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HomeMy WebLinkAboutMiscellaneous - 297 ANDOVER STREET 4/30/2018 (2)I MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800 Ma OnIv (8001392-6108, FAX (800) 851-8424 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.313 REC i-�j '1 5 �Ull TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Re: Insured: WALLY SABET Property Address: 297 ANDOVER ST NORTH ANDOVER, MA 01845 Policy Number: 0748908 Type Loss: Ice Dams Date of Loss: 02108/2011 Claim Number: 284996 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 313 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. MPIIJA Claims Division CMA00021 2/9/2011 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec.313 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA01845 Re: Insured: Property Address: Policy Number: Type Loss: Date of Loss: Claim Number: lkzf'q� FEB 14 2006 TOWN OF NORTH AN'jOVER HEALTH DEPARTMENT WALLY SABET 297 ANDOVER ST, NORTH ANDOVER, MA 01845 0748908 Smoke 12/13/05 226910 02/08/06 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 3 B 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. MPILIA Claims Division CMA00021 BUTTERWORTH & 01TOOLE, INC. P.O. BOX 8294 SALEM, MA 01971-8294 ADJUSTERSIAPPRAISERS FOR INSURANCE COMPANIES ONLY TELEPHONE (978) 741-5731 February 08, 2006 FAX (978) 740-9109 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B TO: Building Commissioner or Inspector of Buildings City/Town Hall ADDRESSES No. Andover, MA 01845 RE: Insured: Wally Sabet Address: 297 Andover Street Policy No. No. Andover, MA 01845 MEN= Loss of: 12/13/05 File or Claim No.: 67-0210 R97CEIVED FEB 1 6 2006 TOWN ut ,.JRTH ANDOVER HEALTH DEPARTMEKI-r Board of Health or Board of Selectmen City/Town Hall No. Andover, MA 01845 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 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. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property and we will recommend to the insuring company that this claim is paid. David Vincent, AIC Adjuster �,V T, Member of National Association of Independent Insurance Adjusters BUTTERWORTH & 01TOOLE, INC. P.O. BOX 8294 SALEM, MA 01971-8294 ADJUSTERSIAPPRAISERS FOR INSURANCE COMPANIES ONLY TELEPHONE (978) 741-5731 February 08, 2006 FAX (978) 740-9109 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 ADDRESSES No. Andover, MA 01845 RE: Insured: Wallv Sabet Address: 297 Andover Street No. Andover, MA 01845 Policy No.: 0748908 Loss of: 12/13/05 File or Claim No.: 67-0210 Citv/Town Hall No. Andover, MA 01845 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 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. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property and we will recommend to the insuring company that this claim is paid. David Vincent, AIC Adjuster A, Member of National Association of Independent Insurance Adjusters DATE -0 Y SYSTEM OW14ER & AD -DRESS SYSTEM LOCkTION DATE OF PLWPING /QUANTfTYPUMPED 7!�--o CESSPOOL NO 'l< YES-� SEPTIC TANK NO YES L",/ NATURE OF SERVICE: RdUTINE t,-�EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLID9-- SOLID CARRYOVER SYSTEM PUMPED BY CONTENTS TRANSFERRED TO FULL TOCOVER BAFFLES IN LACE LEACHFIELD RUNBACK FLOODED OTHER EXPLAIN MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec.313 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA01845 Re: Insured: Property Address: Policy Number: Type Loss: Date of Loss: Claim Number: WALLY SABET 297 ANDOVER ST, NORTH ANDOVER, MAO! 845 0611045 Water Damage 05/03/02 192240 06/12/02 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 3 B 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 Co - gm N 0 CD 0 5 R 0 0) oa 0, co �o OD CO 1. 4 TZ. 44, -4-4>5 =I ; 0 N) Cn CYI I CD C/) fli Cn -4 N) -� =z 14 (D cl) N) C CD ON,) 13 8 S) 8 1 5� 0 I t.� .� .1 ... _... .. 1l .