Loading...
40 FRONT STREET - SIGN PERMIT 40 Front Street Roost AC RL7� DATE(MMIOONYYY) CERTIFICATE OF LIABILITY INSURANCE 05/02/2017 THIS CERI'IFICAI'EIS ISSUED AS A MATTER OF INFOlUYL4TION ONLY AND CONFERS NO RIGHTS UPON THE CER"CIFICA'FE HOLDER.'CHIS 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 REPRESE.NT:ATI'E OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATIONIS 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). PROOL'CER CONTACT NAME JOHN J WALSH INS AGENCY INC/PHS ;VC.ho�,I (866)467-8730 ,No) (888)443-6112 THE HARTFORD BUSINESSS SERVICE CENTER —IL ADDRESS 3600 WISEMAN BLVD INSURER(S)AFFOROING COVENAGE NNIXI SAN ANTONIO, TX 78265 INSURER A The Hartford Accident and Indemnity 22357 INSURED INSURERS BIRDS &BEES LLC INSURERC 40 FRONT STREET INSURER D SALEM MA 01970 NS RERE INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: r THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEDAOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS mi 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 HFVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOFINSURANCE ADDL SURF POLICY NUMBER POLICY EFF POLICY IXP LJMITS I o LTR INSR WVD fMMIDD/YYYY) (MMIDDNYYY) COMMERCIAL GENERAL QAB1LJrY EACH OCCURRENCE D ;� A T DAMAGE CLAIMS-MADE❑OCCUR PREMISES(E...urzenrn) MED EXP(Any one Person) ; PERSONAL&ADV INJURY ; GEWL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE _ ODCV ❑JELT❑LIM PRODUCTS-COMP/OP AGE = b THER b AUTOMOBILE UABILIrV COMBINED SINGLE LIMIT (Ea aciulem) 6 � ANY AUTO BODILY INJURY(Per Person) ALLOWNED SCHEDULED BODILY INJURY(Per accident) g _ AUTOS AUTOS HIREDAUTOS N111-01NNED PROPERTY DAMAGE ; AUTOS (Peraooldenl) UMBREI I A UAB OCCUR EACH OCCURRENCE ; EXCESS LUMS CIAIMS-MAOE (AGGREGATE ; Ed �ETENnoNS TIT— IwRNERscroMRENsanoN - ANDEMoLDYHtSDABILIi'Y TATUTE I X VR ANY PROPRIETORIPARTNERIEXECUTIVVIN ELEACHACCIDENT 5500,000 (Mdafeq:n NH) 5 MREREXCwvPO wn = OS WEC LF4963 06/01117 06/01/18 anda EL DISEASE-EA EMPLOYEE 550(],(]00 It yes.describe Hitler s500,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT DESLRIPTTON OFOPERATIONS/LOCATIONS/VEHIGCMRD 101.Additional RomarMs Schedule,may be attached X mos space is squired) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. RE:A frame sidewalk signs, LOG 001, Bldg 001, 002. S:ERTIFICATE HOLDER CANCELLATION - City Of Salem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED Department of Planning and Community IN ACCORDANCE WITH THE POLICY PROVISIONS. 120 WASHINGTON ST AUTHORaW REPRESENTA TIVE SALEM MA 01970 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD a- R�® CERTIFICATE OF LIABILITY INSURANCE 5/T26/2J015 • THIS CERTIFICATEIS 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 SUBROGATIONIS 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). rRouucw I CONTACT NAME JOHN J WALSH INS AGENCY INC/PHS I !ac°N.E.B (866) 957-8730 Iiti.xo) (868) 443-6112 088411 P: (866) 467-8730 F: ( 888) 4 4 3-61121 301 WOODS PARK DRIVE I IHSUR 11(9)AFFORDING COVH E NMI I CLINTON NY 13323 INSURERA_ 119 r1_f Ji 1. A%:CIde+l1 Pv eRVI INSURER B INSURfli C. BIRDS & BEES, LLC I msuRERO 40 FRONT ST I ,xsuRER E. SALEM MA 01970 INSURERF COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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. MR nPG OF LYSUKA,NCE tRRJ.nm POLNTEF L[x /Vt'e elan PoLII]"\'L"HaFJI I'IIt1Cl"F_1P Lwn COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE ❑OCCUR DAMAGE AMA PREMSET(ERENTED nw) ' MED EXP(A Y pne parson) PERSONAL d ADV INJURY y GEN'L AGGREGATE UMIT APPLIES PER: GENERALAGGREGATE PR0. �POLICYD JECT❑LOC PRODUCTS-COMPIOP AGO OTHER: AUTOMOBILE UABILRY COMBINED SINGLE LIMIT (Ea acckerd) + ANY AUTO BODILY INJURY(Pe,parson) AUTOS ED AUTOS aw SCHEDULED I BODILY INJURY(Pe, lderd) ; HIREDAUTOS� NOWOWNED PROPERTY DAMAGE AUTOSI (Per acadrtt) UMBRELLA DAB —I OCCUR EACH OCCURRENCE EXCESSUAB CLAIMS-MADE AGGREGATE D4 RE GNS uoR[rAlstvlvErsrNorvEn _ a�D GVAlOT£L1'LWHILIrt I X ISEATBTE I IER N ANY PROPRIETOR/PARTNEWEXECUTIVEYN E L EACH ACCIDENT OFFICER/MEMBER EXCLUDE 'S 0 0, 0 0 0 I D A (Mande ws.NHI ❑ MIA IEL DISEASE-EAEMPLOYEE'�j00, 000 DESCRIPT10N OF IEL DISEASE-POLICY LIMIT '500, 000 DESGRIPDON OF OPERATIONS below OESCRWFIONOFOPERAnONSYLOCAnONS/VEHILI MORD 1 VI,Additicnai Remarks Sphe .W,may ,e aUach.d'd more spew Is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. RE: A frame sidewalk signs, LOC 001, Bldg 001, 002. CERTIFICATE HOLDER CANCELLATION " City Of Salem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFIIED I� Department of Planning and Community BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE J ELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Development RFPRESENfTATIVE 120 WASHINGTON ST SALEM, MA 01970 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD JOHN J WALSH INS AGENCY INC/PHS 301 WOODS PARR DRIVE CLINMN NY 13323 AB 01 012020 52262 B 42 C rh����llri�l^���wdnd�i9il��q��dm�hdldhu�l�lll� City of Salem Department of Planning and Community Development 120 WASHINGTON ST SALEM MA 01970-3523 ACORD 25(2014101) DAM IMM/OD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/2s/z014 THIS CERTIFICATEIS 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 SUBROGATIONIS 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 ICONTACT 1 New JOHN J WALSH INS AGENCY INC/PHS I(PANc.N..at) (866) 467-8730 IF (888) 443-6112 088411 P: (866) 467-8730 F: (888) 443-61121 aESS 301 WOODS PARK DRIVE I INSUREINS)AFFORDING COVETUIGE NAICA CLINTON NY 13323 INSURMA Hartford Acct:erJ & Indemnity Co INSURED INSURERS. INSURER C. 1 BIRDS & BEES, LLC IINSURERD. 40 FRONT ST INSURERE SALEM MA 01970 INSUarm F: COVERAGES CERTIFICATE NUMBER: 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. 7 LYSR TPPEOFINSOR.INCE ADDES[BR' FOLTCFN ER POLli(7 FF POLKT'EXP LLHITS /TP /MST[ Rl'D /.{LU/➢D'TPY}J /MMTD/ITTn 17CSES ER 1ALGHiERILUABILnY EACH OCCURRENCECLAIMS-MADE ❑OCCUR PREMI TO RIENENTEDDMAG ( occurrence) MED EXP(Any one person) s PERSONAL S ADV INJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE s POLICY PR T LOC I PRODUCTS-COMPIOPAGG5 JEC OTHER CO SINGLE LIMIT AUTOMOBILE LIABILITYaccident) s 1 (Ea I ANY AUTO I BODILY INJURY(Par person) s ALL OWNED ED BODILY INJURY(Per accident) 5 AUTOSS AUTOS HIREDAUTOS NOWOWNED PROPERTY DAMAGE AUTOS (Per accident) 5 UMBRELLA UAS OCCUR EACH OCCURRENCE s 1 EXCESS LAB CLAIMS-MADE AGGREGATE 5 D IRETENIIONS OFF x'd DAV� sgTRN X I=ATUiE I IER AND IXPLOTP.fSLL96/Ir1 ANY PROPRIETORIPARTNER)EXECUTIVEYM E.L.EACH ACCIDENT $50 0, 0 0 0 OFFICERIMEMBER EXCLUDED? WA A (Manrl:IDry In AN) ❑ 06 WEC LF4963 06/01/2014 06/01/2015 EL.DISEASE-EA EMPLOYEE rSOO, OOO If yes.descdbeunder E.LDISEASE-PODGYUMIT $SOD, 000 DESCRIPTION OF OPERATIONS below ft u10),Addilianal Remarks ScNedub,may be attached!if is required) DESC'tfprDN DFOPERATIONS/LOCATAONS/VEHICO Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy- RE: A frame sidewalk signs, Loc 001, Bldg 001, 002. CERTIFICATE HOLDER CANCELLATION ----- City Of Salem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Department of Planning and Community BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE p g Y DELIVERED IN AC(C�gUNCE WITH THE POLICY PROVISIONS. Development AUTHOMZEDREPIf �NTA SALEM, MA 01970 / Lt ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD JOHN J WALSH INS AGENCY INC/PHS 301 WOODS PARE DRIVE CLINTON NY 13323 MB 01 016487 21746 B 55 A II1'I'I'lll..Il"I'lI��II'1'1II'1111....1IIIIIII III h-1'1II'llIII City of Salem Department of Planning and Community Development 120 WASHINGTON ST SALEM MA 01970-3523 - m Y 0 ACORD 25(2014101 38 FRONT STREET 291-12 COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM GIS#: 15291 Map: 35 B_ -- SIGN PERMIT Loot:t: 06I 1-813 Permit: Sign Category: A-FRAME SIGN eet,T1 t# 291-12 PERMISSION IS HEREBY GRANTED TO: Project# IS-2012-000822 Est. Cost: $0.00 Contractor: License: Expires: Fee Charged:$0.00 BUSINESS OWNER Balance D11e:3.00 Owner: RENEWAL REAL ESTATE,LLC f of Fixtures: Applicant: BUSINESS OWNER DigSafe#_ AT: 38 FRONT STREET UseGroup ConstClass ISSUED ON: 28-Sep-2011 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: 2 A FRAME SIGNS FOR THE ROOST AND THE BEEHIVE 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: BUILDING REC-2012-000898 28-Sep-I1 0 $0.00 GeoTM&D 2011 Des Lauriers Municipal Solutions,Inc. a 9� Permit Nur�b� ' APPLICATIO ERMIT TO ERECT A SIGN n JUL 27 2011 '• !� ! NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED OF PLANNING 6 .�. Location, Ownership and Detail Must Be Correct, Complete, and Legible DEPT NFL CoMyty�➢Ty DEVELOPMENT ;eta Salem,Massachusetts ti Date To the Building Inspector: The undersigned hereby applies for a permit to ❑Erect, a Alter, c Repair a sign on the following described buildings: Street Address Zoning District Hs flaNf sr c Urban Renewal Area a Entrance Corridor e Historic District n None BuildingUse of Telephone I t• floor • o IiaRe3 �, 5trys (Dt5{ (asiD3F I I2"'floor Address y0 'FLot•tr 3r- I3'°floor Telephone q}Qg) R•(4 •f(i63 a Poor E-mail Coot{3&ke« How many businesses are in the building? If a corporate body, name 'SASS-c. .wG-'�'S IC44-C `��,( of responsible officer so Building linear feet Construction Sups License No I Applicant's Space(if multi-tenant) linear feet Address Property linear feet Telephone Mail Sign E-mail ❑Sign Owner o Sign Erector ❑ Other: Sig 1 ST 2 proposed, Sign 3 c Surface a Surface ❑Slurface ❑ Right Angle to Building ❑Right Angle to Building ❑Right Angle to Building n Free Standing ❑Free Standing u Free Standing ❑Awning ❑Awning ❑Awning �rPortable(A-Frame) o Portable(A-Frame) ❑Portable(A-Frame) • ❑Other(specify) ❑Other(specify) ❑Other(specify) Sign Materials Sign Materials Sign Materials Sign Dimensions Sign Dimensions Sign Dimensions Sign Area Sign Area Sign Area 4l! sq ft sq ft sq ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ -L 5- :L. 111 Existing Signs Type Sign Area To Be Removed? sg 1 o neNA y •Surface sq ft ❑yes ❑ no ❑ Right Angle to Building sq ft ❑yes ❑no a Free Standing sq ft ❑yes ❑no Si Own 's Au nz Representative ❑Awning sq ft ❑yes ❑no c Other(specify) _ sq It ❑yes ❑no Property Owner Internal Review I _ 7��Plang&Community Development Department Historical Commission Bui ding Inspector 