BODY EMPOWERED WELLNESS 281 ESSEX STREET UNIT C3�
BODY EMPOWERED
WELLNESS
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275-281 ESSEX STREET 582-09
COMMONWEALTH OF MASSACHUSETTS
CITY OF SALEM
GIS #: X315
Map: 26
Lot: SIGN PERMIT
Lot: 10447 ----- �
Pen-nit: !Sign
Category: (SIGN
Perm t# 582-09 PERMISSION IS HEREBY GRANTED TO:
'Project# JS-2009-001092
Est. Cost. 1$2,910.50 Contractor: License: Expires
,Fee Charged-.1$0.00METRO SIGN&AWNINGS
Balance Due:$.00 Owner: JEFF HOLLORAN
#of Fixtures Applicant: METRO SIGN&AWNINGS
DigSafe# _ JAT: 275-281 ESSEX STREET
UseGroup
ConstClass 1
ISSUED ON: 27-Feb-2009 AMENDED ON. EXPIRES ON. 27-Jul-2009
TO PERFORM THE FOLLOWING WORK.
SIGN PERMIT AS APPROVED FOR DEBORAH ARTHUR UNIT#3 (BODY EMPOWERED WELLNESS)
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF
ITS RULES AND REGULATIONS.
Signature
Fee Type: Receipt No: Date Paid: Check No: Amount:
SIGN REC-2009-001256 27-Feb-09 x - 50.00
GeuT..NISO 2009 Des Lau rices slunicipal Solutions.Inc.
Permit Number0�
APPLICATION FOR PERMIT TO ERECT A SI � e e
-:� t. a
PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED JAN 2 2 2009
Location,Ownership and Detail Must be Correct,Complete,and Legible
DEPT. Or FLF WNG&
CODA MITV O-VEWIDv€K
SALEM,MASSACHUSETTS
TO THE BUILDING INSPECTOR:
The undersigned hereby applies for a permit to ✓ Erect Alter, Repair a sign on the following described buildings:
Location and No. @yaes
I Iz ax �: UVM+ C 3 Zoning/District
Name of Property Owner\T'Q 1�1OI(r)ra V\
Name of Sign Owner &1 l� Jr Address�yL.r'CyL.rTC �jC (ST. j 1T L��
If Owner is a corporate body,name of responsible officer
Name of Licensed Sigh Erector ��yyU����v���I k.D Salem License No.
Address 190 L.D ruo'.. J k ¢T' / �7piG/K /C ,t4 614'94
.
Use of Building: I-Floor I 3b Floor
2^d Floor 4's Floor
Frontage: Building linear ft Property linear ft
Type of Sign Proposed: ❑ Surface Right Angles to Building E] Free Standing ❑ Awning
'Other(specify) &L19 r e /Y I T'
Proposed Sign Materials
Proposed Sign Dimensions Sign Area sq ft
Existing Signs: H/x Surface: Sign Area sq ft
Right Angles: Sign Area sq ft
Free Standing: Sign Area sq ft
Other: Sign Area _sq ft
Signs to be Removed: 1�Type ign Area sq ft
��rt Signature of OwneY°'�
Signature of Owner's Authorized Representative
Estimated Cost of Net Work
Address
$ Telephone
Signature of Property Owner
APPROVALS(Department Use Only):
L
PG&COMMUNITY DEVELOPMENT HISTORICAL COMMISSION BUI ING INSPECTOR
City of Salem Sign Permit Application Worksheet
1-Oct-08
Body Empowered Wellness
281 Essex Street, Unit 3
Zoning (res/non-res) 65
Entrance Corridor(YIN) no
Lot frontage 18 feet
Building frontage 18
#of businesses on site 1
Bldng dist from street center 20
Multiplier 1
Buifdir"
maximum area permitted 18.00 sq ft
i
total proposed sign area 12.25 sq ft
sign 1
length 42.00 inches
height 42.00 inches
sign 2
length 0.00 inches
height 0.00 inches
sign 3
length inches
height inches
Frees 4"! 11l f�7.n f a 6t{'191". . : r_
maximum area permitted 0.00 sq ft (per side)
maximum #of signs permitted 0 signs
maximum height permitted 0.00 ft tall
sign 1
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height 0.00 ft
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height 0.00 ft
Application meets guidelines set
forth in the Salem Sign Ordinance yes
Recommend approval yes
t
These drawings illustrate a proposed sign on an existing building.
