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HomeMy WebLinkAboutMiscellaneous - 200 CANDLESTICK ROAD 4/30/20186 0 CUSTARD INSURANCE ADJUSTERS 3135 Avalon Ridge Pl Suite 200 Norcross, GA 30071 3/26/2015 Gerald Brown Inspector of Buildings 1600 Osgood Street Building 20, Suite 2035 North Andover, MA 01845 Clain Number: Policy Number: Company Name: Date of Loss: Insured: Property Location: 033567802 31891400003 Arbella Mutual Insurance Company 2/15/2015 MichaelMaguire 200 Candlestick Rd North Andover, MA 01845 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, to be 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, Arbella Mutual Insurance Company PO Box 699225 Quincy, MA 02269 CC: City/Town Fire Dept, City/Town Health Dept 14 Location � No. � Date �'%� 14 TOWN OF NORTH ANDOVER Certificate of Occupancy $ 0-0 Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ l Building Inspector 12 6 08:57 65.40 PAIn Div. Public Works V Location No. Date TOWN OF NORTH ANDOVER o ' a Certificate of Occupancy $ Building/Frame Permit Fee $ �' b'•r.°''<� Foundation Permit Fee $ t CH Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector 06/02/98 08:57 65.00 PAID C�4 ( ' Div. Public Works c > D D 2 v Ln - Z Z Z m m m m r D z z io n m t_ z m > Z D r, rri vv - y D > i Z r Z7 Z S z � \` a zrn M�� y C)� v m a � I m a U Jl O nn R N v - = - = - -, Z Z Z ^ ? F - y 1 Q o Ch ^ynyz z yn, z z `" � � a xtt, x © n - m f^ y y m ? T LA � !. N � U a > "w ti -q a z v 0 N � � ~ z � n � at It g 5 , &161-d FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. /APPLICANT FILLS OUT THIS SECTION*"`****** y� APPLICANT (� 5 '� N £� N £ PHONE /c)5- T % ftl LOCATION: Assessor's Map Number y PARCEL SUBDIVISION .176 LOT (s) j✓ STREET 2`'`' ��' ' $/ ' ST. NUMBER Z e USE ONLY*********�******, ******* RE' 7NDATIONS OF TOW AGENTS_ CONSE NATION ADMINI4TRATOR DATE APPROVED DATE, REJECTED COMMENTS, TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS i FOOD INS P TOR -HEALTH DATE APPROVED DATE REJECTED T INS �-EdTOR-HEALTH DATE APPROVED /� DATE REJECTED COMMENTS? PUBLIC WORKS - SEWERIWATER CONNECTIONS ' DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE ,, by ' � ,• ;l i ' „; � F - •; � ��,x,i; I '� .III{ •�'� I if •. �u •�� .,1 v li 1;,. f2 q I I; 3 J J 11 'I' •W � 41. �, j � V•'(3 Q `A O Q I,I ?t o"� Jt ♦� N v `° W i 2 t 7 jw wt , w�: ►tett C �• �� {,� 'f ' I �� 0 I I dl. 2 U u lie; u R i Y i -.I,- } J (<� i'� �; J.• %t� 1 t��tjG04uo ;, ` ^I J ;; C `l I li y y' J 1Zt7 �• tt''y=�js` n tF...�.� J� Z Y ti i t Fy iL"ua;tl.k'� y4 Q �l '.'.I���� .; i r. .I �^y•y , U . I -T' W � � 4 7 W ��i' � � ' ZWV��a�t+W� 2 Ul •� I ♦ f � u � � .. � � Vii'.:: i � C II ,.I�. >t y ti s1 J.••T= 0.;. M I ~� O� W Q '0'+'a 0 � 1 11 E Jhl'i0�:1►U;� Q �1 I :i � ...::�._� *- I- � 1 I I I � v ;i ••' ... ter' � � !�' '� r- > 2 � i• O•n `• " tu tk L4 IIII �_-.- OSI'tf �t,, �1 `• ` ;I i ?if is -' 2otnj2 .'.:•+os. �,1 1: ivj141 k iL1�1JJ i V W 11 O •�I, i S � � � � .1 (�t�'. I ILS I�\' '•+ 1 - _ J• I' n�. � r t MU'yl •% r �'J� OI' 1 i y) .'li 'I . 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THIS CERTIFICATION IS BASED OF LAND IN ON THE SURVEY MARKER3 OF OTHERS, AND 15 NOT A PROFERTY SURVEY, FOR MORTGAGE PURPOSES ONLY. I CERTIFY THAT THF Run hlNr.t ARF I nrATFn Alt Q11nWN ,1 AC r)PAWN FOR I CERTIFY THAT THIS LOT 13 NOT 14 7HE F.I.A. FLOOD HAZARD TONE. 7H13 CERTIFICATION 13 BASED ON THE SURVEY MARKERS Of OTHERS, AND IS NOT A f ROf ERTY SURVEY, FOR MORTGAGE PURPOSES ONLY. I CERTIFY THAT THE BUILDINGS ARE LOCATED AS SHOWN, AND THAT THEY CONFORME TO THE ONING BY-LAWS OF THE GMTV/TOWN OF �%,J 'i�/Pr� WHEN CONSTRUCTED. SCALE I" - 40 DEED BOOK r- PAGE AREA " _. PLAN , 7pf \ 1� ASSESSOR MAP BLOCK Ho. 221.39 F `F�rstEa LOT ' i .