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Home My WebLink AboutMiscellaneous - 614 CHICKERING ROAD 4/30/2018r614CHICKERING ROAD 2101064.0-0009-0000.0 _/� 9800 Fredericksburg Road Nlh San Antonio,TX 78288 USAA® 04664. 1TDSF .JSS1024188449. 01 . 01 .449 NORTH ANDOVER March 25, 2015 120 MAIN STREET NORTH ANDOVER MA 01845-2420 Reference: MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Attention Town Building Commissioner, I am writing regarding the claim referenced below. Policyholder: Earline Mango Reference #: 036575572-1 Date of loss: February 15, 2015 Location of loss: North Andover, Massachusetts Address: 614 Chickering Rd., 01845 A claim has been made involving loss, damage or destruction of the property referenced above, which may either exceed $1000.00 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 and include the reference #. You may submit correspondence or questions to me. My contact information is: Address: P.O. BOX 659460 SAN ANTONIO, TEXAS 78265 Fax: 1-800-531-8669 Phone: 1-210-531-8722, Ext 44405 Sincerely, '4-<11rr-1 `41 Kimberly Schaeffer Property - TFL Unit 2 USAA Casualty Insurance Company PO Box 659461 San Antonio, TX 78265 Phone: 1-210-531-8722, Ext 44405 Fax: 1-800-531-8669 ARR/KKS 036575572 - DM-04664- 1 - 8029 - 26 54577-0914 Page 1 of 1 r !! `9 Date...... ..... `......1.. NORT/, °ft"`° '•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ACMUS� This certifies that �'U.�.............................................................. ....... L� ..C has permission to perform ...im.c c �j�llh' i . /C ,Cr'� wiring in the building of.....................1...../�t�KJ�r a................................... 'at....... ? . ......C.I c K�2�'� .....126.........:;North Andover,Mass. Fee...q� Lic.No...3d.S.�{v.E...... ! ul !?... r l i(. ` / McrkicAL INSPECTOR Check ' ` Commonwealth of Massachusetts Official Use Only _ - Permit No. rl c 715 Department of Fire Services t Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 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: I � 12 k l f City or Town of: tlg?n&gt To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ��I riAle Owner or Tenant _ Q 1h� ��( Telephone No. Owner's Address S&MCr Is this permit in conjunction with a building permit? Yes 19 No ❑ (Check Appropriate Box) %tQL( - 201 Purpose of Building CW00 Utility Authorization No. Existing Service_Lq= Amps l 20/ L tf o Volts Overhead❑ Undgrd CQ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: QCme&= F ?qR-TtQ1.( F1JV4S41 3145 �tbT s �1Ru e s`r`1 art l �`��g!jer,� Completion of the followin table may be waived bv the Inspector o twi— 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- ❑ o.of Emergency Lighting rnd. grnd. Battery 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 TotInitiatin Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:I I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Connecholn El Other No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 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: INSURANCE [ BOND ❑ OTHER ❑ (Specify:) �laT[nC A � &+ Ob (Expirati n Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: f Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete: FIRM NAME: LIC.NO.: Licensee: !�' Signature LIC.NO.: 01, (If applicable,enter "exempt"in the licvve num,Pgr line.) us.Tel.No.: Address: �,� ,L,q,(�' ,,> �///L gtD,i(�-f 1TIJQ�iIJ �f� Ol�� Alt.Tel.No.: r U OWNER'S INSURANCE WAIVER: I am aware that the Li nsee does not have the liability insurance cove ge�allyz required by law. By my signature below,I hereby waive this requirement. lam the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ �j�� - ic � �� t" Date. . 'I 88u � TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING t SSAc tj i This certifies that . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of .��. .(. . ��.1.�.�`�."`��j. .��.v. . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. //S. . . . .Lic. No..-�;/ !�� . . . . . . . . . . . . . . / . . . . . . . . . . . . . PLUMBING I PECTOR Check # f MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: ,MA. Date: f2--30—(O Permit# g (ply C� �1 Building Location:_ ' �Ic��n-+`Nt Il,� Owners Name: Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential�' New:❑ Alteration:❑ Renovation: Replacement:❑ Plans Submitted: Yes❑ No❑ FIXTURES DEDICATED z SYSTEMS LU z W y 0 LA W Z LA 4A 0} J (J W O � °C it z x a in a aLU z z z Q 3 = L W w a Y N 0 a X Q `^ �' Q 0 Q Q H o a Z W Q W z W Z U a LL = J W 2Q LL W 0 0 H J W d' '= OZS O / W a Y = = a 0 3 z Q W 3 a Se z w LU LLJ H H W Q } H ' a Q of to O 01-- > > O = O Q a ca m a a LL = x g 5 oc v, ,n 3 3 3 0 a 0 l9 Q 3 SUB BSMT. k BASEMENT I 1sT FLOOR 2"D FLOOR ) I 3RD FLOOR 4T"FLOOR 5T"FLOOR e FLOOR 7T"FLOOR 8T"FLOOR Check One Only Certificate# Installing Company Name: ❑Corporation Address: 28 rCity/Town: N�w� State: tits El Partnership Business Tel: 1071--fS9 -S-S•3' Fax: ❑Firm/Company Name of Licensed Plumber: l`��,� INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes ❑ No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ® 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: ( Z /--- Title F1 Plumber Signature of Licensed Plumber Cityrrown ❑ Master License Number: 1 '2-) I2� APPROVED OFFICE USE ONLY ®Journeyman