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An application was received from Ricky Zeng representing Moge Tee, requesting permission for a projecting sign at the premises numbered 605 Massachusetts Avenue approval has been received from Inspectional Services, Department of Public Works, Community Development Department and abutter

APP 2021 #35·Council meeting Aug 2, 2021·20 pages·📄 Original PDF (city portal)
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605 Mass Avenue 917 682-0038 50 lbs
WOFilGRS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE I NSU RANCE 175 Berkeley Street Boston, MA 02116 lssued by LM INSI RAIiICE CORPORATION 27243 Policy Number WCs-31S-389517-021 lssuing Office 016C RENEWAL OF: WC5-3LS-389517-020 lssue Date 02-18-21 Account Number 1-3895L7 1. lnsured and Mailing Address NEWCCSIGNINC 2s9 QUTNCY AVE Sub Account 0000 RrsK rD 000972540 QUINCY, MA 02169 Status 03 - CORPORATfON Other workplaces not shown above: SEE ITEM 4. PREMIUM - EXIENSION OF INFORMATION PAGE 2. Policy Period:The policy period is from 04-04-202J- to 04-04-2022 12:01A.M. standard time at the lnsured's mailing address. 3. Coverage A. Workers Compensation lnsurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability lnsurance: Part Two of the policy applies to work in each state listed in ltem 3.A. The limits of our liability under Part Two are: Bodily lnjury by Accident $ 1,000,000 each accident Bodily lnjury by Disease $ 1,000,000 policy limit Bodily lnjury by Disease $ 1,000,000 each employee C. Other States lnsurance: Part Three of the policy applies to the states, if any, listed here: SEE END WC 20 03 06B D. This policy includes these endorsements and schedules: SEE EXIENSION OF INFORMATION PAGE 4. Premium: The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Code Premium Basis Total Rate per $100 Estimated Annual Classifications Number Estimated Annual Remuneration of Remuneration Premium See Extension of lnformation Page Minimum Premium $ 500 (lfA ) Total Estimated Annual Premium $ 2 , 083 Premium will be billed ANNUAL Producer 000+0248/8 TAld FINAI{CIAL LLC 2OO LINCOLN ST APT 1 BOSTON ldA 02111 WC 00 00 0'l A @ 1987 National Council on Compensation lnsurance,lnc. WC 00 00 01 B (CA) Ed. 07 10112011 All Rights Reserved Page 1 of 1 Liberty Mutual" AR lnsured Copy
DN 9' - 3 9/16" 18' - 5 5/16" 13' - 0 5/16" 40' - 9 1/4" 17' - 5 3/8" 10' - 4 3/8" 3' - 3" 3' - 10 1/2" 3' - 11 1/8" 3' - 0" 7 15/16" 3' - 2 7/8" 9 7/16" 16' - 3 9/16" 10' - 2 1/4" 12' - 4 7/16" 2' - 2 15/16" 18' - 9 3/4" 5' - 5" 5' - 9 15/16" 7' - 6 13/16" 1' - 9 9/16" 4' - 6" 7' - 7 15/16" 6' - 7 13/16" 3' - 6 3/8" 6' - 1 1/2" 8' - 0 3/16" 11' - 7 5/16" 17' - 11" 18' - 9 3/4" ARCHITECTURAL AS BUILT SHEET NUMBER DRAWN BY SCALE PROJECT NUMBER PROJECT DIRECTOR PROJECT MANAGER SHEET TITLE DATE SEE COVER SHEET ISSUES / REVISIONS 100% SUBMISSION NO. 01 s BUIL PROFESSIONALS © 2020 AEC CONSULTANTS INC www.asbuiltprofessionals.com A DIVISION OF: AEC CONSULTANTS INC [phone removed] 844 A S B U I L T Essex & Massachusetts Ave Cambridge, MA 02139 Designer Designer Project Number Author 605 FIRST FLOOR AB-10 1/4" = 1'-0" 1 Level 1 605 N
UP 40' - 8 1/8" 4' - 7" 12' - 9 3/16" 13' - 0 3/16" 10' - 3 3/4" 7 1/2" 3' - 1 3/8" 8' - 7 5/8" 6' - 1 7/16" 4' - 8 9/16" 19' - 5 9/16" 8' - 4 3/16" 7' - 10 7/8" 40' - 5 3/16" 11' - 11 7/8" 5' - 11 7/8" 17' - 11 3/4" 4' - 9 5/8" 8' - 2 1/16" 4' - 9 1/4" 5' - 11 1/8" 3' - 7 3/8" 6' - 8 1/2" 7' - 5 15/16" 17' - 9 13/16" 5' - 9 3/4" 3' - 2 7/8" 7 13/16" 14' - 2 7/16" 5 3/16" 4' - 11 3/4" 3' - 4 11/16" 3' - 0" 1' - 5 5/8" 2' - 11 5/8" 2' - 6" 2' - 1 3/8" 3' - 0" 10 7/8" 11' - 5 7/8" 2' - 9" 3' - 0 9/16" 3' - 0" 2' - 5 13/16" ARCHITECTURAL AS BUILT SHEET NUMBER DRAWN BY SCALE PROJECT NUMBER PROJECT DIRECTOR PROJECT MANAGER SHEET TITLE DATE SEE COVER SHEET ISSUES / REVISIONS 100% SUBMISSION NO. 01 s BUIL PROFESSIONALS © 2020 AEC CONSULTANTS INC www.asbuiltprofessionals.com A DIVISION OF: AEC CONSULTANTS INC [phone removed] 844 A S B U I L T Essex & Massachusetts Ave Cambridge, MA 02139 Designer Designer Project Number Author 605 BASEMENT AB-11 1/4" = 1'-0" 1 Basement 605 N
