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318 DERBY STREET - SIGN PERMIT 318 Derby Street Turtle Alley Chocolates Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED G� Sri J. Location, Ownership and Detail Must Be Correct, Complete, and Legible Salem, Massachusetts WN1e Date ( To the Building Inspector: p The undersigned hereby applies for a permit to XErect, ri Alter, ❑Repair a sign cn the following described buildings: �YStreet Address Zoning District , Urban Renewal Area o Entrance Corridor 17318 Derby St. Salem MA 01970 Histo c District o Nona ' e Goldberg Properties Management ow tTelephone hone 978-922-0800 t 'floor retail, Turtle Alley chocolates 2 floor condos ress 42 Rogers St Gloucester,MA 01930 3 floor e7a2e1eocg 4 floor -mail 2halAe2�gr1a0.com How many businesses are in the building? 5 If a corporate body, name of responsible officer Hallie A.Baker ' SeeportSign Works LApplicant's uilding linear feet Construction Saps License No Space(if multi-tenant) 21 near feetAddress 18 Graf Rd.Unit 10 Nimburyport MA 01950 roperty linear feet Telephone 978-483.4444 Mail Sign Permit to E-mail gary(�seaponslgnwarks.com (Sign Owner o Sign Erector c Other: Proposed Signs (Ifni3re than three signs are proposed, . SI n1I Sign 2 Si n3 o Surface I o Surface o Surface Right Angle to Building c Right Angle to Building I D Right Angle to Building o Free Standing o Free Standing o Free Standing o Awning o Awning c Awning G Portable(A-Frame) o Portable(A-Frame) >(Portable(A-Frame) in Other(specify) o Other(specify) window gwNcs o Other(specify) Sign Materials Sign Materials Sign Materials :amwla war:a Ialati/waoa vinylplesac era mvMnvm Sign Dimensions Sign Dimensions Sign Dimensions 28'x36' 2114'.3314' I Sign Area Sign Area l Sign Area sot ft pleese see dap,ann sq ft i sq ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ a1500-111600 Existing Signs Type Sign Area To Be Removed? Sign Owns ❑Surface sq ft o yes u no o Right Angle to Building sq It 0, . G no ❑Free Stand*lng sq It ❑yes ❑no Sign 91Yner's Authorized Representative o Awning sq ft c yes c no 4:�� o Other(specify) sq it ❑yes ono Prm erty Owner IT Internal Review Planning&Community Development Department Historical Commission Approval Building Inspector 03124/0. 'its(i�14 F.fl City of Salem Sign Permit Application Worksheet '•'ir,7ECXi AL. -sill-;- 22-Sep-16 201b OCT 13 P 4. 50 Turtle Alley Chocolates 316 Derby Street Zoning(res/non-res) B5 Entrance Corridor(Y/N) N Lot frontage n/a feet Building or tenant frontage 25 feet #of businesses on site Bldng dist from street center <100 feet Multiplier 1 Building and Blade Signs maximum area permitted 25.00 sq ft total proposed sign area 9.59 sq ft sign 1 Sign length 26.00 Inches height 35.00 inches sign 2 Sign length 47.00 inches height 6.00 inches sign 3 length 41.00 inches height 4.63 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 Commonwealth of Massachusetts 5 City of Salem a , 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 Return card to Building Division for Certificate of Occupancy Permit No. B-16-1190 P FEE PAtD: $0.00 PERMIT TO BUILD DATE ISSUED: 10/18/201 This certifies that 318 DERBY ST NOMINEE TRUST GOLDBERG ANDREW D has permission to erect, alter, or demolish a building 318-C-2B DERBY STREET Map/Lot: 340485.855 as follows: Signs SIGN PERMIT AS APPROVED FOR: TURTLE ALLEY CHOCOLATES Contractor Name: DBA: Contractor License No: 10/18/2016 Building Official Date This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued unfit all applicable signatures by the Building and Fire Officials are provided on this perpri H IC#: "Parsons contracting with unregistered contractors do not hae access to the guaranty fund'(as set forth In MGL c.142A). Restrictions: Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. Salem ® Redevelopment Authority Salem Redevelopment Authority Decision October 12, 2016 318 Derby Street (Turtle Alley Chocolates): Discussion and vote on proposed installation of signage and a-frame sign. SRA Decision At its meeting on October 12, 2016 the SRA voted unanimously (4-0) to approve the proposed installation and a-frame sign at 318 Derby Street (Turtle Alley Chocolates), as recommended by the DRB. Recommendation At its meeting on September 28, 2016 the Design Review Board voted unanimously (6- 0) to recommend approval of the proposed signage and a-frame sign at 318 Derby Street (Turtle Alley Chocolates). Proposal The applicant proposes to install a blade sign and window signage at their store's new location on Derby Street. The blade sign will be 26" x 35" and mounted within the existing standard black metal bracket above the storefront. The window signage includes two sets of white text (one is 47" x 6", and the other is 41" x 4.6"). Bubble designs, which are not considered signage, are shown as being approximately 59" x 29.5", with a generous amount of negative space. The applicant would also like to place a 24" x 36" white plastic a-frame sign outside of their storefront. Please note that the DRB and SRA had previously approved this sign for placement outside of the applicant's current storefront on Essex Street. Com lies? Portable Sign Requirements Y N ? 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 61, 82, 64, 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, Salem ® Redevelopment Authority and fire escapes x - 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-framestyle x - must be internally weighted so that it is stable and windproof. X must have$1,000,000 liability insurance including naming the City and the SRA x if a shared entrance, must share sign with other business es Staff Comments The proposed signage complies with the City's sign ordinance and recommended design criteria for the Urban Renewal Area. In the Urban Renewal Area, 20% or less of a storefront's windows can be covered. In this case the applicant calculated that approximately 23% of the windows are covered, but with the negative space between the bubbles, it is estimated that the proposal meets the 20% threshold standard. If the Board feels that the current design covers too much window space, it can suggest that the bubbles are further compressed toward the bottom of the windows, and/or that the proposed text is reduced in size. Turtle Alley Chocolates 177 Essex St. Salem,MA 1978-740-0660 1 hallie@turtlealley.com September 141h,2016 Design Review Board Go DPCD City of Salem 120 Washington St. Salem, MA 01970 Dear Members of the Design Review Board: Turtle Alley Chocolates II has had to find a new location. To this location(318 Derby St.),we are proposing signage, graphics,and a portable sign. In the attached photos, please find proposed graphics and dimensions of the above. All are in keeping with our brand,Turtle Alley Chocolates, both in Salem as well as Gloucester. The window graphics consist of our bubbles which have been crucial to branding visually in both locations. These bubbles are cut vinyl,will be mounted on the inside of the glass, and have UV protection. Above the bubbles are the words,"Chocolates, Fudge, Caramel,Toffee". These words are in Agenda font, and will also be mounted from the inside. The blade sign is 26"x 35",double sided,and consists of laminate gloss vinyl and latex mounted onto pressed plywood. It will be mounted in the existing frame, as are the neighboring business's signs.The serif is Agenda,the scrip is Apricot. While I am aware that we will have a sign oriented to pedestrians in the erected blade sign, I ask that you consider approving our portable sign as well,as it was just two years ago. We are in the unenviable position of having to move our business in November, and hoping to open in time to fill our customers'holiday needs in December. Turtle Alley will greatly benefit from all the signage it is permitted to have to help us with this transition. The portable sign is internally weighted and measures 2'x 3'. The sign is composed of plastic and aluminum. The fonts are 160 pt.Agenda bold (for the word"Handmade"),and 200 pt Apricot(for the words"Fudge,Toffee, Chocolates, and