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Home My WebLink AboutMiscellaneous - 315 TURNPIKE STREET 4/30/2018N 00 0 ;r, , m 0 X 0 mll 6 m A ASSMIATON AMERICAN CLAIMS SERVICE I. INDEPENCIENT INSURANCE MULTI -LINE ADJUSTERS DIUST BUILDING COMMISSIONER OR BOARD OF HEALTH OR�. INSPECTOR OF BUILDINGS BOARD OF SELECTMAN� 120 Main Street North Andover, MA 01845 RE: INSURED: William J. Palmteer PROPERTY ADDRESS: 318 Turnpike Street, North Andover, MA POLICY NUMBER: PDF0100519372 LOSS OF: 5/5/07, Water main broke causing furnace to crack FILE/CLAIM NUMBER 26886 PD Claim has been made involving loss, damage or destructilon 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 number, date of loss and claim file number. Craig Gillespie Claims Representative 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. Unless we hear from you within the next 10 days, we will not be obligated to pay any portion of this claim to you. August 8, 2007 Date 7 KIMBALL LANE, BUILDING C, LYNNFIELD, MASSACHUSETTS 01940 TELEPHONE (781) 245-9516 * FAX: (781) 245-1077 NA I NAL AMERICAN CLAIMS SERVICE ASSOCIATON INDEPENDENT INSURANCE MULTI -LINE ADJUSTERS DJUSTE �Ios I CIE ICA BUILDING COMMISSIONER OR BOARD OF HEALTH ORI INSPECTOR OF BUILDINGS BOARD OF SELECTMAN 120 Main Street North Andover, MA 01845 RE: INSURED: William J. Palmteer PROPERTY ADDRESS: 318 Turnpike Street, North Andover, MA POLICY NUMBER: PDF0100519372 LOSS OF: 5/5/07, Water main broke causing furnace to crack FILE/CLAIM NUMBER 26836 PD Claim has been made involving loss, damage or destructilon.of the above -captioned property, which may either exceed $1,006.00 or cause Massachusetts General Laws, Chapter 143, Section �, 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 number, date of loss and claim file number. Craig Gillespie Claims Representative i 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. Unless we hear from you within the next 10 days, we will �not be obligated to pay any portion of this claim to you. August 8, 2007. Date 7 KIMBALL LANE, BUILDING C, LYNNFIELD, MASSACHUSETTS 01940 TELEPHONE (781) 245-9516 * FAX: (781) 245-1077 0 I 'Z's Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......................................................... ........................... has permission to perform ................................... I.i� ................................... wiring in the building ............................. at ....... ............. . ...... ............. . North Andover, Mass. Fee ..... Lic. No. .......... 1"9 &: -'q .............. ............. ........... .. ELEcnucAL INSPEcroR Check,, 7961 44 4L Commonwealth of Massachusetts Ofri I cial Use Only Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leav I e 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 (PLEA SE RPJNT IN INK OR TYPEALL INFORM4 TION) Date: City or Town of. NORTH ANDOVER 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) 17/9 7V "A 1PJ11/4L Je e- + Owner or Tenant 6�; Owner's Address a's- Telephone No.617,flb fZST Is this permit in conjunct*on with a buildingpermit? Yes E] No a (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /0 V Amps //P Volts Overhead 5 UndgrdEj No. of Meters New Serviie Amps -Volts OverheadEl UndgrdE:l N i o. of Meters Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: —kee IAC -Cl -fv Y- C,(_ 1 V Cnmnlptinn nfthp MlInwina tnhlo —) be waived h- tha 1"r—in, nfw No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above Ei In- Swimming Pool grnd. grnd. E] N_o.`ol7ffierg__ ing Battery Units encyl—IgHo No. of Receptacle Outlets No. of Gii Burners FIRE ALAR -MS 1 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 No. of Waste Disposers H�eat Pump -Totals: I.Nu!R4�r.. I * Tons I ....................... I TK_W ....................... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local El Municippl F1 Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts ta Wiring: I Dai No. of Devices or Equivalent No. Hydromassage Bathtubs lNo. of Motors Total HP Telecommunications W Irin No. of Devices or Equivaglent OTHER: Attach additional detail if desired, or as required by the Inspector of Wi s. Estimated Value of Electrical Work: _,;Zoa. v0 — (When required by municipal policy.) Work to Start:. 