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HomeMy WebLinkAboutMiscellaneous - 432 SALEM STREET 4/30/2018 (2) 432 SALEM STREET ` 210/037.B-0052-0000.0 J Cunningham Lindsey U.S.,Inc. P.O.Box 703689 Cunning= Dallas,TX 75370-3689 Lindsey Telephone(888)738-8714 Facsimile(214)488-6766 /} CLCAT@CL-NA.COM ***********************AUTO**3-DIGIT 018 763 T3 P1 95000058953 Building Commissioner or Inspector of Buildings 120 MAIN STREET N ANDOVER,MA 01845 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS Ch. 139, Sec 3B Claim Number: 1339126 Policy Number: 1339126 24 Company Name: MERRIMACK MUTUAL FIRE INS 0 Cause of Loss: ICE DAM Ln Date of Loss: 2/27/2015 0 Insured: ROBERT&SHARON BROUSSARD Property Location: 432 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 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. Section 3B.''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 the 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 j 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 Date. ' U 3666 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACNUS� This certifies that . . . erq!?.4. . . . . . . . . . . . S .M has permission to perform . . .:. .Lett. . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . .}3.&O.c. S.S ka.oe. . . . . . . . . . . . . . . . at. . . S.1-. . . . . . . . . . ., North Andover, Massal Fee—)-P,. Lic. No.�3.3.3 . . . . . . . . . . . . . . . . . . . . . . . .,�, PLUMBING INSPECTOR o WHITE:Applicant CANARY: Building Dept. PINK:Treasurer. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING v (Print or Type d06v'—, Mass. Date 19� Permit * 3 C C C' Building Location J ,!�a Owner's Nam�/� . Type of Occupanc"t- 5 I -D&ti tl New ❑ Renovation ❑ Replacement 2Plans Submitted: Yes ❑ No ❑ FIXTURES z Z N Z Y h N N N O ZH z W W Y J N } V < N O O ¢ ¢ N Z N < ¢ ¢ _ ~ N Z O Z N p 0 h W N H W ¢ W ¢ m dl S ¢ ~ < W N = ¢ d C7 Q a C 0 x V Z 1= N W H N ° Q 0 = .¢ a ¢ O W O ° d ¢ 3 < W _ W W LL Y W O S d of Z O p N Z = W F- O V 2 3 Y J m H ° p J 3 Y F- N iL t7 p < S ¢ @ 0 ---� SUB—BSMT. BASEMENT 1ST FLOOR 2140 FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR/� Installing.Company Name t'SOMe-r Q -cj',4(r M A 7 A e-0 Check one: Certificate Address ? C:46/4mt4n) s-P J ❑ Corporation lY) E!i.4 o c--A) . v)'1 A r T c/L/ ❑ Partnership Business Telephone �k1f, Z-197 1 91516/co. Name of Licensed Plumber , INSURANCE COVERAGE: I have a current jAbility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Er No ❑ If you have checked ves, please/indicate the type coverage by checking the appropriate box A liability_insurance policy 1d Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installationspoormed under the permit is su for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g e and apter of the eral laws. BY vLL re of Ucensedum rTitle Type of License: Master % Joumeymab❑ City/Town APPROVED(OFFICE NL License Number 1_3 3 5 BELOW FOR OFFICE USE ONLY FIKAL INSPECTIONS SKETCHES_ ` PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 i I PLUMBING INSPECTOR , t + Date./-. .,, . .. . ..i. . ... .. i NORTH q TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SACMUSES This certifies that . .:(f. l�: . . . . . " has permission for gas installation . . . . t. . . . . . . . . . . . . . . . . . . . . in the buildings of . . 3? U S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . X/: 34 . . SZ6; :. . .��� .. . . . . . . . . .. North Andover, Mass. Fee. f}:' . . Lic. No..`".'.'.`.'. . . . P . . . . . . . . . . GAS INSPECTOR Check# 1 3919 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN_ G (Print or Type) Date �Z Z/UL ' Building S Permit # '�lS 7 Location Owner's . New ❑ Renovation ❑ Replacement El-, Plans Submitted: Yes ❑ No Com- Building Permit No. lulu ix 'A L11Z � I �� � ° > Zo � w I 1 1 < I m ,� �� o o $ W I W = W ~ in a � > Q W H W Z = OC W W 0 V' f— Z J t- Z 1- F w U' O > LL H W J w SUB-BSMT. ( I I I I I I I I _IIIII I I I I I I I I I I I a BASEMENT I I I I I I I I¢ I I I I I I I I __ IIIIIIII_ I I I IST FLOOR 2ND FLOOR 3RD FLOOR I I I I I I I_IIIIIII I I I I I I I I I_I I_I s 4TH FLOOR I I I I I I I I I I I I I I I I I I 5TH FLOOR I I I I I 1 1 1 1 1 1 1 1 1 I I I I I I I I III I I 6TH FLOOR ( I I I I I :IIIIIIII ( I I I I I I I I ' 7TH FLOOR 1 1 1 1 1 1 ;:IIIIIIII I I I I• I I I I I I I I I I 8TH FLOOR ( I I I IIIIIII ' ( I I I I I I: I , I I I I I I I I Check one: Certificate Installing Company Name WATER HEATER INSTALLER-$= ecorp. 14 DARTMOUTH STREET ❑ Partnership VAMEN, MA 02148 ❑ Firm/Co. Business Telephone 791- -�- Name of Licensed Plumber or Gas Fitter S�-n�S , �✓ i INSURANCE COVERAGE: Checkon I have a current liability insurance policy or its substantial equivalent. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy H Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: .Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in the above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. Type of License: Fee ❑ Plumber Check # ❑ Gasfitter Signatur of Licensed Plum r or Gas Fitter Date Er Master �/J7�L APPROVED (Office Use Only) [:I Journeyman License Number BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME AND TYPE OF BUILDING LOCATION OF BUILDING PLUMBER/and or GASFITTER PERMIT GRANTED DATE 1g a 1 ' PLUMBING AND GAS INSPECTOR ; Date. I ".0 RT:�h, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACNUSE� This certifies that . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . N).L� . . . . . . . . . . . . . . . . at. . . . . . . . . North Andover, Mass. Fee. . 14/. ". .Lic. No..'.�a. . . . . . . . . . . . . . . . C LUMBING INSPECTOR Check # p 4 c 5125 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING GO (Print or Type) Date z /o L Building ` Permit # S 2_ J Location Owner's ✓ ati �, Name New ❑ Reno vation ❑ Replacement ° PlansSubmitted Yes-:-❑ No p— FIXTURES Building Permit No I IZ N i v" O Z I JJI I fZ ! I ' IW Z ! n I < ! � l � = + F i iZll" I . O Z Z IZ a O QIVI W �rn F ' = NI." V w NIQ H a 3 X U Z I Of ca H K } c Q F N Y I W a N ! O Q a I � O LL W Q Q K I Q W I C < I Q W ? I C I Q J ? 0 J 01 f- I" W V1 0 _ I J 1 v 1 O_� of Q Y I Q LL W Q � X Q I Z F Z l 1 I N Z I Z Q LL I Y W > '1- QI D I O QIC V = ~Iai< ixl `� ala. IQIaiO JiQ ! ola ( _ 3 !Y in V1 O O J 2 F I LL (� I C 1 3 ! C m C SUB_BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR I I I I I I I I I I l I I I I I I I I I I I I I III 6TH FLOOR - 7TH FLOOR . - 8TH FLOOR Check one: Certificate Installing Company Name WATER HEATER INSUt t.ERr, Corp. 14 ARTMouTH STREET El Partnership Address r MA 02148 ❑ Firm/Co. Business Telephone Name of Licensed Plumber T '� INSURANCE COVERAGE: Checkone ,. i.hove a current liability insurance policy or its substantial equivalent. Yes INo ❑ If you hove checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy L9, Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Moss. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in the above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Fee Sig ature of Licensed PKmber Check # P57 License Number Date Type or Plumbing License: Master I APPROVED (Office Use Only) Journeyman ❑ I BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES FEE PROGRESS: INSPECTIONS - NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME & TYPE OF BUILDING LOCATION OF BUILDING r � PLUMBER PERMIT GRANTED i DATE t PLUMBING INSPECTOR Claim # 1339126 Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road #B North Andover, MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health 0/ Inspector of Buildings Board of Selectmen Town Hall Town Hall North Andover, MA 01845 North Andover, MA 01845 Re: Insured: Dr. Robert F. Broussard Property address: 432 Salem Street North Andover, MA 01845 Policy #: 1339126 Loss of: 2011/10/29 File or Claim No. AD 9628 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,_Sec'--ion_6 to be applicable. If any notice under Mass_Gen_Laws,_Ch._139 Sec. 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 or file number. Glenn Guarente Title: Adjuster On this date, I caused copies of this notice to be sent to the persons named at the addresses indicated above by first class -mail. 11-2-11 Signature and date