HomeMy WebLinkAboutMiscellaneous - 24 MARBLEHEAD STREET 4/30/2018NSC
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PUBLIC HEALTH DEPARTMENT
Community Development Division
February 20, 2008
Ms. Donna Backman
291 Massachusetts Avenue
North Andover, MA 01845
Re: Sewer Back -W at 24 Marblehead Street, North Andover, MA
Dear Ms. Backman:
This letter is in response to your concerns raised regarding your parents property at 24 Marblehead Street. In
addition to your letter I have received a copy of a letter sent to you from Tim Willet of the North Andover DPW. In
this correspondence, Mr. Willett has detailed the procedures that you must take to assist your parents through this
difficult time.
I am not aware of the causes for the delay in this case; therefore it would be remiss of me to comment on them,
however I am concerned for the health of your parents. The Health Department often assists homeowners with
questions regarding sewage back ups and clean ups after floods in order for residents to protect themselves. For
your convenience I have enclosed a fact sheet that has helped others face challenges such as those your parents face.
In closing, please note that the Health Department has no jurisdiction in this private matter between the Town and
the homeowners, however if you have any health specific questions, we would be glad to assist you.
Sincer,
usan Sawyer HS/
Public Health Director
Cc: Tim Willett, Water & Sewer Superintendent
Enc: Clean up Fact Sheet
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com
Mass DEP :: MA DEP Stormwater: Flooding and Sewage Back-ups Home Care G... Page 1 of 4
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Flooding and Sewage Rack -ups: Home Care Guide
Background/Introd uction
Water, Wastewater s Wetlands This document has been jointly prepared by the Massachusetts Department of Public Health
priorities & results Division of Community Sanitation (DPH), and the Massachusetts Department of Environmental
Protection (MassDEP) and is intended to provide guidance to the general public relative to
drinking water managing pathogen risks from direct contact with floodwaters and/or sewage backups.
water resources & wetlands
:t wastewater & septic system
laws and rules
laws
regulations & standards
policies & guidance
permits, reporting & forms
grants & financial assistance
compliance assistance
enforcement
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Cleanup of Sites µ& Spills < a
Service Center o \'
Calendar
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Online Services
Regional Offices
Report Pollution
It is important to note that during and following flooding events, dangerous and even life-
threatening hazards may exist, and the public is strongly urged to contact local and state
emergency management officials for instructions on the procedures or actions necessary to
safely avoid injury during these conditions.
This document is not intended to directly address these public safety issues (such as risks from
accidental electrocution from flooded basements or downed power lines). Additional information on
the public safety hazards associated with floodwaters can be found at the Massachusetts
Department of Public Health, Red Cross and Federal Emergency Management Agency and
Massachusetts Emergency Management Agency websites.
Pathogens are disease -causing agents, which can be in the form of bacteria, viruses, mold spores,
or protozoans, and which are normally present in large numbers in sewage wastes. The nature and
extent of potential pathogen risks of sewer backups and floodwaters will depend in large part on the
potential contaminants expected to be in the waters. In general, the greater the extent of the
sewage component, the more likely the potential for adverse impacts, and the more important the
proper cleanup of the materials that have come into direct contact with the contaminated waters.
The severity of the health threat therefore depends on the source of the water and the extent of
penetration into the building environment. The extent of penetration is dependent on the porosity of
contaminated materials, the quantity of floodwater, and the amount of time the water remains in
contact with materials. Even floodwater or stormwater which has not been directly impacted by
sewage discharges is likely to contain a wide variety of microbiological organisms (e.g., from animal
wastes, street runoff, etc.) and must be properly managed. Some of these pathogens, such as mold
spores, can even establish an ecological niche and present a health risk from chronic exposure for
some time after the event. Preventive measures, and proper cleanup procedures are essential in
mitigating the risk of infection; this guidance is intended to assist the public in these actions.
MassDEP and DPH recognize that flood conditions can occur in any watershed during severe wet
weather events. The potential for, and extent of, flooding depends on many factors, including:
topography, flood storage capacity, the extent and location of development, infrastructure
constraints, and, of course, on the severity of the storm event. MassDEP, through implementation
of its Combined Sewer Overflow Abatement program and Sanitary Sewer Overflow Abatement
program, continues to require infrastructure improvements to mitigate the potential for untreated
wastewater to be discharged during wet weather events. MassDEP also has implemented a
Stormwater Policy which provides for performance measures to control stormwater pollution and
peak flow rates for projects subject to the Wetlands Protection Act, Infiltration/Inflow Control
Guidelines and Illicit Connection Initiative (sewers connected to separate stormdrain systems).
