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HomeMy WebLinkAboutMiscellaneous - 265 GRANVILLE LANE 4/30/2018K) 0 z 6 m 0 z m Cunningham Lindsey U.S., Inc. P.O. Box 703689 Dallas, TX 75370-3689 Telephone (888) 738-8714 CLCAT@CL-NA.COM Facsimile (214) 488-6766 '**'***'***************AUTO**3-DIGIT 018 770 T3 P1 95000058960 Building Commissioner or Inspector of Buildings Ey.r: 120 MAIN STREET 6E� N Andover, MA 01845 07A Cunning�am Va indsey Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS Ch. 139, Sec 3B 1815418 181541819 MERRIMACK MUTUAL FIRE INS ICE DAM 3/2/2015 Mario Giordano 265 Granville Ln 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 313 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. Section 313. No insurer shall pay any claims (1) covering the loss, damage, or destructions to a building or other structure, amounting to the one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to the payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Claim Number: Policy Number: Company Name: 0 CD 0) Cause of Loss: co U) 0 Date of Loss: insured: Property Location 07A Cunning�am Va indsey Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS Ch. 139, Sec 3B 1815418 181541819 MERRIMACK MUTUAL FIRE INS ICE DAM 3/2/2015 Mario Giordano 265 Granville Ln 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 313 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. Section 313. No insurer shall pay any claims (1) covering the loss, damage, or destructions to a building or other structure, amounting to the one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to the payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Cunningham Lindsey Catastrophe Department cicat@cl-na.com 800-867-3885 T 14, OL 0 I S US Date .. .......... TOWN NORTH ANDOVER This certifies that -7-4-. �.. has permission to perform � PERMIT FOR PLUMBING ............. plumbing in the buildinks of ... v. .......... at ... z-- Andover, Mass. ......... 'A �'orth Fee ......... Lie. No.. PLUMBING INSPECTOR Check # 7350 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASF117ING (Print or Typ f Date Permit#, 910 M Building Location 7(cog Owner's Name Type of Occupancy ci—::�L ynn� 6–Q2 t�4 A, New Renovation [7j Replacement Plans Submitted: YeSE] No V/ Installing Company Name k:L -IC 4r %:��--A,'Tlf-(�heck one: Certificate Address 11 Corporation C2 cy)—k F3 Partnership Business Telephon LM Firm/Co Name of Licensed Plumber or Gas Fitter Ej- INSURANCE COVERAGE: I have a current pablitty insurance policy of its substantial equivalent which meets the requirements of MGL Ch. 142. Yes @�r No 0 It you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy El Other type of indemnity 0 Bond D 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 owner[–' Agent 10 Signature of Owner of owner s Agent I hereby cerlity that all of the details and information I have submitted (or enteied) in above application are true and accurate to the bett of my knowledge and that all plumbing work and installations performed under the petmit issued for this application wili be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 ol the General Laws By_ T)W t',�f U mZ,nse &gnMuFe­oI Licensed RV6er or Gas Fitter Title hGastittef Cit /Town F�! aster License Number SG6r—1 Journeyman Z T. Lm cc 1,- X It 0 9 0 0 X Al 401 cc W 0 i- U M X 0 cc C— 0 1xi- W 4t 1z li-zgo CC 0 0 1 cc 0 0 4A A z 0 0 W W z Q W CC Ir W 0- 0 W i- U X JA -A V2 0 > Z 0 i-- Z Ud M j 0 li. M 0 39 .9 0 0 W > 0 0 - IN 11- 0 SUB-8SMT. 13ASEmENT iSTFLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR GThFLOOR TTK FLOOR STH FLOOR Installing Company Name k:L -IC 4r %:��--A,'Tlf-(�heck one: Certificate Address 11 Corporation C2 cy)—k F3 Partnership Business Telephon LM Firm/Co Name of Licensed Plumber or Gas Fitter Ej- INSURANCE COVERAGE: I have a current pablitty insurance policy of its substantial equivalent which meets the requirements of MGL Ch. 142. Yes @�r No 0 It you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy El Other type of indemnity 0 Bond D 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 owner[–' Agent 10 Signature of Owner of owner s Agent I hereby cerlity that all of the details and information I have submitted (or enteied) in above application are true and accurate to the bett of my knowledge and that all plumbing work and installations performed under the petmit issued for this application wili be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 ol the General Laws By_ T)W t',�f U mZ,nse &gnMuFe­oI Licensed RV6er or Gas Fitter Title hGastittef Cit /Town F�! aster License Number SG6r—1 Journeyman Date...'::��/� /It� ... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that/ -2-&4 .. ......... .... �-A has permission for gas installation J in the buildings,of .......... ...................... at 8-�4� -�� !'�CN&th Andover, Mass. FeeP.-�A Lic. No.. Check. # GASINSPECTOR r .1 �LN MASSACHUSETTS UNIFORM (Print or Type) Building Location =40Q Map: Lot: Now J Renovation -3 ATION FOR PERMIT TO DO GASFITTING '�w — 0? -- &C)?�e 5-27 Date Permit # OwnseaNsme Type Of occupancy Replacement J Plans Submitted- Yes J No J Installing company Name B. F Murphy Plbq. & Htg. Inc Cheek one: Certificate Address 72 Holten St. Danvers. MA 0 1923 J Corporation Eallniste Vsko of Work: U Partnership atainess Telephone 978-774:3174 U Firm / Co. Nanw of Licensed Plurriber at Gas Filter Brian F. Murphy INWRANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Ll No Q ff you have chocked AL please indicate the " coverage by checking the appropriate box. A liability Insurance polley U Other type of Indemnity -1 Bond U 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: Ownw C3 Agent Q signature at Owner or Owners Agent I hereby certify that all of the details and Information I have submitted (or entered) In above applicadon are true and aocurate so the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stale Gas Code and Chapter 142 of the General Laws. BY Ty o�fLkww: Z22� Plumber S�n&ured Ucansed Plumbef or GuAlLef Tide Gadner ter I-loensla Numbir, 9352 r city / Town Journeyman IMPROVED (OFFICE USE ONLY) I a 30 14 z I .4 m a a 2 V rn 0 2 r 0 z t ; i