Caramel"). I would like to place the sign 7 feet from the storefront, next to the tree planter to the left of the storefront as you look at it. The location meets the minimum of 5'clearance, and is within 10' of the entrance. Turtle Alley Chocolates has its own entrance.The other businesses in the building have their own entrances. Thank you very much for considering this proposal. I look forward to speaking with you at the next DRB meeting. Sincerely, Hallie A. Baker,chocolatier Turtle Alley Chocolates, Inc. 177 Essex St. Salem, MA 01970 318 Derby Street,Salem, MA Existing Building Storefront 'FI Surrounding Building in Context Turtle Alley Chocolates ] 'G r-,� 318 Derby Street, Salem, MA S Blade Sign — Proposed Signage INC "^7" = Fy 26" - 4y -� turtle all turtle alley 35„ ckocoe uk C�Owfute&. 116, VAI I Y Y FLATPANELSIGN— - �'- 1.5 Thick Face Insert for Existing Sign Frame 26"w x 351 double-sided,custom sign panel insert, laminated digital print ' a t; v. Turtle Alley Chocolates 318 Derby Street,Salem, MA Proposed Window Lettering and Graphics REN ►_ 1 � . ~UaiwAfiub &"Wlb 23i Lod 47" 41" ?x it I;4.625" U_. s • 29.5" 29.5" i 30" 0" L 59.1 291. ��29" _ - - CUT VINYL LETTERING-WHITE plus CONTOUR CUT DIGITAL PRINT GRAPHICS,LATEX-FULL COLOR Window Measurements: Door Windows(2)—29"w x 62"h,Windows(2)—59"w x 78"h,Transom Window(above door)—83"w x 15.5"h Turtle Alley Chocolates 318 Derby Street, Salem, MA Proposed Aframe— Dimensions !'As'iM%;A["tRAIW — twc 20 lK1R'N C:`r[EE X4ri'hl' i uacyiL 51 S[IF, 36„ �. Jp. 7 *HANDMADE* ch�ccsQatela, n � ,j and Canamek 24" 29" Turtle Alley Chocolates 318 Derby Street,Salem, MA Proposed Aframe — In Context _r -kid E • F a s� ClwcofaM. j = i I. p i �8 a� y� > c. � .�� F x• a """ RRR Y.. r � 5 q • t —1 e .� ACC> CERTIFICATE OF LIABILITY INSURANCE DATE ) g/1/2016 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(les) 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 Laurie Robley NAMEBabson-Elwell 6 Davis PHONE . (978)283-1561 FAX No: (978)281-8072 44 Blackburn Center EAIL A-MDDRE INSURERS AFFORDING COVERAGE NAICM Gloucester MA 01930 INSURERA:SafQtV Insurance INSURED INSURER B:The Hartford. Turtle Alley Inc INSURERC:CNA Surety 13188 42 Rogers St INSURER O: INSURER E: Gloucester MA 01930 INSURER F: COVERAGES CERTIFICATE NUMBER:CL169100846 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, ILSR TYPE OF INSURANCE D R POLICY EFF POLICY EXP POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MAGE ®OCCUR PDR MI a AMA6E TO RENTED. D ncal $. 100,000 X BOP X BM0007033 7/15/2016 7/15/2017 MED EXP(Any oneperson) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT❑PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: Norrownetl S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY I NJURY IPx person) $ ALL OMED SCHEDULED BODILY INJURY(Par accident) $ AUTOS AUTOS MIRED AUTOS AUTOS Per edcident NON-OWNED PROPERTY DAMAGE $ $ X UMBRELLA LIAOOCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS-MADE AGGREGATE S 1,000,000 DED I I RETENTION CM00005806 3/29/2016 3/29/2017 $ WORKERS COMPENSATION XPTART R H- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L,EACH ACCIDENT $ 100,000 OfFICERB (Mandatory�En NH MBER EXCLUDED? OOMCLJ4349 3/6/2016 3/6/2017 ) E.L OISFASE-EA EMPLOYEE $ 100,000 Use,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 C BOND - LICENSE 6 PERMIT 62899495 9/1/2016 9/1/2017 $1,00D. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addltlonal Remarks Schedule,may be attached If more space Is requires) CITY OF SALEM/SALEM REDEVELOPMENT AUTHORITY, 120 WASHINGTON ST. , SALEM, MA 01970 LISTED AS AN ADDITIONAL INSURED FOR 318 DERBY ST. , SALEM, MA 01970 AS WELL AS 177 ESSEX ST. , SALEM, MA 01970 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SALEM THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SALEM REDEVELOPMENT AUTHORITY CCORDANCE WITH THE POLICY PROVISIONS. 