The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 235 Middlesex Street i I i f !� I I P I I (� ��1 �1 PO Box 55098 Boston,MA 02205-5098 617-951-0600 TOM- Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall N ANDOVER, MA 01845 N ANDOVER, MA 01845 RE: -Insured: FRANK C CACCIOLA Property Address: 233-235 MIDDLESEX ST,N ANDOVER, MA Policy Number: HMA 0082311 Claim Number: BOS00053691 Date of Loss: 2/25/2015 Company: Safety Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. 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 number. Pam McPherson Claim Examiner 3/18/2015 Safety Insurance Company Homeowners Claims Unit P. 0. Box 55098 Boston, MA 02205-5098 Phone:.(617.) 951-0600 EXT 3521 Fax: (617) 531=2741 Email:PamMcPherson@Safetylnsurance.com . DateX..ge"...... .................... I kORT#1 TOWN OF NORTH ANDOVER 0 Ap PERMIT FOR WIRING 4L CHUS Thiscertifies that ............... .......................... ...................... has permission to perform ....(3A........... .................................. wiringin the building of...............................1-122.............................................. ............... .North Andover,Mass. aa Fee ... .. ..... ..... ....... �ELECTRICALINSPEMR Check # 12-,O!Z!? 4693 Office Use Only The Commonwealth of Massachusetts Pent lo. y/B ,3 Department of Public Safety Occupancy a Fee a,«tea BOARD OF FIRE PREVENTION REGULATIONS S27 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 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Aucfust 14 2003 City or Town 04NO,Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street Number) 235 Middlesex Street A Owner or Tenant Frank Carrinla Owner's Address_ 235 Mi dil l pspx Street , No Andover Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building dwe l l i n0 Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No, of Meters Rev Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters Number"of Feeders and Ampacity Location and Nature of Proposed Electrical Work Install 36000 B T U central air- conditioning s sem t No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total RVA No. of Lighting Fixtures Above In- g g Swimming Pool grnd. ❑ grnd. ❑ Generators RVA 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 Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No, of Disposals No. of pumps Total Total Tons KW No. of Sounding Devices No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices Municipal No. of Dryers Heating Devices KW Local❑ Connection❑Other ' No. of Water Heaters KW No, of No. of Ballasts LowWirVoltage Sijzng No. Hydro Massage Tubs No. of Motors Total HP t- OTHER: INSURANCE 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[a NO ❑ I have submitted valid proof of same to this office. YES❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value o:f'E.lectrical Work S Work to Start . 06/16/03 Inspection Date Requested: (Rough Final Signed under.-the penalties of perjury: � � O • y WrtQ,z) FIRM NAME Bay State Wirin q Co . of Arlington, Inc. LIC. NO. A6733 Licensee Bay State Wiring Co . Signature /' LIC. NO. A6733 Address 64 Mystic Street , Arlington, NtA . 2474 us. Tel. No. 781-643-6570 Alt. Tel. No. 781-643-1856 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 check one) Telephone No. 781-643-6570 PERMIT FEE S 55 . 00 Signature of Owner or Agent