HomeMy WebLinkAboutMiscellaneous - 269 BARKER STREET 4/30/2018 (2)N
1749
APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass. - A19 V 6
Application by the undersigned is hereby made to connect with the town sewer main in Street,
subject to the rules and regulations of the Division of Public Works.
The premises are known as No.
or subdivision lot no.
Owne
Contractor
Z6
Address
Address
ApAlicant's Sirnature s— -a Lk
11
/
PERMIT TO CONNECT WITH SEWER MAIN
The Division of Public Works hereby grants permission to
to make a connection with the sewer main at
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
Street
Street
Division of Public Works
By
See back for rules and regulations
,ED ,
Town of North Andover, Massachusetts
BOARD OF HEALTH
APPLICATION FOR SITE TESTING/INSPECTION
Form No.1
19
Applicant 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.
BOARD OF IFIEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR SOIL TESTS
DATE: (-d z -e MAP & PARCEL: IlAc,,,->
--T- I/c,
LOCATION OF SOIL TESTS:
OWNER:. t. N51-14 FI)V% -TEL.NO.:
ADDRESS:
5,-771
ENGINEER: TEL. NO.: 1?71- 6S(,,- 17610�
CERTIFIED SOIL EVALUATOR: J� 14 Ole P
Intended Use of Land: Residential Subdivision Single Family Home Commercial
-----------------------------
Is This: . X
Repair Testing: _ Undeveloped lot testing:
In the Lake Cochichewick Watershed? Yes
No
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
1. Proof o f land ownership (Tax bill, or letter from owner permitting test)
2. Plot plan & Location of Testing
3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of $200.00 per lot for repairs o
upgrades. (If time is not critical, fee for repairs is $75.00)
GENERAL INFORMATION
I . Only Certified Soff Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Eng ineers can design septic plans.
3. At least two deep holes and two percolation tests are required for each septic system disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the
BOH representative.
5. Full payment will be required for all additional tests within two weeks of test"
mg.
6. Within 45 days of testing, a scaled plan (no smaller than I "- 100') shall be submitted to the Board
of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A.. Conservation Commission Approval:
Date Received: Check Amount: Check Date:
i-,, UP "I
JUM 2 2 ?001
DATE: (-d z -e MAP & PARCEL: IlAc,,,->
--T- I/c,
LOCATION OF SOIL TESTS:
OWNER:. t. N51-14 FI)V% -TEL.NO.:
ADDRESS:
5,-771
ENGINEER: TEL. NO.: 1?71- 6S(,,- 17610�
CERTIFIED SOIL EVALUATOR: J� 14 Ole P
Intended Use of Land: Residential Subdivision Single Family Home Commercial
-----------------------------
Is This: . X
Repair Testing: _ Undeveloped lot testing:
In the Lake Cochichewick Watershed? Yes
No
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
1. Proof o f land ownership (Tax bill, or letter from owner permitting test)
2. Plot plan & Location of Testing
3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of $200.00 per lot for repairs o
upgrades. (If time is not critical, fee for repairs is $75.00)
GENERAL INFORMATION
I . Only Certified Soff Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Eng ineers can design septic plans.
3. At least two deep holes and two percolation tests are required for each septic system disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the
BOH representative.
5. Full payment will be required for all additional tests within two weeks of test"
mg.
6. Within 45 days of testing, a scaled plan (no smaller than I "- 100') shall be submitted to the Board
of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A.. Conservation Commission Approval:
Date Received: Check Amount: Check Date:
cr�
6-
r.Q
Lfpl
tu
,6 60'055#,30" W
4 0. 5"
4 6., 0 4 0 S. F±
r-, vft 4
B A R KER
, Zv--
rt
tu
k
C4
Ck
Cj*
W v
150. 0 0' 7-0 D. H.
4r LANDRIF
I(o .1
Zt OFOEORCE
R. SA RXER
s rREEr �
p, C.)
PLAN OF LAND
N
MORrH ANDOVER MASS.