BODY EMPOWERED WELLNESS
Sign attributes are as follows: i IBM
- 3/4" PVC laminated with digital print SIGN PROJECT
- Steel bars and cast iron scroll
- Vinyl Letters and Logo applied to inside of glass SALEM, MA
October 10, 2008
DRAWING LIST
ARCHITECTURAL y
T-1 Title Sheet y ?'
A-1 Sign Elevation
A-2 Storefront Door Elevation, Rendering, Colors _
mom
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ARCHITECT Owner .a
Gienapp Design Deb Arthur, MS, DPE O
_ $`
Associates, LLC M
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- 89 Nebwary
Street
Body Empowered Wellness,Inc. r '
Danvero.MA 01923 281 Essex Street,Unit C3 i
'
i Tel: 978-750-9062 Salem,MA 01970 ,
Fex: 978-750-9
mi063 978-290-8929 T.
edn�gienapptlesign.com
3/16' STEEL PLATE AND Gienapp Design
BRACKET MOUNT, PAINTED Associates, LLC
' CAST IRON SCROLL 8��
(KING METALS 3/8" ANCHOR BOLT IN LEAD SHIELD, TTP.
#12-33012-138)
STEEL TUBE WELDED TO
(WWW.KINGMETAL$.GOM) ____ oa ersNewbury W 01923
MOUNTING PLATE, PAINTED 1 Tel 978 750 9062
Fax 978 750 9D63
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1 41.011
411
SIGN SPECIFICATIONS m01 1
3/4" PVC BOARD WITH DIGITAL PRINT.
DIGITAL PRINT IS 120DPI DIGITAL 3M VINYL PRINT WITH OVER-LAMINATE FOR "
PROTECTION. COLORS ARE BY BENJAMIN MOORE UNLESS OTHERWISE NOTED. nSign Elevation
1It
COMPANY LOGO DESIGN AND GRAPHICS TO BE PROVIDED BY OWNER. ELECTRONIC Project: 395,13
VERSION OF SIGN DESIGN WILL BE MADE AVAILABLE TO WINNING BIDDER. WINNING Drawn by: AM
BIDDER SHALL SUBMIT TO THE ARCHITECT A 12" X 12" SAMPLE OF PVC BOARD WITH Check by: DG
DIGITAL PRINT SHOWING COMPLETE COLOR SAMPLING (LIGHT AND DARK LEAVES, Date: October 10,200e
NOTE& Scale: t"= 1'-0"
GOLD LOGO, BLACK LETTERS ON GRADIENT BACKGROUND) FOR APPROVAL PRIOR
TO SIGN FABRICATION. I. CONFIRM SIGN LAYOUT WITH OWNER PRIOR TO FABRICATION. Sign ElevationBORDER 3" TALL STROKE (LOGO d LARGE LETTERS) 2 SIGNS TO BE SECURED DIRECTLY TO SIGN BAND WITH 9
LARGE LETTERS ('B' AND "E') 8" 4010021 BLACK BY ONE SHOT, LLG FASTENERS COUNTERSUNK AND SEALED.
3. DIGITAL PRINT TO WRAP EDGE OF PVC BOARD.
SMALL LETTERS ('W') : 2° DARK LEAVES COLOR: 4. DIGITAL PRINTS ARE 12ODPI DIGITAL 3M VINYL PRINT WITH
BORDER COLOR 2154-20 SPICY MUSTARD OVER-LAMINATE FOR PROTECTION.
2154-20 SPICY MUSTARD LIGHT LEAVES COLOR
5. SUBMIT SHOP DRAWINGS STEEL BAR SIGN FRAME TO
LARGE LETTERS COLOR HC-31 WATERBURY CREAM
ARCHITECT FOR APPROVAL
Ieul GOLD BY ONE SHOT, LLC BACKGROUND COLOR LINEAR
b. SUBMIT SHOP DRAWING OF VINYL LOGO AND LETTERING FOR _I
SMALL LETTERS COLOR GRADIENT "SPICY MUSTARD" TO DOOR TO ARCHITECT FOR APPROVAL
4010021 BLACK BY ONE SHOT, LLC WHITE.
LOGO IOS-L GOLD BY ONE SHOT, Ll STEEL BARS: BLACK
EXISTING WALL NEW BLADE SIGN
Gienapp Design
— - MOUNTED LIGHT sassQciates, LLC
FIXTURE TO REMAIN
- 69,,eStreet
DT978 750 9062
s,MA 01923ex 978 750 9063
�i
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ody o- } li _ - -� �— -.
