72 LORING AVENUE - SIGN PERMIT (3) 71 Lokin J Ave,
-P '�J-I V.Permit Number�4 b � :�� d V E
APPLICATION FOR PERMIT TO ERECT A SIGN
• yj NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTED nlC -r OF PLANNING &
1 Location, Ownership and Detail Must Be Correct, Complete, and Legible Cqq MZq�201
U ITy DEVELOPMENT
rr (o
Salem, Massachusetts 7
Date
To the Building Inspector:
The undersigned hereby applies for a permit to XErect, Alter, ❑Repair a sign on the following described buildings:
Street Address Zoning District
// r
12 Loc 11,41, 4 IgtA l d�A 4 � ❑Urban Ren trio Area o NonekEntraCorridor
❑Historic District ❑None
• {+Mt_COHOgwV £S 14OZ e:4t lf� . Use Of Building
Telephone qla j,�y_ 143 1 floor gTCec�
2 floor
Address 3Z0 44CCj3tVgy POAO teVIN(c Tk r floor
Telephone q12 1 4 floor
E-mail QN tfA A.We4lut Io 1,4 L9 1-1 . coM How many businesses are in the building?
If a corporate body, name
lr*
of responsible officerWLTI4C-r_fj6jp
N-+TIONAL, S&N LOI?PU4-ION Buildingr 1' linear feet
Construction Sup's License No N Applicant's Space(if multi-tenant) linear feet
Address Jw UNProperty linear feet
Telephonb ZMail Sign Permit to
E-mail r O7u oucfho rUs L( tG/ �, the ❑ Sign Owner ❑Sign Erector ther. jL A,
Proposedmore . . sheets)
Si n 7 Si n_2 Sign 3
❑ Surface Surface ❑Surface
❑Right Angle to Building n Right Angle to Building ❑ Right Angle to Building
A Free Standing ❑Free Standing ❑ Free Standing
❑Awning ❑Awning ❑Awning
❑Portable(A-Frame) ❑Portable(A-Frame) ❑ Portable(A-Frame)
❑Other(specify) ❑Other(specify) ❑Other(specify)
Sign Materials 146k W1 GaOoj �f Sign Materials UAOw �tN Sign Materials p
Sign Dimensions 51/V1I.kS I ( Sign Dimensions 4 I a Sign Dimensions
Sign Area Sign Area Sign Area p
P U
sq ft sq ft i sq ft C
Sign Height(if free standing) (2 15„ Sign Height(if free standing) _ Sign Height(if free standing)
Estimated Cost of Net Work
$(0000 .00
w
Existing Signs L-11
Type Sign Area To Be Removed i 0 r -s
Surface 5Z sq ft )ryes o no Ilkw
❑ Right Angle to Building sq ft ❑yes ❑no N
bcFree Standing ?-I sq ft X yes ❑no it O tr's t oriz d prese f vat
❑Awning sq it ❑yes ❑no u �'
❑Other(specify) sq It ❑yes ❑no Property J0,wner
Internal Review
Plan ing&Community Development Department Historical Commission
Approval
A
Building Inspector
oarzano�
—f(z.'. (c0 t$ $foS 1�11>11 Gf7 1 (� —1
6V DAL
5_I-HDU FACE ]':
r.ioroER
I
uWs
NOTE: REMOVE fl DISPOSE OF EXISTING
r lxlu xou TEDEBC
CABINET
NOTE: REMOVE DISPOSE SUPPORT STEEL.
