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HomeMy WebLinkAboutMiscellaneous - 31 BANNAN DRIVE 4/30/2018 (3) �r vim. - --- - - - _� Cvnd,Wo- yr �lLL �4e¢ni J I `(�c,l t• t' ^ 2586 ` Date . q .. ............ O�NOR7/y q� o? °gyp TOWN OF NORTH ANDOVER RECEIPT 9S`SgCHUS�S This certifies that.... ............................................... has paid........::..1b, ............................................................................... for ......: Li.00.(G".: ....Ft,L!f!1 L'. ..��................................................. . : .......... Received by.....f/..��.5.�.r�..... 1?, . �.: ................................................. Department.... ...... ......................................................... WHITE: Applicant CANARY:Department PINK:Treasurer X Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number, WPA Form 88 �;Certificate of Compliance 42 000 242-0004 ILI Massachusetts Wetlands Protection Act M.G:L. c. 131, §40 Provided by DEP A. Project Information Important: When filling out. 1. This Certificate of Compliance is issued to: forms on the computer,use Shaheen, Guerrera&O'Leary, LLC only the tab key Name to move your 820A Turnpike Street cursor-do not use the return Mailing Address key. North Andover MA 01845 City/Town State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Chester C. Sullivan 'x"01 Name June 24, 1974 242-0004 Dated DEP File Number 3. The project site is located at: 31 Bannan Drive North Andover Street Address Citylrown Map 38 Parcel 116 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Chester C. Sullivan Property Owner(if different) Essex North 1245 377 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 6/21/11 Date wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 1 of 3 N �I • Massachusetts Department of Environmental Protection Bureau of Resource Pt,,ection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance PCOG Massachusetts Wetlands ProtectioILIn Act M.G.L. c. 131, §40 Provided 242-0004 4 DEP B. Certification Check all that apply: ❑ Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ® Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: PCOC for 31 Bannan Drive only. ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: North Andover Conservation Commission DatC of I suance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office (See http://www.mass.gov/dep/about/region/findvour.htm). Signatur AJ,_ 4' wpafrm8b.doc•rev.12/23/09 _ WPA Form 813,Certificate of Compliance•Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protec,'ion -Wetlands DEP File Number. WPA Form 8B 2 ertificate of Comr Nance t9co c- Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 242-0004 ILIProvided by DEP D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the.district in which the land is located. Detach on dotted line and submit to the Conservation Commission. To: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---------------- North Andover Conservation Commission Please be advised that the Certificate of Compliance for the project at: 31 Bannan Drive 242-0004 Project Location DEP File Number Has been recorded at the Registry of Deeds of: Essex North County for: Property Owner and has been noted in the chain of title of the affected property on: Date- Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpafrm8b.doc•rev.12/23/09 wPA Form 813,Certificate of Compliance•Page 3 of 3 Page I of 4 Hughes, Jennifer From: Hughes,Jennifer Sent: Tuesday,May 26,2009 2:26 PM To: 'kevin maclean' Subject: RE: [BULK]trees in side yard Bannan drive Kevin, Sorry for the delay in contact. I was out of the office Thursday and Friday of last week. At the May 20, 2009 meeting,the Commission confirmed that the two dead/dying trees that I observed and photographed within the wetland on your property could be removed as they may pose a safety hazard. The tree which has fallen over into your brush pile may also be removed. No stumps shall be removed and machinery should not enter the wetland area.The branch overhanging your deck may also be limbed. In addition,the brush pile adjacent to the wetland area and within the North Andover Wetland Protection Bylaw 25-foot No-Disturb Zone should be taken to the town brush disposal area. Please see section 3.2 of the bylaw at the following link: http://www.tewnefierthandever.cerNFaS.cs/NAndeverMA CenservaMen/wet landregf Previous owners of your property were ordered to remove a similar pile in 2003. 