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153 FORT AVE - BUILDING INSPECTION fL�MIsWIiweam@04ND APPRovEO AY Im CITY OF SALEM Dab4-oio-L- WWd Zm%owmd N,r�Lwow m !r�csoo Of Yo No_.L bdldAm 153 -,�6el' Aue M Pfumq Looms h b CONW40M AMC . YM No PamIR t0: BWLom PtB l APPL WATION POft (area whhfh ier Ifppl�l) Fisoo(, p4 moof, lnsW Cgrf nx:t 08* shed, Pool. Aapak/Raplaoa o1%z sr-an PLEASE FB,L.oUT LAmL.Y i COMIPLETELY To A DELAYS N PRoCRsgM TO THE INSPWM OF OWLOING&. '. �WKW4 pnad hweby appNw for a parmk to buod aooa*Ap.to tha.tol"N Ownara Nanm 4. a! �6-Aluo 01soA 3 Cc�i v�Fic rs vrHr� Addlflws a Phone s,�f.��. �r� o.�� AfdNt Wa Name STEtIE N4( Iu011�7" ��tL Aditu a Pharm4�s 70 �.� �f oiszv Wftni. Nana f Diu�� DS!&l61 464&vP LTA Addmu a Phone 7.f AJAIAA' VT- L"" SIP SSS� wi.r M ft pxporr a Umow C" a ttu� /✓a sc I AWA of, Mall! Zdoo A ,/ N a dwwnp,for how� nNNr9 W Era�Md aoN I o? d0� qh�p„M r 5'�o arlr Lfo�Na r O 3'�f� 07.5' f�js. �so�seae . s ft�mof It $NNW UN TNT PENALTY' DESCRp11oN OF WORK TO BE DONE OF paum l2 S7U✓LSO A-6 01770AJ -rD Go,et.4�2G1•� 5�2 vcVVP49: Ten 6UC6 Ue96 A 5S;eetJD MAIL PERMIT TO; F'>OX -4457R -.5t+6eA(4 f A44 O t 4 7.O APPLIrATION FOR ro NGtt�ev��e2 Z. 13.�_ aF�'/SroN LOCATION l53 /Ge,— 04vel/vt PERIWT GRANTED AP�F D )"'E-CTOR OFIMXLDWM f 1 CITY OR SALaMV MASSACMUiarTf ;10 Pusuc P11O►QI m OB►ARTMENT 1mw""I"amm Mum, 3aoFLOOR fir.MA0I970 TaL (970)746-95" UT. 360 FAIL (e70 740-"" aTAMAV A UGOV1C2. JIL MATOO DISPOSAL OF DMN AFFMAM 1a mcordws wA the ploviskm o(UM c 4%SX I aeltsowrladp that m a to &dm OlBlrlft Permit• s11 debris nwMm fibs the=osbvcdm aedvity pvamed by this Btu Part Ad be dhpowd offs a p sly Hems"eolidry moe dlepowd Sei*g a deemed by MM 6 DL 3,15ft lU dd&w in be diapoed ofat 1JD A&7t5 ct,2 �O'gx ml �,ecA-ar 8 SIPMU re OtPamvt ApPlfast Lme FULLY eampteta the fidowinp hLb madom. (PLEASE PRIIPP CLEARLY) lzu"W CRauP ��R►c 2v�uPF� Nano( Appdad Film Name.if my Addtask OW A Sat. The above=US requires that debris Eom the dam huM rmovuiM rehab or other altaad m otbttil&l of Mweme be disposed is a p>ropafy-Gassed solid-waste disposal Miry a de&W by MGL clM S1 SOAK sad tbs bu j&,pataits of Gamma aM to indicate the laadom of tTss r*iciGq. r ` DAE(MWDD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE T oe/10/2004 PRODUCER (978) 745-6464 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rose Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 66 Loring Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 958 Salem MA 01970- INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERAPENN-AMERICA INSURANCE Rumpf Design Ltd INSURER&Granite State 74 Wharf Street INSURER C' INSURER D. Salem MA 01970 — N URER 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. INSR ADUL POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MWDD DATE MMRIDNY) LIMITS GENERAL LIABILITY / / / / EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ $0,000 PREMISES Ea occurrence CLAIMS MADE1:1 OCCUR PA06376443 03/31/2005 03/31/2006 MED EXP(My one person) $ 5,000 PERSONAL B ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGO S 1,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT ANY AUTO (Ea acciderr) $ ALL OWNED AUTOS / / / / BODILYINJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS / / / / BODILY INJURY NON-OWNED AUTOS (Peramiderd) $ PROPERTY DAMAGE (Peramide� $ GARAGELIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY / / / / EACH OCCURRENCE $ OCCUR F71CLAIMS MADE AGGREGATE $ DEDUCTIBLE / / / / $ RETENTION $ $ $ WORKERS COMPENSATION AND WC8724783 02/05/2005 02/05/2006 X TO OTRH- EMPLOYERVRVLABILITY ANY PROPRIETOR�PARTNER/EXECUTIVE EL.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? / / / / EL.DISEASE EA EMPLOYEE$ 100,000 If yes,describe under SPECIAL PROVISIONS below EL DISEASE-POUCY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT City of Salem FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. _ AUTHORIZED REPVXNTATIVE ACORD 25(2001/08) I I , ©ACORD CORPORATION 1988 qti INS026(DiGE)C5 ELECTRONIC LASER FORMS,INC.-(80D)327-0545 Page 1 of 2 QUITCLAIM DEED 2004043001552 B j oe DFED P 2.. We, George J. Hoxha and Christine Hoxha, of Topsfield, Massachusetts, for consideration of One Hundred Sixty-Five Thousand and 00/100 Dollars ($165,000.00) consideration paid, aka Kathleen Olson grant to Kati Olson,/individually, of Salem, Massachusetts 3 .T w�Naeesl9...C1 —p—cp. WITH QUITCLAIM COVENANTS The land, together with the buildings thereon known as and numbered 153 Fort Avenue, Salem, Essex County, Massachusetts, shown as Lot 2, containing 2,315 square feet f on a plan entitled "Plan of Land 151 & 153 Fort Avenue Salem Property of George J. Hoxha&Christine Hoxha, Scale 1"= 10', July 12, 2002,by North Shore Survey Corporation 47 Linden Street, Salem,Ma." said plan recorded at the Essex South District Registry of Deeds in Plan Book 369, Plan 2. Being a portion of the premises conveyed to the grantors herein by Deed of Binh Truong dated May 31, 2001, and recorded with said Registry in Book 17253, Page 593. v � 0) m Executed under seal this 300'day of April, 2004. > Cd a Cd H O ^ w E eorge oxha Christine Hoxha COMMONWEALTH OF MASSACHUSETTS Essex, ss. April 30, 2004 Then personally appeared the above named George J. Hoxha and Christine Hoxha who acknowledged the foregoing instrument to be their free act and efore me. OTARY PUBLIC �k f V My Commission Expires: 2(�alr D `R KA fG Gee 01.30 h S� (9 VL/L/+ 01 ? 0 to b iy 4 Q