Loading...
HomeMy WebLinkAboutMiscellaneous - 100 MILLPOND 4/30/2018� Safety Insurance — - — - - -PO-Box-55098 - — - -- -- - Boston, MA 02205 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: -Insured: SUSAN M LUCY Property Address: 100 MILL POND, NORTH ANDOVER, MA Policy Number: HMA 0437511 Claim Number: BOS00067526 Date of Loss: 2/15/2016 Company: Safety Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. 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 number. Maria Rivas Claim Examiner Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3324 Fax: (617) 502-2846 Email: MariaRivas@Safetylnsurance.com 2/18/2016 NORTH ANDOVER ENDING DEPARTARNT 1.600 Osgood Street lNorth.j"a0ver . Tel: 97.8-688-9545 Fax: 978.688.9542 DATE: ADDRESS; o © fy-N N 0 ti Ar ---Na) WCe— ZONj.NGDT8'TRTO"P OF ' "YFE $iI II�TE .SSI' 4 BUMDI GLAYOUT PR.C3WED: �� NO -WAILAELP, PARKMG SPAM: ZONMG EY LAW MAGE: YES NO BUSM SS FORM FOR 70MI CLERK 2.40 Kohne Occupation (1989132) An accessory use conducted within a dwellling by a resident who resides is the dwelling as his principal address, which is clearly secondaz3r to the use. of the -b..gding for lift piuposes. Home occupations shall 'include, "but iiot'lirnited to the following uses; personal services such as fiunished by an artist or instructor, but not occupation involved with motor vehicle repairs, beauty parlors, animal kennels, or 1110 conduct of retail business, or the manufacturing agoods, which impacts the residential nature of the neighborhood;' d. For use of a dwelling in any residential district or multi faimily district: for a home occupation, the following conditions shall apply. a. Not more than a total of three (3) people may be employgq,,, -the;iiozne occupation, one of whom shall be the=owner of the Iao. , Occupation and rosidi og in said divo ling; b. The use is carried on strictly within the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customW with residential buildings; - d. Not more than iwmn r fiva (25) percent of the existing gross floor area of 1ho dwelihag unit. so used, not to exceed one thousand (1000) square feet; is devoted to 'such use. ha. comectionwith such use, there is to be kept no stock in trad0, commodities or products which occupy space beyondthese limits; e. There will be no display ofgoods or wares visible from the sired; f The building or premises occupied shall not be rendered objectionable or ddrimmtal to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any aiher way become objectionable or detrimental to any residential use within the neighborhood; g. An.y such building' shall include no features of design. not customary in buildings for residential Use. signature Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: -Property Address: Policy Number: Date/Cause of Loss File or Claim Number: Donna Rivera 1,00 Mill, -Pond H P2419746 10/16/2012, Water/Toilet Overflow 26768-J 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. Jim Taylor 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 Mailt /,-) - 1; 21 2- i� Signafbre aKd Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 L6 -i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITTING (Print or Type) NO . ANDOVER , MA Mass. Date_ Z— 194 Permit a Building Location_, M-I,LLPOND Owner's Name NO . ANDOVER, MA Type of Occupancy RES New ® Renovation ❑ Replacement ❑ . Plans Submitted: Yes❑ ' No ❑ Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certificate u Address 91 BELMONT STREET C3 Corporation NO . ANDOVER , MA . 