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HomeMy WebLinkAboutMiscellaneous - 241 FARNUM STREET 4/30/2018 (2)a G ZVk`X­ 01 X ri.' b s n ✓ ` : " $y�'h y 4 riade"Y.N,��'iJ Is �..t��� _,•1' s,` j . M ! - n a i -'Y •ice _ .;.' .� d ,M. 7, `�'.. �r,s,'3t•; ' �'' p N ,y4� �L• �W *4 'e n' .v` .r ��,��y,,_.. ��t�,q�. ,� 1' 'L. ��' a 'c�yP� r���y � ��ec-,� h� e -� J a "Y'k< f i `�� � % i;t. ��'+35 ii 4 v 'fit t�, zs.�`!i i •i, r .'S� y�� •._^;ti�yrt->��/.{k-, x ,,�, � _ } I' ��,•�'R�T'"'J''�'"+>tt tt�`MAP_ 1T F:Ei. �iu."z+�ir.`�'+��'i�Y�`- Ict A •'(.e. r. �' 7 ,' 2' i }r.� z }"� :+r LOTz�'1r \�' '�.1 � _ r t 1.: , , siM lY I + ,� 34 t, r n �. t, J •F 1- .�,r" 0 �. �' t �..• �� STREET PARCEL L # 1 >F �s ?>1�,,yy11 �,�'•1 )� •,,ty�..tiw'rr } y``a" f tj - ) <.'+' c-.. 7 � .. 4' A?44l"•1'Vy+.f'4_ h^ Jay v�� J i%( Ys 'f j. %' .., . i n�S PLAN REVIEW FEE BEEN PAID? . NO j.' at* „r "`'�h PLA4N APPROVAL: DATE l / ill ARP. BY; ill •so- 1"Y '+ v,�-��Skk +ri,!'.i_ .7 J _;+ = n •,a 1�,,. ' .:t. .. rs l r� DESIGNERi"PLAN DATE. �b � . trp r c +,�S E.'j _.,Y .,, � , , � •-' < � .a "2• s r 'r f r f :s -se is �� 4 }r. � r +li CONDITIONS tr f ... .., ; S{r+f '� x .t .�R, � �k ! tom. r�v�fi� iF{ S i X,t J -i. "f i{'}:"" �rm J .'ems .r-. �. +• zf -.. .. 1 5U a,� �}- !``� 4, WATER SUPPLY:` EL w WELL PERMIT' DRILLER WELL TESTS: s CHEMICAL DATE APPROVED BACTERIA I DATE APPROVED � BACTERIA II DATE APPROVED, COMMENTS: t, FORM U APPROVAL: APPROVAL TO ISSUE YES NO I DATE ISSUED o -FINAL APPROVAL: rl ALL'PERMITS PAID NO 'WELL. CONST RUCTION APPROVAL:' NO .:..SEPTIC SYSTEM CONSTRUCTION APPROVAL �Si NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: BY: I Wx ,EW`CONST SSUANCE WC,1'1 PERM1 5Y5IF0 LAITstn•-WN -$18.4 tij ICENSED? L1 CE'NS'* TALLER R' ED? M _-y• NO -AN'. 4STRUCTION kN EW 'REPAIR JCTION:'— CERTIFIED" PLOT.,: PLAN ":REVIEW-.', YES NO CONDITIONS OF APPROVAL YES NO (FROM FORM U) -DWC,PERMIT NO, INSTALLER: 'v -.11 ---------- ' BEGIN" -INSPECTION 4 YES NO: A, EXCAVATION ,'INSPECTION: -.,",,"-.,NEEDED: v u� Atf A, 31 lf j 6 T I 7' a� SED t"PAS -By �NP- i z CONSTRUCTION INSPECTION NEEDED2 4" I ­ 1 -1 , ­�. . -.1.1, 1; 6K -,j -OM, M v A., As BU I LT PLAN SATISFACTORY: S: '­ s't APDATE DATE: E: v. BY FINAL GRADING APPROVAL: E BY ivn IN 4. UCTION APPROVAL: DATE: By_ FINAL CONSTR T 4 i�;, 4 WA j f 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 or requirements. i *****************************APP'LICANT FILLS OUT THIS SECTION*********************** APPLICANT e��"t [�O { PHONE LOCATION: Assessor's Map Number 161 /i PARCEL c9e-<)"7 SUBDIVISION LOT (S) STREET 2.4// Facrh� S'� ST. NUMBER USE ONLY*************** ****** RECOAENDATION,S OF TOWN AGENTS: I RVATION ADMINIS TOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED FOOD INS C -HEALTH DATE APPROVED DATE REJECTED 1ASftCTOR- ALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWERIWATER CONNECTIONS. DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm C) cn m m T m -n CA CD 0 = CD P-4. 