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13 VICTORY RD - BUILDING INSPECTION T1�1"7 IBE APPROVED BY T44E IW,EC=PpQA TDII.PEWfT BEND GRANTED CITY OF SALEM \ - is Pmpwry i_oeaw in Location of �3 U, ^5 /Y/ Ura Hidom District? yak— Do No iUUW , is Pmpwly Loaded in to CorwrNlipn MR? Yw_No x BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, Install Siding, Construct Dock. Shed, Pool, RpaidReplace. Other- PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS W PROCESSWG TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications:Owner's Name R O Le 4 5 VVJ Address & Phone 13 V\C,_6,� 2� 1 ?k) Architect's Name EaLd i Fe ,6 Jti Address & Phone ► N w p,„ S �� ,,�i s jg�a �� - ss�a Mechanics Name Address & Phone ( 1 ww is ttw purpm of fxtll&W Malow of trrWN? n a dwiilirq,for tow nwty fwniita? will tarA*v conform to law Atbwtos? ERf oo coat City Llowm r N A stag Llowisa r CS 0 3 2,).i6 � Now Lispra�sraaat AX ►_3 H 3 S,5 Signature of ApplicenK SKiNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE oj �GI (C n s Oe ( It1^ TGvc t'iJC/g I MAUL PERMIT TO• ki LT/L 1 5 Sr;, Ie"M , !�u Gt570 No. 3/-D� APPLICATION FOR PERMIT TO LOCATION > 3IIC �0.01, PERMIT GRANTED 2.0 APpr, INSPECTOR BUILDI/NGS ' 'q WARM TRADITIONS STO VE SHOPPE A Division of AQUA 17,RRA PROPERTY MANAGEMENT, INC. Contra_cl rc Licence # 032756 ��nrm� �� ✓ L'.d\ti tlyd A. Ferguson, Jr. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 032756 Birthdate: 10115/1954 Expires: 10/15/2005 Tr. no: 6732.0 Restricted: 00 EDWARD A FERGUSON i 15 PICKERING ST DANVERS, MA 01923 Administrator Hoare Inrprovenient Cautractoij License # 134399 Aqua Terra Property Management, Inc. Id\vard Ferguson _ �'� �nr++nro�ruieal!/ o�./�rmac/ru�aQ2 Board of Building Regulations and Standards - HOME IMPROVEMENT CONTRACTOR Reglatratlopi, 134399 Expiration 11/13t2005 '.Type:. PBvale Corporation AQUA TERRA PROPERTY MANAGEMENT,INC. EDWARD FERGUSON� -' 144 PINE ST. � DANVERS,MA 01923 Administrator 144 Pine Street, P. 0. Box 2081 Danvers, MA 01923 978-777-5562 1-800-286-5662 AC J?De CERTIFICATE OF LIABILITY INSURANCE 09/30/2 o) PRODUCER (978)887-4900 FAX (978)887-2404 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Edward F., Sennott Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16-South Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 457 Topsfield, MA 01983 INSURERS AFFORDING COVERAGE NAIC# INSURED Aqua Terra Property Management, Inc. INSURER& One Beacon Insurance Co. 20621 DBA Warm Traditions Stove Shoppe INSURERB: American Home Assurance Co. P 0 Box 2081 INSURER C Danvers, MA 01923 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSft %DD-L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONlia.Jim OMIDDMI LIMITS GENERAL LIABILITY FB1U11863 04/14/2005 04/14/2006 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 CLAIMS MADE O OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,006 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY FBXE50807 04/14/2005 04/14/2006 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ A X SCHEDULED AUTOS (Per person) 500,000 X HIRED AUTOS BODILY INJURY $ i X NON-OWNED AUTOS (Per accident) SOO,000 PROPERTY DAMAGE $ (Per accident) SOO,OO GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIO14 AND WC664-SS-9O 04/14/2005 04/14/2006 - WCSTATU- I OTH- — -- - - -. EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ SOD,OO B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ SOO,000 If yes,SPEC describe SPECIAL PROVISIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Mr & Mrs Robert Smith Jr BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 13 Victory Rd OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. Salem, MA 01970 AUTHORIZED REPRESENTATIVE Peter Sennott/LA ACORD 25(2001108) ©ACORD CORPORATION 1988