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HomeMy WebLinkAboutMiscellaneous - 2155 TURNPIKE STREET 4/30/2018 (2)o m (D - (D rt MAP # LOT it PARCEL # HAS PLAN REVIEW FEE BEEN PAID?[YE� \ PLAN APPROVAL-: DATE �J APP. BY DESIGNER: PLAW DATE CONDITION ' PEA 51-0,VZ- WATER SUPPLY: WELL PERMIT - WELL TESTS: COMMENTS: FORM U APPROVAL: DATE ISSUED CONDITIONS: FINAL APPROVAL: DRILLER_............... ...... .... _________ _ /4/6// -s)Ql-r CHEMICAL DAlE APPRUVED_______ BACIERIA I DATE OPPRUVED ' BACTERIA II DATE ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL.: /°� e SERT z_G__S_Y_SIE(__� NS.T9.4L.RZ�_QN. IS THE INSTALLER LICENSED? YES NO ' TYPE OF CONSTRUCTION: NEW REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLnN REVIEW YES NO CONDITIONS OF.APPROVAL YES NU (FROM FORM U) ISSUANCE OF'DWC PERMIT YES NO _DWC PERMIT NO. � INSTALLER:_T_� PASSED v, BY -------- ---- CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: YES: APPROVAL ,TO BACKFILL: DATE: HY`_—�-- ----- --- — -- FINAL GRADING APPROVAL: DATE BY —_ FINAL CONSTRUCTION APPROVAL: DATE: _BY l 7 - 73 N�Ep S �L';HISS TU►2N'S Th 1; SODfUH 1�I�TL� w1LL )36- ft 3 �L L1iJC12�� TOMDY�r20w 1C-1=o(Zbfr3l.L f (.0TetOs rc3L)R/ i S �,I j C R Ti ,i )zrl-TC-R 15 iNS T qLL (: ,o W 1 L L- ✓ C T -H wtl� j t 2 ! C -s% 6 jn R C S u lL T S G) tl rtiv (o w/v z"n S T H L= A R 4 t? L r M C -I i W lTN rHG� 0WNt1kS THA% S T 6v, -C ot= ft^t y i-URrKt�R P2o6LL-1'1 S . C(�ROL 1S T"Ryln/4 TC) GLT Th & -Coin—) 7—CS%. w� w� LL IV i t nt:F rt l3 C CR-US7- f i T -b r fA7 r WAYS PUTT liv6 H Soil UN t_TLa f (�c-j- 7-/A/ To Ct l= j H vL8 01 :� %i? LL g /� j TG—C KN , R 16 H I N 0 w e h 13 tW Y-, WRNS 3 JAYS Ivo IGC TC) .SCT UP Th l�- CL,vSt1v THC- - wo,j i uNT'It, i )"PrX T Mtn( ft Cv/PIV' PeRMfi wiTo OLt_ �SfG�✓A�u+2CS v/, 17 l S 1�T poSSl13LL' 'Ib (�4t 1 ytZ 514N✓fiTiJ12C v l Pt19Alr,- CAJC&tt,CO 7He" ct,oSim4 e2X t}LRC,91 V -C) &'Qe� �;l7 6 73 9.5-eLA 617 647 7aN » S, hA-GK1,v4 Date: Pages: To: Fax Phone: From: 11 C= ]Fzx Coveir Sheet C,4 -T 617 CHARLEGATE CONSTRUCTION CO. I 1 7 - 'Fax: 617.982.8020 Phone: 617.982.8002 A5 01:48 FAX THE SIMCO CO. C� U01 M/ March 1, 1995 Ms, Sandra Starr Diictor, Board of Ith-- - - Town of North Andover North Andover, Mt4. Dear Ms. Starr: I am writing this letter to swe that my husband and I imderswid that the sodium level at 2155 Turnpike Street is at 50.4, which I also undemnd to be above the normal reading. We have a written agreement with our builder, Santaro builder in Wilmington, to have a sodium filter installed. Additio ), Santaro builders will re -test the level within 24-48 haws and provide you with the test results, 1 apprmatc your continued help with our new house and with the inspection in general. Please let me know if I cart be of Anther assistance or provide additional information. Thank you again Singly, Carol Casey C6nwell (SOS) 681-5428 9 O b W P 0 :�- Omni 0 F=04 E _ ci C O J m ::•= C C N c V Z 00 c ¢ a 0 C) V Z W W Q =O a ii A m Y. m c pm 10 0 •. �- u.. i N E ¢ p1 m c � C=3 ms � = v 0 d C3 co o 1,7i/Ar� -woo di.