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COMMONWEALTH OF MASSACHUSETTS BHP-2004-0378
North Andover FEE
$125.00
Board Of Health
Ogden Well &Pump Co.,Inc.
-----------------
NAME
12 HEATH CIRCLE
- --------------------------------- ----- -----
ADDRESS
IS HEREBY GRANTED A PERMIT
Well Construction
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This permit is granted in conformity with the Statutes and ordinances relating thereto,and
jexpires-----_____-._.._.May 20, - _-- --------unless sooner suspended or revoked.
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May 20,2004 Board Of
-- ------- Health
11
- ----------- ----------- ----
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Town of North Andover
Healtlt`epartment Date: �' 0
Location: �,T�e�e
(Indicate Address, if Residential,or Name of Business)
Check#: 16-;?/
Type of Permit or License:(Circle)
➢ Animal $
➢ Dumpster $
➢ Food Service-Type: $
➢ Funeral Directors $
➢ Massage Establishment $
➢ Massage Practice $
➢ Offal(Septic)Hauler $
➢ Recreational Camp $
➢ SEPTIC PERMITS:
❑ Septic-Soil Testing $
❑ Septic-Design Approval $
❑ Septic Disposal Works Construction(DWC)$
❑ Septic Disposal Works Installers(DWI) $
➢ Sun tanning $ -
➢ Swimming Pool $
➢ Tobacco_ $
➢ TrasIVSolid Waste Hauler $
>b000l4ell Construction $ /47-11
➢ OTHER:(Indicate)
057 _ Health Agent Initials
White-Applicant Yellow-Health Pink-Treasurer
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den Well & Pump Coag Inca
Serving The Ground Water Industry
stry
Jr l 1 ToaaF NORTHANDD ER/
BOARD GE HEALTH
MAY 13 ?rn
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17 Cath rw' ood Road e.Tewksbury,'MA 01876 (978) 453-8200 • (800) 339-9051
Mai 11 04 11 : 14a NORTH ANDOVER 9786889542 p. 3
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BOAA
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+'•� ''�a' • BOARD OF HEALTH
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SAc►+u5ti NORTH ANDOVER, MASS . o r Yti 5
APPLICATION FOR WELL AND PUMP PERMIT
Permit #1 Date 5/1110 f
A permit is requested to: drill a well install a pump t/
LOCATION:^ (Z. Ht&± "1 CI rL. c Lot # ��
Owner J6h-n 6w4n Address 1-.2- HCA+h 0-i 44io Tel
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94
Well Contrctr
dep �. �5 — Add.�KSSb�A14 Tel 9-rY 463"90106
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Add. ��
q�8 �9-03f
Pump Contrctr Sa-KISZ- _
WELLS (To be completed at time of pump test. )
Type of well to" cLn iLj.J Use 1rri�- '
Diameter of well tok i Size of casing -# 1'7 SlA:a
Depth of bed rock Depth casing into bedrock
Seal been tested? Yes (_) No (_) Date of test
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 Health
Plumbing inspector Wiring inspector
Board of Health
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4 TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT p
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 01.845 �',�°•,»°�''t�
CHUSE
Sandra Starr Telephone(978)688-9540
Public Health Director FAX(978)688-9542
January 8, 2002
John J. Ga.ffny
12 Heath Circle
North Andover, MA 01845
Re: Well permit application
Dear Mr. Gaffey:
I apologize for the delay in responding to your application for a well drilling permit. I can
ii
explain that our secretary was out for 3 months on sick leave, that we are training a new
employee, that we are chronically understaffed and that we were trying to deal with bioterrorism
response training and anthrax calls, but that does not excuse the delay in response. I am very
sorry that no one got back to you or to your well driller sooner.
In response to the questions in your letter of December 21, 2001;municipal boards of health
regulate all private water wells in accordance with local regulations under the authority of
M.G.L. c. 111, § 31. Other well- related laws such as M.G.L. c.l 11, § 122 and M.G.L. c. 40, §
54 also relate to Board of Health responsibility andority. Boards of Health are additionally
required to consider any pertinent existing conditionsUhat could negatively affect the health and
safety of the public health or the environment.
Specifically, your well permit application was denied because of the drought alert issued by the
USGS Massachusetts and Rhode Island District in July 2001, and its re-issue in November of
2001. After this second, continued drought alert, and the occurrence of several historical lows
for both ground and surface water, the Board of Health at their December 2001 meeting voted
unanimously to discontinue the permitting of non-essential wells until further notice. (Please
note that in this case an"essential"well is one that provides potable drinking water to a dwelling
that does not have access to municipal water. The word"non-essential"refers to any well that is
not the sole source of potable water for a particular dwelling.) The determining factor that the
Board will use to lift this moratorium is a report from the Massachusetts and Rhode Island
District that the state and/or Essex County in particular is no longer in a drought condition.
Again please let me apologize for our untimely response to your application for a well permit.
The response would have been the same, but it should have been delivered much sooner.
1
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If you have any questions about the content of this letter,please do not hesitate to call me at
978-688-9540 between the hours of 8:30 and 4:30 Monday through Friday.
Sincerely,
J
Sandra Starr, R.S., C.H.O.
Public Health Director
Cc: File
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John J. Gaffey
12 Heath Circle
North Andover,MA. 01845
December 21, 2001
Town of North Andover
North Andover Board of Health
27 Charles Street
North Andover,MA. 01845
Attention: Sandra Starr, Administrator
Attached please find copy of fax regarding the status of my well permit
application. Please advise the reason for rejection of subject well permit so that I can
properly pursue the matter. I herein request the authority bases for rejection including but
not limited to statue, regulating authority and other consideration as the bases for
rejection of my application.
