63 JEFFERSON AVE - BUILDING INSPECTION (10) �� gk9� ?4�� � �''�"� Permit Number/
f, APPL CATION 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:
Street Address 2oning District
? ❑Urban Renewal Area ❑Entrance Corridor
..f �Ei/r&,-fJh �v6pWt Z+ ,'71-1 ❑ Historic Distdd None,
INsD Rp r Mo L L c Use of Building
Telephone '—a ,41 — .-- 4 4- t' floor
. - s e>» . >1c. z,.fluor � Su-� e o2 203
Address 'J v_ rs n V e 3 floor
Telephone 9 �� iC/ - 9 4 floor
E-mail S a l 9 k How many businesses are in the building?
ff a corporate body, name � -
nf responsible officer
�W C,S 4`�aK Building �� ' linear feet
Construction Sup's License No Applicant's Space(if multi-tenant) linear feet
Address Property linear feet
Telephone Mail Sign Permit to
E-mailSign Owner o Sign Erector o Other:
Proposed sign 2 Sign S
M❑ ❑ Surface ❑ Surface
❑Right Angle to Building ❑ Right Angle to Building ❑ Right Angle to Building
Area Standing o Free Standing o Free Standing
❑Awning ❑Awning ❑Awning
❑Portable(A-Frame) ❑Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) ❑ Other(specify) ❑Other(specify)
Sign Mate Sign Materials Sign Materials
M ®lt h•�
Sign Dimensions/ x �„ Sign Dimensions Sign Dimensions
9
Sign Area Sign Area Sign Area
�a s ft s ft sq ft
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
1-7
Estimated Cost of Net Work
Existing Signs
-Type Sign Area To Be Removed? Sign Owner
❑Surface sq ft ❑yes ❑no
❑Right Angle to Building sq It ❑yes ❑no
�ree Standing sq ft ❑yes o no Sign Owner's Authorized epresentative
❑Awning sq ft o yes ❑no
❑ Other(specify) so ft ❑yes ❑no Pr e
Internal Review
Plari inlg Community De a opment Department Historical Commission
Approval
Buildino Innso ccttor