• E a • � N U3 •: -30 CD CO O O N A cm N �-. N O14, m w� c v CD o c o. m N co c •C N 1=- o o." H m to '" R o S m w... c LL O O CO2 CL= ac �LU E v L3 N O C.3 m om�c y fl. m: O'Q = R CD a i N •O H C S. — i) ji D ado a n Fill w co w, J cw a OL Pw w v a Oca � N w,��aw GG w cn i OJ C t U w o w p CZ w u. oj m C/) C/) LU —J ME c q Z ca zCD_ W P 0 :�- Omni 0 F=04 E _ ci C O J m ::•= C C N c V Z 00 c ¢ a 0 C) V Z W W Q =O a ii A m Y. m c pm 10 0 •. �- u.. i N E ¢ p1 m c � C=3 ms � = v 0 d C3 co o 1,7i/Ar� -woo di.• E a • � N U3 •: -30 CD CO O O N A cm N �-. N O14, m w� c v CD o c o. m N co c •C N 1=- o o." H m to '" R o S m w... c LL O O CO2 CL= ac �LU E v L3 N O C.3 m om�c y fl. m: O'Q = R CD a i N •O H C S. — i) ji D ado a n Fill �� �. CC LU Q w W U) co J O O OL CD a Oca � N � C o Z v. LU —J ME c q Z ca zCD_ V C7 o z w Ico •� = N cc > CL H p� z Q C* •� '� w z Z m m z � O O G7 CD �� �. CC LU Q w W U) co CD O O OL CD a Oca C o � � Cc Cc CJ —J ME c q Z ca zCD_ V CO) •� = N cc CL H z G z Z �� �. CC LU Q w W U) P.01 OCT -18=1994 11126 0 '....... . Ott0 AoX iifi3'GWUm - A. -MASS. 01931-IIS3 �4jCjkONIE.6A 28 42 FAX: 1.06)464314 crATIFICan S.F.: A ,� PUMP -flEPORTO.: 00059 VEL INO W9LL N-4 OCTOBE01 is. 109 PMA ARADIN(I MA 010,87 WR*H,QUALITY ONKYSIS ludAt"WO: NOW.W191, 105 foot desp, loogted at 81E6 Tumpike Street, N. Ando.ar, MA. .&IMpHop- Sipp" tlkk$o by Angsip CAano on SepternbOr.28, 1994- TORI 0.01 ?w couistm 00 -ML EL "IN _aU JOELIN 0 0 c), 0 p_ HYdlUf 811fly AcIdIp 100 16 dm M to: I ffd&) 10 Nlots NHM' 06�000*t OVIL) NO 990 .250 -A 0.1 WO 20) *401 1.3 A 0.05 23 150 -Aw LOW (Continued) OCT -18-1994 11;28 BIOMARINe irk &0, tpr 010 AP IIA"31 Wows WO at W# bikead.0 th i1th IkIld 1% ! W dh Agsn& tri tIhS_- "O'S' .0p Mont W emronmlp")�. 310 MR A. i4emns'" Grob DrinWnq'W.".. tf the 00 Ace Unifod Stdo.s. �iireriMitiwritptco A#. i0o�; -The motgangme lovel 40100tod Tnvy osumthe.W010TIP JWO"rM$tYON 8IvJn,"'h';f IN , "ugh the flodItim d0nt*m dOU401 dod lov ANi uddedi the miVmriten for#wPlo who a *'o labi . il not r4nol'*"� pi AgA-rsaUictOcl djete. Rftflon 461 hu6d UoV46 and flug"M W 'oWii them to &bid*. JWd* deNfled Labs MA026 Md MAI 23 - - - - - - -- - - - - - - TOTAL P.02 •''" c5 BOARD OF HEALTH ssACHUeAt NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Permit # �(� Date 7 A permit is requested to: drill a well install a pump, -c-1 LOCATION:�� / U`c/Lot # '�l S Owner Address.l� Tel �- r Well Contrctr / c ��dd •``,7�f5� Tel Pump Contrctr J AddTel WELLS (To be completed at time of pump test.) Type of well 111-+,, Use y ME- 5 - Diameter Diameter of well (o Size of casing % r Depth of bed rock � Depth casing into bedrock 1° + Seal been tested? Yes () No (_) Date of test Depth of well /0 S Water -bearing rock 9q—os — 9 y Depth to water / �/ f Delivers f S GPM for y &rS . (how long?) Drawdown feet after