� ]4 NOTES Ore - BOARD OF HEALTH 120 MAN STREET NORTH ANDOVER, MASS. 01845 TEL. 682-6483 Ext. 32 or 52 �J,Jql wip" 8:30 P.M. - WILLIAM & JEANNE LAFONTAINE - 297 ANDOVER STREET: Mr. William LaFontaine was present. Mr. Osgood stated that he spoke with Mr. Rosati and Mr. Rosati thinks Mr. LaFontaine should tie-in to the sewer or build another system. Mr. Osgood stated that the system has been f ixed to the point that it is not now failing and Mr. Rosati didn't think that he should tie in immediately and that it is okay to give Mr. LaFontaine some time. Mr. LaFontaine stated that the system is not discharging at this time and is running super. He stated that it would cost him $25,000 to tie-in to Town sewer. Mr. LaFontaine stated that there is room for new system. On a motion by Mr. Osgood, seconded by Dr. MacMillan, the Board voted unanimously to withdraw the order letter until such time the septic system discharges again. 6, 6 BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext. 32 or 52 June 26, 1991 William & Marie LaFontaine 297 Andover St. No. Andover, MA 01845 Dear Mr. & Mrs. LaFontaine: Please be advised that the North Andover Board of Health meeting for June 27, 1991 has been re -scheduled for July 2, 1991, at 7:30 P.M. due to the fact that the Board has been requested to attend a meeting at the Middle School on Thursday, June 27th. Please contact the office to confirm your attendance. Very truly yours, Allison C. Conboy Health Agent ACC/rel zw BOARD OF I-ITEIALTH V_r TEL. 682-6483 120 MAIN S L�I Ext. 32 or 52 NORTH ANDOVER, MASS- 01845 June 18, 1991 Mr. William A. LaFontaine 297 Andover Street North Andover, MA 01845 Dear Mr. LaFontaine: The Board of Health is in receipt of your 1991, in which you assert that a cleaning of has returned it to normal working order. The ordering modif jed, letter of June 12, your septic system letter from Michael Rosati dated you to hook-up to the common sanitary withdrawn or sustained without a vote you are requested to attend Thursday . , June 27, 1991 at 8:30 present documents, Or information your system and request that the modified. April 30, 1991, sewer can not be from the Board. the Board of Health meeting on P -M., at which time you may relative to the functioning of order letter be withdrawn or Please contact this office if you cannot attend, feel free to contact me with any questions you may have. very truly yours, Pon Allison C. Conboy, R.s.; CHO Health Administrator ACC/cjP Ift June 12, 1991 Mr. Michael J. Rosati Health Agent Board of Health 120 Main Street North Andover, MA 01845 Re: Sewage disposal system at 297 Andover Street Dear Mr. Rosati: Per your letter of April 30, 1991 (attached), we have had our system cleaned by Andover Septic Pumpers (see attached letter dated June 4, 1991), which has resulted in.the above referenced system returning to normal working order. Section 310 CMR 15.02 (1), as' detailed in your attached letter, states that no system shall be "located, constructed, altered, repaired, or installed where a common sanitary sewer is accessible". Pursuant to the above, it is our opinion that since our system was cleaned and restored to normal working order, that we do not need to comply with the requirements of 310 CMR 15.02 (1). We trust the above is to your understanding and approval. Please feel free to contact either of us, at your convenience, should your have any further questions or comments. Very Truly Yours, William A. LaFontaine F Jeanne D. LaFontain Ift BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext. 32 or 52 April 30, 1991 William & Marie LaFontaine 297 Andover Street North Andover, MA 01845 Dear Mr. & Mrs- LaFontaine: On April 30, 1991, an inspection of the premises at 297 Andover Street revealed the sewage disposal system discharging to the surface of the ground in violation of Title 5 of The State Environmental Code 310 CMR 15.02(20) 310 CMR 15.02 (20) Discharge to Surface of Ground No sanitary sewage shall be allowed to discharge or spill onto the surface of the ground or to flow into any gutter, material discharge onto any private property. You. are hereby ORDERED to have your septic tank pumped IMMEDIATELY (and provide a copy of receipt for service to this office) . The tank should be pumped as often as necessary to prevent further discharge of sewage to the surface of the ground. Further under the authority of 310 CMR 15,02 (12) and MGL Chapter 83, Section 11 you are hereby ORDERED to connect to the common sanitary sewer on Andover Street within 30 days. A repair of the existing septic system will be a violation of 310 CMR 15,02- (1) and will not be allowed by -'Che Board of Health. 