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230 ESSEX ST - BUILDING JACKET •�� Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED b' Location,Ownership and Detail Must be Correct,Complete,and Legible - - SALEM,MASSACHUSEITS TO THE BUILDING INSPECTOR- The undersigned hereby applies ..for a permit to-X_Erect_Alter, Repair a sign on the following described buildings: Location and No._ ap� �� 1L�r7'P/��7 Zoning/District 1`7 4 '\ Name of Property Ow 1ner) \,� Name of Sign Owner of r)0.'� \c Mrnkt l-l�C-K'K)) Address Z )111� tl�sfr �c J'I ��1nr� yIS�J If Owner is a corporate body,name of responsible officer 1`\`\M Fe-n I!n J Name of Licensed Sign Erector �� Salem License No. Address Use of Building: 1•1 Floor 3� Floor 2nd Floor ,1 5:.�...K.-\ 4m Floor Frontage: Building (D y �cn linear ft Property ) �. linear ft Type of Sign Proposed: ❑ Surface Right Angles to Building ❑ Free Standing ❑ Awning Other(specify)J J � \ckc J �-c ri n c �4 )Y ,in �--\ a f S Proposed Sign Materials V e_t,•S\J�v..�\ . r,3 C i I r Z I Proposed Sign Dimensions 'i b X 3 Sign Area 7, ' sq ft E:dsting Signs: Surface: Sign Area sq It Right Angles- Sign Area sq ft Free Standing: Sign Area sq ft Others Sign Area sq ft Signs to be Removed: Type jr'174 ' a ' sq ft Signature, Signat of Owner Signature of Owner's Authorized Repres uve Estimated Cost of Net Work $ �rlS �LI /d� Address c7 -� '\f, ,A, �\ �� Telephone Signature of Property Owner APPROVALS(Department Use Only): - r,44w PLANNING&COMMUNITY DEVELOPMENT HISTORICAL COMMISSION Bunoi INSPECTOR The Commonwealth of Massachusetts Department of Public Safety 'I Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling �(This>Section For,Officiiil.W6Only)y 6uildirigPermitNumber: .Date-Applied ButldingOffsrat `A` '"''' SECTION is LOCATION (Please indiic4e Block 7-.aand Lot li for locations for':which'a'street address is not available)- ' No.and Street.' City/Town Zip Code Name of Building(if applicable) SHCYION2-PROPOSED WORK r Edition of NIA State Code used_ If New Construction check here O or check all that apply in the two rows below Existing Building Pk Repair❑ Alteration Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 9 No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No .K Brief Description of Proposed Work: SECTION 3;COMPLETE THIS SECTION.IF EXISTING BUILDING.UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:.BUILDING.HEIGHT AND AREAI. - Existing Proposed No.of Floors/Stories(include basement levels)8r Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check ai a licable); - A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: Hi h Hazard H-1 O H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1 ❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-113 R-2❑ R-3❑ R-4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION.TYPE(Check as applicable). IA IS IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ I IV ❑ 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 if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ Private❑ or indentify Zone: or on site system❑ required O or trench or specify: permit is enclosed❑ - Railroad right-of-way: Hazards to Air Navigation: M:\Elisn>ric Connnissinn Review F'n,.css: Not Applicable❑ Is Structure within airport approach area? [s their review completed? or Consent to Build enclosed❑ Yes ❑ or No❑ Yes❑ No ❑ SECTIONS:CONTENT OF CERTIFICATE OF OCCUPANCY - - Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: SECTION_9: PROPERTY OWNER'AUT-FIOaIZAT(ON Name and Address of Property Owner G'a z j."eZeel rWa Name(Print) No.and Street City/Town Zip Property Owner Contact Information: �,p�-- �q 7� 1) r -Li1�E—l-asr.tX —-- Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable, the property owner hereby authorizes Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10 CONSTRUCTION CONTROL(Please fdl out Appendix 2) r ,. �- If build::{ is less tban 85,000 cb:�ft:of enclosed s ace•'and or not def ednstrucNoii;Control themdieek here't7and ski Secuon 10.1 ."