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An application was received from Russell House Tavern, requesting permission for a projecting sign at the premises numbered 14 JFK Street approval has been received from Inspectional Services, Department of Public Works, Community Development Department and abutter

APP 2025 #9·Council meeting Mar 3, 2025·30 pages·📄 Original PDF (city portal)

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February 19, 2025 City of Cambridge, MA Primary Location Applicant 1146028 14 Jfk St Sign/Awning Permit & Stuart Pitchel Status: Active Cambridge, MA 02138 2 [phone removed] Submitted On: 12/13/2024 @ [email removed] Owner A 236 Pearl Street 1834 REALTY, INC. Somerville, MA 02145 FACILITIES DEPARTMENT WALTHAM, MA 02451 Hide General Information What option best describes this application?* Sign(s) Description of Proposed Work* Installation of (1) projecting blade sign to read "RUSSELL HOUSE TAVERN" Estimated Cost of Sign(s) in dollars * 21906.25
Describe any existing signs or awnings that will remain (including the size of the remaining signs/awnings).* Two awning signs ("Russel House Tavern") remain on the valence with 1 on each awning. Cambridge City Council approval may be required. Will one or more of the proposed signs extend six (6) inches into the public sidewalk?* Yes You must submit a Projected Sign Application and Abutter's Form to the City Clerk's Office. Sign Information Sign Text* RUSSELL HOUSE TAVERN Illumination* Type of Sign* Internal Projecting Height of Sign (feet)* Width of Sign (feet)* 4 2.8 Height from the ground to the top of the sign Area of Sign (square feet)* (feet)* 10.9 12.8
Height from the ground to bottom of the sign Sign Material* (feet)* Aluminum & Acrylic 10 Projection from the Building (inches) Weight of the sign (Ibs)* 48 125 Is the sign an accessory to a first floor store?* Width of Building Facade for Associated Use (feet)* Yes 45.75 Contractor Contractor Name* STUART R PITCHEL Address* 30 FREEMAN ST E-mail* Telephone* [phone removed] [email removed] License Number* License Expiration Date* 12/20/2026 CS-091230
Contractor's Signature Date* Signature of Licensed Contractor* Stuart Pitchel 12/11/2024 Community Development Approval @ Sign conforms to requirements of Article 7.000 • Sign requires a variance from the Board of Zoning Appeal - • Comments & Exempt under Article 7.000 - City Clerk Internal & Bond Number Attachments Required Drawing of Sign(s) RusselHouse_Blade_v1.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:08 PM
Required Contract with Sign Company SRP revised estimate signed.pdf Uploaded by Stuart Pitchel on Jan 9, 2025 at 11:20 AM = Versions Required Proof of Insurance SRP Sign Corp COl.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:08 PM Required Signed contract between property owner and applicant dfraine_11-21-2024_10-48-32.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:11 PM 14JFK_ApprovedSignCert_241016.pdf 14JFK_ApprovedSignCert_241016.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:11 PM WorksComp_Signed.pdf WorksComp_Signed.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:13 PM draine 11-21-2024-10-58-59.00f dfraine_11-21-2024_10-58-59.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:13 PM signabutterformpdf.pdf signabutterformpdf.pdf Uploaded by Stuart Pitchel on Dec 11, 2024 at 4:13 PM
