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Miscellaneous - 20 SAWYER ROAD 4/30/2018
4 ARBE LLA® INS U RAN C E G R O UP Elaine Dupuis -Lane, Claim Manager 01/19/2016 NORTH ANDOVER BUILDING COMMISSIONER 1600 OSGOOD STREET, BUILDING 20, SUITE 2035 NORTH ANDOVER, MA 01845 Claim Number: 033672505 Policy Number: 57314400000 Company Name: Arbella Mutual Insurance Company Date of Loss: 01/10/2016 Insured: LISA OLDFIELD Property Location: 20 SAWYER RD, NORTH ANDOVER, MA To Whom It May Concern: Claim has been made involving -loss,. damage, or destruction of the above captioned property, which, -may either exceed.$1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, t6be applicable: If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Very truly yours, Cynthia Holden -Amor Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760 CC: NORTH ANDOVER HEALTH DEPARTMENT 1600 OSGOOD STREET, BLDG 20, SUITE 2035 NORTH ANDOVER, MA' 01845 CC: - NORTH. -ANDOVER FIRE DEPARTMENT :.424 MAIN STREET . NORTH ANDOVER; MA d1845-'' II iioo Crown Colony Drive I P.O. Box 699195 I Quincy, MA 02269-9195 I telephone (800) ARBELLA I www.arbella.com No .? J1 u 3 snow A Date.. 7/........... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 1certifies that ............................................................................................. has permission to perform ............................................................................... wiring in the building of ...... r- ..g�-,e ........................................... at ' .�........ //. // ............ .................. . North Andover, Mass. Fee- ............ U6. No. r.'17..5�20 ......... ............................................................... ELECTRICAL INSPECTOR 08/19/98 08:51 35-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer �%E C�nmmunurEttl# �f tt tttl�u E## Office Use Only Permit No�_ ElP1tFIiLYIIPItt IIf Publir FtfPtL1Occupancy & Fee Checked,_ ves-, BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) 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 0XF YAL I�QFQRMATION) Date City or Town of �" (� To the Inspector of Wires: The udersigned applies for a permit to p(�rform the electrical wor described below. Location (Street & Number) �0 'V G I_ "r ,eL P 7 Owner or Tenant Owner's Address Is this permit in conjunction with a wilding per 't: Yes ❑ No / / ©� (Check Appropriate Box) Purpose of Building ti Utility Authorization No. Q � Existing Service �— Amps `tv ( ° Volts Overhead ��/ Undgrnd El No. of Meters New Service !Y Amps c 6 / 2±Ja Volts Overhead Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work :I I- VC No. of Lighting Outlets No. of Hot TubsN o. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle OutletsNo. No. of Switch Outlets No. of Oil Burners No. of Gas Burners of Emergency Lighting Battery Units FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices of Self Contained Detection/Sounding Devices Local Connection ❑ Other No. of Ranges No. of Air Cond. Total tons No. of Disposals No.of Heat Total Total Pumps Tons KW No. of DishwashersNo. Space/Area Heating KW No. of Dryers Heating Devices KWMunicipal No. of Water Heaters KW " No. Hydro Massage Tubs No. of No, of ns Ballasts No. of Motors Total HP Low Voltage Wiring OTHER: INSUr; NCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NOI have submitted valid proof of same to the Office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (PI_e�s0 Specify) Estimated Value of Electrical , Wor yg jt.�, (Expiration Date) Work to Start f4'�y Inspection Date Requested: Rough w/ Signed under theenaities ofer"u Final P 1 ry� FIRM NAME ' Licensee .A i5 _� E' t G (' / LIC. NO. Sign lure��///- . .t .L i /J G_ ' ,� _ / 1 LJIiC. NO. 7� lS-2 0-0 Address / . ! f' �+ (_ • „� �Gy1 CLf J r Btfs�Tel. No. 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 Ft,s permit application waives this requirement. Owner Agent (Please check one) (Signatu Telephone No. Ownr Agent) t�PERMIT FEE $ a of X-6565