081241ID m, Salem ® Redevelopment Authority Design Review Board Proposal August 24, 2011 40 Front Street (Roost): Discussion of proposed portable sign Complies? Portable Sign Requirements I Y N ? Dimensional Requirements: less than or equal to 6 square feet X no more than 24"wide I X I within 10' of entrance door X minimum of 5' (42" absolute)clearance from obstruction Y N l ? Other Requirements: X zoning: must be 61, 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 sign permitted per entrance X cannot be located in front of handicap walkways, or block building entrances, exits, and fire escapes I 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 internally weighted so that it is stable and wind proof. I X I - 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) I 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: RoostA-FRAME SIG 40 Front St Salem, MA scrub: •70 • • bath & b•dr . . roostsalem(?�amailxom life & style shoppingm downtown a �` Nokey�kef %s SA�"l3RD�:`i� ,,,h,4t tts 18" 32„ 25" A-FRAME SIGN ? Dimensions: 18" X 32" p , Area: 4 SF �! Material: repurposed window sash, mdf, paint, ` , x• chalkboard paintVJ Weighted: yes, integral to - sign, example atIMP meeting ` SIDEWALK Total Width: 8' 6" Access w/ Sign: 6' 6" 27 6161, JOHN WALSH INSURANCE Fax:9787459557 Aug 25 2011 4:18 P. 01 OP ID. DE .A FrG�• CERTIFICATE OF LIABILITY INSURANCE I �0812sn1 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the Policy(ies) must he endorsed. N SUBROGATION IS WANED,subject to the terns and conditions of the policy.Certain policies may require an endorsement A atatement on this certificate does not confer rights to the certificate holder In Hour of such endorsement(s). moouoE 978-745-3300 I CONTACT -- - ----- - --- John J Walsh Ins Agency,Inc P O sox 4407 978-745-9557I PHONE 1A1Nr_' Na.6rt FAA not Salem,MAW970-8407 I ADDRESS: Mark W.Beittencourt muvu w,m,EER,,9RIRD04 MSURER(S)AFFORDING COVERAGE NAIC0 WSUM Kathryn Leavy dba Roost Urban I INSURERA:The Hartford _ Country Design &Beehive I INSURERO: Kathryn Leavy 40 Front Street I INSURER:: Salem,MA 01970 MEURER D: WSURERE: NSURERF: COVERAGES 7'trF_��CAT /t,I�UMBER:_ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POR VF INS RRANCE USTFD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHERJDOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB.IEW TO ALL THE TERMS, IN AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAAQj ILTR rmaOF NOPARM wDUUyyeol�vnrr�l POIJCY NUN2ER Pjprypp/y'/yy) IN1 yj LaaTg GENERAL LIA90.TIY "EACH OCCURRENCE _ i 1100kooll A X cOMUERCIAL GENERAL LtABariY X I OBSBAVZ1781 10/06110 10106H1 AMAGE TD RENiED _ PREMISE§(Fs omm2el § 300106NI cLAuns-MADE QX OCCUR MFDE,w(Anyo�P ) § 10.000 X Business Owners I PERSONALa ADV InJuaY a 1.000,000 - I GENERALAGGREGAM B 2.000.000 CiNLAGGREGGXTEUNn APPUESPER (PRODUCTS-COMP/OP AGG S 2.000,000 POLICY jvCa F�LOC I § AUTOMOeILELUBILtTV COMBINED SINGLE Ler S it IEs am�mrlt) ANY AUTO j BODILY INJURY(Per person) § ALILOWNED AUTOS LOWM SCHEDULED F^AUTOS BODILY INJURY(Per A M) § NIBEDAUTOS PROPERTY DAMAGE i (Pa ecCUenrt) NON-ONMEDAUTOS I S EXCERS ASAB CLAM, _ _ —_ I EACH OCCURRENCE s _.._ IJAe I-1I OCCUR��' S 1 AGGREGATE B DEDUCTIBLE I+ I g R6fENm0N S I I S WORXSRS ConPENSAM" WCSTAT OTH: ANO EMPLOYER6'UAIXUTY V!N I I I ITORY LWITS I nil I A ANY OFFICE MEJuB RNARTNERIExECUTIUE ❑ OBWF-DLF4963 08/o1A1 GIVOIJ12 I E.L EACHACCIOENT