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393 Essex Street - C of A application - new sign - backup info City of Salem Sign Permit Application Worksheet 8-Aug-19 Salem Dental Group 393 Essex Street Zoning (res/non-res) R2 (residential) Entrance Corridor(Y/N) N Lot frontage 110 feet Building frontage 46 feet #of businesses on site 1 Bldng dist from street center <100 feet Multiplier 1 The applicant has provided three options for signs: a surface sign, a blade sign, and a freestanding sign. Because this is a Local Historic District, the applicant is seeking a Certificate of Appropriateness from the Historical Commission. The applicant will select a sign in consultation with the Historical Commission. Building Signs maximum area permitted 46.00 sq ft total proposed sign area 6.22 sq ft option 1: surface sign 6.22 sq ft width 28.00 inches height 32.00 inches option 2: blade sign 6.22 sq ft width 28.00 inches height 32.00 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 option 3: freestanding sign proposed sign area 6.22 sq ft width 28.00 inches height 32.00 inches proposed sign height 5.00 feet Application meets guidelines set forth in the Salem Sign Ordinance Yes Recommend approval Yes All three proposed signs meet the dimensional requirements for their respective types. I recommend approval. Once the specific sign type is selected, I will bring the application to the Building Department for a sign permit. ' Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN y a ! 'n NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTED R�f' Location, Ownership and Detail Must Be Correct, Complete, and Legible Salem, Massachusetts - 7//.1-51-47 To the Building Inspector: ate The undersigned hereby applies for a permit to ❑Erect, ❑Alter, ❑Repair a sign on the following described buildings: Street Address Zoning —_District ❑Urban Renewal Area ❑Entrance Corridor J Z�(l'S�Or►G Historic District ❑ None Essex S ? f, LACUse of Building Telephone fig/ .SIoZ 1 floor Dewy • 2 floor n4 � �C'v t1. Address s 3 floor Telephone _ S" L 0 VT_7 « d,, �L{� 4 floor E-mail How many businesses are in the building? If a corporate body,name rFrontage afre onsible officer r. r o/ ' 0- r Building 0/ ' linear feet Construction Sup's License No 0 0 Applicant's Space(if multi-tenant) linear feet Address Property fipp r©x /qS/ linear feet Telephone $ 7/ 7 Mail Sign Permit to E-mail � �� P5� GCS ► � ❑Sign Owner - ign Erector ❑Other: • more ..sed. attach additional Si n 1 5i n 2 Si n 3 Surface ❑Surface ❑Surface ❑Right Angle to Building Right Angle to Building ❑Right Angle to Building ❑ Free Standing ❑Free Standing Yj Free Standing ❑Awning ❑Awning ❑Awning ❑ Portable(A-Frame) ❑Portable(A-Frame) ❑Portable(A-Frame) ❑Other(specify) ❑Other(specify) ❑Other(specify) SigWate ial D S, le DF Si n Materials i( �' Si n Matgrial n l' 'n Caurde /VDU �oub1P `;bn ardPcl f� tan+-Pere S Sign Dimensions Sign Dimensions Sign Dimensions 8 x 3� a: x 3Z 3g X3z Sign Area 6 ,01 sq ft Sign Area Sign Area s ft (�• Z so ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work SignsExisting • Type Sign Area To Be Removed? Sign Owner ❑Surface sq ft *es ❑no Right Angle to Building sq ft ❑yes ❑no ❑Free Standing sq ft ❑yes ❑no Sign ner' ize ntative ❑Awning sq ft ❑yes ❑no ❑Other(specify) sq ft ❑yes ❑no Property Owner Essr Internal Review Planning&Community Development Department Historical Commission Approval Building Inspector 08/24/10 rev The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations Uf I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _, tia .. Address: t �` City/State/Zip: ,, , , Q (w Phone#: 9 7� / 7 � Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ 1 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' [No workers' comp. insurance comp, insurance.* 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no 13. Other ) employees. [No workers' 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. $Contractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: 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 or insurance co rage verification. I do hereby certif hider t e pains ant penalties of perjury that the information provided above is true and correct. Sixnature. Date: Phone#: 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#: Illlf�� III � �II��I� IIIIII ' ` LRLU OEM ;z '0 o q �. 9 IIIIIIIIIIIIIII � IIIIII�TL 7C1 � � � II I �fl�f�lff�llll Illlllllt �� IIIIIIIIIIIII�I cz ct 'u�� I �liiiiu O � - t a �1 3 _ r MTE 7M J, : tc 4-4 }l■`mayi I++ i,..,...,� �llll cc� in 0 3 cam, ^O W o v bA M � `t+ it:r •t'' •r,f: �•••Oat A ,arlr 1� 1 F `•r� 'L' i per' J �. r'� �.. AI r 51 i t`il 4 1 :� z SALEM GROUP 1 11 60"total D D Height 28 x 32 30" height to bottom of sign Carved HDU Beige background, black and gold lettering fonts: Times New Roman, Futura, and Xcetera extruded aluminum 4x4 posts owl i r maw1 t r OW IV r 5 ��� a, i � R F t J F W M � It y! _ . , m T Ln x U f cn 1 9TCD 1 r i i u rfa _ -n WW f r --- - _ qw 14, 't . AL ofiPOO 4 r. r � # ,f AP Ale AA i ..ti 1 I