142 DERBY ST - BUILDING JACKET ; � zZo�
� R
�,� The CommonwealthTt#�'b��ss'�`'c�h�i�e s`
� Department of Public Safety
Massachusetts State Build���a�so�n,�, 3� 3 0
Building Permit Application for any Building ot han a One-or TwaFamily Dwelling
' � ('This Section For Official Use Only) � • �-
Building Pemiit Number: � Date Applied: �� Building OfficiaL �
M �.SECTION 1:LOCATION(Please indicate Block#and Lot#for IocaHons for which a street address is not available)
C�' /5'z i�Gy�'� S�,/e�✓I A,/a ai9�
�' No.and Street City/Town Zip Code Name of BuIlding(if applicable)
�n � �� SECTION 2:PROPOSED WORK �
(J/ Ediflon of MA State Code used_ If New Construcfion check here O or check all that apply in the two rows below
� Existing Building❑ Repair❑ Alteration ❑ Addition❑ DemoliHon � (Please fill out and submit Appendix 1)
f Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
�� Are buIlding plans and/or construcfion documents being supplied as part of this permit applicafion? Yes No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No ft�
Brief escripflon of Proposed Work: �ONSf,�'r�c � !' P K/ S�'7�//G�� /lL[—o� �/'Z
/1 v�Pe �Ho,�- .�ta✓c a ir .tlon/ <3vtif��7� INoN —
�sLr_, �,,-a . 1 '�wr h o — /...,a .✓ti �tr✓ 2%Q� t�
�SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR"�
� � � ' CHANGE IN USE OR OCCUPANCY � � ��° �� "
Check here ff an ExisHng Building InvesHgation and Evaluation is enclosed(See 780 CMR 34) ❑ �� �,.,
Existing Use Group(s): Proposed Use Group(s):
� �� � SECTION 4:BUILDING HEIGHT AND AREA �� � „... �:_
Existing Proposed
No,of Floors/Stories(include basement levels)&Area Per Floor(sq.ff.) a �'
Total Area(sq.ft.)and Total Height(k.) �Da-+�-
SECTION 5:USE GROUP(Check as applicable) ,.;
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ B: Business E: EducaHonal ❑
F: Facto F-1❑ F2❑ H: Hi h Hazazd H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ �
I: InsHtuHonal I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: ResidenHal R-1❑ R-2❑ R-3❑ R-4❑
S: Storage Sl ❑ S2❑ U: Utility❑ Special Use O and please describe below:
Special Use:
� . SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IB 0 � IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA ❑ VB ❑
� SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) �
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
Public❑ Check ff outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal5ite❑
Private❑ or indentify Zone: or on site system❑ required O or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazazds to Aic Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes� or No❑ Yes❑ No ❑
;' �' SECTION S:CONTENT OF CERTIFICATE OF OCCUPANCY . � �
� . Edirion of Code: Use Group(s): Type of Construcfion: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
G➢a t,t.�.vJ S 2�
�
�
� ' SECTION 9: PROPERTY OWNER AUTHORIZATION ' �
XName and Address of Pro frty Owner /
� � �z /y '4i�/�� /'�Z .�v(��9 ��'�i�+ fr�"�Q '/�
Name(Print)�t�/z��� � No.and Stree� City/Town Zl
Property Owner Contact InformaHon: p
�� - - 7��-Z� -to���w�//e,-C� ,�
�Tifle ��--- Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
L�� � �� _/11��v! S--C S�r ��.. ?�j.¢ U197c�
Name Street A dres� s -- City/Town State Zip
to act on the ro.er ownei s behaff,in all matters relative to work authorized b this buildin ermit a lication.
