293 JEFFERSON AVE - BUILDING INSPECTION (2) Permit Number ... .-.
a
`c APPLICATION FOR PERMIT TO ERECT A SIGN
'R NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legible P
Salem, Massachusetts
To the Building Inspector. Date
The undersigned hereby applies for a permit to o Erect, o Alter, ❑Repair a sign on the fallowing described buildings:
• / o Urban Renewal Area ❑ Entrance Corridor
o Historic District o None
• Sil-ctv roe i s
Use of Building
Telephone 1 floor
2 floor
-- Address 3 floor
Telephone 4 Floor
E-mail How many businesses are in the building?
"of
rate body,name 1 '
s onsible olAcer C,0 gsSQ 0
Building linear feet
Construction Sup's License No Applicant's Space(if multi-tenant) linear feet
Address Property linear feet
Telephone
E-mail Mail Sign Permit to
❑Sign Owner o Sign tractor o Other.
St n 1 -- --
x urface Sign�Le SI n 3
Right Angle to Buildin ❑Surface
9 c ight Angle to Building ❑Right Angle to Building
ci Free Standing o Free Standing ❑Free Standing
a Awning ❑Awning g
a Portable(A-Frame) ❑Awning
( ) o Portable Frame)
�Other(specify) a Other(specify)
a Portable(A-Frame)fy) � ❑Other(specify)
Sign Materials Sign Materials Sign Materials
Sign Dimensions Sign Dimensions
(o � '� Sign Dimensions
Sign Area D-0 Sign Area Sign Area
e it �
Sign Height(if free standing) Sign Height(if free standing) it SignHeight(if free standing) aq ft
Estimated Cost of Net Work
Existing Signs
LAn
Sign Area To Be Removed? Si wrier
_sq ft oyes ❑no
• e to Building _sq ft ❑yes ❑no
• ding _,sq ft ❑yes ❑no g wner' A horized Re rase tative
_sq ft o yes n no
cify) _sq ft ❑yes ❑no —
Property
F=�144AA-d V 4 7
P rm Community D elopment Department Historical Commission
�I f
Building Inspector
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