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3 CENTRAL STREET - SIGN PERMIT 3 Central Street Modern Millie I CENTRAL STREET 296_12 COMMONWEALTH OF MASSACHUSETTS GIS#: I99t i CITY OF SALEM Map: 35 Lot:Loc 0234-201 SIGN PERMIT Permit: ,Sign — - - — -Ca-tegory: SIGN Permit u JS-2296-121 PERMISSION IS HEREBY GRANTED TO: Project# JS-2012-000352 Est. Cost: $0.00 Contractor: License: Expires: Fee Charged: $0.00 -.BUSINESS OWNER 1 Balance Due:$.00 Owner: David Pabich #!of Fixtures:1 Applicant: BUSINESS OWNER DigSate# AT. 1 CENTRAL STREET UseGroup ConstClass ISSUED ON. 03-Oct-2011 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK. INSTALL 2 X 3 SIGN FOR MODERN MILLIE THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF .ANY OF ITS RULES AND REGULATIONS. Geool Signature: Fee Type: Receipt No: Date 112iA: Check No: Amount: 13(111DINGRIE -2012-000936 03-Oct-I I 0 $0.00 Gedl NIN (''011 Dec Laurier.Municipal tiolulinns,Inc. Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN • NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED Location, Ownership and Detail Must Be Correct,Complete, and Legible Salem, Massachusetts To the Building Inspector. Date The undersigned hereby applies for a permit to %Erect, in Alter, ❑Repair a sign on the following described buildings: Street�cldress Zoning District Cr'Uroan Renewal Area ❑Entrance Corridor ❑Historic District ❑None 7bo,*A, :floor 7ffa i o OrPt lY businesses are in the building? ACT— of responsible officer Building linear feet Construction SupsLicense No Applicant'sSpace(if multt-tenant) linear feet Address Property linear feet Telephone Mail Sign Permit to E-mail ign Owner o Sign Erector ❑Other: • ' jgto .rnuntiimum� Sign 1 _ Si n 2 Sign 3 o surface o surface n Surface ;kRight Angle to Building ❑Right Angle to Building ❑Right Angle to Building in Free Standing ❑Free Standing o Free Standing ❑Awning ❑Awning o Awning ❑Portable(A-Frame) ,p+ortable(A-Frame) u Portable(A-Frame) o Other(specify) ❑Other(specify) ❑Other(specify) Sign Matgri Is Sign Materials` Sign Materials Sign Dimensions IX Sign Dimensions�l `IX lt Sign Dimensions Sign Area ( t'J Sign Area `7 Sign Area s ft s ft sq it Sign Height(if free standing) Sign Haih (if free standing) Sign Height(if free standing) Estimated Cost of Net Work - , $ EX 6- S)Wm Type Sign Area To Be Removed? Signr O e ❑Surface _sq ft o yes o no o Right Angle to Building sq ft o yes o no o Free Standing _sq ft o yes o no Sign Owner ihorized Representative o Awning _sq ft oyes o no o Other(specify) sq ft o yes ❑no Prope wrier Internal Review MOW 7 Gt,ln Planning 8 Community Development Department n Historical Commission Building Inspector oerzaia�• Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN a NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTEDLocation, Ownership and Detail Must Be Correct, Complete,and Legible Salem,Massachusetts To the Building Inspector: Date The undersigned hereby applies for a permit to igErect, o Alter, o Repair a sign on the following described buildings: StreetAcidress Zoning District roan Renewal Area ❑Entrance Corridor FBC�v ❑Historic District ❑None • Telephone _ 1 floor• • L t ) 2 floor AddressCerl 3 floor Telephone 4 floor E-maillzer How many businesses are in the building? If a corporate body,name „Ate_ of responsible officer Building linear feet ConsinxAm Sups License No Applicant's Space(if multi-tenant) linear feet Address Property linear feet Telephone Mid Sign Permit to E-mail ign Owner ❑Sign Erector ❑Other: 'Sign 1 Sign 2 Sign 3 ❑Surface o Surface ❑Surface ($,Right Angle to Building ❑Right Angie to Building ❑Right Angle to Building `Free Standing o Free Standing ❑Free Standing 'o Awning o Awning ❑Awning 'o Portable(A-Frame) ,rPortable(A-Frame) ❑Portable(A-Frame) o Other(specify) u Other(specify) ❑Other(specify) Sign MatGri Is Sign Materials Sign Materials I- m L�- Sign Dimensions I x Sign Dimensions' `I% t Gtt Sign Dimensions Sign Area ( D Sign Area `7 —1 C.') Sign Area sq ft sq ft sq ft Sign Height(if free standing) Sign Mel ht(if freta standing) Sign Height(if free standing) Estimated Cost of Net Work - $ X G� S 1 t;Y '1✓i 1 Type Sign Area To Be Removed? Sign r • e o Surface sq ft ❑yes in no ❑Right Angle to Building sq ft ❑yes in no in Free Standing —Sq ft in yes ❑no Sign Owner thorized Representative o Awning _sq It o yes ❑no o Other(specify) _sq ft ❑yes ❑no Prope wner Internal Review Planning&Community Development Department Historical Commission 7 Building Inspector oerzano,. Christine Robidoux Modern Millie Vintage & Consignments 3 Central St. Salem, Ma 01970 August 11. 