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122 BROADWAY - SIGN PERMIT 122 Broadway Rainbow Tile � i I 66 LORING AVENUE 829-08 COMMONWEALTH OF MASSACHUSETTS CITY OF SALEM GIS#: X393 -- — Map: 32 Lot: - --ot: 0069 SIGN PERMIT Permit: Sign Category: SIGN Permit# 829-08 Project# JS-2008-001340 PERMISSION IS HEREBY GRANTED TO: Est. Cost: $750.00 Contractor: License: Expires Fee Chazged: SIGN-A-RAMA Balance Due.$.00 Owner: AAV REALTY TRUST,VALASRATGIS A,VALASKATGIS ANNA TR #of Fixtures: Applicant: SIGN-A-RAMA DigSafe# AT: 66 LORING AVENUE UseGroup ConstClass ISSUED ON. 10-Mar-2008 AMENDED ON: EXPIRES ON: 10-Aug-2008 TO PERFORM THE FOLLOWING WORK: SIGN PERMIT AS PER APPROVED FOR SALEM TILE&LAMINATES,INC.(DBA)RAINBOW TILE 66 LORING AVENUE(122-124 BROADWAY) THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. N , Signatu Fee Type: Receipt No: Date Paid: li0-,y0V Amount: SIGN REC-2008-001694 10-Mar-08 $0.00 GeaTMS®2008 Des Lauriers Municipal Solutions,Inc. Feb '12 08 01:06p DPC 978-741.-0404 p.3 PeauitNumbar ✓ �/ e/- i )v, I!_ :L:_ "CIO i At PE VII' TO ]ERECT A SIGN s� }a r 11 :7TMi.,c . 1 CI E:l i@Z L1)1fUPCNRa. SIGVIcERECTED St:rSM,�'IASS.tt:t1U5ET1'S�I TO THE BUILDINC I; ENBE'I:E.CTOR: IccCt > �gp 'fnc under;igaed hereby ap f fi,s i� -a :pc.,--:r; tc _._ I:I: _._ ..._ld' ._✓_.._.__.Elrpai:a s:gt on iia Eoll g described buildings: Location and No. I�a_-,��-YU�:Cc ,�+-?�._.. _ .r,,L2�Y�_,_.... t.o`ninl;/Dis�ca.__ Name of Property OwneicL r J( ]�.Q\ s / -- J� Name of Sign Owner \gym.-4 1-e V...�✓Y14`fbjr^`4'J' rVt'dr:Iae 1 \a� f�j fCX If Owner is a corporate k-:A , o i n:: til ::espom a ::': :r .,� Q:� 2�La, 5� Name of Licensed Sign E:rectn-. Z C ._. .i4-�S1�l,7{`_ ..__...--.•---Saleym�LirennseNNo. Address 7_.s_....lT.x-4 -J .-'---��La'm)e�J Usc of Building: t, (:door..__ ✓. _ _ _---.........:.'a Tkor-__-- Frontage: Buildin:; -_-......._ . ... _.- _..._]k r i Property__ linear ft Type of Sign Proposed: --,I $ rn';re `� I l i l; ,I r !-le:-c I�'r 1.111 g C Free Standing Awning Proposed Sign Materials -.-_-....._._.-_--- _� `�.�.I_ ... _....--_-----//-\\_._- Proposed Sign Dimensio a>—...___........>�... ..5 .. _L. _.....-__. il;r. ld�:a_—�v-- —sgfi Existing Signs: SX)-I n: sq It i :n Ar!*L sq ft hnx !'•:.u,:h::�;': _------.__._.. _.- __ 1;t.3 A.n:rr_-- sq ft ..' ii:.IAwa sq ft Signs to be Removed: T:,p:_ _.- _.- .._-. _.._ ..t A.tra sq It cet'c'.n'It n::a:[. id.epreseatatiue Estimated Cost of Net Wwl.. Ad:t aT. a o APPROVALS(Dcparim,M�r la. I 4PWWGC01("MU14M I Yev{':r lb':•"' H . •;SII}:. ::r:•11 5517N $OILD GINSPECIOR City of Salem Sign Permit Application Worksheet 12-Feb-08 Rainbow Tile 122 Broadway(66 Loring Ave) Zoning (res/non-res) non-residential Entrance Corridor (Y/N) y Lot frontage 55 feet Building frontage 34 feet #of businesses on site 1 Bldng dist from street center 50 Multiplier 1 Building Signs maximum area permitted 34.00 sq ft total proposed sign area 20.00 sq ft sign 1 length 48.00 inches width 60.00 inches sign 2 length 0.00 inches width 0.00 inches Freestanding Signs 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 width 0.00 inches proposed sign height ft sign 2 proposed sign area 0.00 sq ft length 0.00 inches width 0.00 inches proposed sign height 0.00 ft Application meets guidelines set forth in the Salem Sign Ordinance yes Recommend approval yes il 6 � a , il q p 4 F Western Surety Company il il u il il LICENSE AND PERMIT BOND $ For County, City,Town or Village Only-Not Valid for Bonds Required by the State. Not Valid for Contract. Performance,Maintenance.Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. KNOW ALL PERSONS BY THESE PRESEN'T'S: BOND No.L&P- 43346658 d That we, Rainbow Tile & Laminant 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 (Valid only when.a County,City,Town or Village is named as Obligee) amountof One Thousand and 00/100 DOLLARS($ 1,000.00 ) (NOT VALID FOR MORE THAN$25,000) 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 THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed Sign Permit by the Obligee. NOW THEREFORE, if the Principal shall faithfully perform the duties and comply with the laws and ordi- nances(including all amendments),pertaining to the license or permit,then this obligation to be void,otherwise to remain in full force and effect for a period commencing on the 5th day of March 2008 and ending on the 5th day of March 2009 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 thirty-five (35) days from the mailing of notice or as soon thereafter as permitted by applicable law, whichever is later, this bond shall terminate and the Surety shall be relieved from any liability for an*subsequent.acts or omissions of the Principal.Regardless of the number of years this bond shall continue in forcdi the number of claims made against this bond, and the number of premiums which shall be payable or paid,the Surety's total limit of liability shall not be cumulative from year to year or period