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HomeMy WebLinkAboutMiscellaneous - 425 BOXFORD STREET 4/30/2018 425 BOXF0R0 STREET ,t 2101105.C-0055-0000.0 I I { MAP # LOT # PARCEL # STREET ._ _.. �T_-_._...... CONSTRUCTION APPROVAL HAS PLAN REVIEW FEE BEEN PAID? YE5 NO r PLAN APPROVAL: DATE `�/��/% APP. BY•___,.�._ ___ Y_.._..__... DESIGNER: �L��I�IUDI�( 1��5 AT/ PLAN DA'i"E:_ QZ�� CONDITIONS -�--. �_--�- WATER SUPPLY: TOWN 75 ..... • , WELL PERMIT DRILLER._..._._._._----.-.-..--.--...___.._...-._._...___._._....................... WELL TESTS: CHEMICAL DA l E A{'(�fZUVED... BACTERIA I UA i E i1F-'hRUVEU BACTERIA II COMMENTS: FORM U APPROVAL: APPROVAL TU ISSULYES DATE ISSUED /�/� BY ° CONDITIONS: FINAL APPROVAL: . ALL PERMITS PAID NO WELL CONSTRUCTION APPROVAL NO SEPTIC SYSTEM CONSTRUCTION APPROVAL 1\10 OTHER YES NU ANY VARIANCE NEEDED YES FINAL BOARD OF HEALTH APPROVAL: DA i'E•.'. BY: _.. i % 5EP�T•E_SY Z NS19.LL�T QK -� ,^+,'. ,• Via' _ 'h 1,-u ." . ,. ....:...,:;�•}". i .,r ;'• \' 1 � J•� f _. , IS THE INSTALLER LICENSED? f ,, YES NO ` :TYPE OF- CONSTRUCTION: r 4 = NEW REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW ESJ NO • ir CONDITIONS OF..APPROVAL S NO (FROM FORM U) ISSUANCE OF DWC PERMIT r _ YES NO y DWC I PERMIT N0. _{ INSTALLERS 'BUSBY .-, . BEGIN -INSPECTION YES NO. 4: r` ' EXCAVATION . INSPECTION: : NEEDED: i - � = 411 1 A..• +- i ` ' 1 - • 7. ;PASSED HY --'.:CONSTRUCTION INSPECTIONS NEEDED: " AS BUILT PLAN SATISFACTORY: YES: APPROVAL TO BACKFILL. DATE. % - BY FINAL .GRADING APPROVAL: DATE BY ,.'..,FINAL CONSTRUCTION APPROVAL: DATE: BY address s7— Title of File page -� of Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes action Document/ document/ Num. Action Department Board of Appeals — Board of Health — Planning Board _ Conservation Commission — Building Department aDrrrirtrnent of Environmental Manage ment/Division of Water Resources ; t� Deparimeat of Environmental Management/Division of W8ter Resources �.-•j WELL COMPLETION REPORT �,y�._. f WELL COMPLETION AEPORT WfcLl,LIO GEOGRAPHIC DESCRIPTION GEOGRAPHIC DEsentp I+ A / rr 6 \ ess f4S E 4V of Ad ss St N W i rree�J kurlrJ — a CitylTown CitylTown ra"J,f 9 rC:rctoy Well owner"{ �'n --�a + G jrc«+t WeII owner � t43 C(� Address ©r-P1 ajlk re,, � P1 S( t;J W 01 Address P.O. -F cA V 3 J< 2 m) IVC>,-4 h k}'r'?r n >� y!'JLZ N S i v �-• in fenfn jctrrtrJ Board of Health y i+frersrcr. ifrtersecr. w! f5 perm+t obtained: es no❑ jroraJ l3aard at Health permit obtained: yes❑ no jror�J WELL USE WELL DATA WELL USE WELL DATA Domestic.-arPublic. ] ln[tjtstrial [ Total well depth 3 Domestic blic� (ndcrstrial Total well depth {�ft. fJloniloring Q Other D o Monitoring❑ Other Depill to bedrocks it. Waler•bearing roc unconsolidated material: �% er- caring roc inconsolidaled mate Method drilled 0 ff Method drilled o Cc rl r Description 3 Description i rs+rgN/�P Date drilled Date drilled CASING Water-bearing zones: CASIP40 11 From Water-bearing zones: TYPE St 3Yd To Type 5t e f, j t}From ��� -To-apo /�0 21 from Ta & 21 From° T. 7 Length-4-0--ft.Dial.l.D.) in. 31 From To Length q& Dia�.1.D.} ' i». length into bedrock / _ft, Length Into bedrock -C�--t!s It31 From To Gravel pack well: dia. --- ' Gravel pack well: dia. Protective well soap: Protective well seal; Screen: dia. Screen: dia, Grout-J3 Other �I't�i�' � ,_ Slotlength from—ta Groat.