2011 Design Review Board c/o DPCD City of Salem 120 Washington St. Salem, Ma 01970 To Whom it May Concern: I am proposing a portable sign in front of my business. The sign is 2'x 3', and with 4"feet. The sign is metal and is heavy. When sitting at an angle, it never moves. The attached photo is of the existing a-frame that I am using. Currently I am at 103 Washington St which I will be vacating on September 1st and moving to 3 Central St. This proposal is for 3 Central. The a-frame was designed by an artist and does not have any logos. The colors are turquoise and pink, which are Modem Millie brand colors. The frame itself is black metal, the designs are painted on metal sheets. We hang vintage records with attached signs indicating a sale, otherwise the sign is left blank and is visually associated with Modern Millie. I will be moving my business and bringing the sign with me will help my old customers find me at the new space. I would like to locate the sign in front of the small cobble stone area in front of 3 Central. The location meets the 5' clearance and in within 10' of the entrance. My business has its own entrance. The other businesses in the building use different entrances. Thank you for your time. Si rel Stine Robidoux photo.JPG - Gmail Page 1 of 1 r-M c"� � I ✓l t-Yu ,� t https://mail.google.com/mail/u/0/?ui=2&ik=5bb24ffc83&view=att&th=131 b9e5cObea75d... 8/11/2011 - . �� - ,! , � � �� i��� ��� � • ��. s n � ;' ` � #� � � a 1 ♦ n + ` . {■ �� � . � -� . �� � � a r '^4. Modern Millie Vintage & Consignments Sign Permit for new address at 3 Central St. Old address with existing sign at 103 Washington St. Color Scheme: white background, red lettering, blue silhouette of a woman, and grey lettering on the bottom Letter Style: Coolvetica Letter size: 5" Method of attachment: Metal bracket (see attachment) Method of Lighting: 2 Florescent outdoor lights (existing) Width of building: 58 feet ODj ® n Y Western Surety Company , CONTINUATION CERTIFICATE , Western Surety Company hereby continues in force Bond No. 15015375 briefly described as SIGN PERMIT CITY OF SALEM for CHRISTINE ROBIDOUX DBA MODERN MILLIE as Principal, in the sum of $ FIVE THOUSAND AND NO/100 Dollars, for the term beginning July 13 1011 , and ending July 13 2012 subject to all the covenants and conditions of the original bond referred to above. This continuation is issued upon the express condition that the liability of Western Surety Company under said Bond and this and all continuations thereof shall not be cumulative and shall in no event exceed the total sum above written. Dated this 04 day of May 2011 aaa�ga .� ,.,v a� WESTERN U R E T Y COMPANY P . fl;ell ' i as By to Paul T. Bruflat, So0flor Vice President { 'N'" Via ` �,� '°�.g•` `'tr+- x W 1 : , THIS "Continuation Certificate" MUST BE FILED WITH THE ABOVE BOND. ; a Form 90-A-4-2002 ,l , DD% Western Surety Company RIDER It is hereby mutually agreed and understood by and between the Principal/Insured and Western Surety Company, that instead of as originally written: The address has been changed to read: 3 Central Street SALEM, MA 01970 No further changes other than above. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, limits or conditions of the Policy/Bond except as hereinabove set forth. This Rider becomes effective on the 1st. day of September 2011 -, at twelve and one minute o'clock a.m., standard time. �,z Attached to and forming part of Policy/Bond No. 15015375 issued by WESTERN SURETY COMPANY of Sioux Falls South Dakota, to Christine Robidoux dba Modern Millie Signed this 11th day of August 2011 W E N+SUURREE COMPANY By— /. Paul T. Bruflat, Senior ice President Form F5147-6-2002 Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho. Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint Paul T. Bruflat of Sioux Fa11s State of --------aQ-USh_Dakota , Its regularly elected Senior Vice President as Attorney-in-Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed,the following bond: One Sign Permit. Cit�of Salem bond with bond number 15015375 for Christine Robidoux dba_Modern Millie as Principal in the penalty amount not to exceed: $ 51000_.00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary,Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Senior vice President with the corporate seal affixed this 11th _day of August 2011 ATTEST WESTE N / URET COMPANY By B r r L.Nelson,Assistant Secretary Paul T.Bruflaf Senior Vice President STATE OF SOUTH DAKOTA 1 ss COUNTY OF MINNEHAHA - ' On this lith day of _ Auaust _ 2011 before me, a Notary Public, personally appeared Paul T. Bruflat _ and L. Nelson who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Senior Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. inss555ys5y55as5aseay5a,a4 S D. KRELL r S i sEAL NOTARY PUBLIC SEAL r s�c SOUTH DAKOTA�r X s +y55yy5eyys5s55sy5awwasw My Commission Expires November 30,2012 Notary Public Form F1975-9-2006 A� CERTIFICATE OF LIABILITY INSURANCE DATE(MNVDO/Y1 a/u/zou THIS CF,RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE'DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Joan Street SOUCY INSURANCE AGENCY PHONE (978)744-7110 FAR(�As,E0, UVC,N_o0970)741-2059 P. O. Box 4467 EMAIL AODREss:7 souoy@ soucyinaurance.com 85 Lafayette Street PRODUCER 00007572 _MTOMER" _ Salem MA 01970 INSURED INSURER(S)AFFORD)NG COVERAGE _ - - --- -- iNSURERAMaryland Casualty Company 119356 __ INSURER.Northern Insurance Cc 19372 MODERN MILLIE CHRISTINE ROH IDOUX � - - - ILI 3 CENTRAL STREET INSURER c, - INSURERD: _ SALEM INSURER E: MA 01970 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1181100228 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'ADDLjSUBRi LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM DUY EFF l MM%DO/YYYY DMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 _X 1 COMMERCIAL GENERAL LIABILITY i PREMISE ( RENTED I iPREMISES(Ea occurrence) $ _ 2_,000,000 A -� CLAIMS-MADE X_i OCCUR PA5003985290 1/15/2011 11/15/2012 MED EXP(Any one person)- _S 10,000 PERSONAL S ADV INJURY $ 2,000,000 --- - -- GENERALAGGREGATE $ - 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ( PRODUCTS-COMPIOP AGG $ 4,000,000 X POLICY I� PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ ANY AUTO (Ea accident $ ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per.coldem) HIRED AUTOS PROPERTY DAMAGE $ � i (Per accident) � NONOWNEOAUTOS - — - S -_- $ UMBRELLA UAB OCCUR r EACH OCCURRENCE $ EXCESS LIMB J CLAIMS-MADE AGGREGATE DEDUCTIBLE $ RETENTION $ -- $— H WORKERS COMPENSATION WC STATU- OTH- $ AND EMPLOYERS'LIABILITY Yi N _T.OR)U MU 1 _-ER _ ANY PROPRIETORIPARTNEWEXECUTIVE OFFICEMMEMBER EXCLUDED' EN/A E.L EACH ACCIDENT_ $ 100 000 (Mandatory In NH) C003260025 10/23/2010,10/23/2011 100,000 I/yas,describe under EL DISEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,H more apace II required) City of Salem and Salem Redevelopment Authority as listed as additional insureds CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. 120 Washington Street _ Salem, MA 01970 AUTHORIZED REPRES /a v 'W` Paul Soucy/HAL ACORD 25(2009!09) ©1988.2009 ACORD CORPORATION. All rights reserved. INS025(zoosps) The ACORD name and logo are registered marks of ACORD y Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN < k NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED Location,Ownership and Detail Must Be Correct,Complete,and Legible 0 Salem,Massachusetts To the Building Inspector: Date The undersigned hereby applies for a permit to V;Srect, ❑Alter, ❑Repair a sign on the following described buildings: StreetAddress Ca V Zoning� roan Renewai Area u Entrance Corridor E V ❑Historic District ❑None • 'I Aorl) PAPICW