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Home My WebLink AboutMiscellaneous - 65 ELM STREET 4/30/2018 - - -1 65 ELM STREET 210/055.0-0006-0000.0 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Samuel Schwarz & Olivia Cornell Property Address: 65 Elm Street Policy Number: HP3047249 Date/Cause of Loss: 4/28/2015, Mold Damage File or Claim Number: 32124-R Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 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 the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Ryan Werner On this date, I caused copies of this Notice to be sent to the p rs s named above at the addresses indicated above by First Class Mail.—/ Sign and Date ANDERSON ADJ TMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 5L) . Date.. ....... � NORTH °f++``°:•'"° TOWN OF NORTH ANDOVER o ; ' PERMIT FOR WIRING SSACHU`�� This certifies that .................. .......... �.4.:!. f. ......U ......................... has permission to perform ....... <�.. /�!.••................................................. wiring in the building of......... ............................................. O / r at.................................................I r t r j orth Ando r ass. Fee..f�............. Lic.No!�/ l� ' / G { ..� ......� ...................... ....................... LEMICAL INSPECTM Check # /} '� TREC0A0f0AW_4L2H0FAUSSr4C ffffLrM office only DEPARTMWOFPUBLIC.S MY Permit No. �O 9/ BOARDOFFIREPREVEWONRE UL4Tl0W5270W?ZZ-60 Occupancy&Fees Checked VAPPUCATTONFOR PERW TO PERFORM FT, =CAL WORK ALL WORK To BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date_ Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) CJ' Owner or Tenant 410-L4 Owner's Address cS C-"-kms_• Is this permit in conjunction with a building permit: Yes Q No (Check Appropriate Box) Purpose of Building � _ �� Utility Authorization No. VA� Existing Service &C) Amps� /��Volts Overhead �� No.of Meters New Service � Amps / volts Overhead MUndervound Q No,of Meters Number of Feeders and Ampacity 3 /o„ Locatir)n and Nature ofProposed Electrical Work' /t"C> } No.of, ighting Outlets No.of Hot Tubs No.ofTranstbmias Total No.of Lighting Fixtures swimming Pool Above BelowGeKestars. K VAground ground . KVA No.of Receptacle Outlets No.of 00 Burners Na of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.ofZonft Tons No.of Disposals Na of Hen Total Total Na afDeteetionaad pumps Te6s KW btitiniog coon s Jo.of Dishwashers Space Ane*Heating KW Na of Sonudina Devices Na ofSWCoatoined to.of Myers Heating.Devices KWL��gDevkes i Municipal Other Vof Water Heaters KW No.of Na of Connections Si Bailasis o.Hydro Massage Tubs No.of Motors Total HP tattroC Attsttattbthe�gtiar��Crataailau►s . eacnett1iabi6lylnsiratoe cyitdtidng YES NO e �aGdpoofafsareb Y0 NDpi* ff}wl�edtadaBdYE�pirrsci t�fypcafm►r 4thmEngec 1R�ti E BOW (lRf FR (f seSpr�a�yj . . E*A"VAX0MKl"WakS (NAME �' ��b z r'� �/IG�ti Z- LiomseNa _„=L Bttsir>tssTd Na 4P?d/ (7 5 AIL TdIsh EFTSRsSURANCEWAIVER;Imaw mhattbeLxmsed3LgghMlbetmraneco►aWcrAs egmdmtasMpWb?' sftGt alLaws tmysgrmkw, titaspwntwpLctmwaitstbi.mw,t>3mt. .e check one) Owner � Agent Telephone No. �� PERMIT FEE$ Date.. . . .. . . . .. . . .... . . .. s NpRTM pF 3j TOWN OF NORTH ANDOVER p P • PERMIT FOR GAS INSTALLATION SACMUSEt This certifies that Ir. . . . . .�.. . . . . r ! . .�. :.�. . . .�. . . has permission for gas installation . _ . . . . . . . . . + in the buildings of . . .. . . . . .. .0 . A4. . . . I. _. . . . . . . . . . . . at . . . . . . . . . . . . .J North Andover, Mass. Fee..!�l. . .}Lic. No.. 1.�. .�. . . ,. . . . . . . . . . . . . . .SPECTOFi Check# �� J MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) jot 4 • �&/L—LAeAl' . Mass. Date A2Qy I ZX3 Permit # Building Location— f✓ ? 45 Owner's Nam �j///z iw JZ9 W--4 1U7 _Type of Occupancy ESI -1--')CN 71 11 New ❑ Renovation ❑ Replacement Plans Submitted: Yes❑ No p N y W y Y = W y y tL N Q O Z N = W J y W 0 0 m E � _ •Jl 2 o u ►' < _ O r W < m y t- y u¢i 0 0 4 ¢ tr 4 N 0: W Z V W y W < cc t0— C f• S W W y J < W O ¢ Uj> {� }W. U J iA tt 2 < W ' < C ~ t- >. y m 2 0 2 O N S < W > W O 2. < Q < t O O W O W H re C9 16 �. B .d 1 V C > O m H O SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR , STH FLOOR Irt;taliing Company NameCjAe Z T A . :SAM MAT r)r C'' Check one: Certificate Address 3 C'DA C H m/-�ry `f�. ❑ Corporation n1 E 7 H U E tJ Al ra U ❑ Partnership Business Telephone &92 —9 9"7 f 2--'Firm/Co. Name of Licensed Plumber or Gas Fitter "Ro j E r.T A- j A M m r9 TA P(-� INSURANCE COVERAGE: I hive a current I' bility 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 coverage by checking the appropriate box 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 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 [3 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 installations performed under the pe i ued for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner Laws. BY T of License: C� *erber n ure of Licensedu _, or Fitter Title tter License Number M-2) City/Town neyman TO-9 IC r VS E ONL