❑ Other � 1'v�5� Slot" length from to_. STATIC WATER LEVEL(all wells) STATIC WATER LEVET Jai)wells) Stat le water level below land surface ft. Date { Statla water level below land surface_ft. Data ZA2 WELL TEST(production wells) WELL TEST(groduction wells) fDrewdown h, after primping hr.�min.at_s—gpm Ofawdow+t 41, aflorpurnplrig hr. 3D mtn,at gprn How measured, / Recovery ft, aper—hr. min, How measured-,Zq- -�----Reeavery ft. after—hr, min. ° o LOG of FORMATIONS COMMENTS LOG of FORMATIONS COMMENTS Ai�inFaq FromTo r<iorerlsls From -ro z olr��ra r/.nes Driller � a r �•res r/ U) K. Driller � Y� ��� C �f Firm Firm 5kl 1� Address-;& Address 11 City/Town�,/Z" / C'dyTown l I`t> i l Supervising DriNer Reg- J f gORTM , ♦ iAs ►.''�,.,,.••"ty BOARD OF HEALTH ,SSACMusEt NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Permit # Date A permit is requested to: drill a well install a pump LOCATION: 80Xi;/'b Sr- Lot # Owner - -� IIV7-,C/�l7..4 Address i�G. 53/ /t/ �4: Tel pilo �.E'Gr:7� h�ac'PD Well Contrctr ,5'g//G1,/A/G5 q( 750:11.5 Add. ,./(/ /5' Tel 6, 03 Pump Add. Tel WELLS (To be completed at time of pump test. ) Type of well Use �DGSivtE_�T/G Diameter of well Size of casing I Depth of bed rock / Depth casing into bedrock Seal been tested? Yes (�) No (_) Date of test Depth of well :3zlG Water-bearing rock I Depth to water jG Delivers GPM for (how long?) Drawdown feet after pumping hours at GPM Date of completions ;S"�9 3 Signature of well contractor ********************************************************************** PUMPS (To be filled in before installation. ) Name & size of pump Type Size of tank Pump delivers GPM Pipe used in well: Cast iron (_) Galvanized (_) Plastic (_) Sleeve used to protect pipe? Yes (_) No (_) Type well seal Date Signature of pump installer Da a water analysis report submitted to Board of Health 1 mbing inspector I W i r i6Y in pector Department of Environmental Manageyrnent/Division of Water Resources a i WELL COMPLETION REPORT r-� WELL LOCATION GEOGRAPHIC DESCRIPTION Address ae4 _5Y /leer/ circlet City/Town ,N RL? dt v"'lro Well owner Address J_ Ba V 5-31 N S (c rof del Board of Health permit obtained: yes El no Elillte�sect. w/ o�/road WELL USE WELL DATA Domestic [�1 Public❑ Industrial ❑ Total well depth3,? ft. Monitoring❑ Other Depth to bedrock 'Wo ft. r^ I:W::al Laring ro inconsolidated material: Method drilled Date drilled Z Description— 4Lel�yf Water bearing z CASING ones: Type 51 elf ' 1) From ©� To 10 2) From .Zt�) To /t) Length�(Zft. Dia(.I.D.) �'� in. 3) From To Length into bedrock 49 Gravel pack well: dia. Protective well seal: Screen: dia. Grout-13 Other a j,V ho" Slot length from_to STATIC WATER LEVEL(all wells) Static water level below land surface,&_ft. Date WELL TEST(production wells) Drawdown—ft. after pumping hr.__min.at 17 gpm How measured—Recovery ft. after—lir.—min. 0 LOG of FORMATIONS COMMENTS c A Materials From To 0 Driller Firm ( t 1 65 1—�6s Address 2 ���t• t I j City/Town (�1t'r1 N t-t Supervising Driller Reg.# I '"atlutoow"PervIfsIngre is d well driller Please print firmly BOAR OF HEALTH ffpy NORTH SACHUSEtt� BOARD OF HEALTH NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Permit # Date Z1/1 a 19i3 A permit is requested to: drill a well install a pump LOCATION:— _ a7" Lot # Owner - .