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North Andover Board of Assessors
roperty Record Card
Location: 1015 FOREST STREET
Owner Name: CUNHA, HERBERT J
Owner Address: 1015 FOREST STREET
City: NORTH ANDOVER State: MA Zip: 01845
Neighborhood: 6 - 6 Land Area: 1.00 acres
Use Code: 101-SNGL-FAM-RES Total Finished Area: 1924 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 385,700 395,000
Building Value: 177,000 186,300
Land Value: 208,700 208,700
Market and Value: 208,700
Chapter Land Value:
http://csc-ma.us/PROPAPP/display.do?linkId=1464851 &town=NandoverPubAcc 10/19/:
Commonwealth of Massachusetts
Town of North Andover
System Pumping Record
System Owner & Address:
Herb Cunha
1015 Forest Street
North Andover, Ma 01845
Date of Pumping: June 10, 2013
Type of System: Septic tank
Location of System: Right side yard
Gallons Pumped: 1000 gallons
System Pumped By:
John Zanni Pumping Co. LLC
5 Hallberg Park
North Reading, Ma 01864
License #: BHP -2013-0067
RECEIVED
JUN 18 2013
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Contents Transferred to: Greater Lawrence Sanitary District
Date: June 10, 2013 Pumping Technician: DD
This is proprietary and confidential information that may be used only by the
Board of Health for regulatory purposes
Commonwealth of Massachusetts I RE I=—IVSD
Town of North Andover I GCT 0 2 2009
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
System Pumping Record
System Owner & Address:
Herbert Cunha
1015 Forest Street
North Andover, Ma
Date of Pumping: September 23, 2009
Type of System: Septic
Location of System: Right side
Gallons Pumped: 1000
System Pumped By:
John Zanni Pumping Co. LLC
P. O. Box 4
Reading, M 01867
License #: BHF -2003-000159
Contents Transferred to: Greater Lawrence Sanitary District
...__........_ ..........................._.... .
.. _ _.........
Date: September 23, 2009
Pumping Technician: DM
This is proprietary and confidential information that may be used only by the Board of
Health for regulatory purposes
MUGFORD ENTERPRISES INC.
DBA: John Zanni Pumping Co.
DBA: Mugford Brothers Construction
P.O. BOX 4
READING, MA 01867
Phone: 781-944-0149
Fax: 978-475-3520
November 2, 2006
Town of North Andover
Health Department
Town Hall
North Andover, Ma 01845
Gentlemen:
Enclosed please find System Pumping Records.
If you have any questions, please call this office.
Very truly yours,
John Zanni Pumping Co.
�S/
Debbie Mugford
►V
JAN 16 2007
TOHEALT iyDEPAK �'N1ER
Commonwealth of Massachusetts
`zi p City/Town -of NORTH ANDOVER, MASSACHUSETTS
System Pumping Record
Form 4
4
DEP has provided this form for use by local Boards of Health. The System Pum n �Recor must
be submitted to the local Board of Health or other approving auth JAN 1 6 2007 ri. p g
A. Facility Information
TOWN OF NORTH ANDOVER
Important: I HEALTH DEPARTMENT
When filling out 1. System Location:
forms on the l a
computer, use ref �
only the tab key Address
to move your ��yf i 1
cursor - do not —
use the return City/Town State Zip Code
key.
2. System Owner:
ef
Name --- --
Address (if different from location)
City/Town
B. Pumping Record
State Zip Code
Telephone Number
2s
1. Date of Pumping /0 � � � C'
p g Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) [Septic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes ® No
5. Condition of System:
6. System Pumped By
Name j p
�O /j N � /p i✓ N � / u /Yl � C
Company --
7. Location where contents were disposed:
C z- 1f"�p
Signature of Hauler
http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect
If yes, was it cleaned? ❑ Yes ❑ No
Vehicle License Number
Date
-3/—'- 6
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
0
c+ PATRICK J. DONOVAN ASSOCIATES, INC.
"CLAIM AND LOSS ADJUSTMENTS"
P.O. Box 110
Wakefield, MA 01880
(617) 245-5540
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS. CHP. 139, L
,
TH AII''DOVER/
F i'r! TH
TO: Building Commissioner or
Inspector of Buildings
City or Town Hall
N. Andover, MA 018
RE: Insured: Herbert J. Cunha
Property Address: 1015 Forest Street
N. Andover, MA
Policy Number: 616062
Loss Type: Soot Damage
Date of Loss: 3/18/96
Our File Number: WAP23177
Claim has been made involving loss, damage or destruction of the above -
captioned property, which may either exceed $1,000 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 captioned Insured,
location, policy number, date of loss and file number.
Vern Laws
Adjuster
Donovan Associates, Inc.
Wakefield, MA
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.