E11111301110.11111--mil Telephone 1-floor i 2 floor Cel Address 3 floor Telephone 4 floor E-mail I C How many businesses are in the building? If a corporate body,name •n P'r of res onsi6le officer Frontage Building linear feet Construction Sups License No Applicant's Space(if multi-tenant) linear feet Address Property linear feet Telephone Mail Sign Permit to E-mail ign Owner n Sign Erector c Other: Sign 1 Sign 2 Sign 3 ❑Surface c Surface c Surface $,Right Angle to Building ❑Right Angle to Building c Right Angle to Building c Free Standing ❑Free Standing ❑Free Standing ❑Awning ❑Awning o Awning ❑Portable(A-Frame) .Portable(A-Frame) ❑Portable(A-Frame) ❑Other(specify) u Other(specify) ❑Other(specify) Sign Mat ri Is Sign Materials Sign Materials F" A L— Sign Dimensions I X Sign Dimensions, 4(1 11 Sign Dimensions Sign AreaO Sign Area '1 Sign Area s ft s ft a ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ `c ✓i [lh'L (i b7�7kn Type Sign Area To Be Removed? SignOwl r ' e ,a Surface sq ft ❑yes ❑no c Right Angle to Building _sq it c yes c no ❑Free Standing sq It ❑yes ❑no Sign Owner' horized Representative ❑Awning _sq ft c yes c no o Other(specify) sq ft ❑yes ❑no Props er Internal Review Planning&Community Development Department Historical Commission Approval Building Inspector oarsaro,ev Salem Redevelopment Authority Design Review Board Proposal August 24, 2011 3 Central Street (Modern Millie): Discussion of proposed signage Proposal for July 27 DRB Meeting The submission includes a photo and memo describing the sign proposal. The proposal is for a 2' x 3" wooden blade sign. The sign will be relocated from Washington Street to this new location and will hang from an existing sign bracket. Staff Comment The signage complies with City and SRA guidelines. 4 � �T � � � �� f ��. �� � �. • �� � ��� � f ; rY � � r4 � s � � , � • F M 7. ■ 'f r +� Modern Millie Vintage & Consignments Sign Permit for new address at 3 Central St. Old address with existing sign at 103 Washington St. Color Scheme: white background, red lettering, blue silhouette of a woman, and grey lettering on the bottom Letter Style: Coolvetica Letter size: 5" Method of attachment: Metal bracket (see attachment) Method of Lighting: 2 Florescent outdoor lights (existing) Width of building: 58 feet ! ! Western Surety Company ! CONTINUATION CERTIFICATE a ! Western Surety Company hereby continues in force Bond No. 15015375 briefly ! described as SIGN PERMIT, CITY OF SALEM I for CHRISTINE ROBIDOUX DBA MODERN MILLIE as Principal, in the sum of $ FIVE THOUSAND AND NO/100 Dollars, for the term beginning July 13 , --2111—, and ending July 13 2012 subject to all the covenants and conditions of the original bond referred to above. This continuation is issued upon the express condition that the liability of Western Surety Company under said Bond and this and all continuations thereof shall not be cumulative and shall in no event exceed the total sum above written. Dated this 04 day of May 2011 WESTERN URETY COMPANY ,g�y m to k Paul T. Bruflat, S for Vice President p _ dYii$2ki YS45lYke2 ! ° r ! a I THIS "Continuation Certificate" MUST BE FILED WITH THE ABOVE BOND. ; ! P , l Form 90-A1-2002 , OD% Western Surety Company RIDER It is hereby mutually agreed and understood b and between, the Principal/Insured and Western Surety Company, that instead of as originally written: The address has been changed to read: 3 Central Street SALEM, MA 01970 No further changes other than above. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, limits or conditions of the Policy/Bond , except as hereinabove set forth. This Rider becomes effective on the 1st day of September 2011 at twelve. and one minute o'clock a.m., standard time. Attached to and forming part of Policy/Bond No. 15015375 issued by . WESTERN SURETY COMPANY of Sioux Falls South Dakota, to Christine Robidoux dba Modern Millie Signed this 11th day of August 2011 W• E SURETY COMPANY By Paul T. Bruflat, Senior ice President Form F5147-6-2002 Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America,does hereby make,constitute and appoint Paul T. Bruflat _ Of Sioux Falls State ofSQIIrh pakor , its regularly elected senior vice President as Attomey-in-Fact,with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed,the following bond: One Sian Permit, City of Salem bond with bond number 15015375 for .Christine Robidoux dba Modern Millie as Principal in the penalty amount not to exceed: $ 5,000.00_. Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds,policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its 2011 senior vice President with the corporate seal affixed this 11th day of _. August ATTEST WESTE N URET COMPANY V L.Nelson,Assistant Secreta By � - - - �' Paul T.BruA .Senior Vice President STATE OF SOUTH DAKOTA COUNTY OF MINNEHAHA J ss On this 11th _ day of August 2011 before me,a Notary Public, personally appeared Paul T. Bruflat and L. Nelson who, being by me duly swom, acknowledged that they signed the above Power of Attorney as Senior vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. +ws55ro.,se555.,ey5a.....,a55�,a+ r D. KRELL i r r r X SEAL NOTARY PUBLIC �� r r SOUTH DAKOTA Ste- s ����� r r 4ye45wyg5y5yyq.,yr,ayr,.,yya + My Commission Expires November 30,2012 Notary Public Form F1975-9-2006 0I ' I CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YWY) 8/11/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Joan Street NAME: SOUCY INSURANCE AGENCY PHONEj,c (978 744-7110 P. O. BOX 4467 E-MAIL,): ) (MC NoJ: (971)741-2059 ADDRESS:O sOUCy@ SOUCylmeUramCe.Com 85 Lafayette Street PRODUCER 00007572 - C1w2w1_ IV# _ Salem _ MA 01970 _ INSURER(S)AFFORDING COVERAGE _ t19 NAJC.s _ INSURED INSURER A:Maryland CaSUalty-Company _ _ 56 INSURERS:Northern Insurance Co 72 MODERN MILLIE CHRISTINE ROBIDOUX LLLLIA N C 3 CENTRAL STREET INSURER D:_ SALEM INSURER E: MA 01970 INSURER F COVERAGES CERTIFICATE NUMBER:CL1181100228 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR — - y LTR TYPE OF INSURANCE BS a POLICY NUMBER IMMDISYNYVY MM/DD/YEYXYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO-RENTED— k PREMISES(Eaocanencal $ 2,000,000 -- —_ A CLAIMS-MADE X i OCCUR A3003985290 11/15/2011 1/15/2012 '- I-- --- � I ( MED EXP(Any we person) $ 10,000 - — - PERSONAL&ADV INJURY $ 2,000,000 --- GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE APPLIESPER: X ( PRODUCTS=COMP/OP AGG § 4,000,000 POLICY PRO. LOC § AiOMOeILE LIABILITY =de SINGLE LIMIT ANY AUTO $ ALL OWNED AUTOS URY(Per person) $SCHEDULED AUTOS IURY(Peraccident S_DAMAGE $HIRED AUTO$ t) NON-OWNED AUTOS $ $ UMBRELLA LIAR OCCUR EACH OCCORRENCE $ EXCESS LIAR I CLAIMS-MADE( AGGREGATE § DEDUCTIBLE -- rRETENTION $ - — $ �Ny RKERS COMPENSATIONWCSTATU '0D EMPLOYERS'LIABWTV _ TgE,STIT51 E PROPRIETORIPARTNEIUEXECUTIVE Y/N SO�OOO ICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $s,duryin andNH) I WC00326DO25 110/23/2010110/23/2011 rEL DISEASE-EAEMPLOY § 100 000s,tlescribe untlerCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,X more space Is required) City of Salem and Salem Redevelopment Authority as listed as additional insureds CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. 120 Washington Street Salem, MA 01970 AUTHORIZED REPRES OIL i$ Paul Soucy/HAL ACORD 25(2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 poo9o9) The ACORD name and logo are registered marks of ACORD Salem Redevelopment Authority Design Review Board Proposal August 24, 2011 3 Central Street (Modern Millie): Discussion of proposed signage Complies? I Portable Sign Requirements Y I N ? I Dimensional Requirements: X less than orequal to 6 square feet X no more than 24"wide X within 10' of entrance door X minimum of 5' 42" absolute clearance from obstruction Y N ? Other Requirements: X zoning: must be Bi, B2, B4, or B5 X no trademarks other than establishment's X prices,telephone numbers, and Internet addresses shall not be greater than four inches tall X no changeable letters, animation, movement, or sound X only one sin permitted per entrance X cannot be located in front of handicap walkways, or block building entrances, exits, and fire escapes design (color, fixed lettering style, symbols and