105 ESSEX STREET - SIGN PERMIT 105 Essex Street
Jolie Tea Company
City of Salem Sign Permit Application Worksheet
RECEIVED
INSPECTIOt: v
25-Oct-15
Jolie Tea Company
105 Essex Street 101521 A ID 4q
Zoning(res/non-res) B5 V S2
Entrance Corridor(Y/N) N
_ Lot frontage 53 feet
Building or tenant frontage 46 feet
( #of businesses on site 2
Bldng dist from street center <100 feet
(� Multiplier 1
(
Building and Blade Signs
maximum area permitted 46.00 sq ft
Utotal proposed sign area 7.00 sq ft
sign 1
F
Sign length 36.00 inches
height 28.00 inches
sign 2
length 0.00 inches
height 0.00 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
FreestandingSigns - -
maximum area permitted 32.50 sq ft(per side)
maximum#of signs permitted 1 signs
maximum height permitted 12.50 ft tall
sign 1
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height 0.00 It(approx)
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets standards set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes
Permit Number
c APPLICATION FOR PERMIT TO ERECT A SIGN
M / Y NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
Location, Ownership and Detail Must Be Correct, Complete, and Legible
d� Salem,Massachusetts
Date
To the Building Inspector:
The undersigned hereby applies for a permit to (Erect, ❑Alter, ❑Repair a sign on the following described buildings:
AddressStreet
p� c�� ❑ Urban Renewal Area ❑Entrance Corridor
IT -5 kll •-t ❑Historic District a(None
• Use of Building
Telephone T. f- 46 lsfloor (OI1AA4 1p_UA:i_
•
A,My TOS U01PFC6I PJV-i L z^ floor R25lDeirnop—
Address lite ILA"Aw MA61 3 floor jZejlDeKfnKt__
Telephone �) - 3�_ ` I 4 floor
E-mail &K J-68 E9) C6 "c'51-•NrcT How many businesses are in the building?
ff a corporate body, name Frontage
of responsible officer
KE 1:,;; - ( (A Building 5 linear feet
Construction Sup's License No C 5 - 037,12..1 Applicant's Space(if multi-tenant) ?,y linear feet
Address 5 4I CTeU-"p IQ.0A P IQ0uLp01f'T Property linear feet
Telephone 1-T_ 1 v- WqLf Mail Sign Permit to
E-mail ign Owner ❑Sign Erector ❑Other:
Si Proposedn 1
Sign 2 Sign 3
o Surface ❑Surface ❑Surface
ryf9ight Angle to Building ❑Right Angle to Building ❑ Right Angle to Building
❑Free Standing ❑Free Standing ❑Free Standing
❑Awning ❑Awning ❑Awning
❑ Portable(A-Frame) ❑Portable(A-Frame) ❑ Portable(A-Frame)
❑Other(specify) ❑Other(specify) ❑Other(specify)
Sign Materials Pv G Sign Materials Sign Materials
Sign Dimensions 3au X 2. ? Sign Dimensions Sign Dimensions
Sign Area Sign Area Sign Area
"I s ft s ft s tt
Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ Via 1►-rMf-O'11aPJ 61QL
Existing Signs
Type Sign Area To Be Removed? Sign Owner
❑Surface sq It ❑yes ❑ no
❑Right Angle to Building sq ft ❑yes ❑no
❑ Free Standing sq it ❑yes ❑no Sign Owner' ti ' d e entative
wAwning sq tt ems ❑no
❑Other(specify) sq it ❑yes ❑no
Property Owne
Internal Review
Hing 8 Community Development Department Historical Commission
Approval
'.' �
Building Inspector
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Western Surety Company
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LICENSE AND PERMIT BOND
KNOW ALL PERSONS BY THESE PRESENTS: Bond No. ^`•%?
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of iWEtdHP!"I State of iia sarhA_ie:ett as Principal.
and WESTERN SURETY COMPANI-. a corporation duly licensed to do surety business in the State of
tias�acl-�ue'etr_ , as Surety, are held and firmly boundunto the
riry of _.,ler
. State of rras,aclm=err,. , as Obligee, in the pr--nal
sumo£ ,ne Thouaand and op 1pn DOLLARS
( $1, pini. -r,
lawful money of the United States, to be paid to the Obhgee. for which payment well and truly to be niad,,.
we bind ourselves and our legal representatives, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal Inas been
licensed sicla Permit
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 lie void. otherwise to remain in full force and effect until
toter
12- = unless renewed by Continuation Certifir_ate.
