B-19-1300 - 0258 ANDOVER STREET - Building Permit �.. ,.. Permit Number
APPLICATION FOR PERMIT TO ERECT A SIGN /
g� NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legible
�
Salem, Massachusetts
To the Building Inspector: Date
The undersigned hereby applies for a permit to 41erect, ❑Alter, ❑ Repair a sign on the following described buildings:
AddressStreet
❑ Urban Renewal Area ❑Entrance Corridor
❑ Historic District ❑None
Owner:Property
Telephone
•
floor ,,
Address ' .� floor � -,'n
Telephone 4 floor
E-mail How many businesses are in the building?
If a corporate body, name Frontage
of res onsible officer
Sign Erector: Name Building linear feet
Construction Sup's License No Applicant's Space (if multi-tenant) linear feet
Address Property linear feet
Telephone Mail Sign Permit to
E-mail Sign Owner ❑Sign Erector o Other:
Sign 1 Sign 2 Sign 3
o Surface o Surface ❑ Surface
❑Right Angle to Building ❑Right Angle to Building ❑ Right Angle to Building
o Free Standing ❑ Free Standing o Free Standing
❑Awning ❑Awning o Awning
❑ Portable(A-Frame) o Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) o Other(specify) ❑Other(specify)
Sign Materials Sign Materials Sign Materials
Sign Dimensions . i Sign Dimensions Sign Dimensions
.Sign Area Sign Area Sign Area
s ft s ft sq ft
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ , CIZ1
Existing Signs Signatures
Type Sign Area To Be Removed? Sign Ow e
❑ Surface sq ft ❑yes ❑no 7 �f t_
❑ Right Angle to Building sq ft ❑yes o no
❑ Free Standing sq ft ❑yes ❑ no Sign wner's Authorized Representative
❑Awning sq ft ❑yes o no
❑Other(specify) sq ft o yes ❑no
Property Owner
Internal Review
7
Planning&Community Development Department Historical Commission
Approval
Building Inspect
08/24/10 rev