SRP revised estimate signed.pdf SRP revised estimate signed.pdf Uploaded by Stuart Pitchel on Jan 9, 2025 at 11:19 AM 14 JFK St COA Russell House Tavern blade sign.pdf 14 JFK St COA Russell House Tavern blade sign.pdf Uploaded by Sarah Burks on Feb 10, 2025 at 7:15 PM Record Activity
Timeline Due Label Status Completed Activated Assignee Date Branden 12/13/2024, 1/13/2025, Completed 8:08:54 AM 9:17:49 AM Vigneault Review for Completeness 12/13/2024, 12/13/2024, Completed Teal Delys 9:20:53 AM 8:08:54 AM Community Development Plan Review
Due Label Status Activated Assignee Completed Date Sarah 1/13/2025, 2/10/2025, Completed - 9:17:49 AM 7:14:57 PM Burks Historical Commission Brian 1/23/2025, 1/13/2025, Completed 9:17:49 AM McLane 9:47:28 AM Department of Public Works Review 2/10/2025, Active Lori Perez 7:14:58 PM City Clerk Review * Inactive City Council Approval Inactive Bond Stuart Inactive Pitchel $ Sign Permit Fee
Due Label Activated Status Completed Assignee Date Inactive Building Inspector Review Inactive = Sign Permit B0T3
OFFICE OF THE CITY CLERK CAMBRIDGE CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139 PHONE [phone removed] FAX [phone removed] DIANE P. LEBLANC PAULA M. CRANE CITY CLERK DEPUTY CITY CLERK 10/8 , 2024 Cambridge, To the Honorable, the City Council of the City of Cambridge: EACH PETITION MUST BE ACCOMPANIED BY A DRAWING OF PROPOSED SIGN, INDICATING DESIGN AND DIMENSIONS AND LOCATION ON PREMISES. The undersigned respectfully prays that Russell House Tavern (NAME OF BUSINESS) be granted permit to erect a sign of the following specifications in front of premises located at 14 JFK Street (ADDRESS) Type of Sign: Projecting Blade Sign (state whether electric or otherwise and material used in construction) Reading matter to go on Sign: Russell House Tavern 32.75" × 48" × 10" Size: Weight: 125lbs Public Way 121.5" Obstruction: A. 48" (Give exact distance sign is to extend over sidewalk) (Also exact distance from bottom of sign to sidewalk) 121.5" Top: 1695" Height Above Grade: Bottom: NOTICE - REGULATIONS [Section 12.08.010 Municipal Code - Encroachments onto Streets] Section 1212.0 State Building Code - Projecting Signs] • A projecting sign shall be constructed wholly of incombustible materials. • All signs must meet requirements of Zoning Ordinances and Building Code. • Note: Section 12.12.220 provides in part "every owner who maintains a ... structure in or over a street... shall do so only on the condition that such maintenance shall be considered as an agreement on his part to keep the same and the covers thereof in good repair and condition, at all times during his ownership, and to indemnify and save harmless the City against any and all damages, cost or expenses which it may sustain, or be required to pay by reason of such. structure." PROPERTY OWNER OR AUTHORIZED AGENT HEREBY STATES THAT INFORMATION IS TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND UNDERSTANDING UNDER PAINS AND PENALTY OF PERJURY. 1374 1617.438•1868 MASS AVE (Property owner or authorized agent) (Tel. No.) (Address) [phone removed] 14 JFK Street Cambidge, MA. 02136 (Address) (Business owner) (Tel. No.)
OFFICE OF THE CITY CLERK CITY OF CAMBRIDGE [phone removed] FAX [phone removed] ty/TDD [phone removed] DONNA P. LOPEZ INTERIM CITY CLERK ABUTTERS FORM FOR SIGN/AWNING PERMIT Date 12/07/2024 To Whom It May Concern: 18-28 JFK Street As Owner of Agent of Cambridge, of the X Massachusetts, I do hereby declare my disapproval _approval installment of: Canopy over the sidewalk entrance: Awnings over the windows: X Projecting sign: _ of said property. 12/07/2024 Date Signed: PO Box 590179, Newton, MA 02459 Address: ABUTTERS: PLEASE COMPLETE FORM WHETHER OR NOT YOU APPROVE OF THE REQUESTED SIGN/AWNING AND RETURN IT TO THE APPLICANT WITHIN SEVEN (7) DAYS FOR INCLUSION IN THE APPLICATION. SIGN/AWNING APPLICANT: PLEASE FILL IN DATE THAT FORM WAS DELIVERED TO ABUTTER (TOP RIGHT OF THIS FORM) CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139
OFFICE OF THE CITY CLERK CAMBRIDGE CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139 PHONE [phone removed] FAX [phone removed] TTY/TDD [phone removed] DIANE P. LEBLANC PAULA M. CRANE CITY CLERK DEPUTY CITY CLERK ABUTTERS FORM FOR SIGN/AWNING PERMIT To Whom It May Concern: Dano 1/2/24 As Owner of Agent of 1374 MASS AVE Cambridge, of the V Massachusetts, I do hereby declare my disapproval _approval installment of: Canopy over the sidewalk entrance: Awnings over the windows: Projecting sign:_ of said property. Signed: Dato. 11/2/24 Lamil Train MASS AVE CAMBRIDGE Address: 1374 ABUTTERS: PLEASE COMPLETE FORM WHETHER OR NOT YOU APPROVE OF THE REQUESTED SIGN/AWNING AND RETURN IT TO THE APPLICANT WITHIN SEVEN (7) DAYS FOR INCLUSION IN THE APPLICATION. SIGN/AWNING APPLICANT: PLEASE FILL IN DATE THAT FORM WAS DELIVERED TO ABUTTER (TOP RIGHT OF THIS FORM)
CAMBRIDGE HISTORICAL COMMISSION 831 Massachusetts Avenue, 2nd Fl., Cambridge, Massachusetts 02139 Telephone: [phone removed] E-mail: histcomm@cambridgema.gov URL: https://www.cambridgema.gov/historic LIDGE HISTO Chandra Harrington, Chair, Susannah Barton Tobin, Vice Chair; Charles M. Sullivan, Executive Director Joseph V. Ferrara, Elizabeth Lyster, Jo M. Solet, Yuting Zhang, Members RICAL Gavin W. Kleespies, Paula A. Paris, Kyle Sheffield, Alternates OMMISSIO™ CERTIFICATE OF APPROPRIATENESS 14 JFK Street Property: 1834 Realty Inc. Applicant: Attention: Daniel Fraine Cambridge Savings Bank 81 Wyman Street Waltham, Mass. 02451 Patrick Lee Grafton Group Hospitality 14 JFK Street Cambridge, Mass. 02138 The Cambridge Historical Commission hereby certifies, pursuant to the Massachusetts Historic Districts Act (MGL Ch. 40C) and the Cambridge Historical Buildings and Landmarks Ordinance (Cambridge City Code, Ch. 2.78), that the work described below is not incongruous to the historic aspects or architectural character of the building or district: Install illuminated blade sign as shown in the sign drawing by SRP Sign Corp. titled, "Blade Sign 14 JFK St Cambridge MA 02138," and dated October 8, 2024. All improvements shall be carried out as shown on the plans and specifications submitted by the applicant, except as modified above. Approved plans and specifications are incorporated by reference into this certificate. This certificate is granted upon the condition that the work authorized herein is commenced within six months after the date of issue. If the work authorized by this certificate is not commenced within six months after the date of issue, or if such work is suspended in significant part for a period of one year after the time the work is commenced, then this certificate shall expire and be of no further effect; provided that, for cause, one or more extensions of time, for periods not exceeding six months each, may be allowed in writing by the Chair. Case Number: 5252 Date of Certificate: February 10, 2025
Case 5252: 14 JFK Street Certificate of Appropriateness, page 2 Attest: A true and correct copy of decision filed with the offices of the City Clerk and the Cambridge Historical Commission February 10, 2025 on - By Chandra Harrington/sto, Chair. ***---*----********************************** Twenty days have elapsed since the filing of this decision. No appeal has been filed → Appeal has been filed Date / City Clerk
CITY OF CAMBRIDGE Community Development Department City Hall Annex, 344 Broadway, Cambridge, MA 02139 SIGN CERTIFICATION APPLICATION Please fill out this application to indicate the number, type, and dimensions of signage for your building. If you are unsure of the type of sign and/or allowable dimensions, please review the following pages of this application and Article 7.000 of the Zoning Ordinance. Please note the following additional requirements: • All signs must receive a permit from the Inspectional Services Department (ISD) before installation. Community Development Department certification action does NOT constitute issuance of a permit or certification that all other code requirements have been met. Do not contract for the fabrication of a sign until all permits have been issued, including City Council approval if necessary, for signs in the public way. • Any sign or portion of a sign extending more than six (6) inches into the public way/sidewalk must receive approval from the Cambridge City Council and a bond must be posted with the City Clerk. For questions or additional information, please contact cddzoning@cambridgema.gov. APPLICANT INFORMATION Applicant Name: SRP Sign Corporation Phone: [phone removed] Email: [email removed] Sign Address: 14 JFK St CITY OF CAMBRIDGE • CDD • SIGN CERTIFICATION APPLICATION
PROPOSED SIGN Please fill out the information below and attach a sketch of the proposed sign to the application. Each proposed sign requires an individual form to be filled out. For further information on sign types, see the below page. Sign text: Russell House Tavern Sign type: Projecting Sign (including awnings) Area in square feet: 10.9 Dimensions: 32.75" H × 48" Placement height in feet: 10 Depth from façade: 48" Illumination: Internal Sign frontage in feet: 45.75 Area of existing signs to remain: 0 COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATION FOR INTERNAL USE ONLY Sign conforms to requirements of Article 7.000: No Sign requires a variance from the Board of Zoning Appeals: No The signage is approved as it conforms to the requirements of the Harvard Square Overlay, which offers more flexible dimensional allowances than Article 7 Non-conformance with Article 7 includes internal illumination, projection from the Comments: facade beyond 6 inches, and height of an illuminated sign greater than 30 inches. Signature: Date CDD Representative CITY OF CAMBRIDGE • CDD • SIGN CERTIFICATION APPLICATION
NATURAL AND EXTERNAL ILLUMINATION WITH CONDITIONS INTERNAL ILLUMINATION MAX 30 SIGN DING MAX GROUND 2 SIGNS PER LOT FREESTANDING SIGN A free standing sign is attached to or part of a self-supporting structure and is not attached to any other structure. ONLY 2 NATURAL AND ILLUMINATION DE CIGNC DER UNLIMITED # SIGN FRONTAGÉ - - PARALLEL TO STREET- _LENGTH OF BUILDING SO FT MAX 60 ABOVE GROUND WALL SIGN OVERVIEW BY SIGN TYPE A wall sign is affixed so its exposed face and all sign area is parallel to the plane of the building. IF PROJECTION COUNCIL MUST EXCEEDS 6*, CITY SIGN FRONTAGE - ABOVE PARALLEL TO STREET LENGTH OF BUILDING SQ FT MAY 12 1 ONE SIGN PER GROUND FLOOR ESTABLISHMENT CITY OF CAMBRIDGE • CDD • SIGN CERTIFICATION APPLICATION ONLY •EXTERNAL NATURAL AND ILLUMINATION PROJECTING SIGN Please note that this guide is intended to provide an overview of requirements by sign type. Sign shall mean and include any permanent or advertisement, announcement, or direction and which is designed to be seen from the outside of a building. For further information on specific requirements, consult Article 7.000 of the Zoning Ordinance. temporary structure, device, letter, words, model, banner, pennant, insignia, trade flag, or representation used as, or which is in the nature of, an a building face, including marquee, canopy, and awning mounted signs. A projecting sign is attached to and projects from
DATE 10-8-2024 JECT: BLADE SIGN DDRESS: 14 JFK ST CAMBRIDGE MA 02138 ESCRIPTION EXTERIOR SIGNAGE FLE LOCATION ClimerRishop drawing templates Shop Drawing Tamplate. pot CUENT: RUSSEL HOUSE TAVERN DRAWABY: ADAM KNAUER [phone removed] 236 PEARL STREET CORPORATION SRESIGN 48" TAVERN HOUSE RUSSELL 4%" 3½" 41¼" 5%" 14½" 32¾" Gold Translucent Vinyl White Beige Translucent Vinyl Black White Cut Vinyl Text Applied Behind Neon to Sign Face Rule Line, Stars & "Tavern" Push Through Acrylic Opaque Black Vinyl Applied Over Stars Aluminum Fabricated Cabinet Gold & Beige Translucent Vinyl Blade Sign Neon Border & "Russell House" Text 32-3/4" × 48"x 10" Qty. (1)
ing Templatepot DATE 10-8-2024 1-1/2" x 1-1/2" 2" x 1/8" Wall Thickness Aluminum Square Tube Frame Removable Top, Bottom & Front Return Neon Transformers & LED Power Supply .080 Aluminum Face 2" x 2"x 1/4" Wall Thickness Steel Mounting Arm White Neon w/ Tube Stand Building Power Brought to Sign by Others White Neon w/ Tube Stand DICT BLADE SIGN 1/2" White 2447 Push Through Acrylic for Mounting & Service DRESS 14 JFK ST CAMBRIDGE MA 02138 White LEDs RAWN BY: ADAM KNAUER ESCRIPTION EXTERIOR SIGNAGE FLE LOCATION. CantRPshop drawing terplates Shop Dre CIENT: RUSSEL HOUSE TAVERN ([phone removed] 236 PEARL STREET SOMERVILLE, MA 02145 CORPORATION SRESIGN 3021 Beige Translucent Vinyl White Gold Translucent Vinyl Black Rule Line, Stars & "Tavern" Push Through Acrylic Neon Border & "Russell House" Text Gold & Beige Translucent Vinyl Opaque Black Vinyl Applied Over Stars White Cut Vinyl Text Applied Behind Neon to Sign Face 32-3/4" × 48"x 10" Aluminum Fabricated Cabinet Blade Sign Qty. (1)
Fabricated Sign Frame DATE 10-8-2024 Mounting Bracket BLADE SIGN * 14 JFK ST CAMBRIDGE MA 02138 WN BY: ADAM KNAUER LE LOCATION. ClientsLAPshop drawing CLENT: RUSSEL HOUSE TAVERN [phone removed] 236 PEARL STREET SOMERVILLE, MA 02145 CORPORATION SRESIGN Mounting Bracket Fabricated Sign Frame Gold Translucent Vinyl Beige Translucent Vinyl White Black Rule Line, Stars & "Tavern" Push Through Acrylic Neon Border & "Russell House" Text Gold & Beige Translucent Vinyl Opaque Black Vinyl Applied Over Stars White Cut Vinyl Text Applied Behind Neon to Sign Face 32-3/4" x 48"x 10" Aluminum Fabricated Cabinet Blade Sign Qty. (1)
FDC TAVERN HOUSE RUSSELL BLADE SIGN 14 JFK ST CAMBRIDGE MA 02138 DENT RUSSEL HOUSE TAVERN ESCRIPTION, EXTERIOR SIGNAGE Proposed New Blade Sign [phone removed] SOMERVILLE, MA 02145 CORPORATION SRPSIGN TAVE N HOUSE RUSSELL Existing Blade Sign Beige Translucent Vinyl White Gold Translucent Vinyl Black Rule Line, Stars & "Tavern" Push Through Acrylic Opaque Black Vinyl Applied Over Stars White Cut Vinyl Text Applied Behind Neon to Sign Face Blade Sign Aluminum Fabricated Cabinet Gold & Beige Translucent Vinyl Neon Border & "Russell House" Text Qty. (1) 32-3/4" × 48"x 10"
estimate SRPSIGN Date Estimate # CORPORATION 236 pearl street. somerville, ma 02145 t. [phone removed] f. [phone removed] 4847 9/12/2024 Rep Name / Address Ship To Russell House Harvard Square Cambridge Item Cost Description Total Qty Double-sided blade sign. Sign 1 18,500.00 18,500.00T 48" × 32.75" x 10" deep (approximate dimensions: vif) All aluminum fabrication with exposed white neon letters and Noveil Gold neon border as per drawing. Stencil-cut letters, stars, and line with push-through acrylic w/translucent vinyl faces. Welded bracket. Installation 1 Open shop installation during normal business hours 2,250.00 2,250.00 power to be brought to the sign by others permits, police detail, engineering at face value MA Sales Tax 6.25% 1,156.25 Terms: 50% deposit required to begin. Delivery: 4 - 6 weeks from receipt of all required approvals. Total $21,906.25 Balance due upon completion. Estimates are valid for 30 days Police details, municipal license or permit fees and/or aquisition expenses incurred by SRP Sign Corp,, and sales or use taxes where applicable or required are additional charges which shall be born by the Purchaser. Sign permit at face value plus $85.00 per hour to obtain with a minimum 1 hour added to final invoice This contract in accordance with terms stated is hereby accepted. Signed Dated: 9/25
estimate SRPSIGN Date Estimate # CORPORATION 236 pearl street. somerville, ma 02145 t. [phone removed] [phone removed] 4847 9/12/2024 Rep Name / Address Ship To Russell House Harvard Square Cambridge Item Description Qty Cost Total Sign Double-sided blade sign. 1 18,500.00 18,500.00T 48" x 32.75" x 10" deep (approximate dimensions: vif) All aluminum fabrication with exposed white neon letters and Noveil Gold neon border as per drawing. Stencil-cut letters, stars, and line with push-through acrylic w/translucent vinyl faces. Welded bracket. Installation Open shop installation during normal business hours 1 2,250.00 2,250.00 power to be brought to the sign by others permits, police detail, engineering at face value MA Sales Tax 6.25% 1,156.25 Terms: 50% deposit required to begin. Delivery: 4 - 6 weeks from receipt of all required approvals. Total $21,906.25 Balance due upon completion. Estimates are valid for 30 days Police details, municipal license or permit fees and/or aquisition expenses incurred by SRP Sign Corp,, and sales or use taxes where applicable or required are additional charges which shall be born by the Purchaser. Sign permit at face value plus $85.00 per hour to obtain with a minimum 1 hour added to final invoice This contract in accordance with terms stated is hereby accepted. Signed Dated: 19/25
DATE (MM/DD/YYYY) ACORD® CERTIFICATE OF LIABILITY INSURANCE 01/24/2024 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 endorsements). CONTACT Nicole Bobocea Risman Insurance Agency, Inc. [phone removed] [phone removed] H/C No. Ext): FAIC, NO): E-MAIL [email removed] 689 Fellsway ADDRESS: NAIC # INSURER(S) AFFORDING COVERAGE Medford MA 02155 24082 Ohio Security Insurance Co. INSURERA: Norfolk & Dedham Mutual Ins Co INSURED 23965 INSURER B: Ohio Casualty Insurance Co. 24074 Srp Sign Corp INSURER C: 236 Pearl St INSURER D: INSURER E: Somerville MA 02145 INSURER F: CL2412360071 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 ADDL SUBRI OLICY EX LIR LIMITS TYPE OF INSURANCE POLICY NUMBER INSD WVD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 15,000 01/20/2025 A 01/20/2024 BKS60819504 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- LOC POLICY PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ 1,000,000 (Ea accident) $ ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED 91970387A BODILY INJURY (Per accident) $ B 01/20/2025 01/20/2024 AUTOS AUTOS ONLY HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY (Per accident) AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 USO60819504 EXCESS LIAB C 01/20/2025 01/20/2024 CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION $ 10,000 WORKERS COMPENSATION X PATUTE I AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE $ 1,000,000 01/20/2024 B N/ A 01/20/2025 WE190737A N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Insurance verification: Workers' Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. With respect to insured's operations and required in written and signed contract, the following are included as additional insureds in regard to General Liability per forms CG8810 04/13 (ongoing operations) and CG8611 10/16 (completed operations) and Umbrella Liability per form CU6002 04/21. 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 SRP Sign Corp. 236 Pearl St. AUTHORIZED REPRESENTATIVE MA 02145 Somerville -Vicole Bobocca © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25(2016/03)
00033115 AGENCY CUSTOMER ID: LOC #: ACORD® of Page ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Risman Insurance Agency, Inc. Srp Sign Corp & Goodpitch LLC & 234 Pearl Street Realty Trust POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, 25 FORM TITLE: Certificate of Liability Insurance FORM NUMBER: Liability per forms CG8810 04/13 (ongoing operations) and CG8611 10/16 (completed operations) and Umbrella Liability per form CU6002 04/21. Waiver of subrogation applies in favor of the following subject to requirement in written and signed contract in regard to General Liability per form CG8810 04/13, Auto Liability per form AP-2 09/08, and Umbrella Liability per form CU6495 12/07. Additional insured status is primary and non-contributory subject to requirement in written and signed contract in regard to General Liability per form CG8810 04/13. General Liability aggregate applies per project per form CG8870 12/08. Please refer to actual policy for all other terms, conditions and exclusions. ACORD 101(2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston, MA 02111 www.mass.gov/dia ЗагатАнн Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): SRP Sign Corporation Address: 236 Pearl St Phone #: [phone removed] City/State/Zip: Somerville, MA 02145 Are you an employer? Check the appropriate box: Type of project (required): 4. • I am a general contractor and I 1. I am a employer with 8 6. • New construction have hired the sub-contractors employees (full and/or part-time).* listed on the attached sheet. 7. • Remodeling 2. L I am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. - Demolition employees and have workers' working for me in any capacity. 9. _ Building addition comp. insurance.# [No workers' comp. insurance 10. Electrical repairs or additions 5. We are a corporation and its required.] officers have exercised their 11._ Plumbing repairs or additions 3. L I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. 12. _ Roof repairs c. 152, §1(4), and we have no insurance required.] * Other Signage 13.0 employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. † Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ‡Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Risman Insurance Agency, Inc. Policy # or Self-ins. Lic. #: WE190737A Expiration Date: 1/20/2025 Job Site Address: 14 JFK St City/State/Zip: Cambridge, MA Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 12/11/2024 Date: Signature: [phone removed] Phone #: Official use only. Do not write in this area, to be completed by city or town official. Permit/License # City or Town: Issuing Authority (check one): 1 Board of Health 2 Building Department 3_City/Town Clerk 4. Electrical Inspector 5LPlumbing Inspector 6.Other Contact Person: Phone #:
The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): SRP Sign Corporation Address: 236 Pearl St Phone #: [phone removed] City/State/Zip: Somerville, MA 02145 Are you an employer? Check the appropriate box: Type of project (required): 4. 1am a general contractor and I 1. 1am a employer with 8 6. New construction have hired the sub-contractors employees (full and/or part-time).* listed on the attached sheet. 7. • Remodeling 2.• I am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. • Demolition employees and have workers' working for me in any capacity. 9. _ Building addition comp. insurance.‡ [No workers' comp. insurance 5. 10. Electrical repairs or additions We are a corporation and its required.] officers have exercised their 11. Plumbing repairs or additions 3.0 I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. 12. Roof repairs c. 152, 81(4), and we have no insurance required.] * 13.M Other Signage employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Risman Insurance Agency, Inc. Policy # or Self-ins. Lic. #: WE190737A Expiration Date: 1/20/2025 Job Site Address: 14 JFK St City/State/Zip: Cambridge, MA Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 12/11/2024 Date: Signature: Phone #: [phone removed] Official use only. Do not write in this area, to be completed by city or town official. Permit/License # City or Town: Issuing Authority (check one): 1D Board of Health 2 Building Department 3_City/Town Clerk 4.l Electrical Inspector 5Plumbing Inspector 6. Other Contact Person: Phone #:
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