�I�7",CT)�',�� Address �i?C? �'�3i' o9 -5� & Well ContrctrAdd. / �.5,,i(/ Tel�ps3 Sloy Pump ContrctrIj)1611N,.,�raN Add. Tel WELLS (To be completed at time of pump test. ) Type of wellUse Diameter of well Size of casing Depth of bed rock Depth casing into bedrock :96 Seal been tested? Yes ( ) No (_) Date of test Depth of well Water-bearing rock Depth to water Delivers GPM for ¢ (how long?) Drawdown feet after pumping hours at GPM Date of completion clA?3 Signature of well contractor PUMPS (To be filled in before installation. ) Name & size of pump Type Size of tank Pump delivers GPM Pipe used in well: 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 f BUAKI) Ut ►ii,�,�� Town of North Andover ,Mass . Date 'ermit rt APPLICATION FOIZ WELL & PUMP I'ERi'1IT - • p lication i✓s tppi�cation . is hereby made for permit to drill a well ( ) A P Wade to install ( ) a pump system - Lot - .'location : AddressW­Z r c l :owner �XI�G� Address 1� �1e11 Contractor,.SLti��r✓ s s Acldress ;��< o.� +���� `� �/ 7c1 • , T- ,r' ac. .?ump Contractor�j� y &n z2— Address__ Tel `4ELL CONTRACTOR ( To be completed at time of pump test ) Type of Well —Well used for ��7`rsi�•�' Diameter of Well Size of Casing , �8 Depth casing into BedRock .Depth '�f Bed Rock • No .Was Seal Tested? Yes (1) (—) Date. of Testing 93 -Z,?D Well I"ndcd in Wha.t. Nlaterial Depth o-f—Nell — lp De1ivr°rs.-. Gals . Per Min . for 4 hour Depth to Water- —' . � • a t : ' GI'�1 Drawdown feet after pumping --hours Date of Completion ' 3 — ure 1-1:--(,—ontractor 1 gh filled before i nst��1. J.� tion ) pUi1P INSTALLER (To be �n Pump 'I"ype Used Size & Name Pump Siic of Ta ilk Water Pump Delivers CPTI J . pipe Material Used in Well : Cast Iron ( _) C:rnl v'ini zcd ( _) I'l� stic ( _1 . Wcll Pit or Pitless Adapter ( _) Was sleeve usedd to protect pipe? Ycs (_) ) Seal ICU ( _ �1�Yi�c or Na"'c 1�e11 Date p'i�;���r�:� �5 ;:��;� � , Dane %.later analysi.'s . repor-t submitted to Board of iiealth Do -e .release given toowner of record & IM19 . Insp i1— th Inspector I� 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: F LTNT LOCK =NC- Phone ( E38- LOCATION: Assessor's' Map Number C. Parcel � 0 Subdivision Lot(s) a Street .X F O R D S i St. Number ************************Official Use Only***************** ** RECOMMENDATIONS OF TOWN AGENTS: 77 Date Approved / Conservation Administrator Date Rejected Comments JA QIP Date Approved Town Planner Date Rejected Comments Date Approved Food IInspector-Health Date Rejected � !L, 'I/L� Date Approved /a. Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections M "dS r - driveway permit 4/1 F1 pepartment: Received by Building Inspector Date NORTh 04 `, to BOARD OF HEALTH N # 120 MAIN STREET TEL. 682-6483 CMUSEtt� NORTH ANDOVER, MASS. 01845 Ext23 October 29, 1993 Philip Busby, Jr. 9 Pond Lane Atkinson, N.H. 03811 Dear Mr. Busby: On October 28 , 1993 I passed the site of Lot 2 Boxford Street. At that time I saw that the area for the septic system had been excavated. There has been no Disposal Works Construction permit taken out for this lot. You are currently in violation of state and local regulations, since, according to 310 CMR 15. 02 (1) and North Andover regulation 2 . 04 : "No individual sewage disposal system or other means of sewage disposal shall be located, constructed, altered, repaired, or installed . . . until a permit for its location, construction, alteration, repair, or installation shall have been issued by the Board of Health. " This has happened previously with systems in North Andover with which you have been associated. Please note that if it happens again, your installers license will be revoked or suspended for a length of time to be determined by the Board. Sincerely, Sandy Starr Health Sanitarian/Agent cc: Karen Nelson, Director PCD BOH D. Kindred File � a \ 9 POND LANE BUSBY CONSTRUCTION NC. ATK(603) 3INSON, N.H.4603811 CO.,� (603) 362-4650 FAX (603) 362-5051 November 3, 1993 Board of Health 120 Main Street North Andover, Mass. 01845 Attention : Sandy Starr Dear S. Starr; On October 28, 1993 in the morning, I met Dave Kindred and was given the job of grading his lot and installing his septic system. I was assured the plans had been approved. I then instructed my operators to prepare the bed area and tank hole, at which time I left the job, went to Town Hall, found the Health Office changed and the procedure of getting a permit also changed. At that time I called my operator and instructed him that I would go back in the afternoon and get the permit if S. Starr was in. I was informed by him that the Design Engineer from Marchionda Associ- ates was there and he was giving his approval to the bed. We subsequently moved out because I was unable to get in contact with you and your secretary is unable to issue permits. On November 3, 1993 at approximately 10:30 AM I stopped in again to get a permit for septic system installation on Boxford Street, at which time I was handed a letter ( which I will address at a later time)by your secretary. Upon reading the letter, I did not want a lot of time to pass before responding, so I will deliver this note before 3 PM on November 3, 1993. I would like a permit to install the septic system on Lot 2 Boxford Street. If Busby Construction has done wrong by preparing the subgrade of the field and setting the septic tank, we will refill the septic area and remove the tank immediately. (Please advise. ) If I do not see you when I deliver this letter, please call and leave a message or speak to me. ( If the Town does not allow out of State calls. please call collect: 1-603-362-4650. ) Sorryfor the inconvenience and I will resolve this problem p ble as quickly as possible. ossible. Philip A. Busby BUSBY CONSTRUCTION CO. , INC. cc:Karen Nelson, Director PCD Dave Kindred Town of North Andover, Massachusetts Form''°•s p0R71y BOARD OF HEALTH - o � s °• "— DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. h Site Location _'�hk. _.�•- S� Reference Plans and Specs. M- Q t:kno-;6 �A -r' ENGINEER DESIGN DATE k 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 Fee Site System Permit No. i` '' 141. , : , .. s�. t , � r5 ..� i �+ �� ti /� 4.� - • Town of North Andover, Massachusetts Form No. 1 NORTH A BOARD OF HEALTH OFYO 6 0� 19 10 APPLICATION FOR SITE TESTING/INSPECTION ��SSACHUS�S�y . Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time ' CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. .R'QR•lri 1r1II/iV1s'Ll�•.S6tiCAL'r:1.1 ' I I _ �•.I 12 4L .1 l � � gt3r � 10 r _ r FbORROBERT P. Ris N jr 22150 k THIS PLAN IS INTENDED FOR ZONING Y,E HEREBY CERTIFY THAT WE HAVE EXAMINED PURPOSES ONLY. IT WAS COMPILED THE PREMISES AND THAT ALL EASEMENTS, I� FROM EXISTING PLANS AND RECORDS ENCROACHMENTS AND BUILDINGS ARE LOCATED '.� WITH BUILDING LOCATIONS CONFIRMED AS SHOWN. ALL BUILDINGS SHOWN CONFORM (+ IN THE FIELD. IT SHOULD NOT DETO THE ZONING LAWS OF THE MUNICIPALITY USED FOR PROPERTY LILAC DETERMIN— WHEN CONSTRUCTED. ATION. THE BUILDING IS NOT LOCATED IN AN %eft ft HED FLOOD HAZARD AREA. 1� F�c,,M Q. '"i�.►JG�.i�. ysva q&-ora I o Y� ZONING: V-1 REQUIRED SETBACKS:' FRONT: '3c> SIDE: gip' REAR: ,rn+�.+�,.