1 will send a copy of this letter to you if you would like. Wetland Markers designating the sensitivity of the wetland area were also to have been placed on trees per that letter. I do not know if any of this information was shared with you when you purchased your home, but it should have been. Any further work to remove vegetation within the isolated vegetated wetland would need to be permitted, likely through a request for determination. Please feel free to contact me for further information. Jennifer A. Hughes Conservation Administrator Town of North Andover 1600 Osgood Street,Bldg 20,Suite 2-36 North Andover,MA 01845 Phone 978.688.9530 Fox 978.688.9542 From: kevin maclean [mailto:daddymac1224@yahoo.com] Sent:Tuesday, May 26, 2009 2:02 PM To: Hughes,Jennifer Subject: RE: [BULK]trees in side yard Bannan drive Hi Jennifer I was wondering if any thing came out of the discussion regarding my trees. Kevin MacLean Pacific Packaging Pmducts 24 Industrial tray Wilmington MA, 01887 978-8154899 6/2/2009 • 4 --�. tr .� Page 2 of 4 ---On Mon,5/18/09,Hughes,Jennifer yhughes*ta ownofnorthandover.com>wrote: From:Hughes,Jennifer<jhughes@townofnorthandover.com> Subject: RE: [BULK] trees in side yard Bannan drive To: "kevin maclean" <daddymac1224@yahoo.com> Date: Monday, May 18, 2009, 10:53 AM The commission does not usually hold discussions with applicants until a filing has been made.There would likely be some discussion before or after the meeting to determine what portions of your proposal could be done without a filing and what you would need to file for. Our next meeting is Wednesday this week and I will call you the following day to let me know what guidance the commissioners provide. If you needed to file with the commission, the next filing deadline is May 29 for our June 10 meeting. Jennifer A. Hughes Conservation Administrator Town of North Andover 1600 Osgood Street,Bldg 20,Suite 2-36 North Andover,MA 01845 Phone 978.688.9530 Fax 978.688.9542 From: kevin maclean [mailto:daddymac1224@yahoo.com] Sent: Saturday, May 16, 2009 1:31 PM To: Hughes,Jennifer Subject: Re: [BULK] trees in side yard Bannan drive can you let me know when the next meeting will be? Kevin MacLean Pacific Packaging Products 24 Industrial Wg W71mington ALA, 01887 978-8154899 From: "Hughes,Jennifer" <jhughes@townofnorthandover.com> To: kevin maclean <daddymac1224@yahoo.com> Sent:Tuesday, May 12, 2009 2:00:56 PM Subject: RE: [BULK] trees in side yard Bannan drive Kevin, I will need to discuss your request at the next meeting of the conservation commission.Typically,the Commission does not allow removal of trees within a wetland area unless they are dead or dying. I did observe 2 dead trees in the wetland and one just outside the wetland in the area of your brush pile. There is a letter in the building file for your property stating some requirements for the wetland area which include removing the brush pile.This was written in 2003. 1 am attaching a copy so you are aware of some of the issues the previous owners were aware of. In the meantime,there is a limb leaning over your deck and two dead trees on your property. If you feel this or either of the two dead trees is a safety hazard, please remove them. If you need further information at this time, do not hesitate to contact me. Jennifer A. Hughes 6/2/2009 Page 4 of 4 6/2/2009 i Page 3 of 4 Conservation Administrator Town of North Andover 1600 Osgood Street,Bldg 20,Suite 2-36 North Andover,MA 01845 Phone 978.688.9530 Fax 978.688.9542 From: kevin maclean [mailto:daddymacl224@yahoo.com] Sent: Monday, May 11, 2009 6:48 PM To: Hughes,Jennifer Subject: [BULK]trees in side yard Bannan drive Importance: Low Hello Jennifer thank you for coming out to see what we want to do. the 2 trees closest to the street that appear healthy one is growing at an angle to the street because it was starved for sun light before I trimmed the area along the road. both are blocking sun light from getting in there promoting only the vines to grow which continually choke out every thing else. The area is so thick with vines that are so over powering on the healthy growth that things are dieing that shouldn't be. the 2 that are diseased and the big one that fell are just dangerous to keep on the property. I look forward to hearing from you. thanks again Ker.in MacLean Pacific Packagin,g Pivditcts 24 IndilShial IFI'gy II>ilmilz,yon ALL, 01887 978-815-4899 6/2/2009 r ti�'� ",Y'' 4F .rF +��' +wr ■R .i _ L3 a • � 4 � rr+"' it +�.. .. � q F P Vin., #. _ 'I 4 AE C '„Fs i •,,'� f��'�� �4 � 4a , , • r PF • , ow 9 e _ a x��. s• ... �� < j,� .Yi tib, J4 JY If lip f w M a"' ..