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NEW ENGLAND CLAIMS SERVICE, INC.
0 Incorporated 1985
Reply To , , ,,.. Reply To
Mansfield, MA 02048 = 131 Dodge Street, Suite 6
"'�` Beverly,MA 01915
P.O. Box 345 ±,.�•���:.�����
TEL. {508} 337-8058 j�
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FAX {508} 339-5835 FAX {978} 927-3002
wrandall@newenglandclaims.com
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec 3B
To: Building Commissioner or
Inspector of Buildings
City Hall
A).130d_o V el?, mq
RE: Insured: Eleanor Rockwell
APR 7 14011
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Property Address: 968 Salem St, North Andover, MA 01845
Cause of Loss/Date: Ice Dams Loss of 2/2/2011
File or Claim No: BOS048787
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 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.
Mark Randall
Adjuster
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.
Signature Da
FRANK C. GELINAS
I REGISTERED PROFESSIONAL ENGINEER
REGISTERED LAND SURVEYOR
NORTH ANDOVER OFFICE PARK
451 ANDOVER STREET
NORTH ANDOVER, MASS. 01845
TELEPHONE 687.1483
July 5, 1979
Julius Kay, M.D.
Chairman
North Andover Board of Health
North Andover Town Hall
Main Street
North Andover, MA 01845
Dear Dr. Kay:
During the first part of 1976 Mrs. Horace Stevens requested
that I review a proposed subsurface disposal repair at
968 Salem Street. The purpose of this repair was in
conjunction with an upgrading at said address. Because
of the repair nature of the work, I proposed informally
to Mrs. Stevens and the installer, Mr. Kea, that they
install a 1000 gallon septic tank, distribution box, and
2 - 3' by 5' by 8' leaching pits; all to be installed in
accordance to the North Andover Board of Health Regulations.
After Mr. Rea's installation, my office inspected the work
and found it to meet the required standard.
As noted above, this was a repair job of an existing dwelling
and as such no records were kept of the design nor the
installation.
I am enclosing herewith an "as -built" plan which the installer
has provided me to update your records and to insure that
Mrs. Stevens can carry out her intended modifications, i.e.,
subdivide the existing dwelling from 1 room to 3 rooms (living
room, kitchen, and bedroom).
Should you have any further questions, do not hesitate to call
me.
Yours truly,
",, �,(L ,,
Frank C. Gelinas
Registered Professional Engineer
Enclosure
• ENVIRONMENTAL ENGINEERING
• STRUCTURAL ENGINEERING
• CIVIL ENGINEERING
• PROPERTY ANo TOPOGRAPHICAL SURVEYING
�r
BOARD OF HEALTH
120 MAIN STREET
NORTH ANDOVER, MASS. 01845
APPLICATION FOR ABANDONMENT
OF SUBSURFACE DISPOSAL SYSTEM
(SEPTIC SYSTEM)
PURSUANT TO SECTION 310 CMR 15.354
OF THE STATE ENVIRONMENTAL CODE, TITLE V
TEL -6K
Ext23
This form must be submitted to the Board of Health no less than
five (5) days prior to date of abandonment and be accompanied with
a conv of the sewer connection permit.
Name �cc Phone 3�
Address / J
Contractor hired for work:
Name ( 0 �/ ;L Phone
Address �4 rte.
S �4,'A"
Date for scheduled abandonment /'� L-4
s --
Method of septic tank abandonment (check one).
( ) removal ( ) sandfill (} crush ( ) other (describe
below)
Other
Ins7�`ti
Comments
PLEASE DO NOT WRITE IN THE SPACE BELOW
VnP HFAT,TTH ACFNT' S USE ONLY
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APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass. C--, 7 19
Application by the undersigned is hereby made to connect with the town sewer main in \�/ Street,
subject to the rules and regulations of the Divisionof Public Works.
The premises are known as No. / 6c— �`'c/F'w Street
or subdivision lot no.
Owner
Contractor
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PERMIT TO CONNECT
The Division of Public Works hereby grants permission to
Address
Address
W
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plicant's Signature
SEWER MAIN
to make a connection with the sewer main at Street
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
----�lIzz Divisi n of P lic Works
By ter!
See back for rules and regulations