i 600,00q OFFICERMEMBER ARTNERIE N/A _ _ If dbcri � IEL DISEASE-EAFMR Or00 a SOBI OescRlrrwrv`OF OPEMMONSo I iLL DISEASE-POLICY UMr I - -- 600.00M AXED TO 978-7ATION9/LOCATIONSIVEHICLES IAtea1 ACORO tOl,lddeend Remarks 6cheAu:e,Nrtwrn spaea le rw7ulrepj - -- ' FAXED TO:978-740-0404 CITY OF SALEM AND THE SALEM REDEVELOPMENT ALTT14ORITY AS ADDITIONAL INSUREDS ,PERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE �/ABBOVEE�{D�EFSSCC7RIBED POLICIES BE CANCELLED BEFORE CITY OF SALEUNITY DEFT OF PLANNING THE EXPIRATIONACCORDANCE WITH 9NE'IDOL'I;XR• A 'Wo. DELIVERED R1 8 COMMUNITY DEVELOPMENT / ATTN,TOM DANIEL 7/ 120 WASHINGTON STREET aUraoRncn REPtiBSENTATIV SALEM,MA 01970 Mark Mi.SattencourtV Prwdent 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD mime and 1090 are registered marks of ACORD ................. r -.................iJ YY u / e v �DJ P e ' u F e 6 Effective Date:August 8th, 2011 ; Western Surety Company e 9 F ' a i e a LICENSE AND PERMIT BOND ' e v a KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 61126358 Thatwe, Kathryn Leavy dba Roost Urban Country Design d 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 ($1.000.00 ), 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 A FRAME SIGN PERMIT BOND 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 August 8th 2012 , 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, to the Obligee and to the Principal at the address last known to the Surety, and at the expiration of thijy\ej " �lays from the mailing of said notice, this bond shall ipso facto terminate and the Surety ahatiGIfEz4eixp _)f lieved from any liability for any acts or omissions of the Principal subsequent to said dgi [ A•.aythe number of years this bond shall continue in force, the number of claims made ag��n? 's borlia the number of premiums which shall be payable or paid, the Surety's total limit of lxt shall not bd emulative from year to year or period to period, and in no event shall the Surety's total li§.t ity� aIINA.ii =exceed the amount set forth above. Any revision of the bond amount shall not be o Ou%uI&Ve. M1 P P f/Vy/Ti 1�\L\ Date d/N°is�t,\\ 10th day of August 2011 a P P R ° e ® Roost Urban Countr Design F ' c Principal e F ' B ' na F Principal � WE E RET COMPANY t/ R P R a F e ° Paul T.•Bruflat,S&or Vice President e v Form 532-1-2010 ° F F ' B ° � ..�..r..�......` s .. ACKNOWLEDGMENT OF SURETY STATE OF SOUTH DAKOTA 1 as (Corporate Officer) COUNTY OF MINNEHAHA I On this loth day of Parquet 2011 ,before me,the undersigned officer, personally appeared Paul T. aruflat ,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. �V494444 S. EI444M1M19bbV44f S. ECH �� �//v,�//�'./•/,.//�I i aEa NOTARY PUBLIC a^=t •y - - i(RSOUTH DAKOTA�? Notary Public—South Dakota �M14VV44V94Ya4444444V44V4 My Commission Expires February 12, 2015 ACKNOWLEDGMENT OFPRINCIPAL (Individual or Partners) STATE OF as 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 PRINCIPAL STATE OF ss l (Corporate Officer) 1 COUNTY OF } On this day of ,before me personally appeared who acknowledged himselflhereelf 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 ryQ— �Fy1 L / y z a' a e fl� 2 a o ¢ o b ✓/J � w � Pa � d [(✓�� a z z x w U "d JQ J y H 4. > 0 a 4+ V`J ya y� 'O4 0 7J m a rg a o rn w 6 v 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 Untied States of America,does hereby make, constitute and appoint Paul