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Home My WebLink AboutMiscellaneous - 10 STONECLEAVE ROAD 4/30/2018Commonwealth of Massachusetts City/Town of NORTH ANDOVER, MASSACHUSETTS .' System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. 4. Effluent Tee Filter present? ® Yes ❑ No If yes, was it cleaned? Ek Yes ❑ No 5. Condition of System: GOOD 6. System Pumped By: RAGGS INC. Name Company 7. Location where contents were disposed: FITCHBURG TREATMENT PLANT Signature of Hauler http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect t5form4.doc• 06/03 Vehicle License Number X2/15106 — Date System Pumping Record • Page 1 of 1 A. Facility Information Important: When filling out 1. System Location: forms on the computer, use 10 STONECLEAVE ROAD only the tab key Address to move your N. ANDOVER MA 01-045 cursor - do not use the return CitylTown State _ Zip Code key. VQ 2. System Owner: CHRIS KRIBY Name Address (if different from location) ISI City/Town State Zip Code Telephone Number B. Pumping Record 11/02/06 1500 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) ® Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ® Yes ❑ No If yes, was it cleaned? Ek Yes ❑ No 5. Condition of System: GOOD 6. System Pumped By: RAGGS INC. Name Company 7. Location where contents were disposed: FITCHBURG TREATMENT PLANT Signature of Hauler http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect t5form4.doc• 06/03 Vehicle License Number X2/15106 — Date System Pumping Record • Page 1 of 1 Town of North Andover. KA Watershed Septic System Servicing Report Date: 3/29/99 Homeowner: CHRIS KIRBY Street 10 STONECLEAVE ROAD Phone Nature of Service: Observations: Routine X Emergency TOWN OF NORTH ANDOV�� BOA. AR. D OF �i ALTN APR 20 1999 Pumper : RAGGS SEPTIC SERVICE, INC Address: P.O. BOX 1027, CONCORD Phone : 978-369-1100 Good Condition Full to Cover Baffles in Place Leachfield Runback Excessive Solids Heavy Grease Roots Other (Explain) Description of work: ROUTINE SEPTIC PUMPING Comments: 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: 'r PhondQr�% LOCATION: Assessor's Map Number Parcel Subdivision Street Y411rocksye TDa Lots) St. Number ************************Official Use Only************************ RECO14MENDATI0 S OF TO AG S: Date Approved )12 7/ Conservation Administra or Date Rejected Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved L �% Date Rejected Received by Building Inspector Date 0(3 a WW 0 IL o= OF _ Z�z < prria _jU�- ILZ0 Oaa N Z5(A 2mU NW� WOa low �Z 0N UNI <ZF- WSciW 000 H U HX� jWW IL �Z� Z<N ONH UWW WZ_ NJW N N OJ EY9.5 . C- IH=IF- I^I�1I I F- m li llJl�l �;IIIII j FF p rot I I I A W W _ U Z 0 H z 3 W a a U u �> p� °a << 3; :)\ Yo3 i ! TTTT o Y o Ti- x U Ilil71 O z O 0 z 0 K Z zJ`wiDE OR19/1V EY9.5 . C- IH=IF- I^I�1I I l li llJl�l 7I" � � IH=IF- I^I�1I I l li llJl�l FF W _ O O Ou7I u 0 2 << y Yo3 Za O Nw< Y x O •a- 7 C0x�f J Oa " ZjZ Qz vQ 0 a LLp W � ioO3[ O Z2 ua < ! J`O° O Yz. 00�uZ ;i.00�iZ il N i I �— p ec y 0 0. Z 01 �e zO � a uu < u z I u r2 �1 -O 2ZNZ0Z