01845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142- Yes 42Yes K7 No O If you have checked Les, please indicate the type coverage by checking the appropriate box. A Ilabfllty Insurance policy ZI Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner -0 Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) Inove applicallon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this appIIcaQ9.7 will b In pfiance with all perUnent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral Law By T e of License. umber gnatur o c nse s titer um a or Ga Title asritler Master Ucense Number m-3440 City/Town Journeyman APr'f10VFD (0FFZ Q . N � 2 W N N Y U a: Vj N ¢ N rLLU J N x Uj 0 I- In 2 ¢ i- . ( N = `L . O F' W d a N F- � O O = O �`y F- U1 ¢ r _w ¢ ¢ eLU a W a > U. = O W O (A �• _ OU IS: ¢ '� p V ¢ U. O 3 O d J C i O SUB—BSMT. BASEMENT 1ST FLOOR ZN0FLOOR ORD FLOOR 4TH FLOOR I t STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certificate u Address 91 BELMONT STREET C3 Corporation NO . ANDOVER , MA . 01845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142- Yes 42Yes K7 No O If you have checked Les, please indicate the type coverage by checking the appropriate box. A Ilabfllty Insurance policy ZI Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner -0 Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) Inove applicallon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this appIIcaQ9.7 will b In pfiance with all perUnent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral Law By T e of License. umber gnatur o c nse s titer um a or Ga Title asritler Master Ucense Number m-3440 City/Town Journeyman APr'f10VFD (0FFZ Q . Date . /0j!. l t ........:( NORTH TOWN OF NORTH ANDOVER. Of 4 1ti PERMIT FOR GAS INSTALLATION 9 9SSACNUSES - N This certifies that 4. ....... has permission for gas installation. P r.. ............ . 7 v� N. .r+ in the buildings of .... I)?3 oto ................ .a at . ,/x.41.. M ............. . North Andover, Maj. Fee..24'.'... Lic. No. .3 ... ............... ....... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File a5.0o IASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Az j 4L -.Mass. Date 1 19 Permit # O Building Location_ (CSO �t , -1� �� �� Owner's Name ' R' f`�y n Type of Occupancy C�i1 New,d Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No Installing Company Name iAACA Q•. �t V �� AC Check one: Certificate Address Li_ (�,,� ( Corporation �Q�,@ �� �� ❑ Partnership Business Telephone 0q;,- WT - AS's ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter iii ilkc- �o, ' INSURANCE COVERAGE: have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0' No ❑ If you have checked res. please indicate the type coverage by checking the approp, ate box. A liability Insurance policy_21--- Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application ill be in co pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. mplian ;e with all T e of License: l C Title Plumber RN Signatur f U se lura dr or Ga Rtt'i r Gasfitter City/Town aster License be OCA APP I S _ ONL Journeyman r N N N N Y V W W CC N ¢ N M LC N O N F = tt tW9 z►- J o N W F < >' z z O f - m N Wd r- su °°� O 0 W W W N W J Z' W Ci Q UA = = N CC Z <. LC 1=R) W r" G W t N X fW H O. z 1t o i^ z W W J 0lu H i+ en W x ¢ 'z o 0 z W 3 0 v Y W o a Fw- o ' f • SJZ—tiSiriT. BASEMENT 1s "FLoOR ; F 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TKFLOOR 7,rm. FLOOR STH FLO0R Installing Company Name iAACA Q•. �t V �� AC Check one: Certificate Address Li_ (�,,� ( Corporation �Q�,@ �� �� ❑ Partnership Business Telephone 0q;,- WT - AS's ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter iii ilkc- �o, ' INSURANCE COVERAGE: have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0' No ❑ If you have checked res. please indicate the type coverage by checking the approp, ate box. A liability Insurance policy_21--- Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application ill be in co pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. mplian ;e with all T e of License: l C Title Plumber RN Signatur f U se lura dr or Ga Rtt'i r Gasfitter City/Town aster License be OCA APP I S _ ONL Journeyman 14 Y � D m m .z a r . 