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Home My WebLink AboutMiscellaneous - 309 ANDOVER STREET 4/30/2018 309 ANDOVER ST 210i047.0-0025-0000.0 J ` L i k , i I I K]S INDEPENDENT CLAIMS SERVICE, INC. Service • Integrity • Experience Notice of Casualty Loss to Building Under Massachusetts General Laws,Chapter 139,Section 3B January 18,2010 Building Inspector 120 Main Street North Andover,MA 01845 Board of Health 120 Main Street North Andover,MA 01845 Fire Department 124 Main Street North Andover,MA 01845 INSURED: Strobel,John&Shirley ADDRESS:,-q.; 309'Andover`Street,North Andover,MA 0184.5 LOCATION OF LOSS: Same COMPANY: The Commerce Insurance Co POLICY#: ZL6690 CLAIM#: 10-28351 DATE OF LOSS: 12/13/2009 TYPE OF LOSS: Water Dear Sir or Madam: Independent Claims Service is the insurance adjusting firm hired b the above referenced client . Y e t to handle theca boned loss on behalf of their insured. P A 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 notice under Massachusetts General Laws,Chapter 139, Section 3B is appropriate, please bring it to our attention, and include a reference of the captioned insured: Location,policy number,and/or date of loss. Sincerely, INDEPENDENT CLAIMS SERVICE,INC. Gary P Cournoyer 22 Water Street Westborough,MA 01 581 508.366.8535 FAX 508.366.091 7 www.icsclaims.com ,'-.}y,r ..:L}�,t•i ♦.i t 'y y., 1. � � t Crawford Crawford and Company 1001 Summit Blvd. Atlanta, GA 30319 Phone: (800) 241-2541 4/9/2015 Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 Re: Insured: JOHN STROBEL and SHIRLEY STROBEL Claim Number: KAWH17 Policy Number: ZL6690 Our File: 6776-2592016 Date of Loss: 2/25/2015 Type of Loss: Weight of Ice &Snow Location of Loss: 309 ANDOVER ST N ANDOVER, MA 01845 Insurance Company: Mapfre Insurance To Whom It May Concern: 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 3B 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. Very truly yours, Robert Barnett Claim Representative CC: City/Town Fire Dept, City/Town Health Dept 2012 Massachusetts EIectrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§.3L,the a • permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed' (#� A On the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the ,r notification of completion of the work as required in M.G.L.c.143,§3L. Permits shallbelimited as to the time of ongoing construction activity,and maybe deemed_bythe.Inspector-of_Wares abandoned_and.invalid,ifhe— or she has determined that the authorized wor%has not commenced or has not progressed during the preceding 12 month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. J The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of2010 and extended by Sections.74 and 75 of Chapter 238 of \ the Acts of 2012.The purpose of this act is to promote job,growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain•permits and licenses concerning the use or development ofreal property.With limited exceptions,the Act automatically dxtends,for four years beyond its otherwis a applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008_and extending-through August 15,2012. Yule I—Permit/Date Closed: / * Note:Reapply for new permit Permit Extension Act—PermitMate Closed: � i Date..... .......................... + TOWN OF NORTH ANDOVER PERMIT FOR WIRING S C US ES This certifies that ............. has permission to perform ...........................IQ-P) .............. .......znp .............. wiring in the building of.................5777k.13,-- 4...................................... .............. ....... at...... .......1,�........................1,North Andover,Mass. yp Fee... �... Lic. ................ t,g '�e '�4 ..... ....... ELECTRICAL INSPECTOR Check # 3 2- 9196 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC) 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: % 1Z /0 City or Town of: NORTH ANDOVER To the Ins ect r of Wires: By this application the undersigned gives notice of his o ertention to perform the electrical work described below. Location(Street&Number) �- Owner or Tenant Telephone No. Owner's Address --------- — Is this permit in conjunction with builermit? Yes QQ ❑ No (Check Appropriate Box) Purpose of Building J 11'1 S , t Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: Completion o the ollowin table may be waived by the Inspector of Wires. No,of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans. No.of Total . Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o,o mergency ig g d rnd. Battery Units --, No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and • Initiatin Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers P Heat Pum Number Tons_. KW _ No.of Self.-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mumc. al Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* p No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Si s Ballasts . No.of Devices or Equivalent _ No.Hydromassage Bathtubs No.of Motors Total gP Telecommunications Wiring: OTHER: No.of Devices or E uivalent Estimated Value of Attach additional detail if desired,or as required by the Inspector of Wires. ]ec 'cal Work: (When required by municipal policy.) Work to Stark Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: Unless w 'ved by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability ' urance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force,and has exhibited proof of same 4ha ermit suing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Spec I certify,under the pa'ns and enalties o perju that the 'form mon thisCk cation is u'e FIRM NAME: (/ a PP and complet /� C Licensee: LIC U Signature LIC.NO.: (If applicable, e exempt" ' h licens number line.) Address: t(� `jMI U Bus.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Departrnent of Public Safety"S"License: Alt L cl.No OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not 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 Signature Telephone No. PERMIT FEE: $ r' 4 1 1 A