- 10,:�:1 Registered Proofessiional Res onsible for Construction nhol !1r%!�(. G> +.�G/.�LAN .�/ 4 '.2 G'iSr!✓P�ccJ CG/(z'7iLv,i'_ 'Name(Registrant) / Telephone' o. e-mail address 4 ccY.t� Registration Number Ci JFSLwut,��a��'-c ` Al Street Address City/Town State Zip Discipline Expiration Date -10.2GeneralCo'ntractor- LW "'t C Company Name <� J Name of Person Responsible for //Constriction License No. and Type if Applicable ey i �d Street Address - City/Town State Zip Telephone No. business Telephone No. cell e-mail address SECTION 11:WORKERS'.COMPENSATION-INSURANCErAFFIDAVIT M.G'.L.c.152.. 25C 6 ' A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes❑ No ❑ SECTION-12 CONSTRUCTION:COSTS AND PERMIT FEE Estimated Costs:(Labor j Item and Materials) Total Construction Cost(from Ite ' _$ 1. Building $ Building Permit Fee=Total Construe ion Cost x_(Insert here 2. Electrical $ appropriate municipal fac or)_$ 3. Plumbing $ 4. Mechanical (HVAC) $ Note: Minimum fee=$ (contact municipality) 5. Mechanical Other $ Enclose check payable to 6.Total Cost $ p7..ro (contact municipality)and write check n mber here SECTION 13:SIGNATURE,OF BUILDING PERMIT APPLICANT Bentering , - y name below, Ih. - -. - . . . o . _. y enterin g m y hereby attest under the pains and penalties of perjury that all of the i o motion contained in this application is true and accurate to the est of my knowledge and understanding. �f �� c�22v Please print and sign name Title e eph ne No. Date ii' D�P Q c.,,.,._r7( li ��j Cam/ ' f> Street Address City/Town S to Municipal Inspector•.to fill out this section upon application approval: . Name.. Date • 4.�I r I `t rJ j I Permit Number. APPLICATION FOR PERMIT TO ERECT A SIGN . . 9 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: Da The undersigned hereby applies for a permit to Erect, ❑Alter, ❑Repair a sign on the following described buildings: • rban Renewal Area ❑Entrance Corrid( • ,,. • ❑Historic District ❑None K Telephone DU-P IGO U se of Building 1 floor Address R4floor floor Telephone oor -mail man businesses are in the building-, If a Of responsible body, name (WY y Of ras onsible officer - Sup's lie No Building line Applicant's Space(if multi-tenant) i�, lint Address Wra ( lint Property Telephone �o E-mail -il Sign Pennit to MAC 4 (yam_ Sign Owner o Sign Erector o Other: ❑Surface Si r2 _ Si n 3 Aight Angle to Buildingo Surface ❑Surface ❑Free Standing ❑Right Angle to Building o Right Angle to Building ❑Awning ❑Free Standing ❑Free Standing ❑Portable(A-Frame) o Awning ❑Awning ❑Other(specify) o Portable(A-Frame) ❑Portable(A-Frame) ❑Other(specify) ❑Other(specify) I Sign Materials -PVL Sign Materials Sign Materials Sign Dimensions i Sign Dimensions 7jp�• x 22 •5 �� Sign Dimensions Sign Area a Sign Area . � V ft Sign Area Sign Height(if a standing) s ft Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ �400 _ OU Type Sign Area To Be Removed? Sian natures ❑Surface n wn Sq ft ❑yes ❑no ❑Right Angle to Building sq ft a yes ❑no ti ❑Free Standing i ❑Awning sq It o yes ❑no Sign ner's Authoriz Representati ❑Other(specify) sq It ❑Yes ❑no sq ❑Yes ❑no .. Prope r f C - i - jI PizlhPidg&Comm evelopment Department Historical Commission i • Building Inspecto 082a