310 CMR 15.02(12) Qonnection to Common Sanitary Sewer - Individual sewage disposal systems or other means of sewage disposal shall not be approved where a common sanitary sewer is accessible adjoining the property and where permission to enter such a sewer can be obtained from the authority having jurisdiction over it. I The board of Health may require the owner or occupant of an existing building or buildings, wherever a common sanitary sewer is accessible in an abutting way, to cause such building or buildings to be connected with the common sanitary sewer in a manner and within a period of time satisfactory to the Board of Health. Page 2 297 Andover Street April 30, 1991 310 CMR 15.02 (1) Disposal Works Construction Permit - No individual sewage disposal system or other means or sewage disposal shall be located, constructed, altered, repaired, or installed where a common sanitary sewer is accessible adjoining the property and where permission to enter such sewer can be obtained from the authority having jurisdiction over it (310 CMR 15.03 (11). Failure to comply with this order letter may result in a complaint against you in the Lawrence District Court and may r e su '1 4- in the as-sessmant of a fl-ne. Y ou have the right to be heard by the Board of Health if you feel this order should be withdrawn or modified. To obtain a hearing, you must file a written petition with this office within seven (7) days of receipt of this letter. You also have the right to inspect and obtain copies of all relevant inspection or investigation reports,, orders, notices, and other documentary information in possession of the Board of Health; and that any affected party has a right to appear at said hearing. Please feel free to contact me with any questions you may have. Very truly yours, Health Agent MJR/cjp ROTO w RAM, Inc. P.O. Box 295 0 Lowell, MA 01833 0 (508) 452-9022 Andover Septic Pumpers P.O. Box 4173 * Andover, MA 01810 0 (508) 475-2593 Shop: 12 Dale Avenue June 4, 1991 Mr. Lafontaine 297 Andover Street North Andover, MA. To Whom It May Concern: Professional Sewer & Drain Service The system at 297 Andover St. North Andover, MA. is back in working order. We had found that the "D" box was clogged as well as the leaching lines. We snaked and flushed the leach lines. The system should be sufficient with normal maintenance pumpini. ANDOVER SEPTIC PU LS Edward J. Boyle', President EJB: d1r We use our heads.... to solve your sewer and drain problems. UNITED STATES POSTAL SERVICE — * - OES, S, Pm Official Business PENALTY FOR PRIVATE USE,$300 Print your name, address and ZIP Code here N. ANDOVER BOARD OF HEALTH 120 MAIN STREET N. ANDOVER, MA. 01845 S Z N D 1z R: • Complete itetns 1 and/or 2 for additional services. • Complete items 3, and 4a & b. • Print your name and address on the reverse of this form so that we can return this card to you. - Attach this form to the front of the mailpiece, or on the back if space does not permit. I also wish to receive the following services (for an extra fee): 1. D Addressee's Address • Write "Return Receipt Requested" on the mailpiece below the article number.1 2. 0 Restricted Delivery • The Return Receipt Fee will provide you the signature of the person delivered -i Consult postmaster for fee. to and the date of delivery. 3. Article Addressqd to: William & Marip LaFontaine 297 Andover Street North Andover, MA 01845 5. 6. 08 10,21 4a. Article Number P-604 728 968 4b. Service Type El Registered 11 Insured IR Certified 0 COD 0 Express Mail [] Return Receipt for KAPrrhnnHiQP 7. Date of Delivery S. Addressee's Address (Only if requested and fee is paid) GPO: 1991-287-W6 DOMESTIC RETURN RECEIPT kn OD IZ ILL V) A. I 1� P -!