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Home My WebLink AboutMiscellaneous - 43 COACHMANS LANE 4/30/2018 43 COACH? LANE 210/037.A-0022-0000.0 i CIOL CUSTARD INSURANCE ADJUSTERS 6/16/2015 Gerald Brown Inspector of Buildings 1600 Osgood Street Building 20, Suite 2035 North Andover,MA 01845 Claim Number: 033598675 Policy Number: 78463400002 Company Name: Arbella Mutual Insurance Company Date of Loss: 4/11/2015 Insured: Bryan Thorpe Property Location: 43 Coachmans Lane North Andover,MA 01845 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, Arbella Mutual Insurance Company PO Box 699225 Quincy,MA 02269 CC: City/Town Fire Dept, City/Town Health Dept P Date.... ....:.a.a.... ....... NORTH °tt"`°:•1"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING CHUS� This certifies that I...... •?-...... +� - ........... has permission to perform `: ...�..... .?� M-.f................. wiring in the building of....t/.. ..t1..&/-/�..•.--- .................................................... at 4 -- -�.......::�:.;..,....,..t^': a"� ,North Andover,Mass. Fee...4... .... Lic.No. t ��'z?C:........74:� ...... ............... `ELECTRICAL INSPECTOR Check # �/a 5498 Commonwealth of Massachuse s Official Usse Department of Fire Service Permit No. BOARD OF FIRE PREVENTION R G CATIONS [Rev. 1Occu1 99]ancy and Fee Checked l leave blank APPLICATION FOR PERMIT PERFORM ELECTRICAL WORK All work to be performed in accordance with th Massachusetts Electrical Code(MEC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR E ALL INFTION) Date: a Q City or Town of �,. J n d• L e- To the Inspe for of fres: By this application the undersigned gives notice of his r her intention to erform the electrical work described below. Location(Street&Number) 0. Owner or Tenant U aAA MO r Telephone No. Owner's Addre 617K_ j� O Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the followin table may be waived by the Inspe o Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- F] o.o mergency ig ing rnd. rnd. Batt= 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 Initiating Devices No.of Ranges No. of Air Cond. ToiTonal ENo.ofAlerting DevicesNo.of Waste Disposers Heat Pump Number Tons KW Self-ContainedTotals: on/Alertin Devices No.of Dishwashers Space/Area Heating KW Municipal tion ❑ Other No.of Dryers Heating Appliances Kms, Securi S ste o.o =vices or Equivalent No.of Water No.of No. of Heaters KW Signs Ballasts Data Wiring: No.of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 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: Iii ISURANCEX BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work (When required by municipal policy.) (Expiration )ate) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 1 certify, under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: / �i�+?/l") LIC. NO.: Licensee: ignature LIC.NO.: CD oGc72 (If applicable, enter "exempt••in the lic nse number lin ) . BuS.Tel.No.• : �S7d yfr� Address: ' r / 7 Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the icens 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: $ 11111BRINKS HOME SECURITY® Brink's Home Security,Inc.•155 West Street,Suite 6•Wilmington,MA 01887 978-657-0443 Brinks Home Security 155 West Street Suite 6 Wilmington, MA 01887 978-657-0443 978-657-5367 FAX December 21, 2004 To the Inspector of Wires: The address listed on this permit is ready for inspection. If you would like, we can help arrange a time and date for you with the customer for inspection. Also, some towns and cities are letting us write on the electrical permits that a site is ready for inspection. If writing on the permit is acceptable or you would like us to arrange an inspection with our customer, please contact Krista Taylor at 978-657-0443. 4S cerely, J hn Tanner Technical Manager