322 DERBY ST - BUILDING PERMIT APP - ROUGE JACKET GITY-OF j�Tm
P PUBLIC PROPERTY
DEPARTMF.1�iT
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t30Wtiywa=Ms'W= &erg.M&%ACM5k1-M01970
nL'M74i9S"•FAX 97L710.9W
APPLICATION FOR TM REPAIR. REN()%& N Q0NSTRUCTION
DEMOLITION. OR CAANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCT 1 OR BUILDI W
1.0 SITE INFORMATION "
Location Naar: C,05-lyETi'65' An n?we- Building DE✓Gr3 Go�Ts
- Property Address:- -
322 PeXgy 17:
Property is Ioca d in a;Conservation Arse Y/N Historic District YIN
[Addrew
.0 OWNERSHIP INFORMATION
.1 Owner of Land
ame: 6CwGEvRS /h/Xelephone: 79'/ _71br_ lY63
PLEETE THIS SECTION FOR WORK IN EXIATING BUILDINGS ONLY
Existing Z
11CAto0E2 r/ Number of Stories Renovated
se New o
Existing �'po
year of Area per floor (sf) Renovated ��sructonor renovation ?iooz-
of existing building New O
9uef Description of Proposed Work:
f 00 Sf /"�//7!G S,O.gz%tr (jviGpovT
— - Mail Permit to: - -
What is the Current use of the Buildin97
Material of Bu'dding7
CA .� r L If dwelling.how many units?
'MI the Building Conform to law?�v Asbestos?
Amhiteas Name
Address and Phone /(C MASS
gy
Medwids Name o y AYcf f�✓.r/7ys�Tl nth' 7?/ SyS 2760
.� !yy SfCTs
Address and Phone 6o�fl� HIC Registratwn ft LIXL2- —
Construdion Supervisors License
Estimated Cost of Protect S 20 00a• Permit Fee Cakulsdon
Estimated Cost X$71$1000 Residential
Putt Fee iy�,-
. _ Estimated cost i111S10oo Commercial— _ _.__
An Additional$5.90 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in Processing.
The undersigned does hereby apply for a Building permit to build to/the above stated
speci}fcatkms. Signed ned under penalty of perjury /� c
Date
N
Q6
O r
E•- .�� a y � a 3
- a-
owls APPLICATION FOR PERMIT TO ERECT A SIGN R C a`1
NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED FEB � � Znt Z
j., ft Location, Ownership and Detail Must Be Correct, Complete, and Legible l❑ U
Salem, Massachus OF PLANNIPSG "u
Ciyme COMMUNITY DCVELZ&MENT
To the Building Inspector: �
The undersigned hereby applies for a permit to 0 arect, ❑Alter, a Repair a sign on the following described buildings:
' '1 KINL 'lJ n-Urban Renewal Area ❑ Entrance Corridor
"istoric District ❑ None
'Use of Building
• \,
Telephone
1 floor
_ C \i 4
2 floor
Address
Telephone y b C\ 4 floor
E-mail � �� c ) l •.Jc C o'er
How many businesses are in the building?
Frontage
If a corporate body, name r.. vim`
of responsible officer J Building linear feet
• Q " (� Applicant's Space(if multi-tenant) linear feet
Construction Sup's License No linear feet
Property
Address
Mail Sign Permit to
Telephone
ign Owner ❑Sign Erector ❑ Other:
E-mail
• • •• •• • - j= Sign 3
SI n 1 Sign 2
❑Surface ❑ Surface
❑ Surface ❑ Right Angle to Building ❑ Right Angle to Building
❑ Right Angle to Building g ❑ Free Standing
❑ Free Standing ❑ Free Standing ❑Awning
❑ W ning °_Ay aII
g ❑ Portable(A-Frame)
rdPortable(A-Frame) o ther(s ec Frame) ❑Other(specify)
❑Other(specify) ❑Other(specify)
Sign Materials C L
Sign Materials Sign Materials
� Sign Dimensions
Sin Dimensions r r1 Sign Dimensions
g �x Sign Area Sign Area sg It
Sign Area (� s ft _ .__sq ft 7-
Sign Height(if free standing) -�i I
Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ n es
Type Sign Area To Be Removed? Sign Owner
❑ Surface sq ft ❑yes ❑no
sq ft °yes o no
❑no Sign Owner's Authorized Representative
❑ Right Angle to Building sq ft
° Free Standing sq it ❑yes ❑no
❑Awning sq ft ❑yes °no Owner
❑Other(specify) Property
-• 1 J-lnn- �"�`'� Historical Commission
PI416&Community Development Department
Y7U✓
Building Inspector oaznr+o+.•
Permit Number
r
APPLICATION FOR PERMIT TO ERECT A SIGN
40, „,RECEIVED
PERMIT MUST BE OBTAINED BEFORE SIGN IS FABRICATED AND INST JUL 1 6 2007
Location.Ownership and Detail Must be Correct,Complete,and Legible
DEPT.OF PLANNING S
COMMUNITY DEVELOPMENT
City of SAI Fat,MAMCMAETTS
TO THE BUILDING INSPECTOR / Aber Repair a�m the fo��described buildings:
The undersigned hereby applies for
a Pccm\it to—5—/ Eteet -- n
Location and No. ZZ , 1 �J Znig/DkuictV(\QCRv� ma'soL»RX r
f1lS 2- CS L
Name of Property Owner
to Q, 1.5 Brc o �i.i.r /h){_. c7�lX¢.t✓`� IT
Name of sign ownerO o t-In ^ � Address w
If Owner is a corporate body.Home of responsible officer
ns-
Name of Licensed Sign Erecmc
Salem License No.
Address "• ° —
3''Floor C+ri J,O
Use of Building. Y Floor .On O C
you Floor CiM cC _ 4a Floor
Frontage,. Building
A IN S-0 linear h Property c'-i1 p✓U linear it
Type of Sign Proposed Surfsee ❑ Right Angles to Building ❑ Free Standing ❑ Awning
❑ Orher(specit4)
proposed Sign Materials
Sign Area 3 aq ft Jj
Proposed Sign Dimension
s ft
'! Existingsigns: Surface: Sign Area q D t-
Right Ane�les: 1 �e tan Sign Area �1 'I sq h L�
Free Standing: �i Sign Area aq h
Other. Sign Area sq h
Signs to be Removed: Type Sign Area ` y sq h
Signature of Owner c'� A^ `�"—
Signature of Owner's Authorized Representative
Estimated Cost of Net Work �y pt> —14 yAA A- of O-7
Address (as C�OV C Q Sic Ir �Q✓ 0. Y 1
coo - —t
3 Telephone
Signature of Property Owner
APPROVALS(Detai ment Use Only):
V Y HISTORICAL COutanssION D� ING INSPECTOR
G&COtgtuNm DEvsI.OPiNENT
I
V
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