12 HAWTHORNE BLVD - BUILDING INSPECTION (5) Salem, Massachusetts��_
To the Building Inspector: Date
The undersigned hereby applies for a permit to o�rect, ❑Alter, ❑ Repair a sign on the following described buildings:
R
-FwMan Renewal Area
13 ❑His nc i °Entrance Corridor
.. J e
Telephone '
• 1' floor Tr t p
Address S oor
Telephone fl or S�-- Sf'O q5
E-mail
"• 4 floor e'�J
ff a corporate body, name, now many businesses are in the building? l
ofres onsibfeo/ficer `w J
Construction Sup's License No Building
3 linearfeei
Address VVVLSO-71 Applicanfs Space(if ulti-tenant) 2 linear feel
Telephone ,a d r a YI 9 Property linear feel
Mail Sign Permit to
E-mail
/gf) ign Owner °Sign Erector °Other:
SI n f . .. • -
urface Si n 2 Si n 3
❑Right Angle to Building " ❑Surface
°Right Angle to Building °Surface
° Fiee Standing o Free Standing °Right Angle to Building
❑Awning ❑Awning ❑Free Standing
❑Portable(A-Frame) ❑Awning -❑Other(specify) ❑Portable(A-Frame)
----. ° Other(specify) °Portable(A-Frame)'
a Other(specify)
Sign Materials --
Sign Materials Sign Materials
Sign Dimensions Sign Dimensions
Sign Dimensions
Sign Area
( � 2O r Sign Area Sign Area
Sign Height(if free standing) s its ft
Sign Height(if free stanoing) Sign Height(if free standing) s IIIEstimated Cost pf Net Work
$ <:,, �s �9,4-5 yet ►s t m K !o wl�
Type Signature
es
Sign Area To Be Removed?�y5urface YOh Si 0 r
° Right Angle�o Buildi sq ft Lojy
no r
❑Free Standing «--sq ft no
❑Awning sq ft no Sign 0 n Authorized Re s tative
❑ Other(specify) sq ftno
r , e
'II -----— sq ftno --- n
SIC(y1 �t a Property 0 ner
Wl�N1C3 N 5 J(R d SOC .
ning&Community Developmenf:0el Intent
HistoncaPCommission
7m"
Building Inspector �
oazanore�
V t