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HomeMy WebLinkAboutMiscellaneous - 140 CHRISTIAN WAY 4/30/2018 � Form 5 DEOE File NOT 242-452 (To be provided by DEOE) Commonwealth City/Town North Andover :( of Massachusetts Applicant Margaret Antonelli "Brook Farm" \, Christian Way Extension Order of Conditions Massachusetts Wetlands Protection Act G.L. C. 131, §40 and under the Town of North Andover Bylaw, Chapter 3.5 A & B From North Andover Conservation Commi To Margaret Antonelli same (Name of Applicant) (Name of property owner) 1117 Gatewood Drive Address Alexandria, Va. r.?o��Jd Address same This Order is issued and delivered as follows: ❑ by hand delivery to applicant or representative on (date) by certified mail,return receipt requested on February 29, 1988 (date) This project is located at Lots 1-8 Christian Way Extension The property is recorded at the Registry of Northern Essex Book 350 page 462 Certificate(if registered) The Notice of Intent for this project was filed on December 8, 1987 (date) The public hearing was closed on December 30, 1987 (date) Findings The North Andover Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based on the information available to the NACC at this time,the NACC has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act(check as appropriate): (� Public water supply N Flood control ❑ Land containing shellfish Private water supply ® Storm damage prevention ® Fisheries �1 Ground water supply ® Prevention of pollution ® Protection of wildlife habitat 5-1 Effective 11/1/87 Commonwealth of Massachusetts 4 City/Town of a W° System Pumping Record C / UI ,M SV.y`W Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health , 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 fr Imthouse, right front of house, left side of house, right side of house, Left rear of house rear of ho ft side of building, right rear of building, under deck. Cityrrown State Zip Code 2. System Owner: Name Address(if different from location) Citylrown State ✓ ZiC J Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of ;stem: 6. System Pumped By: Neil J. Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc. Company 7. Locre contents were disposed: L.S. a aste Waten �-�3 L:eig�nature ofaul r Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1