0 CL d CD C:j CD CL cr tu CD 0 C CD CLO O co CD LTJ CO2 O Cl) CO2 C2 CO2 -0 to Cl) CD O =r CD CD a. cops CD CO2 O M CO) COO CD co, C—Da m I cm E. =r -O CO) --I A3 CAO) CD CD =r CD 0 i ( cgr!� I CD mrn� on Cv C 03 CD C2 =:s. : 1* !0- COO 10 Z wa 12� 4b CL C/) y OO A CO) .4 ca CLW . C cc C/) wc W% :E vi CD: C/) CD M W CD CD 0 zCD O=r* C/) rC": r�. tz Cl CD w ri 2po 0 AC co) o C=, C/ Cl) to C9 :v Cc: n �z T ro C cm 0 01. C�. 5 cn olrl 0 0 CL ICI) A to 0 M :3 r, tj OT, M Al o.. , z 4.� 7houteview .e'adozatory, 9ife. 66 LITTLETON ROAD WESTFORD, MA 01886 (508) 692.8395 FAX (508) 692-0023 1 -800.649 -TEST Report Number: C-sks-7485 Report Date: Dec. 07, 1992 Client: Sample Taken At: Mr. Roger Skillings Messina Development Skillings and Sons Lot 5AA 269 Proctor Hill Rd. Farnham Rd. Hollis NH 03049 N. Andover MA Sample Taken By: SKS Staff On: December 04, 1992 CERTIFICATE OF ANALYSIS TEST PARAMETER: EPA Max RESULTS UNITS Total Coliform (P) 0 0 Per 100ml Calcium No Limit 16.2 mg/L Copper (S) 1.3 0.08 mg/L Iron (S) 0.3 # 0.37 mg/L Magnesium No Limit 5.6 mg/L Manganese (S) 0.05 # 0.18 mg/L Sodium " 20 15.3 mg/L.- Potassium (S) No Limit 1.7 mg/L Alkalinity (S) No Limit 66 mg/L Ammonia No Limit <0.03 mg/L Chloride (S) 250 13.2 mg/L Chlorine (total) 0.7 0.31 mg/L Color (S) 15 # 30 CPU Conductivity No Limit 216 umhos/cm Hardness No Limit 64 mg/L Nitrates(as N)(P) 10 <0.01 mg/L Nitrites(as N) 1 <0.01 mg/L PH (S) 6.5-8.5 7.7 SU Odor (S) 3 2 TON Sulphates (S) 250 12.8 mg/L Turbidity 5 1.2 NTU Sediment pos/neg pos NT=Not Tested, #=Value Exceeds EPA STD, TNTC=Too Numerous to Count *=Background Bacteria Noted, "=EPA Advisory Limit '=Exceeds EPA Advisory Limit (P)=Primary EPA Standard, (S)=Secondary EPA Standard (may affect aesthetics of drinking water i.e. taste, color, etc.) This water sample, as tested, is considered SAFE to drink according to EPA guidelines. However, one or more of the parameters exceeds EPA secondary standards as indicated by the (#) sign. Massachusetts State Certifiedic/e�rl�� MicH'ael P. Carlson, for Testing Laboratory #MA048 Thorstensen Laboratory Inc. AS -BUILT CHECK LIST and FINAL INSPECTION Proposed Elevations House Tank IN 5g -.M'56 Tank OUT 07, 5�5 D -box IN D -box OUT ,4a, 33 Trench Inverts Line 1 Line 2 Line 3 Line 4 As -Built Elevation � 43,3 4a Bottom of Exc. Stone OK? D -box checked?_z Pipes cemented? 96 Department of Environmental Managemei k,,, , •'r"' WELL COMPLETION REP WELL LOCATION Address 14? & City/Town.A?z{ Well owner�� GEOGRAVHIC DESCRIPTION r��� s E w or (circle) ./.ry . 44 rroaal'g�'' N of rnu. m nths) el Board of Health permit obtained: r yes � no El w/ n.CG (road WELL USE "tobediock Domestic P-P.blic ❑ Industrial ❑ :3,00 ft. Monitoring ❑ Other 1 ft. inconsolidated material: Method drilled Date drilled— CASING Type✓ Length__ft. Dia(.I.D.)__6_—in. Length into bedrock 96 Protective well seal: Grout.