62 JEFFERSON AVE - BUILDING INSPECTION (3) ,!• - 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 7
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:
Street Address Zoning District
JP nq9 ❑ Urban Renewal Area ❑ Entrance Corridor
P��ilSo ❑ Historic District None
Use of Building
• • /C AcG P c dLi
Telephone d' f— ,/off 1' Floor 1u// cJG 1-1C f/.ce-j�r
• go= /M 2n,floor
Address f/;`�'?SQL AJ 3` floor
Telephone 77Y7Y3a / 4 floor
E-mail c q 6 .�Cb/7 How many businesses are in the building?
If a corporate body, name Frontage
of responsible officer -
. i(- 6 O1usgP1)c7-,'-✓ Building 6a linear feet
Construction Sup's License No D Applicant's Space if multi- ant) linear feet
Address STdP.t/S 5 or� /Y Property linear feet
Telephone ��� ��� d yMail Sign Permit to
E-mail Sign Owner o Sign Erector o Other:
Proposed Signs(If more than three signs are proposed attach additional sheets)
Sign 1 Sign 2 Sign 3
❑ Surface ❑Surface ❑Surface
'Right Angle to Building ❑ Right Angle to Building ❑ Right Angle to Building
❑ Free Standing - ❑Free Standing ❑ Free Standing
❑Awning ❑Awning ❑Awning
o Other(specify) ❑Other(specify) ❑Other(specify)
Sign Materials Sign Materials Sign Materials
(.rl aeQ
Sign Dimensions Sign Dimensions Sign Dimensions
Sign Area Sign Area Sign Area
O s ft s ft s k
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work -
$ 0�66. -)
Existing Signs
Type Sign Area To Be Removed? Sign Owner
❑Surface sq ft ❑ yes ❑ no �s
c Right Angle to Building sq it ❑ yes ❑ no
❑ Free Standing sq it ❑yes ❑ no Sign Owner's Authorized Representative
❑Awning sq it ❑ yes ❑ no
Other(specify) sq ft ❑ yes ❑no
Property Owner
Internal Review
PlI
nning&Community Development Department Historical Commission
Approval
Building pector
' it/O1IOB rev