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HomeMy WebLinkAboutMiscellaneous - 235 OLD CART WAY 4/30/2018 r 235 OLD CART WAY 210/107.6-0111-M.0 WAY � ---- - ---- APPLICANT: GAUTHIEP Ii U MAR # LOT` # :PARCEL'# STREET ., : , / / HAS PLAN REVIEW FEE BEEN PAID? `YESNO PLAN. APPROVAL:. DATE ' ` =' APP. BY DESIGNER: �f r PLAN DATE. �^ _ CONDITIONS i WATER SUPPLY: TOWN WELL WELL PERMIT WELL TESTS: CHEMICAL DATE APRROVED - BACTERIA I DATE APPROVED...._.__..._---___-_- BACTERIA II DATE APPROVED.-.- COMMENTS: PPROVED. .-COMMENTS: FORM U APPROVALS APPROVAL TO ISSUE _YES NO DATE ISSUED . -BY w -------- CONDITIONS: - FINAL APPROVAL: ALL PERMITS PAID =CY_E5 NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL =,,=___YES NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVALS DATES-_-_--_-BY: ' r •r , ., .:;.• . �` . SEPTI_t�S_1LS�.�M_�N.�.I43.4L..A_Z�CIN. IS THE INSTALLER LICENSED? NO ,. TYPEOFCONSTRUCTION: NEWT`` REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW NO CONDITIONS OF..APPROVAL YES NO (FROM FORM U) ISSUANCE OF DWC PERMIT NO DWC PERMIT N0. INSTALLER: 1 BEGIN INSPECTION YESyjNO EXCAVATION . INSRECTION: NEEDED: t BY PASSED �� - . CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: DATE• �% / BY �_�_- APPROVAL TO BACKFILL: FINAL .GRADING APPROVAL: DATE_1 - ` •' BY DATE: FINAL CONSTRUCTION APPRODATE:;/-// %� BY I Commonwealth of Massachusetts City/Town of No Andover a w° 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 235 Old Cart Way key to move your Address cursor-do not No Andover Ma use the return key. City/Town State Zip Code �1 2. System Owner: Carnevale Name --- ratan Address(if different from location) City/Town State I Zip Code Telephone Number— � B. Pumping Record � 9 1. Date of Pumping 2. Quantity Pumped: 1— -- Date Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank F-1GreaseTrap ks ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: = � C-P/1 _ Name Vehicle License Numbg� GJ Stewart's Septic Service Company OF NORTHRiM NfR 7. Location where contents were disposed: HEATH OMPA Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 a au er Date gS - ture of Fie Date t5forrn4.doc•03/06 / System Pumping Record•Page 1 of 1 i Form 4 -- System Pumping Record t Commonwealth of Massachusetss Massachusetts System Pumping Record "„' 4 2003 System Owner System Location Carn£v.xle Usibhi, Primary Hone 35 Old Cart Slay. 2'5 Old (:art Way 14;a: tb F.ndr.,vt-r, MA, 01845 N=)rth Ancli*,vc.r, :'., 718r , x (978)-"74-012 `t r'�tnevr�l€� Type: Emergency Routine Cesspool: No Yes Septic tank: No Yes Date of Pumping: Quantity Pumped: Gallons System Pumped By: Wind Riwr Environmental, LLC Permit#: Contents transferred to: Contents Disposed at: Date: Pumper Signature: Condition of System/Other Comments Dep Approved Form - 12/07/95 tAORTtl Town of Andover O4 _? 0, No. 4 0 U 4 � r,�, dower, Mass., 12EDT 22- —1919' 0 LAK+ COC HICHEWICK O't?ATED "'9 CJ BOARD OF HEALTH Food/Kitchle, " St Septic S PERMIT T D THIS CERTIFIES THAT.....L ......la......(:.;. .... .. .... ............................................................................................. BUILDING INSPECTOR has permission to erect,U)060 ftAM& 21.ir OUIII�...co=......w4w.....77.�... a <2 o:u:n�a alto ... ..... ...........I............. buildings on ................................. ) 'ougn tz,� LL A 4� 1-4 to be occupied a IWSG 1XL..V-Vo*'M.1...... W ......z.....up......44"' Im y 61 in every respect co to the terms of the application on file in provided that the person accepting this permit s ct nfo� Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection Buildings in the Town of North Andover. Inspection &MININ&LI PLUMBING INS C REGULATED BY PARA. 114.8-S. B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. :R::o:ug� PERMIT EXPIRES IN 6 M.ONW"41_;_ FEE PAID - Final ELECTRICAL INSPECTOR UNLESS CONS PERMIT FOR FRAMUBUILDING .. . .................... ........... .. ........ LDING INSPECTOR Final jL�q�6— A511- DATE luj4e-rmit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPA T NW Until- Inspected and Approved by the Building Inspect ? orl '2 44� Mo 14 Burner 6 /I f 4 Street No. 4� 1�12 PLANNING FINAL CONSERVATION —FINAL 7 f14 , Smoke Det. -Tlpgj 1 ,1. w SEWER/WATER -FINAL DRIVEWAY ENTRY PERM Town of North Andover, Massachusetts Form No.3 BOARD OF HEALTH f MORTH 19�_ ' F P } "�"�"`•�"`� * DISPOSAL WORKS CONSTRUCTION PERMIT 3 '�•.,.o ,SSACHUSES Applicant � AD ESS TELEPHONE NAME Site Location Permission is hereby granted to Construct) or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. ' �2/YL, 1 CHAIRMAN,BMRD OF HEALTH Fe bo D.W.C. No. �� 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: //i & `C' Phone (0� 1 - 12 ZJ LOCATION: Assessor's Map Number /o 7 d Parcel Z-7 Subdivision Lot(s) /Z Street O�� CA[ wA St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected ,,I&J / Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date 1 Town of North Andover, Massachusetts For No.2 f NORTH BOARD OF HEALTH �M o AL DESIGN APPROVAL FOR ,,..o CMU Sttr SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant,,A Test No. : Site Location __/I.,UT Z WO e-- ann Reference Plans and Specs. ENGINEER DESIGN a DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. --�-� CHAIRMAN,BOARD OF HEALTH Fee Site System Permit No. g DATE ® Z Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER xx SUBSURFACE DISPOSAL DESIGN REVIEW FEE,. �[J PERMIT # DATE RECEIVED APPLICANT ASSESSOR'S MAP ADDRESS PARCEL # LOT # . STREET DG ,o C,41?7- CIJ/ V ENGINEER ADDRESS PLAN DATE DATE CONDITIONS OF APPROVAL: /) ��G-VAr/D�i/ D� IJ� DI�HI�I 5�T B�Ncff�1/�1�.e /7 k/on c-cA1sr• - APPROVED DISAPPROVED PLAN REVIEW CHECKLIST ADDRESS ENGINEER GENERAL 3 COPIES STAMP LOCUS NORTH ARROW L---' SCALE 8� CONTOURS i/ PROFILE SECTION �-� BENCHMARK-110BENCHMARK & PERC INFO ELEVATIONS ✓ WETS. DISCLAIMER WELLS & WETLANDS- ,L WATERSHED? A/0 DRIVEWAYL.,-- .(Elev) WATER LINE FDN DRAIN' SCH40 TESTS CURRENT? 1g8G� SEPTIC TANK MIN 1500G. . 17 INVERT DROP GARB. GRINDER(+200% EDF) 25' TO CELLAR MANHOLE TO GRADE L/ ELEV GW 0 D-BOX SIZE pj- 7 # LINES FIRST 2' LEVEL STATEMENT L---` INLET, QW,g7 - OUTLET,)M, D = (2" OR . 17 FT) TEE REQ'D? LEACHING RESERVE AREA v 4' FROM PRIMARY? '11"" 100' TO WETLANDS 2% SLOPE 100' TO WELLS_,:,,,- 35' TO FND & INTRCPTR DRAINS4' TO S.H.GW 325' TO SURFACE H2O SUPP ✓ 4' PERM.. SOIL BELOW FACILITY MIN 12" COVER FILL? (25' if above natural elev;(10' f below) BREAKOUT MET? TRENCHES ko MIN 660 gpd X SLOPE (min . 005 or 6"/1001 ) � >3' COVER? — VENT V►5 SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) f IS RESERVE BETWEEN TRENCHES? C/ IN FILL? Cid MUST BE 101 MIN.