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Home My WebLink AboutMiscellaneous - 393 SALEM STREET 4/30/2018N OO O ca W w v c v n o m o m 9D co Q � o M Q M o r^ 0 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 018 813 T3 P1 95000059003 Building Commissioner or Inspector of Buildings E120 MAIN STREET NORTH ANDOVER, MA 01845 f Claim Number: Policy Number: M Company Name: co0 M Cause of Loss: 0 Date of Loss: Insured: 0 Property Location Cunnin fiham �% l�Lindsey Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS Ch. 139, Sec 3B 2597269 2597269 06 MERRIMACK MUTUAL FIRE INS ICE DAM 2/15/2015 JOHN H & ROSEMARY DRAPER 393 SALEM ST 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 3B:r: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 th&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 ORT 0 4 Date.. 5--- 2 -Z — 0 6> ................................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... ji�?6�4e� ....... '.� lew . ............................ has permission to perform ...... 0.00..!��jv .... 5��K.4/ ..................... wiring in the building of ..... .................................. at .... 32.5 ....... ..................... . North Andover, Mass. Lic. No./6�.10 ..... 4� .......... Check # 6677 Official Use Only Permit No._ a 7 7 %7fg 6tW079W94,e7W 057 acpant -t off{ S4,%t Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date 5-22 -04 To the Inspector of Wires: Town of A/c? PL.% �-1 A029 The undersigned applies for a permit to perform the electrical work described below. Location (Stmt & Number 31-3 4 [meq Owner or Tenant 7b -1-11V Sot Owner's Address �W+� Is this permit in conjunction with a building permit Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service SOD Amps 21-119 Vats Overhead Urxigmd ❑ No. of Meters J New Service ROO Amps oC 6/O Volts Overhead ❑ Undgmd t"' No. of Meters Number of Feeders and Ampacity j d o -o -yM t' TD eX/ 59/ A- j_ pm-eC- Location and Nature of Proposed Electrical Work cjbnilie�� e)e15711v6OVC�4e-Ab:ie�v Ta vi✓Dc:!?6'lr✓rv[�, C./-fry+�v6e�IP��i{l af'Tibi✓./Ve-Gv,41,1",$/,,� OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws /� I have a current Liability Insurance Policy including Com ted Operations Coverage or its substantial equivalent YES = FfNO = have submitted valid proof of same to the Office YES — tf you have checked YES please indicate the type of coven e by checking the appropriate box INSURANCE = BOND = OTHER = (Please S Estimated Value of Electrical Works(Expiration Date) Al 6% 4-3 1210g3_ Work to Start = '—Z °` �, -= Inspection Date Resquested Rough Final -a-4/ 6gbi-- Signed under the Penalties of perjury: FIRM NAME LIC. NO.//,D 5 q A NO. R"7 7O I" Bus. Tel No. `/ /li & n OCoS?f Address_Alt Tel. No. ,3'?.9 7W OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement Owner Agent (Please Check one) /1f Telephone No9/k 60,�qe PERMITIFEE S (Signatoi%of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool gmd ❑ gmd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Spa ea Heatin KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Si ns Bailases Wiring No. Hydro, Massage Tuds No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws /� I have a current Liability Insurance Policy including Com ted Operations Coverage or its substantial equivalent YES = FfNO = have submitted valid proof of same to the Office YES — tf you have checked YES please indicate the type of coven e by checking the appropriate box INSURANCE = BOND = OTHER = (Please S Estimated Value of Electrical Works(Expiration Date) Al 6% 4-3 1210g3_ Work to Start = '—Z °` �, -= Inspection Date Resquested Rough Final -a-4/ 6gbi-- Signed under the Penalties of perjury: FIRM NAME LIC. NO.//,D 5 q A NO. R"7 7O I" Bus. Tel No. `/ /li & n OCoS?f Address_Alt Tel. No. ,3'?.9 7W OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement Owner Agent (Please Check one) /1f Telephone No9/k 60,�qe PERMITIFEE S (Signatoi%of Owner or Agent) S�v 6/-t of nx-C-b fq c c;�) ZP/-�- 7 s'- n C 1� - o -r,