99 NORTH STREET - SIGN PERMIT (3) 99 North Street
Sushi Garden Restaurant
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99 NORTH STREET 461-11
COMMONWEALTH OF MASSACHUSETTS
CITY OF SALEM
GIS#: 1267
Map: 26
Lot: 0064-201
LSIGN PERMIT
Lot: O
Permit: Sign
Category: SIGN
Permit# 461-11 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2011-000470 _
Est.Cost: $0.00 Contractor: License: E-rpires
Fee Charged:$0.00 State Wide Sign Inc.
Balance Due:l$.00 Owner: H W INC
#of Fixtures Applicant: State Wide Sign Inc.
DigSafe# -,AT: 99 NORTH STREET
UseGroup
ConstClass
ISSUED ON: 29-Nov-2010 AMENDED ON. EXPIRES ON. 29-Apr-2011
TO PERFORM THE FOLLOWING WORK.
SIGN PERMIT AS APPROVED FOR(SUSHI GARDEN RESTAURANT)jbh
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON rtI14�
ATION OF ANY OF
ITS RULES AND REGULATIONS. �I_Signature: ����"'� '�"�-�
Fee Type: Receipt No: Date Paid: Check No: Amount:
SIGN REC-2011-000567 29-Nov-I0 x $0.00
GeoTMS®2010 Des Lauriers Municipal Solutions.Inc.
City of Salem Sign Permit Application Worksheet
No0
Sushi Garden
rth S
99 North Street
Zoning (res/non-res) B1
Entrance Corridor(Y/N) Y
Lot frontage 75 feet
Building or tenant frontage 35 feet
#of businesses on site 2+
Bldng dist from street center 25 feet
Multiplier 1
Building and Blade Signs
ns
maximum area permitted 35.00 sq ft
total proposed sign area 21.98 sq It
sign 1
length 168.00 inches
height 10.00 inches
sign 2
length 45.00 inches
height 33.00 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
Freestanding or Portable Signs
maximum area permitted 0.00 sq ft(per side)
maximum#of signs permitted 0 signs
maximum height permitted 0.00 It tall
sign 1
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height 0.00 ft
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets guidelines set
forth in the Salem Sign Ordinance yes
Recommend approval yes
The entrance corridor guidelines discourage internally illuminated box
signs. However, this proposal is to replace the panels on an existing
permitted box sign without making any other changes.The sign area
conforms to entrancecorridor guidelines.The new awning will not have
text on the angled portion which is more consistent with the guidelines
than the existing.awning.
Permit Number
APPLICATION FOR PERMIT TO ERECT A SIGN
9 NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
art�i °a Location, Ownership and Detail Must Be Correct, Complete, and Legible
��hnvs Salem, Massachusetts
Date
To the Building Inspector:
The undersigned hereby applies for a permit tc Erec , Alter, c Repair a sign on the following described buildings:
AddressStreet
c Urban Renewal Area -trance Corridor
o Historic District c None
UP •
Telephone 1� floor.
• • f2s L 1-6--)c,r eLL t4_-Z. -t 2^ floor
Address /✓Or-6'k S , S P.m- Ai A 3` floor
Telephone (r _ g/g_ 0 4 floor
E-mail How many businesses are in the building?
If a corporate body, name Frontage
of responsible officer ask
• aP���7 2S( w (�eSL y� wf Building linearfe t
Construclfon Sup's License No Applicant's Space(if multi-tenant) W.near f et
Address3 yt i`3 S� w /vr Property linear f
Telephone / _ Z y�- ow Mail Sign Permit to
E-mail c Sign Owner #9ign Erector o Other:
Si•n 1
Sign 2 1 Sign 3
o Surface o Surface c Surface
)f Right Angle to Building c Right Angle to Building c Right Angle to Building
o Free Standing o Free Standing n Free Standing
X Awning Q(Awning o Awning
Li Other(specify) c Other(specify) c Other(specify)
Sign Materials y.0tc.viAerj�l( Sign Materials Yekow Vt—VIFAV, Sign Materials
I
Sign Dimensions 33"HX 4s-"L Sign Dimensions 14'Lx x �z
„ Sign Dimensions
�b H '
Sign Area (0.31 sq ft Sign Area 5;�ZSign Area
s ft sq It
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
Existing Signs Signatures
Type Sign Area To Be Removed? Sign Own r
o Surface sq It o yes n no
XRight Angle to Building __;v_,37 sq It o yes W no
o Free Standing sq It o yes c no Sign Owner's A th�f ized Representative
3f Awning ! b sq It oyes Kno �L7MY, z��-Q�,
c Other(specify) sq ft o yes o no V U 8
Property Owne
Internal Review
an in mmunity Development Departm'/tet` . Historical Commission
Arpreval
Building Inspector
i vows re•
c
STATEWIDE SIGN
643 WaaldnLrun eO Tel.:(617)472.8928
Double Sided Light box faces replace: .ulocy MA O2169 Fax (617):iae'so
45 in
i (� Cra1 sushi Barden
SPECIFICATIONS:
Double Sided Light box faces replace:
J Japanese &Chinese 1/8"Yellow Acrylic face.