NOTE: NEW STRUCTURE IS EXTERNALLYILLUMINATED WITH
GDOSE+lECK LED LAMPS.
s
5'6'CABINET j e'-I'HDU FACE
ELEVEn
■I 'OEEPANGLE
PMHE BiRI1LNPE F ��
al
w r
N PPORTFTedeschARE
w' ' _
GR LPOLE
food Shops ; ELEVEti
r of
r a C _ S
MANUFACTURE d SHIP TWO(2)CUSTOM HOU FACE REPLACEMENTS FOR EXISTING DOUBLE FACED
FREESTANDING SIGN.1-THICK HDU WI WOOD GRAIN SAND BLASTED TEXTURE PAINTED PER BELOW LISTED HISTORIC COLOR
PALLETTE.PANELS ARE MOUNTED BACK TO BACK TO J'DEEP INNER ANGLE IRON SUPPORT STRUCTURE MOUNTED TO NEW
SUPPORTSTRUCTURE
- BE NJAMIN MOOR E COLONIAL WILLIAMS BURG PAIN T OO LLEC TION:
BM CW415 CORNWALLIS RED,BM CW635 BUFFETT GREEN. BM CW435 HALE ORANGE, PMS WHITE
MOTEPANELSARE FROM PREVIOUS SITE REMOVAL.
NOTE: NEW SUPPORT STRUCTURE PROVIDED BY INSTALLER. EXISTING CONDITION:212 6O FT PROPOSED 111 11TI01
NOTE:SUPPORT STRUCTURE TO BE PAINTED 013 OURANODIC BRONZE.LOW GLOSS.
NOTE: SIGN TO BE EXTERNALLY ILLUMINATED Wr GOOSENECK LED LIGHTING PROVIDED BY OTHERS. ,-
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MANUFACTURE S SHIP ONE(1)CUSTOM VF EXTERNALLY ILLUMINATED HOU WALL SIGN. (EMBOSSMENT;
1 W THICK SANDBLASTED HORIZONTAL WOOD GRAIN HOU PANEL
LEVEnwill
PAINTED ACCORDING TO BELOW COLOR SPECS WITH A LOW GLOSS FINISH. 5 w-xDu
SIGN TO BE STUD MOUNTED TO EXISTING FASCIA. (BACKGROUND)
BmmING FASCIA
)-ELEVEN COLOR SPECS:PMS4VC ORANGE PMSJBBC REO,PMS3AgC GREEN
NOTE,GOOSENECK LIGHTING IS EXISTING
Front Elevation S Side Daren-Custom SIF Non llTminamd HDU Wall Sign-Sign B
6 �8'=1'-D' Display SRuom FmWge(Woll Sign):TSA
NOTE:REMOVE 6 DISPOSE OF EXISTING TEDESCHI PANEL,
NOTE EXISTING GCOSEAECK LAMPS TO BE RETRO FITTED WITH NEW LED BULBS.
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Commonwealth of Massachusetts jL\
'r = City of Salem uV
a ' 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Permit No. B-77-621 PERMIT T O BUILD
FEE PAID: $0.00
DATE ISSUED: 7/17/2017
This certifies that JEFFERSON TRUST THE C/O THE HALL COMPANY
has permission to erect, alter, or demolish a building 72 LORING AVENUE Map/Lot: 320027-0
as follows: Signs INSTALL NEW SIGN FOR 7 ELEVEN
Contractor Name:
DBA:
Contractor License No:
7/17/2017
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 haw access to the guarantyfund'(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.
LETTER OF AUTHORIZATION
PURPOSE. By authorizing this letter, the Landlord/Property Owner/Authorized Agent, respectfully
approves the proposed signage and gives authorization to the contractor/authorizing agent to act
on your behalf throughout the presentation/permit process submittals required by neighborhood
and/or city officials.
Date: 417/�i7
To Whom It May Concern:
I (print name): J011N
the (circle one of the following : Landlord/Prope Owner/Authorized Agent for the Tedeschi
at: SEI #37508—72 LORING AVE., SALEM, MA 01970, do hereby authorize, approve, consent
and give permission for Hazel Wood Hopkins, as the authorizing agent to obtain all necessary
municipality approvals & secure sign permits to erect signage at the property referenced above.
