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Page 1 of 1
-lorth Andover Board of Assessors
roperty Record Card
Location: 21 CLARK STREET
Owner Name: POSITIVE START REALTY, INC
Owner Address: 8 CLINTON STREET
City: WOBURN State: MA Zip: 01801
Neighborhood: 34 - 4 Land Area: 2.67 acres
Use Code: 332 -AUTO -REPAIR Total Finished Area: 8740 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 669,700 669,700
Building Value: 487,500 487,500
Land Value: 182,200 182,200
Market Land Value: 182,200
Chapter Land Value:
http://csc-ma.us/PROPAPP/display.do?linkld=1705198&town--NandoverPubAcc 5/6/2011
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Page 1
Clark St, North Andover, Essex, Massachusetts 01845
Clark St, North Andover, MA 01845
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5/6/2011
RECEI EV
Commonwealth of Massachusetts
City/Town of ` PR 0 4 2013
-
System Pumping Record NORTH ANDOVE °►A°HNORTH TR
Form 4NT
MENT
•h _
i DEP has provided this form fqr 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 on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
1. System Location:
Address
ress
-- - -
CitylTown State Zip Code
2. System Owner:
ck
Name
-S-
-
Address (if different frorir location) /
CI— d
____ _ Gtr -
ityrrown State Zip Code
Telephone Number
B. Pumping Record
1. Date of PumpingDate. - I---- , 3____ 2. Quantity Pumped: — — - —
Gauons
3. Type of system: ❑ Cesspool(s)Septic,Tank ❑ Tight Tank ❑ Grease Trap
❑ Other (describe): - — — - -------.
4. Effluent Tee Filter present? ❑ Yes �p}o If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System:
6--c�'
6. System Pumped By
Name--
Vehicle License Number
Company
7. Location where contents were disposed:
a of r
Signalufe of Receiving Facility
'-'3- -
Date — — — -
Date
15form4.doc• 03/06
System Pumping Record • Page I of 1
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
Commonwealth of Massachusetts
City/Town of
System Pumping Record NORTH ANDOVER
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.
E
/.177p� - i 1011
TOWN OF NORTH ANDOVER
WEALTH DEPARTM;:Krr
A. Facility Information
1. System Location:
Address D
_ /—
City/Town
2. System Owner: .�
N me
Address (if different from location)
City/Town
B. Pumping Record
State Zip Code
State [ip uoae
Telephone Number
W
1. Date of Pumping Date L -7—y/- 2• Quantity Pumped: n—n-------
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:
6. System Pumped By
Name Vehicle License Number
---
Company
7. Location where contents were disposed:
Signature of Hauler i{ awreki f�
Signature of Receiving Facility
Date
Date
t5form4.doc• 03106 System Pumping Record - Page 1 of 1
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