SECTION 10:WNSTRUCTION CONTAOL(Please fill out Appendix 2) �� �
ff buildin is less than 35,000 cu.ft.ot endosed s ace and/or not under Construcfion Contro]then check here O and ski SecHon 101
10.1 Re 'stered Professional Res onsible for ConslrucHon Control � �
�T�rs G�c�d.s �/��35 33S/ �no ti��� ,� � f��;i 77 � �
Name(Re&istrant) � q Te1� bone No."i e-mail addres 't�- Registration N�be
/OU l5 N/�ic�/` �� _ .S�p/�.w, iK� . _ �(� ///✓rt.s/7'�� G� /b� Z �/o
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor � -
�Gfly1�5 [�-f'�� S
Company Name ,
Sn�l. G�,Ld.s �S ' b �l 7 2�"(p
I Name of Person Responsiblef9r Construction Lice'n,s/e No. and Type if Applicable
/O D ,� 1�J�r�,1' (I��� S4IY�7 ��C<� � O/S7(�
�S eet Address � City/Town State Zip
/7 35 � 3 57 —— p�a���s,,-/d S�F. L . �.�I ,
Tele hone No. usiness Tele hone No. cell v_� e mail addr�e
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVti M.G.L.a 152.§25C 6 -
� A Workers'Compensation Insurance Affidavit hom the MA Department of Industrial Accidents must be completed and �
I submitted with this application. Failure to provide this affidavit wIll result in the denial of the issuance of the building permit.
Is a si ned Affidavit submitted with this a lication? � Yes❑ No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
I�� Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.BuIlding $ � K
BuIlding Permit Fee=Total Construction Cost x_(Insert here
2.Electrical $ . appropriate municipal factor)_$ ,
3.Plumbing $
4.Mechanical HVAC Note:Minimum fee=$
( ) $ .�7 (contactm �icipality)
5.Mechanical Other $ _• q��
Enclose check payable to `��/��`'
6.Total Cost $ �j fL . (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT � � ��
By enMring my name below,I hereby attest under the pains and penalHes of perjury that all of the informafion contained in this�� �
applicaflon is tr e and accurate to the best of my knowledge and understanding.
� lo�� 8�35 335`/
Please print a a,�i ame Title Telephone No. Date
/Op ,C� �,//�Gt F S� . �. `� � ��5�D
Street Address Ci Town
tY/ State Zip
, ; ( �.
Municipal Inspector to fill out this section upon application approval: J '�l.-�`
� Nazne � �� � Date� �
�_ ,
�. �:� DERBY JOE
RESTAURANTIMPROVEMENTS
142 Derby Street, Salem, MA 01970
Client:
Derby Joe LLC
21 Herbert Street
Salem, MA 01970
Architect: ,��.��R�y�
�E, A 5 ��, Y
Seger Architects, Ina , �, ��,
10 Derby Square, Suite 3N � F �
� � 3f790tsK..
Salem, MA 01970 � �M�R�o��,
PhOne: 978-744-0208 Fax: 97&74401U�qlTyOF��AS��Jy
`� �q 2�[-1
GENERAL NOTES DRAWING INDEX SUBb111TAlLOG PROJECT INFORMATION
i. These documents are the property of the architect ond shall not be capied, Q 20091Mematlonal Bullding Code w/MA State 8th Editlon
dupiicated, altered, modified or revised in any way without the expressed SNEET DESCRu�noN o
written approvai of the architect. ARCHITECTURAL ���TO �<2 OERBY ST�ET
IOCATiON: SAIFN, NA
2. To the best of the architects' k�owledge these construction documents are in COVER SHEET ,ua�srncnan Essex awriry
conformance with the re uirements af the buildin authorities havi� A-i F�ooR aLAN
q 9 9 A-2 EQUIPMENT PLAN ^w'uc^B�c�s 2009 IEHC -MA STAIE BURDING C�E(BiH EOIIION)
jurisdiction over this type af construction and occupancy. p.g SCHEDULEs, NOTEs
A-o INTERIOR ELEVATIONS ZONING AND BUILDING DATA
3. It is the intent of the architect to delineate these documents as accurate as qs INiER10R ELEVATIONS
possible far the purpose of graphic representotion. Do nat "scale" these ZSLJING OISiRICT: Bl19NE55, 8-1
documents. The dimensions shown are to take precedence over scaling the A'8 COUNTER SEcnON Ug: (�ST URAnT AZ ASffMBLY
documents. ihe general contractar shall take full responsibility for any p�WPACYLOAU•
incorrect work and any repair of said work as a result of scaling the OININC PREA: 208 G3_ypg ���5 y'F= 7p$EpTS
ALLOWABLE OCOUPANCY /4 PERSONS
dOCUR12(ItS. PROPOffO OCCIIPPNCY 14 PERSONS
5(%1PE OF WINtK�
4. All work performed by the general contractor shall compty and confarm with / NTEPoOR IYPR04EAIfNTS TO AN E70511NG�ACE. 7F+E MQ7K IS TO INCLUOE;
�OC4� Ofld state building COd2S, ordinonces and regulations, along WIE{1 Q�� bILLWOlM (SERNCE COUryhRTOP @ $HEIVINC UNIfi), 11piTNG INSTM1AilON, Ip1ERI0R PAINT, AW '.