[] Other Description��g� Water -bearing zones: 1) From P:� Z4 To �- 2) From To 3) From To Gravel pack well: dia. Screen: Slot'! STATIC WATER LEVEL (all wells) //' ,,�� Static water level below land surface_lf.1 ft. dia. _ length from_ 1 Da to `47 WELL TEST (production wells) Drawdown_::��ft. after pumping__5j**4' hr.__—A_Qmin. at gpm How measuredRecovery:—ft, after___3._hr. min. 0 LOG of FORMATIONS COMMENTS g c Driller • J / BOARD -OF HEALTH COPY BOARD OF HEALTH Town of North Andover,Mass . Date i9/ rmit _ APPLICATION FOR WELL & PUMP PERMIT - plica tion.is hereby made for permit to drill a well (✓f• Application is de to.install (V�a pump system. _. Lot # • � /1•,�.. cation: Address A S n ✓e /,��,.���Address Ener n/ /�.,�a ✓Yl �T C �.Q n,S Tel. o3-� Addressy'-Soo� �,� <,,,sT„('_ ,11 Contractor--sf�`'>- � - „• , oa ���s"�'�el imp Contractor S i�,', s Sd- 7n� Addressg-% 1%r n! L � ;LL CONTRACTOR (To be completed at time of pump test) W e 11 used for-_____T- /pe of Well Size of. Casing iameter of Well r , g� ` Depth casing into Bed Rock / C)apth V9 Bed Rock Date. of Tcsting � g as Seal Tested? Yes () No (-) - 3QO Well Ended in W.ha.t- Material �6,�.,'� - � p t h •o-f �'J-e-']-�-- -• ' Delivers s_Gals.Per Min. for 4 hours Ppth to Water- feet feet after pumpin_hours rawdown �6O' atGPM g ate of Completion c We ontractor 2igna • ;**-A �cXx�:c:ti:.....n..,...•.,.,.x:. .,,..,..,cam; .,,.'..i•nstal.].ati.on). 'UMP INSTALLER (To be- fill cd i.n be f o.rc ff Pump Type Used 5j ;ize & Name Pump —� • , 30 Carr l �011� -- GPM Size of 'Tank__ later Pump Delivers K1 Galvani �cd ( )°} Plastic 'ipe Material Used in Well: Cast Iron (_) - Jell Pit ( ) or Pitless.Adapter protect pipe? Yes (_) NO(N rype or Name Well Seal Cc O •las sleeve used to )ate is 9�n aG l.'.�.n,. V;:D�rrr t�►r�`c1M►44�t��r�'c��r�4►����'r�M�'r���'�i4�M��r�4�r�C�'t�4�4�r�4�4►4�Y�t�4�4►'tti4�Y►4�'tti'��<�'r�'t ,'::'c:: ;,-ictictic, ,r','r•:;: Date Water analysis report 'submitted to Board of }iea1th Date release given tD owner of record & lilclg. Insp }-{ealth Inspector 'n to O N cn <c Z D 3 3 Z cn D cD (7 O w Z O C� Z v CD CD y o+ O C r) D {A• r _ O v O Z o (N m X W, s j0 cin — CD Z Ln CD D TO -n cn cn D **. CD CD y o+ O AA 2 0 N {A• J�.. a+. Or _ O , O '^ * tit W, s — CD Z Ln CD D •< s 3 .� m co oc 3 , v M s O o a � ° r O () -n W 00 0 D CD N T C) D n O� -- D Z 'n p "... ° m mCD .0 7a rn %A A D ` ,d:, ►. 4A C r 3 FORM U - LOT REMEASE 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*****ff*GG*********** APPLICANT: SS /A1 A () eQ . 11 G Phone v LOCATION: Assessor's Map Number ZJQ />f Parcel Subdivision /ULot (s) �. Street Fill P K) LA M (2 a e -f - St. Number ************************Official use Only************************ RECO103MAIONS OF TOWN AGENTS: Date Approved �� v Conservation Administrator Date Rejected Comments VAT -01 -Am- Arl, Town Planner i Comments .JJZ�O.P. Health Agent Date Approved 2 Date Rejected Date Approved Date Rejected Comments _iF 4VEL4 A&)7- ,�TY��9� - 0 K Td T/E /A/ LtJ�TC� TJ�`ii' LtJ/�TEiP � ��- Public Works - sewer/water connections 007�pwQ✓ 6+..1Cv� - driveway permit e+ rel yap (,CL /�i , �,�� /, ���`0 Fire Department Received by Building Inspector Date NUMBER FEE 13L3 THE COMMONWEALTH OF MASSACHUSETTS $25.00 TOWN NORTH ANDOVER ..................... of............................................................................. This is to Certify that ........ Skillings & Sons ----------------------------------------------------------- NAME ................... 2.4P ... Proctor... Hill-..Roadl___Hollis, N.H. 03049 ADDRESS IS HEREBY GRANTED A LICENSE For --------- Well._Drilling-... Permit ... m..Lat... 5.AA...k draUM ... oad-------------------------------- This license is granted in conformity with the Statutes and ordinances relating thereto, and expires ... ---December 31, 1992 unless sooner suap I e?I\ �,. __r.,_�. -:Y ...:............ .`............--•---................ December 11 2 "...... :.--------------- .FORM 433 HOBBS & WARREN. INC. DATE // 9 z rec. ive • Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER APPLICANT SO B A! Y_ _->; r',:. ASSESSOR'S MAP ADDRESS ENGINEER 5co-g GiCEs PARCEL # LOT # ; STREET 57 . ADDRESS ,SC6DE�� /�� A r�c0 ]Rd, N. A - PLAN DATE 101/919z REVISION DATE CONDITIONS OF APPROVAL: APPROVED /Z I3%QZ DISAPPROVED L--- 'k/ � l� �t � esus E � i�bu� his rANc �S d /-� 55 D 5 r -v ��uG�� ��v� C/�'• %� , l . Qr,j cL t h P + T pla PgR ry 4IN G Z) �Z7 &"o a E�'T- 7T o - c ,!5 Vc XIrj 3) `D -BOX SPE6/F16,IriONS /L1155iN6 4) --RE5erg V� /5 No0/'7 IV -5) 1UETL,9NDS � 15GGA/MEQ M/55/AJG C Al, SUBSURFACE DISPOSAL DESIGN REVIEW FEE O PERMIT # �- DATE RECEIVED APPLICANT SO B A! Y_ _->; r',:. ASSESSOR'S MAP ADDRESS ENGINEER 5co-g GiCEs PARCEL # LOT # ; STREET 57 . ADDRESS ,SC6DE�� /�� A r�c0 ]Rd, N. A - PLAN DATE 101/919z REVISION DATE CONDITIONS OF APPROVAL: APPROVED /Z I3%QZ DISAPPROVED L--- 'k/ � l� �t � esus E � i�bu� his rANc �S d /-� 55 D 5 r -v ��uG�� ��v� C/�'• %� , l . Qr,j cL t h P + T pla PgR ry 4IN G Z) �Z7 &"o a E�'T- 7T o - c ,!5 Vc XIrj 3) `D -BOX SPE6/F16,IriONS /L1155iN6 4) --RE5erg V� /5 No0/'7 IV -5) 1UETL,9NDS � 15GGA/MEQ M/55/AJG C Al, DATE /� Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEES D PERMIT # DATE RECEIVED �3 9 APPLICANT B08 ASSESSOR'S MAP ADDRESS PARCEL # LOT # STREET',4,�/LUs'�y1 5T, ENGINEER _ j Com 6166-6 ADDRESS J-6 /72&AWCO PLAN DATE _l0 �/4�9Z REVISION DATE CONDITIONS OF APPROVAL: APPROVED l Z/ 3hZ, DISAPPROVED L-� D/-- 5SDS I`Z� �GUGGG�/!/� '�7) PZ&,19SC" "i2ENC11�5 61V 56cr'io� 3) -D- BoX SPEC/FiC/97'/ON5 M/3s/1v6 ,3J (UETL/�Nfl 5 U �SGLA/ME.� /�lSS//1/6 (�/, 6/6- OZ �� e PLAN REVIEW CHECKLIST ADDRESSr9i9 ,9/T/j/U/t-J ENGINEER sc,p 7T (gl Z &"S GENERAL 3 COPIES L/ STAMPy CONTOURS t/ PROFILE PERC INFO ELEVATIONS WETLANDS FDN DRAIN c/ SEPTIC TANK WATERSHED?A/O SCH40 [.,-' LOCUS. NORTH ARROW SCALE U SECTIONS BENCHMARK Z--- SOIL & WETS. DISCLAIMER WELLS & DRIVEWAY 4,-," .