-�? rl CERTIFIED PLOT PLAN OF LAND IN AS DRAWN FOR �./ �,� asci,,• ,'�''� �A�✓. i 9 P9 R.A.M. ENGINEERING 160 MAIN STREET HAVERHILL, MA. 508-372-0449 < W 1010 1' =r-4 C MO Q N = d0 d0 CO) A 0 z H �� 9 �a�a o' C o gamy c y �• ? 0: W = > > > m N : O C� Cos n cy� O oGol T .n Z y R C"' CTJ a a o m CD O 'O � � n �' a CL C7 CO o � : �•� �^^ � H _U C /V�/ m O O O � r � C � V1 C Od m.� / d= y O y 3 0 d N Pf Z N d d ►� f ^ < W 0 v co hvJ d O CD H m CL Q � y y ,< m CD °:CA CSD O CDO O c .. ccl w O CD 1 C co) f n y j� CD O m CO)CD O (n vii Z 0;14• G1. o CD O d: d d CL nn ��'.n\ c - O 0 o <�ti O CD c o O m o, . 3 9 2 a r- a w 0 m T0 a 70 0 ?f an- o a yrg 04 M 0 • ok 0 Immi 0 0 c 3 7 J Date ..... ..�J..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING s �.�� This certifies that ...................:.......... ............................ :....................... has permission to perform�-� " ............/.................................................................. wiringin the building of ..................................... ........................................... AV C� ("',North Andover at ................................................................. ... .... `Fee .. . Lic. Nd'� . f j1 /... ELECTRICAL INSP CrTOR Check # �� j It The Commonwealth of Massachusetts o:t(ce Use only my Perrit So. Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 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 112:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date D -o 2— City or Town of To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work scribed below. C Location (Street & N [[ber) 200 , ctrl, d� �, C Owner or Tenant l�J n a I d Owner's Address A5& K4%- A5 OI o v Is this permit in co 'unction with a buildU building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building _Okt( �CajjNO Utility Authorization NO. _ Existing Service2-0 Amps (ZO / R0 Volts Overhead �Undgrd ❑ No. of Meters—, New Service Amps / Volts` Overhead ❑ Undgrd ❑ No. of Meters ° Number of Feeders and Ampacity d Location and Nature of Proposed Electrical Work No. o>_ Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. No. of Lighting Fixtures 3 Above In - Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local Municipal ❑Other 1:1Connection No. of Ranges No. of Air Cond. Total tonsInitiating No. of Disposals No. of pumps Total Total Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, of No. of Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requiremen5s of Massachusetts General Laws I have a current L ility Insurance Policy including Completed Operations Coverage or i substantial equivalent. YES NO E] .I have submitted valid proof of same to this office. YES NO If you have c eked YES,,please indicate the type ofc(v rag by checking th appropriate box./ INSURANCE BOND ❑ OTHER ❑ (Please Specify) U GI 0 6 0 Expir tion Date Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Final Signed unde the penalties of per ry: 01/ q FIRM NAME bee e LIC. NO. c Licensee Signature IC. N0.� Address j a je- 5gler--, .,Lw Bus. Tel. No. Alt. Tel. No. 5/7' 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 Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please Qcheck ones) Telephone NoN 0 v �J PERMIT FEE S Signature of Owner or Agent