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Home My WebLink AboutMiscellaneous - 270 BRENTWOOD CIRCLE 4/30/2018 (3)a AMERICAN CLAIMS SERVICE MULTI -LINE ADJUSTERS Letter 143 March 14, 2016 Town of North Andover Building Department 1600 Osgood Street North Andover, MA 01845 Attention: Building Inspector Board of Health and/or Board of Selectman Insured: Cataldo Location: 270 Brentwood Circle North Andover, MA 01845 Policy: PHO 0100 90 73 04 Loss Date: 1/6/17 Loss Type: Water damage ACS File: 160099 Dear Sir/Madam, Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under, Massachusetts General 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, loss date and file. On this date, March 14, 2016, 1 caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Unless a response is received within the next ten days we will not be obligated to pay any portion of this claim to you. Respectfully submitted, Craig Gillespie Claims Representative 7 KIMBALL LANE BUILDING C LYNNFIELD, MA 01940 PHONE 781-245-9516 FAX 781-245-1077 cla i ms.acs(&_veriizon. net V111d Date ....... ZZ ....... V ...... N2 2 9 7 9 V10 TOWN OF NORTH ANDOVER 0. PERMIT FOR WIRING "c" S This certifies that ...... I , () ........... J.,/�.(.rcj .... ( ........... has permission to perform .......... ................ wiring in the building of ............... . ............................................ it ............... .... 7a .......... � w.n�t.&�y ...... . Ndr'th Andover, Mass-:-� Fee .... I ii��CMCAL iNSPE&Olt Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer we BOARD OF FIRE PREVENT ION REGULATIONS FOfficial Use Only Permit No. cp� Occupancy and Fee Checked ro�. �a [Rev 11/991 (1-ve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in ac'cordancc with the Massachusetts Elcariail Code (NIEC), 5,27 2.00 (PL E, I SE PRX T /iV INK OR TYPE 4 L L INFORM., I TION) Date: CityorToivnof. Ica. 4Vbdt1r,4C To the 1jispector of wil-es: -------- By this application die ulidersigneed glycs noticc. o[his .;7 or her intention to perform the electrical work described below. Locn*tion (Street & Number) A_ - Owner or Tenant ------------ Owner's Address Telephoae.No. �72- Is this perinit in conjunction with a building permit? Purljose Of Building Existinu Service 0 Anips V*olts New Seri -ice Anips Volts Nurnber of Feeders and Anipacity Yes No [�/ (Check Appropriate 13ox) Utility Authori7ation No. /0 Overhead Und.ard No. ofiNicters Overhead Und-rd 0 No. of:Me ters-, Location and Nature of Proposed Electrical Work: No. of Lightina Outlets lNo. Tubs Transformers KVA c*oitt,?ietio,ioritieroiiri,v�i,af�i,,.,,,.,,,,-,..-:..-.jL--.I Generators KAIA I No. of Recessed Fixtures I No. of Ceil.-Susp. (Paddle) Fatis No. o - f -1-1 vVilic Jljjj rol'of Wirt's, 11 No. of Lightina Outlets lNo. Tubs Transformers KVA o[Ilut Generators KAIA No. of Lialiting Fixture5 b Slyinimina Pool Above E] In- I Z, zrrid. i!rnd. itina Battery Units * * Z. No- of Receptacle Outlets No. of Oil Burners FIRE ALAR.111S 11NO. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranaes of Air Cond. Total No. Tons I — No. of Alerting Devices -No -of Waste Disposers HentPunip Number I 11ons] 1 0. of Set -Contained Totals: etection/Alerting Devices No. of Disinvasliers Space/Area Heating XNV Muili—CiDai,--, Local [I I 'p? El Othe, Connection No. of Dryers Heating. Appliances KW Security Systenis: lNo.or * er No. of INO. of No: ofDavices or Equivalent Heaters KIV Sigris BalInsts Do ta 'Wiring: No. of Devices o N o. Hydromass. b ige Bathtubs No. of Motors Total 11P cleco nimuni cations Wiring: Nn- or navif-.. OTHER: 0 IINSURA-NCE COVERAGE: Unless waived by the o-�%mcr, no perrait for the performance of electrical work rnay issue unless the licensee provides proof ofliability insurance;ncluding "completed operation" covera'6e or its substantial equivalent. The undersianed certifies that Stich Coll e s in rorce, and has exhibited proof of same to the pern-lit issuing offlcd!. ge I CHECK ONNE: INSM BOND El OT14ER 0 (Specify:) Estimated Value of Electrical Work.' (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be rcqueste d in accordance withl'YIEC Rule 10, and upon cornoletion. I certif) 1 un dff il is andpenallies is applicatiolt is true and cozr;�Iete. E Npau vfpeFjury, that the ifi tion on tit FIILN I NAIN I t�_-7 / 'e- n., , �� C _. - — LI C. IN 0 14 'e- 9/ .7— LIC. NO.: Licensee: 5- AUSignature (Ifal)plicabte. enicr in Me liceirse number lizze.) V Bus. Tel: No.: 4 R g-- 3 a ;L Address: /&--v 0.