(Elev) WATER LINE TESTS CURRENT? MIN 1500G. �j .17 INVERT DROP !/ -D knllV 25' TO..CR MANHOLE TO GRADE D -BOX SIZE # LINES Z GARB. GRINDER v (+200% EDF) ELEV GW FIRST 2' LEVEL STATEMENT INLETA V2, - OUTLET Z4Z. 3 = / (2" OR .17 FT) TEE REQ' D? LEACHING RESERVE AREA 4' FROM PRIMARY?� 100' TO WETLANDS c/ 2% SLOPE 100' TO WELLS 35' TO FND & INTRCPTR DRAINS 4' TO S.H.GW i/ 325' TO SURFACE H2O SUPP L� 4' PERM. SOIL BELOW FACILITY MIN 12" COVER FILL?(f (25' if above natural elev; 101if below) BREAKOUT MET? TRENCHES MIN 660 gpd(/ . SLOPE (min .005 or 6"/1001) � >3' COVER? - VENT V SIDEWALL.DIST.,2X EFF. W OR D (MIN 61)L,-- IS RESERVE BETWEEN TRENCHES?e--' IN FILL? (,-- MUST BE 10' MIN. c--' 4" PEA STONE? L,--" BOT 44A X LDNG ,3/ Z + SIDE aA 6 X LDNG 3G-5"= TOT 6 %l ,;-nloO (L x W x #) (G/ft2) (DxLx2x#) /. S Noce rQ. �e PrN- j5tc774N Z 55D.5 D / 5 r, 7-6 -PG+cc', 3. D- i3 0,e s P64 4, --Re-5, PJAT 471 -1', ?�P/M, (�. -JFAW S7 li 1 oily b i -JA 4i / 11 1�14- Z4 Lt CLO*vim c� t'- zc� P -S v Owl "Id fire 1 oily b i -JA 4i / 11 1�14- Z4 Lt CLO*vim c� t'- zc� P -S v Owl "Id fire Town of North Andover, Massachusetts Form No. 1 BOARD OF HEALTH 19 A APPLICATION FOR SITE TESTING/INSPECTION Applicant , _ •:k ,. �.�; NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time Fee ' CHAIRMAN, BOARD OF HEALTH Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. z NORTIy BOARD OF HEALTH c f � z ♦ y "• -=-- ,F` DESIGN APPROVAL FOR C"„SEt� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant" M t "GA'4_� Test No. Site Locaon d0./L�►'�--��it� � ference Plans and Specs. �o 0 Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. Fee CHAIRMAN, BOARD OF HEALTH OF HEALTH Site System Permit No. Jt-� 2¢3 / v � / FCt$TERE LAW (� (q3 � r�ATZ,.►..I.V Irl ST • Sc -r--L. G+c��S 2C.•S. S }-l��gY C�rL`r I� -tet gar z \ i-� Ate/ � t U s P'rcrGTTc�p TH E� Co.u. ST o f TI.1 c S Dt S PGtSA�� Sy ST7-c� \ tiJ t] T H E—= G o..i SrtZ�x� t o t. 1 A,4 t7 tiJ AL Ca 2.gbt �..tG. NAb �tz�G r...l tti.t Aa�olZ->aq.vc� w rc-a+-rt4g-- Cis t�QS I V TtEiw1 i A 4.1 t7 Tt+ATT Ft t✓(A TatlrlAt- V \ A.�.c .� 3 c a Gr'(✓tel 4-4 I l93 i qf \ l est J�GAJo �cpJgC._. 1►1�l. Ate-' �._.eo. Z43.3�- t�.l-ry T'AuL Q,¢2.�10 a vT Amo 94,e. 4---, o VI S'r" 242.2 8 �rui✓6.003�) 24-1. q o / v � / FCt$TERE LAW (� (q3 � r�ATZ,.►..I.V Irl ST • Sc -r--L. G+c��S 2C.•S. S }-l��gY C�rL`r I� -tet gar z \ i-� Ate/ � t U s P'rcrGTTc�p TH E� Co.u. ST o f TI.1 c S Dt S PGtSA�� Sy ST7-c� \ tiJ t] T H E—= G o..i SrtZ�x� t o t. 1 A,4 t7 tiJ AL Ca 2.gbt �..tG. NAb �tz�G r...l tti.t Aa�olZ->aq.vc� w rc-a+-rt4g-- Cis t�QS I V TtEiw1 i A 4.1 t7 Tt+ATT Ft t✓(A TatlrlAt- V \ A.�.c .� 3 c a Gr'(✓tel 4-4 I l93 i qf \ l est J�GAJo �cpJgC._. i '.I N L U r 70 N U) _O U t -4J in Q 0 N 1 C 8 I t C f0 C _O Q O 0 O m O L a L Qi r+ v � C O E C G7 3 ,0 m O � � Q O F a v F U O C r U •� C 0 Z 1 ',= a) E i f1 N 0 Cn C 0 m C O E O C O a L Q) V) C O U ! .0 0 m c C a ra Q) 2 O 'O tB O m I Ln m Q) CL 0- 0 O ra 0 m