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Home My WebLink AboutMiscellaneous - 536 FOREST STREET 4/30/2018 (2) 536 FOREST STREET 210/106-B-0095-0000-0 THENORFOLK EDHAi&GROUN November 1, 2011 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1132424 Insured: GARY LETOURNEAU SUSAN LETOURNEAU Address: 536 FOREST STREET, NORTH ANDOVER, MA Policy No.: F0101848 Loss Date: 10/30/2011 Loss Type: Building or Other Structure Damage A claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date and claim or file number: If no reply is received from your office within ten days, we will assume you have no liens of any type against this property, and the claim will be paid in our customary manner. Sincerely, n Marie J. Landers Property Claim Examiner 1-800-688-1825 x1136 NORFOLK&DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street,P.O.Box 9109,Dedham,MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO. Telephone:(800)688-1825 FITCHBURG MUTUAL INSURANCE CO. Roo Fax:(781)329-1818 Date.... .........�a......`06... 40RTI{ �5 Ot�r�ao`e�h. 3? , O0 TOWN OF NORTH ANDOVER O 9 t PERMIT FOR WIRINGlo T< . i This certifies that ..... cT.e /.iC (f/', /yt/ ................ has permission to perform ''/ ry wiring in the building of .. at........:5.7..31... �o�'�T North Andover,Mass. Fee ...... Lic.No .... .;. ...... .. .... ..... IN ELECTRICAL INSPECTOR Check # Commonwealth of Massachusetts official Use only Department of Fire Services Permit No. , BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: — City or Town of: v . / To the Inspector of Wires; By this application the undersigned gives not(74idsAhe—,intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant se$ r Owner's Address S Telephone No. - _0�� Is this permit In conjunction with a building i �permt? Yes No ❑ (Check Appropriate Box) Purpose of Building << fi .� _ d. Utility Authorization No.. Existing ServiceOa Amps f/ O Volts Overhead ❑ UndgrdJ4 No,of Meters New Service . Amps / Volts Overhead❑ Und rd h ❑ No.-of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: eo om letion of the fiollowin table may be waived b the Ins Inspector o Wires. - No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans , o•of Tota Transformers KVA ` No.of Lighting Outlets No.of Hot Tubs Generators 'KVA t No.of Lighting Fixtures Swimming Pool Above ❑ n- ❑ o.o mergency Ig tng rnd. rnd. BatteEy Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners i o. of etection an Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat ump umber Tons W__ o.of Se f-Containe " Detection/AI rtin Devices No.of Dishwashers Space/Area Heating KWunicipa Lo al 0 Connection ❑ Other No.of Dryers Heating AppliancesK`,i, Security Systems: No.ofWater------- o.of No,of Devices or E uivalent Heaters KW °•of Data Wiring: Signs Ballasts No.of Devices or.E uivalent No.Hydromassage Bathtubs No.of MVtors Total HP a ecommunlcations irmg: OTHER: No.of Devices or E uivalent Aa—ch Vitional detail esired, or as required by the INSURANCE.COVERAGE: Unless waived by the owner,no permit for the performance of electrical wok mayector 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 ❑ q9ND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work. /�'ZJ a (Expiration Date) (When required by municipal policy.) Work to Start;.^,�o-O� Inspections to be requested in acco ance with MEC Rule 10,and upon completion. I'certify,under the pains and penalties of perjury,that the informa non ' app ation is true and complete. FIRM NAME:ELECTRICAL DYNAMICS, INC. Licensee:GARY R. LETOURNEAULIC.NO.:A13881 Signature LIC. NO.:A13881 (Ifapplicable,enter--,,----exempt"in the license number line.) . Address: 72B Concord:Street North Reading, MA 01864 Bus. Tel. No.:978-664-IQ _ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance ance coverage normally required by law. By my signature below, 1 hereby waive this.requirement:-[am the(check one) owner ❑owner's agent. Owner/Agent ' Signature __ Telephone No, Location 53 ro 4::b q,,t—:L--v r 5? No. ! Date '5h,31,0 x NaRTh TOWN OF NORTH ANDOVER 3? •. • oAL MT F s D s • _ , , Certificate of Occupancy $ s„CNUS<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ t— TOTAL $ Check #1^ �O 1 9 ! U 3 Building Inspector