120 WASHINGTON ST SALEM, MA 01970 AU E RE ENTATIV ©19818-2014ACORDCORPO ION. All rights reserved. ACORD 25(2014101) The ACORD nalne and logo are registered marks of ACORD INS025(201401) P 6 tl P tl fi r ffective Date: Member 1st, 2016 i P � ° Western Surety Company n � ^ a LICENSE AND PERMIT BOND y n + v a fi KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 62899495 R - + e + Thatwe,Turtle Alley Inc ; n — + P + of Gloucester 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 sumo£ One Thousand and 00/100 DOLLARS (51,000.00 ), 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 Siqn 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 be void, otherwise to remain in full force and effect until September 1st 1 2017 , 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 third��f° 5- fOays from the mailing of said notice, this bond shall ipso facto terminate and the Surety shal��lfel'euplieved from any liability for any acts or omissions of the Principal subsequent to said datts•.Wtie number of years this bond shall continue in force, the number of claims made a nst is bo i ahe number of premiums which shall be payable or paid, the Surety's total limit of 14 shall not bC emulative from year to year or period to period, and in no event shall the Surety's total li` ityprr a�*plaiin" aexceed the amount set forth above. Any revision of the bond amount shall not be c u tl as°ul iv,•e:........-'®4° • 11,07"Waft ZV Datec{lows1st day of September 2016 ; P ' + Turtle Alley Inc _ Principal ; v Aho v 0 Principal + v ° tl WESTE SURET COMPANY P BJV + ^ Paul T. Br at,Vice President ; e Form 552-12-2015 ' P ^ v ' v " v • -- CO�`I � P�IC� �c�� ACKNOWLEDGMENT OF SURETY STATE OF SOUTH DAKOTA 1 ss (Corporate Officer) COUNTY OF MINNEHAHA I On this 1st day of September 2016 ,before me,the undersigned officer, personally appeared Paul T. Bruflat ,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. }bh44O+4h4Sb4iN444ah4ybtiN} �/�/�, ���i�'�� s M. BENT JSE Lt NOTARY PUBLIC S^�t r s SOUTH DAKOTA r Notary Public—South Dakota }4Y4S4 hShh 4944hb A44h4444 } My Commission Expires March 2,, 2020 ACKNOWLEDGMENT OF PRINCIPAL STATE OF y as (Individual or Partners) 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 (Corporate Officer) COUNTY OF as On this day of ,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 commission expires Notary Public C Cz:l Q— F E a U x a Z A a m c z y a E Z C d w z Y o71 0 > `0 M 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 snuth Dakota , its regularly elected V; P PtPciA nt 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 Sion Permit City of Salem bond with bond number_52899995 for Turtle Alley Inc 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 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 Vice President with the corporate seal affixed this 1st day of September 2016 ATTEST WESTEN /� URET COMPANY By ..� L.Nelson,Assistant Secretary Paul T Bruflat,Vice President STATE OF SOUTH DAKOTA as COUNTY OF MIN �'�� ' o, ca On this 1st day of September 2016 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 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. �444g4g444q4qb4444b4q4bq4� a J. MOHR 's i ^ NOiARY PUBLICS f s SOUTH DAKOTA .t v , ' Nota Public f444S444ggq44bbbbqbb4444i My Commission Expires June 23, 2021 Notary To validate bond authenticity,go to www.cnasurety.com > Owner/Obligee Services>Validate Bond Coverage. Forrn F1975-1-2016 �4r*� �r City of Salem Department of Planning & Community Development CHECK RECEIPT AND TRACKING FORM DATE ! 2c� BOARD_ SP g STAFF S(c CLIENT: ✓r{ tC G� ((Q �l(oco�/�1t1 PROPERTY ADDRESS: CONTACT NUMBER: Q7b- ZS PURPOSE FOR APPLICATION: CHECK # 09 D$ AMOUNT RECEIVED: $ 2o. 10905 TURTLE ALLEY, INC. INMMON FOR SAVNGS 42 ROGERS ST GLOUCESTER,MA 01930 53-7094 978.281.4000 /2113 w Judlealleyxom 9/1512016 g" `o PAY TO THE ORDER OF City of Salem $ —20.00 Twenty and 00l100%%kk*ff****kfk i*ffh*fkfk*kfff**fk*ffkkffM*fffiii*fiffk*kkf#ff*ffff*kfkffk***Rf**fff**f*ff**ff***ff*k*k*fk DOLLARS City of Salem Board of Health 120 Washington St. Salem, MA 01970 MEMO 1 {/�IiLY UMagIZEDS , er it fee 1 Derby t. F 1140 10 90 SII• 1: 2 1 13 ?0 91131: 11. 10 8 L. 3 1 411' ----_---__