While these programs are important in managing the risks from exposure to floodwaters, some risk
will always remain, especially for low-lying properties during and following extreme storm events.
As such, MassDEP has collaborated with DPH to develop guidance for the public who may be at
risk to flood conditions. This Guidance includes suggested actions before and after flood events to
minimize the public health risk and property damage. In all cases where flood conditions are
expected or occur, the public should always remain in close contact with public safety officials as
well.
http://www.mass.gov/dep/water/laws/flooding.htm 2/20/2008
Mass DEP :: MA DEP Stormwater: Flooding and Sewage Back-ups Home Care G... Page 2 of 4
Prevention:
If a home is located in an area subject to periodic flooding (such as in a floodplain) or where
sewage backups have occurred, the homeowner should implement "all feasible measures" to
prevent/minimize the nature and extent of impacts from such situations. Such actions can be
preventive or pro -active.
Preventive actions include
1. waterproofing the building foundation and/or sealing cracks in,foundation floor or walls;
2. installation of a check valve or shut-off valve on the building sewer close to where it enters
the structure, which will protect your home from sewage back-ups due to surcharging
conditions in the municipal sewerage system (you must check with the proper sewer
authority prior to taking this action!!); and
3. raising or removing any sink, toilet, washing machine, etc. in the basement that may be
subject to backups when the sewer system surcharges.
Pro -active measures include:
1. purchasing or installing a pump (e.g. sump pump) to pump out water that collects in the low
point of the basement or structure;
2. ensure that building gutter downspouts and drains are directed away from the foundation
and toward low points away from the home;
3. to the extent possible, keep furniture and valuables above flood levels where flooding has
previously occurred; and
4. if minor flooding occurs, follow the water to its point -of -entry and seal cracks or defects to
the extent possible.
Remember, an ounce of prevention is worth more than a pound of cure. Flood insurance is also
vitally important where properties are known to be in floodplains or flood prone areas. More
information on prevention and flood insurance is available on the FEMA website.
Cleanup of Internal Areas
Once the flood waters have receded and the property can be accessed safely, cleanup operations
should commence - Remember to check with local emergency management officials before
returning to a property affected by flooding! The most important steps are to restore the
environment to a dry state and salvage any valuable property. The longer that water/waste are
allowed to remain in your home or on your property, the greater the potential for illness and
irreparable damage to your home, its contents, and environs. Where they may be operated safely,
use of pumps and dehumidifiers will be helpful in restoring dry conditions. In any flood cleanup
project regardless of the source, one should assume that pathogens are present and take
appropriate precautions.
The survival of pathogens depends on a number of factors: location (indoors vs. outdoors), season,
type of surface contaminated, whether disinfectants are used, and also on environmental
conditions such as humidity, temperature, and sunlight. Sunlight (UV radiation) reduces the
survival rate of pathogens with numbers decreasing rapidly with increasing exposure to UV
radiation. Mild temperatures and higher humidity in external situations result in longer survival
times.
Prior to undertaking cleanup efforts, take proper precautions:
• Always wear protective gloves, eyewear, and boots. Rain gear is also advisable.
• Avoid direct contact with sewage material, and be particularly careful of your face and eyes.
Goggles are recommended when using a hose and/or any chemicals.
• Protect all cuts and scrapes. Immediately wash and disinfect any wound that comes in
contact with sewage.
The following steps should be taken to mitigate the microbial risk from a building contaminated with
sewage:
? Any excess water should be removed from the property by pumps, wet vacs, or mopping.
iDehumidifiers and active ventilation should also be used when available.
U s ,M_
http://www.mass.gov/dep/water/laws/flooding.htm 2/20/2008
Mass DEP:: MA DEP Stormwater: Flooding and Sewage Back-ups Home Care G... Page 3 of 4
• All solid waste should be collected and disposed.
