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Home My WebLink AboutMiscellaneous - 240 FARNUM STREET 4/30/2018 (2)N 'o Box 55098 3oston, MA 02205-5098 i17-951-0600 — - 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 NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: SEAN DOWNEY and ELIZABETH G DOWNEY Property Address: 240 FARNUM ST, NORTH ANDOVER, MA Policy Number: HMA 0338739 Claim Number: BOS00049711 Date of Loss: 2/18/2015 Company: Safety Indemnity 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. Blake Wilder Claim Examiner 2/19/2015 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 5317 Fax: (617) 531-6653 Email: B1akeWilder@Safetylnsurance.com 6145 l Date../��3 b N°RT" °�,��°° ;•'"o TOWN OF NORTH ANDOVER a ' ' PERMIT FOR WIRING This certifies that .......Y ............................................................................ has permission to perform wiring in the building of .CP t?. `'e 1 `NN s................................................................. at �� t' X1,1, ,North Andover, Mass. V Fee ... ........... Lic. No.�......... ......... ../!!'............ ...!"' `............... ELECTRICALI PECTOR Check # �_�_ r I Commonwealth of Massachusetts<[Rev. Official Use Only � % q S' Department of Fire Services d Fee Checked BOARD OF FIRE PREVENTION REGULATIOleave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO TION) Date: /6 — /13-0-5 City or Town of: Na'�� A over To the Inspector- of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) a 4o a icu m S-Aep,4 Owner or Tenant 'Ro b6� a l ez-14111 Telephone No. Owner's Address `e Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building e/J, � Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Loca�.tion and Nature of Proposed Electrical Work: f�l Me E' Stn/41%c A/� tr" Completion ofthe fo1/owiniz table ntay be waived by the Inspector of 1Vires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans TransTotal Tsformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- 1:1 rnd. rnd. o. o Emergency Lighting Batterti' Units Units U No. of Receptacle Outlets No. of Oil Burners FIRE ALARrviS I No. of Zones No. of Switches No. of Gas Burners o. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers HeatPu p Number Tons KW Detect pNo. of elf -Co Self-Totnting Contained No. of Dishwashers Space/Area Heating K ❑W Local Municipal El Other Connection No. of Dryers Heating Appliances KW Sec No of Devices or Equivalent No. of WaterKWNo. Heaters of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP / Telecommunications Wiring: No. of Devices or E" uivalent OTHER: Attach additional detail i%desired, or as required by the Inspector of {vires. 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 cov rage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND ❑ OTHER ❑ (Specify:) e)A/ r/ Ye (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: l `/5-8.5 Inspections to be requested in accordance with IMEC Rule 10, and upon completion. l certify; under the pains and penalties ofperjury, that the information on this application: is trite and complete. FIRM NAME: LIC. NO.: F1,Q G A Licensee: SAM C-- Signatur LIC. NO.: (yapplicable,enter "erent t'" in the license nun}�'er /ine.) Bus. Tel. No. 00 Address: (I'lrA%�E�Y _l{P Alt. Tel. No W .: 02 i ONER'S INSURANCE AVER: I am aware t the Licensee does riot 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 PERMIT FEE: S �-C c-0 Signature _ Telephone No. Z� Official Use Only Oornmot�i�ealth of Massachusetts }; i Permit No. �9 _ Department Of Fire Sepfices � Occupancy and Fee Checked �.� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99]0cave blank) j v APPLiCAT`ON FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfanned in accurdance with t}tc Electrical C Kie ,1N1EC). 5_17 Ch1i2 ' DO (PLEASE PRINT INfXK OR TYPE ALL INFORt MTION) Date: City o_ Town of: _�o�,� }�A,sG;��/Qr To the bUpector- of By this application the undersigned gives notice of his or her intention to perform the electrical work described below. N 0 Location (Street & Number) Owner or Tenant Rab Owner's Address .5A W, Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No � (Check :Appropriate Box) Purpose of Building lA.ue //"14- Utility Authorization No. Existing Service Amps — / Volts Overhead ❑ Und rd ❑ No. of Meters — New Service Amps / Volts Overhead ❑ Undard ❑ No. of l4teters — Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wl wk t Z +,'l/pi2 r Completion o1 the following table nia), be trained bi° lire Inspector of I ires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) tans No. s Tota! Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ Ira- ❑ grnd. grnd. a o• o mergency Eighting batters• Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARa1IS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices I No. of Waste Disposers Heat Pump Totals:_ Number Tons KW No. of Self -Contained Detection/Alerting Devices do of Dishwashers Space/Area Ilcatinh KW— I oval ❑ 'Municipal [J- Other Connection -- INo. of Dryers ---_ _V Heating Appliances kAA; (Security Systems: No. of Devices or Equivalent I No. of Water KW No. of No. of No. Data Wiring: Heaters Ballasts No. of Devices or ]Equivalent _ No. Hydromassage Bathtubs No. of illotors Total IIP iciecommunications Wirin No. of Devices or Equivalent 1 OTHER: i a rnncl+ addir.'on -I dci r. i% desired, oras required by tire inspector ql l i irc° INSURANCE COVERAGE: Unless waived by the o'.vncr, no permit for the performance of electrical stork may issue urfles,, the licensee provides proofo.f liability insurance including ``completed operation" covera.ae or its substantial equivalent. The undcrsi<_,ned certifies that such cov'raue is in farce, and has exhibited proof of sank to the permit is�ttine odic:. CHL•CK O IE: INSURANCE B-01",11) ❑ 01-1-fER IJ (Specify:)--- -Al / /C (Expiration Date) !:iUR7atc. Value of <r'lectric al \','ork: (�t:l1Cli r%gllll'Cd b j II'iiii;ICliI:±I i=olit::V.? ".York to Start: /0 -15-•0 In.,peu:ions to be requestcd in :accordance with ,,\IEC Ruic iO, and upon completion. ertif}-, under the Pains curd penalties of neq.my. flirt the ilifin-matron oil this applicati 0n i 'rue and complete, A/1 -_/ e1 Ifs i N:�iI1 : Y L��r .� .�_'_!_F l2(CC�-•_----- - / jj --- 1,i C. :NO.:- Licensee: _ sn/'}C---._�.------- ,i n:ittrr L t iK� � LIC;. ;0.: - -- l;i ,U:pli*.ctb( ntr.r " _'c 7r thr fie+'n, r,tun:nv' trrc. � MIS. '"Cl. 'No 1dd�res;: i�.`(��dP� _ ` _—� -- :ilt.Trl. to.:-_y—`��.�_�'' am xvli "I .)t the LiCe.11sec uoe.s no, Pllvc the liability insurance cov,crzige normall; rquircci by law. By (11}' Sit_'R[tUl1'C l) It)t4, 1 h_CCI :' :C;: P:C 'ILLS rC rlll(Y±71 'Rt. i "lnl Iii.: 1Ch CCk one) crwncr [_] owner's : f1cn-_ C)ttincrl:\gent y � � ``.1„r•aturc 1-c1g,11 onr :v�o. -. -. _ `� tr A N2 2548 Date......0.......�� °:� ;• o TOWN OF NORTH ANDOVER •_•r L PERMIT FOR WIRING This certifies that ....,,��.C1!�....,T .....�.:..: �r+. �.4...................... has permission to perform . ` P wiring ingqthe //building of ......... . ��..1 P.. ............................................. at o� u ..�7 ............. orthLECTOR , Mass: Fee0;W, ,)Lic. No .............. ........... titer-.�'...... .1.......... ELECTRICAL IN Cn�C- WHITE: Applicant CANARY: Building Dept. PINK: Treasurer \+ �A(�j�+�0�.l`��µ��' Office Use only �r/ DEPART1iffiN7 0FPUBL1C'S`IFM Pernit No. J � BOARD OFF1REPRE71ENTT0NREGUL4TIONS527CMR 12.00 ' Occupancy &Fees Checked 1�PPLICATIONFOR P'ERMU TO PERFORMELE=CAL WOR ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 OV LEASE PRINT IN INK OR TYPE ALL INFORMATION)Date-A6-df, Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) a( 0 FIVAIVA ST, Owner or Tenant Aahel' T" Guz e Zi, 1y Owner's Address d V0 E& /r'/l1/>'l z1 Is this permit in conjunction with a building permit: Yes ® No (Check Appropriate Box) Purpose of Building Utility Authorization No. O� Existing Service2., 0 d Amps 124 /a2 0 Volts Overhead Underground ® No. of Meters New Service Ampsm /.� Volts Overhead ® Underground ® No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work C}/dAl4if r1jT11VJ1 R U0 R mA- 4/JAo&1/1fC P11,&�#L To AlrW 0Pe 440 1-0f)7707 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground El ground No. of Receptacle Outlets No. of Oil Bumers No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumers FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local® Municipal Other ftNo. of Dryers Heating Devices KW Connections ® No. of Water Heaters KW No. of No. of Signs Bailasts o. Hydro Massage Tubs No. of Motors Total HP OTHER • :u:• , i • . •v r � • :• i - • irr i0. � • • • • :• :• A � -r..`• ; u r.;- i � • ..• • � • :• a .• i • I �� Vii! . (P�eS>X&y) L n i� Estinti>� ValueofElr�ical Wak $ Rough Final Lioa>SeNa��a6 9a f Lime 7 T d° x/ Sigrmn " -A4 p®� U=wNo BusirmsTdNh arw, o I'fr/1loeY �✓ 2%`tyPy. AiTeLNa OWMM'SPWRANCEWANER,Iama%kmd ifielioa>se t�e*hakrtas ra#Wby&bsxhixm Gaeal Lam anditmysigmkncnthispmnkWplicamv"*As siegtmet>em (Please check one) Owner ® Agent Telephone No. PERMIT FEE ,C/