So//w eq. L l, N
an or Property wne Agent Signature Print Name
l%T/o2 oi�
Date
97?-211Y- /yap
Telephone No. Email Address
,45-57;W/1 IQea ��y �Nc_ 0�5� CtgV4- Sf S 19 lee*, AM DI97o-yst�
Mailing Address of Landlord/Property Owner/Authorized Agent
The Commonwealth of Massachusetts
Department ofIndustrial Accidents
Office of Investigations
600 Washington Street
Boston,-AIA 02111
' www.mass.gov/dia
Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers
Ap Ircant Information ^I Please Print Legibly
Name(Business/Organizafion/individual)_ NA-noNAL, si(o-N C'oxj-�`IIO 4
Address: I011 ��
City/State/Zip:—Perutt-i CT- Phone.#: cS'(a() ) gZQ• r(O(o (�
on an employer?Check the appropriate bor. Type of project(required):.
I am a employer with �d
4. I am a general contractor and I 6 0 New construction
employees(lull and/or part-time).` have hired the sub-contractors
listed on the attached sheet ?• Q Remodeling
2.❑ I am a sole proprietor orpartner- These sub-counactors have g• Q Demolition
ship and have no employees employees and have workers'
working for me in any capacity. 9. ❑Building addition
[No workers'comp.insurance comp,inn ante t
5. [] We are a Corporation and its
10. Electrical repairs or additions
required] officers have exercised their 11.0 plumbing repairs or additions
3. I am a homeowner doing all work right of exemption per MGL 12 oof repairs
myself[No workers'comp.
c. 152 §f(4),and we have no
insurance required-]t 13. Other �Sl�
employees..[No workers'
Comp.insurance regtiiied]
-Any applicant that checla box pl must also fill out the section below showing their workers'cptttp-mita policy iafonffition-
t Hotntowicers who subnlit this affidavit indicating mry are doing an work and then hire outside conttx=must s brrj a new a6davit indicating sorb
?Contractors cant check this box must attached an additional sheet showing the tome of the subs nt actors and state whetha or not th=(21titiet have
eWloyees. if the sub-contactors have employees,they nuutprovide III* work='cotrg).polidy ntunber.
I am an employer that is providing workers'compensation insurance for my emplbyem Below is the policy and job site
informadiomcop()7+N`
Insurance Company Name:Vim.(6 1(0k&-Cz 1 N5u'�NUa
Policy#or Self-ins-Lie-,#: 5Q"150 1 J QS Expiration ter �(• 2 G/G
Job Site Address IZ ( City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the polic er and ezpiratioa 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 tip 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
Iavesti do o the DTA for insuraa covers a verification
I do hereb fy under penalties of perjury that the information provided above is true grid correct
Si ature:
Phone M 170�0 0.
Offuial use only. Do not write in thin area to be completed by city or town official
City or Town Permit/License#
Issuing Authority(circle one):
1.Board of Health 2_Building Department 3.Cityfiown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone M.
I rvtillovy..� _ _
7 DATE(MMIDDNYYY)
—OROe CERTIFICATE OF LIABILITY INSURANCE 01106/2017
CERTIFICATE IS ISSUED AS A MATTER OF,INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
711F^I. THIS TE OES NOT CERTI CERTIIRMATIVELY FICATE IINSURANCOR NEGATIVELY AMEND,E DOES NOT CONSTITUTES EXTEND
ECONTRACT BRTHE COVERAGE AFFORDED BY ETWEEN H ISSUING INSUREES
R(),TE AUTHORIZED
RESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER.
)RTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
JBROGATION IS WAIVED, subject to the terns and conditions of the policy,certain policies may require an endorsement A statement on
certificate does not confer ri his to the certificate holder in lieu of such endcCONTCorzinrsemente S.Sternberg
.ER
Brothers Insurance,LLC. PHONE
(AIC,No,EM):(860)430-3234 ac No:
Tonal Drive,Suite 2 E ORl ,csternberg@smithbrothersusa.com
,nbury,CT 06033
INSURERS AFFORDING COVERAGE NAIC.`.