• All upholstered furniture and mattresses should be discarded, other contaminated furniture
should be removed and cleaned or discarded.
• The affected areas should be washed with a detergent solution to remove sewage -related
contamination, then disinfected and allowed to dry.
Sort damaged contents to be repaired or discarded. Use the following guide relative to discarding
of household material and furnishings.
Usually Discard
Foam rubber
Large carpets
Books and paper products
Always Discard
Food
Cosmetics
Medicines and medical supplies
Stuffed animals
Toys
Mattresses and pillows
Upholstered couches and chairs
Carpet padding
Cardboard
BE CAREFUL
• Assume anything touched by sewage is contaminated.
• Clean and disinfect everything sewage has touched.
• Always wear protective rubber gloves, eyewear, and boots and be especially careful if you
have cuts or open sores.
• Wash, disinfect, or discard any clothing and supplies immediately after use.
Disinfection
Disinfectants are typically chemical agents that reduce significant numbers of pathogens to levels
below those expected to cause disease. Cleaning and disinfection are two different processes.
Cleaning removes the dirt. The processes of disinfection and decontamination are important to
ensure the elimination of pathogens and organisms that were contained in the sewage or that grew
during the period of contamination. Even concrete can be colonized and broken down by
microorganisms if it is allowed to remain wet and contaminated by organic matter. Many household
products are capable of disinfecting surfaces and should be used in accordance with
manufacturer's label directions. A household bleach solution is also an effective disinfection agent,
and can be made by combining one quarter cup of household bleach to one gallon of water. Bleach
should never be used directly without dilution since, in this concentrated form, the bleach can
cause severe skin and respiratory hazards.
To prepare surfaces for disinfection, wash surfaces first with warm soapy water and rinse surface.
Apply the disinfectant solution to all areas of the affected surface, and allow for sufficient contact
and drying time.
When proceeding with cleanup operations, remember that those individuals whose immune
systems are in some way compromised or who are otherwise susceptible due to age, medication,
or underlying illness, are considered to be at greater risk of contracting infections than those
individuals who are healthy.
If you decide you that you need professional help:
• Look under "Carpet Cleaning", "Fire Restoration", or "Mold Abatement" in the telephone
book. If you hire cleanup or repair contractors, be sure they are qualified to perform the job.
Always check references and ask whether they are insured. Certification for these
companies is not currently required or available in Massachusetts.
• Contact your local emergency management officials, to determine if there are resources
available for assistance, or to get referrals for qualified contractors.
http://www.mass.gov/dep/water/laws/flooding.htm 2/20/2008
Mass DEP :: MA DEP Stormwater: Flooding and Sewage Back-ups Home Care G... Page 4 of 4
More detailed information on cleaning up after a flood event can also be found on the Red Cross
website.
Cleanup of External Areas
The majority of the microbial population from sewage flooding onto lawns, tarmac and paved areas
will be inactivated within several days due to exposure to UV radiation from sunlight. A disinfectant
can be used on tarmac and paved areas. Contamination on grass could be left to degrade
naturally. Typically, bacterial numbers on turf are reduced to background levels expected in the
environment within 13 days, but can extend to 20 days on soil and sand in the autumn and spring.
Generally, the least absorbent or pervious surfaces absorb the least sewer and bacterial
concentrations and return to background levels the quickest.
References/Otber Sources of information
Protecting Your Home from Flooding, FEMA, 1994
Repairing Your Flooded Home, FEMA -234, 1992
Flood Emergency and Residential Repair Handbook, FIA -13, 1986
Retrofitting Flood -Prone Residential Structures, FEMA -114, 1986
Protecting Building Utilities from Flood Damage, FEMA -348, 1999
To obtain copies of these and other FEMA documents, call FEMA Publications at 1-800-480-2520
Information is also available on the World Wide Web: Web site
Other Internet Links
Red Cross - Repairing Your Flooded Home
FEMA - Preparation & Prevention
FEMA - Floods
MA Department of Public Health - Storm Fact Sheet
Disclaimer:
The information provided is based on research and input from experienced professionals. The
reader must assume responsibility for adapting this information to local conditions. This document
should be used as a guide and is not intended to replace the advice and guidance of experienced
professionals and public health officials who are able to view a home and assess the needs of the
particular situation.
