HomeMy WebLinkAboutMiscellaneous - 50 MOLLY TOWNE ROAD 4/30/2018 5D MOM wAb
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THER90fi FG LK DIED ARQGROUN
February 24, 2015
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
Building Commissioner, or Inspector of Buildings
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
Board of Health or Board of Selectmen
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
Fire Department or Arson Squad
c/o City or Town Hall
1600 Osgood Street
North Andover, MA 01845
RE: Our File No.: P1587817
Insured: SUSAN M CARGILL
Address: 50 MOLLY TOWNE RD, NORTH ANDOVER, MA
Policy No.: F0226798
Loss Date: 02/23/2015
Loss Type: Building or Other Structure Damage
A 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, Ch. 143, Sec. 6 to be
applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct
it to my attention and include a reference to the captioned insured, location, policy number, loss
date 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 the claim will be paid in our customary manner.
Sincerely,
Michelle M. Roust
Senior Property Claims Examiner
1-800-688-1825 x1171
NORFOLK&DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street,P.O.Box 9109,Dedham,MA 02027-9109
DORCHESTER MUTUAL INSURANCE CO. Telephone:(800)688-1825
FITCHBURG MUTUAL INSURANCE CO. Fax:(781)329-1818
Board of Health SEPTIC SZST'EK
North Andover -"B- -1.1
INSTAILATIGK CHBCK LIST LOT ` YTOwN
COVED DATE DISAPPROVED DATE EXCAVATINOb FAIL
GaRonss ---- —
FAIL OK .
I. Instance Tot
-Y5 a. Wetlands
b. Drains
---- - -
c.. Well
2. Water Line Location
3. No PVC Pipe
!t. Septic Tank
a. Tess -_Length & To Clean Out Cover 3
b. Cement Pipe to Tank - Gln Both Sid( a of Tank
5. Distribution Box
a. Covers & Box - No Cracks
b. All Lines Flo Amg Equal Amount C. No Back Flog
6. Leach Field or Trench
a. Dimensions
b. Stone Depth
c. Capped Ends
d. Clean Double Washed Stone
7. Leach Pits
a. Dimensions
b. Stone Depth
c. Splash Pads
d. Tees
e. Cement Pipe to Pit - Both Sides
f. Clean Double Washed Stone
8. No Garbage Disposal
9. Final Grading Inspection
10. Barricading Covered System
—� 11. As Built Submitted
g. Lot Location
b. Dimensions of System
• c. Location with Regard-to Pere Test
' d. Elevations
e.' Water Table
Board of Health
Nartr ',ndover,? Bey
SUBSURFACE DISPOSAL DESIGN CHECK LIST
LOT
DISAPPROVED DATE -y O
APPRO�ID DATE ��
Provided: Reasons:11-.vl0'5
4
K
Title V FAIL CK
Reg 2.5The submitted plan must show as a minimum!
mums
a) the lot to be served-area,dimensions lot # abutters
location and log deep observation hoes-distance to ties
location and results percolation tests distance to ties
design calculations & calculations showing required leaching area
( location and dimensions of system-including reserve area
existing and proposed contours
(g) location arty, wet areas within 100' of se-page disposal system or
disclaimer-check wetlands napping
h) surface and subsurface drains within 100' of sewage disposal
system or disclaimer
(i) location any drainage easements within 1001 of seiage disposal
7 system or disclairtir-P anni ng Board files
(j) kno= sources of va.ter supply within 2001 of stege disposal e _
system or disclaimer
- { location-of—sny-gropo-sed--ve11 to serve lot-100' from leaching facili
%oo1) location of water lines on property-101 from lea.cbing facil3�y
location of benchmark
(DI (n drivewrays
o garbage disposals
} no PVC to be used in construction
(q) profile of system-elevations of basement, plumb, pipe, septic tank,
distribution box inlets and outlets, distribution field piping and
Other elevations
may3=am ground meter elevation in area se_-;.-age disposal system
s) plan must be prepared by a Professional Engineer or other
professional authorized by lax to prepare such plans
Reg 6 Septic Tanks
(a) capacities-150 of flow, water table, tees, depth of tees,
access, pumping
} cleanout
(c) 101 £rom cellar -,,-all or i.n.ground sing pool
Cd 251 from subsurface drains
Reg 10.2 Distribution Faxes
slope greater than 0.08
Reg 10.1 I b) sup
Sl�e� 'D ts�v 6 c Pic lam 4 P.�.o t�
SOIL PROFILE & PERCOLATION TEST DATA
North Andover, Mass. ' Street No Lot No
Loc/Subdiv. Pland Owner
Investigator S -'ted Observer VICP..
SOIL PROFILE DATES
l."El.ev 2.Elev 3.Elev 4.Elev
5f Z3 � ? _ .
0 0 Z- 0 3 0
1 1 1 1
1 S Ti 5 S Ti-es t e
Pst
2 2 . 2 2 -
3 3 3 3
4 44� 4
C 4ZOW E 1. L-tewc-L Ceb^)SL
T
lit M I 1
5 5 5 5
� z
6 6 6 6
7 7 7 7
8 8 8 8 �esi6�a
9 9 9 - 9
10! 10 10 10
Benchmark Location
Elevation Datum
4 PERCOLATION TESTS
DATES s%j Z.2j s3
Pit Number 1 L4 2 CA)y 3 (44 4
Start Saturation =42 Ct
Soak-Minutes q ; $7 to-. 0,9 -54-
Start a I5 i, 1
Drop of 3"-Time W.t!0 t o: 'SS 1 t: SS
Drop of 6"-Time to;4q M. 35
Mms.lst 3" drop M to ZI
Mins.2nd 3" Drop 3 3 h400-1- 4.0
Percolation I 14