153 FORT AVENUE - SIGN PERMIT 153 Fort Avenue
Willows Variety
d Q
- Permit Number
PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
APPLICATION MUST BE SUBMITTED IN DUPLICATE, ONE SET TO BE FILED WITH THE PLANNING
DEPARTMENT, AND ONE SET (BEARING THE APPROVAL OF THE PLANNING DEPARTMENT) TO BE
FILED WITH THE BUILDING INSPECTOR.
`Om Location, Ownership and Detail Must be Correct,Complete and Legible. Separate
Application Required for Every Sign.
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Application for Permit to Erect a Sign
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Salem, Massachusetts 7 // -mow/
TO THE BUILDING INSPECTOR:
The undersigned hereby-applies for a permit to_Erect,=Alter,_Repair
a sign on the following described building:
Location and No. IS3 W 2T AV`i COmnngjt ii9aning/District
Name of Property Owner_G tiD,,4t, VA�x V,(Z\
Name of Sign Owner___ �eC) 2 x 1-N/?
Address -j 5I. )6 a.- N(
If Owner is a corporate body, name of responsible officer
Name of Licensed Sign Erector all r-;
No................................. PLAN OF LOT
i APPLICATION FOR PERMIT FOR Show Location of Present Structure SHOW SIGN SIZE, COLOR AND LOCATION ON BUILDING;
ALTERATIONS, REPAIRS AND and Signs LOCATION OF OTHER SIGNS AND BUILDING ENTRANCE
DEMOLITIONS
See attached plan.
...............................................CLASS BUILDING
LOCATIONNO ` - - '• - {
...............................................................................
............... ................................Ward....................
j. Q Owner....................................................................
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Permit Granted
........................................................._....... 19.........
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JUL-N'3-NI 08 :29 HM ALL KIND OF SIGNS 9765317765 P. N3
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JUL-99-91 98 :29 r.M ri LL KIND CF = :GNS 9785317765 F. 92
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Date Received
Amount Received
Form of Payment Check ❑ Cash
CHECK PAYMENTS:
write check number
CASH PAYMENTS:
write client initials de
Sign Permit Application Fee
Q Corservation Commission Fee
Payment received for F-1 Planning Board Fee
what service?
0 Old Town Hail Rental Fee
a
Other
Name of staff person
receiving payment
Additional Notes
WILLOWS VARIETY EXPLANATION AMOUNT
GEORGE HOXHA 010
CHRISTINE L.HOXHA 5.7017
153 FORT AVENUE PH.978-744-1300
SALEM.MA 01970
AY T�
MOUNT I �
F 1
DOLlAR5 t
CHECK
DATE ! ORDER OF 1 DESCRIPTION .rya 1 AMOUNT
-Ji/ (,/�(! Of Sc lelYl Silt)
118001001"' 1: 2110701 ? 51: 1 jo ? 11858911•
Original Check and Farm: DPCD Finance
Copy 3: Client
Copy T Application File