0 WNED Br
Lu
0
4A
At
Lfpl
tu
,6 60'055#,30" W
4 0. 5"
4 6., 0 4 0 S. F±
r-, vft 4
B A R KER
, Zv--
rt
tu
k
C4
Ck
Cj*
W v
150. 0 0' 7-0 D. H.
4r LANDRIF
I(o .1
Zt OFOEORCE
R. SA RXER
s rREEr �
p, C.)
PLAN OF LAND
N
MORrH ANDOVER MASS.
0 WNED Br
q�h SEPTIC SYSTEM INSPECTION FORM
ADDRESS (�J , �t,,
DATE INSPECTED
PROPERLY FUNCTIONING? N
WEATHER CONDITIONS
COMMENTS:,
DYE TEST PERFORMED? Y N
DATE?
SKETCH:
7 112
'T774-
If
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. -V '-jP'\Jt?d7
-.;, >400 /
On-site Review
Deep Hole Number � Z. Date:. . 615/p/
Location (identify on site plan)
Land Use YA-PIrp SlopeM
Vegetation
Landform
Position on landscape (sketch on the back)
Distances from:
Time: Weather
Surface Stones
Open Water Body >/479feet Drainage way >/4-**k?feet
Possible Wet Area j A2 feet Property Line feet
Drinking Water Well .770AIld-f6et Other
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
F5
0-14 T-
I,-,
,3
wz�m br4 '�7 4xx
- FviiitimUm ur z nvLc�Q nLuv—&�
Parent Material (geologic) e; le- Of. 9ZF 09 d- C-10 DepftoSedrock:
Depth to Groundwater: Standing Water in the Hole: 09 ^'/C�Weeping from Pit Face: OIV00100�
Estimated Seasonal High Ground Water:
DEP APPROVED FOM - 12/07/95
I
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
z,o 7�
Location Address or Lot No. /V
a/ 012 -
On -site Review
Deep Hole Number . I Date:. 1�1� Time:
Depth from
Surface (inches)
Weather /Y /V
Location (identify on site plan)
Soil Color
(Munsell)
Soil
monling
Other
(Structure, Stones, Boulders, Consistency, %
Land Use Y/7PTP Slope M
Yv Surface Stones
X�V.P-Cj
Vegetation 6.'-c-4-5 5
Gravel)
5-0
Landform
Position on landscape (sketch on the back)
5a - 5�>
C-
Distances from:
Open WateT Body feet
Drainage way
feet
Possible Wet Area feet
Property Line
N� feet
7, J -A Yl$
Drinking Water Well 170W-k/feet
Other
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
monling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
5-0
=;z_ L -
5a - 5�>
C-
/Oxx 2&
Z' 3
r*t,,5
7 -TY
7, J -A Yl$
5V 0
V/3 7—
Z. 5. y4lZ
-------7w-MNUUM OF 2 HOLES REQUIRED AT J:VtKY rmurubtu LnbrUbAL AMLA
Parent Material Igeologic) el 4,#1454 11-e� 77 L--- DepthtoBodrock:
Depth to Groundwater: Standing Water in the Hole: d!f-- Weeping from Pit Face:
Estimated Seasonal High Ground Water: 4- L1
DEP AYPRONT-D FORM - 12107/95
4 q
/'Z
Project Request Record
Town of North Andover
Date: ,-/z 91a
Client Id: ToNA Card Id: ToNA ClientlCompany Namo� BoarA of Health
oy
if
�! "W"
I I
d-
M; 1, '' ' ',;- -
� 0 �g' §
ifle,
8!
§�.`-Sdn y!
P,
-�,"Ti e:,, irec of;
i i.fi7777 -Z7
'Sti
0."
He;,
t
oie�
6V
Y
1 .4
bi " i"'I . , , , " . z � f
-Zioic � W— V
d6 0,
.................
wqy -yll
I
z ;I.