4/26/96
Town of North Ands)ver. MA
Watershed Septic System
Servicing Retort
Date:
Homeowner. i�
Street / /S
Phone
Nature of Service:
Observations:
Description of 'Rork:
Comments:
Routine
Emergency
Pumperj (A�ZZLr�_,
Address : (Z j-D-jQ-60 Q,b
Phone
Good Condition
Full to Cover
Baffles in Place
Leachfield Runback
Excessive Solids
Heavy Grease
Roots
Other -(Explain)
NORTH ANDOVER BOARD OF HEALTH
INSTALLATION CHECK LIST
APPROVED DATE DISAPPROVED DATE tXCAVATION OK
REASON,J:
AIL
OK
To:
1. DXWe
ands
ns
2. Wat Line Location
3. No ��c Pipe _
4. Septic ank
Te - Length & To Clean Out Covers
ment Pipe to Tank - On Both Sides of Tank
5. Distrib 'ori Box
Co r & Box - No Cracks
1 Lines Flowing Equal Amounts
No Back Flow
or Trench
6. Le/Dnsions
pth
nds
uble Flashed Stone
7. Leach Pits
Dimensions
Stone Depth
Splash Pads
Tees
Cement Pipe to Pit - Both Sides
Clean Double Washed Stone
--F.- T o Gar' -age Disposal
-fir i.nal G_ o Inspection
--_
ere -System
110 As - Built Submitted
Dimensions of System
Location with Regard to Pere Test
Elevations
Water Table
NORTH e. OVM. BOARD OF HEALTH
IIrTS ALLA —LON CHECK LIST _
APPROVED DISAPPROVED EXCAVATION OR
Date: Date: ��'kx_r_�
Reason:--- c�
52�7�
As Built mitted
Lot location, dimensions. of system, location in regard to
percolation tests, depth of system, water table
2. Distanc to Wetland Areas, Drains, Street & House, Drainage Easement and Wells.
3. Water L�le Location
4. No PVC ipe
5: Septic ank - Tees, Cement -Pipe to Tank -Joints on both side of Tank.
6. Distri lion Box - No cracks in box or cover, all lines flotir erually from box.
7. Leach Fields - Dimensions, Stone Depths, Capped ends, Clean double-Vnashed stone
8. Leach Pits nsions, Depth of Stone, Splash pact tees, Cement -pipe to tank-
oints on both sides of tank, Clean double -trashed stone
9• No Garbage Disposals
10.Final Gradin f`r'barricading of sub -surface system;
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SOIL PROFILE UERCOLATION TEST DATA
Town CiOj-c®✓z�4
--- -_ Lot No. a
Loc./Subdiv. 2z � ; Plan /
/ f Owner L
Investigator br.qa/%p Observer
77 SOIL PROFILES -DATE
1' Elev. 2•
Elev. 3' Elev. 4'Elev.
............ 0 ----1 0 .�_ 0 --
1
2
3
4
5
6
0
7
0
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1
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5
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2
3
4
5
6
71
8
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�0 �., 10 ��� 10 10 I�
Benchmark Location
Elevation Datum
_
Percol t'on Tests -Date
Pit Number 1 2 3 4 5
Start Saturation
Soak -Mins.
Start Test -Time
Drop of Tl' -Time
Drop of 6" -Time
Mins.lst 3"Drop
Mins.2nd 3"Drop -
Notes & Sketches on Ba k
•r -
Frank C. Gelinas & Associates, North And.
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DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, October 19, 2009 1:30 PM
To: 'herbcunha@hotmail.com'
Subject: I.R. - Septic - Health Dept. File -1015 Forest Street - Herbert J. Cunha
Attachments: I.R. - Septic - 1015 Forest Street- Septic Plan - Page 1; I.R. - Septic - 1015 Forest Street -
Septic Plan - Page 2; I.R. - Septic - Health Dept. File
Importance: High
Mr. Cunha,
Here is the file information for 1015 Forest Street as we discussed over the phone.
Best regards,
;D"e& veize
Pamela DelleChiaie
Health Department Assistant
TOWN OF NORTH ANDOVER
Health Department
1600 Osgood Street
Building 20; Suite 2-36
North Andover, MA 01845
978.688.9540 - Phone
978.688.8476 - Fax
pdellechiaie@townofnorthandover.com - E-mail
http://www.townofnorthandover.com - Website
Nnrec-
If copied to BOH Members - Reference Copy Only - no response requested at this time
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, October 19, 2009 1:19 PM
To: 'herbcunha@hotmail.com'
Subject: I. R. - References for Title 5 (Septic) and Private Well Water Testing
Hello Mr. Cunha,
Below are links for information about Title 5 and the sale of a home, as well as guidelines from Massachusetts
Department of Environmental Protection (DEP) regarding Well Water Testing.
I will also scan your Health Dept. file and send it to you as a reference.
You can go to the Town of North Andover website at: http://www.townofnorthandover.com/ and select —
Town Departments — Health Department — Permits and Applications. There will be a link here for a list of Title
5 Inspectors licensed in the Town of North Andover.
http://www.mass.gov/dep/water/wastewater/`fagsprop.htm
http://www.mass.gov/dep/water/drinking/mapwe112.htm
Best reg""a��1r_�ds, &e
;Vaat
Pamela DelleChiaie
Health Department Assistant
TOWN OF NORTH ANDOVER
Health Department
1600 Osgood Street
Building 20; Suite 2-36
North Andover, MA 01845
978.688.9540 - Phone
978.688.8476 - Fax
pdeUechiaie@townofnorthandover.com - E-mail
http://www.townofnorthandover.com - Website
Notes.-
If
otes.
If copied to BOH Members - Reference Copy Only - no response requested at this time