�” g •l •,a � K� ,, dF,i F. � � '!j S� Jf:i�' `��'r,. ,may � 4 1 a +,� � �e�� •1 �'�`' ` R, .+`fj •,���i+"'' '4'�I }'4 � ? �"�' �i� as _i� ,�, 3 P �ll�Y aY 42 ter... �, t � � � � � dr L r+3 _ '� � • fid. A'"'e,�P�,e r � ri _. f I; �� . 'GFY r14 h ty :p y Yr .3 a ?•� 't; ` n '' ;,.�w( e e R �� � �' �r: r �(xr+.l,r�- f ,r''� �"`wr' � < ,tn•_ � / I �,y,t'� J 4 L•t. ,'�,� � i ti�',, '•� f is a �/'tip�'�`Q� a; -'r �.�y� • v.,.;a,,7�7, '� �.v. �^ vt r}�' � `. r "S J � :1 '1 u I, P3,ES'�+ •Y h�'i.� �, •,{yV l,, _ +: -f •✓ .... ^'st""T*M+f—ct�r„. .'�.r a ���,r,r ,�� �a Ft ���`� ,.Y J � Hfl rl�' rs'`-`h+ � •�,. 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Q$r,�E'<' Ka.W`u: � � x�y-,ps•' —_-dam-iS3�. hz `"rwj rCi�•r x a n s,�fi•'�; � i .a. �.--.----�,�° R rr. 5 �t'v`? ..a � '�, 4 r P�a *r•"�.ti:'. �J,.; Yv��' 'aE�.�°:' ��ti, .� y rtx ;^ier. �_��,. 1. • ,. -::4tH t `��� �,�,! �sr ;v i• \*kms ,6 '_; c i So'r r'i7iE y xb8 s iy5A du i y '9e E:• v ;� A� �Y ` �,'•,7qf 'C J a i _• l r .F . ;J ;:t',ir•4 'kyr ��.i,',� 1.�y J k-. � j •r �� �.3C ,.t 1 � .N d ,s ��t Ryjw"" '�r.r � Y�� ��i`����� NA. < 1, � ��"'PYt _ -tt �9v+r5�+�JJy..y6tY t ,tet ' y< �r}$. �•�r 'r� .f ,, � #e a r� Y` 1 1l. - � ^ • .,.T l C. ,F `� t Hyl .'� _��' a' ,r•..'. > ;.i } at 't✓<E.yF^ a-.'lj �p i�_;�.- � 7 4 - --•r. .� rn �, -•ta ti i,rt.. t R+777YY.... ` a xygJt 7 �1 S?t a. ;�.f yi�j v w r•'`� 7, +' �.:�J, in +Ff. { i .s +;Si� -``,' f e µ���- _ .. ys �Com, `'� Z-'t�3,y�'fi *" ri� ;'� • intj a2��a r e., -i. s 4t �. - i s' A t.s f3 '} Page 1 of 1 Hughes, Jennifer From: Hughes, Jennifer Sent: Tuesday, May 12, 2009 2:01 PM To: 'kevin maclean' Subject: RE: [BULK] trees in side yard Bannan drive Attachments: 31 Bannan.pdf Kevin, will need to discuss your request at the next meeting of the conservation commission. Typically, the Commission does not allow removal of trees within a wetland area unless they are dead or dying. I did observe 2 dead trees in the wetland and one just outside the wetland in the area of your brush pile.There is a letter in the building file for your property stating some requirements for the wetland area which include removing the brush pile. This was written in 2003. 1 am attaching a copy so you are aware of some of the issues the previous owners were aware of. In the meantime, there is a limb leaning over your deck and two dead trees on your property. If you feel this or either of the two dead trees is a safety hazard, please remove them. If you need further information at this time, do not hesitate to contact me. Jennifer A. Hughes Conservation Administrator Town of North Andover 1600 Osgood Street,Bldg 20,Suite 2-36 North Andover, MA 01845 Phone 978.688.9530 Fax 978.688.9542 i I� 5/12/2009 Page 1 of 1 Hughes, Jennifer From: kevin maclean [daddymac1224@yahoo.com] Sent: Monday, May 11, 2009 6:48 PM To: Hughes, Jennifer Subject: [BULK]trees in side yard Bannan drive Importance: Low Hello Jennifer thank you for coming out to see what we want to do. the 2 trees closest to the street that appear healthy one is growing at an angle to the street because it was starved for sun light before I trimmed the area along the road. both are blocking sun light from getting in there promoting only the vines to grow which continually choke out every thing else. The area is so thick with vines that are so over powering on the healthy growth that things are dieing that shouldn't be. the 2 that are diseased'and the big one that fell are just dangerous to keep on the property. I look forward to hearing from you. thanks again Kevin MacLean Pacific 1'ackagzng Products 24 Industrial lay Wilmington MA, 01887 978-8154899 5/12/2009 i Town of North Andover ���?