pumpingJagnature-o-f—well Z t /5 GP Date of completion 9- 28 S y contractor PUMPS (To be.filled in before installation.) Name & size of pump j N P o 6:-t0 AN, J�-c , ,,j(jk Type I Size of tank Z,/ OAA_ Pump delivers 1,5'- GPM -T Pipe used in well: Cast iron (_) Galvanized (_) Plastic Sleeve used to protect pipe? Yes (_) No ( ) Type well seal Date (i' ign ure of pump installer Date water analysis report submitted to Board of Health Plumbing inspector Wiring inspector Board of Health Ilk CERTIFY THAT 40, THE OFFSETS t c .SHOWN COMPLY AND W/TH THE ZONING SBOTIC SSS M r GO NANDD VER MA. O. { ' {�"/ y .. %ED FCUN Sl t . -LOCATED`IN N0: AlVDO ' SCALE / 40 DAT Scott L. Giles R. L. S. 'f 50 Deer Meadow Rood r North Andover, Moss. SEPT/C SYSTEM AS -BUILT TAH -E OFELEVATIONS INV. OUTHOUSE- 5 IN TANK= 9 . 8 OUT TANK.= 92.'8 /hl 0.80X = 92 58 . (1UT DOA X= 92.4/ (2) END PIPE= 9 /. 93 (I. END PIPE= 9/.95.0 Tw'� \DRIVE- -�-� WA Y EASME Cl fib' ✓4 s 9 s . i u .:� r .. i•'4 rK'(kr•,ry A E/ fir{ _ } z r �r CE2T/�/IE-: D TO..6iEo2G 12,194 aj FEM,q . C. PA -1 �8 ooi2G JcrR.tE 2J t q93 ,52' 3W EXIST. )9UILD.,, I'vz A 15000 TURNPIKE S TREET(RTE.. //4) CERTIFY THAT OF THE OFFSETS t c .SHOWN COMPLY AND SEPT/C SYSTEM AS -BUILT TAH -E OFELEVATIONS INV. OUTHOUSE- 5 IN TANK= 9 . 8 OUT TANK.= 92.'8 /hl 0.80X = 92 58 . (1UT DOA X= 92.4/ (2) END PIPE= 9 /. 93 (I. END PIPE= 9/.95.0 Tw'� \DRIVE- -�-� WA Y EASME Cl fib' ✓4 s 9 s . i u .:� r .. i•'4 rK'(kr•,ry A E/ fir{ _ } z r �r CE2T/�/IE-: D TO..6iEo2G 12,194 aj FEM,q . C. PA -1 �8 ooi2G JcrR.tE 2J t q93 ,52' 3W EXIST. )9UILD.,, I'vz A 15000 TURNPIKE S TREET(RTE.. //4) ALL 5 Off. i FSETS SHOWN ARE FOR THE USE S} , : r� THE. BUIL DING /NSPEC TOR ONLY SUCH USE IS FOR THE TERMIMAT/ON OF ZONING { NFORMI r OR NON- CONFORMITY , CONS.TRUC TED.Lao " f 941 CERTIFY THAT OF THE OFFSETS OF .SHOWN COMPLY AND W/TH THE ZONING . DE BY LAWS OF,,.. J- GO NANDD VER MA. O. W HEN y .. WHEN BUILT. . - ALL 5 Off. i FSETS SHOWN ARE FOR THE USE S} , : r� THE. BUIL DING /NSPEC TOR ONLY SUCH USE IS FOR THE TERMIMAT/ON OF ZONING { NFORMI r OR NON- CONFORMITY , CONS.TRUC TED.Lao " f 941 �CjeaLI 3*(,-vt ( W lcof ?I(- /e(o-7 Test before using. Test befc 7 trademark of 3M. -Highland' is a registered trademark of 3M. "Highland' Made in U.SA Made in U, gid' Highland* Hie Notes Not( 6539: 11/2 In. x 2 in. 6539: 1 6549: 3 in. x 3 in. 6549:3 6559:3 in. x 5 in. 6559: 3 h some surfaces Important: May mark some surfaces Importar k and lift correctable ink and lift o Test before using. Test befc J trademark of 3M. "Highland" is a registered trademark of 3M. "Highland Made in U.SA Made in U Id.. Heghland� His lxand �- Notes Not( 6539: 11/2 in. )t 2 In. 6539:1, 6549: 3 in. x 3 in. 6549: 3 6559: 3 in. x 5 in. 6559: e ..w.,,.�.. r.�,.....�e.,r.• KAP.. —A, .