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Home My WebLink About- Permits #12871-1 - 210 HOLT ROAD 11/16/2015 Datel. AR. �................ C�NCRTh TOWN OF NORTH ANDOVER ° n PERMIT FOR WIRING 83ACHu This certifies that f � """ has permission to perform ........ � t 1�� wiring in the building of .............. at ........................................................� � �...................................... North Andover,Mass. (" �� ........... Fee., � � Lic.No. .............................................. ' " .... ELECTRICAL INSPECTOR Check# IL.a'� 4 Commonwealth of Massachussetts. official use only Department of Fire Services Permit No. 1 %1 H BOARD OF FIRE PREVENTION REGULATORS Occupancy & Fee checked Rev.01/07 ° APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00 Date: 10/22/2015 City or Town of:North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Installation Location(Street& Number) 210 Holt Road Owner or Tenant Northside Carting Telephone No. (978) 686-2020 Owner's Address 210 Holt Road Is this permit in conjunction with a building permit? Yes F-1 No Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd No. of Meters New Service Amps / Volts Overhead F-1 Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: low voltage alarm system, telephony- data Completion of the following table maybe waived.by the Inspector of Wires ,, !'No. of Recessed Luminaires No. of Ceil-Susp(paddle) Fans No. of transformers Total KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA i No. of Luminaires Swimming Pool Above Ingmd No. of Emergency lighting No. of Receptacle Outlets No, of Oil Burners FIRE ALARMS No. of zones No. of switches No. of Gas Burners No. of Detection Initiating No. of Ranges No. of Air Cond Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Devices No. of Dishwashers Space/Area Heating KW Connection Local Muni Other No. of Dryers Heating Appliances KW Security Systems* No. of Devices No. of Water Heaters KW No. of Signs No. of Ballasts Data Wiring: No. of Devices No. of Hydromassage Bathtubs No. of Motors Total HP Telco Wiring: No. of Devices Other: Attach additional detail if desired,or as required by the inspector of wires Estimated Value of Electrical Work:$2 7 5 8 . 26 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, upon completion. In conformance with M.G.L. Chapter 143 Section 3L the system will be ready for inspection 30 days from the "Work to Start"date. Insurance Coverage: Unless waived by the owner, no permit for the performance of electrical work may issued unless the licensee provides proof of liability insurance including "complete operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force,.and has exhibited proof of same to the permit issuing office. Check One: INSURANCE 0 BOND = OTHER (Specify) Lexington Insurance.Expiration 12/30/15 /certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Wayne Alarm Systems LIC. NO. C-1111 Licensee: Ralph W. Sevinor E'A� � . - (If applicable,enter exempt in the license line) I �� __� Address: 424 Essex St Lynn, MA 01902 Bus. Tel. NO. 781-595-0000 *Per M.G.L.c. 147,s 57-61,security work requires Department of Public Safety"S"license. Lic. no.SS CO 000160 OWNER'S INSURANCE WAIVER: I am aware that the lccensee does not have the liability insurance coverage normally required by law. By_my signature below, I hereby waive this requirement. 6n I am the (check one) 0 WWr i Owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $ 450 . 00 WYNO 15262 � 1 �� `� ATE ACCOR" CERTIFICATE OF LIABILITY INSURANCE O1/06IDD015 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 pollcy(ies) 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 NA E: ALLAN INSURANCE AGENCY INC. PHONE (978) 745-5905 Fax (978) 745-5483 63 1/2 Jefferson Avenue 2nd Floor EMAIL .davidiVallaninsurance.com ADDRESS P.O. BOX 511. INSURERS AFFORDING COVERAGE NAIC u SALEM MA 0197 0-0511 INSURER A;Lexin ton Insurance INSURED INSURERB:Safety Insurance Wayne Alarm Systems, Inc. INSURER C:Atlantic Charter 424 Essex Street INSURERD, INSURER E L nn MA 01902- INSURERF: 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._ INSRLTR TYPE OF INSURANCE Sr)HT POLICY NUMBER POLICY YFF POLICY EXY LIMITS LTR GENERAL LIABILITY Y / / / / FACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL IJABILIFY / / / / DANIA PREMISES(to NTitErrn 5 50,000 12/30/2014 12 T A CLASht6-1.tAtlF aOCCUR 1203304-04 MEDEXP{Any one perscnj $ _ _1,000 professional liability is / / / / PE.RSONAI.BADVINJURY $ 11000,000 Included in the policy. / / / / GENERAL AGGREGATE $ 3,000,000 GENT AGGHEGATELIMIT APPLIES PER. Fieductihle is $5,000 / / / / PRODUCTS-COMPIOPAGG $ 11000,000 POLICY X PRO' LOCErT AUTOMOBILE LIABILITY / / J J COh181NED SINGLE LIMIT i:n ci 0F1 1 11000,000 B ANY AUTO / / / / BODILY INJURY(Por pe(sw) $ ALL SCFIFDULEO 6218583 05/07/2014 05/07/2015 $ 80DILY INJURY(Po accdoaf) $ AUTOS I AUTOS NON,OVVNED / / / / f1ROPER1Y 11ANIAG $ X HIRED AUTOS X AUTOS $ UMBRELLA LIAR X OCCUR 19883916-04 12/30/2014 12/30/2015 EACH OCCURRENCE $ 4,000,000 A NEXCESS LIAS CLAIMS MADE / / AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 WORKERS COMPENSATION WCIOOI18700 12/25/2014 12/25/2015 X I VVCBTATU- OTH- AND EMPLOYERS'LIANILITY Y I N - FOR 1ER ANYPROPRIETOR/PARTNERI£XECUTiVE� / / / / LL EACNACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDE07 L: _! N I A G (MandaloryhiNH) / / / / EL DISEASE-EAEMPLOYEI $ 1,000,000 If Yox describo under DESCRIPTION OF OPERATIONS L•elox _ ! / / / Et DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS;VEHICLES (Attach ACORD lot,AddiBnnai Remarks Schedule,it more space Is required) CERTIFICATE HOLDER CANCELLATION Wayne Alarm Systems Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 424 Essex St AUTHORI7!r REPRE NT,A/TIVE (t 't/Lf /t1 g�{ , /tl ✓Y t Ld�/ �'f C 'c Lynn MA 01902 ACORD 26(2010/05) / O 1988-2010 ACOR CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are regisitered marks of ACORD COMMONWEALTH OF MA, SACHl1SETf Ir Alar BOAR QF LECfiRICIANS ISSUES THE FOLLOWING ,.L 1 CENSE; A REGISTEREQ SYSTEM CONTRACTOR a WAYNE ALARM SYSTEMS I NC 424 'ESSEX STREET t.,YNN MA 01902 3624 1111,.: 07/3 5050Mmimm live Commonwealth of Niassachusetts Department of Public Safety '+ciuri� S,-,t,nt-S-Lircn.c n License: SSCO-000160 RALPH W SEVINORWAYNE ALARM SYSTEMSINC 424 ESSEX ST LYNN MA 01902 ` ✓,.� . Expiration: Commissioner 09/19/2015 COMMONWEALTH OF MASSACHUSETTS 11:m ® gOFail AF1I)at f,,L,CTRICIANS ISSUES THE FOLLQWING.>.LICENSE AS A FtEC I,5T;EREO SYSTEM TECHN i C I AN,. a RAC PH W SEV(NOR ' �f 424 ESSE'X SfREET !� LYNN MA 01902 3624 ° o7/31./1( 50502