8 GIFFORD COURT - BUILDING INSPECTION 8 Gifford Court
200786 NGM Insurance Company MASSACHUSETTS
P 0 Box 2004 NOTICE OF CANCELLATION
Keene NH 03431
AGENT : 200786 STATE : 20
AGENT PHONE : 617 354 4640
PLEASE READ CAREFULLY
POLICY NUMBER POLICY TYPE CANCELLATION/NON-RENEWAL EFFECTIVE TOTAL DUE I MIN . DUE
NO DAY YR
S 830445 SURETY 11/07/15 12 : 01 A. M. 5125 . 00 5125 . 00
DATE OF MAILING : 10/05/15 ANY EXCESS PREMIUM (IF NOT TENDERED) WILL BE REFUNDED ON DEMAND
G 101 341 341 F/CM
OBLIGEE PRINCIPAL
CITY OF SALEM ROBINN,, O ' NEIL
BUILDING DEPT 8 GI ORD COURT
120 WASHINGTON ST, 3RD FL SALEM, MA 01970
SALEM, MA 01970
***IMPORTANT INFORMATION REGARDING YOUR BOND***
DEAR BONDHOLDER : YOUR BUSINESS IS IMPORTANT TO US !
HOWEVER , OUR RECORDS INDICATE THAT WE HAVE NOT RECEIVED YOUR PAYMENT
DUE 09/23/15 . IF WE DO NOT RECEIVE PAYMENT,YOUR BOND WILL BE
CANCELLED, ACCORDING TO BOND PROVISIONS , AS OF THE EFFECTIVE DATE
AND TIME SHOWN ON THIS NOTICE.
TO PREVENT THIS FROM HAPPENING, PLEASE FORWARD THE AMOUNT DUE SHOWN
ABOVE WITHOUT DELAY. THIS AMOUNT INCLUDES APPLICABLE SERVICE FEES .
THIS WILL BRING YOUR ACCOUNT UP TO DATE . AS LONG AS YOUR PAYMENT
IS RECEIVED BEFORE THE CANCELLATION/NON-RENEWAL EFFECTIVE DATE AND
TIME SHOWN ON THIS NOTICE, YOUR COVERAGE WILL CONTINUE WITHOUT
INTERRUPTION .
A REINSTATEMENT NOTICE WILL BE SENT TO YOU WHEN WE RECEIVE YOUR
PAYMENT . REINSTATEMENTS ARE CONDITIONAL UPON BANK ACCEPTANCE OF
PAYMENTS .BY CHECK .
WE HOPE THIS REMINDER WILL PREVENT A LAPSE IN YOUR COVERAGE . WE
VALUE OUR RELATIONSHIP WITH YOU . IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT YOUR AGENT AS SOON AS POSSIBLE .
TYPE OF BOND:
STREET/HIGHWAY PERMIT
IMPORTANT: STATE REGULATIONS, IF ANY APPLY, ARE ON REVERSE SIDE
60-7622 n0/92; ,��, , OBLIGEE COPY
STATE REGULATIONS
A. INFORMATION FOR MOTOR VEHICLE REGISTRANTS CONCERNING INSURANCE OTHER THAN NON-RENEWAL
Cancellation of the insurance means that the Registrar of Motor Vehicles must, on the
effective date of the cancellation indicated, revoke the registration certificate and
license plates unless -- _ R _ _
1. You receive a reinstatement of. insurance from the same company that has sent you.
this cancellation notice; or-- _
2. You file an entirely new registration application with the certificate` of_
Statutory Insurance properly filled out by some other approved insurance company.
If you elect to secure insurance in a newcompany, such new registration
application must reach the Registrar's office at least two days prior
to the effective date of cancellation, or--
3. You file acomplaint, in writing, at the Board of Appeal on Motor Vehicle
Liability Policies and Bonds, One South Station, Boston 02210, on a form
prescribed and furnished by the Commissioner of Insurance, before the effective
date of cancellation, which entitles you to a hearing before the Board.
Unless you take one of the three courses indicated above, your registration will be
revoked on the effective date of cancellation indicated in this notice and you will be
required to return your certificate of registration and license plates to the Registrar.
B. RIGHT OF APPEAL AFTER CANCELLATION AND REVOCATION
If you have failed to take appropriate action as above indicated under Items 1, 2, or 3,
before the effective date of cancellation, you still have a right to file a written
complaint at the Board of Appeal on Motor Vehicle Liability Policies and Bonds,
One South Station, Boston 02210, on a form prescribed and furnished by the Commissioner of
Insurance, within ten days after the effective date of cancellation of your policy and
recovation of your plates. .
The filing of such a complaint shall not affect the operation of the cancellation or
revocation and your license plates should not be used on or after the effective date of
cancellation but should be returned to an office of the Registry of Motor Vehicles at
once. If a finding is made in your favor the insurance will be reinstated, the registrar
will be notified and license plates and a certificate„of registration, wi_11 again be
issued to -you. '
ZI
C. INFORMATION FOR MOTOR VEHICLE REGISTRANTS CONCERNING INSURANCE FOR NON-RENEWAL
You are required to have compulsory insurance in order to maintain the registration
of your auto. Because we are not renewing your policy, you must arrange to replace your
insurance with another company as soon as possible. A new certificate of insurance must
be filed with the Registry of Motor Vehicles before your present policy expires. If you
are not able to obtain coverage voluntarily from another insurer, you may apply to the
- Massachusetts Automoblie Insurance Plan through any Massachusetts licensed insurance
producer and Commonwealth Automobile Reinsurers.
This notice shall not be deemed a refusal, under section 113D of chapter 175 of the
General Law of Massachusetts, to issue a motor vehicle liability policy or bond.
If you purchase a new policy, your new insurance company must offer to sell you optional
insurance coverages. -Companies may refuse Collision and- Comprehensive coverages under
certain circumstances. All optional coverages are subject to certain deductibles and
limits specified in Massachusetts law.
To Agents and Brokers
If this notice is sent to any agent or broker, the agent or broker must forward it to
the insured within fifteen days of its receipt, unless another company has executed a
new certificate of insurance. Failure to do so may result in revocation of your insurance
agent's or broker's license.
D. SPECIAL NOTICE - PROPERTY INSURANCE
Should you experience difficulty in obtaining fire insurance for your property, You
should contact your local agent or broker for full particulars concerning your possible
eligibility for insurance through the Insurance Placement Facility, Underwriter's
Association or Reinsurance Association (FAIR Plan) of your state.
When you provide a check as payment, you authorize us either to use information from your check to make a one-time
electronic fund transfer from your account or to process the payment as a check transaction. When we use information
from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same
day we receive your payment, and you will not receive your check back from your financial institution.
�p r
CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
w/ 120 WASHINGTON STREET,3� FLOOR
a�d TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS STTIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
April 7, 2015
Assessors Dept
City of Salem
93 Washington Street
Salem Ma. 01970
Re: 8 Gifford Court
Dear Assessor,
This Department has reviewed this Departments records and in my opinion,8 Gifford Court is a legal.
Grandfathered,non-conforming two unit property located in a R-2 District.
This letter is for zoning purposes only and does not imply conformance or non-conformance with any
applicable codes.
Thomas St.Pierre / �p
Building Commissioner/Zoning Officer
Plans must be filed and approved by the Inspector before a permit will be granted.
No. J31/-10y City of Salem Ward C a
IS PROPERTY LOCATED IN THE
HISTORIC DISTRICT? Yes ✓No a
IF SIDING, HAS ELECTRICAL '+tccd3
PERMIT BEEN OBTAINED? Yes_No Home Phone # -?4 -(Q 175
APPLICATION Bus. Phone #
PERMIT TO RO F, RER R INSTALL SIDING
Salem,Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned herebv applies for a permit to build accordin to the f)/��y1lowing specifications:
Owner's name and address
Architect's name
Mechanic's name and address
Location of building,No. F5 CM I P'FO Rb h mt J P-T'
What is the purpose of building?
Material of building? 1;h5E Asbestos? 'tJo
If a dwelling,for how many families'-
Will
amilies°_Will the building confonn to the requirements of the la%? ��FS —
Estimwed cost Contractors Lic o
Signature of applicant
ARKS SIGNED UNDER THE
Q� PENALTY OF PERJURY.
60
o
No, /—/ Ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location g 6" FLor(,f C7—
PERMIT GRANTED
rIvolby 19q/
Approved
!(j c Q( ufl, ng Inspe or
44 A�
�o 'STREET PERMIT
(Citp of 6aiem
Office of Nsvecfor of Ouilbinso
�i f . {all 20 1 7
Armissibn is liere6y9ioen to t h�D L/I
10 Occupypurposes
In fi+onl of estate J. �.i///Ly iri r Zoll
of uo�ema� of street. -
`.Isis permil is lmiledlo 1 20 sub ecllo IFie
proomions of l e oronances andslalules m relation to cSlreels andI e.9nspeclion
and Gonslruclibn of.Turldinys in 16e Gity of cSalem. .3
Direr/w ol'R6!rc cSalvicw n `" 9`upech��',2fui/dmga '
J` V �
To: Page 2 of 3 2014-09-22 08:53:26 EST 16175880432 From: Cristina Medeiros
LICENSE OR PERMIT BOND
BOND NO. S-830445
KNOW ALL MEN BY THESE PRESENTS THAT WE,
Robin O'Neil
of
8 Gifford Court Salem MA 01970 as Principal, and
NGM Insurance Company a Florida corporation with its principal
office at 4601 Touchton Rd East Ste 3400 Jacksonville, FL 32245-6000 as Surety,
are held and firmly bound unto
City of Salem
in the sum of Five Thousand and 00/100 Dollars
($ 5,000,00 ), for the payment of which sum, well and truly to be made, we bind ourselves, our
personal representatives, successors and assigns,jointly and severally,firmly by these presents.