��,�,Utheuwonta J."
qW,ir,'. etae ph-gibi -11
Ippucab VU
N
T. 7 7(."
VA
-7 1.011
IM
P
n-,
A- V�
�Y
Proiect:
Project Id: f770 Project Title: Town of North Andover, Board of Health
(JOB NO) (PROJECT NAME & SIREET ADD S)
Manager: NOW
Billing Group: Billing Code: Fixed Fee
Inggr()upi
Ip
zil
A 1 an V 41-W,
's
ypil,;
S,
X) z
s
Office/formsiijbrqutona
Town of North Andover, Massachusetts Form No. 1
XAORTH BOARD OF HEALTH
,'�E '6,� 0 . � "� 1, 6
6 0
0
7
z APPLICATION FOR SITE TESTING/INSPECTION
Applicant
Site Local
Engineer
9— W-* 1 9-4 lea, -
Test/inspection Date and Time
MAI RMAN, BOARD OF HEALTH
Fee— 9& —
Test No. /00 2
S.S. Permit No.—D.W.C. No.—C.C. Date—Plbg. Permit No
7
BOARD OF HEALTH
4 At
Or r05,
n i *,ftr �,
NORTH ANDOVER, MA 01845 C
HE' TA
r
978-688-9540
JUN 2 2 2001
APPLICATION FOR SOIL TESTS I
DATE: (6 --z-z[b k MAP & PARCEL: /Va /I'> 6 1
LOCATION OF SOIL TESTS: P c� OA eA-
OWNER.. ait, N5.4H.. TEL.NO.:� (o,�L9.-(:Sofo
ADDRESS: 14�q
AJ- IIJ
ENGINEER:
TEL. NO.: 4?71-
69(.-176,B
CERTIFIED SOIL EVALUATOR:
);f[A
U 14-
C -^Cl c4A to
I.,
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This:
Repair Testing: Undeveloped lot testing:
In the Lake Cochichewick Watershed? Yes
No— Y.
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
1. Proof of land ownership (Tax bill, or letter from owner permitting test)
2. Plot plan & Location of Testing
3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of $200.00 per lot for repairs or
upgrades. (If time is not critical, fee for repairs is $75.00)
GENERAL INFORMATION
I . Only Certified Soff Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
3. At least two deep holes and two percolation tests are required for each septic system disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the
BOH representative.
5. Full payment will be required for all additional tests within two weeks of testin-a.
6. Within 45 days of testing, a scaled plan (no smaller than I "- 100') shall !��tipo.-ard
of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soff evaluation forms shall be submitted. JUN 2 6 2001
Please Do Not Write Below This Line
N.A.- Conservation Commission Approval:
Date Received:
Check Amount:
Check Date:
wl�
rV
QZ
% Q�
co
60'055'30 W
140.51
46, 040S.F.t
t--, �,, c,- vft 4
A RKER
PLAN
NORTH
ZVI,
Q:
150. 0 0' rO D. H
4r LANCRIF
I(o 11
k) OF 49EOROE
�:-. A BA RXER
s rREEr
OF LAND
/ N
ANDOVER MASS.
0 WNED B)e
p
C':
Cd
B
% Q�
co
60'055'30 W
140.51
46, 040S.F.t
t--, �,, c,- vft 4
A RKER
PLAN
NORTH
ZVI,
Q:
150. 0 0' rO D. H
4r LANCRIF
I(o 11
k) OF 49EOROE
�:-. A BA RXER
s rREEr
OF LAND
/ N
ANDOVER MASS.
0 WNED B)e
7
WN NORTH An
ONTR
SYSTEM PUMPING
-&�j t I
V
SS, 'EM -LOCATION
RTST
W
pk. kft -from of hou")
i 17;
fl"N
V
. . . . . . . . . . .
Fs
A
UAMM PUMPED
-WON
G,
No
ff "YE"S
MOMIG— EPTIC TAW: No
yESk=MM.
40 -ON -M
114
.9y. sl
ROUmt
EMERG19NCY
D -C
FULL TO COVER
'jll:IUW GREASE
BAFFLES IN PLACE
Rom
LEACHmLD RUNBACK
SOLIDS
SQI�IDS CARRYOVER ON
FLOODED
3
MINGO-Wow OTHER (ExPLAN)
"Turm
lei
141"
Oil
0
J.
%juj_
2751
M
4"ADDRE
00,
0I