HomeMy WebLinkAboutMiscellaneous - 365 CANDLESTICK ROAD 4/30/2018 (3)0\
u
L-1
i
CL
MAP # LOT # ....... ......
_ _
PARCEL # STREET ���t������'���
����������
APPROVAL
HAS PLAN REVIEW FEE BEEN PAID?
PLAN APPROVAL: DATE 17,111 Ilk APP. BY
DESIGNER: PLAN DAT
CONDITIONS..................
�� �� ___
�
WATER SU WELL
WELL PERMIT
WELL TESTS: CHEMICAL DAlE
BACTERIA % UA|E D|`PRUVED
BACTERIA II DAJE APPRUVED___.____
COMMENTS:
)
/ .
FORM U APPROVAL: APNO
0's
DATE ISSUED
___
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID
YES
NO
WELL CONSTRUCTION APPROVAL
YES
NO
SEPTIC SYSTEM CONSTRUCTION APPROVAL
YES
NO
OTHER
YES
NO
ANY VARIANCE NEEDED
YES
NO
FINAL BOARD OF HEALTH APPROVAL:
DATE:
_BY:_
/
/
" 1
SEPT I '___'-____LATI'~
IS THE INSTALLER LICENSED? YES NO
TYPE OF CONSTRUCTION: - NEW REPAIR
NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO
CONDITIONS OF APPROVAL YES NO
` (FROM FORM U)
ISSUANCE OF DWC PERMIT ' YES NO
l]WC PERMIT NO. INSTALLER:
BEGIN INSPECTION
EXCAVATION INSPECTION: NEEDED:
INSPECTION: NEEDED:
AS BUILT PLAN SATISFACTORY: YES:
/
APpROVAL TO BACKFILL: DATE:
FINAL GRADING APPROVAL: DATE'
FINAL CONSTRUCTION APPROVAL: DATE:JBY-
CONSTRUCTION
/
/
f,
SF 3 q
GE�rt �1 Efl �ou U t7(ATIo>tii �_A �..J
�oGATEt� 11...1 6„jo�TH � r` nbL�G� fZ� � I`�IA SS.
4-( a {9'L
cJc- e--r-T L.. G t c...rcS �.•C�.S . 5� +Z 192
t`i otzT t-t A �•-� n oY Ere. , M A ss
a
N_
-
lV TAS-ll✓ (fi 1. Qr�e /
Ot1'1' TAt.-1 t G l . Z E)
wr- So�c 1 Gc .49
" 159.9 2
'z 3 1159 Qo
._2i_kAr
�o.op
/71Z t
C A oc..0 ST►GK., �9 \�!o
� c=.
' 2
r7�ST��'�l. AuDTHAT"T�{� C.ou••+ST'2UC�foa.f
A. I D FAN C4L-.C3T.F-- t(GI NA S P �
1TF4 T!-44E-: DES(,,-E�2rS
(� T cl 1 Ta p Tf-t RT' Tt F M ter l AL-s
S PGI F'IGT-101.-4 S R`{ O alb Gl'•12. 1r�.Op
S G�.�.T'l�'�/ THA
a F•FS�TS S+-la�.�..� ►,J ATZ..� �otL T�-lE,
o` �1
THS cF"FS�cTs
USrc cF' T1-krc. Bvlt..t�t►�16 Z�+SPgcTb
ac���N
c7 K a �,a.J 4J CrvlflPt_y
O /-•� �---Y A w..l p S c.�C. H VSE, l S �� �
�� $�
W r-H •THEZc>QIUG
�rc.Te-_-2ti11►-j ATIotJ <=> &-I rN-;cz,
Q
r -, / o Q- "C> V-1 Coni ;r- =, 2.M (T v
3972
�.�[ N E. ►...t C a u ST 2,UG`r�D.
� f�fS1ERE� �••
lAh�
4igrg2
SI l e. j4!
Commonwealth of Massachusetts
City/Town of
System Pumping Record
Form 4
RECEIVED
JUL 14 2014
TOWN OF NORTH ANDOVER
HEATH DEPARTMENT
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.
. A. Facility. Information
1. System Location: Left / Right front of houseft / ig r of hou , Left / right side of house, Left /
Right side of building, Left / Right front of bu g, Left Ight rear of building, Under deck
City/Town State Zip Code
2. System Owner.
Name
Address (if different from location)
Citylrown stat^ cZip am- de
Telephone Number
r
1'
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped: —
Gallons
3. Type of system-- YP s
Y. ❑ Cesspool(s) eptic Tank ❑Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes Leo If, yes, was it cleaned? ❑ Yes ❑ No:
5. Condition of, System:
6. System Pumped By.-
Nell
y:Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Locan
ere contents were disposed:
G . Lowell Waste Water
--C C=- z �
1.
