B-18-1274 REPLACE ANTENNAS @ CAMP LION 0,. co.,. Commonwealth of Massachusetts _,
a q.a City of Salem
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Return card to Building Division for Certificate of Occupancy
Permit No. B-18-1274
FEE PAID: $198.00 PERMIT TO B U I L D
DATE ISSUED: 11/21/2018
This certifies that CAMP LION OF LYNN MASS INC c/o SPECTRASITE-MA0032
has permission to erect, alter, or demolish a building 488-REAR HIGHLAND AVENUE Map/Lot: 30139-0
as follows: Other Building Permit REMOVE & REPLACE THREE (3) ANTENNAS & ADD THREE (3)
ADDITIONAL ANTENNAS WITH CORRESPONDING RRHS & THREE (3) FIBER LINES @ CAMP
LION ON 2 CAIN ROAD LYNN.
Contractor Name: KENNETH ZINK
DBA:
Contractor License No: CS-108036
11/21/2018
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 until all applicable signatures by the Building and Fire Officials are provided on this permit.
HIC#: "Persons contracting with unregistered contractors do not have 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.
Marcia Kirkpatrick
From: Thomas St. Pierre
Sent: Wednesday, August 21, 2019 12:39 PM
To: Marcia Kirkpatrick
Subject: Fwd: [City of Salem MA] Permit No. B-18-1274 (Sent by Murdock MacDonald,
mmacdonald@clinellc.com)
Attachments: csl_photo.pdf; ATT00001.htm; coi_squan.pdf; ATT00002.htm; bs52xc102
_ma_wc_coi_signed_exp_1-1-20.pdf; ATT00003.htm
Hi Marcia , could you update the GC info and extend six months?Thank You
Sent from my iPhone
Begin forwarded message:
From: "Contact form at City of Salem MA" <cmsmailer@civicplus.com>
To: "Thomas St. Pierre" <TStpierre@Salem.com>
Subject: [City of Salem MA] Permit No. B-18-1274(Sent by Murdock MacDonald,
mmacdonald@clinellc.com)
Hello tstpierre,
Murdock MacDonald (mmacdonald@clinellc.com) has sent you a message via your
contact form (https://www.salem.com/user/856/contact) at City of Salem MA.
If you don't want to receive such e-mails, you can change your settings at
https://www.salem.com/user/856/edit.
Message:
Good morning Mr. St. Pierre,
We pulled Building Permit No. B-18-1274 back on November 21st for Sprint to
modify an existing telecommunications facility at 488-Rear Highland Ave.
Unfortunately there were delays in getting the equipment from overseas. We
are finally on track to receive the equipment, so I am respectfully asking if
we can have a six month extension on this permit? It would be greatly
appreciated. Unfortunately due to the delay, the General Contractor we had
assigned to this job is not going to be able to perform the work so we will
have to change the GC as well. I have attached the new GC's CSL and insurance
docs. Please let me know if there's anything you need on my end to
facilitate this request.
Thank you,
Murdock
1
AC o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D D/YYYY)
12/21/2018
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(ies)must have ADDITIONAL INSURED provisions or 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 Patrick Amaisse
NAME:
All Point Ins Agency PHO NE No,Extl: (201)487-8710 FAX
No) (201)487-8711
224 Johnson Avenue E-MAIL Patrick@allpointinsurance.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Hackensack NJ 07601 INSURER A: Travelers Insurance Co
INSURED INSURER B: Crum&Forster Insurance
Squan Construction Services,L.L.C., INSURER C: Scottsdale Insurance
DBA Squan Solar DBA Sol Providers DBA CSI
INSURER D: Lloyds of London
329 Harold Avenue
INSURER E:
Englewood NJ 07631 INSURER F:
COVERAGES CERTIFICATE NUMBER: CL1711866966 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.
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTRINSD WVD (MM/DD/YYYY) (MM/DDIYYYY)
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED 100,000
CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $
MED EXP(Any one person) $ 10,000
A X XCU COVERAGE INCLUDED Y Y DTC00N238468191ND 01/01/2019 01/01/2020 PERSONAL&Aov INJURY $ 2.000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
POLICY X PRO LOC PRODUCTS-COMP/OPAGG $ 4,000,000
JECT
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY(Per person) $
A OWNED SCHEDULED Y Y BA0N2007671926G 01/01/2019 01/01/2020 BODILY INJURY(Per accident) $
AUTOS ONLY - AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
LIEXP $
A X UMBRELLALIAB X OCCUR CUP9M2589861926 01/01/2019 01/01/2020 EACH OCCURRENCE $ 20,000,000
B EXCESS LIAB CLAIMS-MADE Y Y 5228053632 01/01/2019 01/01/2020 AGGREGATE $ 20,000,000
DED RETENTION$ $
WORKERS COMPENSATION
PER OTH-
X STATUTE ER
AND EMPLOYERS'LIABILITY Y/N 1
A ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA Y UB9M2589861926G 01/01/2019 01/01/2020 E.L.EACH ACCIDENT $ , ,
OFFICER/MEMBER EXCLUDED. 1,000,000
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
C Pollution Liability Y Y VRS0003099 12/21/2018 12/21/2019 !Limit $5,000,000
A Installation Floater V Y DTCO0N238468191ND 01/01/2019 01/01/2020 Limit $1,000,000
D Professional Liability Y y E&01288089A18 07/11/2018 07/11/2019 Limit $2,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE /
I
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