Contacts • Feedback • Related Sites • Site Policies • Help
Mass.Gov • Energy & Environmental Affairs • Department of Environmental Protection
http://www.mass.gov/dep/water/laws/flooding.htm 2/20/2008
Page 1 of 1
DelleChiaie, Pamela
From: Sawyer, Susan
Sent: Wednesday, February 20, 2008 12:13 PM
To: DelleChiaie, Pamela
Subject: Marblehead letter
Can you finish this for me? thx
Dear Ms. M,
This letter is in response to your concerns raised regarding your parents property at Marblehead St. In addition to
your letter I have received a copy of a letter to you from Tim Willet of the NA DPW. In this correspondence Mr.
Willett has detailed the procedures that you must take to assist your parents through this difficult time
I am not aware of the causes for the delay in this case; therefore it would be remiss of me to comment on them,
however I am concerned for the health of your parents. The Health Department often assists homeowners with
questions regarding sewage back ups and clean ups after floods in order for resident to protect themselves. For your
convenience I have enclosed a fact sheet that has helped others face challenges such as those your parents face. In
closing, please note that the Health Department has no jurisdiction in this private matter between the town and the
homeowners, however if you have any health specific questions, we would be glad to assist you.
Sincerely,
Susan Sawyer, REHS/RS
Public Health Director
Cc: Tim
Susan Sawyer, REHS/RS
Public Health Director
978 688-9540
2/20/2008
TOWN OF NORTH ANDOVER
DIVISION OF PUBLIC WORKS
384 OSGOOD STREET
NORTH ANDOVER, MASSACHUSETTS 01845-2909
Timothy J. Willett
Superintendent of Water & Sewer
February 11, 2008
Ms. Donna Backman
291 Massachusetts Avenue
North Andover, MA 01845
RE: Sewer Back-up
24 Marblehead Street
Dear Ms. Backman:
BRUCE D. THIBODEAU, P.E.
DIRECTOR
Telephone (978) 685-0950
Fax (978) 688-9573
I am in receipt of your letter dated February 6, 2008 regarding a sewage back-up at 24 Marblehead
Street. However, I disagree with some of its contents.
In general, when a homeowner suffers damages due to a sewer back-up, we inform the homeowner they
can file a claim at the Town Manager's Office at 120 Main Street. Once a claim has been filed by the
homeowner at the Town Manager's Office, the town's insurance agency will generate a response some
time thereafter.
On Tuesday, November 13, 2007, I went to 24 Marblehead Street as a follow-up inspection from the
problem 2 days prior. Joseph Medolo came out to talk with me. I informed him he could file a claim
for damages at the Town Manager's Office at 120 Main Street. I told him he would have to document
the damages and get estimates to clean the cellar. I asked him how sewage entered the home and he
told me the cap blew off.
Since Joseph Medolo is the homeowner of 24 Marblehead Street, we followed the correct procedure for
sewer back-ups affecting homeowners. I do not know if Mr. Medolo filed a claim our not, but this is
the only way to start the process of seeking compensation. If he has not filed a claim yet, he should do
so immediately. I am returning the documents from the Fire Dept and Certuse Adjustment, they should
be attached to the letter when Joe Medolo files a claim.
Very truly yours,
Timothy J. Willett
Water & Sewer Superintendent
February 6, 2008
To Whom it may concern,
RA—CINE®
FEB 1 2 2008
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
I am writing to the town of North Andover on the behalf of my parents
Joseph and Irene Medolo.
On November 11, 2007 the town sewer pipes backed up ... my parents
home was flooded with raw sewerage.
The town promptly power flushed the pipes checked their home and
said that they should call for help getting the house cleaned.
We called Service Pro they wanted $2,000.00 up front money that my
parents just did not have .... the town did not return my phone calls for
help nor did they even offer to send out a representative of the town
insurance agency get their home clean.
It is now past 90 days and the town has yet to help in anyway.
I am sending you the copies of the police and fire department
reports proving the incident.... and the only bit of coverage that their
home owners coverage will provide.
I am ashamed at the lack of respect that you have given this matter
would you want your family to live like this.
