197 DERBY STREET - SIGN PERMIT (2) 197 Derby St.
Crystal Chamber& Cafe
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APPLICATIOIJ MUST BE SUB1".ITTED IN DUPLICATE , ONE SET 70 5E FILED WITH THE
?LAi;I;It7G DEPARTMENT, AND ONE SET (EEARI !IG THE APPROVAL OF THE PLANNING
DEPARTMENT) TO BE FILED WITH, THE BUILDING INSPECTOR.
—:cow•c, 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 ��1✓ 97 19-
TO THE BLIIL01IaG I;iSPECTOR:
The undersigned hereby applies a P
lifor ermit to LI--crect, _ Alter, _ Repair
a sign on the following described building:
Zoning/District
Location and No. /97 1)rR°RY S I- --
Ilame of Property Owner (lLGrEeiab
Name of Sign Owner f LM C C�N� eci«:v it
Address ' I /
If Owner is a corporate body name of responsible officer
Name of Licensed Sign .Erector 0a- /'YlaRJ' S/G� w` x
_ Salem
License No. .36 3
Address 9q AtMelf S, OF"ti�nr /yA� l
3rd-Floor
Use of Building: 1st Floor L, 4th Floor
2nd Floor
Type of Sign: Surface, 0_ Right Angles to Building, Free Standing,
i
Other (specify) Height: /O gc•%%�nSia
Sign Materials. POOc.ouOr
Sign
' d - S i n Area
• • Sign Dihens ioo-s'
SF
Existing Signs : Surface: L� Sign Area !�'• �' � ���
Sign Area SF
Right Angles. Sign Area SF
Free-Standing Sign Area SF
Other
Signs. to be Removed: Type
,r Sign Area SF
Frontage: Building 6G
FT Property FT
Name and Address of Signature of Owner
Insurance Company:
' Signature of Owners Authorized Representative
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Address 1212��
S i VL C,�Hq/•'� /J9A G/ Sv
Estimated Cost ao5
Telephone
of pew Work7 y5
APPROVALS: Signature of Property Owner
"lanninpar'ncnt S�erintendent o =ts
Sale., _
PLAN OC LOT
'LICATION FOR PERMIT FOR Show Location of Prescni SI•ructuro SHOW SIGN SIZE , COLOR AND LOCATION Oil BUILDING ;
.TERATIONS, REPAIRS AND and Signs LOCATION OF OTHER SIGNS AND DU I LD I NG ENTRAIICE
DEMOLITIONS
...........................CLASS 13UILDINC
LOCATION
...........—Ward..............._.....
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CONDITIONS
................................_......................_.............
...................................... , .. . . ... .. _ . . ._ .. . .. . . _ . . . . . . . _ .... . ..
...............................«...................................... ..;.
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..............._......_............... _ _ _ . . - • - - - . .._ - - • - .. - . - . .
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Permit Granted
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F Western Surety Company
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LICENSE AND PERMIT BOND
For County, City, Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract,
Performance,Maintenance, Subdivision, Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. ;
KNOW ALL MEN BY THESE PRESENTS: BOND No. L&P- 6 O.8 3191
That we, Crystal Chamber & Cafe 197 Derby Street
of the _ city of Salem , State of Massach s t s as Principal,
and WESTERN SURETY COMPANY, a Corporation duly licensed to do business in the State
Of Massachusetts , as Surety, are held and firmly bound unto the
city of Salem State of MassachusettsObligee, in the amount
(Valid only when a County,City, Town or Village is named as Obligee)
of Pive Thousand Dollars and no cents----------- ($_5,000.00 ) DOLLARS,
(NOT VALID FUR MORE THAN$25,000)
lawful money of the United States, to be paid to the said Obligee, for which payment well and truly
to be made, we bind ourselves and our legal representatives, jointly and severally.
THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been
licensed SIGN PERMIT
by the Obligee.
NOW THEREFORE, if the Principal shall faithfully perform the duties and comply with the laws and
ordinances (including all amendments), pertaining to the license or permit, then this obligation to be void,
otherwise to remain in full force and effect for a period commencing on the 99th day of
Marrh , 19-9.Z and ending on the.9sth da
of Mar h 19.x, unless renewed by continuation certificate. y
This bond may be terminated at any time by the Surety upon sending notice in writing to the Obligee and to
the Principal, in care of the Obligee or at such other address as the Surety deems reasonable, and at the expira-
tion of thirty-five (35) days from the mailing of notice or as soon thereafter as permitted by applicable law,
whichever is later, this bond shall terminate and the Surety shall be relieved from any liability for any subsequent
acts or omissions of the Principal.
Dated this_ v'Arl day of "prig 19
Principal
Principal
CountBy Fe�signed _ _ WESTER U
/ _O � OMPANY
Resideliit Agent By Presi ent
ACKNOWLEDGMENT OF SU ETY
STATE OF SOUTH DAKOTA (Corporate Officer)
County of Minnehaha }ss
On this day of 19_,before me, the undersigned officer,personally
appeared Joe P. Kirby who acknowledged himself to be the aforesaid officer of WESTERN
SURETY COMPANY, a corporation,and that he as such officer, being authorized so to do, executed the foregoing
instrument for the purpose therein contained, by signing the name of the corporation by himself as such officer.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
v }u,rl%><'F-+nPf,.,n�56ax.,.ytf•Irf-c7•q}
G.MYERS ' ' Il, .w t�
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^ NOTARY PUBLIC
SOUTH DAKOTA �y� Notary blic, South Dakota
F My Communion Expire.52698 9; _
Farm 849—1-91 i�%fhf:`�N=e�y::4y" "rFiF.Sw.}
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APPLICATION 11U57 BE SUBMITTED IN DUPLICATE , ONE SET TO 5E FILED WITH THE
PLANNING DEPARTMENT, AND ONE SET (EEARMG THE APPROVAL OF THE PLANNING '
DEPARTMENT) TO BE FILED WITH THE BUILDING INSPECTOR.
Location , Ownership, and Detail fust be Correct , Complete
a d Legible. Separate .Application Required for Every Sign.
'•1
Application Tor Permit to Erecta Sign
Salem, Massachusetts
TO THE BUILDING INSPECTOR:
The undersicned hereby applies for a permit to _ Erect, — Alter , Repair
a sign on tie following described building:
Location and No. )` j Dz*-b4S-t -SSOerv, MA- Zoning/District
Name of Property Owner ¢ („' W�n�
Name of Sign OwnerI �P`rv��tt✓
v Address /5 'G 0\ItI
If Owner is a corporate body name of responsible officer
Name of Licensed Sign .Erector 01,IA- /ylv4.L= SrC--�- Gt o/tirl
Salem
Address )-Y License No.
Use of Building: 1st Floor 3rd_Floor
2nd Floor 4th Floor
Type of Sign; V/ Surface, Right Angles to Building, Free Standing,
Other (specify) Height:
Sign Materials.
. Sign Dinens ioo-s' l�D � k' l� � Sign Area 13j 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 30 * - FT Property FT
Name and Address of --�ignature of Owner
Insurance Company:
Signature of Owners Authorized Representative
Address JY
Estimated Cost
of New Work 76(,, cu Telephone 7 YJ^- u us'd
APPROVALS: Signature of Property Owner
S en P Ing Depar:ment Super nte7 ent o t .:ets Historical omnission
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