HomeMy WebLinkAboutMiscellaneous - 1439 GREAT POND ROAD 4/30/2018 M4 GREAT POND ROAD
210/062.0-0009-0000.0
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NORTH jQNTOWGIF NORTH ANDOVER
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9SSAC RUSES
This certifies that . . . . . .•!
has permission for gas installation . . . . . <<, t,•.1 •; . r,li, . 1!., .j
in the b 'ldings . .,��
at . . . . J. !. tt/. (.,. . . . . . . . . . . . . . North Andover, Mass.
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GAS INSPECTOR
WHITE:Applicant L, -SCA Y: Building Dept. PINK:Treasurer GOLD: File
PQ Box 55098
Boston,MA 02205-5098
617-951-0600
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
N ANDOVER, MA 01845 N ANDOVER, MA 01845
RE: Insured: STEVEN PJ PILLA and JACQUELYN R PILLA
Property Address: 1439 GREAT POND RD,N ANDOVER, MA
Policy Number: HMA 0142601
Claim Number: BOS00049626
Date of Loss: 2/17/2015
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.
Pam McPherson Claim Examiner 2/19/2015
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 5061
Fax: (617) 531-2741
Email: PamMcPherson@Safetylnsurance.com
MASSACHUSETTS UNIFOR APPLICATION FOR PERNINT TO DO GASFITTING
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