HomeMy WebLinkAboutMiscellaneous - 11 STONINGTON STREET 4/30/2018 11 STONINGTON STREET
210/019.0-0047-0000.0.
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Ccmmerce InsurancesM
C� The Commerce Insurance CcmpanysM
Citation Insurance CcmpanysM
SM Members of The Commerce Group, Incl"
CLAIMS DEPT. 11 Gore Road,Webster,Massachusetts 01570 (508)949-1500
www.Commerceinsurance.com
February 26, 2013
BUILDING COMMISSIONER or, Board of Health or
INSPECTOR OF BUILDINGS Board of Selectmen
TOWN/CITY HALL Town/City Hall
NORTH ANDOVER MAO1845
RE: Our Insured: ARLINE MCGUIRE
Property Address: 11-13 STONINGTON ST%TTEE
Policy#: ZV7635
Date of Loss: 02/22/2013
File#: CTXV06-XXTT78
Claim has been made involving loss, damage, or destruction of the above captioned
property which may exceed $1,000, or cause Massachusetts General Laws, Chapter 143,
Section 6 to be applicable.
If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate,
please direct it to my attention. Please reference the above captioned insured, location,
policy number, date of loss, and file number on any correspondence.
`ESTHER O'NEILL Telephone: (508)949-1500 Ext: 15388
Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext:15388
On this date, I cause copies of this notice to be sent to the persons indicated above, at the
address above,by first class mail.
February 26, 2013
71
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CcI1 mCuc Ccmpanles ....COMECROWNT-HUS
CIC 254 (Rev.4/95) MAIL M80
7477 Date.. .//h
NORTH
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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
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�9SSACHUSE�
This certifies that . .R . . .!7` C.�. �-� G'
has permission for gas installation . .f..!t— . . . . . . . . . . . . . . . . . . .
in the buildings of . .,, . . . . . . . . . . . . . . . . . . . . . . .
at ;,! . . . S . ��.[� -- . . . . . . . . . , North Andover, Mass.
Fee. J- �._ -Lic. No..2-.t(L3.) . . . .
a}1S INSPECTOR
Check# G G `
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MASSACHUSE7CI'S UNIFORM APPLICATON FOR PERMIT TO DO GAS FITT NG
(Type or print) Date
NORTH ANDOVER,MASSACHUSETTS
Building Locations �'��N �__ „_.. Permit#
ARL Py- �A� �1�� Amount$
/', Owner's Name
New❑ Renovation ❑ Replacement Plans Submitted ❑
a C � F a � O
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v
SUB-BASEM ENT
BASEMENT
1ST. FLOOR
2ND. FLOOR
13RD. FLOOR
4TH. FLOOR
5TH. FLOOR
6TH. FLOOR
7TH. FLOOR
8TH. FLOOR
4
(Print or Cmc one: Certificate Installing Company
Nam e�_ ) 7-, 1114[,L O ICA Corp.
Address n d 13 d x 5'7 A, ❑ Partner.
4,4w4ewre "4 #q nod' S1Z
Business Telephone C,b'S' 9 5-0`7' ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter T�ve Ys A44/let/'iI r-1
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ® No❑
Ifyou have checked yes,please indicate the type coverage by checking the appropriate box.
Liability insurance policy ® 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 Permit Issued for this application will be in
compliance with all pertinent provisions ofthe Massachusetts State Glias/Code an Chapter 142 ofthe General Laws.
Signature ofLicensed Plumber Or Gas Fitter
By. ❑
Title Plumber -R V �33
City/Town ❑ Gas Fitter License Number
❑ Master
APPROVED(oFFiCE USE ONLY) ® Journeyman