mpowere -
We llness U)
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A Perso CPitness&I weCCness Studio m " ` . ' .: z "ALU
.bod emgmeredweCCness.com �- - VINYL LOGO a LETTERING
w
y d LETTERING SIZE: 1 1/4"
97 -290-8929 z
J -
FONT APPLE CHANCERY J
COLOR: WHITE J
W
Door Elevation Detail - Wl;�d
r. W
LLJ
/Y O Q
_ LL
.......—L. r _a..—A..— W LL Q
TV BOLT THROUGH STEEL
FRAME AND INTO U -
SUPPORTING ANGLE O �
EXISTING WALL MOUNTED VINYL LOGO 8 LETTERING W
STEEL TUBEM JUGHT FIXTURE TO REMAIN SIGNAGE APPLIED ON INTERIOR
THREADED HOLE OF GLASS ON EXISTING
STEEL ANGLE
nMounting Location and Door Elevation STOREFRONT DOOR LJJ
� 1/4" = 1- 9 Q
COUNTERSUNK
SCREWS 9" O.C. O
i
DIGITAL PRINT
3/4" PVC BOARD c:
4010021 BLACK
i x .
2514-20 SPICY MUSTARD SMALL TEXT, STROKE, STEEL
BORDER, DARK LEAVES BARS, SCROLL
Mounting Detail
��G �` ' wF Project: 395.13
Drawn by: AM
Check by: DG
' rsx s3 HG-31 CANTERBURY CREAM 109-L GOLD Date: October 10,2008
f LIGHT LEAVES LOGO, LARGE LETTERS
Scale: As Noted
u 3mHfu 6#«.ai A
Proposed Condition
APPROXIMATE COLOR OF
WINDOWS/PAINTED TRIM, MOUNTING 4 GRADIENT
PLATES NO BACKGROUND
6 ,
j olors (colors shown are chromatic) A-2
City of Salem Department of Planning & Community Development
Check/Cash Receipt and Tracking Form
Please complete form and make two copies.
Date Received
Amount Received
Form of Payment Check ❑ Cash II
Client Information eA
CASH PAYMENTS: client initials
Sign Permit Application Fee
❑ Conservation Commission Fee
Payment received for what ❑ Planning Board Fee / ZBA
service? ❑ SRA/DRB Fee
❑ Old Town Hall Rental Fee
❑ Other:
Name of staff person receiving
payment
Additional Notes
BODY EMPOWERED WELLNESS, INC. 173
978-290-8929
281 ESSEX ST.UNIT C3 53-I3/I10 W
SALEM,MA 01970 DATE B1731
PAY 7L� C
To THE 1 1 l�0 >�A/�q �/�'�
ORDER OF Ga aT 1 w , 00
t
rjL [D DOLLARS 8 w„
BankofA encaa�„
ACH RrT 0110001JB
�
FOR
9.000L7311' e0L1000L3131: 0❑46L423139799
���yy,,�',:` S "' ti,1„'gy`.�, "''p}y, „ +,�el.4S 51 .'kT {a.,wJ.;;`7; . ,,T{ •w.+ Y=, Z.
k�c d� 3y fww 41 e L ,t_:, tl vZb. »a.' A::. 3 •3S _ i ro k4 .. ,r e
Original Check and Form: DPCD Finance
Copy 1: Client
Copy 2: Application File
LICENSE OR PERMIT BOND
Bond No.
KNOW ALL MEN BY THESE PRESENTS, That We > G, �,•-\fin �,�
Of 17v� -a ( � c:vxrt ? ll tl .n cis
as Principal, and THE HANOVER INSURANCE COMPANY and/or
MASSACHUSETTS BAY INSURANCE COMPANY, a New Hampshire corporation, and having its
principal office in the City of Worcester, MA, as Surety, are held and firmly bound unto
C:� C'«4�, ,1.x/4 ,hereinafter called the Obligee, in the penal sum of
and No/100 Dollars ( $ )c6- .00) lawful money of the United States of
America to be paid to said Obligee for which payment well and truly to be made, we bind ourselves, our
heirs, executors, administrators, successors and assigns,jointly-and severally, firmly by these presents.