to period, and in no event shall the Surety's total liability for all claims exceed the amount set forth above. Any revision of the bond amount shall not be cumulative. Dated this 5th day of March 2008 c &A I Principal Principal Coun e1 (where aired) WESTER Q U R E T Y M P A N Y d By By— Residenj Agent Senior Wee President ; il ACKNOWLEDGMENT OF SURETY 1 STATE OF SOUTH DAKOTA i (Corporate Oft'icer) ; COUNTY OF MINNEHARA Jss On this 5th day of March 2008 , before mc, the undersigned officer, personally appeared Paul T. Bruflat ppeare ,who acknowledged himself to be the aforesaid officer of WESTERN SURETY CpOMPANY, a corporation, and that he as such officer,being authorized so to do, executed the Foregoing instt u- ; ment for the purpose therein contained, by signing the name of the corporation himself, such�officer. F IN WITNESS WHEREOF, I have hereunto set my hand and official seal. F il il S.PETRIK 02LNOTARY VUBUC SEAL f SOUT OAKOTA Notary Public,South Dakota My Commission E pr Aug 111 1010 Western Surety Company . 101 S. Phillips Ave. w Fo,m s49A-3-2005 Sioux Falls. SD 51104 • 1-605-336-0850 �...- -._ - .. -.._- - —------------ ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) STATE OF ss ; COUNTY OF On this day of before me personally appeared known to me to be the individual— described in and who executed the foregoing instrument and acknowledged to me that _he_ executed the same. My commission expires Notary Public ACKNOWLEDGMENT OF PRI �•I"f'"••,," (Corporate Office rl� ' + 44p, Ns Uf21 +�FLi STATE OF Massachusetts ss 4 s COUNTYOF Essex € � O On this 5th day of March � a 2008 , before me, personally appeared Raelene Lasher - who ac nowledged himse117herself to be the President of Rainbow Tile & I.aminant a corporation, and that he/she as such officer being authorized so to do, executed the foregoing instrument for the pur- poses therein contained by signing the name of the corporatio y himself/herself as such officer. My commission expires &4�- December 28 2012 A4kd 11 Anthony Benevento Notary Public ., W � I , ichNz N a a E W z c U o > a a w City of Salem Department of Planning & Community Development Check/Cash Receipt and Tracking Form Please complete form and make two copies. Date Received , " C" �- Amount Received -Dv � Form of Payment 4�Check ❑ Cash Client Information CASH PAYMENTS: client initials Sign Permit Application Fee ❑ Conservation Commission Fee Payment received for what ❑ Planning Board Fee service? ❑ SRA/DRB Fee ❑ Old Town Hall Rental Fee ❑ Other: Name of staff person receiving paymentn�.; Additional Notes SALEM TILE & LAMINATES, INC. 3570 DBA RAINBOW TILE & LAMINATES 138 CANAL ST. 978-741-0026 l SALEM,MA 01970 53-179/113 ' PAY DATE � - TO 7HE ORDER OF CG '\— $ a — - -- ( DOLLARS 8 Eastern Bank 31 r sn�wt,ruaiero i �� j FOR 1.00357011' 1:01L30i79a': 06 0027723011■ Original Check and Form: DPCD Finance Copy 1: Client Copy 2: Application File MAR-04-00 11 : 16 RM P. 01 b5 d r; 3 ig �Gf o-1- '4 1:{ i x•. I k ' }.in•.' � In ' �... 'i a1 L5 F M y y' 34. �w a *9=ou,(ec6)lrod seso-v car • . .. ; t •. C2610 "'SN3ANVQ•1316AHON S! VNVY* *N /S - , 3 3 E-- �l b f c jo d Il � - ,0AGbRD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MM/DD YYYY) RAINB-1 02/20/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Benevento Ins. Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 497 Humphrey Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Swampscott, MA 01907- Phone: 781-599-3411 Fax:781-581-7200 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER At ARBELLA PROTECTION NSURERS Rainbow Tile & Laminant Raelene Lasher INSURER C: 122-124 Broadway INSURER D' Salem MA 01970 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 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. LTR NSRC TYPEOF INSURANCE POLICY NUMBER DATE MWDD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 NTE A X COMMERCIAL GENERAL LIABILITY 7500031949 09/12/07 09/12/08 PREMISESEEeacarence) $100,000 CLAIMS MADE FX—] OCCUR MED EXP(Any one person) $5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $1,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ee accidenq ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Par accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ a DEDUCTIBLE $ RETENTION $ WC STAT Fr $ WORKERS COMPENSATION AND TORY LIMIT$ ER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERWEMBER EXCLUCED7 E.L DISEASE-EA EMPLOYE S R yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER Trailer $5000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Overhanging sign. The city of Salem as been listed as additional insured. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN City of Salem NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Electric Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 48 Lafayette St Salem MA 01907 REPRESENTATIVES. AUTNBR)2/`/LJD ESENTA VE E ACORD 25(2001108) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001108)