►� CS f*i.so;."RSO Office of the Conservation Department Community Development and Services Division 'l� ORa]MO'.Pp��3 27 Charles Street CAU , Alison McKay North Andover,Massachusetts 01845 Telephone (978)688-9530 Conservation Associate Fax(978)688-9542 September 10, 2003 Ronald Pisani 31 Bannon Drive North Andover, MA 01845 RE: Proposed Rear Deck Replacement at the,property of 31 Bannon Drive Dear Mr. Pisani: On 9/5/03 Julie Parrino, Conservation Administrator, and myself performed a site inspection at your property for the proposed replacement of a rear deck as described in the submitted building permit. Upon this inspection, it was observed that an isolated wetland resource area exists within 100-feet of the proposed work. It was also observed that the old deck had already been torn down and two new sonotubes were added-for the replacement deck. The woman with whom we spoke with during the inspection explained that the new deck would have the same footprint as the previously existing deck. She indicated that no expansion was proposed. Yard debris and grass clippings were also noticed within the wetland resource area and/or within the 25-foot no-disturbance area, which is prohibited. Under the Massachusetts Wetlands Protection Act (MGL c. 131 s.40) and the North Andover Wetland Bylaw(C. 178 of the Code of North Andover), any activity within 100-feet of a wetland or other applicable resource area(defined under Section 178.2 of the Bylaw and under Section I(C) of the Regulations) requires a permit from Conservation. This department has determined that the replacement of the deck would have minimal, if any impacts to the wetland resource area. Therefore,the Conservation Department will authorize the deck replacement within the previous footprint only without a conservation permit filing. Please be aware that any proposed work different from what is proposed or any future work within 100 feet of this isolated resource area would be subject to a Conservation filing. The following conditions shall be implemented and followed in lieu of a Conservation permit filing: • Prior to Conservation's sign off on the building permit, all yard debris and grass clippings must be removed from the resource area and within the 25' no-disturbance area. • Prior to Conservation's sign off on the building permit, the applicant shall permanently mark the edge of the"25' No-Disturbance Zone"with signs or markers spaced evenly every 25 feet incorporating the following text: "Protected Wetland Resource Area" (available at the Conservation Office for $2.00 each). This will designate their sensitivity and assure no further BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 inadvertent encroachment into the wetland and are subject to review and approval by the Conservation Department. • Buffer zone plantings shall be planted along the 25' no-disturbance, or in close proximity to this area if existing limits are being maintained beyond this point, to further deter encroachment into the resource area. • The applicant shall arrange an on site meeting with Conservation staff to discuss the location of the plantings, the specific number of plantings, and type of plantings. These plantings shall be planted prior to the end of the growing season(no later than October 15I'2003). • The Conservation Department shall be notified for an on site post-construction meeting to ensure that the deck was constructed as proposed and that the plantings were planted as advised. Your anticipated cooperation is appreciated. Please feel free to contact me if you have further questions or concerns in this regard. Sincerely, . Alison E. McKay Conservation Associa Cc: NA CC File Building File Town of North Andover b �v4fD/6 Office of the Conservation Department $``` a A Community Development and Services Division �•g�`�?1xo wrp�9 27 Charles Street A CHU Alison McKay North Andover,Massachusetts 01845 Telephone (978)688-9530 Conservation Associate Fax(978)688-9542 September 10, 2003 Ronald Pisani 31 Bannon Drive North Andover, MA 01845 RE: Proposed Rear Deck Replacement at the property of 31 Bannon Drive Dear Mr. Pisani: On 9/5/03 Julie Parrino, Conservation Administrator, and myself performed a site inspection at your property for the proposed replacement of a rear deck as described in the submitted building permit. Upon this