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Home My WebLink AboutMiscellaneous - 30 KITTREDGE ROAD 4/30/2018w 0 =i -i m v c� m O n v Department of Environmental Management/Division of Water Resources WEL,� COMPLETION REPORT WELL LOCATION fih— GEOGRAPHIC DESCRIPTION Address 06 , 0 N O(E)W of Depth to bedrock (feet) 1'. 0 h', k7"'a 11) City[Town Well owner/, %4 b Date drilled Water -bearing zones: CASING Address Type �� N ll� (W) 0 f SO, Length W& ft. Dia(I.D.) in. 3) From To (mi. in tenths) (circle) Board of Health permit obtained: yes X no El intersect. wl OP17) 0""IAr4 I 12(ro �d) WELL USE Domestic El Public EJ Industrial 0 WELL DATA Total well depth 6,6>,6 — ft. Monitoring D Other,18-0.77AY Depth to bedrock Water -bearing rock/unconsolidated material: Method drilled Description Date drilled Water -bearing zones: CASING 1) From V, �Q To Type �� 2) From 4>0 To Length W& ft. Dia(I.D.) in. 3) From To Length into bedrock RO ft. Gravel pack well: dia. Protective well seal: Screen: dia. Grout A Other 019,1116 2AX Slo #_ length from to STATIC WATER LEVEL (all wells) Static water level below land surface -?4& ft, Date WELL TEST (production wells) Drawdown _A01 ft. after pumping I-- hr.— min. at 16 gpm How measured,& W14- Recovery ZjW ft. after-,5—hr. — min. LOG of FORM IONS COMMENTS CD Materials From To Drille Firm Addres City[Town Supervising Driller Reg.# 00 Pd ew i4 �1�13 VLO-00 bl,;? 3/ 1jzJ BOARD OF HEALTH AACH NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Permit Date -0 o A permit is requested to: drill a well install a pump 7 flilpf 0 Lot LOCATION: 36 A I I t Zj Owner. P&D -t_ Address SO kittlWl))�,j�404`Tel We 11 C o n t r c t r Add. e 1 1-1 7- Plam-p Contrctr Add. oq Tel WELLS (To be completed at time of pump test.) Type of well / Use Diameter of well— Size of casin'___�64 0,9. Depth of bed roc Depth casing into bedrock Rel) Seal been tested? Yes No Date of test C) Depth of well oo Water -bearing rock Depth to water Delivers ( aC) GPM for (how long?) Drawdown P0 feet after pumpin hours at GPM 94— Date of completion Si46�t �ref weCll/c/on_Atrac�toi6�' PUMPS (To be filled in before installation.) Name & size of pump Type Size of tank Pump delivers GPM Pipe used in wLl: 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 2 8 f 1 3'1 /-�s I ANAWd "VI-rr NUMBER FEE rHsoomMomWEA OF MASSACHUSETTS�y ' - This is to Certify that ' U{ ...................... ~—^------~'-'---'r..... ^~'-^ ................................................ADDRESS .................................................. IS HEREBY GRANTED A LICENSE 1-4 .......................................................................................... ................................................................................. This licens eand ordinances thereto, and *xpi�s-----'.��---..-----'—_zodem sooner suspended or revoked. ") 46 � LIq a) 4 (U in 0- 0 H 4T jq CL 0 d) o E 22 0 U.- CY "F"ONNk1KE Li Ltj 1- 1 CELFF',TE - 6' DAVID M�,.j_iRELL I— "' 11 YITIFREDGm ROAD NORTH ANDOVER, MA 01845 2. Street Address 3. How many members are in your household? 4. �7 t_ type of sewag� disposal system do you have? cesspool 1 septic tank and leaching area z connection to municipal sewer other (describe) do not know 5. Are the plans (drawings) for our sewage disposal system on file with the Board of Health? �j yes D nc V do not know 6. 19ow old is your sewage disposal system? d 0-5 years El 6-10 years El 11-20 years .7-1 over 20 years El do not know 7. !-,as your sewap6 disposal system been rebuilt or repaired? 7D ves no El do not know L I If yes, approximately how long ago? years. What was done? E. How frequently is your sewage disposal system pumped out? El annually E] every 2-4 years El every 5-10 years El over 10 years El never 9. Tiave you had any problems with your sewage disposal system? El yes %�r no f yes, what problems? El repeated pump -outs needed El system clogs, backs up, or drains slowly F1 odors D sewage surfaces through ground iance are connected to your sewage disposal system? 