— 1--t. 3d,L `h WELL LOC Address! Department of Environmental Management/Division of Water Resources WELL COMPLETION REPORT TION GEOGRAPHIC DESCRIPTION UO ON S E of (feet) (circle City/Townn- 4V# . Aryto datz Aur&.IDf Ka, Si. Well owner R U lS 4 �! f7 1...t (road/ Address /� �5�; i N SS E ( W,) of (ml. in tenths) (clrcle7`"',� Board Health 11'I'tersec[. w/ 1 C.J of permit obtained: yes no (road! WELL USE WELL DATA Total depth 1 U 1T ft. Domestic JR Public ❑ Industrial ❑ well Monitoring ❑ Other Depth to bedrock ft. Water -bearing tock/unconsolidated material: Method drilled ` �-�-' --''p Date drilled Description Is 1 1"-_ Water. bearing zones: CASING 1-i�� it From To Type 2) From To Length2O—ft. Dia(.I.D.)Gin. 10 3) From To Length into bedrock ft. Gravel pack well: dia. Protective well seal': Screen: dia. Grout.[]Othe Slot's length from_ to STATIC WATER LEVEL (all wells) _` r Static water level below land surface ft. Date 2_ WELL TEST (production wells) rr Drawdown �ft. after pumping - hr. 1 0 min. at JS gpm How measured Recovery!9,Jft. after fir. 30 min. 0 LOG of FORMATIONS COMMENTS rs Materials From To d Firm Avellino Well & Pimm Address 244A Haven Street City/Town Re>a l ung, MA 01867 Superv'sing Dri ler RegA 9 Plees■ Print firmly:.. - L-- - - -- BOARD .OF. HEALTH COPY CERTIFIED FOUNDA TION PLAN LOCATED /N NO. ANDOVER. MA SCALE f". 40" DATE 11116194 Scott L. Gi/es R. L. S. 50 Deer Meadow Rood North Andover, Moss. Crc2T/�/FAD To �iE.o,eGr � �c�ic.p i�.lC� /j .UcrT i`J A LOT /A M \ 54,376 S.F. e OR/�E- W.4 Y SME 34' 'EX/ST. " 30.5 N ,PU/LD.,, la2.4-5 30.5 /50.00' TURNPIKE S TREE T (R TE 114) / CERT/FY THAT OFFSETS SHORN ARE FOR THE USE THE OFFSETS OF THE SU/L DING /NSPEC TOR ONLY SHOWN COMPLY AND SUCH USE /S FOR THE WITH THE ZONING DETERMINATION OF ZON/NG SY LAWS OF CONFORMITY OR NON-CONFORMITYSTER 72 NO. ANDO VER . MA. WHEN CONS TRUC TED. WHEN BUIL T. gy� -aqw V�M K0 11411"K, W7 Z Cez 11C �-,T 7 A ik Al All, I W. all Z -Z VA 1 .1 94 Oxy ?R T gg" I.J1 J" 0 M4 5 ow., Wdt : beer V CTM SRI F. i -A L PAal I , 71","ATIE 1A, N4 A TV �94 UT AONS r �n 41 1 Vv� 4C p W 'W�MUIT M W,40- A2--, �8, It" N YA& W 9 IL 'Der I. Ir T _R BOX 949'. 1 2� v'y Rp "M U 0. v:Z ��1'. `�'' ,„„ {� : er1 p tk r�7-�� ir � r t E§ ej;;" '�t y;.'� :�. F,� a3 ,� � �%G y,' - a ,i.. �' y ^,� 6- 4 EXIST,- rw 30. DRVVE,' 5-1 1 -1/0 -41 9 W, N�- VIn —'V�RZ f 71 vB >% A on� ., T7 'SHOWN AIRE FDR MEVSE AL L -G U14L, NS I'A' V-5-61 rH-,E-,-. I -14� A 4Z N or.. "/o ZU/V) sR�.� hFs'r:� ^i r� ;.,�, ,"E�r ,{, Tom: �y`�*t;"'.•^'� Y��3��r�Aj ���`. -"4 7U7 Wv� C-ILIPM 'I OR "-ige/wry /vu/v!!- (-.,U/V CC/11STTRUC rE.2 9 4,4 77 N , 12A2 94 - ART.,& 0 4 � I Y-4; PIWWA IN r v � g 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: Phone LOCATION: Assessor's Map Number a F G Parcel �^ Subdivision /l 4t Lot(s) Street �L7��/i� �i Z� 5� St. Nu, e Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: / Date Awproved Conse rvaticn Administrator Date Rejected Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Com-nents Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections 1JOO5� - driveway permi Fire Department wG 7 Received by Building Inspector Date NORTH 1 O � F A SgACHUSEt Applicant Town of North Andover, Massachusetts BOARD OF HEALTH DISPOSAL WORKS CONSTRUCTION PERMIT I42L AUUKLSS Form No. 3 Q/ 19 94 Site Location //,,,0 S% - Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. Fee CHAIRMAN, BOARD OF HEALTH D.W.C. No. 714D z t - {r .y -.'i+ i : �. t• v :. ft 4. t.•s a 7 4t 'S\i. ai ♦,{ - iS l 4 +y +,� �1;}-:� 4ii;`�4' w�f •A.,yy it M 5 r t ti �'Y'� 1Q � i t i '� ♦ t t t � )}' 'nN' ' .r. 1 '� '.� Ztz yt t.4, i14 •.j� ti ,1 a - - .. � - - � s- 'r 4 y ,.+y {�_.' it � i3iy 1 7 i •'` - - • i" w, NUMBER THE COMMONWEALTH OF MASSACHUSETTS FEE TOWN of ORTH ANDOVER $ 2 5. 0 0 ...........................-•--- This is to Certify that .... AvellinQ --- Ke NAME &... pump .......................................................... •-------2-4.4A-•-Saves n ---St_ T ead�n-g:,... MA ............... ADDRESS IS HEREBYGRANTED A. LICENSE For :_.__.__.._ Well Drilli-- ng - rt - ------•-- --._ . Pemi Lot 1A 2155 Turn ike Street - ._------•-•-------------•-----•-------... .....................-------- --._.-._... •_ This license is granted in conformit expires---DeLaember___31 Y with the Statutes a94. - ori i apses relatin thereto, and . 143 4----------------; unless end �r•i'�voke P em er---,L---------•----:19 cr = =_ FORM 433' •'" - - ......__ � HOBBS $ WARREN. INC.------------------- x� 00147. kS R i y'- ,.�• BOARD OF HEALTH �SSACHUS*NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Permit # PwUr �5 Dates install apump-2--c-L.� A permit is requested to: drill a well LOCATION: ` �� y it ��a Lot # Owner Address P��!/�u �% T- Tel C�P/'t Well Contrctr ,%ti/� c �� �� dd:L fit �T� Tel Pump Contrctr Add Tel WELLS (To be completed at time of pump test.) Type of well Use Diameter of well Depth of bed rock Seal been tested? Depth of well Depth to water Size of casing Depth casing into bedrock Yes (_) No (_) Date of test Water -bearing rock Delivers GPM for Drawdown feet after pumping hours at (how long?) GPM Date of'completion Signature of well contractor PUMPS (To be filled in before installation.) Name & size of pump Size of tank Type Pump delivers GPM Pipe used in well: Cast iron (_) Galvanized (_) Plastic (_) Sleeve used to protect pipe? Yes (_) No (_) Type well seal Date Signature of pump installer Date water analysis report submitted to Board of Health Plumbing inspector Wiring inspector Board. of Health BOARD OF HEALTH October 18, 1994 120 MAIN STREET NORTH ANDOVER, MASS. 01845 Piero Piergentili 84 Shawsheen Avenue Wilmington, MA 01887 RE: Lots lA and 1C Turnpike Street, No. Andover Dear Mr. Piergentili: TEL. 682-6483 Ext 2-3 This letter is to inform you that, on September 29th, 1994 the North Andover Board of Health granted one year extensions on the septic plan approvals for Lots lA and 1C Turnpike Street. If you have any questions, please do not hesitate to call the Board of Health office at the above number. Sincerely, Sandra Starr, R.S. Health Administrator cc: G. Perna File ................................................ VI I e 1":� 0 tA Uj d0 s tA tA uj tv uj Z UJ tA to 7S tv tA ................................................ NOTES Ip w GIANT GLASS CO.ch rn LnV N� t0 V Q CD U w U n O m � v `o 0o z co O a p" 2 O U CD CD M S ' m Z m C? ^_ CA cc m x rn00 ~ . m O w 00 3 z 0 � N 1 O m ep 2 �D O O < O m OC S O m O N 800-54—GIANT/800-54-44268 "WEYMOUTH 617-331-3550 CANTON 617-575-1150 CHELSEA 617-889-4590 LAWRENCE 508-686-8108z BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 TO: Norse Environmental Sarv;aaa 3 Pondview Place Tyngsboro, MA 01879 FROM: Sandra Starr RE• 1A, 1B, 1C Turnpike Street Dear Mr. Erickson: TEL. 682-6483 Ext. 32 This is to inform you that the proposed septic design plans for the above site dated 5-6 & 8, 1992 have been APPROVED. If you have any questions about the next step in the process, please call the Board of Health office. APPROVED WITH THE FOLLOWING CONDITIONS: SCH 40 pipe throughout; elevations of foundation drains noted DISAPPROVED FOR THE FOLLOWING REASONS: BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 TO: Norse Environmental RPr-%TIPAC 3 Pondview Place Tyngsboro, MA 01879 FROM: Sandra Starr RE: 1A, 1B, 1C Turnpike Street TEL. 682-6483 Ext. 32 DATE: a,g 2g, 1948 Dear This is to inform you that the proposed septic design plans for the above site dated 5-6 & 8, 1992 have been APPROVED. If you have any questions about the next step in the process, please call the Board of Health office. -.Ke7 APPROVED WITH THE FOLLOWING CONDITIONS: SCH 40 pipe throughout; elevations of foundation drains noted DISAPPROVED FOR THE FOLLOWING REASONS: DATEz_ Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER APPLICANT ADDRESS ASSESSOR'S MAP PARCEL # LOT # STREET # ENGINEER All)CS ADDRESS % Yh rfS bG/D PLAN DATE ����� REVISION DATE CONDITIONS OF APPROVAL: �Mi¢�/1�f1�C -o �/ Z.-2- oG --ON b RAl tl APPROVED DISAPPROVED SUBSURFACE DISPOSAL DESIGN REVIEW FEE '� PERMIT # DATE RECEIVED�A APPLICANT ADDRESS ASSESSOR'S MAP PARCEL # LOT # STREET # ENGINEER All)CS ADDRESS % Yh rfS bG/D PLAN DATE ����� REVISION DATE CONDITIONS OF APPROVAL: �Mi¢�/1�f1�C -o �/ Z.-2- oG --ON b RAl tl APPROVED DISAPPROVED PLAN REVIEW CHECKLIST ADDRESS / ENGINEER GENERAL 3 COPIES I -- PROFILE PROFILE &---' & PERC INFO/1��//t/ WATERSHED? 10 SCH40 SEPTIC TANK STAMP 1/ LOCUS L-- SrCALE �� CONTOURS SECTION �/" BENCHMARK ele✓a� ��`� ELEVATIONS SOIL WETS. DISCLAIMER !/ WELLS & WETLANDS SLOPE MIN 1500G. [/ DRIVEWAY_ WATER LINE DRAINS .17 INVERT DROP GARB. GRINDER(+200% EDF) 25' TO CELLAR !/ MANHOLE TO GRADE /� ELEV GW D -BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET - OUTLETS?.�O = f /7 (2" OR .17 FT) LEACHING RESERVE AREA C/ 4' FROM PRIMARY? 