other authorities havin urisdiction. ihe eneral COfitldCtOf IS f25 onsible t0 DUNP 9NK, ANO NRN1911NC5. TOILET PpRililON WALLS YALL BE INSTALLID. Ll(?1TNG AND SEATNG
9 � 9 P � Z` ,� AREAS WiLL BE MSTALIID. KITpiQV EQIIIPMENT NA1 BE INSfALLEO, iHE EXIStING BACK AftEA NILL ��
be awore of these requirements and governing regulotions. aPF'i�(1VF.D ae coN�aho To n ert�r ,�n orar, vmm �o weuc u�.
'�:�bj�c�to approval by anq other s '>..
5. The general contractor sholl thoroughly review ond become familior with these �c..�oritchaviagjurBdictio�s. �r
documents. Upon review, the general contractor shall document and �otify i"""' or SAI�EM,MAS9. �i�'' '
the arohitect o( any errors, omissions, discrepancies and / or incansistencies F="t' 9D��1EPiTI(�I$
priar to the stort of any portion of the proposed work. The architect shall � '. ` ,". -� -: '
i review the proposed corrections after the receipt of notification. The Li .
?L,�^;°�.'.�A'PROYED SOLELY FOR1 IGTw1�FQF
discovery of discrepancies and / or conflicts after the start of work shall 6e r.Pe aNc �oenrwn or ra+?��a�� °��c��.
the full responsibility of the general contractor to repair ar replace. a�� Fi�: �acrecnon �nic=s"-;����"7 TO A
PIHALTESTAND INSPECTION,FORCAhiFLEiECf3MBL1`
n.rEC`c'Y1TF1 T.Y.0 PIRE C09E.
6. lhe general contractor is respansible for electrical and plumbing design work
and is to meet all applicable codes.
; COAT RACK PREFAB. TRASH Q,'tS'�,�,e� S; ♦'8�
WOOD FRAME SCREEN DOOR SHEO
REFRIG. WITH CLOSER y
PRIME AND PAINT EXIST � JOt08 �
W000 DOOR TO REMAIN O
EXIST. YARD
A55 rep � �w�..
RAISED CURB � 6" F.D. SHEET � � �\ � � �
1 A A-5 s ° v�Nv� �
n-s �FLOORING �± �
V
g REFRIG.
A_5 VESTIBULE �
SHELF(6'A.F.F. ; �o� I o I �o� �/ EXIST. STA RS C Vy N
�-� �� 03 C �
-- --- ----------- -- ---------------.' NON-SLIP REMOVABLE „ �Cep t��7 � �
�3� F100R MATS OVER ^-5
GRAB BARS PER AAB d 4 � � SHIEET NNYL RAISED CURB 1 A � 6 F.D.o SHEET � � �o,� �
ELONGATED K�HLER ; fL00RING n-s 6 VINYL i;
TOILET WITH SEAT UFAS ��� • �P S����2 AREA "- � A-s �FLOORING
56" X 60' RAISED " +/- 02 � � i g
tO CIEAR FLOOR 3 Servin �
"EMPLOYEE WASH SPACE A_4 9;:, j , � � � �/ A-s
� i
HANDS" PLACARD _ _ _____ ___ � I SHELF(6'A.F.F. ' �\ � �\ �f EX
/ 3� �� A-4 , %\ � i�
i1LTED MIRROR 2 TOP � 1` I ------ --
� - � I ��` -3" ,: --�---_' - R.f
BOBRICK SOAP ___ _ _ —_ \ 4 i O
DISPENSER � '�, A-i � � Partiai plan at Trash Enclosure
TRASH RECEPT. O 4'-6" ` i � � sca�: i/a' _ �'-o• y �
WiTH LID HIGH 1 \\ , i ;
SHELF � } � EXISTING TRACK LIGHiING TO REMAIN
FOR IT/ rn. �` � � � W .�
` '-----
DEMO EXIST WALLS, RADIO � o: �, i w t/�
SHELVING, HEATER = O �
ENCLOSURES AND MIRRORS � `` _ W �
5�-0" I O �.�'
Os " ��I y, �
SAND/STAIN �" � O i �
EXIST WOOD �� 2 EMERGENCY LIGHTING BATTERY PACK � `"'
'FLOOR TO Seating "-` Q
STAIR REMAIN -� REIOCATED HEATING ELEMENT. DEiERMINE
N.I.C. � 1'-2° APPROX. L1N. FOOTAGE AVAILABLE IN
SEATING AREA. SUPPLEMENT AS REQUIRED WALL KEY
REMOVE EXIST. HS �( AT AVAILABLE WALLS TO REMAIN. COORO.
