25 Woodside Ave Electrical permit.pdf
Inspectional Services Department, Department of Public Works · from the Town's request portal · released Aug 15, 2022 · 8 pages · 251 KB
open the file ↗ · original at the source ↗
8/15/22, 11:32 AM
Town of Winthrop, MA
E-21-152
Electrical Permit
Status: Complete
Applicant
Ronald Salvucci
ron@massbayelectric.com
125 Orleans Street
East Boston, MA 02128
617-590-7792
Project Info
Total Estimated Cost
365,000
Location
Near 25 Woodside Ave.
Brief Description of Proposed Work
Electrical service to street lighting controller
Occupancy Type
Commercial
Permit is in conjunction with a building permit
O
OpenGov
08/15/2022
Date Created: Jun 18, 2021
Primary Location
25 WOODSIDE AVE
Winthrop, MA 02152
Owner:
Town of Winthrop, MA
45 Pauline Street Winthrop, MA 02152
Utility Authorization #
30399374
Work to Start:
06/29/2021
Estimated Cost of Work Associated with Building Permit (Do not include the dollar symbol [$].)
Owner Information
Owner Name
Town of Winthrop, MA
Primary Contractor
Owner Phone Number
617-846-1601
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Electrician's Name
James Moulison Jr.
License #
17466A
License Type
Electrical
Type of Business
Mailing Address
125 Orleans Street
State
MA
Preferred Telephone #
857-256-2046
Email
ron@massbayelectric.com
I certify, under the pains and penaities of perjury, that the information on this application is true and complete.
OpenGov
Business Name
Mass Bay Electrical Corp.
License Expiration Date
07/31/2022
License Active
(C4
Corporation/Partnership/LLC License #
City
East Boston
Zip Code
02128
Alternative Phone #
Sv
Service
New or Existing Amps
New 200
Volts Overhead
120/240 0
Underground Number of Meters
w 1
Feeders
# of Feeders Ampacity
1 200
Fixtures
No. of Recessed Luminairies
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No. of Luminaire Outlets
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No. of Luminaires
7
No. of Switches
No. of Ranges
No. of Dishwashers
No. of Water Heaters
No. of Hydromassage Bathtubs
No. of Hot Tubs
No. of In-Ground Swimming Pools
No. of Gas Burners
AC Total Tons
Heat Pump Tons
Space/Area Heating KW
No. of Ballasts
Motors Total HP
Transformers Total KVA
Generators KVA
No. of Security Systems Devices or Equivalent
No. of Data Wiring Devices or Equivalent
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No. of Receptacle Outlets
No. of Ranges
No. of Waste Disposers
No. of Dryers
Water Heater KW
No. of Ceil.-Susp. (Paddle) Fans
No. Above Ground Swimming Pools
No. of Oil Burners
No. of Air Conditioners
No. of Heat Pumps
Heat Pump KW
No. of Signs
No. of Motors
No. of Transformers
No. of Generators
No. of Emergency Lighting Battery Units
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No. of Telecommunications Wiring Devices or Equivalent
OpenGov
Fire Alarm Fixtures
No. of Zones
No. of Alerting Devices
No. of Self-Contained Detection/Alerting Devices
Alarm Type
Total Fixtures
No. of Detection and Initiating Devices
Please enter the Total number of fixtures (calculated by adding all of the fixtures entered in the 2 sections above)
General Wiring (Residential & Commercial)
Annual Maintenance
0
General Outlet Wiring
O
Temporary Wiring (Temp Service)
O
Gasoline Pumps
O
Laundromats
0
Well pump
O
Insurance
Feeder & Panel Wiring
2)
Machine & Motor Wiring
QO
Gasoline Stations (complete)
0
Carnivals & Shows
0
Furnaces
a)
Sewer Ejector Pump
a)
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| have current liability insurance / workers' compensation policy or its substantial equivalent
Yes
Insurance is not required
0
Workers' Compensation Insurance Affidavit
Are you an employer? Select from the options below.
lam an employer with full and/or part time employees.
Policy and Job Site Information
Insurance Company Name Policy # or Self-ins License #
USI Insurance Services LLC WCCZ11257341071
Expiration Date Type of Insurance Coverage
02/01/2022 Liability Policy
Workers' Compensation Affidavit Signature
I do hereby certify that under the pains and penalties of perjury that the information provided above is true and
correct.
