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HomeMy WebLinkAboutMiscellaneous - 120 HAY MEADOW ROAD 4/30/2018 120 HAY MEADOW ROAD id .210/1.04.B-0065-0000.0 r red rJ7 GD RECYCLED PAPER g� Contents:40%Pre-Consumer•10%Post-Consumer Page No. • Of Pages F. P. REILLY & SONS, INC. 206 Andover Street, Suite 11 ANDOVER, MASSACHUSETTS 01810 (508) 475-1237 PROPOSALSUBMITTEDTO PHONE DATE — STREET JOB NAME ' r\ L ;. CITY,STATE and ZIP COEe JOB LOCAT ON ARCHITECT DATE OF PLANS JOB PHONE a We hereby submit specifications and estimates for: ...................................................................................��............................................................................................ 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I I MP prapggr hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: ). Payment to be made as follows: dollars($ f All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders, and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. Acceptance of Proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. 1 Date of Acceptance: Signature 'I'vP4 I� Q¢o�a�TY LIt.lES FZor1 Ea�tyCt►JCy `.iiSSni� 2�' �l•.�s � �ro¢DS 9i►� `j.•�T�1E �fo�+oS6p t.F,e,��l FiF,t,D J�hL� Si; Aad 1g•� 50' : q� hG 3) At l •Ae A tvl 41.L' AQo,.1,.ID S�(S-rE H SAS SNAu- Ufayrei Ppm or I�hB.Z ' -t'tw e=1 r� Sots. A09 �Ept,ncE� i�►-t 11 ��Ect PIr-D FILL• 13� e.�P,�,ce D w iT� � ►s�pc�U• LE."5 TFIAJ loco aAL.. '�.) GoNfi'ixuc�'iot`! �j�th►,1. ts� tt-i. Ell !►_" cl o'oo' - G,s�F a¢rl A i�G� t:1 iTi�! '�'rr'Ir�'� � 'TN6a A KrDav2 "er.ea l%F 1 � �„y� w n � 4'I E;A w'1��� t�6&,u 1.�f 1c:•ti1S tal t.l L.c� � G�,1 t-I1•.r1 el�Y G>F' t t-I�lE.�'"S I taZ I oy'o"@ � O of 5"�' `\ t(p4 oAT Ho op �I ��� - 15 I, ,� I a = 14 Z, t52 b�&v- - p 1 I� . 1 1 12� k ► ta,T �-�►� .�� - 1 1 1 e,C1A1�1�tJL, f•�,t. �+t:eQE W A01 i,pA tilGU!�fi• �17 1 '1 �SVr tM RA SUBSURFACE DISPOSAL SYSTEM LOCATED IN 0oeTH A b©\/e z j 1'I `a� rzo AS PREPARED FOR DATE : MAY Z-3, 1 ,q q SCALE: Zo ' `�D� C U�o if � I KENGINEERING MERRMA C SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS i 66 PARK STREET • ANDOVER. MASSACHUSETTS 01810 or TEL (617) 473-3555, 373-3731 Commonwealth of Massachusetts _ City/Town of . System Pumping-Record Form 4 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. A. Facility. Information 1. System Location: Left/Right front of house, Rig rear of hous Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/ Ig rear of building, Under deck Address l a o V V ` .ez, 1 V a ` 4j%,, Cityrrown State Zip Code 2. System Owner. i Name Address(if different from location) City/Town �Q �Q15 State-�� C l�C�p Code �\, ; �\1 ? W 6 Telephone Number B. Pumping Record 1. Date of Pumping date 2. 0 tity Pumped: Gallons .. 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yap 00If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of tem: 6.- System Pumped By: Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc- Company ncCompany 7. Location where contents were disposed: C�.L S'. Lowell Waste Water Sign Haul Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 I I RECEIVED JUL 5 2013 Commonwealth of Massachusetts TOWN OF NORTH ANDOVER City/Town of ftr 6tAHEALTH DEPARTa t�6r+) I�lil�Jr System Pumping Record Facility Information: System Location: GD H01, p [KL2 CtOU) Address Nt�c�A City/Town State Zip Code System Owner: Name: Adress (if different from location of pump) City/Town State Zip Code Telephone Number Pumping Record Date of Pumping Quantity Pumped �, U gallons Type of SystemSeptic Tank Grease Trap Other (what) System Pumped by: B CAVk Company: ROOTER-MAN 46 Portland Street Lawrence, MA 01843 Location where contents were disposed: Date Signature of Hauler . 0.1 Massa-;�.-Iriusetts JUL '1 81011 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT a ipyyp EA AWA State p - -- T Record r " ���:x_ a ca Record - Las _1 anK_ Crease Trap ` R0--t — _. its — Commonwealth of Massachusetts RECEIVED City/Town of System Pumping Record JUN 2 s 2006 Form 4 TOW �Ar wURTH ANDOVER HEALTH DEPARTMENT 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. . A. Facility Information Important: When filling out 1. System Location: forms the computer.use u only the tab key Address to move your cursor-do not use the�return GitylTown State Zip Code key. 2. System Owner: Name 1L1 Address(if different from location) City./Town. Stated<&q ��( Zip Code' Telephone hone Numberr B'• Pumping Record 11 1 A. Date.of Pumping nate 2- Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Ic Tank- ❑ Tight Tank ❑ Other(describe): 4: Effluent Tee Filter present? F] Yes o If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of Syste 6. Systeril Pjimped By-. Name ` Vehicle License Number Company -- . ..7. Coca where contents were Asposed:. azo-d Sig lure f alller Date h.ftp://www.mass.gov/dep/­water/approvals/t5forms.htm#inspect t5form4.doc•06103 System Pumping Record•Page 1 of 1 REC N Commonwealth of Massachusetts -D City/Town of I JUN - 5 2006 System Pumping Record Form 4 TO%�IN OF NORTH ANDOVER HEALTH DEPARTMENT 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. . A. Facility Information Important: When filling out 1. System Locattiionn- forms the /�'� K \u computer, r,use only the tab key Address '8 to move your cursor-do not Cit frown use the,retum y Stat Zip Code key..: 2. System Owner: Name Address(if different from•locatio Cityf rown State Zip Code 019 Telephone Number B. Pumping Recocd 1.: .Date.of Pumping Date 2. Quantity Pumped. Gallons 3. Type of system: ❑ Cesspool(s) is Tank ❑ Tight.Tank ❑ Other(describe)` 4. Effluent Tee Filter present? ❑ Yes EI If yes, was it cleaned? ❑ Yes ❑ No 5. Condition ofSy�st�e���C�`J�� - 6. Syste Pu peed By -Name Vehicle License Number Company 7. Locati where contents wer Isposed: Sign f ure f uler Date http://www.mass.gov/depiwaterlapprovalt,/t5fonns.htm#in spect t5fonn4.doc•06!03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts City/Town of I RECEIVED System Pumping Record Form 4 JUN - 5 2006 M DEP has provided this form for use by local Boards of Health. TfretiSystem,�aord must be submitted to the local Board of Health or other approving ajjthKjjfjjTH DE"ARTME ''r A. Facility Information Important: When fining out 1. System Loca on: forms on the computer,use only the tab key Address to move your cursor-do not use th&retum Cityfrown State Zip Code key. 2. System Own Name Address(if different from location) City/Town State Zip Code Telephone Number .B. Pumping Record 1. .Date.of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) otic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ YesNo If es was i t clean ed. Yes, Y ❑ ❑ No 5. Condition of Syst btq"ipx_� 6. System Pumped By �--` :Name � — Vehicle License Number Company -- .7. 1_ocatio ere cont e wers osed: p c igna ur of Hauler Date I ate hftp://www.mass.govldep/water/approvals/t5forrns.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 I i Commonwealth of Massachusetts City/Town of I - RE �IVE� System Pumping Record 2 2 2006 Form 4 MAY F NOR DEP has provided this form for use by local Boards of Health. TH ANT)OVER The S Ste � lwN?ingAeco`Fd must be submitted to the.local Board of Health or other approving authorii. . A. Facility Information Important: When filling out 1. Sy e ca ion: � _. r�,n. forms on the � \ � computer,use only the tab key Address to move your t!'. �{� jj _ cursor-do not - I " use theretum City/Town State Zip Code key. 2. System Owner F ccA e, Name Address(if different from location) _ City/Town State�� ��ip Code" Telephone Number .B. Pumping Record �- 1. Date.of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ cesspool(s) eptic Tank ❑ Tight.Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes Leo If yes, was it cleaned? ❑ Yes`❑ No 5. Condition f System: 6. System Pumped By Name ( Vehicle Licenme Number Company -- 7. tocati where contents We^sposed:: Ofr Sign ture f uler D ate http://www.mass.gov/dep/`water/approvalt,/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 LrH TOWN OF `A �- SYSTEM PUMPING RECORD f: DATE:_____ SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of hoose) C L I, DATE OF PUMPING: QUANTITY PUMPED : 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: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.LLS.D Lowell Waste Commonwealth of Massachusetts I . A-nd rUV+-- , Massachusetts System Pumping Record Systen Owner System Location j Date of Pumping: 15' _ a� :�� Quantity Pumped: p b gallons Cesspool: No Yes Septic Tank: No I] Yes 14 System Pumped by: vctt'e44a License# Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector. I s� Commonwealth of Massachusetts Massachusetts System Pumping Record System Owner System Location s Date of Pumping: �� Quantity Pumped: gallons Cesspool: No 14Y Yes Septic Tank: No U Yes System Pumped by: vared4ft 5if&7 wed License# i Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector: