HomeMy WebLinkAboutMiscellaneous - 43 MOUNT VERNON STREET 4/30/2018 i
43 MOUNT VERNON-STREET
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1tia TOWN OF NORTH ANDOVER
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Swam PERMIT FOR PLUMBING
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This certifies that . . . . .�--.`-. ' y�. . . . . . . . .
� has permission to perform __.. . . . . . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at 3. . '? . . - -. �'� . . . . . ., North Andover, Mass.
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Fel . . . . . .Lic. No.. . . . . . . -`. . . . . . . . . . . . . .
'dG INSPECTOR
Check H -3z;IY
6545
PO Box 55098
Boston,MA 02205-5098
617-951-0600
•: 2015
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845
RE: Insured: BERNADETTE HOLLAND
Property Address: 43 MOUNT VERNON STREET,NORTH ANDOVER, MA
Policy Number: HMA 0316277
Claim Number: BOS00059498
Date of Loss: 2/23/2015
Company: Safety Insurance Company
Claim has been made involving loss, damage or destruction of the above-captioned property,
which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be
applicable. If any notice under Mass. Gen.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 number.
Marc Savosik Claim Examiner 4/20/2015
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 3543
Fax: (617) 531-6679
Email: MarcSavosik@Safetylnsurance.com
Date. � • -�
"oRT"'14, TOWN OF NORTH ANDOVER
3? .� •._.. o�
° PERMIT FOR PLUMBING
CHUS
This certifies that . . . . f � �!'. �!h.�. - • • • • • - • • • • • . . . . . . •
has permission to perform . . . t'. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . ., G.� .�t-1` . . . . . . . . . . . . . . . . . . . .
at . . .3. . . :r . . .1 J t. l?44.:c .. . . . . . . .. North Andover, Mass.
Fee. 3 .' . .Lic. No..q.71). . . . . . . . . . . . . .
PLUMBING INSPECTOR
Check # 4J /
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3
7093
mH,SAC � � r
HUSETTS UNIFORMAT
(Print omalw-lass
PPLIC A ION FOR-PERMIT TO DO PLUMBING
.
Date 20 40L(/ PrmIt # a
Building Lo tion
.Owner' m
Type of Occupancy
New❑ Renovation ❑ Replacements
Plans Submitted: Yes❑ No❑
FIXTURES
B.P. # SEWER #
SEPTIC # .
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Z
o m N¢ w ¢ Z a z z
CL 0z z 4 0
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SUB-BSMT ¢ m .o 0
BASEMENT
IST FLOOR
' 2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR '
STH FL00
I
stalling Company Name
idress Check one: Certificate
❑ Corporation
isiness Telephone 2 ❑ Partnership
me of Licensed Plumber or Gas Fitter �/Firm/Co.
NSURANCECOVERAGE:
have a current ii bility insurance policy or Its substantial equivalent, requirements of MGL C which meets the
Yes 1 No . c3h. 142.
you have checked Yes, please Indicate the type of Covera e b check the
g Y g appropriate box.
liability Insurance policy'Er"' Other type of indemnity ❑ Band ❑
WNER'S INSURNACE WAIVER: 1 am aware that the licensee does not have the insurance cgverage required by Chapter
12 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
gnature of Owner or Owner's Agent Check one: i
Owner ❑ AgentJO t• i
eby certify that all of the details and information I have submitted (or entered)In above appiication are true and ac
nowledge and that all plumbing work and Installations performed u `
!rtinent provisions of the Massachusetts State Plumbing Code and h r the permit Issued for thi a curate to the hest of
to 42 of e G eral Lew Ilcation will be in compliance with
ly
itle Signa re of Licensed Plum er
:ity/Town
PPROVEI)(OFFICE USE ONLY) Type of Licenser p,M�ster .
0 Journeyman
License Number-1-.5 3 �j
BELOW FOR OFFICE USE ONLY
f`
FINAL INSPECTIONS STET , PROGRESS INSPECT10Ms I
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Na �
APPL-MATION FOII PERMIT TO 00 PLUMBING
NAME i TM OF"Lulls
LOCATION OF MU"IIO _
KED
I
PIMMT GRANTED
DATE ------_._._ 19
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FLUMM
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ING INSPECTOR
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BELOW FOR OFFICE UaE ONLY `
f
fl_ N114:1NfIPEC'hOli MIMES FEE PROD:RR83 IN iPIIOTION8
NO.
APPUCATION POR PERMIT TO 00 PLUMOINO I
I
UNDERGROUND ROUGH
COMPLETE ROUGH.
FINAL INSPECTION
PERMIT GRANTED
DATE
PLUMBINO INfIPECT.OR