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HomeMy WebLinkAboutMiscellaneous - Exception (114)I MetLife Auto & Home® Homeowner Operations Field Claim Office Attention: Claims P.O. Box 6040 Scranton, PA 18505 (800)854-6011 January 22, 2016 North Andover Building Inspection 1600 Osgood St, Suite 2035 North Andover, MA 01845 Our Customer: Bruce G. Appleton & Xu Gong Claim Number: JDF70582 BL Date of Loss: January 7, 2016 Dear North Andover Building Inspection: Pursuant to M.G.L. 139 § 3B, please be advised that a property loss at the address referenced below has been estimated to have damage to the dwelling or other structures that will exceed one thousand dollars. Please let us know within ten (10) days if there is a pending or existing lien against the property as provided by M.G.L. 139 § 313, or if there is an intent to initiate proceedings to perfect such a lien. Loss Location: 23 Edgelawn Ave Apt 4, North Andover, MA Sincerely, Michael Laws Metropolitan Property and Casualty Insurance Company Senior Claim Adjuster (800) 854-6011 Ext. 7442 Fax: (866) 531-9732 Email: mlaws@metlife.com MetLife Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its affiliates, Warwick, RI. MPL MA-REGDEPT Printed in U.S.A 0698 E'VECTR/C INSURANCE '�mm, '0Mwy July 30, 2012 Building Commissioner or Inspector of Buildings Town Hall North Andover, MA 01845 RE: Insured: Alejandro Orozco Property Address: 23 Edgelawn Ave, Apt. 2, North Andover, MA 01845 Claim Number: 2012073006901 Policy Number: 63066411-11 Date of Loss: 07/17/2012 Form of Notice of Casualty Loss to Building Under Massachusetts General Laws Chapter 139, Sec. 3B Claim has been made involving loss, damage or destruction to the above captioned property, which may equal or exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct to the attention of the undersigned and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. On July 30, 2012, copies of this notice were sent by first class mail to the entities and addresses noted herein. John. Bachmann Claims Specialist Cc: Board of Health or Board of Selectmen Town Hall North Andover, MA 01845 Fire Department or Arson Squad Town Hall North Andover, MA 01845 75 Sam Fonzo Drive Beverly, MA 01915 800.227.2757 www. Electricinsurance.com Date ....��!.�k. ...... 6 TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION s + h �9SSACMUSESS R This certifies that ............ . ............. . i has permission for gas Inst llation in the buildings of c�11 Q �r , ,!%�Ii'% ........ North Andover, Mass. Fee L'U . Lic. No.g3,3.3.. .......................... GASINSPECTOR it Check #6 44840 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print %A Type , o .wMass. G Building New p Renovation p Z^^qunit # ers Name !� _ Type of Occupancy I� EsI i ---)civ -ri rq Replacement Plans Submitted: Yesp No p Installing Installing Company Name M Al T A r 01 Check one: Certificate Address 30 06A C H ih A ry 'i -NI, p Corporation M E T H U E 0 01 A D ($ ❑ Partnership Business Telephone 1a �92 –5 (7 -7 f 2--'Firm/Co. Name of Licensed Plumber or Gas Fitter 'f r) O E P T A - 5A m m H A Pc-) -- INSURANCE COVERAGE: I have a current f}�bility Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes lad' No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability insurance policy Other type of indemnity p 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: Owner❑ Agent ❑ Signature of Owner or Owner's Agent 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 ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ne Laws. By. T of License: GZ�' Plumber 1,Wnbtfure of Ucbnsed PlumMror Gas Fitter Title tter 9er License Number �33� CAy/Town Journeyman O IC —ON–LYi— a Y .. MOSSES Installing Installing Company Name M Al T A r 01 Check one: Certificate Address 30 06A C H ih A ry 'i -NI, p Corporation M E T H U E 0 01 A D ($ ❑ Partnership Business Telephone 1a �92 –5 (7 -7 f 2--'Firm/Co. Name of Licensed Plumber or Gas Fitter 'f r) O E P T A - 5A m m H A Pc-) -- INSURANCE COVERAGE: I have a current f}�bility Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes lad' No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability insurance policy Other type of indemnity p 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: Owner❑ Agent ❑ Signature of Owner or Owner's Agent 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 ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ne Laws. By. T of License: GZ�' Plumber 1,Wnbtfure of Ucbnsed PlumMror Gas Fitter Title tter 9er License Number �33� CAy/Town Journeyman O IC —ON–LYi— a LU W S U lu W Y N z O F- U W N 2 J • z u. 'a ml O z• N O O G O r � O W Z d ' Q O W z O F V J � o. d W W W i LU W S U lu W Y N z O F- U W N 2 J • z u. 'a ml