COUNIERS � IN FlELD WITH OWNER'S FORCES
EXISTINO
RELOCATED BASEBOARD NEW FRAMING ANO F�OORING TO MATCH
HEATERS f�TRLOYJEREO BAY WINDOW SHELF. T1P. DEMOUSH gp
' CL. N�
—MOOIFY EXIST. JAMBS TO MAXIMIZE OP'G ;,z
PROPOSED
TR SIDEWAIK TR IN EXIST STOREFRONT. PROVIDE OFFSET �`�
' ADA HINGES TO OPTIMIZE OP'G. INSTALL !� u
REMOVE EXIST. WOOD THRESHOLD. INSTALL CLOSER AND LEVER HARDWARE FOR tS�
NEW ALUM. BEVELLED T'HOLD PER AAB ACCESSIBILITY
n Proposed Floor Plan REQUIREMENTS �
' 5��: ,i�� = ,•-o°
�
MAY 18, 2015 PERMIT SET
_ .-.R��A ri n
, ,�''v'Ca�:., A. g��J;`��
���
�,P
; I BREAD SHELF (REACH READY) �o � �
TOASTER ABOVE �i o.3�1oe
e���-.,�� AM1BR!D$�. 5.,,
REFRIG. 2 X4 S S �' � 5 � �gP�'�
TA PREP. /
( FRI ABLE
GREASE TRAP /� 03 � � �
BELOW `n-��rep �; �-
6" F.D. �"j � �
7 p Y W � �
CLEANING ^-g 6 S OR M � `
SUPPLIES AND "-5 R AD . x m
MOP RECEPTOR 3 BAY SINK � �' m�
A_5 VESTIBULE a
\ \ / N.I.C. � ,Q v
MOP RACK SHELF(6'A.F.F. �\ � � FREEZER/ REFRIGERATOR W d �
BELOW COUNIER C7 Q �
W �� � a,
-3° � �` �, „�., � � r��; �
v
F 4z fi; "��
°a � � � F � ��p�� �. �i.���
�4 UP ':x`�`u =i�. r� M, .
EFF'v� A 02 ��'�'��
TOII. RAISED " +/- �;
;; PAPER TOWEL 3 S@Nlfl `� , OUMP SINK
o�sP. A-. g� ����.�
� .� ,
� � � ���'� A <
�P�� r�.� _� �, � �� a�
� F � ,� � �y� ���� vY HAND SINK WITH GUARD SURROUND �
� �t �� 4 � "� LEMONADE CARAFE �
:. . �. � n-a � � r�":, cA
� 4'-6" �� � ` ;� ICED TEA CARAfE W ,�
� � � I BE 81 R�� �A DISPLAY W `n
CARAFES '� � ) qppV� SNELF A80VE 0 ti v
rn. � ��r� �:_ �z€� � V .e vi
�= DRIP �,: �� �:�$� �� �
�';� SEALED WOOD COUNTER W v >,
T R A Y ��� �,�� � � ON W00� BASE CABINETS 0 A '�
�.��_. ,..� ' ��,. �:� ti °'
-""` COFFEE STATION WITH ,'�+ A
5'-0" � u STORAGE BELOW CQ �
�, ' TRAS'FI BELOW IN a�
���; CA8INET �
Ot 2 _ ,.