✓ 47 PEA STONE? r BOT q X LDNGSIDE ,�jd X LDNG ��� = TOT (L x W x #) (G/ft2) (DxL•x2x#) Olt P-0413D Op LOT 64 gr ulOY -Z- NofjTH A�vpOv�l�, MA. PPS► CA�J Il 1o1��17 (,)A-fg f{ Sc�ppyt Wnl ❑ wElc_ AP ouCDlYJTC SS SEPTIC SYSTEM T 5►C� APR7OV v6 /Oun1o,'?►TY C. P�AtJ DE54 &IJCt'C,��v DATA ���r. �iSAPPxavE� Co,�p�r�o�s ,Y D� 3� StPr(C Sl►STEtii l�SjA 11�T�o�1 CX4VAT(dJ,) 1NSPE'6T(O&J 94 Q P/JSS [] F41L �SP�rlon� Pf PE FVVM HaLI66--' ry TJ 0 t� L1 Pry SS I--] ROIL /�PP(�dvEp 9/3TC AP[21�7V(NG Aurfo/-�iTy I Ns 4 AVDITIOMAL. (xj5ibcj jonj5 ���A► 'y) — DiSAPPJ?ovl;D D,a rC FV,-)4L A PPIN)V4 L P&)6 v'i-►o TOWN OF NORTH ANDOVEP, UA I'tcj SYSTF-M PUMPINQ "CC)fZD SYSTEM OWNER dt AD S SYSTEM LOCATION DATA OF PUWNp .—,._QUANTITY PUMPBD:_ l't3lPOOL: N0, YBS ...... ` Snpuc 1'xnk; NU YES.. t/ NA ruKu 4F 9ERvICE: K©U'fENk RECEIVED QbShXVA'(1GN3: ` 0001)C®NVIT1ON ✓ ^FULL 'T'U (,ovER JUN 0 3 2005 FEBAVY OSB BAYYLES 1N PLACE:. ROM _ -TOWN OF NORTH ANDOVER 5QX�/c/��s®syi ,T SOLIDS - Lp�E�ACMUD KUNBAC'�K HEALTH DEPARTMENT WA�`iEWVi�ll�r SOLIDS ....... FLOODED J13�II9 CARRY®YAR; OTHER EXPLAIN *sy.wm Pfd byPO Q% ,..rr1i tea, VUMMENTS. avN YtN'1'S fKANSYbKFi o 1'(, Date..... 2557 TOWN OF NORTH ANDOVER 0 A PERMIT FOR WIRING 40 �,SSACNUSES This certifies that ......��- IeA.11all......... ....................... ......................... has permission to perform ..... .`'.o: .......5.7:r/.</ -4e ...................... wiring in the building of....Z.-A....... I./...tl-/....(/.,j": 0.- . ............ . .. .... ...................... 6��•N h AO;M- ............. Lic.No.Y;9/3 ............... Fee.... ................................................ ELECTRICAL INSPECTOR �C)3 9/27/95 11:25 35.00 PAID INK:Treasurer GOLD: File WHITE: Applicant CANARY: Building Dept. P Office use only q CS '014t Tammmulmith off �sar#aefts Permit No. lepartme= of ITubUr —Aafttq Occupancy A Fee Checked 319 (l i BOARD OF FIRE PREVENTION REGULATIONS 527 CUR 12:00 ° (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK / All work to be performed in accordance with the Massachusetts Electrical Cade, 527 CMR 12:00 J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1 &1�4 Q* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for apermit to perform the electrical work described below. Location (Street & Number) A'07-466- ' T466- 42 a 3-� o--4'D (?,ogler Ct44 y Owner or Tenant 2 - 13 G C l7-�L D R a Owner's Address c7' aJ'q y Is this permit in conjunction with a building permit: Yes _ No G (Check Appropriate Box) Purpose of Building Utility Authorization No. c-d 6'73-2 Existing Service Amps Volts Overheaa '! Undgrnd No. of Meters New Service /60 Amps APO/ -:P q6.Voits Cverneac _ Undgrnc No. of Meters ✓ Numoer of Feeders and Ampacity l AL U —rz,i Location and Nature of Proposed Eiec:ncai 'Nork No. of Lignting Cutlets No. .f -ct –ups i No. of ransformers otal TKVA No. of Lignting =xtures I Swimming Poo! Above'-- in- — grnc. — r-nc. _ Generators KVA No. of Emergency Lighting No. of Recectac:e Cutlets ! No. of Cil Surners Battery Units No. of Switch Cutlets No. at Gas Burners FIRE ALARMS No. of Zones No. of Ranges ' No. of Air Ccrc. °Ldt No. of Detection and :cns Initiating Devices "eat Tota! Totat No. of Discosats i Nc.ofP;-cs Tons No. of Sounding