T Bruflat - of Sioux Falls , State of South D kota , Its regularly elected Senior Vice President as Attorney-in-Fad, 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 A FRAME SIGN PERMIT BOND City of Salem -- bond with bond number 61126359 for Rathrvn Leavy dba Roost Urban Country Design as Principal in the penalty amount not to exceed: $ 1,000.00 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 duty adopted and now in force,to-wit Section 7. Al 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 Attomeys-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 loth day of August , 2011 ATTEST ry� a WEST E N U R E T>1 COMPANY L07' By a .� L.Nelson,Assistant Secretary Paul T.Bfuflaf,Senior Vice President aaaaa+ininllgr STATE OF SOUTH DAKOTA Jjas S '. COUNTY OF MINNEHAHA ,,100 �aV.O,.t' fit On this loth day of August 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. {4bh444bh4hhbh4hhh44hb44b{ r D. KRELL fSEAL NOTARY PUBLIC SE�At r s SOUTH DAKOTA r {444hh44444h4hhbb44hh444 { Notary Public My Commission Expires November 30,2012 Fovn F1975-9-2006 ,acoRl �-� CERTIFICATE OF LIABILITY INSURANCE 05 20 2013 THIS CERTIFICATEIS 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 CERTIFICATEOF 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 ADDITIONALINSURED,the policy(ies)must be endorsed. If SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONIACI JOHN J WALSH INS AGENCY INC/PHS PONE A 088411 P : (866 ) 467-8730 F: (800) 308-5459 h MAIL Ne,Ear (866) 467-873Q AIc.Nal: (800) 308-5455 301 WOODS PARK DRIVE ADDRESS: CLINTON NY 13323 INSURER(S)AFFORDING COVERAGE NAICk INSURER A: Hartford Accident & Indemnit Cy G) INSURED INSURER B: f� BIRDS & BEES , LLC INSURER C 40 FRONT ST INSURER D SALEM MA 01970 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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. ILTIRNSR TYPE OF INSURANCE INSR WVD POLICY NUMBEfl IMMIOOIVYVYI (MMEFF MIIDDA'VYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 DAMAGE I T(E.. EU COMMERCIAL GENERAL LIABILITY PREMISES IEa ocwnence) S CLAIMS MADEOCCUR _ _I I MED EXP Any one person) S u u PERSONAL&ADV INJURY S GENERAL AGGREGATE S GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S POLICY JECOT � LOC 5' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I Ea accidend JII ANYAUTO I BODILY INJURY(Pal p.a.rl $ ALL OWNED I I SCHEDULED u u BODILY INJURY(Par accudentl S H AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE 5 AUTOS IPer..,don0 S UMBRELLA UAS I RETENTION $ OCCUR I I ' I EACH OCCURRENCE 9 EXCESS LIAR CLAIMS-MADE u IJ AGGREGATE 5 DEOI - 5 WORKERS COMPENSATION X I WC TATU- OEq AND EMPLOYERS'LIABILITY E TO A OFICERMEMBERANY RXCLUDED?XECUTIVE�/N'/N' NIA 08 WEC LF4963 06/01/2013 06/01/2014 E.L EACH ACC(DENTS rjOQ' 000Q (Mandatory m NH) ua LJ EL OI SEASE-EA EMPLOYEE] 5 55 Q Q , Q'O Q D Yea,describe antler 500, 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ uu DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AUnch ACORD 101.Additional Remarks SchedWo,if more space n r wk.dl Those usual to the Insured' s Operations . Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. RE : A frame sidewalk signs, LOCI 001 , Bldg 001, 002 . CERTIFICATE HOLDER CANCELLATION City of Salem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Department of Planning and Community BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Development DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 120 WASHINGTON ST AU7NOR12E RPRESENTATIVE�7 SALEM, MA 01970 K 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD JOHN J WALSH INS AGENCY INC/PHS 301 WOODS PARK DRIVE CLINTON NY, 13323 04676 City of Salem Department of Planning and Community Development 120 WASHINGTON ST SALEM, MA 01970 o _ V ACORD 25 (2010106) 38 FRONT STREET 398-10 COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM GIS 7: TM91 Map: I35 - — Btock` - SIGN PERMIT Lot: 0611-813 Permit: Sign — -- Category: SIGN_ Pemut 398-10 --- PERMISSION IS HEREBY GRANTED TO: Project t `JS 10-20 -000609 Est. Cost: $750.00 Contractor: License: Expires Fee Charged:$20.00 (Footprint Signs Balance Due:$;00 Owner: RENEWAL REAL ESTATE, LLC - - -- -- - of Fixtures I Applicaftt: RENEWAL REAL ESTATE, LLC — - — --- Digsafe# _ .AT: 38 FRONT S`PREET UseGroup — ConstClass _ ISSUED ON: 19-Nov-2009 AMENDED ON: EXPIRES ON: 19-Jun-2010 TO PERFORM THE FOLLOWING WORK: ERECT SIGN 20'X 36'FOR ROOST URBAN COUNTRY DESIGN THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM ipPON�' 0LATI N OF 4YIIOF ITS RULES AND REGULATIONS. �LJJ,,�� Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: SIGN REC-2010-000709 19-Nov-09 158. $20.00 GcoI 2009 Des I-auriers Municipal Solutions,Inc. City of Salem Sign Permit Application Worksheet 21.Oct-09 Roost 40 Front Street Zoning(res/non-res) 65 Entrance Corridor(Y/N) N Lot frontage 20 feet Building or tenant frontage 20 feet #of businesses on site 1 Bldng dist from street center 20 feet Multiplier 1 Building and Blade Signs maximum area permitted 20.00 sq ft total proposed sign area 20.00 sq ft sign 1 length 36.00 inches height 20.00 inches sign 2 length 60.00 inches height 18.00 inches sign 3 length 60.00 inches height 18.00 inches sign 4 length 0.00 inches height 0.00 inches sign 5 length 0.00 inches height 0.00 inches Freestanding:Signs 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(approx) 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 Permit Number 0..-\� APPLICATION FOR PERMIT TO ERECT A SIGN �( 3v - '. NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED Location, Ownership and Detail Must Be Correct, Complete, and Legible �8rpy ° Salem, Massachusetts 10 r S I ag —/ Date To the Building Inspector: The undersigned hereby applies for a permit to Erect, ❑Alter, ❑Repair a sign on the following described buildings: Street Address —Zoning District rban Renewal Area a Entrance Corridor D f I>Arl> 3 f ❑Historic District ❑ None $6 SnLC-µ a.E-r4&44� LL,' II - . 1 . . Telephone q{tt ".4-L-•{g I is floor pP,4 Ci /efrGGer ' KATis LOAVy 1� 2 floor ppsSmfmr&&� Address 4ft yD fAON1— ST, S4cekt, H4 I 3"floor Telephone (e) 4"floor E-mail ro Dst SAI[A+ a o)wtAt t .co+t I How many businesses are in the building? S If a corporate body, name Frontage of responsible officer P"T PLr-141— atCrNs I Building APP,uK r2o linear feet Constructon Sup'sLicenseNo I I Applicant's Space(it multi-tenant) 2a linear feet Address I 240 GAN4r- ST , Sh1E4&, PAAE I Property Aj#Ae a tzo linear feet Telephone qs►q> , }( ( 366$ Mail Sign Permit to E-mail I I o r 2 , ej i.f w o s Sign Owner o Sign Erector o Other. Sign 7 Si n 2 Slin 3 Li Surface urface ❑ urface might 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 Sign Materials Sign Materials 1 pJc- VSNYL Pa,L,tt— Sign Dimensions/ Sign Di nsions r ra Sign Dimensions 3V,r x 20'r T(p0" K ��") x