Seating ^-° ,�-r
STAIR
N.I.C. �
� ��
�
CL. ��
u�A�
SIDEWALK
� Proposed Equiprnent Plan �
� ��: ,,4� - ,._a� a
MAY 1 B, 2015 PERMIT SEf
-' General Notes: ��s� °'9�.,
� LIFE SAFETY LEGEND � ' �'
1. Hot water suppiy provided by landlord via common tank.
Owner to provide boosters os required to maintain correct �� °� 108
temperature per health code. �--� PATH OF TRAVEL o�
� LIGHTED EXIT SIGN LOCATION
2. Provide floor drain connected to waste system in Prep. 1� LIGHTED EXIT SIGN W/ � �q � � � �
QreQ. DIRECTIONAL ARROW F �'
V
3. Flour. lighting in Prep Area t0 be provided W�th required � SURFACE MOUNTED — FIRE � �
EXTIN(�dISHER CABINET ►•
protection, lenses, etc. Provide 50 FC to prep surfaces. x
EMERGENCY LIGHT � �
4. Trash to be stored in prefabricated enciosed shed, a .�'�
raised above grade 6" and remved off—site daily O SMOKE DETECTOR � q ,�
� � �
5. Exterior wails have existing fur out to accommodate � PULL STATION d
baseboard heating.
HS HORN STROBE
6. New toilet to receive 3 Z" sound attenuation balmkets in GENERAI NOTES:
existing and new walls. remove inside face Of Wd�� material 1. VERIFY LOCATION OF EXIST�NG UTILITIES AND EXISIING FIRE i
SUPPRESSION SYSTEM. MODIFY HEADS AS REQUIRED FOR NEW
t0 facilitate installation Of insulation. Install f12W � GWB LAYOUT. WORK TO 8E PERFORMED BY �ICENSED SPRINKLER
finish. Prime and Paint CONTRACTOR �
� �
WALL TYPES w� �
�
ROOM FINISH SCHEDULE . „z.. �,� o � �'
U ��
_. • 2 x 4 WOOD STUDS 0 i6" O.C.
FLOOR FINISHES BASES WALL FINISHES CEILING LTa A �.
Fi — SHEET VINYL Bt — VINYL BASE W7 — PAINTED GW8 Ct — PRIME PAINT EXIST T1N CLG 3 1/2" SOUND ATTENUAT70N � b
I � BLANKET INSULATION ti A
f2 — REFINISHED EXIST WOOD 82 — PAINTED WOOD W2 — FRP PANELS C2 — FRP OANELS OVER EX. GWB � ��2. Cws �+ �
W3 — PRIME/ PAINT EXISTING CQ
�y '.
1 GW8 PAflTR10N FlRE RATING UL R�TINC �STINC CODES �;
� �
q A
'A GW8PAR71TION�NOMISULAiION) FlRE RAi1NC UL R� �C �SnNC COUES
ROOM ROOM FLO�OR gASE WALL CEILING CEILING REMARKS � �
NO. NAME FINISH FINISH FtNISH HEIGHT REST. S10E • EXISIING WALL SURFACE. PAINT
Ot SEATING F2 B2 W3 C1 9'-3" • EXIST. STUDS
02 SERVING F1* Bi W3 C1 9'-3" * PROVIDE WALKING ANTI—MICRO MATS , 3 i/2" SOUND ATIENUATION g�
03 PREP F1 61 W2 C2 e�2N G�iNsu�anaN z
TOILET SIOE ^
❑ 7 -3 • ' �e
