201 WASHINGTON STREET - SIGN PERMITr210 Washington Street
Soucy Insurance Agency, Inc.
I
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.:I'H THE
-Li-NNMG ,.EFARTMENT, 1D EARI' --E 0- _ .. ' - E PLAN ING
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mplete
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f
�,�a_.�- � Application for Permit to Erecta Sign
Salem, Massachusetts la 6 191il
71 THE 1 .;SPECTOR:
_ndersirne:: :,ereby applies -o- a pernit _o -I/— Erect , — Alter , — Repair
sign on t`2 -cllowinc descriteu tuildin;:
=ocation and llo. 301 Wa� �LV�s6,n Zonir•c//D; , trict
';a-c .r Property Owner U UXik S M\WOIk `""'1,bTtub�
':ame of Sign Owner (�out,N Tv ee �w -1 —
nY« j 7
ddress a0� ltkSln �o-v S+ t�
If 'aner is a corporate hopy 1417e of resoonsible officer
Name of Licensed Sign Erector �5y. Efinns
n —T Salem
,;ddre, s �„ ,,.�Ow1 �' •,I License No.
Use ur BuiiJinq: 1st Floor / 3rd Floor
2nd Floor Lith Floor
Type of Sign: Surface, Right Angles to 3uilding,
Free Standinc,
_ Other (specify) Height:
Sign Materials kuuniwuu. Cb-bawd I Qp��CwcFP.cle ��
! `� I Sign Area �9 SF
Sign Dimensions � 4 1`-� � g
Existing Signs : Surface: Sign Area ISD } SF
Right Angles : Sign Area SF
Free-Standing Sign Area Sr
Other Sign Area SF
Signs to be Removed: Type S� 61- Sign Area I 0 r SF
Frontage: Building SOI FT Property _FT
Signature of Owner
Signature of Owners Authorized Representative
Address
Estimated Cost
of New Work (�CO'C» Telepnone
APPROVALS: Signature of Property Owner
.)
Sale P a rsg Department Super ntenpent or [-ce[5
istonca ommiss on
ON REVERSE PLEASE SHOW SIGN SIZE, COLOR, LOCATION; LOCATION OF OTHER SIGNS AND
3UILDING ENTRANCE.
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SOUCY INSURANCE Y,INC.
O
I
City of Salem, Mass.
K ELECTRICAL DEPARTMENT
9
44 Lafayette Street
PAUL M. TUTTLE , CITY ELECTRICIAN
DATE. . . . . . . . . . . . . . . . . . . . . . . .
To: INSPECTOR OF BUILDINGS
Salem, Mas
ty.
Electrical Contractor
•-.----.. - (Signature of Applicant)
v� <-1 ------------------
.� /
-'-- - --
-- - - --------------•-
has signified th r Intention of performing the required electrical
work,
•- - - -•--•- . ...................Street
in conjunction with a Wiring . of sign by,:
- - / ��.[� - S`. ' ...................... signContractor
` -
ISSUED BY
This is a requirement, preliminary to the issuance of a permit
for the s g installation by the Inspector of Buildings.
ORIGINAL-SIDEWALL INSTALLER
PINK COPY.BLOG.INSP.
YELLOW COPY-ELEC. FILE
UNITED GRAPHICS, INC. EASTERN BANK 5943
d/b/a SIGN EXPRESS
287 RANTOUL STREET P.O. BOX 3106 53-179/113
BEVERLY, MAO 1915
PAY -V�otv" -t ezv & of (00 1 DATE ��'C�S(G� AMOUNT �µr•0�
TOTHE �• cl S° `
ORDER
OF
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