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HomeMy WebLinkAboutMiscellaneous - 114 BOSTON STREET 4/30/2018 (2) 114 BOSTON STREET / 210/107.6-0008-0000.0 ^�� 's.,A I;ewis , MAP # LOT PARCEL # STREET�._� ............. _.__.__... .:._.__........ CONSTRUCTION ARFIRO....... HAS PLAN REVIEW FEE BEEN PAID/? YES NO PLAN APPROVAL: DATE I/Zd Iq APP. BY_ DESIGNER: J R12l�AG �b PLAN DATE:__-� l _ CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT DRILLER._..._.__.___.........__._....._.__..._........ _.._._._.._.._._.........._... WELL TESTS: CHEMICAL DAIE APPROVED __.._._._.___. BAciv-RIA I DA fE (IPPRUVED ....... y BACTERIA II DATE APPROVEll__.___..______.__ COMMENTS FORM U APPROVAL: APPROVAL 1'0 ISSUE YES NO DATE ISSUED BY CONDITIONS: FINAL APPROVAL: . ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES 140 OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE:._..,_ BY: ..__ . IS THE INSTALLER LICENSED? ' + — E� NO TYPE OF CONSTRUCTION ? NEW REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO i r CONDITIONS OF..APPROVAL. YES NO (FROM FORM U) r 'ISSUANCE OF DWC PERMIT ' YES NO DWC PERMIT N0. INSTALLER:, BEGIN INSPECTION YES 0: " %_:EXCAVATION , INSPECTION: : NEEDED: PASSED HY CONSTRUCTION INSPECTIONS = NEEDED: AS BUILT KLAN SATISFACTORY: YESs APPROVAL TO. BACKFILL. DATE: Ll BY :FINAL. GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE: BY Town of North Andover, Massachusetts c�t'tOoTe �1 BOARD OF HEALTH DISPOSAL WORKS °0 CONSTRUCTION PERMIT,,,- o p � s cHUSEt� DISPOSAL WORKS CONSTRUCTION PERP D.W.C. No. Fee -- Applicant NAME ADDRESS Site Location Name Permission is hereby granted to Construct ( ) or Repair ( ) an F Site_ //¢ �,7aI ;: Sewage Disposal System as shown on the Design Approval S.S. No. S.S. No- 191:: CHAIRMAN,BC Form No. 3 Fee :: D. LtonF. Johnston & Co., Inc. �c Donna Dupuis Donald F.Johnston&Co.,Inc. 114 Boston Street Associate Builder North Andover,MA 01845 Builder's Lia#012428 ' Phone:978.682-1619 ° Q Fax:978--682-1083 - Email:4coinc@AOL.com NEW ENGLAND CLAIMS SERVICE, INC. ❑ Incorporated 1985 Reply To Reply To Mansfield, MA 02048 0.;V 131 Dodge Street,Suite 6 P.O. Box 345 A$SOUh7pN Beverly, MA 01915 r.mPENEIENT TEL. {508} 337-8058 "wa�ST'xSq TEL 19781927-3000 AONER FAX{508}339-5835 s FAX{978}927-3002 wrandall@newenglandclaims.com Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings EC�I�ED City Hall North Andover, MA 01845 AUG 13 2014 RE: Insured: Donald &Nnacy Johnston TOWN OF NORTH ANDOVER Property Address: 114 Boston Street, North Andover, MA 01845 HEALTH DEPARTMENT Cause of Loss/Date: Windstorm Loss of 7/3/2014 File or Claim No: BOS052492 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL 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 claim or file number. Section 3B. No insurer shall pay any claims (1) covering the loss, damage, or destruction to a building or other structure, amounting to one thousand dollars or more, or(2) covering any loss, damage or destruction of any amount,which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code,to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. 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. Very Truly Yours, C_�W 1-11auea Mark Randall Adjuster m.randallnecs@comcast.net {978} 223-7332 cell 4w OCT 0 7 2005 TOWN OHNORTH D PARTMENTER SY87EN-1 PUMPINU RF �Y�Y$ OWNBR ADDUSS DATE OF PVM,F1NQ;� Q, w ���J�NrzrY UMNCe PpOl ; Np-- ... . Y43.. rVK6 ON 3bRY jc.e: Kvv•r1N�•. tn�tK�it„k� . UtiziUAYA ► 0000 CONOITIoN IVY ROOT3 w.... LLAC H(FjeLp KUN8AC.'F, 6+�C&98IY6 801.1p$ �TPLOODev "OL CDCAIVAYOYUK .. -. OmER EXPLAIN , X, �'VMMhNT�. v/r I trN 1'� fll.�Nyl�KKb i t • gm (FkbA)-T STEP) = r�o.ao -Sox iA - 96. qr D-- 86x bv?" .:, 19 , 3/ P IT /A/ P rT--"J ins 5E. 7 •S �f 3 AQ D 5� 65T 6 A T � A i - fir, _ � _ i . � ,, - I , � _ ,a r l t � y�\� '�. � 1 t � • Y ..3 1 . ._ i i �.� �y � ��� r� I �+ r /"1 ,j �\ .,t ,� •{ a a._ - - -" i � f Address,. tz>5-T6k ST Title of File Page of Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes: T action Document/ document/ Num. Action Department Board of Appeals — Board of Health — Planning Board — Conservation Commission — Building Department TOWN OF NORTH ANDOY31 '� SYSTEM PUMPING RECORD I'ENI OWNER & ADDRESS SYSTEM LOCATION _ (example; left front of house) JO1)aS*1 i3os)6p,S-r Nc) A70 U,\,I, OF PUMPING ���QUANTITY P U M P C D 3060 G'ALLU' .S C i:»I'UUL: NO _ YES SEPTIC TANK: NO YES � A T U R E OF SERVICE; ROUTINE EMERGENCY OI FRVAT 10NS: GOOD CONDITION, FULL TO COVC1� HEAVY CREASE BAFFLE'S IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER Oj�HER (EXPLAIN) S1 ,.)TLM PUMPED BY: C UNI M F=NTS: UN I I:'.N"I'S' i'IZANSFEIZIZED TO: Town of North Andover of No RT s OFFICE OFc? y4. °off COMMUNITY DEVELOPMENT AND SERVICES ►- A * 146 Main Street KENNETH R-MAHONY North Andover,Massachusetts 01845 "SSACHUSEt Director (508)688-9533 April 11, 1995 CERTIFIED MAIL Z 115 835 538 WN E R, OARH Mr. Donald F. Johnston 114 Boston Street APR 10 1995 North Andover, MA 01845 RE: Opposite 305 Boston Street (DEP # 242-742) Dear Sir: At a public hearing held on Wednesday April 5, 1995, the North Andover Conservation Commission unanimously approved to levy a fine in the sum of$100.00 for illegally crossing a Bordering Vegetated Wetland (BVW). This resource area is subject to protection under the Massachusetts Wetlands Protection Act (3 10 CMR 10.00) and the North Andover Wetlands ByLaw(Ch. 178 of the Code of North Andover). Any person who violates any provision of this ByLaw or of any condition or a permit issue pursuant to it may be punished by a fine pursuant to Massachusetts General Law, Chapter 40, Section 