue:— Permits Roq: 7Yea ON. ❑ac_ E,dmad Dee: SSalez' Dal¢: peeiel Note:— ❑ON6 MylproduDete: s,NNms° Salem AIA 15U614B68J p in9aa'pyads,q ar: ■l' LIT MenI. EquiPRemal fleq:- _ av'wam Imtaneaction,,on mtn: B-'15-0&'14868 SHEET, LI AFF CURRENT SIGN ELEVATION I SCALE 1I8-=1'A' PROPOSED SIGN ELEVATION I SCALE 3.3' VREVERSE CUT _ _ WHITE OUTLINE - � _ HTM LIGHTING ANGLED REFLECTOR -WI STOCK BRACKETBLACK 2'X6^ALUM TUBE)rLux sTRcxE 3'IAM SrRdcE \/ PTM FASCIA TBD r it'-10'6 ITEM B-- 1)SET OF NON-ILLUMINATED CHANNEL LETTERS WI RACEWAY 8 GOOSENECK LIGHTING SCALE'.Irf=1'1Y JOB#:— '' ' WDIMIINUSeme.D0k11N0'S r• 1 1• Recewey'2%6ALUMINUM RECTANGULAR TUBE Date [.mmem M 4 Canal Street Salem MAl�9 REVISELLCAM0F0.3mITEM B-MANUFACTUREBINSTALL Lener Face. 316'WMITE PLEX RI3DEDA16341MNe DP1w1.14 REASEDWOUNEC6SewR BARN11SET Of NON-ILENECK LIG CHANNEL LETTERS W/ DRACNET4CLORFORt�ACEWYBGOOSENECK LIGHTING Leuer Tnm 1'BLUE ORION1 '"'3 TM emsese3emmolwaren Letter Hand 050 CHEVRON BLUE BEA ICOIL STOCK) r-16 REMSEDWOSEN6CR l on. 11-6-15 1%.. waneser.IMET FOR OPTION 1 •pGPm24M 24151x[MNGGW WSipl Aru:50.1 SF 11-5 REMOVE OPTIONS :MGB Oe1e:115 mm®p�°ad.��NQ"o'a"""'@i°... Lope Fac.:U16'WHITE PLAT w' 11.5 REPLACE PYLON OPTenn- Om.: !�.ArtworkRe: ❑Yes■No PhomsAvd; ■Yes 11 N. ■RED 3M33 ADDHEIGHTS u Owe: ®ww1M ■INTENSEEl 3e3o-1P 77A MAKEJ REMOVEALLOwe:OPTIONSfe.xa�� SalemMA150514568J sfpa DapespeR: eWpsPeo A..R: ■ree l_Na Lead flat..: .=iE ftdlion: Date: B-15-061-14868Lopo Remm: .040 WHITE BEA ion. larn SHFf 1 70 GOOSENECKS/RACEWAY BY BARLO HUDSON 15'-114 LETTERS/LOGO BY BARLOMEX 5 LIGHTING RSARLO HUDSON LIGHT FIXTURES 1'REVERSE CUT___---_ ELECTRICAL CONDIUT WHITE OUTLINE J-80X AND RACEWAY L_T BLACK GOOSE NECK LIGHTING (EXACT DIMS TBD PER SITE SURVEY) / 3'10' / NEW 1.5"ANGLE BRACKETS DTY141 / PTM MANSARD ROOF i ALUM TUBE rt+Aa SrPONE rs1w 11-10[ PTN fRscIR TeI 11-101/1- i Ww PLATE (B"SQx.25') ITEM B-NOWILLUMINATED CHANNEL LETTERS WI RACEWAYS GOOSENECK LIGHTING —THIS £KET TO BE LEFT LO DHELD CUT SCALE'.112"=1'0' -1'$1 i 0'-10114^ LOGO T 1,-3" V-11 112" Iri^- LETTERS SCALE 112'=1' CREW LETTER JOB Jot Neme:UUK11NV 5 Ci¢uils I Location: ❑Int ■E+I. Loc.Plan Provided _Yne LJNo Lee.PLan Provided:❑Yes ❑Np IBRado 1pcatien: 4 Canal Street Seem MA Amp 20 Omm Hole.: ■Yes ll No Wart i Allowed:— ESO Be,: ❑Yes CNo -.ar:MQ'MGS ULLoCaeon: ❑SmOE)IDpMNA #ol CnveTmckr Base lmp Req: ❑Yes ONo 75up pbc.e. s•k+ua BAflN Vdut¢ IOMer VM TM ISeGie tF.0.1NV. 9 120 face Mae�nlum MMen�Lum�Th:Yifi'Special Vet'CIO Type:— Else lnsp fleq: LI Vez nrvo lemrerzaeae Eu lemlutrsm OvemiRM fleq:DYes❑No #� Sion leap Ran: ❑Yes ONo Lendlaa oan:11-(r15 ss•.k..mozrzuv U.L. — — •. ••I mq�a�e� N wwl°�u®alPimru B.a MM:pMaoeEGJte..n:.040Ac..WSi.: —IreemvOFitelwl ❑Yes ❑No I Oev n:MGH pete�lld � vawu°umvmm�ennmav Sudede-.4an:M N'el O F.p O Dry _ - . .v.vreswwsuevnexmvv.vavavamurz..