Send help to 24 Marblehead Street, HOME of Joseph and Irene
Medolo
7onna
ctfully
"Backman�/-
291 Massachusett Avenue
North Andover, MA 01845
978-683-0622
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North Andover Public Safety
Dispatch Incident Detail
Printed: 11/26/2007 15:32 Printed By: jburke
CAD Incident No: 2007000025234 Police Incident No: Fire Incident No: 2007000004267
How Reported:
Telephone
Reported Type:
FD - Water Problem
Received Date:
11/11/2007 12:29:21PM
Priority:
High
Dispatched Date:
11/11/2007 12:29:46PM
Call Taker:
No Entry
Arrived Date:
11/11/2007 12:35:53PM
Shift Supervisor:
No Entry
Cleared Date:
11/11/2007 1:00:43PM
Reporting Officer:
Lieutenant/EMT Weir, John A
Active Date:
11/11/2007 12:29:21 PM
Dispatchers:
Communications Officer Burke, Jo
Domestic Violence: No
Communications Officer Gravel, JE
-- --- - - - - - - - -- - -- - ----- -- -- ------
Nature:
-- -- -----------------------------------------------------------------------------------------------------------------------------------------------------------------
FD - Water Problem
Police Response:
No Entry
Landmark:
Fire Response:
No Entry
Incident Address:
24 Marblehead Street, North Andover, MA 01845
Action Taken:
FD Incident Only
Sector:
Stat. Area:
Incident Types:
FD - Water Problem
Sub Stat. Area:
Census Tract:
- - - - - - - - - - - - -- - - - - - - ---------------- ------------ -- ----------------------------------------------------------------------------------------------------------------------------------------------
Caller Seq. # Caller Name Caller Address
Caller Phone
No caller information
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
recorded.
Other Involved Persons:
Name
Address
Telephone Involvement
No other involved
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
persons recorded
Business Name
Business Address Business Type
Business Phone 1 Business Phone 2
No Entry
- - -- - - - - - - -- - I - -- - - ----------
No Entry No Entry
----- --------------------------------------------------------------------------------------------------------------------------------------------------------------
No Entry No Entry
Police Alarm ID
Police Alarm Description
No Entry
-------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
No Entry
Fire Alarm ID
Fire Alarm Description
No Entry
----------------------
---------------------------------------------------------------------------------------------------
-----------------------
Structure ID
Structure Name Structure Address
No Entry
No Entry No Entry
Units Assigned
Personnel
E1
Lieutenant/EMT John A
Firefighter David T Heb(
FIREFIGHTER Ryan J -
Vehicle Make Vehicle Model Plate No Tow Type Tow Business
... .-.-.--------------------- --- - ----- --------------------------------------------------------------------------------------------------------------------------------------------------------------
Dispatcher Remarks
2007/11/11 12:29 Gravel, James 551 WATER PROBLEM. DPW NOTIFIED AND RESPONDING.
2007/11/11 12:37 Gravel, James 551 P-11 REPORTS DPW ON SCENE.
2007/11/11 13:00 Burke, John 526 ENGINE 1 REPORTS DPW HAS CLEARED AN OBSTRUCTION IN LINE. PROBLEM RESOLVED.
ENGINE 1 RETURNING.
Call Taker Remarks
No Entry
Page 1 of 1 DIFormSingle v3.6.1/CR10 Rev. 04/15/07
c^
CERTUSE ADJUSTMENT, INC.
200 Chauncy Street, Suite 201, Mansfield, MA 02048
Phone: (508) 337-6066 / Fax: (508) 337-6065
Joseph Medolo
24 Marblehead Street
N Andover, MA. 01845
RE:
Our File #
Dear Policyholder:
Enclosed is our Building Repair Estimate and/or Stater ,cnt of Loss.
PROPERTY Damage
FIS009130
Please be advised that, in accordance with the Terms and Conditions of your policy's replacement cost provisions,
your loss has been settled on an actual cash value basis pending repair/replacement of the damaged building or
personal property items involved. The amount of money being withheld represents the difference between the
agreed replacement cost and the actual cash value.
In accordance with the aforementioned replacement cost portion of your policy, you have 730 days from the date
of loss to repair the damaged building areas, and/or to replace the damaged items involved in order to make claim
for the depreciation being withheld.