Signed with our hands and sealed with our seals,the 3 =` day of 20=ry.
WHEREAS, A LICENSE OR PERMIT has been granted by the Obligee to the above bounden
Principal for T nuv�ur��_ Ws_111_'P'5 , (.., c .
Now, therefore, the Condition of this Obligation is such, that if the said Principal shall faithfully i
observe the provisions of the Laws,Ordinances,and Resolutions,governing the issuance of this License or
Permit,then this Obligation shall be null and void,otherwise to remain in full force and effect.
Liability under this bond shall terminate as of the-:L-- day of e 1,V,) ;_ 20_9a, as to i
any acts subsequent thereto, unless said bond is continued in force from year to year by the issuance of a
continuation certificate signed by the Surety.
The Surety may cancel this bond at any time by filing with the Obligee ten 10 days written notice
of its desire to be relieved of liability. The Surety shall not be discharged from any liability already accrued
under this bond, or which shall accrue hereunder before the expiration of the ten day period.
BY:
-1 BY: ..
V
t � 3�'�vDA✓ Qo /�? >
in-Fact
Attorney
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWERS OF ATTORNEY
CERTIFIED COPY
KNOW ALL MEN BY THESE PRESENTS:That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,
both being corporations organized and existing under the laws of the.State of New Hampshire, and CITIZENS INSURANCE COMPANY OF
AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint
Deborah Caron,Michael Pangione,Linda Reifke,Rose Ann Trafincante,Joan Lessard and/or Brendan Rogers
of Amesbury,MA and each is a We and lawful Attomey(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,
and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated
any and all bonds,reoognizances,undertakings,contracts of indemnity or other wrifings obligatory in the nature thereof,as follows:
Any such obligations in the United States,not to exceed Seven Hundred Fifty Thousand and No/100($750,000)in any single instance
and said companies hereby ratify and confirm all and whatsoever said Attomey(s)-in-fact may lawfully do in the premises by virtue of these presents. -
These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which
resolutions are still in effect:
"RESOLVED, That the President or any Vice President, in conjunction with any Assistant Vice President, be and they are hereby authorized and
empowered to appoint Attomeys+nfact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and
all bonds,recegnizances,contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the
seal of the Company.Any such writings so executed by such Attomeysan-fact shall be as binding upon.the Company as if they had been duly executed
and acknowledged by the regularly elected officers of the Company in their own proper persons."(Adopted October 7,1981 -The Hanover Insurance }
Company;.Adopted April 14,1982-Massachusetts Bay Insurance Company,Adopted September 7,2001- Citizens InsuranceCompany of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE- COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS
INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by a Vice
President and an Assistant Vice President,this 21st day of July,2008. -
THE.HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
-„
04 )
CITIZENS-1 SURANCE COMPANY OF AMERICA
r.
MaryJeanneon,Vice Presidet
GD
Robert K.Grennan,Assistan: iceRresident
THE COMMONWEALTH OF MASSACHUSETTS )
COUNTY OF WORCESTER )ss.
On this 21st day of July 2008, before me came the above named Vice President and Assistant Vice President of The Hanover Insurance Company,
Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers
described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company
Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their
signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations.
v�d Notary Public
yrmaure.wa
My commission expires on November 3,2011
I, the undersigned Assistant Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance
Company of America, hereby certify that the above and foregoing is a full, We and correct copy of the Original Power of Attorney issued by said
Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect.
This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance
Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America.
"RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted and
executed by the President or any Vice President in conjunction with any Assistant Vice President of the Company,shall be binding on the Company to the
same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted
October 7, 1981 -The Hanover Insurance Company,Adopted April 14, 1982 Massachusetts Bay Insurance Company,Adopted September 7,2001 -
Citizens Insurance Company of
GIVEN under my hand and x x ,� d as,at Worcester,Massachusetts,this day of O r�c.s� ,200ri.
