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147 NORTH STREET - SIGN PERMIT --- • AND -,w 2 1 V h � rt TOA �c 14 4 q!/, �I � 5�6 -oiBS �4x ME!WIN— m I I *�� I'WIAN Karen Hubbard owner 781-941-2066 FAX 781-941-2067 171 Broadway, Route 1 South saugus@signarama.com Saugus,MA www.signarama.com/01906 Independently Owned and Operated mrJACKSON HEWITT JOHN MCMANUS Franchise President 221 LEWIS STREET 147 NORTH STREET LYNN,MA 01902 SALEM. MAO 1970 Tel 781-596-3656 Tel:978-740-0731 Mos'Off"ae Indepen0enlly Owretl avd pperalld IMPORTANT MESSAGE FOR I lA,llll� Q( LM !'l(.LJ DATE J TIME LP.M M OF PHONE AREA GOOE NUMBER EXTENSION p FAX ❑ MOBILE AREACOOE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILLCALLAGAIN WANTS TO SEE YOU RUSH RETURNEO YOUR CALL WILL FAX TO YOU MESSAGE SIGNED Universal 48005 LITHO IN U.S.A. II n. / •- a - _ r e� r �;� '"; . 1f� � � 4 '.ry � �� 4 '. �1' i • � 1� L� moi.. i �- �• ! , �r+rosc Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN j /t a PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED ly Location, Ownership and Detail Must be Correct, Complete, and Legible SALEM,MASSACHUSETTS TO THE BUILDING INSPECTOR: The undersigned hereby applies for /a permit t1o�. / Erect_Alter, Repair a sign on the following described buildings: Location and No. 1/y C T'S ��ly' Zoning/District Name of Property Owner }-T-,"(3S ((� er r Name of Sign Owner .� � ` , fl/ (N-)`-� ,M I/4NV3 Address�E If Owner is a corporate body, name of responsible officer G `l Name of License .d Sign Erector (�-�L�- ,fy 5 L(3 N Salem License No. t VF Address T Ln` F,fl/jW 0 gJ_� U4-c� 0 d 2_ Use of Building: 1�Floor 3rd Floor 2"d Floor 411 Floor Frontage: Building �- l �eaz ft Property :53 1 linear ft Type of Sign Proposed: Surface �tght t Building Free Standing E] Awning Other(specify) V 5 I Proposed Sign Materials U a ------------- Proposed Sign Dimensions �T2 �; T Z I W+dN Stn 3 �[ Sign Area sq ft Existing Signs: Surface: Sign Area s ft Right Angles: Sign Area sq ft Free Standing: Sign Area sq ft Other: Sign Area sq ft Signs to be Removed: Type Sign Area ( sq h Signature of Owner C�k'�1'�"1 Estimated Cost of Net Work Signature of Owner's Authorized Representative �n $ /3L`3� Address Telephone �-� (o _ L Signature of Property Owner ' APPROVALS (Department Use Only): PLANNING&&COMMUNITY DEVELOPMENT HISTORICAL COMMISSION BUILDING INSPECTOR e - -ec POP �irsaara•rs Ldway, Route 1 South gus, MA 01906-2066IFax:781-941-2067 ugus@signarama.comIt gnarama.com/01906 Name: Company: C Phone: Fax: E-mail: Comments: O File: _ Date:10/3/2005 Time: • a Colors: + O x rM Fonts: V ME � Approval: Date: 177 This design and drawing submitted for your review and approval is the exclusive property of SIGN*A*RAMA. It may not be reproduced,copied,exhibited or utilized for any purpose,in part or in whole by any indlvlduel inside out outside without written consent of SIGN*A*RAMA. *A*F3gM�� 2 Alumalite signs with black trim cap 171 Broadway, Route 1 South 58 in Saugus, MA 01906 Ph:781-941-2066/Fax:781-941-2067 _ Email:saugus@signarama.com vinvw.signarama.com/01906 I JACKSON NEWITT cv Name: TAN SERVICE i Company: Phone: -- - E-mail: JACKSON HEWITT SmTAX SERVICE Comments: — - - - File: - - - - — 144 in Date:10/5/2005 Time: Colors: Flush mounted directly to building with screws Fonts: Signs are 1/4 Alumalite edges are trimmed with black trim plastic Approval: Date: they will have black and red vinyl graphics applied to them . One is 21" high x 58" long, and One is 21" high x 144" long This design and drawing submitted for your review and approval is the exclusive property of SIGN*A*RAMA. It may not be reproduced,copied,exhibited or utilized for any purpose,In pan or In whole by any individual inside out outside without written consent of SIGN*A+RAMA, ^^ O/'3U✓zUUS IU :ZB PAGE 002/002 Fax Server ACM. CERTIFICATE OF LIABILITY INSURANCE °ATEI370 01YYYY) PRODUCER 8 90 2005 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION Ry1Ant Droop Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO Box 10660 HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR JACXBONVILLE rL 32247 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ..___ INSURERS AFFORDING COVERAGE NAIC# INSURERA' AABurAnOR Co n oP Atirias 19305 Rub Design, Inc., Dba Sign-A-sou --... INSURER B MARYLAND CASUALTY 19356 117 CRO88 LANE INSURER C. BRVRRLY NA 01915 INBURERD IN6URERE -_----- —_- - COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDRICN 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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PODCVNUMBER PO Y VE Policy YR TION UMITS GENERAL LIABILITY EACHOCCURRENCE E 00.0 A A X COMMERCIAL GENERAL IJAGIL ITV PAS 000332017 11/8/20D4 11/8/20D5 PREM SE91ERo'.:'U"Ummm) E .1,000,000 CLAIMS MADE �DOODP MEC EXP(An onaeml E 10 D00 PERSONAL E ADV INJURY E 1,000,000 GENERAL AGGREGATE E 2,000,000 0ENI AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGO E 2,0 0,000 POLICY PRO X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LW7 E A A ANY AUTO PAH 000332017 11/8/2004 11/8/2005 (EA II _1_,000,_000 ALL OWNED AUTOS SCHEOULED AUTOS BODILYINIURV B (Por ILYIN) X HIRED ALTOS BODILY INJURY E X NON-OWNED ALTOS (Pr amq (PN ar PROPERTYaAanO DAMAGE E GARAGE LIABILITY ALTOONLY-EAACCIOENT S ANY AUTO OTHERTHAN EA ACC E AVID ONLY ADO E BXC ENIUMBRELIA LIABILITY EACH OCCURRENCE 9 2,000,000 A A Y OCCUR CLAIMS MADE PAS 000332017 11/8/2004 11/8/2005 1 AGOREOATE E 2,000,000 I DEDJC71BLE E E RETENTION E E B WORKERS COMPENSATION AND MC 000332058 11/8/2004 11/8/2005 1 X A U- I 'EF' EMPLOYERS'UABILCY ANV PROPgIETORIPARTNEWEXECUiIVE E L EACH ACCIDENT E 100,000 LOYE _ OFFICERIMEMBER EXCLUDEDP E L DISEASE-EA EMPE _ 500 000 IIN tlMalba untler J 8�EGIAI. ROVISIONS bal. E.L.DISEASE�POI ICV LIMB I A 100,000 OTHER DEB C MFTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED By ENDORBEM BIT I SPECIAL PROVISIONS BION PAINTING OR LRITEIRING CPITIFICATE HO ER CANCELLATION SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION RIA DReION, INC., Om BION—A_pIILp DATE THEREOF,THE ISSUNG INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER MIMED TO THE LEFT,BUT FAILURE TO CO SO SMALL 171 BROADWAY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,R9 AOENTS OR SAUGUS MA 01906 REPRBBINTATIVE6, AUTHOWEO REPRESENTATIVE JWSNLFI""."""0 ACORD 28(2001/08) GI 0 ACCRD CORPORATION 1008 Page 1 Of L 80Y1Yr AA 8/30/2005 10:28 PAGE 002/002 Fax Server ASA,. CERTIFICATE OF LIABILITY INSURANCE DA8/ —TE(MM - 30/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hylant Group Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO sox 10660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR JACKSONVILLE FL 32247 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC A INSURED '- .— -- Bub Desi INSURERA. Aaauranae of Aaarioa 19305 Design, Inc., Dba 81gn-a-ranm INSURER B. tYUiYLAND CASUALTY 19356 117 CROSS LANE INSURER C' BEVERLY HA 01915 INSURER D' INSURER E COVERAGES 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 CCNTRACT 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAM. 1317 POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONDATE MI DATE fMM,0DAOk LIAllf6 GENERALUABIUTY EACHOCCURRENCE S. 1,000,O 00 A A X COMMERCIALGEN PAL LABILDY PAS 000332017 11/8/2004 11/8/2005 PREMISES EB aoaienm $ 1,000_,000 CLAIMS MADE �OCCUR MEC E%P(M one roan) $ 10,000 PERSONAL A ADV INJURY A 1,000 000 GENERAL AGGREGATE $ 2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000 000 POUCY F7 PRO- IPCT Y LOC AUTOMOBILE UABILITY COMBINED SINGLE LIMIT A A ANYAUTO PAS 000332017 11/11/2009 11/8/2005 TEA=dWl) E 1,000,000 ALLOWNEDAUT09 BODILY INJURY $ SCHEDULED AUTOS (Pw person) X HIREDAUTOS BODILY INJURY X NON OMEDAUTOS (Pa wdmm) E PROPERTY DAMAGE $ (Pa itw4 ) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AERO OAN EA ACC $ AUTO TO ONLY AGO $ EXCROWUMBRELLA LIABILITY EACH OCCURRENCE S 21 000,000 A A X OCCUR FICLAIMS MADE PAS 000332017 11/8/2004 11/8/2005 AGGREGATE $ 2,000,000 E DEDUCTIBLE $ RETENTION $ $ e WORKERS COMPENSATION AND INC 000332058 11/8/2009 11/8/2005 YI TI STA u 0 R. EMPLOYERe'LABILITY ANY PROPMFORMARTNERIEXECUTIVE EL EACH ACCIDENT S 100 000 OFFICERIMEMBER EXCLUDED? EL DISEASE-EA EMPLOYE $ 500,000 Il yee aeealDe un°e EL DISEASE-POLICY LIMIT $ 100 000 SPEGIIAL PROVISIONS W.w OTHER DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES,EXCLUSIONS ADDED By ENDORSEMENT I SPECIAL PROVISIONS SIGN PAINTING OR LETTERING CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION HUH DESIGN, INC., DBA SIGN—A—PAHA DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 171 BROADWAY IMPOSE NO OBUGAT10N OR UABIUTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. SAUGUS MA 01906 AUfHOMEUREPRESENTATIVE AU."t ACORD 25(2001,08) ©ACORDCORPORATION 1988 Page 1 of 1 a Workers Compensation and Employers Liability ZURICH Insurance Policy MARYLAND CASUALTY COMPANY Information Page NCCI CompanyNo.: 10545 ACCOUNTNUMBER: M015518238.001-00001 Branch Policy Number Producer Code Previous Policy Number 7-3 COLUMBUS I WC 0033205800 02331403 NEW Servicing Address P.O.BOX 10197 JACKSONVILLE Pi.32247-0197 ITEM 1. Name Insured and Mailing Address Producer Name and Servicing Address HUB DESIGN,INC.,DBA SIGN-A-RAMA HYLANT GROUP,INC. 117 CROSS LANE PO BOX 1687 BEVERLY MA 01915 '1'OI.EDO Oil 43603-1687 (419)259.6030 This Information Page, with policy provisions and endorsements,if any, completes this policy. Insured is: CORPORA110N Risk I.D. No: F.E.I.N.: 86111o9a9 Other Workplaces Not Shown Above: see SCHEDULE OF INSUREDS AND LOCATIONS ITEM 2. Policy Period: From: 11/08/2004 To: 11108/2005 12:01 a.m. Standard Time at the Insured's Mailing Address ITEM 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 Each Accident Bodily Injury by Disease $ 500,000 Policy Limit Bodily Injury by Disease $ 100,000 Each Employee C. Other States Insurance: Pan Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND,OH, WA,WV, WY AND THOSE LISTED 1N 3A. D. This policy includes these endorsements and schedules: SEE FORMS AND ENDORSEMENTS APPLICARLE LIST ITEM 4. The premium for this policy will be determined by our manuals of rules, classifications, rates and rating plans. All information required on the following Classification Schedule (s) is subject to verification and change by audit. SEE CLASSIFICATION SCHEDULE Total Estimated Standard Premium $ 671.00 If indicated below,adjustments of premium shall be made: Premium Discount $ Expense Constant $ 264.00 Annually Premium for Endorsements $ 15.00 Semi-Annually Taxes and Surcharges $ 33.00 Q Quarterly Total Estimated Annual Premium $ 983.00 Monthly Minimum Premium $ 216.00 Deposit Premium $ 983.00 Issue Date: 11110/2004 04SURF.DCOPY Countersigned By Authorized Representative JACKSON HEWITf® -- I All PANE & G.Y- 1 -A _ ... NOTE: ... .a .. ..•a i �»w��' Mme... +}5-99;124 City of Salem Department of Planning & Community Development Check/Cash Receipt and Tracking Form Please complete form and make two copies. Date Received 9 13 Amount Received 0 Form of Payment Check F] Cash CHECK PAYMENTS: C�Z write check number CASH PAYMENTS: write client initials Sign Permit Application Fee Conservation Commission Fee Payment received for 0 Planning Board Fee what service? 0 Old Town Hail Rental Fee Other Name of staff person receiving payment �� n c�c✓� I n Additional Notes 1y7 ^ C/L %J JOHN McMANUS X1492 FR SHARON MCMANUSDHA JACKSON HEWITT TAX SERVICE oATE 49 MASS AVE. DANVERS,MA01923O THE �OF 1 DOLLARS 8 4.... RIVER WORKS CREDIT UNION LYNN,MA 01905 1�p��/(/J� 1: 2 113 51: 00 ?011 ?0 W3II i49 2 Original Check and Form: DPCD Finance Copy 1: Client Copy 2: Application File