Date
t5form4.doc- 06/03 system Pumping Record • Page 1 of 1
DATE:
s
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE OF PUMPING: " "
CESSPOOL: NO YES
NATURE OF SERVICE: ROUTINE
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
(example: left front of house)
� eAc +1 rl&-�
TITY PUMPED GALLONS
SEPTIC TANK: NO YES
EMERGENCY
i
NOV 30 2001
L ---J
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
CONTENTS TRANSFERRED TO: 6 0
�(r2�41
our' H -E t�2.4S
IVT ANAL'- I(01. Q-�e
o�r-rau Ll- ►G1.26
lu 8ex lr�•r-c-
�T 160.4-9
t59.92
Z IS9.4o
aw 3 • 1 SB Ao
Q
0
h
�o.00
C A OL.r-- STtc-- 9
�oAD
2
hQ
L..OGATEO 1U `„loe,T�; A�r�d���_�i1''ArS,
4-(q jq2
C�xp 5(tZMe
A u fl cv /A SS
1
1.0
�v
a
L- ter- 2 o A
6 \
= C- -2TIF� TH o �FSETS S+io..��►,J tc%V-4C-- X02 THE,
THE, O F'1-rSTLT� USE, o P' T4 -+E, F3 u l t. n i ►.1 �, Z u SPEC'e7
S i-1 d tea.! 4..t C.�1�lPL.`y O f..it✓`/ A �...� fl c7 UC.H VSE+ l S �o >��
W r -ir4 THE. Z"ou Iu C-, L7rc,T E✓2 t-� ".j AT l o ►..,f (Z
`a LA\A1S o F CouFo2M T / o2. Ljc=, .1 G'ol.l F-o2�'11TY
►.10 QT4-1 AU nod [�2.. \Af N l✓ ►...i C-- cc u i5, -r 0-L)GTF-fl.
}
OF
2(4
4-(Rlg2
in
Q
CD
V)
CD
C)
0
Ln
L1
AW
Qo .
C ,n* O
i
� 0 A
7
C7
O
n
O
3
CA
O
(4
Co
Q.
D
O
D
p�
(D
-i
ni
_r
cn
�p
O
n�
Q
O
rD
o °
3
7
Q
CD
V)
CD
C)
0
Ln
L1
AW
Qo .
Town of North Andover, Massachusetts Form No. 3
NORTH BOARD OF HEALTH
19 92
o� t.,..o tl,1tio
o�;.o��`cy DISPOSAL WORKS CONSTRUCTION PERMIT
,SSACHUSES
Applicant Tim MP1 vi n 42 FnGfPr StrPPt
NAME ADDRESS TELEPHONE
Site Location Lot 20A Candlestick Road, North Andover, MA
Permission is hereby granted to Construct (x ) or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
jy C AIR N, WAF H TH
Fee
D.W.C. No. S`_�i..t
z z(a��
�.(a/q2
it
w
I
}
m
w
cr
w
2
En
� m l\
/J
I1
I
BOARD OF HEALTH
Sheet C of
TOWN OF NORTH ANDOVER
SUBSURFACE DISPOSAL DESIGN REVIEW
EE &o PERMIT # _ IE—DATE RECEIVED
kPPLICANT 7j0 + JQ#-.a0S'e
ADDRESS
I
ENGINEER
ADDRESS
PLAN DATE
CONDITIONS OF APPROVAL:
APPROVED R
DISAPPROVED
ASSESSOR'S MAP
PARCEL #
LOT #
STREET
REVISION DATE
To tQo a A eo k
S 4,,o, "� '' �"�" ' 7-0 0S C-0
1
FORM U
TOWN OF NORTH ANDOVER
LOT RELEASE FORM
SUBDIVISION
ASSESSORS MAP /-// . A
SUBDIVISION LOT(S)
PERMANENT ADD,RES SASS
STREET /ter►/ /�,_
U-NED BY D.P.W.
APPLICANT /yj ,�,� 914 PHONEJ—
DATE OF APPLICATION --2 -2
TOWN USE BELOW THIS LINE
CONSERVATION COMISSION
CONSERVATION MIN.
DATE APPROVED _/Z
DATE REJECTED
DATE APPROVED
TIATE REJECTED
BOARD OF HEALTH
HEALTH S ITARIAN
`¢ /31721.5
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY. PERMITr_n.<
/WATER CONNNE//C��TIOfN�K/ti
FIRE DEPT. -t
RECEIVED BY BUILDING INSPECTION
DATE
TE APPROVED
DATE REJECTED
I
Ily
This form shall be signed by the agents of the Planning and Health Boards,
the Conservation Commission prior to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
1 k•• : fx✓aR "+a.r° Y .> e }p Fajz• �Ftkrr•x: H,
kf>' y 4p d• t
Town of North Andover, Massachusetts Form No. s
t NOR*h BOARD OF HEALTH
;,. o • 1+
�+ •_+'.'. '• °0 1—\.�l o� is
19 1
DESIGN APPROVAL FOR
ssACNUSE� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant—Slob,Test No. ;
.t •
Site Location
Reference Plans and Specs./1/1 �1
`
ENGINEER ,. DESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installe
in accordance with regulations of Board of Health.
DRI�c -3 "17�2e►v Ti�►_J ,.2_0 6stRE�i
Se� 'Rol CHAIRMAN, BOARD OF HEALTHV
J 4
I
Fee Site System Permit No. 95 —
Town ,of�North' Andover, Massachusetts Form No. s
NORrM BOARD OF HEALTH ,!`
DESIGN APPROVAL FOR
HUStt SOIL -'ABSORPTION SEWAGE DISPOSAL SYSTEM
kpplicant Test No
t.
Reference Plans and Specs.`
ENGINEER *DESIGN 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
Site System Permit No.