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HomeMy WebLinkAboutMiscellaneous - 75 SECOND STREET 4/30/2018 (2)f - r 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: Property Address Policy Number: Date/Cause of Loss File or Claim Number: John & Lucy Licciardi 75 Second Street HP0646792 8/28/2011, Wind Damage to Roof 25228-B 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. Bobby Keeser 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. Signatur and Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Location 175 No. a�5 / ? Date 6 �7 �aCe- TOWN OF NORTH ANDOVER irtificate of Occupancy $ iilding/Frame Permit Fee $ iundation Permit Fee $ her Permit Fee $ sewer Connection Fee Water Connection Fee e C�+p,EQ` / Building Inspector I p,L Div. Public Works N I x I i2b 9S O N z k © o y� � ❑ F k Q x a E K p A w C a F O 5 ❑ d G'y cnO ❑ O d a rn a v 'e a c w w w a zu U z C C c O O O O O O cz O C Ln O O O Ow O w Z Z 'A F C .❑ C a O z w w C O w a O Q ^W N n. Z M ti rn ❑ ❑ q w <n v F� rO O a ° z 4 F� F Qj k" > z c F W O C c`nzi C F O d e W w C Z G z G � � ❑ C Er rn F• Z d Q Q C O 0-11 � 09 N ci I O o ❑ -= ❑ ,.� c 0 CC I � O O � c o z a G F U CC w r G i .�.7 d i p � x Kj C Li vwi rn a � d z z 0 z O U U v z A � O d � � c c V O O C L W 0-11 � 09 N ci I O o ❑ -= ❑ ,.� CO CC I � O O � c o z a G O w E W Z G7 U CC w r G i .�.7 d i p � x Kj C Li vwi rn a � d z 0-11 � 09 N ci I O O ❑ ,.� CC � O w W U CC w r z z 0 0 O U U � C \ W N ci I O O ❑ ,.� CC � O W CC w r � ci I O ❑ ,.� p W 5 r North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number o�SS& is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (Location of Facility) Cd Signatu e of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I I r I Cl) m a] U) 0 m CO) 10 CD 0 Z O O CL r d O � n� o p CDQ cr c CD O d 0 Cc CD c CD CD COP) O CO) 'C7 C9� c O c CO) IM n CD 0 PF CD CD Cn* CD CA CD a cmG CD Vt W.dMftft r to I C A a IN • N O � y = aO 5.m � � O C C, m C7 y m _Q=0 mm ? -o y "•I � a -• a o m O CD N O N O ® Ca © nj n O�� O '•► O ZS.0 O N C9 • CD CD O N a m Co CO) d CLom: d C co a rD co y m 1 y CD O .n0... G n O W O : CO _ 41 � O ' CD O�:� <➢ . C .D . = m ^ • W y 1 Ow O : Q O � O CD d d y O C O ce �� cn p 0 cn 0 C/)c ?fof y V1 r � N -D n � O m Cf) p GQ -oil 0 co ca 0 C �t p x r) c nw n t -ll 2 IN • N O � y = aO 5.m � � O C C, m C7 y m _Q=0 mm ? -o y "•I � a -• a o m O CD N O N O ® Ca © nj n O�� O '•► O ZS.0 O N C9 • CD CD O N a m Co CO) d CLom: d C co a rD co y m 1 y CD O .n0... G n O W O : CO _ 41 � O ' CD O�:� <➢ . C .D . = m ^ • W y 1 Ow O : Q O � O CD d d y O C O ce �� cn p 0 cn 0 C/)c ?fof y V1 C w N -D n � O m O -0 O IN • N O � y = aO 5.m � � O C C, m C7 y m _Q=0 mm ? -o y "•I � a -• a o m O CD N O N O ® Ca © nj n O�� O '•► O ZS.0 O N C9 • CD CD O N a m Co CO) d CLom: d C co a rD co y m 1 y CD O .n0... G n O W O : CO _ 41 � O ' CD O�:� <➢ . C .D . = m ^ • W y 1 Ow O : Q O � O CD d d y O C O ce �� cn p 0 cn 0 ?fof y z w cn n � O w O -0 O p GQ -oil 0 zd C) 0 C �t p x r) O O y n v H 0 0 c