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0094 WASHINGTON SQ EAST - BPA-06-362 Ck /o3y -V1.1M IftST-9E ffL4#ND Af4PAOVED BY T44E JdSPFCTDB PRIOR TD.A.PE 3W REINO GRANTED CITY OF SALEM No.-� ` Date 10.�31�5 Is Property Located In Location of tiw Historic District? Yes No 8aildiag Is Property Located in5f Bw Conservation Aral? Yes No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool, Repair/Replace, Other: S yLti+-,I t 1 Q K A• _ . Q:;:'n, PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name T 1 re 'akm � -' So CAZA—, a S alevr, Address & Phone q4 tt)a5k.� sa l=a (47F) WS -3Y08' Architect's Name Address & Phone ( ) Mechanics Nam! 6 or//n_ .•r r-- Address & Phone )/)� We }`^s� � ��y�o� '"fI Qt)-)— //)A Wtst is tiw purpose o1 building? '�5 tp , Material of bulldk>g? g a dwaking,for how many famines? WE building conform to law? y as Asbestos? D Estimated cosh/ S , 0 Gty License a N P' state Lcense N auraa Iaprovewomt Lic. d �S-ozgots X L,c� �o�Ss TSLD LI s c S 1OD"UNDER PENALTY OF . URY DESCRIPTION OF WORK \\TO BE DONE MAIL PERMIT TO: SO Z T- S ©S i v v 1 2\ Z1 l I I 0 No., l ZC�3 APPLICATION FOR 7� PERMIT TO LOCATION _ PERMIT GRANTED 7APP OV�D 71!Aic� INSPECTOR OF BUILDINGS i ACORDM CERTIFICATE OF LIABILITY INSURANCE r 08/29/2005 PRODUCER (978)977-4884 FAX (978)977-0850 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Elliot,` Whittier, Hardy & Roy ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Elliot Whittier Hardy & Roy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centennial Drive eabody, MA 01960-7931 INSURERS AFFORDING COVERAGE NAIL# INSURED Gordon Industries, Inc. Et Al INSURERA: The Hartford American Ramp Systems Inc. INSURERS: Safety Indemnity 33618 202 West First Street INSIRERc: National Union Insurance Co. South Boston, MA 02127 INSURERD. First Cardinal Corp. INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR DATE MM/DDIYY DATE MM/DDf/Y GENERAL LIABILITY 08CESOA4922 01/01/2005 01/01/2006 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES EaocICILNoen. $ 300,000 CLAIMS MADE OCCUR MED EXP(Any one Person) $ 10,000 A PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ 2,000,000 X POLICY JECT LOG AUTOMOBILE LIABILITY 1629436 11/28/2004 11/28/2005 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) Included GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY. AGG $ EXCESSIUMBRELLA LIABILITY BE3835213 11/28/2004 11/29/2005 EACH OCCURRENCE $ 1,000,000 X OCCUR ❑CLAIMS MADE AGGREGATE $ 1,000,000 C $ DEDUCTIBLE S X RETENTION $ 10,00 $ WORKERS COMPENSATION AND 02000SIO0009105 01/01/2005 01/01/2006 X rORVLJMITs ER EMPLOYERS'LIABILITY E L.EACH ACCIDENT $ SQQ,QQQ ,. D ANY PROPRIETORI R/E%ECUTIVE EXCLUDE[)? OFFICER/MEMBER EXCLUDED7 E.L.DISEASE-EA EMPLOYEE $ 500,000 If SPECIAL PRO yes,describePROVISIONS below E.L.DISEASE-POLICY LIMIT' $ 500,000 SE OTHER 1629436 11/28/2004 11/28/2005 SCHEDULED VEHICLES ONLY 011ision $500 81 omprehensive $SOO DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS ichienzi Construction is additional insured with regard to general liability as per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Michienzi Construction BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 11 Sixth Road OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Woburn, MA 01801 AUTHORIZED REPRESENTATIVE j / Steven Ro /CASEY -\A ACORD 25(2001108) FAX: (781)937-9507 ©ACORD CORPORATION 1988 Side View: AR4NP. , AMERICA'S LEADING RAMP 40" RISE / 38' RAMP Job Name: 1.05" RISE/ 'RAMP Knights of A 8 C o E Columbus / F 6 H Solem, L-6 L-6 L-34 L-44 L-54 I MA 550 7 BTP 6" 6" 39" lfl 4T f 57.5" 47. 54a 540 530 10-7-05 34" 33" 51PIS TOTAL 21° (� Location:5' -10'�-- 5' —��— 8' —+�— 8' 4' --�— 8' �— 8' —�— 4' AmRnmp C� Boston J r/ h � TO VIeW' �ELEV.=5 . ' Requested: -- %5 Jon G. 5x5 FULL RAILS Phone: Q 80TH SIDES B 800-649-5215 LEVEL 12, Fax: ELEV,,0 ix5 5x5 617-268-3701 48" J I H G F E D Gate: LEVEL 10-7-05 P• 3' 47'-10' 02127 NOTES Drawn By: SI � e � � 1. Pat 1 G�S ST Checked By: Sean Job Number: a 4 ` }4ry' ■iY � p 1 i r�y�_�` ' • Ali y � i RZ m :4, two "'+fv' ------------------- � ry x � r � k i \ i Y VIA AN ati J t 'v p. � f �u:. ♦ fp. � �t _.I 3 fT Aj y Y ., �:w l�f.