109 LAFAYETTE STREET - SIGN PERMIT (3) 109 Lafayette Street
Lonnie's
APPLICATION FOR PERMIT TO ERECT A SIGN
Saiem, Massachusetts 19_�Lv
PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
APPLICATION MUST BE SUBMITTED TO THE BUILDING INSPECTOR WITH STAMPED APPROVAL
FROM THE SALEM REDEVELOPMENT AUTHORITY.
TO THE BUILDING INSPECTOR:
The undersigned hereby applies for a permit toyErect,
Alter, Repair a sign on the following described
building.
Location �Fgyc- �L sr Zoning/District
Name of Property Owner � �wr3CC�iiUcr- �. �,QQQy
Name of Sign Owner
Address 169 �� FRy�rl� st
If Owner is a corporation, name of responsible Officer /�
Name of Licensed £rectorfY %lK � CQ
Address tj 5I (2� 52e!✓ J� ' CfOO Salem License No./_oEz l
Use of Building: 1st Floor 3rd Floor
2nd Floor 4th Floor
Type of Sign: Surface Right Angles
�tto�SBuilding
Free Standing Other
� � Height:
Sign Materials : �Z'VZ A_4'11LeC�
°Srgn Dimensionsw6LS- �.z S/l�%c�. Sign Area 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 FT Property FT
Signature of Owner } I
Name & Address of Address �G�E�S
Insurance Company: r'
Telephone D - /'/ 7 -`i 8 (� L18 P't
Estimated Cost of New Work:
APPROVALS -
� i
APPLICATION TO ERECT, ALTER, OR REPAIR PLAN OF LOT
A SIGN IN THE CITY OF SALEM
-------------------------------------- Show Location of Present Structure
snd Signs
BUILDING LOCATION:
BUILDING USE:
-------------------------------------
-------------------------------------
CONDITIONS
t
------------------------------------
------------------------------------
PERMIT GRANTED
19
ON —COUNTS
OAY E O V NT
- 6_ .9531
SALEM WARD EIGHT CAFE, INC. 4-71
53-179/113
PAY
TOTHE
OR R OF
I
..+' TOTAL ov
LESS %oISCouNT 9'.v! NC`
tern &nk SALEM WARD EIGHT C
LESS �C PRESIDENT-EIGHT
c RER-
TOTAL DEDUCTIONS 2M ONION STREET
LYNN.MASSAOIIUII T S
AMOUNT OF GNEGN
11200953111E 1:01L300981: 02 4016 and `r
License and Permit Bond
_ r• �i`ir ❑- GROUP
Lumbermens Mutual Casualty Company
An Illinois Corporation
American Motorists Insurance Company
An Illinois Ca,,,am ian
American Manufacturers Mutual Insurance Company Bond No---------------_-T—_—
!.n Illinois corporation
Know all men by these presents, that_..—_ahibDd-eau_Raa-Lt.C_.TrusY_._—...._-_._—�
----------_3_Lvard_St.-:---Sa1en,- L;A, G�. 74._----.-----------
--
(Name and Address)
as Principal and The Undersigned Surety, are held and firmly bound
City of Salem
_-.----.—, as Obligee, in the
- ----------------------------------
penal sutra oi__-___ five thousand ------_---------Dollars 0--_).
lawful money of the United States, for which payment, well and truly to be made, we bind ourselves, our heirs, ex-
ecutors, administrators, successors and assigns, jointly and severally, firmly by these presents.
Whereas, the Principal has applied to the Obligee for a license as a (or permit for)_--- —
Now, therefore, the condition of this obligation is such, that if said Principal shall faithfully
perform the duties of such licensee or permitee, and in all things comply with the ordinances, rules and regulations
appertaining thereto, then this obligation shall be void; otherwise to remain in full force and effect, until__---
-
This bond may be terminated at any time by the Surety upon sending notice in writing, by certified mail to the
i p
clerk of the municipality with whom this bond is filed and at the expiration of thirty (30) davfrom the mailing of said
notice,the liability of such Surety is thereby terminated and cancelled;and provided further,that nothing herein shall affect
any right or liability which shall have accrued under this bond prior to the date of such termination.
SIGNED, sealed and dated this._ 0th day of..._JU_1y_---------___---------_-----
_--,
Principal
Countersigned
E.A. Stevens rety:.__r_'1.rL4' 1_Ss�.IL_11sa11ld d. t1JX--L'S S_L1ufllzl Inctrranre CO
_---_— CO. , Inc.I[1CNamc of Company
Rnident Agent
BY
' :-D&-
B ` z 7-/-, ?C� _ L GLC
v/ ------ -- ---------
'" Attorney-in-Fact
Important: Accountine Information
10.10.5 M'IL,,\
Producer Name
nS._C4...�.-l.tl~..---------- .;::`,allo<, ,s,
a,
Address.-Sox-.1£ - --i1alden-,- r: , 02isu
--- --- ------------------
Producer Code. _A!-8191------- --------
Send one copy of the bond to your super- ••"'�'• =,+•f
yiwng office w the some day executed.
1`1<735-1 12-86 ]M
PINNWO IN U.S.A.
NO CARBON REQUIRED
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