106 2-/* Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [-I BOND [:] OTHER [:] (Specify:) I certify, under tit e pains and penalties ofperjury, th at the information on this application is true and complete. .�i FIRM NAME: 9 LIC. NO.: Licensee: Z-,--,11,1 Z -P -A ill't_r SignatureZ,.., �4� LIC. NO.:�� fl? 7 (Ifopplicable, enter "exe t" ' th h �41S? mp in, e ic§nse number line.) Bus. Tel. No.;9'V-3�*-_1/2, Address: .. i�1,4 4�1 /V,) �4 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-6 1, security 6rk requires Department of Pub.lic Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my sig7re below, I hereby waive this requirement. I am the (check one) El owner F -1 owner's aizent. Owner/Age Signature A V Telephone No.wgdi2o rPERmT�FEE: s AdEhh, p,gam-w—, Safety Insurance WO Form of Notice of Casuafty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner.or Board of Health or Inspector of Build-1-ngs Board of Selectman City Hall City Hall N Andover, 'MA 0 1845 N Andover, MA 0 1845 Rff 'Asur-ea: William & Annjulie Palmteer Property Address: 318 Turnpike St., N Andover, MA 0 1845 Policy Number: DF00009612 Claim Number: 2200001128 Date of Loss: 12/30/2010 Claim has been made involving loss, damage or destruction of the above-6aptioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chqpter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chgpter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned i.nsured, location, policy number. Date of loss and claim or, file number. Dan Cairney Date 12/30/10 Safety Insurance Company Homeowners Claims Unit P. 0. Box 55098 Boston, MA 02205-5098 (800) 951-2100 x 5389 Phone. Fa�,:, (617) 531-2730 hel, Date./ ot TOWN OF NORTH�A�-.166VER 0 ---ANIAL P PERM IT'FOR.PLU M BING This certifies that .... . ..... -kj I * I ........... has permission to perform ..... . ....................... plumbing in the buildings of . . . P11V z /1, , . / . . ............... ..... . ... .. at .... ......... North'Andover, Mass. Fee. . Q7-'-7Lic. No./ o. '7�'J ........... ?-- ............... PL MBING INSPECTOR Check 7628 ,j4 M MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (17ype or print) NORTH ANDOVER, MASSACHUSETTS Date 111'lell"— Building Location 17 1 UP a 6f, Owners Name A4 Permit Amount Type of Occupancy New Renovation Replacement Plans Submitted Yes 0 No E] FIXTURES i (Print or type) Check one: Certificate Installing Company Name Corp. Address Partnet--L- Business Telephone FimVCo. Name of Licensed Plumber: J-0 6- G 'e - Insurance CoveLraM Indicate the type of insurance coverage by checking . the appropriate box: Liability insurance policy Other type of indemnity Bond Insurance Waiver: I, the undersigned, have been made aware mat the licensee of this application does not have any one 4 the above threF insulance 4fil h' SIgnature Ownc- Agent I hereby certify that all of the details and information I have submitted (or entered) in Ave application are true and accurate to the best of my knowledge and that all plumbing work ar erformed under Mrmit Issued for this application will be in stallations p compliance with all pertinent provisions of the M s ' acrusetts Stte Plt7king-Codc A"dC pter-i-42"M"tre-General Laws. f �'r' , , & / 'If By: bignapre of Licensea Inumber Ift of Plumbing License Title e 7s, 5' City/Town Tricpse Number aster VPROVED (OFFICE USE ONLY E 1111,111111111111.011 M 4 'r.-1111 IMMM-NNNOMM WMM i (Print or type) Check one: Certificate Installing Company Name Corp. Address Partnet--L- Business Telephone FimVCo. Name of Licensed Plumber: J-0 6- G 'e - Insurance CoveLraM Indicate the type of insurance coverage by checking . the appropriate box: Liability insurance policy Other type of indemnity Bond Insurance Waiver: I, the undersigned, have been made aware mat the licensee of this application does not have any one 4 the above threF insulance 4fil h' SIgnature Ownc- Agent I hereby certify that all of the details and information I have submitted (or entered) in Ave application are true and accurate to the best of my knowledge and that all plumbing work ar erformed under Mrmit Issued for this application will be in stallations p compliance with all pertinent provisions of the M s ' acrusetts Stte Plt7king-Codc A"dC pter-i-42"M"tre-General Laws. f �'r' , , & / 'If By: bignapre of Licensea Inumber Ift of Plumbing License Title e 7s, 5' City/Town Tricpse Number aster VPROVED (OFFICE USE ONLY E