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HomeMy WebLinkAboutMiscellaneous - 1600 GREAT POND ROAD 4/30/2018 1600 GREAT POND ROAD '`OA D / 210/062.0-0037-0000.0 I DOWNEASTADJUSTERS PO Box: 116 • 7 Elan Street• Boxford, MA 01921. TEL: (978) 887=8766 • FAX: (97.8)887-0660. 12/7/2017 Building Commissioner or Inspector of Buildings City/Town of N. Andover c/o City/Town Offices N. Andover, MA 01845 i NOTIFICATION UNDER M .G .L . c . 139, §313 RE: BAY STATE Insured: Bert & Ruth lannazzo Policy No.: HP2171759 Date of Loss : 12/5/2017 i I Dear Sir or Madam: DownEast Adjusters is the independent adjuster retained by BAY STATE to investigate and adjust the captioned claim for damage to a building or other structure at the property at 1600 Great pond Rd. Pursuant to M.G 1 . c. 139, §313, BAY STATE hereby notifies you that payment of $1,000.00 or more may be made in connection with the captioned claim. If the City/ Town of N. Andover intends to initiate proceedings under M.G.L. c. 139, §3A; c. 143, §9, or c. 111, §1276, please forward the notice required under M.G.L. c . 139, §36, to my attention within the time provided under that statute. Thank you for your attention. Very truly, I Mark Malley General Adjuster cc BAY STATE i SIMSOLO w _ � Office Use On 7 — _-_ l u � L11MMVnWt# of Uggar UStft9 Permit No. +i3epartmtttt of Public 96afetu Occupancy& Fee Checked / 'w - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 also (leave blank) U 353 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (X* or Town of NORTEi ANDOVER To the Inspector ci Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) /�Q� �� U� RZr Owner or Tenant nQ n�7 Owner's Address !' 4M�' Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Go Existing Service J00 — Amps�. - Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work __T No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVA Above In- No. of Lighting Fixtures I Swimming Pool grnd. ❑ grnd. ❑ I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets I No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Air Cond. Total /! No. of Detection and No. of Ranges tons Initiating Devices Disposals No.oHeat Total Total No. of f Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices I. Local Municipal ❑Other No. of Dryers I Heating Devices KW ❑ Connection No: of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER )tQInt rA ro tl�� �� W � Rat �'L 1 lar► aJ� 1��P lJnl ' i2 a 2 fT v- i - S INSURANCE COVERAGE: Pu suant to the requirements of Massachusetts general Laws ^ I have a current Liability Insurance Policy including Compl�e Operations Coverage or its substantial equivalent. YES NO I have submitted valid p -of of same to the Office. YES Y NO = If you havecheckedYES, please indicate the type of coverage by checking the appro ate box. �JeOj Z ZC1 1 r �-� > �� INSURANCE BOND - OTHER _ (Please Specity) ( x'ir ion Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of perjury: FIRM NAME-� 4" E LIC. NO. _ Licensee J Me /I Signature LIC. NO. �� L ,�//r �/ (\� �1 Bus. Tel. No. 6 �_e)12 �3 Address J! � ) �h �` �L��Ct"z �r� 6�� � Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws. and.that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x•5565 u' �+t+�� 'yam-,-..s.-.1•-�: �. Date.......l....�..`�...9&/ 2972 NORTH TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING ,SSACIIus� This rtifies that ......!.4; 1.... � ...... , . ............ hasperTsio��11 to p rform ....,,::......... ....... .. %7..... a.... ..... 7. wiring in the buildi g of... :.. �1 ................................ at..../ rJ... ... .. ... .?........... ,North Andover,Mass. g Fee.kL n....... Lic.N C ................ ..................... ........ ......... \ ELECTRICAL INSPECTOR 035 l' � *G,/)l y�7 WHITE: Applicant CANARY:Building Dept. PINK:Treasurer GOLD:File Q ° 2 i 4 O Date.... NORTI� °`,�``°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SACMU This certifies that ........T-.1.tmos.Z.ZL......0(�.0............... .................... has permission to performN ' ...W.-.C.�A.►............a.............................................. wiring in the building of...... q'� ,No7................ ndov ass. at/W....6:?!tt.,/ .............. `L....... W ........ // . y Fee ,.. , ..00 Lic.No... ..... .......... ......... ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer O:i icc Ls Only / 95� he Commonwealth of Massachusetts0. "Department of Public Safety 00occupancy & Fee CheckedBOARD OF FIRE PREVENTION REGULATIONS 527 CMR 123/90 (leave Dlank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFOP-HATION) Date 3 — �p-©o City or Town of Q(h A 1y Dov ER, To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number)_ Owner or Tenant s A,ti-1 G Owner's Address Is this permit in conjunction with a building permit: Yes 2r No ❑ (Check Appro �ex)- Purpose of Building ' M A,L N #0,,1V L E Utility Authorization NO Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters New Service _Amps ZU / ZO`� Volts Overhead ❑ Undgrd� No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Q E uJ EA is, K)�N f-kl C-6 &J a No. of Lighting Outlets No. of Hot Tubs r No. of Transformers TKVAI No. of Lighting Fixtures Swimming Pool Above In- g g g grnd. ❑ grnd. ❑ GeneratorsNo. of mer KVA No. of Receptacle Outletsc::Zo No. of Oil Burners Battery EUnitsncy Lighting No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones f/� Total No. of Detection and {�© No. of Ranges No. of Air Cond. r tons Initiating Devices I No. of Disposals No. of pumps TTons Total No. of Sounding Devices `�— No. of Dishwashers S ace/Area Heating KW No. of Self Contained P Detectio�Idlin2g 'ces niCiNo. of DryersHeating Devices KW Local❑ her No. of Water Heaters KW Si of No. o Low Voltage Signs Ballasts Wirine /} No. Hydro Massage Tubs No. of Motors 1?_>Total HP I v " OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Li ility Insurance Policy including Completed Operations Coverage of i substantial equivalent. YES( NO ❑ I have submitted valid proof of same to this office. YESIV NO ❑ If you have c cked YES„please indicate the type of coverage by checking the appropriate box. INSURANCE have ❑ OTHER ❑ (Please Specify) Expiration Date) Estimated Value of Electrical Work S_ ,301 Work to Start ZZ-C�o Inspection Date Requested: Rough Final Signed under he penalties of ypJurY: FIPIM NAME I-`�.-�� � 1�I N fa- _Lig:. NO. Lic^_nsee�����F%t \ iranr�_ ignature U. LIC. NO. Address��' e' -o0u� � "V� ) Bus. Tei. No. G('`�g• Alt. Tel. No. fJ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- � stantial equivalent as required by Massachusetts General Lawss and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S • i v�/ Signature of Owner or Agent C/� fl 01.0( WILLIAM J.IANNAZZI,INC. 09871 L^2G7ri'J (�Q�ict �c Ct cam_ .- 910 5 77 C)C) WILLIAM J. IANNAZZI, INC. 191 CHANDLER RD ANDOVER BANK 09871 ANDOVER, MA 01810 ANDOVER, MA 01810 (978)686-7300 53-7047/2113 PAYTHE ORDERER OF C,) \ DOLLARS 8 Security features Included. Details an bads. MEMO_ 1279kt1 /Um' 'ICi<Lr/ . 577 -- - `- -----� s 11'00987111' 1: 2113704771: 65 22050222311' k