wr, ,)Vws Sign Area Sign Area Sign Area .S sq itI S sq ft sq tt Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ asoD. I I Existing Signs I Type ISign Area To Be Removed? Sign Own7uthorized o Surface sq it ❑yes ❑ no wKight Angle to Building -4•S sq It �es- o no • Free Standing sq It ❑yes ❑no Sign Owntative ❑Awning sq tt ❑yes ❑ no •Other(specify) sq it ❑yes ❑ noProperty j1 Internal Review r_1 fanning B Community Dbvelopment Department Historical Commission r Building Inspector r f uovoe rep 20"x 36" hanging sign *White background "Multi colorerd logo and lettering "Double sided "PVC mounted from bracket perpendicular to wall roo vW ± '. country de0ign • e i. oa a � w o a us w (� 9 V � C O O 4 mow t 71 INS 18"X625" White 1 Background Multi Colored 19 Logo and Lettering Digitally Printed �1 on Rim and Applied at Direct to Wndow PMS 383 ` PMS413 l - r �a PMS 464 20"h x 36'W IY _--0Y'- fO�moilN er°pvto° v PMS 476n 'While r, Background 'Mull Colored Logo and lettering 'Double-Sided PMS 158 'PVC Mounted From Bracket L •to W.01dlcrd°r 1{r to W°II 1 Version 1 Drawing for Petmittiag I October 13-2009 Roost Style to match bracket for J. Mode and Fiddlehead, both neighboring businesses on Front St. 16" 42" e 6 l ..1. �q �', .. M Uf C7 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 I Check Cash Client Information CASH PAYMENTS: client initials r-l"12ign Permit Application Fee Conservation Commission Fee Payment received for what ❑ Planning Board Fee/ ZBA service? SRA/DRB Fee Old Town Hall Rental Fee Other: Copies Name of staff person receiving payment Additional Notes 1 KATHRYN E. LEAVY 12-0e 156 JAMES L METSCH 3 SMITH STREET CT. MA ROCKPORT,MA 019W1329 / 53-I3/l82 20 /O /b/ J `j 82720 Oate Pay to the r. Order nt C'C 'l �.ra IJ TJ'o�+CY DJ«A2-S nollors Bankof America��„ ACHi 011"IM ' For 3i�J '*a --Ij: ^^ 1:0 1 i000 1381: 0046 i 79 36 398110 Original Check and Form: DPCD Finance Copy 1: Client Copy 2: Application File Company ective Date: December 3, 2009 Western Surety K LICENSE AND PERMIT BOND . a KNOW ALL PERSONS BY THESE PRESENTS: Bond No 70840263 C � t That we, Katherine Leaw dba Roost Urban Country Design i u R of the Citv 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 ( $I,000-ao 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 Sian 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 December 3rd 2010 ,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 i�tj,0,e Obligee and to the Principal at the address last known to the Surety, and at the expiration of tt x 'j d*ys from the mailing of said notice, this bond shall ipso facto terminate and the Surety sh .�hereu o""zt'b- ieved from any liability for any acts or omissions of the Principal subsequent to said ;' date, R e ''t .e number of years this bond shall continue in force, the number of claims made a.: 6 'this bon 'a="d�he number of premiums which shall be payable or paid, the Surety's total limit of aka . Ira ty shall n t be cumulative from year to year or period to period, and in no event shall the Surety's total exceed the amount set forth above. Any revision of the bond amount shall not be 6 , c�' . r: 1 i ``tpbl4� DiN Dated this 3rd day of December 2009 r KATHERINE LEAVY DBA ROOST URBAN E Y' COUNTRY DESIGN Principal ' Principal �l COUNTERSIGNED WESTE SURET COMPANY BY NOT NEEDED i Resident Agent By— Paul � r Paul T.Bruflat,SeAor Vice President Y Form 532-2-2006 w r