�Cer,6 57�7 116, ",qwbdone __R4 107" lr5�_ Alt. Tel. No.: �'-7 3 3 gy OWNER'S ENSURANCE W.UVER: I am avmrc that the Licensee does -not have the liability insurance coverage normally �equircd by By iny signature below, I hereby waive this requirement. I am die (check one) C1 owner 0 oxvncr's 3"ent. Owncr/A-crit -R1111T 17r. E: S- Sionature Telephone Nio.- FPj; 04/03/01 12:14 FAX 978 682 1646 LANDERS ELECTRIC BOARD CF FIRE PREVENTION REGULATIONS off-Joal use only Permit No - Occupancy and Fee Cheziced LRg�- 111991 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ali work to be perratnied in accunlanct: with the mav=husctis Eloarimi Code (Nlr,.C). SZ7 9WIRl 2.00 TL ElIsE njw ix jsx oi? TrPE ALL ityroitti 710,N) D4tc: .. CiryorTownor: Y(/,,. Alyhetlrk TO III e Ih-sp eclor of Wires - By this applic:don the undersign -ed gives no[icc ofbis or hcr iDLeZlion to pe6om (he eleCIric:1 work described below. Loc:(Uou (Street & N.Number) ��7J 16940:e:11 W" 10 evls�e 40 At 002 Owner or Tenant Owner's Address Telephone.Nlo, Is this pertnit in conjunction witil 3 buildin,.R permil? Yes INO (Check Appropriate Dox) Purpose of Building &.F/ 4or ct- ff— Utility AutherizationNo. /40 /J9 *'0 Exi5dng!iervica,�ev,4 Amps I Vol Ls Ne%V Ser4ktlCe - Amps Volts Number of Feeder.; and AnTptlCity Location 'and Nature of Proposed Electrical Work. Overhead 0 Und.ord � No. ofAleters. Overhead C1 Undeard El No- of.Nleters:' U No. of Recessed Fixtures -r- 1,4o- of Ceil.-Susp. (Paddle) Fins 0. of _r", n s f o r m e rs XVA T No.9f Lizzliting Outlets lNo. of Nut Tubs Generators KVA INO-.0f Lighting F-=tures Swimming Pool Above fn-- I _rn4d. C:1 amd. L -J No. of EmersencrLig.titnig Battery Units No.of Receptacle Outlets 11io.o[ORBurn M FIRE ALAILNIS No. of es No. of Switches INLm of Gas Burners - 1NO. of Detectioa;wd IlIttlating Devices No. of Ranges ToLU Dto. a( Air Cond. Tons No. orAlertiug Devices xo orWiste Disposers IN mb T W 1,1,, r_J oas 'I, Tot2� : No. *[Salf-Contalna�--- Detoction/Alarti.e Dcices No- of Dish w*2shers Space/Area He2fina KW cull' - al Local r, "T Other onnectil)n No. of Dry= Heating Appliunces XNV cculll!os NO rMotortgulvalent INO- of W2 ter xW HeAters I F7 a f AN -0. of Signs B2112sts D2ta 11,41ring. No. ofDe%ices or E5utymlent tJrdeC0MMUniC2ti0ns No. HN .,drDi=ss.2&e'Bnthtubs I INO-of Motors Total 10 I Wi , N -CL a r D mvices a r E 74f %* en t 10 7TH E R: Alfach adiffird),01 eflad Y-damed, or = required by the Im ,pactor of Wirex- INSTDR-CNCE CON7ERAGE.- Unl= %%-aivcd by the au-ner, no pe M. -t for the perrbr=nce orelectrical W,ork inay issut: unless the Uccnsca provides proof ouability insuriancc;ncluding "complctcd operation" covenic or its substantial equlvwcnL 11C undersigned cerffics that such covc e is in rorcc. alid tlas Mkbited Proof Of $*me to the permit issuing office. CHECKONNE. WSURANCE FIBSOND (I 01HER 0 (SPeCifr-J Estitnated Value of Ejcrl�ical Work fflm required by municipal policy-) (F-tpim6on Dale) Work- to slart—!�//o/-e 11upections to be requested in accord2nce with MEC Rule 10, and upon completion. fccrizyj- underth painsandpenal,11V14" * rj� at A E 11 rfig an;0ziffis appricatiell is 117te and camp1dr- LJCNO.-.- Licensee: JA&4f:?,C5- AAMISI-goature "d,�2 LIC.NO.-- (#'appticahlr. viter -exi-gypt - in ike ficeme mmsbir asle.) Address: le -"O 57�- //V AW060F)e 11.4 6/1�� AlL'Tl.,No OWLNER25 ENSIUR. "--k.NCZ WAIVIER; I am at%= 1b3I the Lic=C: doeS nothave the liability Ins=nce cove:2ge nor.=Ily fequired by law. By Tty sigralure below, I hembywai%v this requirement- I = the ((!hCCk one) 0 owner 0 ownees:gcot O)YnerlA:ent 17. C. Signature Telephone No. PEP-4A-rrr FFz. 71 84 04/03/01 12:14 FAX 978 682 1646 LANDERS ELECTRIC FROA Landers Electrical Co., Inc. 1000 Osgood Street P.O. Box 793 No.Andover,MA 01845 Tel: 978-686-3828 Fax 97&682-1646 DATE: TO: SUBJECT: Number of Pages: (Including Cover Sheet) M 1 i2 "J