2 i-t N ' In m A —1 O •.�� • Z s N m O N _ _ A m_ 0 o 0 m Z i rA r Y � D m m m s �o -a r i-t m In Q 0 z m z •.�� • O N m_ 0 o 0 Z i a r N a O O 71 m to N 2 N (� m m A 0 z ,dk:....�:k�r�r ^.-'►az+.+'{""r^"""'~ ..,, ..- T -, y�.y.�.s,,_�_.l...Y,,. _._,-„K.,�;..-�c.a..-.k.-:a-»-ter _.;__ '.s.�� 1` 0 ' 2w0 i Date. `/.,...... s ,40RTIy .1 TOWN OF NORTH ANDOVER p PERMIT FOR GAS INSTALLATION EE �9SSACNUSEt This certifies that . /Av:F. j . 4 l ..... ........... has permission for gas installation q 6 .-...... ..:..... rt; in the buildings of ... ............................. C at ............... , North Andover, Mass. Fee. ?..:.. Lic. No..k4?k ,.�.. ... !gid ........� GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File A 4. L f�es Us• Otey 01 L1Tzm IIII==Uh III �� .of haft Yr ^..> v A Fee Clee.)cedS� (leave blank) BOARD OF SIRE PRt'•!c'aIT'iCN RrIULATMNS "Y: C.'�A 1200 APAP-�LICATiON FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in ac--rdancr with the massac^.usetts E:ectricai Cade, S27 CW; 12' a (PLEASE PRINT IN INK OR TYPE ALL INFCRlt.�,TION) Date � b a,.ali/ or Town of NORTH ANDOYER To the In pec:or of wires: The ucersigned acpties 'or a perrrut to-er`crm trtt •xcrK described !:etow. Locution (Street & Numb r) Cwner cr Tenant Ll _ p•6 -P — C%vner's AC=ress Is tnts permit in .cnjur :ionCwith a cuilCirg -err-t;: Yes _ No A� (C~eck Acp:cpna:a ?Cxj P' -r= --se c4 BulicinC ) Utility Autncnzation No. -is"nca SzeNica Amos —r v t/C::s Cuerne c 77 URC_ -c = No. at Meters X12 v Can; c Ar ps iGlis L Ve!'2a . Lin No. of Meters Nu:rG_. r_necers an : Art.cac:ty -- - \ - =csac c IP. C9 tis 0kA)4G No. Z. _ _ nng ..•..:e!s .. ., __ I -. _. -_. .__> �O:dt No. _ ransterr.,ers Ci Ne. :r ••n = xtt:res _.cn,. c Swtnnr.irc P.=t - _ .. I -- _ -_ _ Ganeratcrs KVA No. at =:rergene•/ ::Snting No. -' --__:ace _ur.e•s Nc.:. =_.hers =-eery Units y . :, Swttcn Cut:ets No. _. =3s 9__ I B--r-vs = =_ .ALARMS No. cf -=r.es '7 -• NC. c: -a _c::cn arc I ,No. _. Kansas No.:. ::r :_r=. ;:.5 I r.tuaung Lav ces No. -isccsats ea: '::al a:al .Nc.-: ?_r=s ':r- :: I No.:, acuncing Cavtces No. =r Sett C:zntatneC No.y -isnwasners I S=aeet,rea-___.-= <',V I -e!ec::cn1SQuMc1ng -ewces No. =r Zr.ers . :: I ea=rte =sv ces _:cat i Muntc:=at Omer Cznnec::=n _ No. -r '.nater seaters K'N Sicns _-.-'_. '•v'r"rc No. -vcro .tassa= _.=s No. c. .._. _ -,'--• -= ! . -_== INJL:PANCc ^V ErAGII. P•=r3uant :0 zns reCuuements : ..'as sacn_sa-s genera! L3w5 - - YES NO I nave a c:.rent t_:acuity insurance P_Itc-1 •nrtc:r.-y C =:arae C=eta=ens ,average Cr ;:s su=s:antral ecutvatent. _ _ nave su=rncea vatta = _et of same :o 'no C!fice. ycS` = NC = •t you nave cnecxec YES. tease tnCt=ate :ne ryce of c=verage =y -necxtng ane mate cox. BONO = 011-1EP = tP'ease==een!! tvSl.;PANCc (Ex=trat:on a:et E:ec^cas 'Marx S 200 Es::.ratec Valu• ct ,Wcm :a Star.ins=eo=n _a:a=ec::es:a 'cugn �+na) S:gnea _near :.:e Peratnes at ;ertury: ��.t NAME t1C. NO. D ACare.. /"-• �`S-"l -�b%"W%.VU !__x Alt. :et. No. CwNER-S INSUF:ANCZ'xA+VEP: I am aware a at 'e _-ce^see =a" -et rave ane Insurance o=verage or Its suostannal eautvatent as re- eulree Uy Mas"Crtusott$ General laws. ana =+at riY srr3: ars =n =s =er- a acottcatton waives ruts reeutrement. Owner Agent .Please cnecx one) Q.ecrere NO. PERMIT F=_= 3 isignalure at Owner =r +Sena .�.^ +C.............^`f"i+.r�.�.r�.:.rJi�i7'itis+s.�+'"�IIF.''+"'[+."`.�'+.w�.v:•s , Date ...:. `...... ... �'° 2877 NORTF� ar°?�``°.:•�"o°� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING "C This r This certifies that ................ :.....%...:.... �... r� ........ has permission to perform ...... 1�.... 1l G � Y': �'t ... � `....:.......:........ wiring in the building of .... at ... ...................... North:Andover, Mass. Fee .. ... Lic. No. CTR[CAL IN s>� zt. ori i (� WHITE: Applican2"jF 9 ARY: Build j� &pt. PINK: Treasurer GOLD: File/ yarn .