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Home My WebLink AboutMiscellaneous - 222 PLEASANT STREET 4/30/2018 222 PLEASANT STREET % 210/085.0-0005-0000.0 Safety Insurance P.O. Box 55098 Boston MA 02205 617-951-0600 October 05, 2016 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: BARBARA KODYS Property Address: 222 PLEASANT ST, NORTH ANDOVER MA Policy Number: HMA0442960 Claim Number: BOS00071927 Date of Loss: 9/30/2016 Notice of Loss Under M.G.L. c. 139,§3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 313 that[Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600, extension 5015. Sincerely, Allan Leavitt Claim Examiner WSafety Insurance P.O. Box 55098 Boston, MA 02205-5098 1-617-951-0600 August 5, 2016 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectmen City Hall NORTH ANDOVER,MA 01845 Insured: BARBARA KODYS Property Address: 222 PLEASANT ST,NORTH ANDOVER, MA Policy Number: HMA 0442960 Claim Number: BOS00070998 Date of Loss: 8/4/2016 Notice of Loss Under M.G.L. c. 139, 4 3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated below, and include with such notice a reference to the above-described insured, property address,policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at (617) 951-0600 EXT 3213. Sincerely, Allan Leavitt Claim Examiner Date ��1.:`�/!V.... .... NORTH °f t,.ao ,°1+ 3� TOWN OF NORTH ANDOVER • - X PERMIT FOR GAS INSTALLATION SACHUSEtt This certifies that . . . . .o .v . . . . has permission for gas installation in the buildings�of/ . . .. . . ..°A.4?. . G/ . . . . . . . . . . . . . . . . . . . . . . at . . .Z ZZ„ �"f-�4�`•'`? ST. . . ., North A lover, Mass. Fee. .Z Lic. No.:�7`.S. . . . . . . . . . . . . GAS INSPECTOR Check# 8148 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 02 WOH A,0V0\J�n-- , Mass. Date 05Z0822.01ZPermit # Building Location Z22 PUASAVT ST. Owner's NameDAV10 IM►GrARirLLA " A �� A.I�DUE►2� rlK Type of Occupancy New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ N N WN Z Y Z rt of N N V U) a N O ft N F- x f- O NW A z o Ld a a ¢ a M a T. m rn ►- W w o — a a �' a N N C9 U W x N Z Q a O. C > W W W N , E Q x a x (9 lc W F' W F' s H Q W J < ~ f' r N in - O 2 O x Q uw � W z. < it < a x '.x o o s a 3 o tl U G y c a o SUB—SSRAT. BASEMENT ' 1ST FLOOR 2ND FLOOR 3RD FLOOR _ 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR IE�:H 1 - i i i I -H Installing Company Name COLUMBIA G&S GF MASSACHUSETTS Check one: Certificate # Address 55 MARSTON STREET SCJ Corporation 1862 LAWRENCE, MA 01841 - 2312- ❑ Partnership Business Telephone 9 7 8-691- 640 6 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have a current liabiiity insoura❑nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checked res, please Indicate the type coverage by checking the appropriate box. A liability insurance policy P< Other type of Indemnity O Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.- Check one: Signature of Owner or Owner's Agent Owner❑ Agent El I hereby certify that all of the details and information I have submitted(or entered)in above-application are true and accu�te to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n Ompliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (/ By T e of License: Plumber Signature of Licensed Plumber or Gas Title Gasfitter Master License Number 374-5 City/Town Journeyman APPROVED OFFICE USE ONLY ` 1 BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FES APPLICATION FOR PERMIT TO iDO GASFITTING 1 ` ~` NAME & TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC:. NO. PERMIT GRANTED DATE __19 GAS INSPECTOR No _ 1� J Date� .. ............... NoRTsj 3:°;t;��`°.;��"a°� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING s ,SSAC/lus� This certifies that 7 .... ;. ................................................................. has permission to perform _......�..... ' wiring in the building of > . ' �1 ........:.. North Andover,Mass. Fee..�h�........ Lic.No. F............................................................. ELECCRICALINSPECTOR 10/27/98 13:36 35,Q0 RAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Office Use Only Tommonwralt4 of Massar4usP##s Permit No. Department of Jiuhlic _*afeg Occupancy&Fee Checked 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 OR TYP/�ALL INFO�R�ATION) Date /0` YO, City or Town of_/�/IJy 1 ryd-y-ew To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) ST- Owner TOwner or Tenant VAP, 0 We-L�'1 5 Owner's Address .56L rv,._ Is this permit in conjunction with a building permit: Yes ❑ No I_.I (Check Appropriate Box) Purpose of Building Utility Authorization No. t9b ray Existing Service Amps —J Volts Overhead r❑ Undgrnd ❑ No. of Meters New Service Amps A22 /Volts Overhead u Undgrnd ❑ No. of Meters _ Number of Feeders and Ampacity �^ Location and Nature of Proposed Electrical Work J erwce No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Above In- 9 9 Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal ❑ Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: r ` INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws [-have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO ❑ 1 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 app ppriate box. INSURANCE 15 BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work$ (Expiration Date) Work to Start _ Inspection Date Requested: Rough Final I6 Signed under the Penalties of p FIRM NAME l LIC. NO.— Licensee Signature * LIC. NO. 6, - �C Bus. Tel. No.�t 3 -)rrj Address t�f� Alt. Tel. No. OWNER'S INSURANCE WAIVER:)-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 this permit application waives this requirement. Owner Agent (Please check one) (Signature of Owner or Agent) Telephone No. PERMIT FEE$ x-6565 + Date.. . .. `NORM 'IM o� TOWNOF ORTH ANDOVER ' PERMIT F ARANSTALLATION ACMUSEt This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at - 3.�, ,r'_.�?: ��7. - �, North Andover, Mass. Fee/ tg�. Lic. No.. . . . . . . . . . ., - ',� " GAS INSPECTO'�i, Check# � 'I '17 t SEITS UNIFORMAPPUCATON FORPERWr TO DO GAS UrnNG pe or print). Date NORTH ANDOVER,MASSACHUSETTS GCHUSETTS Building Locations L" 7 Permit# Amount$ nJ C C) Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted ❑ WNJ rA U z G4 vi cn un O P4 y F 01 W e z F o �a rA z a z a Ow zH W °°' a Y — Oaa. Hcn G a H o SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3 R D . FLOOR 4TH . FLOOR .5T H . FLOOR 6TH . FLOOR 7TH . FLOOR ,8T H . FLOOR (Print or type)� � Check one: Certificate Installing Company Name 4�/z� fZL/ horp. Address f04 & X j "Id 3E'Zi :Co BusinessTelephone . . Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check o I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked Les,please' dicate the type coverage by checking the appropriate box. ❑ Liability insurance policy Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued is application will be in compliance with all pertinent provisions of the Massachusett to GCe oGeneral Laws. Signature of Licensed Plumber Or Gas Fitter Title By. � Plumber / 3 ; City/Town ❑ Gas Fitter License Number ® Master APPROVED(OFFICE Use ONLY) ❑ Journeyman