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HomeMy WebLinkAboutWiring Permit - Permits #12772 - 396 CHESTNUT STREET 9/25/2014 Date. .... ... ..................... TOWN OF NORTH ANDOVER 10 PERMIT FOR WIRING 6 . ,83A CHU This certifies that ................................................. as permission to perform rye ............................. wiring in the building of...........,`................... ............................................................. at ...........—,�, North Andover,Mass. .................. ......ff�......................... ........ ............. Fee.................. Lic,No ................ .......... ................................................................ ELECTRICAL INSPECTOR Ch eck# FOR PCRO&TO) PERFORM ELECT RICAL INK K ILI-Woricio Cade(bfcc)A527QMXMOO o� `iaY°° H ��Vl YI l 0 ve i2-- A'a theY17spectorof 1,2p s'. 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L".41.7-t ,�,rmmx m,�`i'hon?agJ: oa '�`�pric�&finets{er"exempt„na relce��can�s.bzt?in �_ �.tym 'E i r._ zuq � ;. z, ._� z�s'�G�C�r,(;�"-`.5'��SEL�3v0J1L(i3ulo�.LiccncdTcQt��•L!'LoY�hlSft%oar{a1'•a,���rCafJtEyentBiuT1�Z�C6.f�S�71Lz+�e,Jt�nre: QOJ,1/9 X I UcC� 1y%12B1a �Z°�2�u0r78(O dry l8tcb��Fi%3?'SrB YSL� ii7LB 6Pi t,r 7 t c'�C"geC D7e{�ili xlet I It71VifE °r5J.3gout hH a •+rr,r.rf...n--� .v-r.T v-+..+.H-._vtn---.•N...< .+..+rwq-r Yt av w4+.c • P a../n-. rH n..—.{.r k-t ,-rry,... vv rr 4t•eV ,y ..v v re a , v h ur+, v 4 AGC�RL7► CERTIFICATE OF LIABILITY INSURANCE DATE09/25/203YYY) 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 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 N ADD Risk Services Northeast, Inc. NAME:PHONE Morristown NJ Office (A/C.No.Ext): C866) 283-7122 FAX No.: (800) 363-0105 y 44 Whippany Road, suite 220 E-MAIL a Morristown NJ 07960 USA ADDRESS: O 2 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Zurich American Ins CO 16535 ADT LLC INSURER B: American Zurich Ins c0 40142 ADT Security Services 1501 Yamato Rd INSURER C: Boca Raton FL 33431-4408 USA INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:570051395419 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. Limits shown are as requested INSR TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY GLO EACH OCCURRENCE S2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S1,000,000 PREMISES Ea occurrence CLAIMS-MADE q OCCUR MEll EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 rn GENERAL AGGREGATE $4,000,000 rn GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $4,000,000 X POLICY PRO LOC o AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT � Ea accident ANY AUTO BODILY INJURY(Per person) O ALL OWNED SCHEDULED Z AUTOS AUTOS BODILY INJURY(Per accident) N HIRED AUTOS NON-OWNED PROPERTY DAMAGE M AUTOS (Per accident) w .L. N UMBRELLA LIAB OCCUR EACH OCCURRENCE U EXCESS LIAB CLAIMS-MADE AGGREGATE DED I RETENTION B WORKERS COMPENSATION AND wc509589701 10/01/201310/01/2014 WC STATu- OTH- A EMPLOYERS'LIABILITY YIN wcS09589801 10/01/2013 10/01/2014 X TORYLIMITS ER ANY PROPRIETOR PARTNER/EXECUTIVE E.L.EACH ACCIDENT $2,000,00O OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000 .4111. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) �a �0 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. INSPECTOR OR OF WIRES d.= TOWN NORTH ANDOVER AUTHORIZED REPRESENTATIVE �-o 124 MAIN ST. NORTH ANDOVER MA 01845 USA e."'�i2YCll1 L+l ?%Cs ©1988-2010 ACORD CORPORATION.All rights reserved. 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