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Home My WebLink AboutBuilding Permit #Exception - 1 HARVEST DRIVE 5/1/2018 � Safety Insurance AUTO•HOME •BUSINESS P.O. Box 55098 Boston MA 02205 617-951-0600 January 11, 2018 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: KATIE PRIESTLY Property Address: 1 HARVEST DRIVE, UNIT 311, NORTH ANDOVER MA Policy Number: HMA0145727 Claim Number: BOS00080470 Date of Loss: 1/1/2018 Notice of Loss Under M.G.L. c. 139,§3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that[Safety Insurance Company] ("Safety") has received a claim involving loss damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. 1% If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600, extension 5015. Sincerely, Allan Leavitt Claim Examiner � Safety Insurance AUTO•HOME •BUSINESS P.O. Box 55098 Boston MA 02205 617-951-0600 January 03, 2018 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: MELISSA N TURLA Property Address: 3 HARVEST DRIVE UNIT 208, NORTH ANDOVER MA Policy Number: HMA0352384 Claim Number: BOS00079980 Date of Loss: 1/2/2018 Notice of Loss Under M.G.L. c. 139,§3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600, extension 5015. Sincerely, Jessica Tuccelli Claim Examiner Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Department Building 20, Suite 2035 1600 Osgood Street North Andover, MA 01845 RE: Insured: Steven Perlini & Scott Spindler Property Address: 2 Harvest Drive, Unit 102 Company: Vermont Mutual Insurance Company Policy/Claim Number: DF13054159 DFA19938 Date/Cause of Loss: 10/24/2016, Water/Washing Machine Leak Our File Number: 33782-RP Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Rob Parilla, Ext. 119 On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Sigi ur and Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Cc: North Andover Health Department North Andover Fire Department Building 20, Suite 2035 795 Chickering Road 1600 Osgood Street North Andover, MA 01845 North Andover, MA 01845 } Safety Insurance P.O. Box 55098 Boston MA 02205 617-951-0600 November 18, 2016 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: ELIZABETH DESMARAIS Property Address: 3 HARVEST DR UNIT 104, NORTH ANDOVER MA Policy Number: HMA0384849 Claim Number: BOS00072601 Date of Loss: 11/1/2016 Notice of Loss Under M.G.L. c. 139A 3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 313 that[Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, §6 applicable. In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600, extension 5015. Sincerely, Allan Leavitt Claim Examiner a • COfficial Use Only mmonwaza& as ;VA66acL69 j L �[} Permit No. �L��At Y�l 1ri� a9 _7i,. YtrttlC'63 D Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: October 12,2015 City or Town of- North Andover,MA_ To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street'&Number) 2 Harvest Dr# 106 Owner or Tenant Shirley Cabral Telephone No. (978)957-8761 Owner's Address 2 Harvest Dr# 106 Is this permit in conjunction with a building permit? Yes M No M (Check Appropriate Box) Purpose of Building V.4 yd_QA n a Utility Authorization No. Existing Service Amps / Volts Overhead M Undgrd rl No.of Meters New Service Amps / Volts Overhead r] Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: _Installation of a low-voltage, wireless burglar alarm system. Completion of the followin table may be waived by the Inspector of Wires. o.of Recessed I� o.of Ceil.-Susp. (Paddle)Fans No.of Total Transformers KVA [ o.of Luminait T��of Hot Tubs Generators KVA_ P o.of Lumina �� Above In- o.of Emergency Lighting l rnd. nd. BatteryUnits No.of Recep� FIRE ALARMS o.of Zones oP Noqry No.of Detection and t►`' No.of Switr' '•,pyo ---Initiating Devices No.ofRar ,; < -ting Devices T DateNo.of W �p co.. lerting al No.of F �NuSr p eMQ0 4t �/ tion Q Other RM�T F RTN AN No.off This ce'�I�es R Q V Q � uivalent �1 t has Pe that �� WIRI G FR fi11S o , N /Equivalent No' W Sj b to .�!�.� s Wiring: "jig i" he Perform "�••`l r E uivalent t O` at bttj/d• •...�� Ing of �-^y i -% ••••......'