O4 TOILET F� u� W� C� g'_3'� 2 GWB PARTfiION flRE RA71NG BP RA11NG TESTING CODES �i
NA ��
M
�
�
MAY 18, 2015 PERMIT 5ET
. �yJ.."..-.r,�
,y \���A. S �i •`' A
� � f' � �
O �p
, HUNG CHALKBOARD
Pfo. to5
MENUS - PROVIDE TIN WALL AND CEILING TREATMENT TO �qp,�gR�p�, �
HOOK AND EYE REMAIN - PAINT pqp
HANGING SYSTEM ,q� 9Q'�
FOR EASY REMOVAL �
� '4�i
DOUBLE BREWER EXISTING BEADBOARD PANELLING TO
GRINDER REMAIN. PRIME AND PAINT z '� �
ESPRESSO MAKER TOII. �
TOILET OPEN DOUBLE BREWER °^�
W �n
1 �" THK. STONE BAR TOP P•�S ASE � � �
a R
U y�
FR. REF. FREEZER/ REFRIGERATOR ICE OPEN
MICR . BIN SHEL pG .�°4
W v
� o �
C
AAB HEIGHT FLIP COUNTER ON HWGES
AND CLOSER
Elevation at Back Wall Elevation at Face of Counter
1 SCALE� t/4` = i'-0° � SCALE 1/4° = 1'-0"
DOOR T1PE A - 2 PANEL HUNG CHALKBDARD EXIST, ilN WALL AND CEIUNG Ri
SOLID CORE WOOD PAINTED DOOR MENUS - PRdVIDE
HARDWARE: HOOK AND EYE HANGING SYSTEM HUNG CHALKBOARp TO REMAIN � �
CLOSER FOR EASY REMOVAL MENUS - PROVIDE EXIST WALL TRIM TO REIMAIN (P&P) � '
LOCKSET HOOK AND EYE �5,� p I
HINGES(3) TIN WALL AND CEILING TREATMENT TO HANGING SYSTEM EXIST. BEADBOARD TO REMAIN (P&P) W °�
REMAIN - PAINT w �
BEADBOARD/ TIN WALL FINISH TRANSITION FOR EASY REMOVAL �
w ,:
RAIL TO REMAIN - PRIME AND PAINT 0 �
EXISTING BEADBOARD PANELLING TO V � �'
REMAIN. PRIME AND PAINT DUMP SINK HAND SINK W u �
__ WiTH TRIM WITH TRIM O A v
i �" THK. STONE BAR TOP �"+ A
O FINISH PLYWOOD BAR FRONT WITH �` COFFEE STATION COUNTER � �
O APPLIED MOLDING MEDALLtONS EQUALLY � HOLE IN COUNTER TO TRASH W
SPACED RECEPT. IN CABINET BELOW A
� ���� � a � FINISH WOOD BASEBOARD TO MATCH
30" �
c � ���� � � M
AAB HEIGHT fLIP COUNlER ON HINGES o OPEN STORAGE BELOW ALL COUNTERS MODIFY EXIST. FUROUT fOR ��
AND CLOSER PROVIDE ADJUSTABLE RECESSED HEATING. RE-ROUTE HEATING AS �z
STANDARDS(2 PER SIDE) REQUIRED. CALCULAiIONS FOR LOADS ��
STEP UP BEYOND AND COVERAGE 8Y OWNER FORCES
Elevation at Face of Counter Elevation at Side Wall A�
2 SCALE: 1/4" = t'-D' " SCALE: t/4" = i'-0"
et
a
MAY 18, 2015 PERMIT SET
.' NA `� ' �
��,� � :�. SE"'�F�;
� DOOR TYPE A1 - FLUSH �`�O� cF`,�,�`
' SOLID CORE WOOD PAINTEO DOOR
FRP PANEL CEIUNG CLADDING FRP ON ALL SURFACES COAT RACK HARDWARE: �' �p�p� ` A
FRP PANEL CE�LING CLADDING LOCKSET � gq�p�, �
TYP FRP ON AlL SURFATYP HINGES(3) �aA �.J"
S/S SHELVING TYP.
