HomeMy WebLinkAboutMiscellaneous - 1011 GREAT POND ROAD 4/30/2018W �
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BOARD 017 I-IEALTH
146 MAIN STREET
TELEPHONE# (508) 688-9540
APPLICATION FOR ABAADOVIfENT
OF SUBSURFACE DISPOSAL SrSTI,Af
(SEPTIC SYSTEM)
Pursuant to Section 310 CMR 13.354
of the State Environmental Code, Title V
Name 7\4r k
Address ID l( e',
Contractor hired for work:
Name
Address
Phon
Date for scheduled abandonment ?z 1 �
The septic system at the above address1as been ab ed according to
Title V specifications. ,^ '
ontractor
Method of septic tank abandonment (check one). O removal O sandfill
(C) crush ( ) other
Name of Offal Hauler 1& 10 C�'q
This form must be returned to the North Andover Board of Health.
PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH
REPRESENTATIVE'S USE ONLY.
Inspecting Agent Date
. � ��
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Alan K. Venus &, Company, Inc.
TIM
Property & Casualty Adjusters
(603) 883-1882 G Established 1982 ,
Fax (603) 595-7728 T` (617) 426-3036
Fax (617) 426-3039
New Hampshire Massachusetts
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH.,139, SEC. 3B
TO: BUILDING COMMISSIONER or BOARD OF HEALTH or
INSPECTOR OF BUILDINGS BOARD OF SELECTMEN
City/Town Hall City/Town Hall
North Andover, MA 01845 North Andover,,;'MA 01845
INSURED: Mark DiSalvo
PROPERTY ADDRESS: 1011 Great Pond Road
North Andover, MA 01845'
POLICY NO: HP0249687
LOSS OF: 3/24/93
FILE OR CLAIM NO.: 93ABI13379
Claim has been made involving loss, damage or destruction of
the above captioned property, which may either exceed $1,000
or cause MASS. GEN.. LAWS, CHAPTER 143, SECTION 6 to,be
applicable. If any notice under MASS. GEN. 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.
President
Title
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.
LbIqP,
Signature and Dat
P.O. Box 458 Suite 610
Windham, New Hampshire 03087 31 Milk Street
Boston, Massachusetts 02109
air G•��,tg �. ,
.. '4g 87.54 •
GRE7AT POND ROAD
NOTE: I HEREBY CERTIFY THAT THE PREMISES
SHOWN ON THIS PLAN ARE NOT LOCATED WITH-
IN THE FLOOD HAZARD AREA AS DELINEATED
ON THE MAP OF COMMUNITY N0.250098B.-Nn.
MASS. EFFECTIVE Vine 15', ! 9e3
BY THE DEPARTMENT OF HOUSING AND URBAN
DEVELOPMENT -FEDERAL INSURANCE ADMINISTRATION
This plot plan was not mode from an instrument survey end is drawn for the use
Of the mortgegee, for mortgage purposes only.
179.79
_MORTGAGE PLOT PLAN
Location NORTH' .:AND_0WR-
Scale 1 in. = 60 ft. Date 001.91 1985
Plan reference: Being tot 8 on a plan_
by Bros.seur Associates, Surveyor .
dated August . 21 t 1964 Recorded
in the Lunj Court Pion 16'728
filed witt cert, 5725 , Bk
SELWYN & KIRWIN ASSOC., Land SiAryeyors
14 Linden Avenue, Belmont
I hereby certify that the building shown on this
plan is located on the ground as shown thereon
and that it conforms to the zoning and building
laws of the towr, of No rt h Andover
H,hen construVted and t t 'ct' ns on record