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HomeMy WebLinkAboutMiscellaneous - 20 IRONWOOD ROAD 4/30/2018N WE FEW Reply To To Mansfield, MA 02048 P.O. Box 345 TEL. {508} 337-8058 FAX (508) 339-5835 Incorporated 1985 �rrrc:s�s< wrandall@newenglandclaims.com RECEIVED 1." , `, 2013 IqSLEALTH OF N0R1H AN00VER [)Elt!nM Reply 131 Dodge Street, Suite 6 Beverly, MA 01915 TEL. {978) 927-3000 FAX {978) 927-3002 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings City Hall North Andover, MA 01856 RE: Insured: Dennett Daniel C..& Susan . Property Addres. 20 Ironwood RoadD. Cause of Loss/Date: Water Damage 2/2/2011 File or Claim No: BOS050928 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. Section 3B. No insurer shall pay any claims (1) covering the loss, damage, or destruction to a building or other structure, amounting to one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to ,w section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. Paul A. Dionne Adjuster 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. Signature Date NEW ENGLAND CLAIMS SERVICE. INC. ❑ Incorporated 1985 Reply To .y Reply To M�. Mansfield, MA 02048 1 IA"'R 131 Dodge Street, Suite 6 S P.O. Box 345 �3Beverly, MA 01915 TEL. {508) 337-8058 TEL. (978) 927-3000 FAX {508} 339-5835 FAX {978} 927-3002 wrandall@newenglandclaims.com Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings City Hall North Andover, MA 01856 RE: Insured: Dennett, Daniel C. & Susan Property Address: 20 Ironwood Road Cause of Loss/Date: Water Damage 2/2/2011 File or Claim No: BOS050928 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. Section 3B. No insurer shall pay any claims (1) covering the loss, damage, or destruction to a building or other structure, amounting to one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. Paul A. Dionne Adjuster 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. Signature NA AIR Date �/rs�/rte Date. �......`...`......... ° TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. �!�` :. C( .C.- ..-f ...../..................... has permission for gas installation . ;Ir. . ................ . in the buildings of ....h �'. ?'� - .................... . at .. ...(.l?. c,: r. �: ............ . North Andover, Mass. Fee. Lic. No. G/ ........ ........ .... L ... .-`..... . ,GAS INSPECTOR Check # C 2 �> 3x0'2 I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) _ C NORTH ANDOVER Mass. Dater 0 Y• 1 uilding Location Permit # Z Owners Name zgc•j ik 1 ►��12�-fes New —1 Renovation II Replacement Plans Submitted n FI XTURrIZ r� u (Print or Type) k Check one: Certificate Installing Company Name An8p a, L r Q11,a . £ Iktg• Cc,� Tnc.. � Corp. 2122 Address 20 AeAgon `Dr. ()tit+ �WlO Partner. Firm/Co. Business Telephone: (979.) Name of Licensed Plumber or Gas Fitter�jp�,rt,,Q Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy f Other type of Insurance Waiver: I , the undersigned, have this application does not have any one of the Signature of owner/agent of property indemnity Q Bond Ej been made aware that the licensee of above three insurance coverages. Owner U Agent D I heseby certify that all of the devils and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations perforated under' Permit issued for this application will -be in compliance with all pertinent provisions of tho Massachusetts State Cas Cade sad Chapter 142 of tho General Laws, YPE LICENSE: PPlumber asfitter• Signa ure of Licensed 0Master Plumber or Gasfitter Journeyman 99%3 License Number N N • N a7 V x tL � LU W .N = F -+ O W f < a x ~ = O W d N CS . W w ►- t W .. toss a F- a to 0. a tt z W t - 4 0 LU Q w o J C z V d— W •• C7 x ... Q 4 a Q W O �' Q w y r w X q a e� a✓ z � r z �, W I- w C P, U. r f. W z< w e a -: < >- ¢ m= o z O W x 0 t- o Sub-8sti1T. BASEMENT IST FLOOR ' 2ND FLOOR 31112 FLOOR ' 4Tt•i FLOOR STK FLOOR 6TH FLOOR 7TK FLOOR STH FLOOR (Print or Type) k Check one: Certificate Installing Company Name An8p a, L r Q11,a . £ Iktg• Cc,� Tnc.. � Corp. 2122 Address 20 AeAgon `Dr. ()tit+ �WlO Partner. Firm/Co. Business Telephone: (979.) Name of Licensed Plumber or Gas Fitter�jp�,rt,,Q Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy f Other type of Insurance Waiver: I , the undersigned, have this application does not have any one of the Signature of owner/agent of property indemnity Q Bond Ej been made aware that the licensee of above three insurance coverages. Owner U Agent D I heseby certify that all of the devils and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations perforated under' Permit issued for this application will -be in compliance with all pertinent provisions of tho Massachusetts State Cas Cade sad Chapter 142 of tho General Laws, YPE LICENSE: PPlumber asfitter• Signa ure of Licensed 0Master Plumber or Gasfitter Journeyman 99%3 License Number