*6 0 4 2L -e-":"9 6,3 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) .Sent to William & Marie Street and No. ..LaFontaine P.O., State.and'ZIP Code 29 7, A rldover Stzeek Postage S Certified.Fee Special Delivery Fee Restricted Delivery Fee .Return Receipt showing to whom and Date Delivered Return Receipt showing to whom, Date, and Address of Delivery TOTAL Postage and Fees S 2.29 Postmark at Date� mailed.5/2/91. a� SL 7; ul Fo cc M cA w E c2 cL cc E CUI LU 8 f E z cc M c3 E CC uj >. u c2 t.1 . E "a 8L fi -CC o.— B LL, Go cm Lu m3: 2 CC 2 E;.W 4 cwr i T� a� 01 IORTol 0 0 BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext. 32 or 52 April 30, 1991 William & Marie LaFontaine 297 Andover Street North Andover, MA 01845 Dear Mr. & Mrs. LaFontaine: On April 30, 1991, an inspection of the premises at 297 Andover Street revealed the sewage disposal system discharging to the surface of the ground in violation of Title 5 of The State Environmental Code 310 CMR 15.02(20) 310 CMR 15.02 (20) Discharge to Surface of Ground No sanitary sewage shall be allowed to discharge or spill onto the surface of the ground or to flow into any gutter, material discharge onto any private property. You are hereby ORDERED to have your septic tank pumped IMMEDIATELY (and provide a copy of receipt for service to this office). The tank should be pumped as often as necessary to prevent further discharge of sewage to the surface of the ground. Further under the authority of 310 CMR 15,02 (12) and MGL Chapter 83, Section 11 you are hereby ORDERED to connect to the common sanitary sewer on Andover Street within 30 days. A repair of the existing septic system will be a violation of 310 CMR 15,02 (1) and will not be allowed by the Board of Health. 310 CMR 15.02(12) Connection to Common Sanitary Sewer - Individual sewage disposal systems or other means of sewage disposal shall not be approved where a common sanitary sewer is accessible adjoining the property and where permission to enter such a sewer can be obtained from the authority having jurisdiction over it. The board of Health may require the owner or occupant of an existing building or buildings, wherever a common sanitary sewer is accessible in an abutting way, to cause such building or buildings to be connected with the common sanitary sewer in a manner and within a period of time satisfactory to the Board of Health. Page 2 297 Andover Street April 30, 1991 310 CMR 15.02 (1) Disposal Works Construction Permit - No individual sewage disposal system or other means or sewage disposal shall be located, constructed, altered, repaired, or installed where a common sanitary sewer is accessible adjoining the property and where permission to enter such sewer can be obtained from the authority having jurisdiction over it (310 CMR 15.03 (11). Failure to comply with this order letter may result in a complaint against you in the Lawrence District Court and may result in the assessment of a fine. You have the right to be heard by the Board of Health if you feel this order should be withdrawn or modified. To obtain a hearing, you must file a written petition with this office within seven (7) days of receipt of this letter. You also have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, notices, and other documentary information in possession of the Board of Health; and that any affected party has a right to appear at said hearing. Please feel free to contact me with any questions you may have. Very truly yours, Michael J. Rosati Health Agent MJR/cjp SACHUS BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 April 30, 1991 William & Marie LaFontaine 297 Andover Street North Andover, MA 01845 Dear Mr. & Mrs. LaFontaine: TEL. 682-6483 Ext. 32 or 52 coy'%Tk on April 30, 1991, an inspection of the premises at 297 Andover Street revealed the sewage disposal system discharging to the surface of the ground in violation of Title 5 of The State Environmental Code 310 CMR 15.02(20) 310 CMR l5.0L_L20)_ Discharge to Surface of Ground No sanitary sewage shall be allowed to discharge or spill onto the surface of the ground or to flow into any gutter, material discharge onto any. private property. You are hereby ORDERED to have your septic tank pumped IMMEDIATELY (and provide a copy of receipt for service to this office). The tank should be pumped as often as necessary to prevent further discharge of sewage to the surface of the ground. Further under the authority of 310 CMR 15,02 (12) and MGL Chapter 83, Section 11 you are hereby ORDERED to connect to the common sanitary sewer on Andover Street within 30 days. A repair of the existing septic system will be a violation of 310 CMR 15,02 (1) and will not be allowed by the Board of Health. 