p v02000O O of C N Q p m 0[ z W< 01 mZpS 0 O O z 00 in m Wa a Rp W K .F0 p K m p Sa I V Oy N N 0aa W< J N Of 3 H N 3 m LANIGAN ASSOCIATES, INC. Building Commissioner Inspector of Buildings Board of Health Board of Selectman Town Hall North Andover, MA. 01845 Mav 26, 1994 L A I RE: Notice of Casualty to building under MASS. laws Chap 139 Sec 3B Claim has been made by the insured for loss, damage or destruction of the property indicated below which may either exceed $1,000.00 or cause Mass. G.L. Chap 143 Sec 6 to be applicable. If any notice under Mass. G.L. Chap 139 .Stec "B is appropriate please direct It to the writer and indicate a reference to captioned insured, location, policy number, date of loss and L.A.I. file number. Insured HANLEY, Martin R. Jr. Property 96 Staqe Coach Road Policy # HPN 290 [615 Loss of 4-1-94 L.A.I. file # 4516 ,1 Wm. N. Lani Adjuster On the above date I caused copies f this notice to be sen to named above, at addresses indicated above by firclass ma 1. A l t 7 Y Wm. N. Lan' an Adjuster ons : Mav 26. 1994 120 Main Street, Nashua, New Hampshire 03060-2757 Telephone 603-889-9339 FOXNI 4 - SYSTEM PUIIPL\G REC0RD Commonwealth of Massachusetts NORTH ANDOVER Massachusetts' V w 5 2002 L_ .. ......t System Pumping Record ystem Owner System Location KIRBY 10 STONECLEAVE ROAD Estimated Date of Pumping: 6/20/02 Quantity Pumped: 1000 gallons Cesspool: NO ❑ Yes 0 Septic Tank: No ❑ Yes 0 RAGGS SEPTIC SERVICE, INC. S) -stem Pumped by: d . b - a . E. A. COMEAU SEPTIC License r: Contents transferred to: WATER SOLUTIONS G'ROUP, TAUNTON' Date 7/12/02 Inspector RAGGS SEPTIC SERVICE INC wo FORM 4 • Sl'S` %t PLTINIP •G RECORD Commonwealth of Massachusetts'%, o� 'D 6F NORTH ANDOVER Massachusetts 2 System PumRing Record ).stem«ner System Location KIRBY 10 STONECLEAVE ROAD t Date of Pumping: 2 / 3 / 04 Estimated Quantity Pumped: 1 500 gallons Cesspool: No ❑ Yes ❑ Septic Tank: No ❑ Yes RAGGS SEPTIC SERVICE, INC. S) -stern Pumped by- d.b.a. E . A. COMEAU SEPTIC License r: Contents transferred to: WAYLAND SUDBURY TREATMENT PLANT Date 3/19/04 Inspector RAGGS SEPTIC SERVICE INC. TOWN OF NOR SYSTEM PUMP DATE: 1/17/05 SYSTEM OWNER & ADDRESS KIRBY 10 STONECLEAVE ROAD [ANDOVER G RECORD RECEIVED JAN 2 4 2005 TOWN OF NORTH ANDOVER I HEALTH DEPARTMENT SYSTEM LOCATION (example: left front of house) LEFT BACK OF HOUSE DATE OF PUMPING: 12 / 8 / 0 4 QUANTITY PUMPED 1500 GALLONS CESSPOOL: NO X YES SEPTIC TANK: NO YES X NATURE OF SERVICE: ROUTINE X EMERGENCY OBSERVATIONS: GOOD CONDITION X FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: RACGS SEPTTc SFsgvTc F Tums COMMENTS: CONTENTS TRANSFERRED TO: WAYLAND—SUDBURY mer Date of Pumping: 51-3 ) (I commonwealth of Massachusetts Massachusl 9 SEP 27 2011 OF NORTH ANDOVER LTH DEPARTMENT 1 a �� Co Quantity Pumped: /5a a gallons Cesspool: No Yes , ❑ Septic Tana:: No ❑ Yes ❑ RAGGS SEPTIC SERVICE, INC. System Pumped by: d.b.a. E. A. COMEAU SEPTIC License -- Contents transferred to: _WATER SOLUTIONS GROUP, TAUNTON Date 5 13 Inspector RAGGS SEPTIC SERVICE. INC.