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Home My WebLink AboutWire Permit - Permits #13108 - 6 EAST WATER STREET 2/13/2015 ND gu _ �Nl 111,001 Date \\................. ME NE tt4QTOWN OF NORTH ANDOVER IN T ail \\ _ PERMIT FOR WIRING RE\\ g Fit) 3 NI sM L 10-0 This certifies that \\ V� ...... .... ................................................. A has permission to perform ....IMM ......... o011 UNEwiring in the building o \ ....... ................................................ 0 at \ ....... .wort Andover, ass. �\ MEN' ......z...................e Fee ... 1C. �. .... .::e .... » - ... INN 11-710-00 INN ELE iC CTRAL IN WECTOR z � 1� #gas \ \\ All IME All �_ _� Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 3 )03 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. ]/07] (leave blank ) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEQ,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2 - 13 - 15 City or Town of. NORTH ANDOVER To the r of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 6 - 8 East Water Street Owner or Tenant GUFM�alandrino Telephone No. 9783821809 Owner's Address Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box) Purpose of Building_ residential Utility Authorization No. N/A per National Grid Existing Service 100 Amps 120/ 240Volts Overhead FX] Undgrd 0 No.of Meters 2 New Service, 200 Amps 12Q 240 Volts Overhead E@ Undgrd [:1 No.of Meters 2— Number of Feeders and Ampacit.y Location and Nature of Proposed Electrical Work: Replace service due to it being pulled down by truck. New meter socket and new paneM N o.o EfR Recessed OffELtL2��lowin T- table ma Inspector of Wires. res uminai�s 0.0 otal No.of Recessed Luminoires No.of Ceil.-Susp.(Paddle)Fans T Transformers KVA o'a N of I �jj .of Luminaire Outlets No.of Hot Tubs Generators KVA 0 n No. ..... 1121 "i; ng No.of Luminaires Swimming Pool 9 rnd. rud. ED] Batte units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones.0 etec ion an No.of Switches No.of Gas Burners E Initiatia�Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers TI—esit 1'11"111 NJ �1 1 . . � el- .onta e 'j,11 1�b 121! Tons It otal Detection/A rtm Devices um� )SI No.of Dishwashers Space/Area Hearing KW Co' nnection 0 Other No.of Dryers heating Appliances KW ecurit. , stems: No. f evices o !,quivalent No.of Water-- V0--o—f No.of Data Wiring Heaters KW Si us Ballasts No.of Devices or Equivalent No. Hydronkassage Bathtubs No.of Motors Total tip Te—Recommunications Wir4,, : N(L of Devices o a uiva cut OTHER: New Service — Estimated Value of Electrical $2000.00 Attach additional detail if desired, or as required by tile Inspector of Wires. Work: ('When required by municipal policy.) Work to Start:- 2113/15 _Inspections tobe requested in accordance with MEC Rule 10,and upon completion.INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work :nay issue unless the licensee provides proof'of liability insurance including"completed 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 [A BOND [1 OTHER D (Specify:) I certify,under thepains andpenalties of perjury,that the infirmation on this application is true and complete. FIRM NAME: Vaz Electric Inc. LIC.No.: A13153 —75�-,� �-7 Licensee: Vin&e-nt—Zizzo --- e_- Signature//7 1,,%- 7 LIC.NO.: E29588 (If applicable,enter "exempt 11 in the license number line.) -37 Bus.Tell. No.. 78184490 Address: 16 Griswold Street Revere MA, _92151 Alt.Tel.No.:-jJLj2a9BM *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I ant the(check one� owner owner's a9ent, C)n Owner/Agent Signature $ Felephone No.