Proposed Existing Specifications: * 040 sliver aluminum panel w/ Welded 1”x1” Galvanized tubing frame. * 040 black aluminum letter boxes 3” return w/ 1” black trimcap. * 1/8” white acrylic faces. * 3/4” stud mount standoff from panel * Internal white led lighting illumination, UL Listed. * Letter boxes to be mounted on the panel. Sign installed in location shown on attached photo This sign is intended to be installed in accordance with the requirement of Article 600 of the National Electrical Code and/or other applicable local code. This includes proper grounding and bonding of the sign. Side View 2” panel sign 3” thick letter boxes 3/4” stud mount standoff .040 x 3” ALUMINUM RETURN 1/8” ACRYLIC ALUMINUM CANOPY 3” 3/4” STUD MOUNT STANDOFF 23” 144” 13" LED Channel Letter Customer: Company: Phone: Original: Revision: Estimate($0 Means No Price): Address: City: State/Zip: File Name: Job No: X Date Print Name So Lim Ting 605 Mass Ave. Cambridge [phone removed] MA 02139 03/29/2021 Moge Tee Cambridge 07290 This image is for general reference only, and may not accurately represent the actual product. The undersigned, in his or her individual and official capacity, hereby certifies that the quoted prices, designs, specifications, terms, and conditions are accepted . New CC Sign is authorized to perform the work as specified. NEW CC SIGN 259 Quincy Ave. Quincy, MA 02169 TEL: [phone removed] / [phone removed] Fax: [phone removed] [email removed] NEW CC Sign ALL RIGHTS RESERVED Moge Tee
LED Channel Letter Customer: Company: Phone: Original: Revision: Estimate($0 Means No Price): Address: City: State/Zip: File Name: Job No: X Date Print Name So Lim Ting 605 Mass Ave. Cambridge [phone removed] MA 02139 03/29/2021 Moge Tee Cambridge 07290 This image is for general reference only, and may not accurately represent the actual product. The undersigned, in his or her individual and official capacity, hereby certifies that the quoted prices, designs, specifications, terms, and conditions are accepted . New CC Sign is authorized to perform the work as specified. NEW CC SIGN 259 Quincy Ave. Quincy, MA 02169 TEL: [phone removed] / [phone removed] Fax: [phone removed] [email removed] NEW CC Sign ALL RIGHTS RESERVED Moge Tee Proposed Existing Specifications: * 040 sliver aluminum panel w/ Welded 1”x1” Galvanized tubing frame. * 040 black aluminum letter boxes 3” return w/ 1” black trimcap. * 1/8” white acrylic faces. * 3/4” stud mount standoff from panel * Internal white led lighting illumination, UL Listed. * Letter boxes to be mounted on the panel. Sign installed in location shown on attached photo This sign is intended to be installed in accordance with the requirement of Article 600 of the National Electrical Code and/or other applicable local code. This includes proper grounding and bonding of the sign. Side View 2” panel sign 3” thick letter boxes 3/4” stud mount standoff .040 x 4” ALUMINUM RETURN 1/8” ACRYLIC ALUMINUM CANOPY 4” 3/4” STUD MOUNT STANDOFF 23” 144” 13"
Existing Lightbox ( change the facade ONLY) Customer: Company: Phone: Original: Revision: Estimate($0 Means No Price): Address: City: State/Zip: File Name: Job No: X Date Print Name So Lim Ting 605 Mass Ave. Cambridge [phone removed] MA 02139 03/29/2021 Moge Tee Cambridge 07290 This image is for general reference only, and may not accurately represent the actual product. The undersigned, in his or her individual and official capacity, hereby certifies that the quoted prices, designs, specifications, terms, and conditions are accepted . New CC Sign is authorized to perform the work as specified. NEW CC SIGN 259 Quincy Ave. Quincy, MA 02169 TEL: [phone removed] / [phone removed] Fax: [phone removed] [email removed] NEW CC Sign ALL RIGHTS RESERVED Moge Tee 36" 54.50" 14.80" 6.50" Proposed Existing Specifications: * Existing Light Box (change the facade ONLY) * 3/16” white acrylic sheet * apply sliver color vinyl. Sign installed in location shown on attached photo
Sign Sample:
New CC Sign &Aluminum Inc. 259 Quincy Ave. Quincy MA 02169 Tel:[phone removed] ccsignboston@yahoo. com Customer Moge Tee 605 Mass Ave. Cambridge MA 02139 So Lim Ting: [phone removed] [email removed] lnvoice 07290 Date 312912021 invoice 07290 P.O.# Terms Item Description Qty Rate Total Sign LED Channel Letter: - 23"x144" SliverAluminum Panel - 4" Sliver Aluminum return letter 2 2800.00 5600.00 Acrylic Sheet Existing Lightbox: - 36"x54.5" Acrylic Sheet - Sliver Vinyl 2 300.00 600.00 PERMITFEE not include permit fee, will refund over pay. estimate 1000.00 INSTALLATION dvBs E No 350.00 I Tax 387.50 Signatureorcrient: /J g lrtl*t Total 7e37.s0 SignatureoftheSale t.*"q;,..J "^r", ? (Z\ l>\ ,|
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): _ Address: City/State/Zip: Phone #: *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: Policy # or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: 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. Signature: Date: Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (check one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Type of project (required): 6. New construction 7. Remodeling 8. Demolition 9. Building addition 10. Electrical repairs or additions 11. Plumbing repairs or additions 12. Roof repairs 13. Other 1. I am a employer with employees (full and/or part-time).* 2. I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers’ comp. insurance required.] 3. I am a homeowner doing all work myself. [No workers’ comp. insurance required.] † Are you an employer? Check the appropriate box: 4. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers’ comp. insurance.‡ 5. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers’ comp. insurance required.] New Cc Sign Inc. 259 Quincy Ave. Quincy MA 02169 [phone removed] /857-205-5678cell I 2 I Sign Liberty Mutual WC5-31S-389517-021 04/04/2022 605 Mass. Ave. Cambridge MA 02139 SIGN 04/05/202[phone removed]
Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers’ compensation for their employees. Pursuant to this statute, an employee is defined as “...every person in the service of another under any contract of hire, express or implied, oral or written.” An employer is defined as “an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.” MGL chapter 152, §25C(6) also states that “every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required.” Additionally, MGL chapter 152, §25C(7) states “Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.” Applicants Please fill out the workers’ compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers’ compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers’ compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under “Job Site Address” the applicant should write “all locations in ______(city or town).” A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department’s address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center, 2 Avenue de Lafayette Boston, MA 02111 Tel. [phone removed] or 1-877-MASSAFE Fax [phone removed] www.mass.gov/dia Revised 7-2019 City