148 Derby Street sign Cof A application Date Stamp
Salem Historical Commission
120 WASHINGTON STREET SALEM.MASSACHUSETTS 01970 For Office Use Only
(978)519-5685 FAX 1978)740-0404
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
Pursuant to the Historic District's Act (M.G.L. Chapter 40C) and the Salem Historical Commission Ordinance,
application is hereby made for issuance of a Certificate of Appropriateness for:
❑ New Construction ❑ Moving ❑ Reconstruction ❑ Alteration
❑ Demolition ❑ Painting 0 Sign ❑ Other
District: ❑✓ Derby Street ❑Lafayette Street ❑McIntire ❑Washington Square
Address of Property: 148 Derby St.
Name of Record Owner(s): Patrick Schultz
Owner Mailing Address: 40 Summer St.,Salem,MA 01970
Description of Work Pro osed
Please type or print clearly.Attach additional slieets, as necessary
New blade sign,but using existing bracket.
New outward facing sign above doorway.
Name of Applicant: Th wling wolf,LLC ❑✓ Owner❑Contractor❑Tenant❑Other:
oe
Signature: l Date:3/1/2017
Tel. #: (978)979-5770 E-mail Address: Papawolf.schultz@gmail.com
Certificate will be mailed to the owner unless otherwise in4kgedlhere:
Certificate should be mailed to: Name-
Mailing address: -P— d rUrr. cr City: �G'-�� State: 14t-
Permit t � -� '••
APPLICATION FOR PERMIT TO ERECT A SIGN
1 NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and LegibId)EPT- OF PLANNING',&
_ COMMUNITY DEVELOPMENT
Salem,Massachusetts
To the Building Inspector: Date
The undersigned hereby applies for a permit to rfrect, ❑Alter, ❑Repair a sign on the following described buildings:
elf 1-7 C�I `�7D ❑Urban Renewal Area L Entrance Corridor
r>gistoric District :_None
Telephone 1 floor
Sign • Name
�1�� L1�QfiQLC^
2 floor j7Cs7�'r� e ✓
Address
S' C- 3 floor a
Telephone -� _ s -1 d 4 floor
E-mail ,_Lj0� � ,C_ L�,� ' n �� How many businesses are in the building? ,2_
!f a corporate body,name Frontage of res nnsible officer-
Sign �
Erector: �"a' Ce2P.-si' v� Building �linearfeet
Construction Su p's License No S-_ O Applicant's Space(if multi-tenant) linear feet
Address
Telephone 1 Q11e', �� Property linear feet
�7 ZI
` YE-mail ,04__s h-,vA�r� j.� ign Owner ❑Sign Erector ❑Other:
5i n 1 Slgn 2 Si n 3
❑Surface ❑Surface ❑Surface
�Right Angle to Building ❑Right Angle to Building ❑Right Angle to Building
❑Free Standing ❑ Free Standing ❑Free Standing
❑Awning ❑Awning ❑Awning
❑Portable(A-Frame) ❑ Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) ❑Other(specify) ❑Other(specify)
Si n Materials Sign Ma vials
J" 1,4 .e— Sign Materials
Sign Dimensions Si n Dirrgg nsions Sign Dimensions
Sign Area ( Sign Area ** -VA Sign Area
-U' ��c�-� ft s ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) sq ft
Estimated Cost of Net Work
$ 3 00, 00
Existing Signs
Type Sign Area To Be Removed' Sig7Own
o Surface sq ft �ye ❑no
Right Angle to Building ��{ pe5 ❑no
❑Free Standing sq ft ❑yes ❑no Sign Owner's Au horized Representative
•Awning
❑Other s eci sq ft ❑yes ❑no
(specify) sq ft ❑yes ❑no
Pr.pe y O r
Intern al Review
Planning&Community Development Department Historical Commission
Approval
Building Inspector
08/24/10 rev
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