HomeMy WebLinkAboutMiscellaneous - 206 BOXFORD STREET 4/30/2018N
i
Commonwealth of Massachusetts, R V, -;D�
City/Town of
DEC 1 1 2012`
System Pumping Record
Form 4, 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.
A. Facility Information
1. System Location: Left / Right front of house, Leftight rear of hous Left /right side of house, Left /
Right side of building, Left / Right front of building, Left / Right rear of building, Under deck
Address
City/Town State
2. System Owner.
Name
Address (if different from location)
Citylrown
State
Zip Code
Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping �' i I�2 Quantity Pumped:
Date Gallons
3. Type of system: ❑ Cesspool(s) CV/Septic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes
5. Condition of System:
6. System Pumped By.
Neil Bateson
Name
7.
Bateson Enterprises Inc
Company
contents were disposed:
No If yes, was it cleaned? ❑ Yes ❑ No
F5821
Vehicle License Number
11 —02 ^1 I v�
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
TOWN OF NORTH ANDC
SYSTEM PUMPING REC
DATE:
RWCEIVED
NOV - 9 2005
TOWNHEALTH DEPARTM NT ANDOVER
SYSTEM LOCATION
(example: left front of house)
DAM OF PUMPING:- QUANTITY PUMPED (`" GALLONS
CESSPOOL: NO L --YES SEPTIC TANK: NO
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
YES
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
CONTENTS TRANSFERRED TO: G` c ` S ,
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BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
6 mim
A
90
1. ,. NAME.DATE
2 . ADDRESS i-r�- .3 v
'� . .. .LOT N0. s . TEL. .
3. NO. OF BEDROOWS . . . DEN YES ; N0. .
/+6 GARBAGE GRINDER YES NO.. % . .
5. SHOW DII'vENSSODS OF HOUSE
b. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DII:ENSIONS OF LOT
g. SHOW LOCATION AND SIZE OF SEPTId TANK OR CESSPOOL
9, NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10, SHOW LOCATION OF BROOKS, STREAKS, DITCHES, LEDGE OUTCROP, ETC. 7ur?u-
11., SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
/ 'w ��•� V(, �W"� �J CLiti %1.C. �. ,'-it'dj. t.. �' � rt ��
H. Verrille
p(o Boxford St.
APPLICATION FOR SEWAGE DISPCSAL IMTALIATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
Rnxfnrc] St. I will install this system in ac-
cordance with all the laws of the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2%. I will install a con-
crete septic tank of 750 gal, in size. A manhole (s) permitting easy cleaning
will be provided with removable cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of 180 lineal (s]PMUA� feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
w in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The .joints of these
A pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/8" to 1/0 (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further agree not to cover any portion of this installation until approved by the
inspection officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE .E:,�-74��,/�' �
a
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE i, /%4
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE., s
Signature of Ltpecting Officer
Percolation Test 5 min. Soil: Clay -gravel
Garbage Grinder
.rapt ,OE xedmedg98
A .R usb.hed8-VzM 992M
thegA ff flaaH
d,+MaH 3o bxsog
.882M xevobaA ddxoV
rMbs-xed8 esIM uea
sdd snlht7sd3b cad iebio al badssupsx ab ,nbsm asw noldsn.b=!!A nA
;grid no answes- 30 LG8og8!b" sos3xuadus edd '101 Ilbs erf f 30 QdxlIdsdtua .
04.M-f4V evneH lo edle Salb lud deeun bxd3Xoe bssogoxq
. Bld at Is-tansg n i bast erlT
s bns Japdrioo levs ig bns xrlb 3a esw six$ edd at Ilosdut sdT
.beloubnoo sswr deed 001191001eq edun.tm C
ed >Insd otdg6a adexonoo noflAg OZT .s dsdJ bebaemmoai�x at II
sglq nlsxb to dael Iseall 081 ddlw x,-oddsgod bons Cera
,, 8xuf� 1�Suxd �7sV
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x.Co�a Extf . b ros.i 11W
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September 30, 1961
Miss Mary Sheridan R• N.
