400 HIGHLAND AVENUE - SIGN PERMIT (11) 400 Highland Avenue
Urology Consultants
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APPLICATION FOR PERMIT TO ERECT A SIGN
Salem, Massachusetts 19_
PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
TO THE BUILDING INSPECTOR:
The undersigned hereby applies for a permit to Erect,
Alter, Repair a sign on the following described
building, IJ ( /1 �_ -
Location I ���)k�L(f r 1w" Zoning/District
Name of Property Owner " fix rrlI. J'
Name of Si�gNn1 Owner Ikro � 4I 061" �'N, 1
Address '141/ N« Z� 6y6
If Owner is a corporation, name of responsible Officer �I
mo / Name of Licensed Sign Erector
l_,4,NA I `//I 1 I L,-D- /J
-j ''t�Address � lu�%lavu �Wv� rGG+�?O41 License No. l- -I
Use of Building: lst Floor / 3rd Floor
2nd Floor 4th Floor
Type of Sign: Surface Right Angles to Building
Free Standing Other ( ) Height: _
Sign Materials ; � en 1� (i IAAAw(AV/1
Sign Dimensions : 2 " � 13 �4 Sign Area SIO SF
Existing Signs : Surface : Sign Area SF
Right Angles : Sign Area SF
Free-Standing: Sign Area SF
Other: Sign Area SF
Signs to be removed: Type Sign Area SF
Frontage : Building Z- + FT Property FT
Signature of Owner I c lcw YlAJ'LV2
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Name S Address of Address 7 �r � 4u d iZ C, 4( YY)p
Insurance Company: w N
Telephone ,� � ��
Estimated Cost of New Work: ka2
APPROVALS . 11
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® 3 Lakeland Park Drive 3692
Peabody,MA 01960
(978) 536-6600 53179/113
ORPORATION
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EASTERN BANK
270 UNION STREET
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