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HomeMy WebLinkAboutMiscellaneous - 1850 SALEM STREET 4/30/2018 (2)N SiK'_'1Jlr:�S.SiF-ib.d!1•!'rdeYrL'e970i? RTT DF rVE ���� � �', ,'{ ���:q• to � .� .m '' �'"rec`o'rd DEP..has provided jht, form for uaa by local Boa. ba +ubml((ed to the local Board of Hoalth or othe A. Facl1if%Iry lnforttlon 9out SysWm l.ocaUon; OrUy V)4 lab k4y Addre9� S- U" t1H`ntum':�1'„';:';::CItY/Tvwn ��',;:.. �'.'',•`'AS'P�.•�ii'i2'�" S 3f8n1 OW � '`..;�,1;• •; ,' , . .� '�,`�� ''�•t'`il.'i �?`�iJ.'�t i; y'�;ri1,1.�1�,/p' .1:; Iwtif.'V ��''�t. .. �////�/�//�/Jj/�J�(�( NarTll rQ 1777-7-777or, -•,1 :,. Yl ,•� �`tl't'•', •i'1�.1 �.�;. ;',t � •.I; '1lt'.1. �, .' �•�,, �� � 1V\ 1 ;i'• Addrdforen! rom bcaUon) r PumpInO Rt�e9ord.1- Dah of Pumpin9` po a 2. Quantity Pumped Type Pf.ayafsm,'. ❑ Cesspool(s) 6p(lc 'Tank s or ��LhOTh 2J� Iem F Qrnpino _ Up cwd State —_ I010phono NumOO! `• �] /Other (descrlba�;• .� •. 1, ^'i. ;.,f 4. EfflUenf 7e9 Fllfe Y r• 1,,,.,. .:.. (.P(�senf? CHUSE7T S �ECEIV ED s or ��LhOTh 2J� Iem F Qrnpino _ Up cwd State —_ I010phono NumOO! `• �] /Other (descrlba�;• .� •. 1, ^'i. ;.,f 4. EfflUenf 7e9 Fllfe Y r• 1,,,.,. .:.. (.P(�senf? ❑ Yes / ,,'�'6,,1'•Co�dl�lon'Q.�sY.i,�'m.�,.`�.;; .e'er Y+ / i � :� � �+ fJ Jir!��li J �:.I•... ,1, a1' ,1 �, / rl �� i• l ' S ,'r, ',6 Sy �„Pumped By, ' �C-j .,. ,.. •., '::�..'.r,;�':.•:;�• err, p ' .1”; �''i ;`�;> ;�:" ;',;a'ail:.�ar�,rl;+ � L1. w,�,� i�t(Gd �' :rl)�j'afi'•�l•��;`°�'' '' •c 1'+�I+``(.'Ir'j�i����:r.r.•��ir.rM�ii�1�1�t(1'�•la�y�!c',Jl�,;{�'Y�l(!1�%j�S�f/���,41i���.��.: ... ( I, �• :.,: T;a' l' o hese co�len�s d ` '`''':'', �( �<�•:.�,t,f�• :;,� .Were lYposed; '� r It';I,n �! d1` -.Y .�•( i'.� t!,JIYJIj/rt p ,�',, ;`: >, � . ,:�, r .,. Slpnaltue of Heule�;��.';,iro,.r...,,.,,:1. •. lY?�N�ww,rnas�,gov/dePhvaler/epprGva)SIWorms,hUn#Inspact �7 GillOn) -- ❑ TI9h( Tank If yes, was I( cleaned? ❑ y,s nV4hlcle Ucenie Ntunb4r , Dcl� Syttam PwnD!np Reco,� ' :;;; .F,F fll •,"��1 t�rS�'It,'�{ ✓y',�,. f, � 1 i I ' DERhai provided thls form for use by local Boards Health. of be subtttitted to the local'Board �The�Sysife _ g e ord must of Health or other approving a thU ority. A. Facility Information UN 4 2007. �,. Important. j,r 1Hh4n fiJUn� out 1 System LOoallon :. To'v,�, ur NORTH ANDOVER ; forji OfttI10 t :4L 1.'. EPARTMENT. only the tab key Address to move your cursor do not use the returnCity/Town Sta key IJp Coda' ` `"' 2 System Owner "t. Name Address (If different from location) CltyrTown State Zip Code Telephone Number Pumping:.Re{ord �' f 1 '- !vM ,� lit ,t. �' '�i rft.. 1� %'�S r rl•I .. ':. 6� 2. Quantity Pumped; -500 ..� >• 1 ata of Pumping Date Gallons TypB Of system.. ❑ Cesspool(s) ❑ Se tic Tank p ❑ Tight Tank Other (descrlbaj; Effluent Tae FUter present? . ❑ Yes o If yes, was if cleaned? ❑Yes w . • :; .. 