310 CMR 15.02(12) Co I nnection to Common Sanitary 3ewer - Individual sewage disposal systems or other means of sewage disposal shall not be approved where a common sanitary sewer is accessible adjoining the property and where permission to enter such a sewer can be obtained from the authority having jurisdiction over it. The board of Health may require the owner or occupant of an existing building or buildings, wherever a common sanitary sewer is accessible in an abutting way, to cause such building or buildings to be connected with the common sanitary sewer in a manner and within a period of time satisfactory to the Board of Health. Page 2 297 Andover Street April 30, 1991 310 CMR 15.02 f -U Disposal Works Construction Permit - No individual sewage disposal system or other means or sewage disposal shall be located, constructed, altered, repaired, or installed where a common sanitary sewer is accessible adjoining the property and where permission to enter such sewer can be obtained from the authority having jurisdiction over it (310 CMR 15.03 (11). Failure to comply with this order letter may result in a complaint against you in the Lawrence District Court and may result in the assessment of a fine. You have the right to be heard by the Board of Health if you feel this order should be withdrawn or modified. To obtain a hearing, you must file a written petition with this office within seven (7) days of receipt of this letter. You also have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, notices, and other documentary information in possession of the Board of Health; and that any affected party has a right to appear at said hearing. Please feel free to contact me with any questions you may have. V ery ; truly yours, Michael J. Rosati Health Agent MJR/cjp ,AORTH BOARD OF HEALTH -1 TEL. 682-6483 120 MAIN STREET Ext. 32 or 52 N RTH ANDOVER, -MASS. 01845 0 June 18, 1991 Mr. William A- LaFontaine 297 Andover Street North Andover, MA 01845 Dear Mr. LaFontaine: The Board of Health is in receipt of your 1991, in which you assert that a cleaning of has returned it to normal working order. The ordering modif ied, letter of June 12, your septic system letter from Michael Rosati dated -.-Up to the common sanitary you to hoOR ained without a vote withdrawn or sust you are requested to attend Thursday, June 27, 1991 at 8:30 present documents, Or information your system and request that the -Aified. ILL if you cannot attend, feel free you may have. April 30, 1991, sewer can not be from the Board. the Board of Health meeting on p.m., at which time you may relative to the functioning of order letter be withdrawn or Please contact this office to contact me with any questions ACC/cjP Very truly yours, Allison C. Conboy, R.S.; CHO Health Administrator 10 BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 April 30, Wil . arie a ine -297 Andover St �No' MA 01845 TEL. 682-6483 Ext. 32 or -52 bW'\ 1991 Dear'Mr. & Mrs. LaFontaine: On April 30, 1991, an inspection of the premises at 297 Andover Street revealed the sewage disposal system discharging to the surface of the ground in violation of Title 5 of The State Environmental Code 310 CMR 15.02(20) 310 CMR 15.02 (20) Discharge to Surface of Ground No sanitary sewage shall be allowed to discharge or spill onto the surface of the ground or to flow into any gutter, material discharge onto any. private property. You are -hereby ORDERED to have your septic tank pumped IMMEDIATELY (and provide a copy of receipt for service to this office). The tank should be pumped as often as necessary to prevent further discharge of sewage to the surface of the ground. Further under the authority of 310 CMR 15,02 (12) and MGL Chapter 83, Section 11 you are hereby ORDERED to connect to the common sanitary sewer on Andover Street within 30 days. A repair of the existing septic system will be a violation of 310 CMR 15,02 (1) and will not be allowed by the Board of Health. 