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
, . s b CITI S INSU CE CO PANY OF ERICA
b3f
ste�16L arsui, ssistan ice Pres nt
s
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275-281 ESSEX STREET 637-10
COMMONWEALTH OF MASSACHUSETTS
CITY OF SALEM
GIS#: .. a . 3151*_-,
Map 26 yz
Lot: 0447
SIGN PERMIT
Perrlut __ ' '„.` 1 Sign '._
Category:_ SIGN .
Pemut# 63710 PERMISSION IS HEREBY GRANTED TO:
Project#„ . JS-2010-000983 M_ pnk .".
Est.Cost: $400.00 i Contractor: License: Expires
Fee Charged:$0 00A SIGN-A-RAMA
Balance Due:$.00;, Owner: JEFF HOLLORAN
#'ofFixtures `- MHVRA5Applicant: SIGN-A-RAMA
DigSafe# _ z AT: 275-281 ESSEX STREET
UseGroup
ConstClass,3
ISSUED ON: 29-Mar-2010 AMENDED ON: EXPIRES ON: 29-Aug-2010
TO PERFORM THE FOLLOWING WORK:
SIGN PERMIT AS APPROVED FOR(ROBERT TREZZA)jbh
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ?
ITS RULES AND REGULATIONS.
Signat
Fee Type: Receipt No: Date Paid: Check No: Amount:
SIGN REC-2010-001138 29-Mar-10 x $0.00
GeoTMS®2010 Des Lauriers Municipal Solutions,Inc.
1 n
City of Salem Sign Permit Application Worksheet
18-Feb-10
Coven
281 Essex Street
Zoning(res/non-res) B5
Entrance Corridor(Y/N) N
Lot frontage 26 feet
Building ortenant frontage 26 feet
#of businesses on site 1
Biting dist from street center 30 feet
Multiplier 1
Building and iBlade Sib ns
maximum area permitted 26.00 sq ft
total proposed sign area 25.00 sq ft
sign 1
length 36.00 inches
height 24.00 inches
sign 2
n length 57.00 inches
height 48.00 inches
sign 3
length 0.00 inches -
height 0.00 inches
sign 4
length 0.00 inches
height 0.00 inches
sign 5
length 0.00 inches
height 0.00 inches
Freestandin ''Si ns at a d2
maximum area permitted 0.00 sq ft(per side)
maximum#of signs permitted 0 signs
maximum height permitted 0.00 ft tall
sign 1
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height 0.00 ft
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets guidelines set
forth in the Salem Sign Ordinance yes
Recommend approval yes
. ., PT�IERING_ pp
cafe &
dessert bar
ARTISANAL
C
281 Essex St 1
Salern, MA 0197
-- (tel) 212-444_24 0
N. J
0 f
i
I
Permit Number
APPLICATION FOR PERMIT TO ERECT A SIGN
Is
NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legible f /
Salem,.Massachusetts / S
Date
To the Building Inspector:
The undersigned hereby applies for a permit toErect, ❑Alter, ❑Repair a sign on the following described buildings:
Street Address Zoning District
R I 5� owl � roan Renewal Area ❑Entrance Corridor
❑ Historic District ❑None
Use of Building
Telephone 1Floor C�
• 2 _z'floor
Address 3 -floor
Telephone CS7� 3fr�`� 4 floor -
E-mail Cf gj`; JfJ� How many businesses are in the building? 3
If a corporate body, name (� Frontage
of res onsible officer K0 e(+- i
Building linear at .
Construction Sup's License No Applicant's Space(if multi-tenant) linear feet
Address S i 51( d5-tm ol M Property linear feet
Telephone 1I Mail Sign Permit to
_
E-mail �S S�YLe2sIgQ0.lda`YK��Cup n7777.er o Sign Erector er.