Health Agent
Board of Health
North Andover, Mass -
Dear Miss Sheridan: ne the
requested in order to determine the
An examin
ation was made as req sal of sewage
suitability of the soil for the site OfcHerve disposal
proposed Boxford Street building
The land in general is high•
e subsoil in the area was of clay and gr
avel content and a
Th
S conducted.
5 -minute percolation test watic tank be
It is recommended that a 750 gallon concrete sep
ed together with 1$0 lineal feet of drain pipe'
install Very truly yours,
.William J. ri coll
WJD:hd
TOWN OF �•��a�-�
SYSTEM PUMPING RECORD
SYSTEM OWNER & ADDRESS
LID Zll�f
�Lo �' & it rj �� -
SYSTEM LOCATION
(example: left front of house)
�'A b a -a (k �6 "C
DATE OF PUMPING: ^ Q3, QUANTITY PUMPED: V 0 0"C GALLONS
CESSPOOL: NO YESSEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM
COMMENTS:
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
BY: Bateson Enterprises, Inc.
CONTENTS TRANSFERRED TO:
System Owner
�II Commonwealth of Massachusetts
10' , Massachusetts
System Pumping Record
Date of Pumping:
Cesspool.- No ) Yes
System Location
10()-D Quantity Pumped: j OZ) -6 gallons
Septic Tank: No Yes L
System Pumped by: Fdtred4rt Srla ftaed License #
Contents transferrred to : Greater Lawrence Sanitary District
Date:
Inspector:
"�� 6
Cuttttlu�Ntrtalllt of Alpssttritustals
Massachusetts
j'iltllll"tatt`tta I-"S���ieni Cc:iiott
z C12,�
. � . Quenlit�' huutp�cit t
tme or i,umoslg
Cesspool: ��t �
1'es U ;Crt,ti� K16 a Yes
� License N:
sy�slenl Pumped by.
Coulenls irnttsf'etreJ to:
Mote Inspeclor
i�
r •
1
.,
1,
Commonwealth. of Massachusetts
City/Town of
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 LOcatiom
t(�. ` f �Qe
p 6 `
only the tab key
to move your
Address
cursor - do not
use the return
City/Town State Zip Code
key.
2. System Owner
Name
Address different from.location)
(if .
Cityfrown Stat
r Zip Codp:—
Telephone Number
13. Pumping, Record
-((0
1: Date. of Pumping Date 2- Quantity' Pumped:
Gallons
.3. Type of system ❑ Cesspool(s) Septic Tank ❑ Tight.Tank:
❑ Other (describe)...
4: Effluent dee Filter present? ❑ Yes ' If yes, was it cleaned? ❑ Yes `❑ No
5. Condition f Sysfem:
6: System FuTpee By
Name Vehicle License Number —
0"A
Company
7. Locatio hereontents were di
— -
Signa .re f auler Date
http://www.mass,gov/deplwater Japprovals/t5forms htm#inspect
t5form4.d6c• 06/03
SystemPumping Record • Page 1 of 1
North Andover Board of Assessors Public Access
yoMj
Ort.Y�°o cryo
3= e..r. •'y''0 Ot
h y 1
h n �Y
l+us'
Return to the Home page click on logo
New Search
Sales
Summary
Residence
Detached Structure
Condo
Commercial
Comparable Sales
Parcel ID: 211
Click
:k
Page 1 of 1
Property
Record Card
4
North Andover
Location: 206 BOXFORD STREET
Owner Name: ELLIOTT, CAROL A
JOHN A LOZIER
Owner Address: 206 BOXFORD STREET
City: NORTH ANDOVER State: MA ZIP: 01845
Neighborhood: 5 - 5 Land Area: 1.41 acres
Use Code: 101 - SNGL-FAM-RES Total Finished Area: 1394 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 378,800 353,500
Building Value: 167,700 169,500
Land Value: 211,100 184,000
Market Land Value: 211,100
Chapter Land Value:
LATESTSALE
Sale Price: 175,000 Sale Date: 10/07/1991
Arms Length Sale Code: Y -YES -VALID Grantor: WYLIE JOHN T
Cert Doc: Book: 03329 Page: 0173
http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=990366 w,,i1/18/2007
North Andover Board of Assessors Public Access
pORTy
of,,�.e Bryn
3a b�.. ..;;•,a of
h �
diq&sntV+uS �'
Return to the Home page click on logo
New Search
Sales
Summary
Residence
Detached Structure
Condo
Commercial
Comparable Sales
Page 1 of 1
Tomm oFNofth. A Wove
lElsard Of AsseSS01'S
Property
Record Card
Parcel ID: 210/104.D-0056-0000.0 Community: North Andover
SKETCH
Click on Sketch to Enlarge
�f --ET-
PHOTO
Location: 206 BOXFORD STREET
Owner Name: ELLIOTT, CAROL A
JOHN A LOZIER
Owner Address: 206 BOXFORD STREET
City: NORTH ANDOVER State: MA ZIP: 01845
Neighborhood: 5 - 5 Land Area: 1.41 acres
Use Code: 101 - SNGL-FAM-RES Total Finished Area: 1394 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 378,800 353,500
Building Value: 167,700 169,500
Land Value: 211,100 184,000
Market Land Value: 211,100
Chapter Land Value:
LATEST SALE
Sale Price: 175,000 Sale Date: 10/07/1991
Arms Length Sale Code: Y -YES -VALID Grantor: WYLIE JOHN T
Cert Doc: Book: 03329 Page: 0173
http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&LinkId=990366 M 8/2007
Commonwealth of Massachusetts
City/Town of
a.
System Pumping Record
Form 4
l
RECEIVED
NOV 2 5 2008
TOWN OF NORTH ANDOVER
DEP has provided this form for use by local Boards of Health. Oth """ ' ; e
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
Important:
When filling out 1. System Location: Left front, left rear, left side of house. Right fronCrightlrea�r,ight side e.
us
forms on the
computer, use
only the tab key Address
to move your
cursor - do not
use the return City/Town State Zip Code
key. 2. System Owner:
Name
Address (if different from location)
City/Town State -Zip Cod
Telephone Number
B. Pumping Record
1. Date of Pumping
3. Type of system
2 Q antiIty P d'
�
�
Date D umpe Gallons
0 Cesspool(s) eptic Tank r] Tight Tank
0 Other (describe):
4. Effluent Tee Filter present? 0 Yes L2-fVo If yes, was it cleaned? 0 Yes [I No
5. Condition of System:
r\ C) tcoc- 01 ) r"\-
4e�-
6. System Pumped By:
Neil Bateson
Name
Bateson Enterprises Inc
Company
7. Locatio re contents were disposed:
�.L.S.D� Lowell Waste Water
of
F 5821
Vehicle License Number
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
Commonwealth of Massachusetts
kvC4' /Town of
4 System Pumping Record
Form 4
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
vQ
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:
Citylrouun
2. System Owner:
K
Address (if different from location)
State
Citylrown
B. Pumping Record
1. Date of Pumping Date 2
3. Type of system: ❑
❑ Other (describe):
Zip Code
StateZip Code
� — ) /
Telephone Number
Quantity Pumped: Gallons
Cesspool(s) Septic Tank ❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes -'No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition -Of System:
Q
System P m z
Name Vehicle License Number
Company
7. Location
co tents wee
N i
Date
t5form4.doc^ 06/03 System Pumping Record • Page 1 of 1
Commonwealth of Massachusetts
City/Town of
System Pumping Record
M SV •
Form 4
DEP has provided this form for use by local Boards of Health. Other forms ��"l4 g1EP TMgNT I
information must be substantially the same as that provided here. Before uS' [ I 11 tl M2 r% VVILI I 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 ftontaj
rear of hou , t rear of ho
right front of house, left side of house, right side of house, Left
side of building, right rear of building, under deck.
Cityrrown State Zip Code
2. System Owner:
Name
Address (if different from location)
City/Town
B. Pumping Record
1. Date of Pumping
3. Type of system: ❑
Stat ,3 Zi Code
Telephone Number
Vk —` o -(c)
Date 2• Quanti Pumped: Gallons
Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes No
5. Cond' ion oA System:
o -� J�l�
6. System Pumped By:
Neil J. Bateson
Name
Bateson Enterprises Inc.
Company
If yes, was it cleaned? ❑ Yes ❑ No
7. Locati re contents were disposed:
L.S.
F5821
Vehicle License Number
Date
t5form4.doc• 06/03
System Pumping Record •Page 1 of 1