310 CMR 15.02(12) Connection to Common Sanitary Sewer - Individual sewage disposal systems or other means of sewage disposal shall not be approve, where a common sanitary sewer is accessible adjoining the property and where permission to enter . such a sewer can be obtained from the authority having jurisdiction over it. The board of Health may require the owner or occupant of an existing building or buildings, wherever a common sanitary sewer is accessible in an abutting way, to cause such building . or buildings to be connected with the common sanitary sewer in a manner and within a period of time satisfactory to the Board of Health. Page 2 297 Andover Street April 30, 1991 310 CMR 15.02 LU Disposal Works Construction Permit - No individual sewage disposal system or other means or sewage disposal shall be located, constructed, altered, repaired, or installed where a common sanitary sewer is accessible adjoining the property and where permission to enter such sewer can be obtained from the authority having jurisdiction over it (310 CMR 15.03 (11). Failure to comply with this order letter may result in a complaint against you in the Lawrence District Court and may result in the assessment of a fine. You have the right to be heard by the Board of Health if you feel this order should be withdrawn or modified. To obtain a hearing, you must file a written petition with this office within seven (7) days of receipt of this letter. You also have the right to inspect and obtain copies of all relevant inspection or investigation reports, orders, notices, and other documentary information in possession of the Board of Health; and that any affected party has a right to appear at said hearing. Please feel free to contact me with any questions you may have. MJR/cjp N Very truly yours, Michael J. Rosati Health Agent Ln fu in 0 (1) 4-d in (A Tl� V c m t o 0 E 42 IJ w 0 ce v a o E a m O'd 14 E u 0 c C) u 0 in (v Z 1 'c (1) E CL 9) in V) V) E E 0 0. �Z_- fu > b (n c 0 u I _0 0 ca ru 76 Q) r- 04 0 LO MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec.313 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER.MA 01845 Re: Insured: Property Address: Policy Number: Type Loss: Date of Loss: Claim Number: WALLY SABET '297 -AND -0 -VER ST�NORTH ANDOVER, MA 01845 0611045 Weight of Ice and Snow 01/06/01 183812 01/24/01 �t sc 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 3 B 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 uw 6 � v ­yj .he* P(QY dod �hI4 (orm for u8o t)y ic JUL 0 7 2008 ^81 Soardili of 0 a SY3(e 0 n I J��od (o the local Bcarc (,I HQa (n or oltior -p H m P , : " :. �� p ------------- T A, 1, P m p n o PmPing Efflum TOO FMO( p (p,.5 o n r? f_-, 771 Qn IpQn gf,sxi I y M e 0 CM 7.� L le, n Were nl�p_ 500: hy 4�' d m a pr 6 form 5, 0 �SQPUc Tan�, ___1 rl,,�, V4_ 1? ye5 �acill�y Inforrl)-ation SYstem LoraUon: c,.201 7 WY �Cl� L�4 ri Lum T�iy 7 Ownv.,. (s,971V A4d[74-_40tafvi7( 7rom K�" UQn) 7— T A, 1, P m p n o PmPing Efflum TOO FMO( p (p,.5 o n r? f_-, 771 Qn IpQn gf,sxi I y M e 0 CM 7.� L le, n Were nl�p_ 500: hy 4�' d m a pr 6 form 5, 0 �SQPUc Tan�, ___1 rl,,�, V4_ 1? ye5 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800 Ma OnIv (800) 392-6108, FAX (800) 851-8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.313 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: WALLY SABET Property Address: 297 ANDOVER ST, NORTH ANDOVER, MA 01845 Policy Number: 0748908 Type Loss: Water Damage: All Other Damage Loss Date of Loss: 12/06/2012 Claim Number: 309004 1/10/2013 ly 5 Z 0 13 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 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