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HomeMy WebLinkAboutMiscellaneous - 1057 JOHNSON STREET 4/30/2018 1057 JOHNSON STREET let .21-0/1-07-A-027-9-000.0.0 b � 7 OT MAP # L PARCEL # STREET __..__..._.._....__......�. CONSTRUC.TI.ON_APPROVAL HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE APP. DESIGNER: PLAN CONDITIONS -- WATER SUPPLY: TOWN WELL WELL PERMIT DRILLEf2._..._._.------.......__._......_.__.._..._..... ........_..... . __....... . . WELL TESTS: %BA I CAL DA I E API-FZUVEU._._.__-.._--.._._._..--- E R I A I DA I E flPPRUVED BACTER II DA1-E elf='PROVEll__.-__�___..__-__.__ COMMENTS: FORM U APPROVAL: APPROVAL TO ISSUE" NO DATEISSUED _-- __-... _... ...._._.-.._.._.-_..._._..__� CONDITIONS: FINAL APPROVAL: . ALL PERMITS PAID NO WELL CONSTRUCTION APPROVAL YES NU SEPTIC SYSTEM CONSTRUCTION APPROVAL ` - NO OTHER YES NU rW�Ts. -- NO Z) YES ARY ANY VARIANCE NEEDED /�/� FINAL BOARD OF HEALTH APPROVAL: DATE:_ �D•L�/16--By: ,. . '1}e. h�•'_.r,•• . .• , r '-.1.,{ ±",i� r � 1 � �� ',±C�itTi r't� '� 4 S #••F ',q�-� r« ot ,SEPTIC SY�' i' NSS$�►Ir. QLI ��.."r �ti'TI � � .. '.9.Ijir-. •:'r a:.. '_X}:.ij,�"!.•:: .v� t~'t� .�1v�s S�- ?• "''"'•"� !Is' THE INSTALLER LICENSED?~ �„� �.:'�:�+r•. YES NO TYPE OF- CONSTRUCTION. +� NEW REPAIR' , .-..NEW CONSTRUCTION: CERTIFIED PLOT. PLAN REVIEW_ NO �: CONDITIONS OF_APPROVAL ... _ YES NO (FROM FORM U) ,' r ,• •` "4ISSUANCE-OF DWC.•PERMIT ? - YES NO r DWC PERMIT NON 7(�/� •: •_ `• INSTALLER 44BEGIN INSPECTION S� 0.; ' _ EXCAVATION . INSPECTION: .: NEEDED: PASSED n f BY CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: '- APPROVAL. TO BACKFILL: DATE: BY /f FINAL . GRADING APPROVAL: DATE �� � BY /01 �dZ�l`� BY FINAL CONSTRUCTION APPROVAL: DATE: TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE:-Q1 SYSTEM OWNER &ADDRESS SYSTEM LOCATION vr�,, - (example: left front of house) �-� - 6f �1d use DATE OF PUMPING: QUANTITY PUMPED15tin GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: /_ �eL504-4, rvcl- COMMENTS: CONTENTS TRANSFERRED TO: �- �� Commonwealth of Massachusetts City/Town of RECEIVED System Pumping Record Form 4 APR 2 9 2009 DEP has provided this form for use by local Boards of Health. Other for sTR A gIsIQQVER information must be substantially the same as that provided here. Befor nI chreck w1u,your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: Left front, left rear, left side of hous Ri ht on right rear, rights f house. forms on the computer,use only the tab key Address � to move your D v / cursor-do not. C4/Town State Zip Code use the return key. _ 2 System Owner: _t Name Address(if different from location) CitylTown State/-, p C e Telephone Number (� B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: El Cesspools) eptic Tank [j Tight Tank Other(describe): 4. Effluent Tee Filter present? El Yes U AVO If yes,was it cleaned? p Yes No 5. Conditlorl of System: 6. System Pumped By: Neil Bateson F 5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location Where contents were disposed: �L.S.D/ Lowell Waste Water r igna ure of H u r Date t5form4.doa 06/03 