Devices 11 No. of Sail'Contained No. of Dishwasners Scace/Area -ieating Detec::oniSouncing Devices y No. of Dryers Heating DevicesCN Locai _ Municioa! t i;Other Connection ! No. of No. of Low Voltage No. of Water Heaters KW ! Signs Satiasts Wiring i No. Hvcro Massage Tubs No. of `.Motors –,oz a; `iP C T H E INSURANCE COVERAGE: Pursuant to the recuirerr.ents of `.tassacnzjseas genera) Laws I have a current Liaciiity Insurance Policy inc:ucing C:.mc:etec Ccerat:cns Coverage or its sucstantial ecuivaient. YES = NO = 1 have suomitted valid proof of same to the Office. YES = NO = if you nave cneckea YES. please indicate the type of coverage by cnecxing the appropriate box. - a. INSURANCE Jr BONO = OTHER = (P!ease Scec:fy) Z&egg` —e TS' (Efxoiration Date) Estimated Value of Eiectncai Work S 30 Q 'N '9-f- _ o'2S orx :o Start –2' ' tnscec::on Date :=.zcuestee: � Fnai Signed under the Penalties of perjury: ?RM NAME ` LIC. NO. pensee -ZALD ate` 1 OA96.1 Signature- UC. NO. V Bus. :ei. No. - Address t�3 r-A R'Vi �N � "l9 G✓�// ,alt. Tel. No. AUX d CWNEA'S INSURANCE WAIVER: I am aware :hat :re Licensee odes not have the insurance coverage or its substantial eduivalent as re- cuirea by Massachusetts General Laws. and :hat my signature on :rias permit aoptication waives :his requirement. Owner Agent ;Please cnecx one) I 'eieonone No. PERMIT FEE S ;Sgnature at Owner or Agent FORM 4-SYSTEM PUMPING RECORD CURRIER SEPTIC & DRAIN SERVICE 107 FOREST STREET;MIDDLETON,MA 01949 V (978)774-2772 COMMONWVALTH OF MASSACHUSETTS P ,MASSACHUSETTS SYSTEM PUMPING RECORD SYSTEM LOCATION: SYSTEM OWNER: ' r �3S7 00 COY �� � � GLC � -7 o r a a � DATE OF PUMPING: e-1-�7- 00. QUANTITY PUMPED: �0 CJ GALLONS CESS NO SEPTIC TANK: NOE:] YES LJ O YES O SYSTEM PUMPED BY: CURRIER SEPTIC & DRAIN SERVICE CONTENTS TRANSFERRED TO: ZS • DATE: �/- 7-DG INSPECTOR: RECEIVED Commonwealth of Massachusetts JULI g X011 City/Town of No. Andover NORTH AN N System Pumping Record TOWN HEALDTHDEPAR MEDNTR a 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important: When filling out 1. System Locatio forms on the lti computer, use only the tab key Address to move your No.Andover Ma 01845 cursor-do not City/Town State Zip Code use the return y key. 2. System Owner: r� cctx�G � Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping2. Quantity Pumped: Date 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: c C—C–).nc( 6. to P mpe n,: C_tj 00 Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Ste art' Pre-treatment ant, 20 So. Mill Bradford, Ma 01835 g of H Date I Signature of Receiving Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 I � r z07,03 ,4c. I S A N N - uT G'S O C EASF/YJE�t/T � . r ' E�A,NA6 c D E U/ET D0 TO. WN OF NOR BOARD OF HEA�°Oi FRi i \ OCT 1995 w M . 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I AjV. <f IM6,E�-rem z = Z00,30 T2*3 It EM D Tem TRP2 =700,oy It It It TE*3 o� .10-r IZ X90 o�'r 9o.ISo s.F _ 0 y Box T ' SEP�� G TAA.-JK i4-o A ` ryiv- h - \�5.0 AS BUILT PLAN OF SUBSURFACE DISPOSAL SYSTEM LOCATED IN WORTH A►JDoVER , "A, AS PREPARED FOR LEI, J GET"' -y DATE : ILJoME:f"SER S, 1995 SCALE: 1 140' x-07 1Z 01-CL-CAR-7 WAY MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS: 66 PARK STREET 0 ANDOVER, MASSACHUSETTS 01810 0 TEL. (sad) 475-3555, 373-5721