21. The penalty for violations of this ByLaw are assessed on the basis of square foot alteration to a wetland resource area. The NACC, at my recommendation, agreed that a fine in the sum of$100.00 was appropriate. This fine shall be paid prior to the issuance of the Order of Conditions for the above referenced project. Sincerely, / 9 Michael D. Howard Natural Resource/Land Use Planner cc: Ken Mahoney,Director of Community Development&Services 'Sandy Starr,Board of Health Administrator BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Parrino D.Robert Nicetta Michael Howard Sandra Starr Kathleen Bradley Colwell - o---...._-. KAREN H.P.NELSON r Town of 120 Main Street, 01845 K � D"e``°r NORTH ANDOVER (508) 682-6483 . M� BUILDING CONSERVATION p°4 DIVISION OF PLANNING PLANNING & COMMUNITY DEVELOPMENT VIOLATION NOTICE Issued from: NORTH ANDOVER CONSERVATION COMMISSION Issue to: Mr. Donald F. Johnston Date• April 11, 1995 D.E.P. No• 242-742 Location/Property: Opposite #305 Boston Street The North Andover Conservation Commission has determined that the activity described below is in violation of the Massachusetts Wetlands Protection Act. (M.G.L. Ch. 131, sec. 40) and/or the Town of North Andover Wetlands Protection Bylaw. Extent and Type of Activity: - Illegal crossing of a Bordering Vegetated Wetland (BVW) If this violation is not immediately addressed as required below, an Enforcement Order will be issued, which may include a stop work order, which may be followed by legal action. Required Action: - Payment of fine in the sum of $100.00 prior to the issuance of Order of Conditions. Questions concerning this violation notice should be directed to the North Andover Conservation Office, Town all, . 120 Main Street or by calling (508) 682-66483 xtension 26. Signature: C .11.J �ju' - FORM 4_SYSTEM PUMPING RECORD� SEPTIC & DRAIN SERVICE 107 FOREST STREET; MIDDLETON,MA 01949 (978) 774=2772 COMMO EALTH OF MASSACHUSETTS ve ,MASSACHUSETTS SYSTEM PUMPING RECORD SYS- liTEM OWNER: \\ SYSTEM LOCATION:cl Ll n o J617 DATE OF PUMPING: ` o C� J QUANTITY PUMPED: ``1 �� ---- , __ GALLONS CESSPOOL: NO D YES 0 SEPTIC TANK: NO . s � YES �----- SYSTEM v STEM FUMFED By: CARRIER SEPTIC & DRAIN SERVICE i CONTENTS TRANSFERRED TO: L :DATE: CJ --------------- INSPECTOR: Y' . .�• �j • I'ROs�osEG SuQSueF.fGQ SEwAla �IsPt2S4_ Si-Sreq TOWN OF NORTH ANDOVER l3 o t fG 11 /x Z. 'Z 2 3-0-K.-Z,r- -,y / z = 3 Cgs •A P 5/DE iA/A1 L .s-b'� 'x =2 �` x: z Cno L, - P,eOP41EG 1cr �it.vd/.vG Approved 0. 