HomeMy WebLinkAboutMiscellaneous - 94 FOXHILL ROAD 4/30/2018 (2)��' �
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LaMarche Associates
5 North Road, P.O. Box 250
Chelmsford, MA 01824
978-256-8586
Fax: 978-256-8590
August 27, 2013
Building Commissioner/Inspector of Buildings
NORTH ANDOVER, MA 01845-2936
Board of Health/Board of Selectmen
NORTH ANDOVER, MA 01845-2936
NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B
Claim has been made involving loss, damage or destruction of the property captioned below, 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 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, cause of loss and LA file number.
Insured: CHRISTOPHER & MELISSA DIMINICO
Loss Location:
94 X HILL ROAD
NORTON ANDOVER, MA 01845-2936
Policy Number:
PHOO100793057
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Date of Loss:
8/1/2013
SES,
Cause of Loss:
Mold Damage
iC�WNC1i Np{�TH aMEN'EI�
1- EA1—''T � DEPA°ii�tiN
LA File Number:
MA -2-23262
-
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.
Kris Kirkpatrick
Adjuster
LaMarche Associates, Inc.- 800-349-1525
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address 01/"l, /i�O
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
❑ yes ❑ no do not know
6. How old is your sewage disposal system?)( 0-5 years ❑ 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
Elyes no ❑ do not know
If yes, approximately how long ago?
years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ annually P"Cr--
Elevery 2-4 years Elevery 5-10 years Elover 10 years ❑ never,A!'zY�
9. Have you had any problems with your sewage disposal system? El yes � no
If yes, what problems?
❑ repeated pump -outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
10. How many of each appliance are connected'to your sewage disposal system? i
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains showeribathtub 2-,—
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher a 5CAP ' fsw�7GrL
clotheswasher Ma A/13" srdcwA a&u )o - 1V6 !jMAIO MAh6
12. Does your property have a lawn?' yes ❑ no
If yes, approximately what size? / w��
El than 1/4 acre 1/4 acrev'rl& ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year 7-4-
Season(s)
-4Seasons) of the year 3'aug.1 s ur+r+bt . GA t I-
14.
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
CIM/14AW,',\//( t w ? Di
Check here if your lawn is maintained by a professional landscape contractor.
IT I t--! .T—r-.-- !-1 7-
,i
1. Name Y��a/J
2. Street Address �!fAon
O
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
Econnection to municipal sewer
� other (describe)
❑ do not know
5. Are the plans (drawings) for your sewage disposal system on file with :the Board of Health?
❑ yes ❑ no do not know
6. How old is your sewage disposal system? X 0-5 years ❑' 6-10 years ❑ 11-20 years
i over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ ves 'ps, no ❑ do not know
If ve ,, approximately how long ago? years: What was done?
8. T -Tow frequently is your sewage disposal system pumped out? ❑ annually PQgS f4O T
Qeve 2-4 ears ❑ every 5-10 years El over 10 years El never . Arr4y_ �' y
3. Fi2ve you had any problems with your sewage disposal system? ❑ yes V no
l }yes, what problems?
❑ repeated pump -outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
El sewage surfaces through ground
10. r -1't -w many of each appliance are connectedto your sewage. disposal system? i
:,�7 a .hing machine dishwasher P garbage disposal
dehumidifier drain sump pump �^ � toilet �
r0o '/uavement drains showeribathtub _
11. i'' ease state theme' brand and type (liquid or powder) of detergent you use for:
C ishwasher &IA GADF fe'-D.—C2.
c otheswasher &b Pazrra®a�F Atha Ades,^14 u�a lD ► we 09 0 NRhf- �4�NEYl�G�
12. foes your property have a lawn? X yes ❑ no
F=r•F, approximately what size? W N-)
{ r mess than '/4 acre '/a acrk*' 10' El 1/2 acre El 3/4 acre El acre
j I more than 1 acre (Specify) acres
13. cx,, often do you fertilize your lawn?
. of applications per year
•'p on(s) of the year 3'1f&&,&, . S u.�nA&E , FA 14.
1 eil _e state the brand and type (liquid or granular) of lawn fertilizer you use:
1•
Cbccfl here if your lawn is maintained by a professional landscape contractor.