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249 LAFAYETTE STREET - SIGN PERMIT 249 Lafayette 3t Garber Family Dent ,lry 111-d lowr+ , -� ® t«..f ti� �� Permit N 1•-Y APPLICATION FOR PERMIT TO ERECT A SIGN 13 2012 NOV 14 2012 NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTED DEPT OF PLANNING& CANNING location, Ownership and Detail Must Be Correct, Complete, and Legible ..OMMl"7 µEtd- Salem, Massachusetts �Z ate To the Building Inspector: The undersigned hereby applies for a permit to o Erect,IKAIter, ❑ Repair a sign on the following described buildings: Street Address Zoning District �J fi p / r �_f�� J_ ❑ rban Renewal Area Entrance Corridor O( 1✓ L Alk 7 istoric District ❑None • a /)Op—6- rRf/L Use of Building Telephone 7g-/_ 6 _ 76 1 floor _.C4,4-eZ •� ' czza/L, 2 floor C� £ Address t ! La- -L -e Ale S ¢ 3 floor Telephone s� �ifA O/9"-Zr9 4 floor E-mail S G v r'� A.Ie4 How many businesses are in the building? ) Ira corporate body, name Frontage orresponsible officer N A PA M A Building H 2 linear feet ConstiWion Sup's License No Applicant's Space(if multi-tenant) J-7 linear feet Address /gti (3Roac�Wci R,k IAl &eL u5 NA / Property p. L74 az.n linear feet Telephone 78l_ yt./l _ 2ob4, Mail Sign Permit to E-mail SAN S QZ Si A/Gt QAiLiA . Com iign Owner o Sign Erector o Other: Proposed Signs(if more than three signs are proposed attach additional sheets) Si n 1 Si n 2 Sign 3 ❑Surface o Surface ❑Surface ❑ ight Angle to Building o Right Angle to Building o Right Angle to Building Free Standing o Free Standing ❑ Free Standing ❑Awning ❑Awning ❑Awning ❑Portable(A-Frame) ❑Portable(A-Frame) Portable(A-frame) ❑Other(specify) ❑Other(specify) Other(specify) Sign Materials pVC pp woe Sign Materials 74111iTrgin Materials Wu Sign Dimensions 4 g n x 3 6 _` Sign Dimensions Sign Dimensions Sign Area N'L Sign Area Sign Area N116 s ft s ft sq It Sign Height(if free standing y ret' Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ q0,0.00 Existing Signs Mpit-[ Type Sign Area To Be Removed? Sign Owner ❑Surface sq ft ❑yyes no X Right Angle to Building sq ft s(yes n no ❑ Free Standing sq ft o yes o no Sign Owner's A ori ed Representative ❑Awning sq It ❑yes ❑no ❑Other(specify) sq It ❑yes ❑no Prop caner � Internal Review Planning&Community Development Department Historical Commission Building Inspector oenanor.v 8 on 00 3/4 in. PVC Panel WGA&BERM , Family Dentistry .5 LO 0 m www.GarberDentistry.cofn 978 -744- 8495 d 4"x4"Vinyl Post Covers with a PT Post Insert �J 1..4s ids •� a .nu. D 19 4 4A Stan Garber Printed on 06/29/12 Page:54 01529 Dear Am, 00994 Dear Anthony, Arm Petersen Ann's bd/ / Anthony Pira Anthony's bd I / 275 Washington St 2 Hawthorne Blvd Unit Marblehead MA 01945-3335 Name2 bd/ / Salem MA 01970-7708 Name2 bd 01796 Dear Scott, 00879 Dear Matthew, Scott Peterson Scott's bd/ / Matthew Pitzer Matthew's bd 68 Broad St 43 School St Salem MA 01970-3142 Name2 bd/ / Salem MA 01970-2337 Name2 bd 01255 Dear Andrew, 01621 Dear Xavier, Andrew Petty Andrew's bd/ / Xavier Pixley Xavier's bd 54 Evans Rd PO Box 442 Marblehead M.',01945-2447 Name2 bd./ / Swampscott MA 01907-3442 Name2 bd 00175 Dear Lindsey, 01458 Dear George, Lindsey Phdbrook Lindsey's bd/ / George Pizarro George's bd 23 Arbella St#3 101 Canal St Salem MA 01970-3937 Name2 bd/ / Salem MA 01970-0845 Name2 bd 00878 Dear Kelley, 00995 Dear Carol, Kelley Phildin - Kelley's bd/ / Carol Pizza Carol's bd 190 Bridge St Apt 5407 1 Courageous Ct Unit 503 Salem MA 01970-7406 Name2. bd/ / Salem MA 01970-6671 Name2 bd 01797 Dear David, 01841 Dear Carol, David Phillips David's bd/ / Carol Pizza Carol's bd 7 Mariners Way - 1 Courageous Ct Unit 503 Salem MA 01970-6843 Name2 bd/ / Salem MA 01970-6671 Name2 bd 01074 Dear Raymond, 00176 Dear Elizabeth, Raymond Piccinni Raymond's bd,/ / Elizabeth Plourde Elizabeth's bd 147 Elm St 205 Highland Ave Unit 2308 Marblehead MA 01945-3349 Name2 bd/ / Salem MA 01970-2754 Name2 bd 00689 Dear Holly, 00690 DearJose, Holly Picone Holly's bd/ / Jose Polanco Jose s bd 11 Appleton St Apt 1 205 Bridge St Apt 108 Salem MA 01970-1658 Name2 bd/ / Salem MA 01970-3967 Name2 bd 00358 DearJoan, 01798 Dear Lori, Joan Pierce Joan's bd/ / Lori Polizzia Lods bd/ / 31 Belleview Ave 47 School St Salem MA 01970-1143 Name2 bd/ / #2 Salem MA 01970-2337 Name2 bd 00530 Dear Suzanne, Suzanne Pierce Suzanne's bd/ / 00691 Dear Derek, 65 Essex St Derek Poole Derek's bd Salem MA 01970-5253 Name2 bd/ / 5 Osborne Hill Dr Salem MA 01970-1022 Name2 bd 01075 Dear Tom, Tom Pierce Tom's bd/ / - -00996 Dear Jenna, 5 Winthrop Ave Jenna Poretta Jema's bd Marblehead MA 01945-1629 Name2 bd/ / 420 Essex St Salem MA 01970-3152 Name2 bd 01347 Dear Ayala, Ayala Pignato AyalA bd/ / 00177 Dear Matte, 76 Green St Marie Poretta Marie's bd Marblehead MA 01945-2422 Name2 bd/ / 26 New Derby St Unit 205 Salem MA 01970-3898 Namc2 bd/ / City of Salem Department of Planning & Community Development Check/Cash Receipt and Tracking Form I Please complete f — -- -I P arm and snake two copies. Date Received ) Amount Received ---"---- _Form of Payment q _°Check (� Cash Client Information CASH PAYMENTS: client Initials Sign Permit Application Fee ❑ Conservation Commission Fee Payment received for what ❑ Planning Board Fee/ ZBA service? SRA/DRB Fee ❑ Coples Other: Name of staff person receiving payment �I Additional Notes 3289 GARBER FAMILY DENTISTRY 249 LAFAYETTE ST. -� ' SALEM,MA 01970 : 5J515110 ` PAY DATE__ 1THE {9d OROER OF // $ C zo, VV - DOLLARS B .I So reign Bank PART OF THE SANTANDER GROUP FOR _ / 1110032B911■ 1:0110751501: 7 300494 30 2011' 0 V ri,lin.il C110Ck Wd Fenn: (_.)))y L - .,.r C: )h'/ 2: '. I Ir '. I 1.. City of Salem Department of Planning & Community Development I Check/Cash Receipt and Tracking Form Please complete form and make two copies. Date Received Amount Received ----- Form of Payment ! _RCheck f] Cash Client Information CASH PAYMENTS: client initials Sign Permit Application Fee Conservation Commission Fee Planning Board Fee/ ZBA Payment received for what service? ❑ SRA/DRB Fee Copies Other: Name of staff person receiving �� payment Additional Notes 3289 GARBER FAMILY DENTISTRY 249 LAFAYETTE ST. SALEM,MA 01970 DATE 1 5-7515-110 PAY rn TO THE ORRDERDER OF -Al --U"L D it F � 4tj� / DOLLARS e ._.....,.. ,' So reign BmR PART OF THE SANTANDER GROUP rj FOR ii1003289u■ t:0ii075i50i: 73001,94302011M Orkpiial Chuck olid Form: �),v'I7 r�� n•: ;t Cady L vrr