10. 1 low many of each appli i..-ashing machine dishwasher v*' garbage disposal Cehumidifier drain sump pump toilet roof/pavement drains shower/bathtub 11. Please state th� b I rand and type (liquid or powder) of detergent you use for: e iShwasher j dotheswasher 12. Does your property have a lawn? EK"'Yes 0 no If Ves, approximately what size? 17 less than 1/4acre El 'Aacre El 1/2acre 3/4 acre acre more than 1 acre (Specify) acres 13. Hlow often do you fertilize your lawn? 1-4o. of applications per year. 3 X Seas,on(s) of the year 0"� L�_A_ r 91 14. Pleas"tate the brand and type (liquid or granular) of lawn fertilizer you use: V q PA" ,,I A N- SY Check here if your lawn is maintained by a professional landscape contractor. WATERSHED RESIDENTS QUESTIONNAIRE 1. Name CELESTE & DAVID WETHERELL ZO KITTREDGE ROAD 2. Street Address NORTH ANDOVER, MA 01845 3. How many members are in your household? 4. What type of sewage disposal system do you have? El cesspool septic tank and leaching area connection to municipal sewer El other (describe) F� do not know 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? El yes El no V do not know 6. How old is your sewage disposal system? d 0-5 years El 6-10 years 0 11-20 years El over 20 years F do not know 7. Has your sewage disposal system been rebuilt or repaired? El yes V no F1 do not know If yes, approximately how long ago? years. What was done? 8. How frequently is your sewage disposal system pumped out? El annually El every 2-4 years El every 5-10 years, [I over 10 years El never 9. Have you had any problems with your sewage disposal system? El yes Czr no If yes, what problems? D repeated pump -outs needed El system clogs, backs up, or drains slowly F1 odors 0 sewage surfaces through ground 10. How many of each appliance are connected to your sewage disposal system? washing machine dishwasher v"" garbage disposal dehumidifier drain sump pump toilet roof/pavement drains shower/bathtub 11. Please state the brand and type (liquid or powder) of detergent you use for: dishwasher clotheswasher 12. Does your property have a lawn? a�yes El no If yes, approximately what size? R less than 1/4 acre El 1/4 acre 1/2acre El 3/4 acre El 1 acre V more than 1 acre (Specify) 2, '2- acres 13. How often do you fertilize your lawn? No. of applications per year. Season(s) of the year 14. Pleas"tate the brand and type (liquid or granular) of lawn fertilizer you use: VCheck here if your lawn is maintained by a professional landscape contractor. 01 Permit # BOARD OF HEALTH NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Date A permit is requested to: drill a well install a pump '�:' 2-T. LOCATION: NP 7"r(IYIO� Lot # L Owner-2A�12 Address- 1�ittgll) 4-4T e 1 Well ContrctrJ*6�////��4�/�Z6 Q) Add.&/. Z-4,,-IyhielZl�� Pump Contrctr Add. -Tel WELLS (To be completed at time of pump test.) Type of well Diameter of well Depth of bed rock Use Size of casing Depth casing into bedrock Seal been tested? Yes (_) No (_) Date of test Depth of well Depth to water Water -bearing rock Delivers GPM for (how long?) Drawdown feet after pumpinq hours at GPM Date of completion— PUMPS (To be fill r Name & size of pump h o-5 e-. '�- —5- Inca Size of tank Pipe used in wLl: Sleeve used to prot Date 5 14- ZA),e 0 `5'�' e'e r A/Z all Date water analysisreport submitted to Board of Health Plumbing inspector Wiring inspector Board of Health V NUMBER THE CoMMomWsA OF MASSACHUSETTS 4 FEE This is to Certify that !4)it ---------------------------------------------- NAMR ................. --1�.L-'-_--_____-___---'---_--'-'_'-_-_-______ ADDRESS IS HEREBY GRANTED A LICENSE -----'----------'----------'------'--'----'----'----------- �omo��o -------'''--- This license with the Statutes and ordinances relating thereto, and .............................. unless sooner suspended wrrevoked. .. . ........ 