System Pumping Record•Page 1 of 1 &ORTN ` ,tc °+ BOARD OF HEALTH O F 9 120 MAIN STREET TEL. 682-6483 �9SSACHUSNORTH ANDOVER, MASS. 01845 Ext23 January 30, 1995 Scott Giles 50 Deer Meadow Road North Andover, MA 01845 Re: Lot #1 Johnson Street Dear Scott: This is to inform you that the proposed plans for site referenced above have been approved on the following conditions: 1) Please show limit of soil excavation around leach area on site plan. 2) Benchmark needs to be set closer to system. If you have any questions, please do not hesitate to call the Board of Health Office at the number above. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp ORT Town of -0. s over GG �► L No. art yy dower, Mass., &C to 19 5 T O �- LAKET COCKICKEWICK ADRA7ED PPa\ Cl BOARD OF HEALTH PERMIT T Food/Kitchen Septic System Ol�l� �` �o a�� O��Y BUILDING INSPECTOR THISCERTIFIES THAT L{.'�Yl..................... WVi.... .... ................x............�................................(. ` "'"""""' Foundation has permission to erect..tJ�<M....fR MOL buildings on .l:Q .11......S�km.` ..... .�............................ Rough to be occupied as tRrMI. .. fk1l.t11..O!d.��IMAA.0.so...... ...CiQ(L...G•91 ............^'"�'..... Chimney provided that the person accepting this permit shall in every respec conform to the terms of the application on file in • Final this office, and to the provisions of the Codes and By-Laws relating to the Inspect' n A r iQ nd Construction of Buildings in the Town of North Andover. WhAY��K FOUNDATION ONLY PLUMBING INSPECTOR REGULATED BY PARA. 114.8-S. B.C. -- VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough D LG W FEE PAID t 021 Final PERMIT EXP S O 196 - ELECTRICAL INSPECTOR UNLESS CON TI Rough PERMIT FOR FRAMUBUILDING . .. .. .. ......... ......................... ........ ....... . Service BUILDING INSPECTOR DATE: 9� FEE PAID' �� � Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display Conspicuous Place on the Premises — Do Not Remove Rough p Y in a Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. QPAIPP /IAIATFR PIKIAI nRIVFWAY FNTRY PFRMIT FORM U - IAT 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: /��y ��/1�-- Phone LOCATION: Assessor's Map Number ld709 Parcel 13l c4 Subdivision Lot(s) Street :To�041.5C:�. Some,t St. Number -b 5� ************************Official Use Only************************ RECO A IONS OF TOWN AGENTS: p Date Approved Co se ation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections -7:721,o 94��� - driveway permitG+J -�- 9� Fire Department Received by Building Inspector Date , CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. 1 SCALE:1"= 50' DATE:9/5/95 Scott L. Giles R.P.L.S. 50 Deer Meadow Road CiJ North Andover, Mass. o o N #3 0)�f n $ c9 O ~1} O Lq N�A LOT #1 ary. 43,850 S.F. SEPTIC CERTIFIED 9/18/95 TABLE OF ELEVATIONS OUT OF HSE.