The permit was in limbo for two months.No qualifying reason was given for
rejection. I expect a more expeditious response.
Thank you in advance
i
John J. Gaffey
FROM FAX NO. Dec. 13 2001 07:39AM P1
(64� SIM- UNGS AND SONS Irrc.
Wells • Pumps Filters
FAXDate: Q
Number of pages including cover sheet: Z
To: /'
B From:
Phone: C" � Phone:
(603)465-3500
Fax hone: r le a
CC: Fax one:
Ph (603)465-3512
REMARKS: UrgentFor our review
Y [] Reply ASAP Please comment
J,141
269 Proctor Hill Road Hollis, NH 03049
(603) 465-3500
Phony (603) 465-3512 Fax w
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FAX N0. Dec. 13 2001 07:39AM P2
• ;v uyrls�i! Vs' ill�111.111
Town Of ,North Aodover,Mass .
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APPLICATION FOR WCLL & PUMP PE'RMI'T
Pt. %.cation .is hereby made for permit to drill a well (1�. Application
ode to install tl a pump system'. —
)cation: Address 1,2
// � • LaC /J .
�nersla—An' Address ee
�jl
� !}1 Te 1';
S
III Contractors /nc�� f..sL�IJ Addressel .
imp Contractor _ Address °aOY�
Tel . .
:LL CONTRACTOR (To be completed at time of lnttnp test )
�r '
pe of Well /�-K tJeLi used for /fi'T�q{�Urj
ti rr
ameter of Well Size of Casing
!pth of Bed Rock Depth casing; into beet Rock
.s Seal Tested? Yes (–) No (–) Date. of Tc'stin8
!pth -of I I – .. Well Ended in Wha.t. Material
'nth to Water_ nelivrrs Gals . Per Min. for 4 hour
-•down feet after pumping__hours- at �_ Z' GPM
tte of* Completion
Signature t7e Contractor
rkX�:4e�:Ys:•.,�itS'tuYtSr:'t�t�'t:'.•.�;C:k)Yikaa:'t::x�ti:�t:..::::'toir:... ..st3't:r::i:;r:. ...::'ria::::«'.::c;Y'►t::«�•a�':«•�xu*y:k�Y�
IMP INSTALLCR (To be-- filled kn' before installation) r
.ze & Name Pump Pucitp 'Type Used
iter Pump Delivers CPM S1le of 1'ank._
.pe Material Used in Well : Cist Iron t_) Galv,nnized t^) Plastic (–►
.11 Pit ( ) or Pitless lldapt¢r t�)
:s sleeve used to -protect pipe? Yes (_) NO(–} TYpe or Name Well Seal!
ite f V1
-fe eater analyst's . report submitted to Board of 11dalth
release given to owner of record & 11ldg.• Insp
TC,r i
�R
11calth Inspector
24-1V.
O
John J. Gaffny
12 Heath Circle
N. Andover, MA. 01845 � u.sPHir) hc:-
� MIDDLETON.MA
01999
ur:rre�sr,:-ss nasmcseavice DEC
PMOJ"dT 0 I
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7099 3220 0009 9265 593 9269 $3.910!845 05
Town of North Andover
North Andover Board of Health
Attention: Sandra Starr, Administrator 'WAM6
27 Charles Street ls$ �� - --
ri North Andover MA. 01845
Nil i�
Return
i6 4 A. r v } 111111-If 1111111111l1i 111tl.: tl!!Hillilti!!I!!!I!
PATRICK J. DONOVAN ASSOCIATES, INC.
Claim ald ROSS Ajustments "
P. O. BOX 110 r�
WAKEFIELD, MA 01880
TEL. (781) 245-5540 — FAX (781) 245-7016
JUN 4 2001
May 15, 2001
Building Commissioner
City or Town Hall
North Andover, MA 01845
Insured : John J & Marion S Gaffny
Property Address :12 1,1 ath._Ciircle North Andover
Insurer : Vermont Mutual Insurance Company
Policy Number : H012150111
Type of Loss : Water Damage
Date of Loss : 5/13/01
Our File # : WAP32433
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.
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.
zz.e�.
Vern Laws, Adjuster
VL/so
ISSOCUTION Of INDEPENDENT INSURINER AIJI)STERS
of Mas=husetts
NEW ENGLAND ENGINEERING SERVICES
INC
r
June 18, 2004
r of rvor�r A►vG�,� i
dASD CF N€{LTE!
Susan Sawyer
North Andover Board of Health JUN 2 2
27 Charles Street
North Andover, MA 01845
Re: 66 Haymeadow Road,North Andover, Septic System As-Built
Dear Susan:
New England Engineering is submitting a septic system as-built for the above referenced
property. We have also included the system installation certification form. Enclosed are
three (3) copies of the as-built plan and one copy of the installation certification.
If you have any comments or questions please do not hesitate to contact this office.
Sincere y,
l
Thomas Hector
New England Engineering Services, Inc.
60 BEECHWOOD DRIVE-NORTH ANDOVER MA 01845- 978 686-1768- 888 359-7645-FAX 978 685-1099
TOWN*OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( )constructed;
64 repaired;
by To 0A1 S ow C
located at Co q,1-(1 -,69114c�,,J
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit# ,plan dated ,with a design flow
of 5-50 gallons per day. The materials used were in conformance with those specified
on the approved plan;the system was installed.in accordance with.the provisions of 310
CMR 15.000,Title 5 and local regulations, and the final grading agrees substantially with
the approved plan. All work is accurately represented on the As-built which has been
submitted to the Board of Health.
Bed inspection date: l
ginper Representative
Final inspection date: -5 o�O-y
Agin epresentative
Installer: Uc.#: Date:
Engineer: o`' RICH 9 Date:
TnNGARo Cld�c
19021
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