��@A�IIIlSf2 CUISIne Lettering in vinyl red&black.
Ma-c)u`t e 's'ws� q Awning refabric:
ll Take-Out • Delivery Yellow vinyl fabdglettering In vinyl red&black.
Fxlsu g
Awning refabdc:
jaae�a.eerr
jSushi arden • Take-Out • Delive 978-744-9998
V— — � Via � @q — — — ry 744-9995 aaPnx«ad
G.- — 14 ft
SPECIFICATIONS: Client MUST REVIEW&APPROVE CLIENT Mr.Qing Xlong Pang JOB In
NO Aluminum box. all drawings BEFORE production. COMPANY Sushi Garden Restaurant DRAWN Lucy ORDEROATE 11-01-2010
tti m®.•o., �•.m m.eime..:.l-�.ermewe.eurlw. TITLE
'Mite l(e•Arillelam. ae"-.�m.m..-.,...a m.ae,.a..euum.am m-.a..m.nc ADDRESS 99 North St Signage
•Lettering In vinyl red 8 blecx CITY Salem sTATEaw MA
wmxrMe wre TEL 617-818-6407 FAX IFILE ID
r
The Commonwealth of Massachusetts ,
_ Department oflndustrialAccidents
Office of Investigations
600 Washington Street
r Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information // Please Print Le ibl
Name (Business/Organization/Individual): e_vJ I a-2.S � S'i
Address:_S_V3 ",�n�t/c�S�
City/State/Zip: La w Z'r^-c`r A4/X 6-2,46J Phone#: 6Q- (Q -L— P 7�
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g• ❑Demolition
working for me in any capacity. employees and have workers'
comp. insurance.$ 9. E]Building addition
[No workers comp.insurance p•
required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself o workerscomp. right of exemption per MGL
y � ' P 12.❑ Roof repairs
insurance required.]t C. 152, §1(4),and we have no
employees. [No workers' 13.® Other 5'i yt_S .
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site
information "
Insurance Company Name: f'vl I L �4 fti 1 c MA -&L �C,
Policy#or Self-ins. Lic.#: tn/r_- e3a 07Q Expiration Date:_2-4 2 io 'to Vi 411
�
Job Site Address: R q A/DY E S h City/State/Zip: <A e— Ai A
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration 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 up 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
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties ofperjury that the information provided/above is true and correct
Signature: t x C i/ Date: tl f b f /I
Phone#: 41-7 2— $ Z�
Official use only. Do not write in this 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. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
City of Salem Department of Planning & Community Development
Check/Cash Receipt and Tracking Form
Please complete form and make two copies.
Date Received U�/, l C3,0iJ
Amount Received
Form of Payment 2'C—heck ❑ Cash
�ign Permit Application Fee
❑ Conservation Commission Fee
Payment received for what ❑ Planning Board Fee/ ZBA
service? ❑ SRA/DRB Fee
❑ Copies
Other:
Name of staff person receiving
payment -
Additional Notes Go
9 S4A
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104
DATE U 05-76151110 ,
li
i PAYER THE O Safe
m i ?0. {
ORDER OF L c.1(,L p(V
�li(le/1T L�� J DOLLARS
*Sovereign BanK
FOR A°
11'00010411' 1:011,07SISOI: 3980 2 5 709 5011•
Original Check and Form: DPCD Finance
Copy 1: Client
Copy 2: Application File
November 9, 2010
RE: Sushi Garden, Inc.,99 North Street, Salem, MA
To whom it may concern,
I, Tommy Tam, the president of H. W., Inc., am writing to authorize the tenant,Sushi Garden, Inc.,to
erect a new signage at 99 North Street,Salem, MA. H.W., Inc.,the landlord of 99 North Street, Salem,
MA, has approved that Sushi Garden, Inc. doing business as "Sushi Garden" at 99 North Street, Salem,
MA. Please contact me at 781-888-0045 for further assistance regarding the signage.Thank you.
Sincerely, II`, ^
H.W., Inc. nECEI M El. I
�i�
Nov 0 g 2010
Dept,ofFT[ar,r- :.>&
President,Tommy Tam