=109.11 363 7• IN TANK =108.42 89• 1 OUT TANK =108.15 INTO BOX =108.01 OUT BOX =107.82 #1 =107.37 OF fto #2 =107.48BOA VER/ o #3 =107.64 ARD pF HTM #4 =107.40 rn � SEP 1 9 I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY Of SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING �, c BY LAWS OF CONFORMITY OR NON-CONFORMITY �' FCtSTER�� NORTH ANDOVER s o WHEN BUILT WHEN CONSTRUCTED. r /���L IPM�g Town of North Andover, Massachusetts Form No.3 t NORTN BOARD OF HEALTH 1 Q ,1'O •0 I I J� e OL F 9 ' o`�`��" �* DISPOSAL WORKS CONSTRUCTION PERMIT 'tet SSACHUSE Applicant_ NAME ADDRESS TELEPHONE Site Location : Permission is hereby granted to Construct (L/or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN,BOARD OF HEALTH Fee D.W.C. No. i fill i � I i � i `t�\. �. \ t. 'i•. t �� t. t EYt\N i���4 `��.! <L `\�I;�l a t •Y, ,. � .. lam► gyp, 1.Y �[y��,�7yyge,�2�•�,��RY• s hypy��f, t. � � �T��k��F����\•t�` �.kW�,�'�C�C,Cd;1,1d�1��.•i`.�'St,'��•t�F'h3'�2i.'�.'t:L�` ` .�}���.�'.V�.hC.St�'�.1�!..lSi`��.�3 F:�:t��, 1 ,`i Yu>r. � ��' _� .1.. Y�.i. Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH0 19 / APPLICATION FOR SITE TESTING/INSPECTION ��SSACHUSE��y Applicant—o7' 1�`?.'LA jj {-- NAME ADDRESS TELEPHONE Site Location � m 1 Engineer ,LX-tllt( ./ NAME ADDRESS TELEPHONE Test/Inspection Date and Time X/4-- A _ CHAIRMAN,BOARD OF HEALTH Fee ' t/ Test No. (13 61 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. iJ � HN-PAUL C NSTRUCTION INC JUNE 3, 1994 DEAR SANDY, ENCLOSED PLEASE FIND A CHECK FOR$150.00 AS PER YOUR REQUEST, REGARDING THE SOIL TEST ON TURNPIKE STREET. I SPOKE WITH SCOTT GILES AND WE ARE READY TO DO THE TEST AT YOUR CONVENIENCE. COULD WE DO BOTH A DEEP HOLE AND A PERK TEST AT THE SAME TIME? PLEASE GIVE ME A CALL WHEN YOU'VE SCHEDULED THE TEST OR IF YOU HAVE ANY OTHER QUESTIONS. THANK YOU. SINCERELY, i JHCK.ERUB4'E o 6p W.A.: 71 2543 Main Street • Tewksbury, MA 01876 • (508)657-6007 THIS CHECK IS IN PAYMENT OF THE FOLLOWING: HN-PAUL sati,Y� s f 6368 ^ �p ^ 2543 MAIN STREET r r N$T RUy�ON C TEWKSBURY,MA 01876 INC (508)657-6007 ;•:. ` ', >' ANDOVER SAVINGS BANK 53.7047/2113 ANDOVER, MA 01810 PAY 1 ` DOLLARS TO THE J ._'r... ORDER OFr D / d LW/1I I' V13 AUTHORIZED SIGNATURE >� ' = 11'00636811' r:12113704771: 65 220512 811' y� ��3- ���- (�oo�- � �kG�-- FOR DATE & TIME M OF <PHCINfiI!. PHON 11 — �'gQIJ Y[IURCALI AREA CODE NUMBER EXTENSION '. f�t�ASE,CAtt: MESSAGE 7 e � VI/1tL�l1Lf lit..0 AC�A1N �AMf Tb` % I � SEE YCJLi It1tANT�u T.0 S>rE'IDt.� SIGNED TOPS FORM 4003 (508)657-6007 1f ` J ` HN-PAUL C NSTRUCTION INC Custom Homes p Additions ® Garages c 2nd Levels 2543 Main Street Tewksbury,MA 01876 JACK BERUBE' _ Louts J. Kmiec. JR.'.APPRAISER -- PAac No. tows res . f OW4DR�1lGL,[lQGtg011 •;ter;: :. J I- . i /NORTH ANDOVER If ' szs AT r "-,A 3 Y JE�V M. DUBS �',d�•, 6' 421 ;.8� { �S�-•io3 DULL Tb. tq8`3 .SCS` 66 IS mayu JEAhr J.TJIJI�d( . TTF ' BAN l.p3 '2 !� A'c. M,LTo}i C.s C,LEiN �` c A1: I! :gJLIV ti E. kL'• A Lor rt ; C/a. C F �IrdC - taOi+tilC 7`4+ Z72. 1952 3 .K t93A-ij 7— Ac.— Ac. i .., �,M, pAN•.w.w.M :.. ..�. �.+....,� EAU'S '� .. .-F, . � oS7o /J HtL �. VQ EA s;. 0�4CL1r�1 �:=C L6: FOR DATE V TIMEP. 1#rllz� 7INA a PFtON�D OF C� (f/®� RETfJt�NED PHONE--u � YC�t3R CALL .: AREA CODE NUMBER EXTENSION MESSAGE- Ake ESSAGE PLf ASCALt n ' 1tUtLI.CALL. /�/ ACxAfftil SES YC3U 1NA(�TS Tt3 Si> 4QL! .:............................................ SI ED TOPS FORM 4003 DATESheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER ! SUBSURFACE DISPOSAL DESIGN REVIEW FEE �` PERMIT # zo DATE RECEIVED APPLICANT JACK ASSESSOR'S MAP 07- 1-2 a�"4.3 114,91A.) 5r ADDRESS rEsBv�Y PARCEL # LOT # STREET �cl��.f/5bti sJ` ENGINEER <--O 17- 616 ADDRESS O 11 iG1a101040 -:F- D - / ) .A PLAN DATE /l/ate/A/,::7- REVISION DATE CONDITIONS OF APPROVAL: APPROVED DISAPPROVED GO/L �5XC/9 V�9TiQrt1 PLAN REVIEW CHECKLIST /� ADDRESS �/ `! ' �/5p� ENGINEER SCOTT G166 166- S GENERAL 3 COPIES STAMP LOCUSy NORTH ARROW (/ SCALE !/ ri 49 CONTOURS V PROFILE�� SECTION 1/ BENCHMARK BE SOIL & PERC INFO 4- r ELEVATIONS `' WETS. DISCLAIMER r/ WELLS & WETLANDS ,/ WATERSHED?)/_/0 DRIVEWAY i (Eley) WATER LINE v FDN DRAIN SCH40 V TESTS CURRENT? SEPTIC TANK MIN 1500G ✓ . 17 INVERT DROP ✓ GARB. GRINDER(+200% EDF) 25 ' TO CELLAR i,,� MANHOLE TO GRADE ELEV cam— GW D-BOX SIZE # LINES FIRST 2 ' LEVEL STATEMENT INLETD/ G"61;�_- OUTLET/6,�-3e _ : -7 (2" OR . 17 FT) TEE REQ'D?/&/O �) LEACHING MIN 660 GPD? RESEVE AREA L/ 4 ' FROM PRIMARY? 2% SLOPE 100 ' TO WETLANDS Or- 100 ' TO WELLS L,---- 4 ' TO S.H.GW 35 ' TO FND & INTRCPTR DRAINS ei 325 ' TO SURFACE H2O SUPP 4 ' PERM. SOIL BELOW FACILITY MIN 12" COVER 4-� FILL? �(25 ' if above natural elev; 10 ' ifbel w) BREAKOUT MET? �--� TRENCHES / MIN 660 gpd v SLOPE (min . 005 or 611/100 ' ) 1/ >31COVER?-VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) ✓ IS RESERVE BETWEEN / LC3 TRENCHES? �IN FILL? ✓ MUST BE 10 ' MIN. 4" PEA STONE? BOT �U�QU X LDNG��" + SIDE (0 X LDNG�� TOT l 7 �w (L x W x #) (G/ft2) (DxLx2x#) (G/ft2) Copyright© 1993 by S.L.Starr ,kORTN BOARD OF HEALTH H P t • s c 120 MAIN STREET TEL. 682-6483 ♦ 9 �9SSAC'HUSNORTH ANDOVER, MASS. 01845 Ext23 December 12 , 1994 John-Paul Construction, Inc. 2543 Main Street Tewksbury, MA 01876 RE: Lot 1 Johnson Street Dear Mr. Berube: This letter is to confirm that on December 1, 1994 the North Andover Board of Health granted a variance to the distance of a leaching area to wetlands to allow the proposed leaching area on Lot 1 Johnson Street to be installed no closer than seventy-five (75) feet to the wetlands on the southeast side of the lot. If you have any questions, please do not hesitate to call the office at the above number. Sincerely, Sandra Starr, R.S. Health Administrator cc: G. Perna, Dir. DPW, Acting Dir. PCD S. Giles File Town of North Andover, Massachusetts Form No.2 MORrM BOARD OF HEALTH � w F --- DESIGN APPROVAL FOR ass"C"U5`` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. Site Location • Reference Plans and Specs. ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee �' Site System Permit No.�� 6Ze� TO F NORTH ANDOVER mss✓ ARD F HEALTH _ Locatio 5 w Permit Food Service S Retail Food $ Limited Retail $ Seasonal S Disposal Works Installers $ Disposal Works Construction $ Soil Testing $ Design Approval Permit Dumpster Permit $ Burial Permit $ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Well Construction Permit $ 0 0 m Funeral Directors Permit $ Massage Establishment License $ Massage Practice License $ Suntanning Establishment $ Offal/Trash Hauler $ cv Other $ 1 6 6 0 Health Agent White - Applicant Yellow - Dept. Pink - Treasurer PLAN REVIEW CHECKLIST ADDRESS Z&-9- ;t,�y�ax� ENGINEER GENERAL 3 COPIES STAMP LOCUS NORTH ARROW SCALE CONTOURS PROFILE SECTION BENCHMARK SOIL & PERC INFO ELEVATIONS WETS. DISCLAIMER WELLS & WETLANDS WATERSHED? DRIVEWAY (Eley) WATER LINE FDN DRAIN SCH40 TESTS CURRENT? SEPTIC TANK MIN 1500G . 17 INVERT DROP GARB. GRINDER (+200% EDF) 251 TO CELLAR MANHOLE TO GRADE ELEV GW D-BOX SIZE # LINES FIRST 21 LEVEL STATEMENT INLET - OUTLET = (211 OR . 17 FT) TEE REQ1D? LEACHING MIN 660 GPD? RESERVE AREA 41 FROM PRIMARY? 2% SLOPE 1001 TO WETLANDS 1001 TO WELLS 41 TO S.H.GW 351 TO FND & INTRCPTR DRAINS 3251 TO SURFACE H2O SUPP 41 PERM. SOIL BELOW FACILITY MIN 12" COVER FILL? (251 if above natural elev; 101if below) BREAKOUT MET? TRENCHES MIN 660 gpd SLOPE (min . 005 or 611/1001 ) >31COVER?-VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) IS RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 101 MIN. 4t1 PEA STONE? BOT X LDNG + SIDE X LDNG = TOT (L x W x #) (G/ft2) (DxLx2x#) (G/ft2) Copyright© 1993 by S.L.Starr J HN—PAUL n . : _. . C NSTRUCTION INC November 9, 1994 Dear Sandra Star, I respectfully request being put on the agenda for the Board of Health meeting on November 17, 1994. 1 am proposing the construction of a single family dwelling located at Lot# 1 Johnson Street. I am requesting a 15' -20'variance from the Board of Health bylaw regarding septic system setback to vegetated wetlands. If you have any questions, I can be reached at(508)657-6007. Thank you. Sincer j John F. Berube' 2543 Main Street • Tewksbury, MA 01876 • (508)657-6007 7y��E LIJ 195 /g Z),/,5 i9 I} L �,V To 'AEU/S�DNS , /VO dw I � I ) I r - � I 1 i i r y , SANDRA STARR , 01/30/95 I APOLOGIZE FOR OVERSEEING THE FACT THAT ON THE #1 SKETCH I LEFT WITH MIKE HOWARD IT APPEARS I WOULD LIKE TO MOVE THE HOUSE ABOUT 15 ' CLOSER TO THE SEPTIC SYSTEM .THAT SKETCH WAS PLACED OVER A RECENTLY REVISED PLAN THAT WAS MOVING THE HOUSE FURTHER BACK ON THE LOT . THE PLAN OF RECORD SHOWS THE PROPER LOCATION OF THE HOUSE AND THIS SKETCH IS PLACED OVER THAT . I BELIEVE THE DISTANCE TO THE SYSTEM WOULD NOT CHANGE . IF I AM MISTAKEN , PLEASE CONTACT ME . AGAIN , I APOLOGIZE FOR THE OVERSIGHT . THANK YOU , RAY ALLEN 682--9760 PS . I ALSO UNDERSTAND NEW REGULATIONS ARE TAKING EFFECT ON 03/31/95 . COULD YOU TELL ME WHAT THE DEADLINE IS FOR FILING CURRENT DESIGNS . THANKS AGAIN . I CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MAS _ SCALE:1"= 50' DATE:9/5/95 OF HAN Scott L. Giles R.P.L.S. SEP J 50 Deer Meadow Road (\� _ North Andover, Mass. lJ\J o o O s 'o co \\ Ycq x` LOT #1 °ry 43,850 S.F. o 36389 „ 0 ° rn _ I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE 1H THE OFFSETS OF THE BUILDING INSPECTOR ONLY $� SHOWN COMPLY AND SUCH USE IS FOR THE i3 WITH THE ZONING DETERMINATION OF ZONING h BY LAWS OFD CONFORMITY OR NON-CONFORMITY NORTH ANDOVER t lANO WHEN BUILT WHEN CONSTRUCTED. i i