100' TO WETLANDS t,-� 2% SLOPE 100' TO WELLS V 325' TO SURFACE H2O SUPP — 35' TO FND & INTRCPTR DRAINS 4' TO S.H.GW 4' PERM. SOIL BELOW FACILITY r MIN 12" COVER FILL? (25' if above natural elevation; 101if below) TRENCHES n , S MIN 660 d LOPE min .005 or 611/100')L,-,"' >3' COVER? - V gP (ENT SIDEWALL DIST. 2X EFF. W OR D (MIN 61) t/ IS RESERVE BETWEEN TRENCHES? V IN FILL? MUST BE 10' MIN. bl-' 4" PEA STONE?,\<,/ BOT 390 X LDNG5162+ SIDE �,Co�% X LDNG (�� TOT 746 (L x W x #) (G/ft ) (DxLx2x#) LIEUTE02 of UMMSMUITAlt. ! - NORSE ENVIRONMENTAL SERVICES, INC. 3 Pondv/ew Place Tynpsb% Mass. 09879 TEL. 649-9932 TO WE ARE SENDING YOU ( Attached O Under separate cover via O Shop drawings O Prints ❑ Plans ❑ Samples O Copy of letter O Change order ❑ COPIES OAT[ No. OESCRIPTIoN THESE ARE TRANSMITTED as checked below: O For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted O As requested ❑ Returned for corrections O For review and comment ❑ O FOR BIDS DUE 19 REMARKS 7,)fr-o \\kk- the following items: ❑ Specifications ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US UW4 COPY TO SIGNED: j, fli 1 �pL i BOARD OF HEALTH ' 120 MAN STREET �' •` ""'''�`g NORTH ANDOVER, MASS. 01845 1 .. ,SSACMUs� t { � � .!, ,r 5f Norse Eny'ronmentalfGarv;aA� a 3Pondview Place , Tyngsboro,' MA 01879 f tz , Andra Starr . - 1'A,II.;1B, .a 1C . ;Turnpike Street TEL. 682-6483 Ext. 32 DATE:. ZL ,,, 2 g o 1 9 92 J N Ill: c iDear Mr.�EErickson }t} ry �h gWi s''[w'�.;�t� r'�`�ahF� &'IIK� �t��t �, � This is`to inform:' -you that the proposed septic design plans for the above site dated 5-6 & 8, 1992 have been _ `APPROVED. ., ` 6 if you<have-any questions about the next step in the process, please call the''Board of Health office. T APPROVED WITH THE FOLLOWING ''CONDITIONS: ?DISAPPROVED FOR THE FOLLOWING REASONS: i A ,SCH 40, pipe throughout; elevations of foundation drains -noted }t} ry �h gWi s''[w'�.;�t� r'�`�ahF� &'IIK� �t��t �, � ,,I it ...�� - 4 jn'. .. •^(u � �,�j � ... - f't .y��gil { ., f(� NJ ?DISAPPROVED FOR THE FOLLOWING REASONS: i A fihAa Yk eqk 7 ti ' ftv! }•'G ¢ : i to r. I r 1P- r,, v f I i 7 ,. tl ,- s 1 3 - -- -- --- -- Tv? �°` - - - - - --- -- - -- - - - - - b- s ON - --- --- �1 , r .- - --- --- -- - - = 0- --- t O �t Ln 21, zr k>< NJ 6< Commonwealth of Massachusetts W City/Town of NO. ANDOVER a System Pumping Record Form 4 �M 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. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. rab reran A. Facility Information 1. System Location: 2155 TURNPIKE ST. Address NO.ANDOVER City/Town 2. System Owner: CAROL CORNWELL Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): 11/4/05 Date Cesspool(s) 4. Effluent Tee Filter present? ❑ Yes R. No 5. Condition of System: 6. System Pumped By: Benjamin Shute Name J's Septic & Drain Company 7. Location where contents were disposed: GLSD MA State State Telephone Number 2. Quantity Pumped g Septic Tank 01845 Zip Code Zip Code 1500 Gallons ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No H79 406 Vehicle License Number 11/4/05 Date t5form4.doc- 06/03 System Pumping Record - Page 1 of 1