In order to make claim for the depreciation, you must supply us with receipts, cancelled checks and contract for the
repairsto show, the necessary amount actually spent to repair or replace. All documents must be original ones, as
photocopies will not be accepted. Cash receipts are not acceptable unless run through a cash register.
In accordance with the policy conditions, no suit or action on this policy for recovery of any claim shall be
sustainable in any Court of Law, unless all the requirements of the policy have been complied with.
Please sign and return the enclosed Sworn Statement in Proof of Loss & Subrogation Agreement to our office at
your earliest convenience to expedite. payment. Please also be'advis,d that in making this offer, your insurance
carrier neither waives nor invalidates any policy defenses and they reserve all rights and provisions of this policy
of insurance without regard to liability. Should you have any questions or concerns, please feel free to contact our
office.
Very truly yours,
A A
Jeffrey ag djuster
Certuse Adjustment, Inc.
CERTUSE ADJUSTMENT, INC.
200 Chauncy Street, Suite 201, Mansfield, MA 02048
Phone: (508) 337-6066 i Fax: (508) 337-6065
SWORN STATEMENT IN PROOF OF LOSS
AND SUBROGATION AGREEMENT
$232,000.00
F0105391
AMOUNT OF POLICY
POLICY NUMBER
11/11/2007
FIS009130
DATE ISSUED
FILE NUMBER
11/11/2008
DATE EXPIRES
AGENT
To the Norfolk & Dedham Mutual Ins.. By the above policy, you insured Joseph Medolo to the property described under Schedule
"A"
1. Time and Origin: A PROPERTY loss occurred on or about 11/11/2007. The cause and origin of said loss was
PROPERTY.
2. Occupancy: The building described, or containing the property described, was occupied at the time of loss as follows and
for no other purposes whatsoever:
3. Title and Interest: At the time of the loss, the interest of your Insured in the property described therein was same as above.
No other person or persons had any interest therein or encumbrance thereon, except mortgage company.
4. Changes: Since the said policy was issued there has been no assignment thereof, or change of interest, use, occupancy,
possession, location or exposure of the property described, except: n/a
5. Total Insurance: The total amount of insurance upon the property described by this policy was, at the time of the loss,
Same as indicated above, as more particularly specified in the apportionment attached under Schedule "A", besides which
there was no policy or other contract of insurance, written or oral, valid or invalid.
6. THE REPLACEMENT COST LOSS WAS $2,500.00
7. THE ACTUAL CASH VALUE LOSS WAS $2,500.00
8. LESS THE DEDUCTIBLE OF $
9. FOR A NET CLAIM OF $2,500.00
7B. Recoverable Depreciation, if applicable, is in the amount of $ within 730 days from the date of loss.
10. The said loss did not originate by any act, design or procurement on the part of your Insured, or this affiant; nothing has been done or with
the privity or consent of your Insured or this affiant, to violate the conditions of the policy, or render it void; no articles are mentioned
herein or in annexed schedules but such as were destroyed or damaged at the time of said loss; no property saved has in any manner been
concealed, and no attempt to deceive the said company, as to the extent or said loss, has in any manner been made. Any other information
that may be required will be furnished and considered a part of this Proof.
11. The Insured hereby assigns, transfers, and sets over the insurer any and all claims or causes of action whatsoever kind and nature which
the Insured now has or may hereafter have, to recover against any person or persons as the result of said occurrence and loss above
descnbed to the extent of the payment above made.; The Insured agrees that the insurer may enforce the same in such manner as shall be
necessary or appropriate for the use and benefit of the insurer. Either in its own name or in the name of the Insured that the Insured will
famish such'papers, information, or evidence as shall be within the Insured's possession or control for the purpose of enforcing such
claim demand, or cause of action. The Insured covenant that no release or settlement of any such claim, demand or cause of action has
been made
12. Furnishing of this blank or the preparation of proofs by a representative of the above insurance company is not a waive of any of its rights
Insured #1Signae/Date Insured #2 Signature /Date
STATEMENT OF LOSS
FM1014 Limit Of Liability is $2,500.00
Total Claim Payments:
Total Amount Paid to Insured -Coverage A $ 2,500.00
Coverage A
Insured
Joseph Medolo
Policy No
FO105391
RCV
$
4,071.82
Claim #
PO758530
ACV
$
3,619.97
Our File #
FIS009130
DED
$
250.00
NET
$
3,369.97
REC
$
451.85
Coverage A - Building
Replacement Cost
$
4,071.82
Less Recoverable Depreciation
$
451.85
Actual Cash Value
$
3,619.97
Policy Deductible
$
250.00
Net Payment
$
3,369.97
Coverage A Net Payment Breakdown:
To Insured
$
2,500.00
FM1014 Limit Of Liability is $2,500.00
Total Claim Payments:
Total Amount Paid to Insured -Coverage A $ 2,500.00
Certuse Adjustment, Inc.
