BP-469 FIELD COPY
Dartmouth Building Department
400 Slocum Road BUILDING i�n/�o11 reT32D
P.O. Box 9399 PERMIT [ILA IT L LC
North Dartmouth, MA 02747
Telephone 508-999-0720
DATE February 5, 1991 iB PER IT NQ. 469
APPLICANT Daniel Faria ADDRESS 345 Highland Ave. No. Dartmouth
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO land (_) STORY temporary trailer dueDWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) fiue,a.
AT (LOCATION) Albro Ave. No. Dartmouth,_MA 02747 ZONING
DISTRICT
(NO.) (STREET)
a BETWEEN AND ,1
1:5m (CROSS STREET) (CROSS STREET)
m SUBDIVISION LOT A 13 BLOCK 70 _ _ SIRE
I
V
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O l
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION 3
F
p PE)
04 REMARKS: Trailer permit expires one year from date of issue.
AREA OR ERMIT QQ.�
VOLUME ESTIMATED COST 50•00 P FEE .p 50.00
(CUBIC/SQUARE FEET)
OWNER Daniel Faria {
ADDRESS345 Richland Ave. No. Dartmouth, MA 02747 ByILDWG_DToJ. Silveira smp
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
DEPT. FILE COPY
Dartmouth Building; Department zo
400 Slocum Road - sBUILUING 04
P.O. Box 9399
North Dartmouth, MA 02747 PERMIT VALIDATION
Telephone 508-999-0720
DATE February 5, 1991 ( 469
APPLICANT Daniel Faria. ADDRESS 34b Highland Ave.PER I NoT.N Nuartlouth
- (NO.) (STREET) (CONTAIN LICENSE)
PERMIT TO land (_) STORY temporary trailer due to DWEBLIE.RNG UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) tire _. -
AT (LOCATION) Albro Ave. No. Dartmouth, MA 02747 ZO IN CT
(NO.) - (STREET)
a. BETWEEN AND
m _ __ (CROSS STREET) (CROSS. STREET)LOT
..
m SUBDIVISION LOT 13 BLOCK 70 SIZE
a
O
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
0
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
m (TYPE)
LL REMARKS: Trailer permit expires one year from date of issue.
AREA OR - 50.00 PERMIT $ 50.00
VOLUME ESTIMATED COST if, FEE
(CUBIC/SQUARE FEET)
OWNER Daniel Faria
AODRESB345 Highland Ave. No. Dartmouth, MA 02747 ByILDt `d o J. Silveira smp. .
(Affidavit on reverse side of application to be completed by authorized agent of owner)
.a
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF A
ADDRESS
(NUMB R) - (STREET) - (CITY)
APPROVED BY TITLE
DATE 19_.
ULI l( t� PERMIT NO. / .
°�C�` ` ° is . TOWN OF DARTMOUTH DATE ISSUED a/s/v
' . � 7
6w 114)1� "�` S I TOTAL COST �`->U
H"�1 � ���� "� APPLICATION FOR
�, rcC: 'S� '� DING PERMIT LESS APPLICATION FEE
lee4 FINAL PERMIT FEE 50.
61)
/1\ . WM-REFUNDABLE
)_. LOCATION OF BUILDING �J
J 01 Number & Street 9.�t— ��� � 01.1 Zoning District
02 Cross Streets(between) �yhh and
03 Lot � Plat / 04 Subdivision Lot
OWNERSHIP COST ,
05 ❑ Private (individual, corporation, 36 Cost of Improvement
non-profit institution, etc.) 36.1 To be installed but not
06 ❑ Public (Federal, State, or local government) included in the above cost
TYPE OF CONSTRUCTION 36.2 Electrical
07 ❑ New Construction 36.3 Plumbing
08 ❑ Addition -Type of Room(s) 36.4 HVAC
09 ❑ Alteration 36.5 Other - Specify
10 ❑ Foundation Only 37 TOTAL example: elevator M2
11 ❑ Demolition (#of units if residential)
12 ❑ Moving (relocation) STRUCTURE
STATISTICS 38 ❑ Wood Frame
13 Number of Bedrooms 39 ❑ Masonry (wall bearing)
14 Number of Bathrooms (Total) 40 ❑ Structural Steel
Full-Tub 41 ❑ Reinforced concrete
3/4 - Shower 42 ❑ Other- Specify
1/2 - Toilet Only
RESIDENTIAL-PROPOSED USE DIMENSIONS
15 ❑ One-Family 43 Number of stories
16 ❑ Two or more families 44 Total square feet of floor area, all floors,
Number of units based on exterior dimensions
18 ❑ Shedge 45 Total land area, square feet
19 ❑ Carport
20 10 Swimming Pool SEWAGE DISPOSAL
In-Ground Above-Ground
21 ❑ Woodstove 46 ❑ Public or private company
22 ❑ Fireplace —y 47 ❑ Private (septic tank, etc.)
