63 JEFFERSON AVENUE - KI MARTIAL ARTS 63 Jefferson Ave
Martial Arts
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Commonwealth of Massachusetts
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City of Salem
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mA _ 120 W ashinglon St 31d Floor Salem,MA 019,0(9,8)745-9595 x5641
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Return card to Building Division for Certificate of Occupancy
Permit No. B-15-593 P
=EE PAID: $20.00 ERMIT TO BUILD
DATE ISSUED: 6/19/2015
This certifies that NSD REAL ESTATE, LLC
has permission to erect, alter, or demolish a building 63 JEFFERSON AVENUE
Map/Lot: 240210-0
as follows: Signs FREE STANDING 18' X 96' FOR MARTIAL ARTS
Contractor Name:
DBA:
Contractor License No:
G6/19/2015
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 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 e142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
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Permit Number
APPL CATS ION FOR PERMIT TO ERECT A SIGN
1 NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTED
�I f� Location, Ownership and Detail Must Be Correct, Complete, and Legible
Salem,Massachusetts
To the Building Inspector. Dale
The undersigned hereby applies for a permit toErect, u Alter, a Repair a sign on the following described buildings:
Street Address Zoning District
777777 ❑ Urban Renewal Area ❑,Entrance Corridor
❑ Historic District �None
SD -z a Lephone —n 4 — Z 4 1 floor
— alyl n ytC• 2 floorddress n Ve 3 floor
ephone 9 �� Z �cr X 9 0 4 floor
E-mail S a k F0.09 k How many businesses are in the building?
Ifa corporate body, name Frontage
of responsible officer
• Sa"L a q6aA Building 00 linearfeet
Corlstuction Sup's License No Applicant's Space(If mufti-tenant) linear feet
Address Property linear feet
Telephone Mail Sign Permit to
E-mail I Sign Owner ❑Sign Erector ❑Other:
,.
SI n 1 Sign 2 Sign S
❑ urface u Surface ❑Surface
❑ Right Angle to Building ❑ Right Angle to Building ❑Right Angle to Building
�ree Standing u Free Standing ❑Free Standing
in Awning ❑Awning u Awning
❑Portable(A-Frame) ❑Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) ❑Other(specify) ❑Other(specify)
Sign Mate ri�Is Sign Materials Sign Materials
V; f lej h.
Sign Dimensioni Sign Dimensions Sign Dimensions
/ x9 C
Sign Area Sign Area Sign Area
�a s ft soft sq ft
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$
Existing Signs
Type Sign Area To Be Removed? Sign Owner
❑Surface sq it ❑yes ❑no
❑Right Angle to Building sq ft ❑yes ❑no
tiasree Standing sq ft ❑yes ❑no Sign Owners Authorized Fiepresentative
u Awning sq ft ❑yes ❑no
❑Other(specify) sq ft ❑yes ❑no
Pr
Internal Review
Planrnng I jCcTmmunity DetfeTojiinent Department Historical Commission
Approval
Building Inspector
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Sales & Service • Collision Experts
978-338-5797
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FOR LEASE
MANSARD 508-641 .6244
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PORT '
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City of Salem Department of Plannin
Check/Cash 9 & Community Develo
Receipt and Trackingpment
Please comp/ele form and Form
Date Received �O 1.5. / make lWp copies.
S
Amount Received
�-20 . cy
Form of Payment
Client Information Check
❑ Money Order
CASH PAYMENTS: Wha/A�rr
client initials --?�
11 "Sign Permit APPlicatlon Fee
PaYment received for What ❑ Conservation Commission
Fee
0 Planning Board Fee
service? /ZBA
❑ SRA/DRB Fee
❑ Old Town Hall Rental Fee
Name of staff ❑ Other:
Person receiving
PaYment
Additional Notes
,A • •' PTERNATIONAL MONEY ORDER T5-tole
els
`ids MoneyGram K�V r sOA
06'15/2115
To Validate:Touch the stop sign,
then watch it fade and reappear O 10681167950
.
CD MONEY ORDER
PAY TO THE
: JORDEROF/ ' -r
pj0
PAGAR .
co - IMPORTANT-SEE ACK BEFORE CASHING '�Irl E N T Y DOLLARS
W
�i qua CENT
Ln 2
= PURCHASER,SIGNER AOR D ER E COMPRADOR,FIRMA OEL LIBRADOR
PURCHAffKBYSKININCYOIIACREET ME SERVIL CHARGE AM(NO OTHER TERMS ON THE REVERSE AIX
ADDRESS./ 'rAiSGI r^"r ( - 7�� T- r r
((Z:) 7 DIRECCON: I i I 14�_f 4939 �Q 3
Payable Through ISSUER/DRAWER:l Citizens Alliance Bank MONFYGRAM PAYMENT SYSTEMS,INC. 39899101661219950
Clr Clara City,MN
Original Chet L1.091916i87t: 10C38 1167950211' 90
COPY 1: Client
COPY 2: Applicnc-on File
City of Salem Sign Permit Application Worksheet
6 1.—C
18-Jun-16
KI Salem Martial Arts
63 Jefferson Avenue JUN I I P 3 S O
Zoning(res/non-res) I
Entrance Corridor(YIN) N
Lot frontage 126 feet
Building or tenant frontage na feet
N #of businesses on site multiple
UJ r Bldng dist from street center <100 feet
Multiplier 2
> CV
11111111111liciling and Blade -
wN n' maximum area permitted 30.00 sq ft
00
total proposed sign area 0.00 sq ft
w Z sign 1
�'— length 0.00 inches
w height 0.00 inches
G o
c^ V 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
�pg Signs
maximum area permitted ,65.00 sq ft(per side)
maximum#of signs permitted 1 signs
maximum height permitted 25.00 ft tall
sign 1
proposed sign area 12.00 sq ft
length 96.00 inches
height 18.00 inches
proposed sign height 0.00 ft(approx)
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets standards set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes