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Home My WebLink AboutMiscellaneous - 575 TURNPIKE STREET 4/30/2018 (6)A L Cac CLAIMS DEPT. March 11, 2002 Ccmmerce Insurance The Commerce Insurance Company Citation Insurance Company Members of The Commerce Group, Inc. 11 Gore Road, Webster, Massachusetts 01570 (508) 949-1500 www.Commerceinturance.com BUILDING COMMISSIONER or INSPECTOR OF BUILDINGS TOWN/CITY HALL N ANDOVER MA 01845 RE: Our Insured: DR SUNANTA OBER Property Address: 575 TURNPIKE ST #26 & 28 Policy#: H15536 Date of Loss: 03/08/2002 File#: MX3500-HAV950 Board of Health or Board of Selectmen Town/City Hall Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. TINA YANCZEWSKI Claim Adjuster Telephone: (508)949-5215 Toll Free: 1-800-221-1605, Ext: 5215 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. March 11, 2002 DOOR VANDALIZED CcmmCrc C4)mpanles .... COME GROW WITH us CIC 254 (Rev. 4/95) MAIL 443 1 Office Use Onl 01 4E (,fammllnwr# Of 4.7( g56aZ4u0P11q Permit No. _ 43epartment of Public �afetu Occupancy &Fee Checked 'a %r BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3iso (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 ,g 7(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �,l r or Town of NORTEI ANnOVFR To the Inspector of Wires: The udersigned applies for a per t to perform the �,elelctrical work described below. Location (Street & Number) 75— �U' P ja Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Purpose of Building Existing Service Amps _� Volts New Service Amps _J Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work. 1` No. of Lighting Outlets No.:` Lighting Fixtures No. of Dryers No. -of %Nater Hoaiers. Yes ❑ No � (Check Appropriate Box) - Utility Authorization No. Overhead ❑ Undgrnd ❑ No. of Meters Overhead ❑ Undgrnd ❑ No. of Meters No. of Hot Tubs No. of Receptacle Outlets In- r-7 grnd. L-- _ I No. of Switch Outlets No. of Ranges No. of Disposals No. of Dishwashers No. of Dryers No. -of %Nater Hoaiers. Yes ❑ No � (Check Appropriate Box) - Utility Authorization No. Overhead ❑ Undgrnd ❑ No. of Meters Overhead ❑ Undgrnd ❑ No. of Meters No. of Hot Tubs Above Swimming Pool grnd. ❑ In- r-7 grnd. L-- _ I No. of Oil Burners No. of Gas Burners Total No. of Air Cond. tons Heat Total Total No.of Pumps Tons KW Space/Area H,,ating . KW Netting {)avice;; nYV - I No. of ---N 6. of IOW -I Signs Ballasts No. of Transformers Total KVA Generators KVA No. of Emergency Lighting Battery Units FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices ❑ Municipal r— Other Local Connection Low.VoTfage - Wiring No. Hydro Massage Tubs ........... I No. of Motors �T/otaall HP OTHER �` tt� Ili 1 SCJ Ch� INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a cuj16Ent Liability Insurance Policy including Co ple ed Operations Coverage or its substantial equivalent. YES NO 1 have submitted valid proof of same to the Office. YES NO _ If you have checked YES, please indicate the type f coverage by checking the a4#! p p,.�opriate box. INSUPANCE 'SR BOND OTHER = (Please Specify) (Expiration Date) t Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Roug Final Signed under a Penalties of p jury0 FIRM NAME �1 Zig L' LIC. NO. LIC. NO. Licensee Signatur C�, �� g 7 Cy fy Bus. Tel. No. l` Address (l Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that t e Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws. and that my signature on this permit apptica0on waives this requirement. Owner Agent (Please check one) o u� Telephone No. PERMIT FEES (Signature of Owner or Agent) x-6565 Date....:L. �... 787 -f VtORTH �•``°:°1"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SAcmUS This certifies that C =ti ....... has permissioi-to perform ........... ........ .... ` wiring in the building of .. at ......, •. ......... ........ North Andover, Mass. r Fee ... Lic. No. f4 ............. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ;t 01 4e Lfommlvnurr# of 14fitt000r4u.Betts department of Public t6afetu BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Q�„ Permit No. �8��(�(nJJ' Occupancy & Fee Checked o� CJ � 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR :00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date e:� 7 (%* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to 'pje�rform the electrical work described below. Location (Street & Number) ` 15 �7-01--RAl" //I<E Owner or Tenant I_�Q A/ 7R Z_1UE ' - uy e-Z� P H — Owner's Address f� Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building Existing Service Amps __J Volts New Service Amps _I Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Utility Authorization No Overhead ❑ Undgrnd ❑ Overhead ❑ Undgrnd No. of Meters No. of Meters �_�\ I No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVA OTHER INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including C m feted Operations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to the Office. YES NO If you have checked YES, please indicate the typ coverage by checking the apriate box. r INSURANCE BOND OTHER —� (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Signed under the Penalties of perjur FIRM NAME Licensee l2 f C t4z4, 4 " (� � N Bus. Tel. No. E / Ze J � - " — - Address ��+'�� fAlt. Tel. No. OWNER'S INSURANCE WAIVER- I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) � Q Telephone No. PERMIT FEE S (Signature of Owner or Agent) s-5565 Above In- No. of Lighting Fixtur s Swimming Pool grnd ❑ grnd. L_7 Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices No. of Sounding Devices of Self Contained No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers iNo. Space/Area Heating KW Detection/Sounding Devices Municipal Local 1:1 Connection El Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including C m feted Operations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to the Office. YES NO If you have checked YES, please indicate the typ coverage by checking the apriate box. r INSURANCE BOND OTHER —� (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Signed under the Penalties of perjur FIRM NAME Licensee l2 f C t4z4, 4 " (� � N Bus. Tel. No. E / Ze J � - " — - Address ��+'�� fAlt. Tel. No. OWNER'S INSURANCE WAIVER- I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) � Q Telephone No. PERMIT FEE S (Signature of Owner or Agent) s-5565 "i.0""r ��.-]] ' + . � � Q �.....1.... _ - Date ..................... . >� `_P 786 TOWN OF NORTH ANDOVER A PERMIT FOR WIRING �. i a This certifies that ................ ..................... r has permission to perform .:,r.!.,.�. ... . ` ... ..:...... ... ..... wiring in the building of .'..., . r at ...(,./,!!{ ,::...... ,North Andover, Mass i ' Fee ... �....:".'�Lic. No. .................................. ....:........... ELECTRICALINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer