142 CANAL STREET - PARADISE DENTAL SIGN PERMIT (4) 142 Canal Street
Paradise Dental
City of Salem Sign Permit Application Worksheet
IVED
L 8V RW IEZ
3-Aug-16
Ma a AUG —8 A O I Paradise Dental Associates
142 Canal Street
Zoning(res/non-res) I
-Jt Entrance Corridor(Y/N) Y
Lot frontage 452 feet
Building or tenant frontage 75 feet
(� #of businesses on site
Bldng dist from street center 171 feet
o Multiplier 1.25
Building and Blade Signs
maximum area permitted 93.75 sq It
I
total proposed sign area 60.73 sq ft
sign 1
length 265.00 inches
height 33.00 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,
maximum area permitted 62.50 sq ft(per side)
maximum#of signs permitted 1 signs
maximum height permitted 15.00 ft tall -
TOTAL PYLON SIGN sign 1
proposed sign area 19.11 sq it
length 82.75 inches
height 33.25 inches
proposed sign height 12.00 it(approx)
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets guidelines set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes
The pylon sign will be a reface of an existing piece of signage.
Signage on building will be cast lit(exterior).
Permit Number
APPLICATION FOR PERMIT TO ERECT A SIGN
D 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 XErect, XAlter, c Repair a sign on the following described buildings:
Street Address Zoning District
142 Canal Street, Salem, MA 01970 I n Urban Renewal Area ❑Entrance Corridor
n Historic District None
''• Snakebite Realty, LLC-PHI Realty, LLC Use of Building
Telephone 978-375-5574 1 floor Dental Practice
Snakebite Realty, LLC-PHI Realty, LLC 2" floor
Address P.O. Box. 1074 Winchester,MA 01890 3 floor
Telephone 978-375-5574 4 floor
E-mail cbdoyle@gmail.com How many businesses are in the building? 1
If a corporate body, name Frontage
of responsible officer
' The Sign Center Building 463 linear feet
Construction Sup's License No N/A Applicant's Space(if multi-tenant) linear feet
Address 40 Orchard Street Haverhill.,MA 01830 Property linear feet
Telephone 978-372-3721 Mail Sign Permit to
E-mail Jenni.Crowell@thesigncentercom n Sign Owner rXSign Erector n Other:
Sign I Si n2 Sign 3
&Surface c Surface n Surface
n Right Angle to Building n Right Angle to Building n Right Angle to Building
❑Free Standing c Free Standing n Free Standing
n Awning o Awning c Awning
n Portable(A-Frame) c Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) ❑ Other(specify) ❑Other(specify)
Sign Materials 2"HDU Sign Foam Sign Materials Sign Materials
Sign Dimensions Sign Dimensions Sign Dimensions
33"h x 265"w Overall Dim.
Sign Area Sign Area Sign Area
70.8 sq ft sq ft sq ft
Sign Height(if free standing) N/A Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ 7630.94
Existing Signs
Type Sign Area To Be Removed? Sign Owner
c Surface 19.11 sq ft c yes ;(no Please SEW attached letter of Auth.
❑Right Angle to Building sq ft o yes c no
XFree Standing sq ft ❑yes o no Si Ow s Au oriz Representative
n Awning sq ft ❑yes o no Jenniffer Crowell (Agent)
X Other(specify)Reface Existing Py or sq ft n yes c no
Tenats panel onlyperty ner
lease see attached letter of Auth.
/
Planning Community Mvelopment Departmentlistorical Commission
Approval
Building Inspector
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City Of Sarum,. MMOMAGOONS
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Satan, MA 01970
07r=2016
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If you have any qw0jaw regardieg this rooter pkat W (me to c+math uzs 4i;
Thank you,
INSIG•1 OP ID: DK
CERTIFICATE OF LIABILITY INSURANCE DAT2/0912015
12109!2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,subject to
the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements).
