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HomeMy WebLinkAboutMiscellaneous - 1794 SALEM STREET 4/30/2018 (2)FOItM U TOWN OF NORTH ANDOVER LOT RL•'LEASE FO1U1 SUBDIVISION ASSESSORS MAP ' SUBDIVISION LOT(S) PERMANENT ADDRESS ASSIGNED BY D.P.W. STREET APPLICANT :41 0(S PHONE DATE OF APPLICATION TOWN USE BELOW THIS LINE PLANNING BOARD DATE' APPROVED TOWN PLANNER DA'Z'E REJECTED CONE ERVATION COMMISSION � ,\ I .4 l�'�<< CONSERVATION ADMIN. Dn'E'E APPROVED DA'Z'E REJECTED BOARD OF HEA DATE APPROVED 3 HEAL H ANITARIAN � ` �H Clln'1'E REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any but1ding permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. .. � '1 ' f,S ♦•�, to Yi'F�S� -'} _' V ' • ��� +` t f ?,r ��a ��,((r� , t r t s' `8 ;:� a �"`f'�4�i�tki L-"}tr�'r�k«` t �c •y r }at ,Ft ," � t { PLODS PLAN S' q! 47,��;;trSze,LLhL.tiM��'1t 1 rah j t j 4th ifft 4 --- 1 f' 1. 4 S'7'°a r( t. t lr � s,��k{n•w r • ��V>��tNZ ��t� f rT�„�• � �^ }a . ' North Aioa#autot BIS ' Pat k nrt� Shi rle ert 1O a taxa t7 .t�` x[ 4't�t^b Et i . fk` t c• { 7 - Yxe., 1ji Rr.+• ' t jw`: a•J.t}7t'J+� 1'! j ;qq, » j+�i� '� . ��� y�i,�P,. a� ��, �, s l• 4''' } 01981p�i"k`�`x*1 �^p...! + •��J ri y�.� F �` Y . bix�#t, } I ,�,� rt j�'. �`�,��' Y �' � •�. y• t � �_-� ��^ f r . iqq U. %C k�•` =ii + ; ��6.,Litl'g. - � iT'`#��. - • f y ���•4 t r _ wr ` t f h • 1. •h' . l ra 'tom j '{ C1t t+.l,n•'T,�v4 •�' . 4 w rt .4 1i�~ut i`y� 4:',y t` F i }"` • - 1 4 I.1. 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Board of Health • BEPTIC snTEK , North An ver MaBB- INSTALLATICH CHECK LIST LOT — <APNOVED DAT $ DI Fit OVED tXCAVATICH oK FAIL ea6onst i FAIL of ' 1- Distance Tot . / a. Wetlands b. Drains C. Well 2. Water Line Location 3• No PVC Pipe 4- Septic Tank- a. -Tees -_Length & To Clean Oat Covers. b. Cement Pipe to Tank - Oa Both Sides of Tank 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amounts C. No Back Flow 6.- Leach Field or Trench r a. Dimensions b. Stone Depth of c. Capped Inds d. Clean Double -Washed Stone' J ?• Leach Pits a. on b. Sto a Depth c. ash Pads ` d. eas e Ce�aent Pipe to Pit - Both Sides. Clean Double Washed Stone 8. No Garbage Disposal i 9.Final Grading Inspection 10. Barricading Covered System 11. As Built Submitted. - ' _ a. Lot Location ` b. Dimensions of System / c. Location with Regard -to, Pere Test d. Elevations ` e: Water Table SOIL PROFILE & PERCOLATION TEST DATA, Cdr' Lot No. � Town/City No.&Street• y c. OwnerC�� Lo Subdiv / Investigator4 �L Observer ` ILES DATE 1. Eley.____,_ SOIL PROF ?' Elev. 3' Elev._____ 0 0 ... Benchmark Elevation 1 2 3 4 5 6 7 8 9 10 Location Datum Percolation Tests -Date 1 2 3 4 5 6 7 8 9 10 4'E1ev. Pit Number 1 2 3 4 5 3� Start Saturation Soak -Mins. Start Test -Time Drop of 3" -Time Drop-of911-Time Mins. st "Dro Notes & Sketches on Back Frank C. Gelinas & Associates, North And. PPROV ED D1kTE PROVIDED Tithe 5 Reg. 2.5 1 Reg. 6 `:a`l'H AND" _ r ­a _tqD Or. HEALTH .r r DISAPPROVED DATE TIME REASON Pail OK The -submitted plan must show as a minumum: ( the lot to be served (area, dimensions, lot //,abutters) (Planning Board -files) (b location and log of deep observation holes -distance to ties (c) --location and results of percolation tests -distance to ties (d) design calculations & calculations showing required leaching area (e) location and dimensions sf system _(including reserve area) existing and proposed contours location of any wet areas within 100' of the sewage disposal system ot- disclaimer (check wetlands mapping. (h) surface and subsurface drain's within 100' of sewage disposal system of disclaimer (i) location of any drainage easements within 100' of seiiage disposal system or disclaimer (planning board files) (j) known. sou of supply within- 200' of sewage disposal--.sys-tem_ ar= :disclaiher ( location- .of any proposed •well to serve the -lot (100' from leaching facility) �(-focation location of water lines on property (10' from.leachin acilities) of benchmark riveways arbage disposers o PVC is to be used in construction profile of the system (elevations of basement, plum pipe septic tank, distribution box inlets and outle•:-s Kdistribution.-field piping and any other elevations) (rte maximum ground water elevation in area of sewage disp system (s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Setic Tanks (a) Capacities - 150% of flow, water table, tees, depth of tees, access, pumping, Cleanout 10' from cellar wall or inground swimming pool d 25' from subsurface drains ;g.11.2 ;g.11 .4 :g.11 .11 =g-15.1 �g.1 5.1 ag.15.4 ag.15.8 ag.=3.? :g.14.1 �g.14.3 :�g.14.4 - .-1.4:5 614 6- e g ."14 . ?-. ag.14.11 i' eg. 9.1 eg. 9.6 tribution Boxes () Slope greater than 9.08 (b� Sump _ Leaching Pits Leaching pits are preferred where the installation -Is possible (a) Calculatio of leaching area (minimum 500 S.F.) (b) Spacing (c) Surfac drainage 2% d Cove material �) fe t• cY C-1 L c n Fields a iGreater than 20 minutes/inch /Area- (minimum__900 S.F.) , /ohstruction of field Surface drainage 296 (e 20' from cellar wall or inground swimming pool Leaching Trenches (a Calculations of leaching area (min. 500 S.F.) (b Spacing (4 f-tmin. 6 ft. with reserve between). (c Dimen sio 01 � on(e one ,- M- --Surface--drainage 2% Downhill Slope Slope x to be shown�a� by/x 150 = �to be shown Pump o (a Approval (b� Stand-by power y ti ' TbWN OF NORTH'ANDOVFR�� SYSTEM Pump.NG P C(D's � l M UWNFR & ADDRESS� SYST 'M LOCATION wti,�--� F m -for hese. J U S'I'G OF PUM1'INC; ` 'v QUANTITY f'UMf'CD 1000 L Lu� C, UU`L,:"'NO L YES SEPTIC TANK: NO YE5 �ATUKE OFSERYICE: ROUTINE.-- -- EMERGENCY CUO'D CUNUiTLON.. _____�, PULL TU COYCk fI A` Y YY .,Q -R E A S C D A F F L L S IN 1)* [. A C[ RQ. OTS LEACHFIELD RUN L3ACK.•• CXCESSI•YE.:SOLIDS FLOODED' SOI;IUS CARRYOYIrR ;,A HER (liX%A.IN) �� � ! .' Y it • PUMPCD DY;:. - :' i•�'. 0NTI,'-NTI TIZANSFC, IZIZED TO: TOWN OF NORTH ANDOVER DA 1*t, Sy M PUMPI'NQ RECORI.) . .... .......... m SYSTEM OWNF,R & ADDRESS Wh�fl • . IV 0 - QN1) 0 Vef- ---- ------- ;YSTEM LOCATION RECEIVED NOV - 3 2004 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DATE OF PUMPING PUMPED: —7 CLSSP(X)L: NO YES Septic Tank: No- YES NA rURE OF SERVICE: KourINE.."GEN(ly OBSERVATIONS: GOOD CONDITIONL4uLL,Imyj (COVER HEAVY ()REASE BAFFLES IN PLACE .ROOTS LEACHRELD RLTNEIACK BXCF,SSIVE SOLIDS FLOODED SOLID CARRYOVER-- OTI-fER EXPLAIN sYstom Pumped by a. CUMMENTS. CUN I LN 1','i f'KANS,FhRRBD I-0 �K All 4o; RECEIVED I"OVIN. ov )MK 'H ',�, -, ., . DEC 0 6 2005 ♦U.AI't�YSTT�,-1 PPILAU p, c))4, L ej TOWN OF NORTH ANDOVER 7"'rM0�UA4 HEALTH DEPARTMENT s _TE ........ UT . T R DA0 ------ rvx 6 OF JeAyl I H a. —77 F'VLL l'vk:oy):x ONER -EXPLAIN il wn (7N CSS•, ,G.�,-�,; �:- � ., . ni L. ..' j;�: I', Advantage Claim Services 2100 Lakeview Ave. Dracut, MA 01826 JUN 18 2008 L'rO FOFForm of Notice of Casualty Loss to BuilgLr nO` `glAtVDoVER Under Mass. Gen. Laws, Ch. 139, Sec. 3B ENT To: Building Commissioner or .Inspector of Buildings Town Hall address North Andover, MA 01845 01845 Re: Insured: Patrick Whitley Property address: 1794 Salem St // Board of Health or Board of Selectmen North Andover, MA 01845 Policy #: HP2516372 Loss of: 04/29/08 File or Claim No. AD 8198 Town Hall North Andover, MA Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass Gen Laws, Ch. 139 Sec. 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. Herb Berger Title: Adjuster On this date, I caused copies of.this notice to be sent to the persons named at the addresses indicated above by first class mail. Signature and .d e Weston Solutions, Inc. 5z ® ® 1 Wall Street Manchester, New Hampshire 03101-1501 603-656-5400 • Fax 603-656-5401 www.westonsolutions.com Selectmen's Office Town of North Andover 120 Main Street _ North Andover.; Massachusetts 01845 Tier I Permit Extension Lucent Technologies Merrimack Valley W 1600 Osgood Street North Andover, Massachusetts 01845 / MassDEP RTN: 3-0174 -777 awl Aslo �� rNnol aNd Hj-2i0 � Q ,^1 I z L To Whom It May Concern: Wes R -Solutions, Inc -i-s notifying the Board of Heal at a �LegalNotice of Application for Tier I Permit Extension will be published in the 7 August 2008 edition of the Eagle Tribune for the former Lucent Technologies Merrimack Valley Works located at 1600 Osgood Street. An Application for a Permit Extension will be filed with the Massachusetts Department of Environmental Protection (MassDEP) on 8 August 2008. MassDEP last issued a Tier I permit extension for this site on 11 August 2003. This notice is made pursuant to 310 CMR 40.1403. A copy of the Notice of Application for Tier I Permit Extension is enclosed. If you have any questions, please call me or Jim Soukup at (603) 656-5400. Very truly yours, WESTON SOLUTIONS, INC. Frederick R. Symmes, P.E. Project Manager FRS : kmc Enclosure cc: J. Soukup, WESTON an employee -owned company GAPROJECTS\11621039\PWB Area\permit_extension&fee-2008\selectman Ietter.DOC O RPAP a Ali �I4�A_ ugusxN.08 -777 awl Aslo �� rNnol aNd Hj-2i0 � Q ,^1 I z L To Whom It May Concern: Wes R -Solutions, Inc -i-s notifying the Board of Heal at a �LegalNotice of Application for Tier I Permit Extension will be published in the 7 August 2008 edition of the Eagle Tribune for the former Lucent Technologies Merrimack Valley Works located at 1600 Osgood Street. An Application for a Permit Extension will be filed with the Massachusetts Department of Environmental Protection (MassDEP) on 8 August 2008. MassDEP last issued a Tier I permit extension for this site on 11 August 2003. This notice is made pursuant to 310 CMR 40.1403. A copy of the Notice of Application for Tier I Permit Extension is enclosed. If you have any questions, please call me or Jim Soukup at (603) 656-5400. Very truly yours, WESTON SOLUTIONS, INC. Frederick R. Symmes, P.E. Project Manager FRS : kmc Enclosure cc: J. Soukup, WESTON an employee -owned company GAPROJECTS\11621039\PWB