inspection, it was observed that an isolated wetland resource area exists within 100-feet of the proposed work. It was also observed that the old deck had already been torn down and two new sonotubes were added,for the replacement deck. The woman with whom we spoke with during the inspection explained that the new deck would have the same footprint as the previously existing deck. She indicated that no expansion was proposed. Yard debris and grass clippings were also noticed within the wetland resource area and/or within the 25-foot no-disturbance area, which is prohibited. Under the Massachusetts Wetlands Protection Act (MGL c. 131 s.40) and the North Andover Wetland Bylaw(C. 178 of the Code of North Andover), any activity within 100-feet of a wetland or other applicable resource area(defined under Section 178.2 of the Bylaw and under Section I(C) of the Regulations)requires a permit from Conservation. This department has determined that the replacement of the deck would have minimal, if any impacts to the wetland resource area. Therefore, the Conservation Department will authorize the deck replacement within the previous footprint only without a conservation permit filing. Please be aware that any proposed work different from what is proposed or any future work within 100 feet of this isolated resource area would be subject to a Conservation filing. The following conditions shall be implemented and followed in lieu of a Conservation permit filing:. • Prior to Conservation's sign off on the building permit, all yard debris and grass clippings must be removed from the resource area and within the 25' no-disturbance area. • Prior to Conservation's sign off on the building permit, the applicant shall permanently mark the edge of the"25' No-Disturbance Zone" with signs or markers spaced evenly every 25 feet incorporating the following text: "Protected Wetland Resource Area" (available at the Conservation Office for $2.00 each). This will designate their sensitivity and assure no further BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 11 inadvertent encroachment into the wetland and are subject to review and approval by the Conservation Department. • Buffer zone plantings shall be planted along the 25' no-disturbance, or in close proximity to this area if existing limits are being maintained beyond this point, to further deter encroachment into the resource area. • The applicant shall arrange an on site meeting with Conservation staff to discuss the location of the plantings, the specific number of plantings, and type of plantings. These plantings shall be planted prior to the end of the growing season(no later than October 15I'2003). • The Conservation Department shall be notified for an on site post-construction meeting to ensure that the deck was constructed as proposed and that the plantings were planted as advised. Your anticipated cooperation is appreciated. Please feel free to contact me if you have further questions or concerns in this regard. Sincerely, Alison E. McKay Conservation Associa' Cc: NA CC File Building File Town of North Andover ti x R?k Office of. the Conservation Department Community Development and Services Division 27 Charles Street Alison McKay North Andover,Massachusetts 01845 Telephone(978)688-9530 Conservation Associate Fax(978)688-9542 September 10, 2003 Ronald Pisani 31 Bannon Drive North Andover, MA 01845 RE: Proposed Rear Deck Replacement at the property of 31 Bannon Drive Dear Mr. Pisani: On 9/5/03 Julie Parrino, Conservation Administrator, and myself performed a site inspection at your property for the proposed replacement of a rear deck as described in the submitted building permit. Upon this inspection, it was observed that an isolated wetland resource area exists within 100-feet of the proposed work. It was also observed that the old deck had already been torn down and two new sonotubes were added for the replacement deck. The woman with whom we spoke with during the inspection explained that the new deck would have the same footprint as the previously existing deck. She indicated that no expansion was proposed. Yard debris and grass clippings were also noticed within the wetland resource area and/or within the 25-foot no-disturbance area, which is prohibited. Under the