This bond may be ter niinated at. any time by the Surety upon sending notice in writing. by First. Class
T.S. Anil, to the Obligee and to the Principal at the address last lulown to the Surety, and at the expiration
of thirty-fi e Y3Gt,flaps from the mailing of said notice. [his bond shall ipso facto terminate and the SmetV
shall ther�PUpon be vIieved from any liability for any acts or omissions of the Principal subsequent to said
date. Regardless of Site number of years this bond shall continue in force, the number of claims made
against this bond aiitl the number of premfrmrs which shall be payable or paid, the Surety's total unlit of
linbilii;v shall not be cumulative from year to dear or period to period, and in no event shall the Suretv's total
liability for all claims exceed the mnount set forth above. Any rrvision of the bond amount shall not. be
�umulali�a'
Dated this .1::r day of �ct• Le�- -i1=.
i �7iLIE TEA ���INE'A1iT. LL''
Principal
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Principal
\VESTS SURET COAIPANI-
By
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Form 532-12-2071 _
Paul T. Bruflat. ' nior Vice President
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ACI NOWLEDCMENT OF SURETY
STATE OF SOUTH DAKOTA i ss (Corporate Officer)
COUNTY OFA NNEHAHA I
Cm this _kat_ day of Octel es =015 before me,the undersigned officer,
personally appeared Paul T. R r u l at ,who acknowledged himself to be the aforesaid
officer of WESTERN SURETY Ci)MPANY. a corporation, and that,he as such officer,being authorized so to doexecuted
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 any hand and official seal.
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SiSEAL NOTARY PUBLIC SEAL s
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Ph 'muiasion E:-p.ire:- Augu:=t 11, 2ol6 ACKNOWLEDGAIENT OF PRINCIPAL
STATE OF ss
(Individual or Partners)
1,
COUNTY OF
On this day of , before me personally appeared.
known to me to be the individual_described in and who executed the foregoing inst.rnrnent and acknowledged to me
that._he_ executed the same.
bly commission expires
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL
STATE OF (Corporate.Officer)
COUNTY OF �•ss
On this day of 1 -, before me personally appeared
who acknowledged himself/herself 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 conunission expires
Notary Public
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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
-nut T. Bnaflat of Sioux F11-
State of s-ith D-4 t- its regularly elected ic= Ire_.ida nt
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 Si,:m Permit City of Salem
bond with bond number 62565?7`
for V,LIE TEA rOMPAN LL--
as Principal in the penalty amount not to exceed: $
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. a by such other officers as the
Board of Directors may authorize. The President. any Vice President, Secretary, any Assistant Secretary, a the Treasurer may appoint
Ahomeys-in-Fact a 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 or 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
`Ji.e Pxesi•ient with the corporate seal affixed this 21st day of C�rroL--i
•
ATTEST WESTE N URET COMPANY
/ By
L. Nelson.
ssistant Secretary Paul uflat,Vice Resident
STATE OF SOUTH DAKOTA
COUNTY OF MINNEHAHA as
On this -1st day of 0Ctoh,eI _015 before me,a Notary Public, personally appeared
Paul T. Bruflat and L. llelson
who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as 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.
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My Commission Expires August 11.2016 Nctary Public
Form F1975-1-2012 �rrNs'
CNA Transaction Report & Invoice
Principal Information: ID
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V.-LIE TEA LL,-
11. L==.ECH RJG;
Agency Code: 4--1 -,
YOU CAN PAY ONLINE BY VISITING ONLINEPAY.CNASURETY.COMI
Transaction Description: Transaction Effective Date: for_1) 1
Written By.
Description:
Obligee:
Effective Date: 1, - _ i ._)IL' Gross Premium Charge:
Expiration Date: If-,, ' --01�= _
Current Penalty: 'l , - - Commission Amourd - - - • -
Reneval Method: Net Amount Due:
Change Detail:
Agent: You may remove stub below to use as a billing/credit invoice
__--....._.__—___------------------_-_-.._-----------------_.___ _......._.._._-__-_.._.._----_------------_____......_—__.-_______.—_.._..—_--.__. _
CNA Surety INVOICE
CO.# I BOND/PD 11 Yy t 11F C111 DATE ANNIVERSARY DATE PROCESSDATE PENALTY
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PRINCIPAL ?'-'LIE TE>=_ C')IlEA1-1'i, LLQ
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RISK STATE ILA VVRITTENBY ✓fie=T:SLri St112t CJGipari%
DESCRIPTION -SiQll E'e Linn
OBLIGEE -'it' Ot 53121u
AGENCY CODE
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Your agent is: N ;� A A Ir,glID3n Ce? AgefiCf, IIIG.