--- tPERMIT FEE.: $ Li R't,7W, 11tCT ' ,; � � y J . SHEET METAL WORKERS ISSUES THE FOLLOWIN6 LICENSE S A STE R T I CTED EPA Clean Air Section 608 OWWT)C:erfffi Cate:Jan,2 ,9 'VINCENT A ZJZZ0W 16 GRISWOLD ST O702I 1 7 s Requirod by 4FR z,Subpad F REVERE MA 02151-1907 ,. .. _ ,.. t"1�1 .; ➢ ( r„{ fr,,�l ri t r i, rI �P 1� i r�r Safety .44,OfConsume', ,�:�r'rr�r�,�',^r"Tite Of C onsuume',a��nirs&Bvsi4ss firg"Nuuduon E IMPROVEMENT CONTRACTOR i , l U ti'DM 142,968 Type. M,. 1 0 [T CENT A ZIZZO REVERE MA 02151 Undersecretary 07 2MIS 'v�tir�aYri STATE OF NF-W HAMPSHIRENAME' VIN y a rintn� r ,i V,r � rye zs �F/ M I asm sinus us�res� u NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES hd The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington. Street, Boston, Massachusetts 02111 617-727-4900 - http://www.mass.gov/dia As required by Massachusetts General f,aw. Chapter 152. Sections 21, 22 & 30. this will give you notice that I (we) have provided for payment to our injured employees under the above-mentioned chapter by insuring with: LIBERTY MUTUAL FIRE INSURANCE COMPAN Y NAME OF INSURANCE—COMPANY PO Box 9525. Manchester,NI-I 03 1('R "()0) 562-3936 ADDRESS OF' INSURANCE WC2-31 S-365623-064 10-01-2014 10-0 1-2015 POLICY NUMBER EFFECTIVE DATES POMPEO AND SONS INSURANCE 464 HIGH STREET MI MA AGENCY 02155 1'7 . /81) 391-1,630 NAME OF INSURANCE AGENT ADDRESS PHONET VAZ EI-ECTRIC INC 16 GRISWOLD STREE'T REVERE. MA 02151 EMPLOYER A.DDRESS EMPI.,OYER'S WORKERS' COMPENSATION SATION OFFICER.(IF, ANY) DATE — WMCAT, TRVATMENT The above-named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions ofthe "Workers' Compensation Act, A copy ofthe First Report of injury must with to tile ill'jUred employee. The employee may select his or her own physician, 'File reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention. employees are he17eby notified that the insurer has arranged far Such attention:� at the NAME OF.HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER hSUred Copy COMMON POLICY DECLARATIONS RENEWAL of SCOTTSDALE INSURANCE COMP Policy Number cps1a231oa ��" CPS2021270 Home Office: One Nationwide Plaza • Columbus, Ohio 43215 Administrative Office: 8877 North Gainey Center Drive - Scottsdale,Arizona 85258 1-800-423-7675 A STOCK COMPANY ITEM 1. Named Insured and Mailing Address VAZ ELECTRIC INC 16 GRISWOLD STREET REVERE, MA 02151 Agent Name and Address XS Brokers Insurance Agency, Inc. 10 Granite Street. Suite #2 Quincy, MA 02169 Agent No.: 20007 Program No.: KJ ITEM 2. Policy Period From: 09/21/2014 To: 09/21/201S Term: 3 6 S DAYS 12:01 A.M., Standard Time at the mailing address shown in ITEM 1. Business Description: ELECTRICAL SERVICE & INSTALLATION In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy.This policy consists of the following coverage parts for which a premium is indicated. Where no premium is shown,there is no coverage.This premium may be subject to adjustment. Coverage Part(s) Premium Summary Commercial General Liability Coverage Part $ 1, 7 s o Commercial Property Coverage Part $ NOT COVERED Commercial Crime And Fidelity Coverage Part $ NOT COVERED Commercial Inland Marine Coverage Part $ NOT COVERED Commercial Auto Coverage Part $ NOT COVERED Professional Liability Coverage Part $ NOT COVERED Total Policy Premium: $ 1,750.00 $ $ Policy Total: $ 1 7so.00 Form(s)and Endorsement(s) made a part of this policy at time of issue: SEE SCHEDULE OF FORMS AND ENDORSEMENTS 25% MINIMUM EARNED PREMIUM GC/ISM 10/21/2014 THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S),TOGETHER WITH TIRE COMMON POLICY CONDITIONS, COVERAGE PART(S),COVERAGE FORM(S)AND FORMS AND ENDORSEMENTS, IF ANY, COMPLETE THE ABOVE NUMBERED POLICY. OPS-D-1 (8-10) INSURED opsdlj.fap `�`� � � Y