vv
Attachments
(Pa")Plans.paf
Uploaded by Ronald Salvucci on Jun 18, 2021 at 2:47 pm
(Pefinsurance Certificate.pdf
Uploaded by Ronald Salvucci on Jun 18, 2021 at 2:40 pm
(PaflLicense A.pdf
Uploaded by Ronald Salvucci on Jun 18, 2021 at 2:40 pm
History
Date Activity
“Jun 18,2021at 2:20pm _ Ronald Salvucci started a draft of Record E-21-152
Jun 18, 2021 at 2:47 pm Ronald Salvucci submitted Record E-21-152
Jun 18, 2021 at 2:47 pm approval step Inspector Reviewwas assigned to Danny Gray on Record E-21-152
Jun 20, 2021 at 5:57 pm Danny Gray approved approval step Inspector Review on Record E-21-152
Aug ll, 2021 at 9:37 am Sharon Sicurella waived payment step Permit Fee on Record E-21-152
Aug 11, 2021 at 9:37 am inspection step Inspectionwas assigned to Danny Gray on Record E-21-152
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Date Activity
: Nov 19, 2021 at 1145 am “ Danny Gray altered J inspection step Inspection, c! changed status from Active to ‘Complete ,
on Record E-21-152
Nov 19, 2021 at 11:45 am inspection step Final inspectionwas assigned to Danny Gray on Record E-21-152
Nov 19, 2021 at 11:46 am Danny Gray altered inspection step Final Inspection, changed status from Active to
Complete on Record E-21-152
Nov 19, 2021 at 11:46 am Danny Gray completed Record E-21-152
Timeline
Label Status Activated Compieted Assignee Due Date
«f —_Inspector Review Complete Jun18,2021at2:47pm = Jun 20,2021 at5:57pm DannyGray -
Permit Fee Waived Jun 20, 2021 at 5:57 pm Aug 11, 2021 at 9:37 am - .
fi
Permit Issuance Issued Aug 11, 2021 at 9:37 am Aug 11, 2021 at 9:37 am - -
Inspection Complete Aug tl 11, 2021 at 9:37am = Nov 19, 2021 at1l:45am DannyGray = -
Cc
Final Inspection Complete Nov 19,2 2021 at 11:45am Nov19,2021atl1:46am DannyGray = -
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Client#: 635265 MASSBAYE
ACORD. —_ CERTIFICATE OF LIABILITY INSURANCE bare upon
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: ff 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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Naneec" L Welch
USI Insurance Services LLC FUONE, exp, 781-376-2681 FAX Noy: 781-376-5035
12 Gill Street Suite 5500 EMAIL. leslie.welch@usi.com
Woburn, MA 01804 INSURER(S} AFFORDING COVERAGE NAIC #
855 874-0123 INSURER A: Liberty Mutual Fire Insurance Company 23035
INSURED INSURER B ; Starr Indemnity & Liability Company 38318
Mass Bay Electrical Corp iNsuRER c ; Employers Insurance Company of Wausau 21458
125 Orleans St INSURER D ; Ironshore Specialty Insurance Co 25445
East Boston, MA 02128-126 INsuRER E; North River Insurance Company 21105
insurer F ; Navigators Insurance Company 42307
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 !1S SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ISR TYPE OF INSURANCE ey Shan POLICY NUMBER (MDB) (MDB) LIMITS
A |_X/ COMMERCIAL GENERAL LIABILITY 1B2Z11257341111 (05/01/2021 | 05/01/2022, cach OCCURRENCE $2,000,000
| cLAIMS-MADE [xl OCCUR AMIR ES TO nce) $500,000
|_| MED EXP (Anyone person) _| $10,000
| | PERSONAL &ADVINJURY | $2,000,000
| GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
|__| POLICY [x jeer [ ] Loc PRODUCTS - compP/oP AGG | $4,000,000
OTHER: $
A | Avtomoaivg LiaBiLiry AS2Z11257341021 05/01/2021 | 05/01/2022 (QMENED SINGLE LIMIT | <4,000,000
X/ ANy AUTO BODILY INJURY (Per person) | $
[| QYNED wy SCHEDULED BODILY INJURY {Per accident) | $
LX MERRomy | ARSE eens
$
B |X| UMBRELLALIAB |X | occuR 1000587055211 05/01/2021 | 05/01/2022 EAcH OCCURRENCE $25,000,000
E EXCESS LIAB CLAIMS-MADE 5228092764 (05/01/2021 | 05/01/2022 accrecaTe $25,000,000
F | {oeo | X/ rerewrions0 IS21EXCZO866TIV 05/01/2021 |05/01/202 $
C_ | WORKERS COMPENSATION, vn WCCZ11257341071 05/01/2021 (05/01/2022 X [EfRure | [Se
ANE EBSD ART NBRERESUT™ET Tra ex. exci acoment __|s500,000
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE| $500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below £.L. DISEASE - POLICY Limit | $500,000
D | Pollution 004045902 (05/01/2021 | 05/01/2022 $3,000,000 Per Occ
Liability $6,000,000 Aggregate
$10,000 Deductible
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
RE: Evidence of Insurance only.
CERTIFICATE HOLDER CANCELLATION
. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Mass Bay Electrical Corp THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
125 Orleans St. ACCORDANCE WITH THE POLICY PROVISIONS.
Boston, MA 02128-2126
AUTHORIZED REPRESENTATIVE
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© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of1 The ACORD name and logo are registered marks of ACORD
#S831994580/M31929601 LzwcD
OMMONWEALTH OF MASSACHUSETES «3%
DIVISION OF PROFESSIONAL LICENSUR
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CONTROL # J12073514
IMPORTANT
If your license Is lost, damaged or destroyed; is inaccurate; or
needs to be corrected, visit our web site at mass.gov/dpi for
instructions to ensure the proper mailing of your Renewal
Application and any other correspondence.
This license is subject to Massachusetts General Laws and
regulations, Your license is a privilege, and cannot be lent or
assigned to any person or entity under penalty of law. Keep this
license on your person or posted as required by law and/or
regulations.