23 CI Other - Specify Z-4) N
WATER SUPPLY
48 ❑ Public or private company
NON-RESIDENTIAL - PROPOSED USE 49 ❑ Private, (Well, cistern)
4 ❑ Amusement, recreational
25 ❑ Church, other religious PRINCIPAL TYPE OF HEATING FUEL
26 ❑ Industrial 50 ❑ Gas
27.. ❑ Parking Garage 51 ❑ Oil
28 ❑ Service station, Repair garage 52 ❑ Electricity
29 ❑ Hospital, institutional 53 ❑ Coal
30 ❑ Office, bank, professional 54 ❑ Other - Specify
31 ❑ Public utility
32 ❑ School, library, other educational TYPE OF MECHANICAL
33 ❑ Stores, mercantile 55 Will there be central air conditioning? ❑Yes ❑ No
34 ❑ Tanks, towers 56 Will there be an elevator? ❑Yes ❑ No
35 ❑ Other - Specify
PARKING PER ZONING BY-LAWS
57 0 Enclosed 58 ❑ Outside
59 Does this building contain asbestos? ❑ YES ❑ NO If yes complete the following:
Name & Address of Asbestos Removal Firm: •
IDENTIFICATION - To be completed by all applicants PLEASE/ 4PRINT �/
60 Owner (print ,A/d//� 7 , //f/ 'A3 n :5 ,'y9 ,0/ AIL-- �— v + ��11
AME MAILING ADDRESS TELEPHONE NO.
61 Signature DATE d-2.—lJS
Builder's
62 Contractor (print) License No.
NAME MAILING ADDRESS TELEPHONE NO.
63 Signature DATE
64 Architect or Engineer (print)
NAME MAILING ADDRESS TELEPHONE NO.
65 Signature DATE
CERTIFICATION TO PERFORM WORK
66 I/We hereby appoint
NAME ADDRESS
as my/our agent for the purpose of applying for and obtaining a building permit for the work to be done described in this
application.
Signature DATE
ADDITIONAL INFORMATION
67 Has A-1 or Determination been issued by Conservation Commission? ❑ YES ❑ NO
Submit copy of notification sent to DEQE and the State Dept. of Labor Industries and result of air sample analysis after
asbestos removal is complete.
68 Owner or Agent - I certify under peril of the penalties of perjury that the information herein is accurate to the best of
my knowledge.
Signature DATE
Owner or Agent
69 BOARD OF HEALTH REVIEW DATE
Inspector or Authorized Person
COMMENTS:
70 DPW- WATER Service No. SEWER Service No.
To be completed upon issuance of permit- (if applicable)
71 I will post permit and address so as to be visible from street.
Signature DATE
Owner or Agent
72 I have received list of required inspections
Signature
DATE
Owner or Agent
4'3 TOWN OF DARTMOUTH
f4 BUILDINGtDEPARTMENTc
s /
�
'' Date �� `�i / ! % /
Name In Payment of Amount
p d J
atuf id tf/l
V V'GV'/
cN V .9 SAL%
n
?0 400 Slocum Road • P.O. Box 9399
so-: North Dartmouth, Massachusetts 02747
RECEIVED
OFFICE OF THE 91 FEB 19. PR 3,9 508-999-0704
BOARD OF HEALTH :. FAX 508-999-0738
DARTMOUTH BUILDING Din
February 19 , 1991 -
Mr. David J. Silveira
Commissioner r R
Dartmouth Building Department d' ^ '
400 Slocum Road ''' „�'�
North Dartmouth, MA 02747
Dear David: Resk
While investigating the violations at the trailer located Itrit43/4
at Plat 70 , Lot 13 Albro Avenue, it was noted that perhaps
similar cases could be avoided in the future.
Accordingly, we respectfully request that you notify the
Board of Health whenever a trailer permit is issued, in
order to allow the Inspectors the opportunity to verify
whether a "septic system" exists on the property.
Your assistance in this matter is greatly appreciated.
Very truly yo rs ,
44492446x4earril
DARTMOUTH BOARD OF HEALTH
DBH:psd
cc: file
•
Dartmouth Building Department
400 Slocum Road
P. O. Box 9399
Dartmouth, MA 02747
508 999-0720
February 4, 1991
Mr. Daniel Faria
345 Highland Avenue
North Dartmouth, MA 02747
Re: Plat 70 Lot 13 (Albro Avenue)
Dear Mr. Faris :
Be advised that after inspection of your property
located at Plat 70 Lot 13 I found that the drainage is
not connected to the septic tank. This is a violation of
the Massachusetts State Plumbing Code CMR 248 Principles
#7 and 16, Section 2. 03 Definitions of Terms-Plumbing
Systems (see copy enclosed) .
This system must be made to comply to the
Massachusetts State Plumbing Code FORTHWITH. Failure to
vacate the premises or correct the situation will result
in the necessity of legal action.
This order may be appealed per 248 CMR Section 2. 04
sub-section 20 to the Board of State Examiners of
Plumbers & Gas Fitters.
Your prompt cooperation will preclude any unnecessary
inconvenience.
Sincerely,
,j"{
stc1
Roger Olivier
Plumbing & Gas Inspector
RO:lls
CC: Board of Health
Enclosure
Certified Mail # P 898 499 092
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1 . 2.027 7:.f1 ....c.yrincip;sar: •
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1 w
dioundins of Prinrrioltr... This Cede is rhundect unarm certz.in ortriCiPk,'S of
c fatt, thrbt p ry ancetritabiy
• enviroomehrol. rearAtrint, ash sarannropel dositmen,
InSt&ilea alO; acid- ater maaratertatitri plumbing :tryst Errk.::i.
.34' ca:lil3i.17 tfOr!R',r,P.Cti0O. rriay vary l-dut. the hosts
SaftataRY arsrl Sn'int . Onnolitliin llerlodelo art.:1 necadasturts toar'
hsroresecir, situations arise which are rot spestriiirally CO,,itttiftf.n"f trl tt11..0 C.Od::t, thy
fittell triterpretsrinfi :shall he rirrattrie by the rasard,or:State. latharanusts crl rtharttlartira
ears! Cas Bit tam.
The ollow:mit uhrociplas shisil chrinply with Rh Arh.eeS Of Llif.: St,... l'3:72.F.lititti
Code and Titr.es of the Efwiropmental diode.
(I) Princintlit No. -1 -- All Occupied Premises Must Have Potable Water. ./::
premises tate-tidal:7J for IO-IT:lan hablratiorri, radcohancy, or use must 'a,..1 proviesnri
with a starpply of cubicle rdhster. Such a water cnt:',2itj sisal] or!: ha t2ZIMSE.O1COOR. Ottth unsafe or Cluestior3a,.)1cn water SOUr. ".q±Z., ROT Oh.;tt.t.it tc.:.'t; _,,t),ICOff:t to ..'ilf..,.; :Itt,:2Rnitr.tr,. .t.r.'
backflovr, hackpressure nr backerittliananaa.
(2) ltlypncir.lcilo. 2 -- Ailirrouete Water Inctquiria4. Plumbing fixtures. devices,
. ,
and astattassitaricas, must :ars stir:drilled nritit -.riot ,r.r; sufficient :trm-rte. .::-"i C.. :.'.“.. •
r.V....n&stir e•ri sciebruste to enable (boor: ran function tat-pertly ape ,apt?)(y.y.,.
-...tocor c:nation-in at use. . ..
