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160 FOSTER STREET
__�__ -2101104_D-0025-0000.0
MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723-3800 Ma Only(800)392-6108. FAX(800)851-8424
5/3112006
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.313
RECEIVE®
NORTH ANDOVER HEALTH DEPT.
JUN - 6 2006
NORTH ANDOVER TOWN HALL TOWN OF NORTH ANDOVER
NORTH ANDOVER MA 01845 HEALTH DEPARTMENT
Re: Insured: KENNETH E. LINDAUER& ELAINE FINBURY
Property Address: 160 FOSTER ST, NORTH ANDOVER, MA 01845
Policy Number: 0756806
Type Loss: Water Damage
Date of Loss: 05/29/2006
Claim Number: 230541
Claim has been made involving loss, damage or destruction of the above captioned propert,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 the
attention of the writer and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
MPIUA Claims Division
CMA00021
Address /166 _ Y Title of File Page of
Date File Open: Date file closed:
Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes
action Document/ document/
filum• Action Department
Board of Appeals — Board of Health — Planniing Board — Conservat on Commission — Building Departrment
G_
,oard of Health
:1ar+,3: :�ndover,2Sas'a• _
sUBsOFACE DISPOSAL DFMGN CHECK LIST f.,�•S�NOEG
-LOT F�.S/" e sr
APPRCNID DATE DISAPPROM DATE
Provided easonsl
V
Title FAIL CK �.
The submitted plan roust show as a n n�m=l
Reg e V
a) the lot to be served-area,d�ensians lot ,abutters
blocation and log deep observation hoes-distance to ties
c location and resents percolation tests-distance to ties
d design calculations & calculations showing required leaching area
(e) location and dimensions of system-including reserve area
f) existing and proposed contours
(g) location any tint areas thin 100' of sedge disposal system or
disclaimer-check wetlands mapping
(h) surface and subsurface drains within 100' of sewage disposal
system or disclaimer
(i) location any drainage easements within 1D0' of seiage disposal
system or disclair-er-Planning Board files
(j) kno= sources of meter supply vithin 200' of Be 6 di al e _
system or disclainer
_- (k)- location of any. -propssed well to serve 10t-100!fYnm_ hin
leacg facili-
(1) location of meter lines on property-10' from leaching facility
(m) location of benchmark
(n) drive-ways
(o) garbage disposals
(p) no PVC to be used in construction
(q) profile of system-elevations of basemsnt� plumb, pipe, septic tank,
distribution box inlets and outlets, distribution field piping and
Other elevations
(r) maA=m ground imter elevation in area se-wage disposal system
(s) plan must be prepared by a Professional R gineer or other
professional authorized by lax to prepare such plans
Reg 6 Septic Tanks
(a) capacities-150% of flog, water' table, tees, depth of tees,
access, pining
(b) cleanout pool
(c) 10' from cellar v-a11. or in.groim s --ng
(d) 25' from subsurface drains
Reg 10.2 Distribution Faxes
(a) s ape greater than 0.08
Reg 10.4
i n
t Dec ,1.? ,19``!�
:Susan. Crandall
cam: 160 c+oster t
160 Foster St/, _ -- — .
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'dam , No.Andover,Mass ., _ _>g� t _�: _
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��' � ' �K Dear Ns. C 'randall i
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f7• Ls ., neVf septic tank a.11��. `�J^�� J�jtl��1.~� oot Leac{?
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was constructed ui�c.,�r t �c �;r,p�rciv it 03- Z s o": ;�cc.
4njk �5+ The1nStall> t2 "! �� )�?C?c3].c?c.; s3t' sfactory , tn(.,
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kt5 ti
r ..' S(311 CGi'tt :1 t:; ons Geer ('.ouoC•. t'iuio :"i:1 C. eoi- :iIt:'.%
Tt ;?IUs:. b not'.,Ci t flat: t"I'tea so!)t..-_C.
Yui p!� •... I .. -
system was iatc".fli'L'r` to ip1
dwelling
Very
:iCi 3el
Insrector
12-16-FS Nd re7,- Lfit
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