0f.Syst9 m, 6 Sy e�r1 Pumped G ,f t S . it ' 'nt' a� ham. Fi",Y }ri,�y�,i�i 4s '',:t"a'�;t '•� }�i'••' , y' ,r�� /1 , #9 Number Y Y ',, r fyd(J t ► k r srY Ilk .,r`J'J�v�'�''' J onjW tv. •. 1 • � f 11 1 Y .. . y J, I 14 •fl4'rii y%��i,'.lt�J •I f'�j�'��IAt�t'l. tA`t • Location where contents yvere di;3posed; L •' 1 'i� �• ✓ L'.1 �••,a. �. .11 S, �. •.`f.....t .. ,: Date httpJ/www, mass. gov/dept.wafer/iMovals/t5forms, htm#Inspect t5forrn4 doa 06103 System Pumping Record • Page 1ot t Commonwealth of Massachusetts �1 City/Town of NORTH ANDOVER, MASSACHUSETTS System Pumping umping 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. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. ray �enen A. Facility Information 1. System Location: APR 0 5 2006 TOWN OF NORTH AND_OV_ER Address rmlE - A�.��a� City/Town State 2. System Owner: Name Address (if different from location) City/Town i,ompany 7. Location where contents were disposed: &g4651' z"� - Sig ature of Vier http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect t5form4.doc• 06/03 State Telephone Number Zip Code Zip Code 2. Quantity Pumped: Gallons iSeptic Tank ❑ Tight Tank If yes, was it cleaned? ❑ Yes ala, �v Vehicle License Number -Z'i�� Date System Pumping Record • Page 1 of 1 UD/ li/-UkJL) iJ:J/ JUbj/.3bbil I I AJo( AIVD61/er 0•o µ. )ZO Mom St, Na il A no coi, W-MuI L 1 m tr i 5 i tWA&.... i / ANDuvtr PHOE ul STBQRTIS samc ?-Am sMWCE 47 WjjtOAD grp BRNIMM, MA 81835 978-372-7471 •:. • • • 1 .I� II t/ 6 a lira _ 53 10Za /vo?b �2 he i fij 97 v /qjL IQ -'- F57 ateF5 1 bcb Aood /aCY-) I is Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B TO: Building Commissioner or Inspector of Buildings Town of N. Andover o Board of Board of Selectme t. Town.of N. Andover N. Andover, MA 01845) addresses ( N. Andover, MA 01845 ) ( RE: Insured: Paul D. & Maria A. Hudson Property address: 1 1850 Salem Street ' N. Andover, MA Policy No. HOP8610348 Loss of 1 / 1 / 91 19 File or Claim No. WAP1 2442 Collapse 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. General Adjuster Titles 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. PATRICK J. DONOVAN ASSOCIATES, INC. lnria.,rttia 5/16/91 _. P.O. BOX 110 Signature and date WAKEFIELD, MA 01880 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: AL c� //- Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) 6f5 /)0% Street / �S-o -g/1 L e�m St. Number / 6a) ************************Official Use Only************************ V/ RECOMMENDATIONS OF TOWN AGENTS: v Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector -Health Date Rejected Date Approved Septic Inspector -Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Department Received by Building Inspector Date TO — - _ — — - - OA ti 1T��{I//Mjf - l _r u I i7�17G�i` p=tq* eD �; C tE'.F E.+•. .64 "'r] .'1� AMPAD NO. 23-176-40 SETS NO. 23-376-200 SETS Town of North Andover, Massachusetts Form No. 3 HORTM BOARD OF HEALTH Ot,t``o ,• 1ti0 19 ' r- DISPOSAL WORKS CONSTRUCTION PERMIT ,SSACNUSEt Applicant LU ME ADDRESS TELEPHONE Site Location19��YYI Permission is hereby granted to Construct (A or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN, BOARD OF HEALTH T � Fee D.W.C. No. bII 7 Y �� � , Y .Y ♦y S f,1 1 F,2o� TOL�/v /SSSE,Sso,e,: SAP �sE-E D�E'.o 1co/e .eEST'/eis>ioi✓5 OF �EcoR O. S AI�E-,PEd Y TO THE T/r,-E /,vSdPOT ANO z4 =L 4 T To 7.M.6' ffW Al ' ;V47' T.VE On'ELG/✓6 If LOC.47E'O 47.11 T/i/E LOT AS S.�iy'N ANO T,v.4T /T OAFS LO.vFLaPiY1 �N IY/Ti/ Ti4/E �/►"N OFj(/�i (/O�47►'E�PZON�.vG !E6!/GAT.t�JvS i// A /O �/ �OD��� /1�/�� ,pL�G.I.eDi.✓6 SETeIC�t'S FeO.t1 SxPEETS 'S FarTNE.0 CE,�T/FY TN.IT riV/S OA✓ELL/iV6 /S �✓OT O.PAN�iV FO.P LOLATEO /N' TiyE FEOEPAL. 000 fi'AZAEO /.PEA. JTEPAEN E. S ; �P. S. TE TiV/S Pf AN Fo,(� �/o�TGoGE Pc%{/OSES ' SOT FD,P � Bovvoty' aerEe��,��N.orsov. doavo�.eY itiFo,P.H- �E��/A1AGt' E-•v6uiEE•P/low SE•Pr/CEs .47 -lo -41 ro,rE.4,,, fror� Ex�sr�vc .cEcatOs. GG 100•41ow .ST.rEET � � %7b� ANOOI'E�C, ,y�ASSAI,v!/SETTS O/B/O % vl D t 1";eo172 7224vv /O to A3 .9.vG0 fA/E'E f �liF G'C. G ' �8 �sE� I>EEO FO�e ,ems ST/� /CT/O/✓S OF DECOR O. S .4, REBY TO Tye T/T,E /NS'leaC Avo I o�L © T R4 4 XI TO TiIE* B.4-V�r ;W47' 7AI-r- r'ELG/.u6 /S ,O[5CTE0 ON T/1E LOT AS S.s•Cif'N ANO TiviOT /T OAFS CO.vFAPiYI ��/l/ f��l IY/Tf/ T/IE T27/YN OFj(/,QV�� �PZON/.v6 lE6r/c 4T,t�,vS j/ (/ O L/��DD��/ 0/ / ,PLS"G.I.QOiN6 SErQ,IC.C.S %rOM ST.PEETS � LOT [ivES. "' -S Farr I-nr LE,rT/FY TN,+T T.✓rs owe-E«/.vs is,voT LOC.4TEp /,y Tae FOPA✓i/ ,c,52,P Bovvory �"rE,e>Miuor/ov. eo�.vo.+�Y i,�Fo,P,�- �E��/M•4Gt' �•V6.WEE•P/,c/6 SEP/�/lES ATiO�/ TA.t'E.(/ frO.Y/ E.t'/JTi.�/G ,�e�'q{OS. Glo �4-P.f� ST.rEET � / %7b� A.VDDYET, /yJASS�v�,V!/SETTS O/B/O (ARD OF Hsi 'I __IF50 5- i tiol�-Fh AU IPOUEI� I MA , �4 VF(-' ��ti I_ hIV50rU _ (ti,��-Gtr �� �.'► r -r - Q Ibc'��I D WELL- �P ouCD]�T'C SS -, 1, i- ou /JG AU11-)oi ay PLAN DISIMlIZ�NI�I DI SA PPRo VEp iA 6E R�SoNs C7xlOv4T(c►N )AJSIPt�-G i ro&1 P4'I - I V 5P6-�-Tlo0 bPFl3c)vE 0 i:�45 S [] FA I PIPE FlzvA-A t I o ry TA 0 K Ll PA SS 1::7 FML DI�PPRUv�!> D,�1 C� Ri /J50 NS FRAL APPROVAL APS RMAJG AUTHoRoTy PATI ZZ�� APPRWV-16 TOWN OF NOR' T SYSTEM Pum IN UA 11, SYSTEM OWNF.R,& Al$DREll (S ANDOVE-P, 0 RECORD RECEIVED OCT 0 5 2004 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT SYSTEM Loc i17- 9A, �. DATE OF PUMPING: QUANTITY PUMPED: YES'. SOPtiC Tank: Nu YFS NA rURE OF SERVI 01384RV RAUftL4PQN ._._.FULL COVER "-KEATY- Opw-AsEBAMES IN PLACL ROOTS LEACKFI-F-LD RUNBACK BXCESSIVE SOLIDS FLOODED SOLID CARRYOVER I_..._..._.OTHER EXPLAIN Sy*tom Pumped by /,nQ. �OMMENTS. . ................ .. CUN I'LN FS f'KANSFbRR.BL) 1,C) jc/, a ,C\ Commonwealth of Massachusetts W City/Town of North Andover System Pumping Record Form 4 /GSM 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 fromng,dlattee accordance with 310 CMR 15.351. 5. Condition of System: X solids 6. System Pumped By Mike Snow Name Vehicle License Number Stewart's Septic Service Company 7. Locations here contents wer disposed: Steyr rf s;Pre-Yeatment P 20 So. Mill Bradford, MaSL1.8 - S/2111 nature of Hauler Date Signature cei ng Facility Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 A. Facility Information JUN -7 2011 Important: When filling out 1. System Location: TOWN OF NORTH ANDOVER I forms on the HEALTH DEPARTMENT computer, use 1850 Salem St only the tab key Address to move your North Andover Ma 01845 cursor - do not use the return City/Town State Zip Code key. Q 2 System Owner: Hudon Aff Name ehO Address (if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Da2e11 2. Quantity Pumped: 1500 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: X solids 6. System Pumped By Mike Snow Name Vehicle License Number Stewart's Septic Service Company 7. Locations here contents wer disposed: Steyr rf s;Pre-Yeatment P 20 So. Mill Bradford, MaSL1.8 - S/2111 nature of Hauler Date Signature cei ng Facility Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts City/Town of No andover 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 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 1 r key to move your Address cursor - do not No Andover use the return- —l- Cityi i own key. 2. System Owner: ! i -j r Name Address (if different from location) Ma State t Zip Code City/Town c State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date f 2. Quantity Pumped. Ions 3. Type of system: ❑ Cesspool(s) - Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other (describe): 4. Effluent Tee Filter present? ElYes No If yes, was it cleaned? ❑Yes El No 5. Condition of% ^^tem: 6. System P e Name Vehicle License Number Stewart's Septic rvice Company 7. Location where contents were disposed: Stewart'sfRre-treatment Plant, 20 So. Mill Bradford, Ma 01835. Signatureiof pede-hAng Facility Date Date t5form4.doc• 03/06 V .. System Pumping Record • Page 1 of 1 No Andover 1600 Osgood St Building 20 Suite 2-36 No. Andover, Ma 01845 Date Name & Address 2 -Jul Bake N Joy Willow St✓ �5 3 -Jul Coltin 316 Rolwey Tavern Lane 9 -Jul Bake N joy Willow Ave +/ 3Sh I 12 -Jul Mukherjee 30 Sherwood Dr°-" 18 -Jul Hanny 45 Innis street/ 19 -Jul Butcher Rte 125v,---, 1 v't `l p SCr o 6� 19 -Jul Chipolte 93 turnpike✓ 21 Driscoll 110 Forest street✓ 6 -Jul Hudson 1850 Salem street 27 -Jul Ferragamo 1112 Tnpk street-/ 27 -Jul Perry 303 Berry street v- 30 -Jul Barry 62 Stone cleave road J&S Development dba Stewart's Septic Andover Septic 58 South Kimball Street Bradford, MA 01835 C;allnnc C nmmPnte 4800 Grease 1000 Xsolids HG 5000 Grease & ** 2 inside grease traps 1000 Good 1000 good 200 grease 3000 grease 1500 good 1500 good 1500 good 1500 good 1000 good j5� 0c� Jo (3C)C)