,3) Pranctiolu No. rs -- Hat:a:later Ruperred. Hot water must be surarrld,r,r) o all ...
,..
unotf I fi 1.2.Xt.WV.,S VI h.1 Ch 1 i 0 r'.1 1 all Incz.[:.!: or ::irtquire hot Wate,r for their taro:ass ORE .•.-
.3.21ci function. .. ,
•
(4) Priohntite No. 4 -- Wa!,:er Conservation. Plumbians must be designed and ..
•adjustad ri.) asit ...Se throarnstra urtaitttty of water consistent with pm.per
OCO'faitYlliallOr3 and c:mining.
(5) Pri-ndirair:No,2, 7- 0).--arders of Etmlosion or Overheatipr. Dewnas and :
. .
appUancus TOf YiPaintn' .3..1C, stertilR wirier ITIU-St. 'tf,t on hasp:toed arid tru:thlrad as nn-..,
guara. agninsr d a.n2 a..,:; Incas, earplesion or Oven-healiniyn,. .
•
tfi) Flinsinhle J)-ltd. qsts- ? rdul.reclydurcrblar,LB............ Each family dwelling must.
,....ave at least ortit water closet, cite. laVtOtOR2t, RO:tt kitehtfil-Wrte. Sit);t, one Bathtub
- Or shower sag. '...trundr,st troy or norms-sr:trams far a wash tug naadatua, tr, rsrptt.. lnosite require MI.r.ItS Of' SZJIi t 8 t t Ott Tn"..'. Pn:titan:al in/Odeon_ flin. !Yr...lin:O.:, tWOf.fttlitO,
.... .
raransin:,? lair:allies, one taunt:By ta), Cr tcritr.thic!:? 11CtErl,,,..
part-her:id ...tr rent:lion morzol, stand be cOCer,i1C!,,r, on ,tenetilino ii7ninehry
FaCilitCs f; this PrUncipr rade laurd.d.ry troy tit: Wenei.!.-:.;:.,:- road:it:sr: for. rahrtry
twenty aparrmants or fr.scrion theta-of, rthaLl be arceptiihre irk Hn. intt for 'Jai
'al:tartly. .
Aar other .rtror.tures f,. habitation must be equipped with sufficisnt sal-lilac.'
far es. Piturdrizint: fixtures M.I.:St. f,:trt, made of sharable- smooth, .noandettrartorrt
and corobston rtestinliis.r. no and in Inc free iirern honor;wart frtr ling
rat-faces.
(7) pinerictiti4f..._No„7 7- pri..page System:if Adequate Size. The drairvt.se, system
4/7
must ft- artratrittal, cat-runs:tati ttitt: h - -•• iftsa. tit quard agaths_St favi.bg, .cteposit
•-.:, :•.--;.,:,,.•.s. -6OtICL rldst,)-rtisa, ranj. tirtt...O. nO. ..• ...,.:. t.n.nRn...1Utti SO arrf,Iger; t.tOtIt the pipes
may dr.:, rnsi..,y ciarosbd, ,
i1
fit) P-Rt'nicle No (l - r':'''''‘'I'' Vifttr'-''';'' and rood Workratrinshin The •"'oofir, o
....
:„the pitorthino rnostem rrozi. be cal .Hisilnii, ..iti,trienot, iron from ttetst:”Ve
.1(vOinCrit inn:hilt itnil SC) dre.sirtasti 3.O.e. CO,tO.,.,...n.tOlf t'LE. tO gide satisfactory sernri. fon
reissoica'rare einitrinted. Ll.i.
(9) ,PritaraniaLe No. b -7 Tristitin ..e.alert_Tran...s_.?..yro.taittecl. Bach fix bra- directly
(dolman rsif ro tRT cl--.---,..7-ag•• zny. tEsil !r•nr-:-.: ...,n., 10.20.:n;.,:.)0.nn with a litruid-S,7li tren.
NO) PrirataiteNot0 -- Trap Seals Shall Be Protected. The drained? systom
most be n:,:ncy15t.t2; to pmore al') raddnuede. nhaerion of L.!' in ait innnalts v.aa•b. n,3 •...)... •••
eat/frII'- ft,
240 Clutt, _ 6
.,•
OP! ctia(-nue('
tlecaacr of siond -a. 2-s3721.10, fanatuot of tau seaLs UridCt oncnitions of
.. (liar ry use.
11) Princjp[e Nt 31, T.-../JttaliSt CitLi Airstfy!.$)de. Each vent terminal must
ext to tne coo- air a( the se, inst.aii,,,d pc cm ,n;sdfni•ze
11';OStc.lb als ;Oka rad tha are ef e(2 (n ice tecHine.
(12) (3ncip1tle: 1225_Tiait (hypo:rime Ertnerr.. The plumbing system most
be satocime(1 ict . ria teena asv .. ffective-9.y Otselose all leaks Ann oefacls to
Jot( atk or (he a. .erials.
112) Prlincillie fla 13 -- Exclud. e Substances from the
No suns:once k och will ,,, or accenteate clitt,.(jing of pions, nirotiliace
explosive tift11'fil-118, 4CtStrtnt the f ttt or ;hair -pints, or piste:fere crit.loly with The
114) firinpiple .14 Prevere Contamination_ Proper protection shall be
provided le pre.::: auntewitrainsa of rood, water, sterile goods, and cc-filler
, tials ay laeOW of Sity - : •. When necessate the are, elegy ice. or
i,;(tance shall tar . oranecled mai:only with the- 201±0 nreina„ts aystein.
t18) t' c &eNc cnJyLof Ventilation. No water closet or similar
hat ure Ecale be imaiteri in re"). :Jr flti;iMp:.ttiment which is not rapopealy ho-atect
v11ntate.C1.
Principle 161:-..-Jpdiyirina. Sewafite pi..s.posa! Systems,. if water closets
oiher plureboi: fixtures are ia,tartect in buildings where there is no sewer
witein a temp:nap!: distance, so Lie provision 5.1.-7.4.(l be made ter Et:SOOSiyitt t.st
Poe sewage :317 .. - accepted me,. de ot sow.--.2k, pima(rat eh, arid d
-,: Prevent; ewer Flopti:o.E. Mere a plumbing draninree
stir:en; bona ihon-, the public (-war
: die to i'30€VC,1 Is OVern.OW in the builkoot?„
i18) Principle. bie 18 -- Proper Lintenance. 1,31Almbing systems shall be
mayntraciari In a 7 re woo sero tin lii conch lion from the in rocleoinit rol both
[ 9) Prins-idel : t3 Fin-ore- :hail Pio Accessible. All plumbing fit:tut:84
4-3811 be se .i1),1)Cirty aV'i at tat 11:17.CeSr:ible thteti intended
.atte Utr
12C) fitilliaiplyNa 10 -- Sc - -- LSafety. Plumbine shall_ he installed with
fee reriars to 7 -ota-ye:ion • narci- or rnr:n?h1,:i «ref
tiateietration of Sot( walls;at: tttc.rtr sot(aces feetooe ticatEitri.
121! Princnale N7 21 -- Protec- , round and Sparracri Water. SegaST.7.12 or other
4.-estst triesi act a- cliar-lier?ried 22t in:Placa .ottyaitfaurt water risatiar ahato
itest heap tt'7,21'2 (t: SO some acc. rodoi !ft(2 att..
Prier:-a , : Treatment of Special. Wastes. All
ma a 7 : beCi.ircht 6,771!s•srtts.- ((ie. anal welfare of -aa'-
of any euildinta, steal eat cr.-Pref.