Insured Joseph Medolo
Address 24 Marblehead Street
N Andover, MA 01845
Policy No F0105391
Building Repair Estimate
Type Of Loss
PROPERTY
Date Of Loss
11/1,1/2007
Claim Number
: P0758530
Our File No.
FIS009130
Trade Recapitulation Trade Total Depreciation% Deprec Total Total
Finish Carpentry
$1,194.64
12.00%
$143.36
$1,051.28
Carpeting
$1,542.46
20.00%
$308.49
$1,233.97
Cleaning
$66.00
0.00%
$0.00
$66.00
Temps/Repairs
$300.75
0.00%
$0.00
$300..75
General
$120.00
0.00%
$0.00
$120.00
Demolition
$369.60
0.00%
$0.00
$369.60
Cleanup & Removals
$184.80
0.00%
$0.00
$184.80
Trucking & Hauling
$293.57
0.00%
$0.00
$293.57
TOTAL
$4,071.82
$451.85
$3,619.97
LESS DEDUCTIBLE
$250.00
NET CLAIM
$3,369.97
Certuse Adjustment, Inc.
INSURED: Joseph Medolo
Policy No : F0105391 Claim Number : P0758530 Our File No. : FIS009130
Action Description Quantity /Unit Unit Cost Total
SUB TOTAL $3,339.34
OVERHEAD @ 10% $333.93
$3,673.27
PROFIT @ 10% $333.93
— — - — $4,007.20
SALES TAX @ 5% (On Materials Only) $64.62
--- ---- $4,071.82
LESS DEPRECIATION
LESS DEDUCTIBLE
NET CLAIM
$451.85
$3,619.97
$250.00
$3,369.97
Building Repair Estimate Page 2 of 2 COPYRIGHT 1987-2004 SJV .,
E >
' Certuse Adjustment, Inc.
200 Chauncy St.Suite 201,
Mansfield, MA 02048
1-508-337-6066
1-508-337-6065
JEagan@CertuseAdjustment.com
www.CertuseAdjustment.com
Insured
Joseph Medolo
Type Of Loss
:PROPERTY
Address
24 Marblehead Street
Date Of Loss
: 11/11/2007
Replace
N Andover, MA 01845
Claim Number
:P0758530
Claimant
Our File No.
: FIS009130
Address
Adjuster
: Jeffrey Eagan
Insd. Phone #
: (978)688-0968
Policy No
F0105391
Inspt. Date
: 11/13/2007
Action
Description
Quantity /Unit
Unit Cost Total
Interior
Finished Basement
Stairway,
Special
Demo/Prep Wall Paneling and
$1.89
Wall To Wall Carpeting
Replace
Wall Paneling
Special
Repair Drywall/Sheetrock Walls
Replace
Carpet Wall To Wall NQ
Special
Move/Protect/Reset Furniture
General Conditions
Actions
23.50 x 15.00 x 6.75
24.00 x 3.00 x 0.00
8.00 HR $38.50 $308.00
519.75
SF
$1.89
1.00
LS
$250.00
47.17
SY
$26.50
4.00
HR
$25.00
Finished Basement Total:
$982.33
$250.00
$1,250.01
$100.00
$2,890.34
Repair Mildewcide Allowance 1.00 EA $55.00 $55.00
Special Cleanup & Debris Removal 4.00 HR $38.50 $154.00
Special Trucking & Hauling/Disposal 1.00 TL $240.00 $240.00
Actions Total: $449.00
0
r
Certuse
Adjustment, Inc.
Property Claims & Appraisals
200 Chauncy Street, Mansfield, MA 02048
(508) 337-6066 Fax: (508) 337-6065
November 14, 2007
Joseph Medolo
24 Marblehead Street
North Andover, MA 01845
Re Sewer Back Up
File No. FIS009130
Dear Policyholder:
We enclose our estimate of damages for your review.
** If you are in agreement, please contact our office so that the proper paperwork can be submitted to your insurance
carrier for prompt payment. Please note that if your total Replacement Cost of loss exceeds $2,500.00, you may
be required to sign a Proof of Loss.
** Should we not hear fromyou within the next five business days, we will be under the assumption that you are in
agreement with our estimate. We will then forward these details to your insurance carrier for their review and
approval. Please note that these details are subject to the company's review and agreement.
We therefore reserve the right on their behalf to make any corrections or changes to this amount that they may
have after their review. If your company authorizes this amount of payment, you will receive this payment
promptly. If they have any questions as to the adjusted amount, we may have to review these details with them as
well as re -adjust these details with you. We will work quickly to revise any issues they may have. We will revise
these issues and re -submit them to both you and the carrier for payment. Payment will then follow.
*.* Should you have any questions pertaining to your building details, we want you to call us. You can reach us at
the above telephone number each day from 8:30 a.m. to 4:30 p.m. We look forward to hearing from you. We
hope to finalize this matter for you shortly.
Also, please be advised that while we continue to review and investigate the cause and origin of this loss and the extent
thereof, your insurance carrier neither waives nor invalidates any policy defenses and continues to reserve all rights and
provisions of this policy of insurance without regard to liability.
Very In ly yours,
Jef rey n
Certuse Adjustment, Inc.
"Situated at the Crossroads of Southeastern Massachusetts"
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Location
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NORTH TOWN OF NORTH ANDOVER
9
Certificate of Occupancy $ _
,s
cHuet Building/Frame Permit Fee $
\sgs
Foundation Permit Fee $
Other Permit Fee $ _
TOTAL $ `� S
Check #
5 4 L O Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED: �^
SIGNATURE: r `
Building Commissioner/Inspector of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide R red
Provided
Recmired Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public ❑ Private ❑ Zone Outside Flood Zone ❑
1.8 Sewerage Disposal System:
Municipal ❑ On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
-NG - v�
ame (Print) Address for Service:
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
ELicense
Address
V
Signature Telephone
Not Applicable ❑
Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
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SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of Proposed Work(check all applicable)
New Construction ❑
Existing Building ❑
Repair(s)
❑
Alterations(s) ❑
Addition ❑
Accessory Bldg. ❑
Demolition ❑
Other ❑ Specify
Brief Description of Proposed Work:
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
Completed by permit applicant
�OI�FiCiAL-USEONLY
I . Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, , as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Print Name
Signature of Owner/Agent
y
Date
NO. OF STORIES
SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TI HERS 1
2 3
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION
THICKNESS
SIZE OF FOOTING
X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL, GAS LINE
D. Robert Nicetta
Building Commissioner.
(978) 688-9545
•'(978) 688=9542 Fax
Town of North Andover
Building Department
27 Charles Street
North Andover, MA. 01845
HOMEOWNER LICENSE EXEMPTION
Please print
DATE .
JOLOCATION �(
B i
Number
PRESENT MAILING
City Town
-.Pb
Street Address
Phone
maplot
Work F
Tip
The current. exemption for "homeowners" was extended to include owner -occupied: dwe►Gngs
of two units or.less and to allow such homeowners to .engage an indMdual,W. hire .who:does .
not possess a license, provided that the owner acts as supervisor. (State Bu►7dng Code Section 108.3.5. 1)
-DEFINITION OF HOMEWOWNER:
Persons) who owns a parcel of land on which he/she resides or intends. to reside, on which
there is, or is intended to be, a one or two family dwelling. attached or detached structures ac-
Gesso .y to such use and/or farm s&uctures_ A person who constructs
more than one home in a
two-year period shall not be'considered a homeowner.
The undersigned "homeowner' assumes responsibility for compliance with the State. Building Code and other
Applicable codes, bylaws, rules and regWlations,
The undersigned "homeowner" certifies that he/she understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she wiN
comply with said procedures.and requirements.
HOMEOWNER'S SIGNA
e
r.
.APPROVAL OF BUILDING OFFICIAL l4 A � � Q�-
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