�HS�
Sign 1 Sign 2 Sign 3 dq IEAil CSa
❑5rface o Surface - o Surface
®'Right Angle to Building ❑Right Angle to Building ❑ Right Angle to Building
❑ Free Standing ❑ Free Standing ❑ Free Standing
❑Awning ❑Awning ❑Awning
❑Other(specify) ❑Other(specify) ❑Other(specify)
Sign Materials �` I L Sign Materials Sign Materials
Sign Dimensio s I I Sign Dimensions Sign Dimensions
Sign Area Sign Area Sign Area'
s ft s ft sq ft
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ O
Type Sign Area To Be Removed? g /ow
o Surface sq ft ❑yes ❑no
-
o Right Angle to Building sq ft ❑yes ❑no
❑Free Standing sq ft o yes ❑no Sign Owner's A?ori d Representative
❑Awning sq ft ❑yes o no
o Other(specify) sq ft ❑yes ❑no
Property Owner
JAA Internal Review
Planni g&Community Development Departmen Historical Commission
Approval
Building Inspecto
' - 11/01/08 rev
"M-.�N�eita..�V!�NIJ 61`. M1 • �P �.A�� �}.p� g� � fj J'
1 a4
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IN
414
� L �d � f ��1 r ��� •� r � �!. f
' • I e � e
' � I
_ ECEIVE
MAR 17 2010 p
J� DEPT. OF PLANNING&
i COMMUNITY DEVELOPMENT
p ---------------
OD
ective Date• February 18, 2010
Western Surety Company•
LICENSE AND PERMIT BOND
KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 70878370
That we, Coven, LLC
a
of the City of Salem — State of Massachusetts as Principal,
and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of
Massachusetts as Surety, are held and firmly bound unto the
City of Salem State of Massachusetts as Obligee, in the penal
sum of One Thousand and 00/100 DOLLARS ( 51, 000.00
lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made,
we bind ourselves and our legal representatives, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been
licensed Sign Installation
by the Obligee.
NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply
with the laws and ordinances, including all amendments thereto, pertaining to the license or permit
applied for, then this obligation to be void, otherwise to remain in full force and effect until
February 18th 2011 , unless renewed by Continuation Certificate.
This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class
U.S. Mail��tgrAe Obligee and to the Principal at the address last known to the Surety, and at the expiration
of t ��Ys from the mailing of said notice, this bond shall ipso Facto terminate and the Surety
sh .(khePeu„pp�
ori AC;, 1eved from any liability for any acts or omissions of the Principal subsequent to said
'
dat�:: "rdI"e$g'oe number of years this bond shall continue in force, the number of claims made
agaw4 his bon t1-dithe number of premiums which shall be payable or paid, the Surety's total limit of
lijVty all not be emulative from year to year or period to period, and in no event shall the Surety's total
h CaA' t ' `s�exceed the amount set forth above. Any revision of the bond amount shall not be
cuntc tr H.®.... .,.
hrplrutgNi
Dated this 18th day of _ February 2010 .
COVEN, LLC
Principal
Principal
WESTE SURET COMPANY
By
r�
Paul T. Bruflat, SeAfior Vice President
v Form 532-1-2010
ACKNOWLEDGMENT OF SURETY
STATE OF SOUTH DAKOTA 1 ss (Corporate Officer)
COUNTY OF MINNEHAHA I
On this lath day of February 2010 , before me, the undersigned officer,
personally appeared Paul T. Hruflat ., who acknowledged himself to be the aforesaid
officer of WESTERN SURETY COMPANY, a corporation, and that he as such officer,being authorized so to do, executed
the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such
officer.
IN WITNESS WHEREOF,I have hereunto set my hand and official seal.
}44V44\\\4\VVV4\4V4\\4\44}
e S. EICH %
S SEAL NOTARY PUBLIC(SEAL
+ SOUTH DAKOTA i Notary Public—South Dakota
}4\4444444\4\4\V4VV4VV4V}
My Commission Expires February 12, 2015 ACKNOWLEDGMENT OF PRINCIPAL
(Individual or Partners)
STATE OFi ss
COUNTY OF
On this day of ,before me personally appeared
known to me to be the individual _ described in and who executed the foregoing instrument and acknowledged to me
that—he— executed the same.
My commission expires
Notary Public
ACKNOWLEDGMENT.OF PRhNCIPAL " .
STATE OF' (Corporate Officer)
COUNTY OF } ss
On this day of ))) before me personally appeared
who acknowledged himselftherself to be the
of a corporation, and that he/she as
such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing
the name of the corporation by himself/herself as such officer.
My commission expires ,
Notary Public
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N Transaction Report & Invoice
CNA .SLA UR Principal Information: ID: 009558589
CNA SURETY COVEN, LLC
PO Box 802875 281 ESSEX ST. , C-1
CHICAGO, IL 60680-2875 SALEM, MA 01970
Agency Code: 20-00435
CLEMENT E OESJARDINS INS
AGENCY INC
P 0 BOX 368
SALEM MA 01970
Transaction Description: NEW Transaction Effective Date: 02/18/2010
Number: 70878370 FILE LOCATION: SIOUX FALLS
Written By: WESTERN SURETY COMPANY PHONE: 800-331-6053
Description: SIGN INSTALLATION CITY OF SALEM
Obligee: CITY OF SALEM
CITY CLERK PREMIUM 6100.00 {
93 WASHINGTON ST.
SALEM, MA 01970
Effective Date: 02-18-2010
Expiration Date: 02-18-2011
Current Penalty: $1,000.00
Renewal Method: cc Gross Premium Charge: $100:00
Commission Amount:
Net Premium Due:
Change Detail:
Agent You may remove stub below to use as a billing/credit invoice
-----------------------------------------------------------------------------------------------------------------------------------------------------------
CNA Surety
INVOICE
FILE NO. EFFECTIVE DATE ANNIVERSARY DATE PROCESS DATE PENALTY
0601 70878370 I 02-18-10 I 02-18-11 I 02-18-10 I 51.000.00
PRINCIPAL COVEN, LLC
281 ESSEX ST. , C-1 SALEM, MA 01970
RISK STATE MA _ SF
DESCRIPTION SIGN INSTALLATION CITY OF SALE `
OBLIGEE
AGENCY CODE
20-00435 CHARGE $100.00
Your agent is: .
CLEMENT E DESJARDINS INS
AGENCY INC
P 0 BOX 368
SALEM MA 01970
Transaction Report & Invoice
a
CNA SURETY Principal Information: ID: 009558589
CNA SURETY COVEN, LLC
PO Box 802875 281 ESSEX ST. , C-1
CHICAGO, IL 60680-2875 SALEM, MA 01970
Agency Code: 20-00435
CLEMENT E DESJARDINS INS
AGENCY INC
P 0 BOX 368
SALEM MA 01970
Transaction Description: NEW Transaction Effective Date: 02/18/2010
Number: 70878370 FILE LOCATION: SIOUX FALLS
Written By: WESTERN SURETY COMPANY PHONE: 800-331-6053
Description: SIGN INSTALLATION CITY OF SALEM
Obligee: CITY OF SALEM
CITY CLERK PREMIUM 6100.00
93 WASHINGTON ST.
SALEM, MA 01970
Effective Date: 02-18-2010
Expiration Date: 02-18-203
Current Penalty: $1,000.00
Renewal Method: cc Gross Premium Charge: $100:00
Commission Amount:
Net Premium Due:
Change Detail:
Agent You may remove stub below to use as a bilring/credit invoioe
-------------------- --------------------------------------------------------------------------------------------------------------------------------------
CNA Surety
INVOICE
FILE NO. EFFECTIVE DATEANNIVERSARY DATE PROCESS DATE PENALTY
0601 70878370 02-18-10 02-18-11 02-18-10 $1 .000.00
PRINCIPAL COVEN, LLC
281 ESSEX ST. , C-1 SALEM, MA 01970
RISK STATE MA SF
DESCRIPTION SIGN INS ALL IO -C - F A
OBLIGEE
AGENCY CODE
20-00435 CHARGE $100.00
Your agent is:
1
CLEMENT E DESJARDINS INS
AGENCY INC
P 0 BOX 368
SALEM MA 01970
City of Salem Department of Planning & Community Development
Check/Cash Receipt and Tracking Form
Please complete form and make two copies.
Date Received '+ 'gyp
Amount Received
Form of Payment heck ❑ Cash
Client Information �^
CASH PAYMENTS: client initials
,O-S�Ign Permit Application Fee
FiConservation Commission Fee
Payment received for what Fj
Planning Board Fee/ ZBA
service? SRA/DRB Fee
Old Town Hall Rental Fee
Other: Copies
Name of staff person receiving
payment
Additional Notes
134
ROBERT A TREZZA 01-10
126 PLEASANT STREET 1-1367/260
APT 3 296
MARBLEHEAD MA 01945
�- (� Dollars ai d
Bank
America's Most Convenient Bank•
1:02 O 31119 0134
Original Check and Form: DPCD Finance
Copy 1: Client
Copy 2: Application File