PRODUCER CONTACT
Sinclair insurance Group Inc. NAME: Diane Kletner
1 Monarch Place AIDD.N.. Eiu:413-234.3157 _ ja1,Nop_413.234-3167
Springfield,MA 01144-2410 -E-MAIL - — ----
Salvatore Damato ADDRESS:dkietner@srfm.com
INSURERIS)AFFORDING COVERAGE NAICIN
__..._._.............. INSURER A:Peerless Insurance Company 24198_
INSURED Insignia Inc.dba The Sign INSURER e:
Center&The Instant Sign -
Center INSURER C:
Kahn Realty Trust - --
_............
40 Orchard St. INSURER 0:
Haverhill,M 01830 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
/NSR -- NOUL WORRGUCP-Eck POLICY npv —
L TYPE OFINSIIRANCE POLICY NUMBER MMIDO(YYYY MhvDDMYY UNUTS
GENERALUAINUTY EACH OCCURRENCE 5 1,000,00
A X I COMMERCIAL GENERALLIABILITY BKS66377349 1211212015/ 12)1212016 PREMISES E�oSrEI7_e— 5 300,00
CJIMS-MADE ?OCCUR MEDEXP(Arryompamo0) S 15,00
X BLKT All P&NC _ PERSONAL S ADV INJURY 5 1,000,00
X BLKT WOS GENERAL AGGREGATE 5 2,000,00
,:FN"_AGGREGATE LIMIT APPLIES PER: LI�PRODUCTS-COMPIOPAGG 5 2,000,00
POLICY x PRO- LOC $
AUTOMOBILE LIABILITY I I
Ea stwDIN E L MIT
eU S 1,000,00
A _�.ANY AUTO BA8731663 12112/2015 1211 212016 BODILY INJURY(Per person! s
ALL OWNED SCHEDULED "-- _—
AUTOS ^ AUTOS BODILY INJURY(Per actidanq 5
X MIRED AUTOS �AUOTOSSED PER ACCIDENT $
X BlktAl x WOS !�- 5
X UMBRELLA UAB X .00CUR EACH OCCURRENCE S 5,000,00
A EXCESS UAB CLAIMS-MAGE US056377346 1211212015 1211212016 AGGREGATE s 5,000,00
DEC) X IRETENTWNS 10000 s
WORKERS COMPENSATION xWC STATU-
AND EMPLOYERS'LIABILITYY LL T E
A ANY PROPRIETORFARTNERIEXECUTNE YIN
C8734253 12/12/2015 12/1212016 E L EACH ACCIDENT S 600,00
OFFICERNEMBER EXCLUDED? FNI NIA
(MandatoWn NH) E.L DISEASE-EA EMPLOYE S 500,00
lips descdbeudder
DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY OMIT I 5 500,00
A Bikt Bldg&BPP BKS56377349 12112/2015 12/1212018 Bikt Bldg
Spec incl Theft &BPP 3,220,81
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAaach ACORD 101,Addillaml RemaMs SchadW ,S more spaee is re4ulre n
CERTIFICATE HOLDER CANCELLATION
INSIG-A
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Insignia,Inc.dba ACCORDANCE WITH THE POLICY PROVISIONS.
The Sign Center
40 Orchard St. AUTHORRED REPRESENTATIVE
Harverhill, MA 01830
®1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
l
The Commonwealth of Massachusetts
Department of IndustrialAccidents
Ogee of Investigations
I Congress Street, Suite 100
Boston,MA 02 11 4-2 01 7
www mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contr2eters/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name(Business/Organization/lndividua0: Insignia, Inc. dba: The Sign Center
Address: 40 Orchard Street
City/State/Zip: Haverhill, MA 01830 Phone#:978-372-3721
Are you an employer?Check the appropriate box: Type of project(required):
LM 1 am a employer with 35 4. ❑ I am a general contractor and I
employees(full and/or part-time).
+ have hired the sub-contractors 6. ❑ New construction
2.❑ f am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any rapacity. employees and have workers'
[No workers' comp. insurance comp. insurance.:
9. Building addition
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ 1 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 applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they arcdoing all work and then hire outside contractors must submit anew alridavit indicating such.
tConaactors that check this box most 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 most provide their workers'comp.policy number.