material) complements and is compatible with the design of the establishment's primary sign(s), abutting properties, and the general streetscape in the immediate vicinity of the establishment X must be made of durable, rigid material such as, but not limited to, wood, plastic or metal, in an A- frame style X must be internal) weighted so that it is stable and windproof. X must have$1,000,000 liability insurance including naming the City and the SRA NA if a shared entrance must share sign with other business es Other Compliance Issues NONE - neon sign: - non-static signs: - illegal signs: other: Standard Conditions: If a shared entrance, if other business wants to share, this business must collaborate - The sign may be placed outside only during the hours of the establishment's operation. - No sign shall be placed within the public right of way for the duration of a declared snow emergency. - No sign shall be placed within the public right of way on October 31. - The sign must be free-standing and shall not be affixed, chained, anchored, or otherwise secured to the ground or to any pole, parking meter, tree, tree grate, fire hydrant, railing, or other structure. Additions such as flyers, ribbons, balloons, illumination, electrical components, speakers and the like shall not be added to any portable signs. Additional Recommended Conditions: Christine Robidoux Modern Millie Vintage & Consignments 3 Central St. Salem, Ma 01970 August 11. 2011 Design Review Board c/o DPCD City of Salem 120 Washington St. Salem, Ma 01970 To Whom it May Concern: am proposing a portable sign in front of my business. The sign is 2'x 3', and with 4"feet. The sign is metal and is heavy. When sitting at an angle, it never moves. The attached photo is of the existing a-frame that I am using. Currently I am at 103 Washington St which I will be vacating on September 1 st and moving to 3 Central St. This proposal is for 3 Central. The a-frame was designed by an artist and does not have any logos. The colors are turquoise and pink, which are Modern Millie brand colors. The frame itself is black metal, the designs are painted on metal sheets. We hang vintage records with attached signs indicating a sale, otherwise the sign is left blank and is visually associated with Modern Millie. I will be moving my business and bringing the sign with me will help my old customers find me at the new space. would like to locate the sign in front of the small cobble stone area in front of 3 Central. The location meets the 5' clearance and in within 10' of the entrance. My business has its own entrance. The other businesses in the building use different entrances. Thank you for your time. Si rel Chrstine Robidoux a.aame..iru- knmau Page 1 of 1 r a r t - 7 https://mail.google.com/mail/u/0/?ui=2&ik=5bb24ffc83&view=att&th=131 b9df8e87bc87c... 8/11/2011 A. CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYV) 6/11/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NTACT Joan Street NAME: SOUCY INSURANCE AGENCY PHONE 9761744_7110 - AMAIL Ex9 P. O. BOX 4467 A : p/E . (978)741-2059 SS DDRESS:l emucyQeoucyinsurance.COm 85 Lafayette Street PRODUCER 00007572 CUST4MFJ31Dp: Salem _ MA 01970 INSURER$ AFFORDING COVERAGE INSURED - -- tJ— _ NAIC k_ _INSURER A'Mary land Casualty Company 19356 MODERN MILLIE CHRISTINE ROBIDOUX INSURERS Northern Insurance Co 19372_ 3 CENTRAL STREET INSURER C:— — - — — INSURERD: SALEMMA 01970 INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER:CL1181100228 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS ADDL.SUBR _ LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER MM/UDY/PYYY ` MM%DOOYYY UMRS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 l X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED- - — PREMISES(Eadourmnce $ 2,000,000 A _ _ CLAIMS-MADE X OCCUR PAS003985290 1/15/2011 1/15/2012 1MED EXP(An one person) § 1Q,000 PERSONAL&ADV INJURY $ 2,000,000 -- - GENERAL AGGREGATE $ 4,000,000 GEN AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ 4,000,000 X POLICY I-1 PRO- �r OC 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS rPROPER� INJURY(Per person) $ SCHEDULED AUTOS INJURY(Per acdden) $ HIRED AUTOS DAMAGE p $ NON,OWNED AUTOS $ — $ — UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB OCCUR - AGGREGATE g DEDUCTIBLE $ RETENTION $ — B WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY WC STATU- 0TH ANY PROPRIETORIPARTNER/EXECUTIVE© TORRZZ rM S I _ER OFFICER/MEMBER EXCLUDED' N/A EL EACH ACCIDENT $ 100 000 (Mandatary in NH) WC003260025 10/23/2010110/23/2011 If yes.tlescribe under E1. DISEASE-EA EMPLOYE $ 100,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY OMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach CORD 101,Additional Remarks Schedule,it more space Is required) City of Salem and Salem Redevelopment Authority as listed as additional insureds CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. 120 of Street FSalem, MA 01970 AUTHORIZED REPRES Paul Soucy/HAL ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD Western Surety Company Y CONTINUATION CERTIFICATE Western Surety Company hereby continues in force Bond No. 15015375 briefly s described as SIGN PERMIT. CITY OF SALEM _ for CHRISTINE ROBIDOUX DBA MODERN MILLIE as Principal, in the sum of$ FIVE THOUSAND AND NO/100 Dollars, for the term beginning July 13 2011—, and ending July 13 2012 subject to all the covenants and conditions of the original bond referred to above. This continuation is issued upon the express condition that the liability of Western Surety Company under said Bond and this and all continuations thereof shall not be cumulative and shall in no event exceed the total sum above written. Dated this 04 day of May 2011 WESTERN URETY COMPANY .rFrV , V y . �W N y Paul T. Bruflat, S =or Vice President c f Y , h , r i i e ' THIS "Continuation Certificate" MUST BE FILED WITH THE ABOVE BOND. ; Y i e- i i Fam 90-A-4-2002 - e� , 4 Western Surety Company RIDER It is hereby mutually agreed and understood by and between the Principal/Insured and Western Surety Company, that instead of as originally written: The address has been changed to read: 3 Central Street SALEM, MA 01970 No further changes other than above. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, limits or conditions of the Policy/Bond , except as hereinabove set forth. This Bider becomes effective on the 1st day of September 2011 at twelve and oneininute o'clock a.m., standard time. Attached to-and forming part of Policy/Bond No. 15015375 issued by -` WESTERN SURETY COMPANY of Sioux Falls, South Dakota, to Christine Robidoux dba Modern Millie Signed this 11th _day of August 2011 . W E SURETY COMPANY By Paul T. Bruflat, Senior ice President Form F5147-6-2002 Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America,does hereby make, constitute and appoint P_­' T Bruflat of Sioux Falls State of South Dakota ,its regularly elected Senior Vice President as Attorney-in-Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed,the following bond: One Sian Permit City of alem bond with bond number 15015375 for Christine Robidoux dba Modern Millie as Principal in the penalty amount not to exceed: $ 5,000 C0 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds, policies, undertakings. Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Senior Vice President with the corporate seal affixed this 11th 2011 _day of August ATTEST WESTE N UUR�ET COMPANY By B r /. r �ssistant Secretary Paul T.BruflarSenior Vice President STATE OF SOUTH DAKOTA COUNTY OF MINNEHAHA Jj as On this 11th day of _ Auoust 2011 , before me,a Notary Public, personally appeared Paul T. Bruflat and . Nelson who, tieing by me duly sworn, acknowledged that they signed the above Power of Attorney as senior Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. iyyyyyyyyyyyyyyyyyyyyyyyy} r r D. KRELL s r S SEAQ NOTARY PUBLIC SEAL s rQbSOUTH DAKOTA�r r r }yyyyyyyyyyyyyyyyyyyyyyb } My Commission Expires November 30,2012 Notary Public Form F1975-9-2006 Iµ photo.JPG- Gmail Page I of 1 �M 9 etil i a .. r V txN -P?oPCV, 9 ISE P( tz�Z LSD https://mad.google.com/mail/u/0/9ui=2&ik=5bb24ffc83&view=att&th=131 b9e5cObea75d... 8/11/2011