The condition of this obligation is such, that whereas the Principal has obtained, or shall obtain, a license or permit from
the Obligee for
Street opening bond for dumpster use
at 8 Gifford Court Salem MA 01970 for the term commencing on the 22nd day of
September , 2014 and ending on the 22nd day of September 2015
NOW, THEREFORE, if Principal shall faithfully observe and comply with all terms of the underlying license or permit,
and all Ordinances, Rules and Regulations, and any Amendments thereto, applicable to the obligation of this bond, then
this obligation shall become void and of no effect, otherwise to be and remain in full force and virtue.
The Surety may, if it shall so elect, cancel this bond by giving thirty (30) days written notice to the Obligee and the bond
shall be deemed canceled at the expiration of said period; the Surety remaining liable, however subject to all the terms,
conditions and provisions of this bond, for any act or acts covered which may have been committed by the Principal up to
the date of such cancellation.
PROVIDED, HOWEVER, that this bond may be continued from year to year by certificate executed by the Surety hereon.
Regardless of the number of years or terms this bond remains in effect, and regardless of the number and amount of
claims that may be made,the maximum aggregate liability of the Surety is limited to the penal sum of the bond.
SIGNED, SEALED AND DATED on this. 22nd day of September 2014
Robin O'Neil
By
NGM Inssuurrahnce Company
By I Y/
Attorney-in-Fact
Annie Lukas
68-QQ-0002a-05
To: Page 3 of 3 2014-09-22 08:53:26 EST 16175880432 From: Cristina Medeiros
®NGM INSURANCE COMPANY POWER OF ATTORNEY
a.re of en 'swwnm mea P S-830445
KNOW ALL MEN BY THESE PRESENTS:That die NGM Insurance Company,a Florida corporation having its principal office
in the City of Jacksonville,State of Florida,pursuant to Article IV,Section 2 of the By-Laws of said Company,to wit
"SECTION 2.The board of directors,the president,any vice president,secretary,or the treasurer shall have the power
and authority to appoint attorneys-in-fact and to authorize them to execute on behalf of the company and affix the seal
of the company thereto,bonds,recognizances,contracts of indemnity or writings obligatory in the nature of a bond,
recognizance or conditional undertaking and to remove any such attorneys-in-fact at any time and revoke the power
and authority given to them."
does hereby make,constitute and appoint Annie Lukas its true and lawful Attorney-in-fad,to make,
execute,seal and deliver for and on its behalf,and as its act and deed bond number S-830445 dated September 22,2014 ,
on behalf of * Robin O'Nell•"^
in favor of City of Salem
for Five Thousand and 001100 Dollars($5,000.00 )
and to bind NGM Insurance Company thereby as fully and to the same extent as if such instrument was signed by the duly authorized
officers of the NGM Insurance Company;this act of said Attorney is hereby ratified and confirmed.
This power of attorney is signed and sealed by facsimile under and by the authority of the following resolution adopted by the Directors
of NGM Insurance Company at a meeting duly called and held on the 2nd day of December 1977.
Voted:That the signature of any officer authorized by the By-Laws and the company seal may be affixed by facsimile to any
power of attorney or special power of attorney or certification of either given for the execution of any bond,undertaking,
recognizance or other written obligation in the nature thereof; such signature and seal,when so used being hereby adopted
by the company as the original signature of such officer and the original seat of the company,to be valid and binding upon
the company with the same force and effect as though manually affixed.
IN WITNESS WHEREOF,NGM Insurance Company has caused these presents to be signed by its Assistant Vice President,
General Counsel and Secretary and its corporate seal to be hereto affixed this 20th day of March,2013
NGM INSURANCE COMPANY By:
Bruce R Fox
Vice President,General Counsel and Secretary
State of Florida,
County of Duval
On this 20th day of March, 2013. before the subscriber a Notary Public of State of Florida in and for the County of Duval duly
commissioned and qualified,came Bruce Pox of the NGM Laurance Company,to me personally known to be the officer described
herein,and who executed the preceding instrument,and he acknowledged the execution of same,and being by me fully sworn,deposed
and said that he is an officer of said Company,aforesaid:that the seat affixed to the preceding instrument is the corporate seal of said
Company,and the said corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority
and direction of the said Company;that Article IV,Section 2 of the By-Laws of said Company is now in force.
1N WITNESS WHEREOF, I have hereunto set my hand and affixed by official seal at Jacksonville,Florida this 20th day of March,2013
t
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1,Brian J Beggs,Vice President of the NGM Insurance Company,do hereby certify that the above and foregoing is a true and correct
copy of a Power of Attorney executed by said Company which is still in force and effect. IN WITNESS WHEREOF,I have hereunto
set my hand and affixed the seal of said Company at Jacksonville,Florida this 22 d'a'y'off September 2014 ,ry
WARNING: Any unauthorized reproduction or alteration of this document is prohibited.
TO CONFIRM VALIDITY of the attached bond please call 1-603-358-1343.
TO SUBMIT A CLAIM: Send all correspondence to 55 West Street, Keene,NH 03431 Attn: Bond Claim Dept.
or call our Bond Claim Dept.at 1-603-358-1229.