wition saincetu p.i.- Ey:dents tip,- either ttotiracted roc tlispot-m0 of or -tetra,'
ritiOr •!tnt thtt. senita7, drainage syeten is accordance Ain itte
et( authorities
92: 1-2,!. tattoos
tieperal. 12. he purpose 0, his Code, the following terms shall, have the
telercaritt pai'C 1 sc1inr. No az temen 5t-naravcdrfine CrOartat7 s•••07,stS
whie't are usira ,rcernanee their establishati dictionary mea-Oils cote pi
t; it is net. • :y te tHiThs heir meanly-hit as used in this Code to tooari
nnirporlerstarouria
248 CMR - 7
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. .iiyabilain. I...• :...,t fr.-4:,.-'i Ch.liY ,• :i7ril'el"-iC Crf the Fnuard of Stet.", E.:pin:liners of
:.....„...,...,;....„:: -,,,.: .. ......,&pi.f.:.:.:. ,.rj;j:Z,..-: .r 1321_ PiUlr..b.3r, a:•:. 27:::::..li CU.'. by ti..tat.,. pt. IS 9
.11b..]:•*•,".:.b. ;.: ",:•:.,,i0S'. i•.•--;•.turS1.. nib iyiaani., zanalier practice, rgaimri17:k .n."1.1 ib X•.1.1b0..3
cuis-i.s...•..bb 10 ...,11‘y L.:::.:1::, 0: jr.S.T.'.0 nliapi•asai et" iatiagn
rbr•.:;.•,.0 Lb.,••• ;H. liSbt-. PS.1.1.rd Liam. that nattier, nib to plE.IPIT",:f
, rirUrr. Cbtl,••.-• ‘,,/, of .n. laplia... i yin...inv. laiiigirinun- f Mfr. a .bC,,.!1t. -b-bN i"..:•:. OY:t.")0..:;";
P.i.".;: ii.„ a t:••.;... cif' ',IL. OU• r..1±0“0 '..rb.ii :nit.:t riwintript iren the tntiti.trittoti•
' tniruipPportit spent Sr itutti... ttin .y 4.. "iiiinagaid rUum.L.2.r erny. On agamatic, binning
••• .r...fU'ih,:, L".":">..• :"..S".-:i or pipet tiepin:. init.. ie. the tion......ti;, tippipl ci• t.tlt. itptett.pript .. dev2.
ice rt.
t Ati vino. .. t.it,ntiipt "(puce:, etc."! pr.-IP:Pr lirteci atiicictin in. filo direction of nit*
it.rrei, f .::•, •:.. "!)," n'.tr.,..fl.,.:-..S ... rur iS.S.r.0.b.bi.! flIf %. li.,-,1•11ad 2).U.t"bb•SI.'".
onolr
1"..b....-.:,:j.0."::.1...f;•.".., c.p!. lrasiablleni zy. ninteclagy, devinaa. or appii.ance.rt eitile.•0 SUbpli0d •
?:•:0,":"",-, ..:.IS: ::.. •:.b.Oul.r. Cl.S.S". 0•,, . 1-0 is0 iha an alma...L.1,n, ayanyinn viiiya anhich tivty H-r.:....••
rer,......t. inn.
::•.ititt.,,ntip. .iiiii.,...i.......;tio,ti. 1,:i.....i. retin. iitt'itrative Aririt:y.)
,. ... . . ..,
#4.7"7 Nunitinni• " .....uni Ei•pia iiii •• 3irin,7 "LysZoism ircludes the venter ittippiy 'end ...
inettittintipt. , ...Pei; pit:tinning Lit:tures anct trilpitt.i. snit, 'it•it.stei 3t:1"..i V,,'•nt.
....2,..;d.:•4" ..,..,..',., -..-•,, :.e....,." ....r..,A -,. liSairLri Silebr..i.ibi" ... :Th.-•••,3.-:ti."‘ria ce nnec 1 ionti,
-...2,r,b..."'......, :-..,..,..:-.. ..:0; bt: E.•• /o2r.i., 0 tbbi" CMI:."-•'.11.. E,b '•`1)J1 :S.:::3; "..".itli. b!". pill.lbr.",
0.: ..:::.i.dr.(.0.00p.abb.. ..;...•,15..bli.0 .•5•:.:.'1::••• tyta Iiimparty ling. •
- iiiipifultuliit lini•-• 2.. . Wii.ta"." •ruu . Lai; i.rupupitie5 ntaaniii. irl Zs.MOUllt°• sficiant 'Hi,
,..-1-LS".;:k-.. •.S.r.".,..:....,., .0,7' h-",Yr-rr.:".....:. i..-0i-;;.y.... . .....,..c.t.I. J.;..":".0,•;!:,.. ;.;:i. '.1.1c•..,,,l'ioi“-.);.•iln.i., 5..-:...,. c.,•-••...,Y11.,: d. .
•• 0...1....i;•.)...":"'. ..,;.•.....',. c.C.71.1c00X• Ut...; •::."."S req..;rirr0U11...:"--. 0 i ',".:10 kb.,•:000...:S '.".•:'' ..,....•.1
%;:1:S.-SbY-..::.. :. . •. !2 i7•0.•:-"irb b•i-. U. , I.• Mnb",.isn ti' QUat•L y ,r,,b.•;:tr,.2r•;:ply,
lia Li', ciassi fica lion of plaiinning (lei:Le-en, private shati
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SENDER:Complete items 1 and 2 when additional services are desired,andcomplete items 3 and 4.
Put your address in the"RETURN TO"space on the reverse side.Failure to do this will prevent this.
card from being returned to you.The return receipt lee will provide you the name of the person
- delivered to and the-date.of delivery".For additional fees the following services are available.Consult
postmaster for fees and check boxfes)for additional service(s) requested.
` 1. EI¢how tq wjigm galivered,.date,and addressee's address. 2. 0 Restricted Delivery.
3.Article.Addressed to: - 4.Article Number
P 898 499 092
Mr. Daniel Facia Type of Service:
345 Highland Ave. Registered Insured
North Dartmouth, MA 02747 C7 certiflad ® coo
GGGG7777 Express Mail
Always obtain signature of addressee or
agent and DATE DELIVERED.
'5.dim-Mare—Addressee S.Addressee's Address(ONLY if
requested and fee paid)
S.Signature—Agent
X
7.Dale of Delivery
PS Form S i l;Feb.1986 - DOMESTIC R,JTURN RECEIPT
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UNITED STATES POSTAL SERVICE ; y
r t OFFICIAL BUSINESS. repg U.,d `s SENDER INSTRUCTIONS 1
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} in the space below. 11P 1 ,
•Complete items 1,2,3,and 4 on 1 !
the reverse. U 1 +
•Attach to front of article if space
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article.
•Endorse article Return Receipt. PENALTY FOR PRIVATE I I,
Requested"adjacent to number. USE.$300
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i .RETURN Print Sender's name,address,and ZIP Code in the space below.
1 -'
TO
TOWN of DARTMOUTH
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<UILDING DEPARTMENT 1I�
- I .•4'3y_', Slocum Rd. / P. O, Box9v99 :. ; ,,
North Dartmouth, MA 02747
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LE COP
NEIL LEAHEYA CLAIMS SERVICEy
9nvesliyalions — ..4dpasintcnfs — Appraisals
RECEIVED 125 WILBUR AVENUE
SWANSEA, MA 02777
'Si MR 26 Pp) j az TEL.508-675-1533 • FAX 508-677-9889
DARTMOUTH BUILDING DEPT.
FORM Off? NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH.139, SEC. 3B
To: Building Commissioner Board of Health or Fire Department
or Building Inspector Board of Selectman
400 Slocum Road 400 Slocum Road 140 Cross Roads
Dartmoutn Mass . 02747 Dartmouth, Mass . 02747 Dartmouth, Mass . 02714
Reference: Daniel J. and Susan C. Faria
345 Highland Avenue
No . Dartmouth, Mass . 02747
Faria Family Trust
Daniel J. & Susan C. Feria, Trustees
1213 Old Fall River Road (Albro Ave. )
North Dartmouth, Massachusetts
Fire: 12/14/90
Worcester Insurance Company
Policy #DW 05 73 02
Co. Claim #F60-12 31 03 U
N. L. File #8564
Policy #DW 20 93 44
Co. Claim #F60-12 58 14U
N. L. File #8583
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, Chapter 139, Section 3B is appropriate, please direct
it to the attention of the writer and include a reference to the cap-
tioned insured, location, policy number, type and date of loss and the
claim or file number.
NEIL aLEAHEY CLAIMS SERVICE
-et oeil-ccie
Neil Leahey, Managing a�eljuster
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.
March 25, 1991
� alp/ t
Neil Leahey, Managing uste ' y/�
CC: Worcester Insurance Company /®/f �f