70 100.00, il 1-� ree T 9 J-1 1911, Oak 15 Oak I J. I - - - - - - - - - - - - - 41 - I J. 1 ------- 8" Cedor J. 1 Lot 30A IJ5,750 S. F. '10 ree T 9 J-1 1911, Oak 15 Oak ,LORTH Town Of North Andover 0 00 Community Development & Services William J. Scott I 'A 4 10 Director 27 Charles Street Building (978) 688-9531 North Andover, Massachusetts 01845 C14US Per my conversations with your office and with Nick Bennedetto of ND Landscape, Fax 978-688-9542 the following changes have been made to the application for a well to be drilled on #30 (lot McKinney Well Co. Rt 108 Plaistow, N. H. Board of Appeals 06/15/00 (978) 688-9541 Re: 30 Kittridge Road Building Department (978) 688-9545 Per my conversations with your office and with Nick Bennedetto of ND Landscape, the following changes have been made to the application for a well to be drilled on #30 (lot 40A) Kitteridge Road, North Andover, MA. Conservation The address on the application has been changed from 430 to #25. This is due to the Department (978) 688-9530 location of the proposed well to be on the adjacent lot to #30 rather than to be on the same lot. Although the owners of both lots are the same, it is important to have the application reflect the lot on which It is being built and is to serve. Without the placement of an easement or a lot Health Department line change, this water well should only be used to serve lot 39A or #25 Kitteridge Road. (978) 688-9540 Secondly, please note the change of the location of the proposed well. In discussion with the Town Planner, and after review of the Bear Hill subdivision file, it was determined ec+ Public Health ' that the location of the well must be altered. The subdivision file indicates that the proposed i ae Nurse C:P-4— location of the well on Lot 39A is within a drainage area built specifically for the proper (978) 688-9543 drainage of the subdivision. Therefore, it !T_su�ggested that the location be moved outside of b e" the area (see attached plan) while also maintaining distance from the utility easement. Ifyou�',/"' Planning have any questions regarding this change please contact the Town Planner, Heidi Griffin, at Department 688-9535. (978) 688-9535 Lastly, please note that although this well is for irrigation only, it must still meet all the requirements applicable to drinking water wells. Please submit all paperwork required in addition to the well test results. This permit, #0 11, has been issued under the acceptance of these recommendations. Also note that you are responsible to apply for all applicable plumbing and electrical permits. If you have any questions regarding this issue please do not hesitate to call the Health Department. Thank you for your anticipated cooperation in this matter. Sincer, Ford, R. S. ealth Inspector CC: Sandy Staff, Health Director David Wetherell, homeowner File W. Springfield, MA (413) 781-2897 Quincy, MA (617) 479-2619 Mattapoisett, MA (508) 758-6633 Rhode Island (888) 881-4598 Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 Attention: Records COMPANY: POLICY NUMBER: CLAIM NUMBER: INSURED: LOSS LOCATION: DATE OF LOSS: DESCRIPTION: CLAIMANT: OUR FILE NUMBER: Gentlemen: Pittsfield, MA (413) 442-6328 Worcester, MA (508) 754-4100 Cape Cod & Islands (888) 881-4598 Hartford, CT (860) 525-9034 Board of Health Town of North Andover 120 Main Street N6rth Andover, MA 0 1845 Attention: Records Underwriters at Lloyds London QMD1022474 Celeste Damon 30 Kitteredge Road, North Andover, MA 03/15/2011 Puff -Back B 11-3 6280 IVED JUL - 6 2011 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Claim has been made involving loss, damage, or destruction of the above captioned property which may either exceed $1,000, or cause Massachusetts General Law, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B, is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, company claim number, date of loss, and claim or file number. a4yt ly ur yt ua taglino Adjuster P — 617-479-2619 F — 617-479-1740 paulb@georgebutleradjusters.com On this date, I caused copies of this notice to be sent to the persons named above at the address indicated above, by first class mail. Secretary June 28, 2011 P.O. Box 710120, Quincy, MA 02171