FRP ON ALL SURFACES � OFM P
T1P � a •
\ 3 BAY SINK /Y j h � � �
/ I II \ ��) � W� DRAINBOARD �
REFR�GERATOR/ FREEZER / I i; � I � � '�
� I �i � III \ W rn
� I j� I ��� A1 \ � ��
REFRIGERATED \ � 11 / O� U o,�
R
SANDWICH PREP � I; / � -� � -� � � � �' m o
UNIT � „ �
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City of Salem Sign Permit Application Worksheet
i . RECEIVED
SERVICES
20-May-15 PECIO
Derby Joe
n 142 D Derby
street 1 S J L 2 g All: 12
Vr/ Zoning(res/non-res) B1
Entrance Corridor(Y/N) N
Lot frontage 70 feet
Building or tenant frontage 17 feet
1 #of businesses on site 2
I n Bidng dist from street center <100 feet
V Multiplier 2
` B dR t'.art Btat e$s%ts _,Lid _. �• _:..._-�
maximum area permitted 34.00 sq ft
total proposed sign area 15.28 sq ft
sign 1
length 30.00 inches
height 36.00 inches
sign 2
length 20.00 inches
height 56.00 inches
sign 3
length 0.00 inches
height 0.00 inches
sign 4
length 0.00 inches
height 0.00 inches
sign 5
length 0.00 inches
hei ht 0.00 inches
maximum area permitted sq ft(per side)
maximum#of signs permitted signs
maximum height permitted ft tall
sign 1
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height 0.00 ft(approx)
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets standards set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes
Approved by Historic Commission
6
Permit Number
• APPLICATION FOR PERMIT TO ERECT A SIGN
NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legible
Salem, Massachusetts
Date
To the Building Inspector:
The undersigned hereby applies for a permit to Erect, ❑Alter, ❑ Repair a sign on the following described buildings:
Address ❑ Urban Renewal Area ❑ Entrance Corridor
o�Flistoric District ❑ None
• (J W�� Q/ Use of Buildina
Telephone ( '-:-(,ZJ3Uc�J 1s floor
• q r vv t t1 i awrA Lui 2 floor
Address (. :I— - 4 3 1C.+, Mt- 3 floor
Telephone u - (h -r 4 floor
E-mail .`n� t CS ; ., �� yv- How many businesses are in the building?
ff a corporate body, name j
of res onsible officer ltiv�l _1
GO NLc rj Er NS Building I linear feet
Construction Sup's License No -Zob Qc.( Applicant's Space(if multi-tenant) ) '� linear feet
Address , Lbr� Property ZQ linear feet
Telephone ol tj S — oOj Mail Sign Permit to
E-mail �jdJ I (Sign Owner o Sign Erector o Other:
Si Proposedn 1 Sian 2 Sign 3
❑ Surface sLSurface o Surface
/(Right Angle to Building ❑Right Angle to Building ❑Right Angle to Building
o Free Standing ❑ Free Standing ❑ Free Si
❑Awning ❑Awning ❑Awning
❑Portable(A-Frame) ❑Portable(A-Frame) ❑ Portable( -Frame)
❑Other(specify) o Other(specify) ❑Other(sp9 'fy)
Sign ri s Sign Materials��I JW� Sign Materials
Sign Dimensjt?,n�f� fr Sign Dime��stf brr Sign Dimensions
Sign Area ..55 Sign Area .x 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
$
Existing Signs signatures
Type Sigp,4rea To Be Removed? Si9�pmer e /
❑Surface sq ft ptyes ❑no y
ps Right Angle to Building sq ft ❑yes ❑no
❑Free Standing sq ft ❑yes ❑no Sign Owner's Authorized Representative
❑Awning sq It o yes ❑no
❑Other(specify) sq ft ❑yes ❑no
Internal Review
Pla &Commu e e opment Department istorical CommissioApproval
Building Inspect r
oerzaia rev
-501
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Commonwealth of Massachusetts .
City of Salem
120 Washington St,3rd Floor Salem,MA 01.970(978)745-9595 x5841
Return card to Building Division.for Certificate.of Occupancy
FPermit N B-,5_76 PERMIT TO BUILD
EE PAID: $0.00
DATE ISSUED: /4 2 15
This certifies that CONCEPT SIGNS
has permission to erect, alter, or demolish a building . ,142-148 DERBY,STREET Map/Lot: 350367-0
as follows: Signs SIGN PERMITtAS"APPROVED'FOR: DERBY JOE
.. y
Contractor Name:
DBA: t
1,
Contractor License Na t
8/4/2015
Building Officiale Date
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official
may grant one or more extensions not to exceed six months each.upon written request. `.All work authorized b this permit shall conform to the approved a y pe pp application and the approved construction documents which this permit has been granted. `
All construction,alterations and changes of use of anybuilding end structures shall be in compliance with the local zoning by-laws and codes.
a
This permit shall be displayed in a location clearly visilife'from access street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. t _
The Certificate of Occupancy will not be issued until allf applicable.signatures by the Building and Fire Officials=a a provided on this permit.
HIC#: 'Persons contracting with unregistered contrwctore do not have access to the guaranty fund"(as set forth in MGL C.142A).
Restrictions: f
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.