INSURER A-Continental Insurance Co. 35289
D INSURER B:State Auto Property and Casua Insurance Cc 25127
National Sign Corporation INSURER c:Travelers Property Casualty Company of America 25674
780 Four Rod Road INSURF.RD,Val]U Forge Insurance Com an 20508
Berlin,CT 06037 INSURERE:
INSURER F
_RAGES CERTIFICATE NUMBER: REVISION NUMBER:
3 IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
tTIFiCATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
;LUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADOL SUBPOLICY EFF POUCY EXP LIMITS
TYPEOFINSURANCE I POUCYNUMBER MM M CH 1,000,000
X I COMMERCIAL GENERAL LIABILITY DAMAGE TO
B
DAMAGE TO RENTED $ 300,000
CLAIMS.MADE �OCCUR X 5095051353 0111912017 01/1912018 PR MISES Ea 15,000
MED EXP An one on $
PERSONALS ADV INJURY S
1,000,000
2,000,000
GENERAL AGGREGATE S 2.000,000
GEN'L AGGREGATE LIMppLT.APPUES PER: PRODUCTS-COMP/OP AGG S
POLICY a jECT a LOC
OTHER: COMBINED SINGLE LIMIT S 1,000,000
If �'
AUTOMOBILE LIABILITY
BAP241771401 01119/2017 01/79/2078 BODILY INJURY Per ar- 01 5
7ANY AUTO BODILY INJURY Peraaident S
OWNED BCHEDULED
AUTOS ONLY AU�TNO�S Ep PROPERTY
awidefDAMAGE $
'Y AUKS ONLY X AUTOS ONLY
s 5,000,000
X UMBRELLA LAB X OCCUP. EACH OCCURRENCE $
EXCESS UAB CIAIMSMAOE
UP-14P21895-16-NF 01/19/2017 01/19/2018 AGGREGATE S 5,000,000
DEC) X RETENTIONS 10,000 S
X PER OTH-
WORII�RRS COMPENSATION $00,000
AND EMPLOYERS'LIABILITY YIN 5095051305 01!19/2017 01/79/2018 L.EACH ACCIDENT s
ANY PROPMETOR/PARTNERIEXECUTIVEPY S❑ NIA 600,000
(IMFCF1n NH)EXCLUDED? EL.DISEASE-EA EMLO
ff yes desaiDe under LDISEASE-POLICY LIMr S
500,000
DES RIP71 N OF OPERATIONS bWw
;RIPTION OF OPERATIONS I LOCATIONS IVEHOUSS(ACORD 101,Addidanol Rema/¢Schedule,may be aearl,ed R more space's requited)
RTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
li
AUTHORED REPRESENTATIVE
ORD 25(2016103) C 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
City of Salem Sign Permit Application Worksheet
12-Feb-10
Tedeschi Food Shops JUL -b A 8: 01
72 Loring Avenue
Zoning (res/non-res) B2
Entrance Corridor(Y/N) Y
Lot frontage 368 feet
Building or tenant frontage 72 feet
#of businesses on site 2
Bldng dist from street center 70 feet
Multiplier 1
Building and Blade Signs
maximum area permitted 72.00 sq ft
total proposed sign area 72.00 sq ft
Surface Sign
length 216.00 inches
height 48.00 inches
sign 2
length 0.00 inches
height 0.00 inches
sign 3
length 0.00 inches
height 10.00 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 32.50 sq ft(per side)
maximum#of signs permitted 1 signs
maximum height permitted 12.50 ft tall
sign 1
proposed sign area 27.54 sq ft
length 66.00 inches
height 60.08 inches
proposed sign height 12'5" ft
Application meets guidelines set
forth in the Salem Sign Ordinance Yes
Recommend approval yes
The surface sign and the freestanding comply with the dimensional
requirements. Both signs will be externally lit with Gooseneck LED
lamps.