HomeMy WebLinkAboutMiscellaneous - 20 IRONWOOD ROAD 4/30/2018N
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Reply To
To
Mansfield, MA 02048
P.O. Box 345
TEL. {508} 337-8058
FAX (508) 339-5835
Incorporated 1985
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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 �>
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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
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(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
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STK FLOOR
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(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