�nxuu Kai M of .St Betind Wtl:— nwit,amR Req: ❑1'es uN. En inauln: pate: Notes'. flwums:M.C— Th:.Oat OepW:5" Craw Spxa Sl¢e:— PBrmN3 Req: 'l Vea ❑Nq �flar10 EVMaun' Dere: �Rrvmue�luee' =-. �s<iMvwevegMk6Wtd» �scb 6aes. pate: NmM Psdempauw�y dal1-r Myler. ■t- LI2' llEquR.Rental Req:— spedel Nom:— ]palK. RotluCeue Oete: I'xri°'"` Salem W%150614868 J rmpswa�MrvamdW%iaMesg� - Inaialladaa pare: B-15-06-'14868 sNEEr.a.t 5'-0 P REVERSE CUT.._....... h N WHITE OUTLINE �n E' SIiE BLRNEY gEONgED / (.'LRflLNi_IGN ELf'M .:.-E\:i °' C /.' 1'ftETAINERS PiM HAS COOL GRAY 4c CREW EIUSIIXB PYLON JOB Eximinp Sq Ft. New Sp H. too.Plan Previd, _ _ ■ Slew Sue. IJ EusungC'NaxESO Req: 2TSmb oF%:- ❑1'rs L'Na Bme loop Req'. -- 4-STEEL TUBE TO MATCH Working Nrs Allowed- Ela lnpRaq \ - EXISTING 4, PTM #mCl Voll Tka SlenlepReq: \\\Y/ EMS COOL STEEL SI Ar of cr VeANe TYpe- Sgn al looPolar,R Ovemight Reg❑yesp Nv #:- Police Germ)Req Equip.Ramal rep Permas Req Leet LN ■�nr _ p5W- �_. Spxiel Nme:- CUhn - Cmne Mgt Req PYLON SIGN JOB -EXISTING STEEL TUBE L Custom LEstmzian Pwgu :- STEEL SME Circuits Extrusion TYpe:- OuemXy.- Wetl:- WALLTXIN. Repairer Sin. LEO Mlg:- "up SEE I I vale e ITEM C- (1)C/P REPLACEMENT PYLON SIGN CABINET Fmmmg: Sool =Nolo. Dalai— STUB WALL I I U.L. SCALE'.1'=1'-0' CebinatIM Planes of LED:OI C2 DIegr- Pole Crram:CYeSSoe-Mel- C No SUMMOLocatlanNUINat Damp E3Ory Face Mm:LAcm Crse.C/eren Th:- TotalR- Curter Pole Lyes CNo ULlCe m: CS"D Top Copy:- Nara.or Vertical Lemping:- Oaeep Burial LJ YThZAmm cure;_ CNo Anchor taelt es - Size:-FN Ynre��lieNr S1'il> Special Nart, Flats Sae:- L W- Th. Special Nme:- nwnnmaran 0Poor CNeon ■LEO Fmnq Site.-L—W--0-O JOB#-- 10 Job Name.D0MIN0'S r• Cabinet PT1:1 PbIS R I-�er'.'PT>,I Palea.,A'ILRo Oepe CanrnwR Lrcminn. 4 Canal Street.Salem MA REM CMANUFAOTURE&INSTALL COOL GRAY ac PMS COOL GRAY 4. 79 pRlsT°uao'1pnRosPwyour mm.pv MOIMGB 11I 06 REPLACEMENT PYLON SIGN CABINET Face/BecAmmol:Y16 WHITE LEXAN Pole Cover. 11-5 REPLACE PYLON OPT Chien: BpRN _ ADD HEIGHTS P1" 1M iwb svralPRIMIGo Copy:RED 3630,3381NTENSE BLUE LEO:WHVE FSU SURVEY REQUIRED 11-6 MAKE J REMOVE ALL "L.dWdpia Rt Gt5 ros eamnrs 36W.121APPLIEOVINYL OPTIONS " ' pe"rarei mm i"sm GROUPDate:11G Sign Area:35 SF Special Note:- Dem.ArtworkRep: ❑Yee■Na PhotosAvail: ■Yes iNo Date: temm Lean—io, '�, Di" ddDate: FxN.me SalemMA150614868J Sign Depoaifion: Corp Space Avail: ■Yes LI No ALL COLORS ARE FOR REPRESENTATION ONLY. Dale: B-��J-��Y�4868SEEACIUALSAMPLES FOR COLOR KIM Me: Sxf F: iO City of Salem Department of Planning & Community Development q CHECK RECEIPT AND TRACKING FORM c DATE / (S BOARD STAFF CLIENT: I (/ PROPERTY ADDRESS: Z, CONTACT NUMBER: 0(7-- 90? PURPOSEFOR APPLICATION: S� � CHECK # 1,,5- 70 AMOUNT RECEIVED: $ y Barlo Signs Intemational inc. "'5314 Permit Account ®woaxu 1570 158 Greeley St Hudson,NH 03051 O r 603-882-26 g X%Citizens Bank® x:0 & &4015331: 33 & 29922 &611' 1570