Area\permit_extension&fee-2008\selectman Ietter.DOC O RPAP 4 Jun 26 08 09:28a Steve Sheehan A • [Click here ant type addressl facsimile transmittal 9786882663 To: Ms. Pamela Dellechiaie Fax: 978-688-8476 From: Steve Sheehan Date: 6/24/2408 Re: Septic Pages: 5 CC: ❑ Lkgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle Dear Pamela: Attached are the septic pumping records for 216 Rea Street as discussed last month. Thanks for the help, Steve Sheehan P.1 Jun 26 08 09:28a Steve Sheehan 9786882863 p.2 �" Commonwealth of Massachusetts City/Town of NORTH ANDOVER, MASSACHUSETTS System Pumping Record !� Form 4 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 forms the computer, use 1. System Location: 1 �o only the tab key sncor Address %/ k u -doot use the return City/Town State Zip Code key. 2. System Owner: Name Address (if different from location) City/Town — State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping pate /� U ` -� 2. Quantity Pumped: ons i 3. Type of system: ❑ Cesspool(s) peptic Tank ❑ Tight Tank ❑ Other (describe): --- 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: _. 4/L`JYl_ Name Company Vehicle License Number 7. Location where contents were disposed: igna ure of Hauler Date http:!/www, mass. govldep/water/approvalSA6forms. htm#i nspect t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 Jun 26 08 09:29a Steve Sheehan 9786882863 p.4 aCHUSETT Q4 :a:� 1:'�i • �Y. i.�,,.,lylr��ry `{��f .ia+.l.,o7(S�r l��;r'.�;i;,\i�J1 t rw•r:r.r, .. `• r;'''t' J :! DaP has provided this form for use by local Boards of Health, The Sys.ram Pum 1n c� be subml($ed fo ha.iccal Board of or other approving authority, P 8 A; Facility fn' _C)T tion — LiT7O0(�1nL., r (lli/Q Ou!S�'Stem l.008l10n. vily t,',o tyb X4 Ad 193) / C7_w, do not 3'�O��Lt t:.� 6'H nftum�vl�:•.�: � .CIG'yligvn/------------- �C� 1• lra �AifY::Si,�2it:•S SlBrp C . ` 'r'',. ,�� V'�)rl ,1Y::�.r�'l.�ti';�: Y�,y�,j r.,. :t,. .. �t',vwpy ,t!•.4',:5,.: ,. c.� /' - WrIf 31 `t } Addrati (J dlNorrtnl frorn 10"UVIq Ctty/Tawn $lut �� J Up coos ------ P6 Pin R69ord.. J: � ., >,v �l. L r • rr !� , .,�. flus, } -� Delo cf P4,mpin9 Ot7to 2. OuanLry Pumped: `7YP.e ofayale cilloni } ❑ Cesspoo!(sr ❑ SeptiC Tank Q TI9ht Tank 1r r ,'jfr —0. l"fffuanl Tea Filter r$s.snl? Y �,) ❑ es. ❑ No If yes, w r ca %..�.i'�t✓,�'t:S::'�1r.j: �r�,� };:,. 89 �5 Cl nod? ❑ YES ❑ 5� CQndlUori'.'r,',9 3f r r h r �17tn ri7! Jlli', J: , F ) r ' r r •� 77 77 .,.�. .L^,{Ir':�,.'.i r511.': L1':�irjr�•ti l•�'/..f�., P7vm ed B G �r 1 1.�G8!i 'Yr:�• •, r,� rr.V ��v�'. { :i1t� 1� "1,•' •'(�'��' • ;�• ��id9 •: !r �.r�/11,�{� .(/)�' :f' .r�Y- /,/ryJ/�/7+ tlinb 8'� �,11t '.'l.! h .•4Jt �• ` J ) / r tai r ` �'f '7JI.`'•.�('. fl., fy Nl,fa iG'�l.r .'. ♦jN .�i,l�{ 41, ::i. 7:��' LOCBUpp.W118r� , „coycents y�'©re c`l3pcsed: hL,,,.,hvu'w,maas,gov/de�•'waI•. o`t• a. er/epProYaja/(Vomr :htm#Inspect Sycfarrl Ptunpinp Re;_)M N Jun 26 08 09:29a Steve Sheehan i 9786882863 ❑ Stewart's Septic Service J Andover Septic U Stratiham Hill Septic (978)372-7471 (978)475-2593 (603)772-5548 Date of Service CZ -- � -- tomer Name: Service Location: Phone: Address: 58 South Kimball, Street, Bradford, M_9 0183.5 P.5 U Roto -Ram (978) 452-9022 -- P�►Y FROM THIS RILL _ U Reg. Nature of Service -- - ...– — -- —_-- U N/C U Reg. Maint. U Emergency Lip: -- Septic Tank Pumping and Cleaning U Day J Night "Done the Right Way" ---------- Not Responsible for Covers or Irrigation Systems Special Instructions U- Completed U Incompleted Reason: Per:– AM/PM -- -- Services Rendered - --- Vacuum Pumping Observations Drain Cleaning 'U Septic. Tank ID Good Condition U Main Line U Drywell U Le.echfield Runback Q Toilet Bowl U Leech Pit / Overflow U Riding High U Kitchen Sink U D -Box (liquid level) U Bathtub / Shower J Pun-ip Chamber U Full to Cover _1 Vanitv U Grease Trap TD. Excessive Solids U Floor Drain U Catch Basin Top/ Bottom U Vent U Portable Toilet U Use No Powdered Soap U Sewer Jet .a Other U Heavy Grease Other _ U Roots Footage: — Size: U Suggest Electric U Under 1000 gallons Q 1000 gallons U 1500 gallons Rootering U 2000 gallons U 3000 gallons D 4000 gallons U Van Called U 5000 gallons U Other U Other Aisc. J Digging Charge U Backhoe U Inspection J Location tr. '" U Consultion :5. U Certification: P/F J Service Call U Estimate Reason: J Labor U Portable Toilet Rental Q Pump Repair — J Waiting Time U Baffle U Repair Digging Charge is Per Driver U Chemical Treatment Discretion U Other Description of work Recommendations Terms of Payment Vacuum Pumping Drain Cleaning — NET 15 DAYS_ Yr. Month Yr. Month Terms 8. Conditions !J Cash U Check U Credit____ i. Not responsible for damage beyond curb line. 3. 1.5% per month will be charyed ;o accounts past due. 2. All complaints shall be reported within 48 hours. 4. The purchaser agrees to pay all Coll of collection, Customer Signature Serviceman Parts Tax Discount- Total iscountTotal - ���•� ••••�•i' � r �.��� � .� t;• X11+ • ,tI f'� , .) •..i �, : Ir..���� �•�R�4... %��r r `/:. '. • r.�. ♦ am, at I . • . • -494 'Rec •' 0 p haf provldad lhl)Ylorm ror rev NOV 1 3 200 l to the Iocel 8oarc cr npJ lnCUr QO IC) Or Hoa, ?^d $y 3,d'?i P ' • • ..:.':. � ..., .:,. , .. or ccn T6�g�rN�f�1`F�%� A. FaclII Inf rrrttlon ,�` rn lM n gym' Y CIr7/1� , Owner..',,•. '.. A64 4� (IldVfirrnl rcvnbuUCn) Te,epnon� ,t,_...umAino Regord 1cJlgln:' ' / p ,sit: j: .• :,l „ :• ,,:, �'� A.�6 Oal� o! Perp rYPe PI eys(am,.. DCe99p001(y)9 5opuc Tangy .Q+Ohar (dascriba�, •' '4, E!fivanc iea F11c0('Pf.0.3ent'1 [' Yv9n' i,• `�" �)'-:µJi„�r r:, •:.J. . vIG • . J>`' •,iGS'. �% '�� Y��' 'fir Y`t� ;`�' �• •� • � l ' � !•',S•I .'/+�+�I :• .��',f �O��q lili.,t•'',; d�, �' ��I��,if Vl!1, •il��:' . on.wh©le cor�leny'• 0.0 015posoa. ��:•'n:�w.mesa.gOY/d<jwaler/epprcYa�s/161om1�,h.naln9pacl 7 'Isnl Tan, If y69, ne9 i; veaneo? _des r��ll-h/lvl ;.)WH N.- Or �� r 1�'\ Commonwealth of Massachusetts W City/Town of No. Andover System Pumping Record Form 4 �M Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. QQ ietran JUL' 18 L011 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 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 1. No.Andover City/Town 2. System Owner: Name Address (if different from location) Citylrown Ma State State Telephone Number 01845 Zip Code Zip Code B. Pumping Record 1 1. Date of Pumping Date ' 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: �5cfl 6. S tem Pumped By Name Stewart's Septic Service Company 7. Location where contents were disposed: Vehicle License Number KA— f*1400r- t5form4.doc• 03/06 System Pumping Record • Page 1 of 1