0 7/-A 9 S'.a 6 - Date L6/ -�.,. __ / 'Db GAL SCALE = / /'= .ZO' s-WTE = 19 C4 G • / 7/1cl 3 ga � �s' 1�l Ow�vER R E yam-f3 9� Signature DC N/9 L D ,j o�, /Vs f o/V /! � Lac s5 Y1 o,./ A/c A t A /-7N D a VL-ec, /IMS - JOCArlo": LIE5/6 AlER cro.SEPR cT BAR6 445,CL G �H OF M / WESTWARb 0RCLE . i Ala. M A W Ater , AIAs S BtALLo v •o 'A� Nn. 4B4 Z�//�• � TEC. GG�-493 � F . o ;i �s�on`•,si s��'� / t/�t�� E QESiGAl OATH = x�9 •f5 °� t3•M- r Ex i5 /5-00&fi4. �c 9q.7v Q5PERM:aC.IT/opt/ TLSM Z w3 ¢ #S f �►- �3 o x D4 Mr TAP OE4EYAr/o,N 4�• 4 0 t S4rZACW r/OA/ / - .HI/J. MSN V/A/. Min/ /I'nr �� DROP 9-m4- ORQP O 7ESr PITS it/ A*z 10.3 sa DA M CS TbP ELFYAT/ lip. 40 X 9T• 7 f SO/[ TYPESof ANO W" WAmk M 8 L E G-RaV t 4- tiC _ ZoC4 riow 3o—s lolv Ro � -�- 80rTokt F1EY4rro ? S�F P TESTS c.4�/A/1CTE0 BY t .To.5,-P / r 64,?BA6ALL0 , RX ?�� W/rNESSED BY P44A./ D65/EA! 6e/TER/.4 cS'NEET I OF Z � I ` I FeECAST- CD/UCRETE SEEPAGE P1T Y WASNED CCG 5-A4FD SMAA-- -14 /12- W,4SHE1P L'�PU.SflEO STtl NE � �Z" �'1AX/MG'M CD!/F� �Q�UBLE !'YASNEI>-<f ASHD SPK• T-//-��� /Z" /f�IAX!/NUN1 L'Dl/E� //VLE% PIPE p p 0 G7 O O O p d O C� fl D - �� C7 O O O d r sPL.4sH PAZ) O O O O O O O i -- - O UEEPAG6 P1 r- t�KrioAl A-Q e- EEPA6E P/r- SEC 7-10,V B-B c�CA /s =P . Q�, cSCAGE -3-N ¢"idCA5TleOA1, S=•oos OR SCA SeEPAar= AeEA _ I c74. f T PEP- P17 / $'�s0'�AG• GDNC.eErE SEPT/C TAAI/G ' ¢''�SOL/D P.U G'•,SEAGE� .Td/itlTS� S=.005. ;� /Q' _ _,i— 2 SHALLOW SEEPAGE P/T CDG � ,� . .. j ,C3a f'o M (,A-T A a 1,E A?9.74 S6EPA6E P1T- — PZ,4AJ RDF/L E f�E\ ►s3_9 �,c�CALE -3�8.. _�._Oa / 4RD ltlrJ c>CALE f�E�T'-" / � P/�OF/LE — �66PAf7E P17- PLAN.! AVO S6 -10A/�S I Town of North Andover, Massachusetts Form No.Z f MORTq BOARD OF HEALTH � w 9 x s DESIGN APPROVAL FOR ,4 CRUSE' SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant j Test No. Site Location y� s� kaz=ZL • Reference Plans and Specs. • NGINEEIR DE GN 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. PL A AJ csAlo /mi4 13,C Z) SUBSUIC X-f 40 SEWA(w s b1SPm%4Se TE�t /30t- Z' �Xl; t' 1 3a8, -X ! z = 3CsG •Pt> TOWN OF NORTH ANDOVER S/2)E IA L O�x �'5-�X 1=3 $ o 2 SO G,,c>,�, fo ,�AL GAedD I� / oa G�4L S��'rL/c f�yiY.� 'CAGE = / ��= .z o' 414 r& 19 C4 G / 7/!qy 3 Date it/ 6l7/4.p'f,eiG-1, OWwER REY 9-l3 43 Signature -�-o-��'�'' DG lV/i L �}o�,/ .5 74 o/1 // 'fe 13GS101V Roly ' /tfo AtA IVNZ7oVI-71, Mh' , ,10CArloAl: LEES/Cs A/ER cTa3EPw cT. BARSAbALL 0 .0 Rs. H OF M z i .. 'a= Wo. RkA,61A/er , /SASS RAGALLO y Nn. 4g4 o z x9� •rs °` M. Ex 1�S /5-0 0 Gfy 4. SCPfIC 1-14 NK {Fri 1 S • j ZpmtocArloAj 7rsrs so/ -3 ,Cxo5� D-Dox LurE 6-ir- 9a S 7VP EZ.Ei/Ar1coJ 4 g• 40 O y. $ fi O� 7c AOr7bM EIEY4 rAW 9.3 , 57 .,S4rZ1lCi4r140A1 / .N/.a/. Min/ M.,.v F— X /I`nr 9" D.QOP !"is 6" ORo�P .t/ia. M/n/. A!AA/ M/w/ Ll mmmmm� I14 Rr4rGiCA r/ON f 4rT Al��a /.� M•-• � .4!„✓w Many/.: O TFST PITS it/ A*Z o 3 Ac¢ DA rE x�7`G5' TDP CZE44 TIW 9P. 40 '� 9r•psuF b.s Q�� 7 -w/e- TYPES wArFR rAecE GR,9 v L ' X 97. 95' ZocA 7-140 Al Al o%l j o BoTTom &EUArlo ,�. _ •; '1 / _ f--- TESTS <CN4UC-rED QY TOSEPAI T 64R8A(SA440 , R SfO GF SESD BY PzAAi t DFslFAj 6elTER/.4 c5''"EET / OF 2 I i u r I r I 1` FwECAST com!: ,2ETE SEEPAI�E PIT 6 �8"7a 3B" WASHED CCU5AFD .SMVE . "ro/1Z" W.4SHEd L'QU.S�/E� .50 NE /Z" i1'lf1X/MGN1 CD!/E2� �Z" ifilAX//LIVM CD!/E� �DoUBLE i'IiASHEl�-�JASHO SPK. T//-(0� /NLET PIPE O O O d O O O O t � C5 O C� ' 2'X Z'X 3 CJNC2ETF O O O O O O sGL.4st/ PAD _ O O O O O O O O 49 // oGAO O G cSEEPA6E //T - �Kr/opt/ A-A GE P/T- SEGr/.Oy 8-B cSCAGE -38"=/'-,D" ¢"�CASTS,e,OA1, S=.00S OR SCI► I P'1/G • SGEPA4E AREA PE�e P/T. GOA/CRETE SEPT/G TA Al/L "lKSDG/D P.(/.d.,SEAGED TOlAi7-S, S=-005• 2. SHALLOW SEEPAGE P/T TT � � ..��,_�__.__ Imo.- -�- ;��• - - -. 3G" L4 4 w Lr QQ f m abs Ae1E 74 t I :7�; blo b; L Q r; cSEEPAGE P/T" -- PL.4.y n o 14�U sCdLfi f�E�T"' /!" '� P�2DF/[.E cSSEEPAGE P/T PLA Al QNB SEC 7-to Ai S SAAS ET �l 17E S Ilr A ALAN t5i' Du/lAj f-,coposED SUSSaRFara SEwAG` bl5PMs.,._ <S'esre,41 l30 7,- -/Z308 -,Y L.z. = 3 C G •� !� ,��vv TOWN OF NORTH ANDOVER S!2)E iA//21 L so'x ��s'x _3 �` x - ��� L��'• '- P,eoPcUEG Lor a,c. .bl"a Appro ed f074A/.. 3� � � Sam �G9G • ,a•D Date _9 20 g-3 /Too G.4L &ALE 19C4 G • / 7/!5,9 3 Signature /Vd OWAJER: R E v A&--13 93 Do lvlg L b �}o� Ns f b/V 9 /! 3e Z3Sf GN A' 0li,P LOCArlow: ZI LIES/G A/ER c)2)3 N cT BAR SA454Z1-G tH OF M / WESrWARA CIRCLE Ala. IQEAD✓,t/!, , /t�1As S. +� �AR'8' A.GAL LO v //•�1• w' TEL. GG¢-4983 4 Nn. 4pq . \�z `- ��; [VAL / !//��� j QESiCsA! DATA = x99 •r� °` BM• E . Sf±Ptjc 1,-14 Al j< I / I x 9q.7v ZPERC40CAr/ON 7VSr3 MO/ 4wZ jw3 +�¢ lS� D-l3ax (! DA Mr a-!r,- 4 :, 9 kl 7VvP ECEyor10#4-1 48. 40 o g © 0/\ 7z� k 8077vM E[EYW rA2.v ?.3 , .6., .S•ITUtATioA/ / - ,c�/�. MIAv AflAl. MiN AfAW M/.v g ik-A 0t.ArioN •4.4nE M•,,. /u M� i ,41,�r W Mi�j/� fir--- O TFSr PITSDA M i xc� } X 9 7'G Sp rOP ELE✓AT/ • 40 �-- AA10 wArFR rA ec E Gka v It 4- 40C4 r/O A/ Aloe',(jo 30s lolv C/4 8orrom E1Eu.,4rro 'c .719 —___ �• '/ = f� 'cf o? G/� f. t,}�f G/'�1 S /2'> TESTY aw4uc mD BY ToscpA, J S4,e8A6ALLO , Rx 7LS73 K//rAIES-,ED BY PzAA/ t G&stew Ge/TERI.t cYA4EEr � OF 9 ' a P.2ECAS7- COA/G,2E7-C SEEPAGE PIT W-45NE2> CCa5AfED S7 AA-- /Z" /1'IfIX/MG'M CavE� "ro/IZ" W,4SNE0 Ciel-I-WED .STONE �LbIJBLE 1'l/ASNE!> -AASH .SPK. T-//-�O) _ •- IMI-C-7- PIPE cal t i a. .ice" _ !•' `s �` 3" ' , .s�br3 p O d O O O O C� L7 2"X Z'X 3 CJNC�ETE O O O _T, O O O d sPL.4.SH PAD O O O O O O O , o D UEEPAGE P T- &icrloA/ A-A cSEEPAGE P/T- cSEGT/oma! B-B i c�C.4CE 3�8••' -D•• cSCAGE 3/B„'�•�„ —' ¢"l�CASTSROA.(, S=.00s OR SCA ' � • SEE PACGE AREA = 3 f 6 c74. �5T PE,e P/T. /�'c�s0`�AL. GD�t/GQErE SEPTIC TA?J!� _ ¢'' SOL/D P•/%L'•,SEALED Ta/A-17-S, S=.00-17- - .21 =.005 2 SHALLOW SEEPAGE P17 ,-n,6 if I ob AelE 291'744 Li . L..A SEEPAGE r/T- PROS/L E' �E� •, -X3-9,3 `SCALE 3/8.. _�._�., it o I��O sCA�E - � I�Ek'T�` �� � PROF/L E cSF�PAC,&- P/T PLA AI 4AjD cS�EC T/O A/�S �f lE ET � OF Z PLAN REVIEW CHECKLIST ADDRESS /14�3057DAJ7 ENGINEER GENERAL 3 COPIES c/ STAMP LOCUS NORTH ARROW SCALE CONTOURS PROFILE SECTION BENCHMARK ✓ SOIL & FERC INFO c/ ELEVATIONS WETS. DISCLAIMER WELLS & WETLANDS WATERSHED? A/0 DRIVEWAY (Eley) WATER LINE FDN DRAIN SCH40 TESTS CURRENT? SEPTIC TANK 5-1,14f6 MIN 1500G. . 17 INVERT DROP GARB. GRINDER (+200% EDF) 25' TO CELLAR MANHOLE TO GRADE ELEV GW D-Box Lr, ING SIZE # LINES FIRST 2' LEVEL STATEMENT INLET - OUTLET = (2" OR . 17 FT) TEE REQ'D? LEACHING RESERVE AREA � 4' FROM PRIMARY? 100' TO WETLANDS ✓ 2% SLOPE 100' TO WELLS / 35' TO FND & INTRCPTR DRAINS 4' TO S.H.GW 325' TO SURFACE H2O SUPP ✓ 4' PERM. SOIL BELOW FACILITY -- MIN MIN 12" COVER FILL? (25' if above natural elev; 101if below) BREAKOUT MET? TRENCHES MIN 660 gpd SLOPE (min . 005 or 6"/1001 ) >3 ' COVER? - VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) IS RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? BOT X LDNG + SIDE X LDNG = TOT (L x W x #) (G/ft2) (DxLx2x#) FORM 4-SYSTEM PUMPING RECORD CURRIER SEPTIC & DRAIN SERVICE 107 FOREST STREET;MIDDLETON,MA 01949 (978)774-2772 COMMONWEALTH OFNo ASS��ACC�HUSETTS V4Cfo L/ yVTASSACIiUETTS SMTFX PTIRIPING RFS SYSTEM LOCATION: SYSTEM OWNER: \ In S D ''] vt I L150 �b GALLONS _QUANTITY PUMPED. f --- DATE OF PUMPING: l - �� " � V Q CESSPOOL: NO 0 YES SEPTIC TANK: NO 0 YES 0` SYSTEM PUMPED BY:-CU RIERCEPTIC & DRAIN SERVICE CONTENTS TRANSFERRED TO: f Q Q INSPECTOR: 6e"-)?f DATE: l FEB 3 PITS MIN 660 LEACHING GW MIN 4' BELOW BOTTOM MANHOLE/PIT EXCAV 2x EFF W OR D 12"-48" STONE SURROUNDING BOT + SIDE x LOAD = TOTAL (L x W x #) (2 x (L+W) x D x #) CHAMBERS MIN 660 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT , MANHOLES % 12"-48" STONE 3 SPLASH PADS c--� SLOPE . 005 BED/TRENCH (Bed max. 60' X 601 ) BOT 3a8 ���+ SIDE a X LOAD TOTAL-7-1-15-7�-Xo (L x W x #) (2 x (L+W) x D x #) FIELDS MIN 900 ft2 LEACHING PERC RATE FASTER THAN 20M/IN GW MIN 4' BELOW BOTTOM OF FIELD PIPE ENDS JOINED W/NON-PERF. PIPE? 4" PEA STONE? DIST LINE SLOPE .005? >3 ' COVER - VENT SCH 40 MIN 12" COVER L x W = T x LDNG > DESIGN FLOW? DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY gpm L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME gpm MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1' below inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL OP. SWITCH `SON Ay~ jo 14H. I . 5 I i �1����-�I� �y��' CSC �✓'C-r" I I I A II S I I i � ' I i � ill 'I Ili �I � Ili l j •, =� _i l �� j I I l i I I � � I ' •l I I I l i l I � II I I ISI I II I hi lffl IV -o"PWIS I I R 117 i • I I i I I I I S I � I •' � II I III i I I i � I III k ��TIZCG ��O srDN S 7" /V TS A PL A AJ 5A Ocvl/V4 reOPOSED SZ1&SI/IRF4CE SEWA46 bls�>_ sksne,41 SIDS i /.QZ L So 3 ,e.2 ~ 34 aS., Zor v.CAL/NG f• 4 t.��. ��� t � � O� ;- �G9GP � A%c 74.g/Y& &ALE - / _ �a� b-4re7/ 3 R E�y dt_ a OWA/ER DO n//i L D L�a AA/5 r� o Io ll � l.3G5fGN A. �/� �. LOCArIOPJ: F L`ES/C,�vER �TasE� cT BA�2t4.4cxALL o , .�-s• �„t�+ or ,� WESTLI/AR-6 CIRC4Z Mo. 0FAC✓A/4 , / /IAS S. Nn. 464 cr������2`, / f Q6S/G Ai O A rA - z' 9q 74, z CSS 'S ✓ � N Z PF.,4t'DC,/T/ON 725T1 JO/ /c, X 9 O Tlhp ECEdAr1or4j q a?- 4o S4 rzll,t.4 r/OA/ M/N. .K�AJ- ,N�i�/i Minim f€O O-rs," DROP // AflN. ApAt AfNJ' M/N r F � joe"064T/0.v R•CM M•v. /u .N.-• / .41,E.w M��/•. s _ 7EST PITS x77• . t roP ELEY,4T/ R. 4o X pT. 7 ,so/c rYPEs S tA b s G e �-- AAID _ WATr-,e rABLE GRA1/l6e4- 17. - 9?• �j LOcAr/OBJ I�lo � 3o-s t Ro-1-1 BDTTOM E1E✓.4rlo •?'/f - l � TESTS cavaiG TES T 6Y TOSEFN 64�?BCA6A4-0 ! , R S �`o.? CF f3C•��O�-s �f P TE 13 STs W1 sEo SY PZAAI t G15,516" Cel rE'R/A cS'NEET I OF Y PeECAST COA16ZETE SEEPAGE PIT WASHED rCa51lED Z70N,- . "roZ- WASHED �'iPL/S�/E,b .STOME /Z" X//HG'M CDIiE,e CGbUgLE yYASHEI> /MLE— P/PE w/T/-/ 7-E--) it"MAX- ,i. : - - Z �. O O O O O O fl O C5 2"X 2'X 3 CJNCeEIE 0 O O O 33" © O O O d SPLASH PAD O O O O O O O " 57al .. 8' f lie UEEPAGE P r Q-A cSEEPAGE PiT- cSEGT/opt! B-B cSCALE 3�8 � "/-���_ rSCALE 3�8„-�•�„ ¢"�CA�TSROcl, S=.005 DR SCIS 46 /''.1/C SEEPAGE AREA PEP- P/T. sld0 COAL. G��tlGeETE SEPT/C TAVA, � � ¢'' SOL/D RUe-,SEALED TDi�Ilrs, S=.00s. � _ ,2 SA7.4LLOW SEEPAGE P/T rri CD 61 DO Ll L4 f a�A a Z 91,746 Ld SEEPAGE P1r PLAti/ PROF/L R ry. 7- 93 SCALE a Lfi t t`9 "-• {� - PROF/G E SEE PAGE P/T PLA Al QNB SEC 7-/O A/.S Sore ET TOWN OF NORTH ANDOVER SYSTEM PL'MI'ING RECORD APR 5 J DATE 3-1,7-62V 6''y a SYSTEM OWNER&ADDRESS SYSTEM LOCATION DATE OF PUMPING QUANTITY PUMPED 70 60 CESSPOOL NO YES SEPTIC TANK NO YES NATURE OF SERVICE: ROUTINE MERGENCY OBSERVATIONS; GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN LACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY COIIIEENTS: CONTENTS TRANSFERRED TO ECEIVED Commonwealth of Massachusetts R City/Town of North Andover FEB 14 2017 ' a System Pumping Record TOWN OF NORTHANDOVER Form 4 HEALTH DEPARTMENT M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location- on the computer, use only the tab I 14 key to move your Address cursor-do not North Andover use the return key. Citylrown f State Zip Code 2. Syste Owner: )) �VAI � I� Name man Address(if different from location) Citylrown State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping D ��I 2. Quantity Pumped:ate Gallons 3. Component: ❑ Cesspool(s) 91Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Observed co dition of component pumped: Isa � 6. System uTYrped Name Vehicle License Number Stewarts Septic 58 So Kimball St Bradford Ma Company 7. Location where contents we r d sposed: 20 ill st br dford ma (- 14, -t - � Sign ur of Haul r Date Signature of Receiving Facility(or attach facility receipt) Date r t5form4.doc•11/12 System Pumping Record•Page 1 of,