�� Fee ' s GD•:..'94� ••• s required by the Inspector of Wires. i1c �L on completion. Choc k •No "' •... c al work may issue unless 1 # s/ ' -5 ....... tantial equivalent. The uing office. .,North A I certi unw_` BLE�TRrcAt Sp er,Mass. e a LIC.complete. FIRM NAM :,Qew.- C 1355 EcroR•........... Licensee: J5i� LIC.NO.:D 434 (If applicable, enter"exempt"in the licen� _� s.Tel.No.: 800-689-9554 Address: 3750 Priority Way S Drive. Suite z,_ Alt.Tel.No.: 866-502-3559 *Per M.G.L.c. 147,s.57-61, security work requires'r, Lic.No. SSCO-001258 OWNER'S INSURANCE WAIVER: I am aware that the L'iu �� ity insurance coverage normally required by law. By my signature below,I hereby waive this requi`r em. one)0 owner ®owner's agent. Owner/Agent Telephone [PERMIT FEE:$ Signature No. t � � The Commonwealth of Massachusetts Department of IndustrialAccidents �=- Office of Investigations r _ 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Aimlicant Information Please Print Legibly Name(Business/Organization/individual): Defenders. Inc. dba Protect Your Home Address: 3750 Priority Way S Drive, Suite 200 city/state/zip: Indianapolis, IN 46240 Phone#: 317-810-4720 Are you an employer?Check the appropriate box: Type of project(required): 1.[Z I am a employer with 3 4. FJ I am a general contractor and I employees(:Full and/or part-time).` have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship arid have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers comp.insurance comP. insurance. required.] S. ❑ We are a corporation and its 10.W Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 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 as the policy and job site information. insurance Company Name: MJ Insurance Policy#or Self ins.Lie.#: TCJ U B 1116 LO3015 Expiration Date: 07/01/2016 Job Site Address:?- e��-1 �1/e, (_uo City/State/Zil,._ { oxk '61045 Attach a copy of the workers'compensation policy declaration page(showing the policy number and exra .ition 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 ofperjury that the information provided above is true and correct Si afore:Y= t WlJ1 MNJA Date: l I Phone#: A UA 1 -591- �LXYJ Official 91- Official use only. Do not write in this area,to be completed by city or town of lcial. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector . 6.Other Contact Person: Phone#: COMMONWEALTH OF MASSACHUSETTS -TI"IM-TY-11, CONTROL# UVAKu OF IMPORTANT ILECTRICIANS -ICENSE A damaged or destroyed:is inaccurate;or E FOLLOWING L if your license is lost, JSSUES TH .- CONTRACTOR needs to be corrected,visit our web site at mass.9ov/dipi for I A -REGISTERED SYSTEM �tt- ewal instructions to ensure the proper mailing of your Ren Application and any other correspondence. DEFENDER SECURITY CO PROTECT Y am This license is subject to Massachusetts General Laws and STEPHEN CEHRLACH V.�w 0 regulations.Your license is a privilege,and cannot be lent or 3750 PRIORITY WAY-..S.OUTH rAlu assigned to any person or entity under penalty of law.Keep this 2 STE 200 license on•your person or posted as required by law and/or regulations. AND 1 ANAPOL I S IN 46240-3815 1355 C 07/31/1,61 38220 j COMMONWEALTH-OE: MASSAC.HUSETTSMCONTROL# 1 J Q)-L ry I BOARD OF IMPORTANT ELECTRICIANS ISSUES THE FOLLOWING LICENSE If your license is lost,damaged or destroyed;is inaccurate;or .A REGI S I EKED SYSTEM TECHNIC] needs to be corrected,visit our web site at mass.gov/dpi for instructions to ensure the proper mailing of your Renewal 14 Application and any other correspondence. STEPHEN C EHRLICH This license is subject to Massachusetts General Laws and regulations.Your license is a privilege,and cannot be lent or 369 CENTRA.L ST.REET assigned to any person or entity under penalty of law.Keep this UNIT f-4k,LU license on your person or posted as required by law and/or 9- regulations. :0 OXBOROUIG,H. -MA 02035-2637 434--D 01/31/1,6 45560 Employer. DEFENDER SECURITY COMPANY SSCO-001258 STEPHEN C EHRLICH 3750 PRIORITY WY S DR 9200 INDIANAPOLIS IN 46240 12/03/2016 For DPS Licensing information visit: www.IVIass.Gov,,DPS i NOTICE OF COMPLETION OF ELECTRICAL WORK Pursuant to M.G.L. c. 143, § 3L, Stephen Ehrlich hereby provides written notice to the inspector of wires that the electrical work outlined in the preceding permit application has been completed.