Massachusetts Wetlands Protection Act (MGL c. 131 s.40) and the North Andover Wetland Bylaw(C. 178 of the Code of North Andover), any activity within 100-feet of a wetland or other applicable resource area(defined under Section 178.2 of the Bylaw and under Section I(C) of the Regulations) requires a permit from Conservation. This department has determined that the replacement of the deck would have minimal, if any impacts to the wetland resource area. Therefore, the Conservation Department will authorize the deck replacement within the previous footprint only without a conservation permit filing. Please be aware that any proposed work different from what is proposed or any future work within 100 feet of this isolated resource area would be subject to a Conservation filing. The following conditions shall be implemented and followed in lieu of a Conservation permit filing: Vprior to Conservation's sign off on the building permit, all yard debris and grass clippings must e removed from the resource area and within the 25' no-disturbance area. nor to Conservation's sign off on the building permit, the applicant shall permanently mark the edge of the"25' No-Disturbance Zone"with signs or markers spaced evenly every 25 feet incorporating the following text: "Protected Wetland Resource Area" (available at the Conservation Office for $2.00 each). This will designate their sensitivity and assure no further BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ' 1 Oadvertent encroachment into the wetland and are subject to review and approval by the VConservation Department. Buffer zone plantings shall be planted along the 25' no-disturbance, or in close proximity to this area if existing limits are being maintained beyond this point, to further deter encroachment to the resource area. The applicant shall arrange an on site meeting with Conservation staff to discuss the location of the plantings, the specific number of plantings, and type of plantings. These plantings shall be 4anted prior to the end of the growing season(no later than October 15I'2003). V The Conservation Department shall be notified for an on site post-construction meeting to ensure that the deck was constructed as proposed and that the plantings were planted as advised. Your anticipated cooperation is appreciated. Please feel free to contact me if you have further questions or concerns in this regard. Sincerely, 4 Alison E. McKay Conservation Associa Cc: NA CC File Building File CARTER & TOWERS ENGINEERING CORP. �u„Vit s, c®assa��l a�ec�Keporb JOSEPH D. CARTER, P-E. & R.L.S. 6 FAIRVIEW AVENUE SWAMPSCOTT, MASS. 01407 Tr 1. 542.0386 1 . a KISF SOLL1UO L I N. 81 ----4 U-3Dc--W,� Q. /C_o0ST"C-Tlo�/ �OT 0 O'c`7. !c, 9�a? i - - Tothe Salem 5G Savings Bank and Lawyers Title Ins . Co . I hereby certify that I have examined NORTH ANDOVER, MASS, the premises and all easements, . SCALE, 1" = 40 ' encroachments and buildings are August 11 , 1975 located on the ground as shown. further certify that the buildings sbown conformed to the zoning laws of North A Ia°sse 'hen Constructed. � `N Of Rfj�9y I further certify that this property o� JOSEPH In the DAVID is not located WER ti established flood hazard area. . u •p t6a7 0 SU10 A Joseph D. Carter R.L.S. #9381 J/ �LN Commonwealth of Massachusetts _ CitylTown of EINED System Pumping Record Form 4 3 2010 DEP has provided this form for use by local Boards of.Health. Other formslyr7, EO TER information must be substantially the same as that provided here. Before usi r local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health orother.approving authority. A. Facility Information 1. S : Left side of house, Right side of house, Left front of house, Right front of house, Left rear of house, ight rear of house. Left rear of building. Right rear of building. Address City/Town State Zip Code 2. System Owner: Name i Address(if different from location) City/Town Stat ip Com._ Telephone Number B. Pumping Record 1. Date of Pumping Date( L 2- Quantity Pumped: Gallons 3- Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of Syste�m�c,-A t ` v\- 6. 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locaf ntents were disposed: G.L.S. Lowell VY6stqVqter Signature o aul r Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1