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HomeMy WebLinkAboutBLDS-23-002931 e aW r, )cri- 11 .€-/ i.,:>l Z.rld • / 6. newt ieCf iYri- perm 1 he vY/.►` �?•t�o�- of RECEIVED R �'! % TOWN OF YARMOUTF[ BUILDING DEPARTME1 o - 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 eats 1 6 'NOV 23 2022 �•' l - BUILDING DEPARTMENT SIGN PERMIT APPLICATION 8y Date 1A3/70zz. _ Application Accepted Permit No. = - / ' ( 6(.4)5.. 23-pb2931 Applicant Instructions 1) Applicant shall complete both sides of application. 2) One application form is required for each sign. Each sign will be assigned its own permit number. 3) Applicant shall attach separate 8 %z"x I I"sheets including the following diagrams: A) Design,dimensions and colors of the proposed sign B) Freestanding Signs:provide certified plan by a professional land surveyor that describes how the proposed sign meets the zoning requirements included in Zoning Bylaw 303.5.6 or 303.5.4.2 (as applicable). A stamped and sealed"as-built"will be required before the permit will be issued. C) Attached Signs:show length of portion of building frontage that is occupied by applicant. D) Temporary Signs: show location for sign 4) Sign permits are$40.00 each,payable at the time of application. Address of proposed sign T J7 ' Historic District Name of Business for proposed sign 44•- .o/" / C,,,'o Name of Business owner ,/ .-�l ' S�J�' cl 3 S 30 t )rtbi " k[ Mailing Address of Business owner?D ettoc. If r- o Business Owner Phone:Business fj -3 7,9-4/O$/ Home Name of Building Owner AZ ge0� Phone 8- cog- ';' -i Sign Builder 9ii _t-( Sign Materials_ //t// Sign Builder Address p29/ 41,,),/)'lts Phone (JZ.5-,361-1"?gii Singly Occupied Building ' Business Center, Internal Light External Light Freestanding Sign Size: • Attached Sian /Main ? /Ch6r ' 50(1 in t X-MOSS Si�J f } Temporary Sian Size: Dates: III 25I22- \211 ` a Please complete other side of Sign Permit Application „........41N ROBEBOU-03 JMILLS ACORO” CERTIFICATE OF LIABILITY INSURANCE DATE 1 (23/DDIYYYY) �� 11/23/2022 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 License#1780862 CONTACT N ME; HUB International New England PHONE FAX No),(781 792-3400 600 Longwater Drive (A/C,No,Ext):(781)792-3200 ( ) Norwell,MA 02061-9146 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Scottsdale Insurance Company 41297 INSURED INSURER B:Lloyd's of London 15792 Our Wild Animal Lagoon,LLC INSURER C: P.O.Box 115 INSURER D: Centerville,MA 02632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUBR W POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD VD IMM/DDIYYYY) IMM/DDIYYYYI 1,000,000 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE X OCCUR CPS7610650 6/27/2022 6/27/2023 PREM SESO(Es occur ence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENII_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ CMNED AUTOMOBILE LIABILITY Ea accidentSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED —1 SCHEDULED AUTOS ONLY -AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED'? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ g Miniature Golf Cours XSZ195180 6/27/2022 6/27/2023 R/C$1,000 Deduct 500,000 B Building&BPP XSZ195180 6/27/2022 6/27/2023 R/C$1,000 Deduct 45,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) LOC: 62&68 Main St.Rt 28 W Yarmouth,MA 02673 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28, South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD