HomeMy WebLinkAboutMiscellaneous - 150 LACY STREET 12/2/1993 NUMBER FEE
THE COMMONWEALTH OF MASSACHUSETTS $25 . 00
TOWN--------- of --------N-ORTH-AND-OVER-------------------------------
Charles M. Rollins Co. , Inc .
Thisis to Certify that ------------ . . . ----------•---•-••----.......---•-----•...............•......••.•.............•.................
NAME
129 De ot Road, Boxford, MA 01921
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ADDRESS
IS HEREBY GRANTED A LICENSE
For ......................Li-c.en-se---to...D.ri-11---We.1-1....7---Lat...U-0...Lacy----st-rae.t----------------
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This license is granted in conformity with the Statutes and ordinances relating thereto, and
expires----December 31 1993
-------------------- -.,------------------------------unless si7,p
sooner d fl
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-----Dec-em-ber----2----------------------19---9-3 -------- ...L. --. ............
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FORM 433 HOBBS a WARREN, INC.
OORYN
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Cf 10
C14us BOARD OF HEALTH
NORTH ANDOVER, MASS.
APPLICATION FOR WELL AND PUMP PERMIT
Permit # A /- Date
A permit is requested to: drill a well install a pump
LOCATION: I- Ac-y � 7- Lot
Owner , e,
Address Tel
Well Contrctr Add.
2-
Tel
Pump Contrctr Add. Tel
WELLS (To be completed at time of pump test. )
Type of well Use
Diameter of well G size of casing
Depth of bed rock —Depth casing into bedrock
Seal been tested? Yes ( ✓) No (
Date of test 613
Depth of well Water-bearing rock
Depth to water Delivers GPM for
(how long?)
Drawdown feet after pumping hours at GPM
Date of completion
Signature of well contractor
PUMPS (To be filled in before installation. )
Name & size of pump Type_
Size of tank Pump delivers GPM
Pipe used in well: Cast iron (_) Galvanized (®) Plastic
Sleeve used to protect pipe? Yes (®) No (®) Type well seal
Date
Signature of pump installer
Date water analysis report submitted to Board of Healthy
Plumbing inspector Wiring inspector
Board of Health
ra
BOARD OF HEALTH
120 MAIN STREET TEL. (582-6483
"SSACHUSE' NORTH ANDOVER, MASS. 01845 Ext23
December 29, 1993
Jay Philbin
10 Lacy Street
North Andover, MA 01845
Dear Jay:
I have in front of me your Form "U", a copy of the water
analysis report, and the application for a well and pump permit
for Lot #20 Lacy Street. There are some items that need to be
addressed before I can sign the Form "U" . They are as follows:
1) Planning and Conservation must sign-off on the Form "U"
before Health.
2) Highlighted areas on well permit must be completed.
3) Highlighted areas on water analysis report either
exceed what North Andover considers primary
contaminants or are missing.
If you have any questions, please do not hesitate to call me
at the number above.
Sincerely,
Sandra Starr
Health Agent
SS/cjp
FORM U LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: 0 6,v3 AN Phone
LOCATION: Assessor's Map Number Parcel
Subdivision Lot (s) 2-0
Street n r,,j �7) St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS: 4
a )>6, Date Approved O
Conservation Administrator Date Rejected
Comments2 + ��� ayl - r/ 4✓
ewa
64( 1 r C .
Date Approved 3 g
Town Planner Date Rejected
Comments
Date Approved
Food I�fnspector-Health Date Rejected
Date Approved
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
driveway permit
Fire Department
Received by Building Inspector Date
DEC- 1 .5-93 WED U i4 r-[-I L t-,Hrtii i C.. :=, I Him. wriwL r i i - C,U C.
low
Ora-t-nitt, 6tate 21nalpff"Calt
Main ®ffiee;LaboratOry At; Tramway Marketplace At; Daniels Arteslan Wells
61 East Broadway Route 16 & 2s
Route 3
Derry, NH 03038 West 08sipee, NH 03890 Sanbornton, NH 03209
(603) 432.3044 (603) 539.5551 (603) 286-3303
CZrz: t ir t i for D- rznking
SENT TO: James Philbin TEST NO, ; 12074
10 Lacy St.
No. Andover, MA 01845
TEST
PATE: December 9, 1993 LOCATION; Lot 20 Lary St. e�
No. Andover, MA
PARAMETER RESULT RECOMMENDED LOWER DETECTION
MAX.LEVEL(PPM) LIMIT (PPM) I
2 PH 8 , 77 UNITS 6.5---8.5
HARDNESS 44 150 4
CHLORIDE 250 0.1
NITRATE 0.5 10.0 0.5
NITRITE 1 . 0 0.05
SODIUM 48.8 250 0.002
2 IRON 1 .02 0.3 0.03
MANGANESE 0. 03
0.05 0.01
COLIFORM ABSENCE /100 ML ABSENCE 0
OTHER BACTERIA /100 ML 200 0
COPPER 1 .3 0,02
ARSENIC 0.05 0.001
LEAD �!
0.015 0.001
CHROMIUM 0.1 0.05 a
CALCIUM 9.4 NONE SET 0,01
7ATV 250 10.0 —
COLOR 10 CPU 15 1
ODOR TON 3
mY >10 NTU 5 0. 5
T.D.S. PPM 500 0.001
THE'TESTED /PARAMETERS MEET CURRENT STANDARDS FOR DRINKING WATER,
XX THE TESTED PARAMETERS MEET CURRENT PRIMARY STANDARDS FOR DRINKING WATER, �I
BUT SOME SECONDARY PARAMETERS EXCEED STANDARDS.
THE TESTED PARAMETERS FAIL CURRENT STANDARDS FOR DRINKING WATER,
----DUE-TO PRIMARY STANDARDS OUTSIDE OF LIMITS.
r
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COMMENTS: ALKALINITY - 92.6 PPM SULFATE - 31,4 PAM e_
SPECIFIC CONDUCTANCE :- 260 UHOMS MAGNESIUM - 0.774 PPM
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TNTC DENOTES TOO NUMEROUS TO COUNT.
1 DENOTES PARAMETERS THAT EXCEED PRIMARY STANDARDS; CAUSES VEST FAILURE.
2 DENOTES PARAMETERS THAT EXCEED SECONDARY STANDARDS; DOES NOT FAIL TEST,
NOTE: SUBSEQUENT SAMPLES FROM THE SAME WATER SOURCE MAY VARY, j
Authorized by SG