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MetLife Auto & Home®
Homeowner Operations Field Claim Office
Attention: Claims
P.O. Box 6040
Scranton, PA 18505
(800) 854-6011
MITtnLif,
February 24, 2015
North Andover Building Inspection
1600 Osgood St, Suite 2035
North Andover, MA 01845
Our Customer: Jorge and Jane P. Solano
Claim Number: JDE91925 03
Date of Loss: February 13, 2015
Dear North Andover Building Inspection:
Pursuant to M.G.L. 139 § 3B, please be advised that a property loss at the address referenced below has
been estimated to have damage to the dwelling or other structures that will exceed one thousand dollars.
Please let us know within ten (10) days if there is a pending or existing lien against the property as
provided by M.G.L. 139 § 313, or if there is an intent to initiate proceedings to perfect such a lien.
Loss Location: 2198 Turnpike St, North Andover, MA
Sincerely,
Coleen F. Perry - Cat Team
Metropolitan Property and Casualty Insurance Company
Claim Adjuster
(800) 854-6011 Ext. 7440
Fax: (866) 636-4630
Email: cperryl@metlife.com
MetLife Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its affiliates, Warwick, RI.
MPL MA-REGDEPT Printed in U.S.A 0698
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N2- 341-#2
Date.../t...
...........til............
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... � �..o ... F .. ..............................................................
has permission to perform ..... .......................................
''wiring in the building of-... .......................................
at.S ..... ....................... ......................... . North Andover, Mass.
Fee3L ... . ........ Lic. No.,��2Q
................................................
ELECTRICAL INSPECMR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
offiea! Use Only
Permit No. j 407--,,
Occupancy and Fee Checked
(Rev. 11/991(leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work: to be performed in accorda= with the Massachusetts Electrical Code (1vlECI 527 CMR 12.00
(PLEASE PRINT IN INK OR TYP INF RATATIOI� Date: _W—N d
City or Town of: 1 ` i (� To the Inspector Wires:
By this application the undersigned gives notice of his or her kenuon to perfforiq the electrical work descnbed below.
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Location (Street & Number)
Owner or Tenant _ i ! )r
Owner's Address
Telephone
Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead
New Service Amps / Volts . Overhead ❑
Number of Feeders and Ampacity
MIN
Location and Nature of Proposed Electrical Work A,, rA[
Undgrd ❑
Undgrd ❑
No. of Meters
No. of Meters
Cnmletinn n(rba fnllmu;.,v rni;v ,,.m, ;tee.; ;— 4—
No.e
No. of Recessed Fixtures INo.
of Cel-Susp. (Paddle) Fans INo. of Total
Transformers KVA
No. of Lighting Outlets INo.
of Hot Tubs
Generators KVA
No. of Lighting Fixtures - -- ISwimmiag
Pool Above ❑ !n- ❑ (
rnd. grnd.
o. of t me gcncy t2,
Battery Units
No. of Receptacle Outlets INo.
of Ort Burners
FIRE ALARMS INo. of Zones
No. of S%vitchesINo.
of Gas Burners
No. of Detection and
Initiating Devices
No. of RangesINo.
of Air Cond. Total
Tons
No. of Alerting Devices
b
No. of Waste Disposers
Hcat PumpNumber I Tons JKW
Totals- I
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
S ace/ArmHcating
p ° I'�
Municipal
Low ❑ Connection C1 Other
No. of Dryers
Heating Appliances 1,'W
vs� or Eauivaicnt
a Na of Devices
No. of Water KW
Heaters
o. o No. of
Sim Ballasts
Data Wiring
No. of Devices or Eauivalent
No. Hydromassage BathtubsNo.
of Motors Total HP
Telecommunications Wiring:
No. of Devices or Eauivaient
OTHER " +
Ana di additional detail if desired oras required by the Inspector of W'res.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
(Expiranon Date)
Estimated Value of lectrical Woric $ • (When required by municipal policy.)
in Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion.
1 certify, under th pains A penalSes of perjury, thatthe information on this appCication is true and complere
FIRM NAME: ADT Security Services Dr.,,•• lio.17 is NH 03049 LIC. NO.: 1533C
Licensee: John S. Bassett Signatu C. N0: 1533C
(If applicable, enter "exempt"in die licetrsenumberline.) Bus.Tel.No.•J03 594-5900
Address: Alt. TeL No.:_603 594-5928
OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Owner/Agent
Signature Telephone No.
FP.EPNflT FEE. S