I am are employer that is providing workers'compensation insurance for my employees. Below Ir the policv and job site
information.
Insurance Company Name: Peerless Insurance Company
Policy#or Self-ins. Lic.#:WC8734253 Expiration Date: 12/12/16
Job Site Address: Paradise Dental at 142 Canal Street City/State/Zip: Salem, MA 01970
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal 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 may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do herebyrtify finder the pain , nd penalties of perjury that the information provided above is true and correct.
Si fore: / Date: 07/28/2016
Phone ;i q '
Offtcial use only. Do not write in this area,to be completed by city or town ofjlcial.
City or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
the sign center
get noticed.
Town of Salem, Massachusetts
Department of Planning and Development
120 Washington Street
Salem, MA 01970
08/01/2016
Dear Department of Planning and Community Development,
Enclosed please find the documentation required for us to submit a Sign Permit Application
for our client Paradise Dental at 142 Canal Street. We are requesting a Sign Permit for the
installation of:
- (1) 33"h x 265"w x 2" HDU Sign foam, dimensional letters and logo set,
painted with studs for mounting above front entry building fagade. Total of 70.8
Sq. Ft.
- (1) 33.25"h x 82.75"w retainer face replacement with cut vinyl graphics to re-
face the existing tenant panel on main pylon. Total of 19.1 Sq. Ft.
Enclosed you will find one set of drawings showing the proposed signage, our Workman's
Compensation Certificate, letters of authorization and a check for$81.00 for the
application fee's.
I would like to submit our proposed signage design to the City of Salem, MA Building
Department August schedule. I believe all the necessary documents are enclosed, however
if I have overlooked anything, or if you have any questions or concerns regarding this
project please call me at 978.372.3721. I thank you for all your help with this matter, your
kindness is very much appreciated.
qyoum,
Jenniffer Crowell
40 Orchard Street I Haverhill, MA 01830
thesigncenter.com I signs@thesigncenter.com
PAMEDICALTaradise DentaftParadise Dental - Front Elevation.plt 7/28/2016 1:57:13 PM Scale: 1:113.01 Height: 555.854 Length: 1130.070 in
Paradise �) Dental
Associates
14- 4'-6'
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265 in
2 7,n
70.8 Sq Feet 20,9 in:,s 6,nLParadIs&q) bent;aI 11 9'n
38.5 in� AssocTa-tes — i
96in
35.3 in
Paradise Dental date 7/22/2016
the sign center 142 Canal Street, Salem MA designed by B Monahan
file name Paradise Dental - Front Elevation.plE
qc-L noticed. Sales Associate Jay Kahn details 2" HDU sign foam letters and logo painted
bronze (mp20157) and teal (PMS 7712C)
Stud mounted
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PAIMEDICAUParadise DentaltParadise Dental-Tenant Panel.plt 7/28/20161:56:54 PM Scale: 1:61.89 Height:527.637 Length:400.214 in
x Paradise��D
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33251n35.)5In
182 75 in
85 25 in
19.1 Sq Feet
the sign center Paradise Dental date 7J22/2016 designed by B Monahan Jry
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142 Canal Street, Salem MA file name Paradise Dental-Tenant Panel.plt
ed, Sales Associate Jay Kahn details Pylon tenant panel reface
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Commonwealth of Massachusetts
o City of Salem
a `^ 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595x5641
Return card to Building Division for Certificate of Occupancy
Permit No. B-15-876
PERMITFEE PAID: $0.00 TO BUIL D
DATE ISSUED: 8/17/2016
This certifies that THE SIGN CENTER
has permission to erect, alter, or demolish a building 142-bidg2 CANAL STREET Map/Lot: 330006-0
as follows: Signs SIGN PERMIT AS APPROVED FOR:
PARADISE DENTAL ASSOCIATES
Contractor Name:
DBA: /
Contractor License No:
V ` 8/17/2016
Building Official 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 Oficial
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.
H IC#: "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.