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CONTINUATION CERTIFICATE
Western Surety Company hereby continues in force Bond No. 62565773 — briefly ,
described as SIGN PERMIT CITY OF SALEM
MEMBER 0014937604 - --- - — - -
for JOLIE TEA COMPANY LLC
as Principal,
in the sum of$ Dollars, for the term beginning
October 21 , 2016 , and ending October 21 2017 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 26 day of September 2016
>`y`a��aHtcar ;a@WESTERN URETY COMPANY
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By
_+ w Paul T.Brqorat,Vice President
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THIS"Continuation Certificate"MUST BE FILED WITH THE ABOVE BOND.
Form WA-8-2012
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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 of South Dakota ,its regularly elected 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 CITY OF SALEM
MEMBER #014937604
bond with bond number 62565773
for JOLIE TEA COMPANY LLC
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 duly adopted and now in force,to-wit:
Section 7. All bonds,policies,undertakings,Powers of Attorney,or other obligations of the corporation shell 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
Vice President with the corporate seal affixed this 26 day of September 2016
ATTEST 7eN SUR CO PANY
C` o 2Z n� By T-
0 L Nelson,Assistant Secretary Pau . Bruflat,Vice President
`nhb4•^ P�!'ryy4fiW c..P M iY�ri.
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STATE OF SOUTH DAKOTA F �r
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COUNTY OF MINNEHAHA
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On this 26 day of September - 2016 ,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 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.
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}yyyyyyyyyyyyyyyyyyyyyyy} My Commission Expires June 23,2021
To validate bond authenticity, go to www.enasurety.com > Owner/Obligee Services > Validate Bond
Coverage. *s
Form F1975-1-2016 %4P
• SF
CNA 7.800-331-6053
PO sox 5077 Sm.Fab SO 57177-5077 Fax 1-605-335-0357
www.cnwurety.wm
September 26, 2016
JOLIE TEA COMPANY, LLC
116 Larch Row
Wenham, MA 01984
File# 62565773
JOLIE TEA COMPANY, LLC
$1,000.00
Company Code: 0601
Written By: WESTERN SURETY COMPANY
SIGN PERMIT CITY OF SALEM
MEMBER#014937604
Enclosed is your renewal certificate. To continue your bond coverage and keep it in force, you must
file this renewal document with the city of Salem.
If you are no longer required to post this bond, please write the word "Cancel' directly on the
document, and return it to CNA Surety.
If you have any questions, please contact your local agent.
Enclosure
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Western Surety Company �f oPM"
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CONTINUATION CERTIFICATE
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Western Surety Company hereby continues in force Bond No. 62565773 briefly
described as SIGN PERMIT CITY OF SALEM
MEMBER 46014937604
,
for ,IOLIE TEA COMPANY, LLC
as Principal,
in the sum of$ ONE THOUSAND AND NO1100 Dollars, for the term beginning
October 21 , 2017 , and ending October 21 , 2018 , 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 27 day of September 2017
WESTERN URETY COMPANY
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By Paul T. Bruflat,Vice President
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THIS"Continuation Certificate"MUST BE FILED WITH THE ABOVE BOND.
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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 of South Dakota its regularly elected 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 _SIGN PERMIT CITY OF SALEM
MEMBER #014937604
bond with bond number 62565773
for _70LIE TEA COMPANY LLC
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 duly adopted and now in force,to-wit
Section 7. AAI 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-Fad 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
Vice President with the corporate seal affixed this 27 day of September , ._ 2017
ATTEST WE /N SUR COMPANY
By 4
L. Nelson,Assistant Secretary P .BmIlat,Vice President
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STATE OF SOUTH DAKOTA '; L@�
COUNTY OF MINNEHAHAas
On this 27 day of September 2017 before me,a Notary Public,personalty appeared
Paul T.Bruflat and L. Nelson
who,being by me duly sworn,acknowledged that they signed the above Power of Attorney as 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.
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NOTARY PUBLIC SEALr
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