�rnruarrravrrwnnz»r.can^arr:rai»rsv,ar��.araa,vanu�,man�ramvr•v�oaawo.a;a �Q t CERTIFIED PLOT PLAN MARCHIONDA & ASSOC. , INC. ENGINEERING AND PLANNING CONSULTANTS I hl Wo . [�,f\ll�O�lCCZ , h�( C� 62 MONTVA'LE AVE., SUITE I AS PREPARED FOR STONEHAM, MA. 02180 lti16. . (617) 438-6121 SCALE: r`: ( DATE: IJ c A FILE No.: r , Y Town of North Andover, Massachusetts Form No.3 40RTFI BOARD OF HEALTH -LUL `' A 19 DISPOSAL WORKS CONSTRUCTION PERMIT SSACHUSE Applicant i ` NAME A RESS TELEPHONE Site Location ont -n�-� C� Permission is hereby granted to Construct or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. • CHAIRMAN, BOARD OF HEALTH Fee D.W.C. No. �'` � NOV - 1 WED 1 6 : ._' 7 p _ b 1 I I �yu I q 1 ip � � r 15aoc�L •. pv� � � r,.•�-o�c ' w�,•�, it •r• ELEVATIONS TAKEN AT TOP OF PIPE THIS IS TO CONFIRM THAT I HAVE INSPECTED THE CONSTRUCTION OF THE DWELLING ELEV.',, t-il-I CP6 SAID DISPOSAL SYSTEM LOCATED ON TANK IN: 1(o "'5; t LOT Z 154> fi:>Z0 �$M44-r TANK OUT: 1 ► .A THE GRADF5----A.R•f AS SPECIFIED IN THE D—BOX IN: mt, sl PLANS ,X SPEC -I'CATIONS DATED D—BOX OUT: 1�t ,�•1 BY M ��2Ch1.0'ffD '` C„ IN M1�IGSi;G r' ' END OF DISTRIBUTION4� LININ A: 1`b1"L'".;' 1.04 B l'�1,2•'3 t3t � .. C: �-- A 4,J, A'l 1r wwy.mawynrrr AS-BUIL"f SEWAGE DISPOSAL MAPCNIONDA & ASSOC., INC, SYSTEM PLAN ENGINEERING AND PLANNING CONSULTANTS 62 MONTVALE AVE,, SUITE I ���� �`«,��c>V�Z-• M� STONEHAM, MA. 02180 10 (617) 4.38-6121 AS PREPARED FOR SCALE: 1i1..40 DATE: 1► Iv �''y ' o)4 S-"-L, t a M & A FILE No,: . rr,y, ..►cw,wrocar,.+woaara.w�w+ la i� NORT�4 own of over o north dower, Mass., . '/ �r A°RATED .0 BOARD OF HEALTH PERMIT T I .LD Food/Kitchen Septic SystemJA iz/. ,,� a BUILDING INSPECTOR THIS CERTIFIES THAT...... „ -.. ... .r,.(40 *................................................:...................... Foundation " ... Rough,tk 10 C' 1 U has permission to erect.#~.. . .. buildings ...:...................... . / :: .. ... . .� r v... to be occupied as.'+ ... *� .. *chimney G,l(: `d l3 h person accepting this permit shall in e respect conform to the terms%f the application on file in provided that the pe so ac p g p y p PP Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of , (,j Buildings in the Town of North Andover. PL BI G ' SPECTOR ;. . PERMIT FOR FOUNDATION ONLY : VIOLATION of the Zoning or Building Regulations Voids this Permit. ou REGULATED BY i -,i A. 114.8-S. B.C. n UNLESS CONSTRLJ PERMIT EXPIRES IN 6 MONTHS >_ CTIORTA FEE PAID ©��� ELE ICAL INSPECTOR zw r PERMIT FOR FRAME/BUILDING R°"gl0l� : sr..� :.. .. . ........... Service DATE:2-,�:�FEE PAID' 4--- BUILDINGECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display In a Conspicuous Place on the Premises — Do Not Remove Rough / »{ p Y p Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. F14i DEPARTMENT C i Burner PLANNING 99C 1 AL CONSERVATION F I N A Lo4 A Street No. 1 Smoke Det. SEWER/WATER 64, JINAL DRIVEWAY ENTRY PERMIT AS-BUILT CHECK LIST and FINAL INSPECTION Proposed Elevations As-Built Elevation House Tank IN Tank OUT D-box IN D-box OUT 1,3 J31 Trench Inverts Line 1 i<31. d !3/, 3-4 Line 2 13/, 93 - 1'3/-��- Line 3 Line 4 Bottom of Exc. �� U Stone OK? D-box checked? Pipes cemented? TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: SYSTEM OWNER&ADDRESS SYSTEM LOCATION (example: left front of house) L 1� DATE OF PUMPING: 10 0c)- QUANTITY PUMPED I �b 7 GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: � �� ' COMMENTS: CONTENTS TRANSFERRED TO: i ��c�r�tr��rar�a �'�rtPvrrxtvr�, ��c. I! iso U11LUUN 00AU wCSTI ORU, MA 01886 (5UM) 699.0395 IAx (505) 892.0023 1.000.640 TtOY Report NIMbart C-wpo-9971 Report Datet June 14, 1993 Clients Sample Takan At$ wilmifigton pump suppiX Inc. Flintlock P.O. Box 517 Boxford St. Wilmington, MA 01007 N. Andover Lot. g2 BWUplb Taken By;client Ont June 11, 1992 CDRTIrIcATjt or ANALyoxe i TEST PARAMETER: BrA Max R,EBULTs UNITO Total CQUfarm (P) 0 0 Per 100ml calcium No Limit 1547. . mg/L Copper (a) 1.3 <0.02 mq/L Iran (B) 0.3 0.12 mg/L Magnealum No Limit 2.2 s,g/L Manganese (s) 0.05 <0.01 mg/L sodium 20 14.8 mg/L rotaedium (s) Na Limit 0.7 mg/L Alkalinity (s) No Limit 69.5 mg/L Ammonia No Limit 0.03 mg/L Chloride (a) 290 1 9.6 m9/L chlorine (total) 0.7 <0002 mg/L Colon (B) 150 CPu Conductivity NO Limit 190 umbos/cm Hardness No Limit 40 mgr/)L Nitratee(as N) (p) 10 0.02 g Nitrites(ea N) 1 40.01 mg/L 7.6 ou Odor (0) 3 0 TON sulphntes (S) 250 1609 mg/L turbidity 5 0.45 NTU Oedim•nt pas/noq hog NT-Not Touted, 9=Value Exoeadb EPA STD, TNTCsTpp Numerous to Count. *-Daakground Bacteria Not4pd, "k%tPA Advisory Lis►it '-Exceeds tPA Advisory Limit (P)-Primary EPA standard, (0)=saoondary EARA Stondard (may offdat aesthetica of drinking water i.e. taste, color, etc.) Thio wator sample, as tested, meets or exceeds EPA health standards far. the paramoters listed above. The quality of this water is Accepted as POTABLE according to LPA standards. MaDhachueetts state Certified M aw Carlson, for Testing Laboratory $MA040 Thoretsn.ien Laboratory Inc. i PLAN REVIEW CHECKLIST ADDRESS ENGINEER GENERAL 3 COPIES (..�-' STAMP r-''� LOCUS G/ ' NORTH ARROW SCALE � CONTOURS PROFILE SECTION '-� BENCHMARK SOIL & PERC INFO �� ELEVATIONS WETS. DISCLAIMER WELLS & WETLANDS :/ WATERSHED? /4//O DRIVEWAY (/ (Elev) WATER LINE FDN DRAIN L-� SCH40 TESTS CURRENT? y �� SEPTIC TANK / MIN 1500G. . 17 INVERT DROP GARB. GRINDER �(+200% EDF) 25' TO CELLAR Z/ MANHOLE TO GRADE ELEV GW D� D-BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET OUTLET 0/.36 = (2" OR . 17 FT) TEE REQ'D? LEACHING RESERVE AREA &--' 4' FROM PRIMARY? ►,rte 100' TO WETLANDS i-. 2% SLOPE L--- 100' TO WELLS 4,-' 35' TO FND & INTRCPTR DRAINS --' 4' TO S.H.GW 325' TO SURFACE H2O SUPP ✓ 4' PERM. SOIL BELOW FACILITY �--" MIN 12" COVER 6-----FILL?�25' if above natural elev 10'if elow) BREAKOUT MET? ! TRENCHES / MIN 660 gpdL,,- SLOPE (min . 005 or 6"/1001 ) e--� >3 ' COVER? - VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 6' ) y- IS RESERVE BETWEEN TRENCHES? �/' l IN FILL? L-----MUST BE 10' MIN.L 4" PEA STONE? BOT X LDNG Z/( + SIDE X LDNG6 = TOT (L x W x #) (G-/f—t2) (DxLx2x#) j ." h1AfRCHIONUA & ASSOCIATES, INC. 0-FTUEM W 72QKOVOUMQ- �I. Engineering & Planning Consultants 62 Montvale Ave. , Suite I r Stoneham, MA 02180rd _ -J--- DATE JOB NO. (617) 438-6121 �� ^� S//2, 3 ATTENTI N dr TO ..... ........................................_......_'......._.......................................................__. _. _... _ , fl RE: ----......................................_....................._....._......... ....................__..__.......__._ ►`�� . � ce oov WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via —the following items: ❑ Shop drawings Co/prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION R15-�4l5 e7D Lc>i I t C oT -L sT THESE ARE TRANSMITTED as checked below: CB/Or approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ Four your use ❑ Approved as noted ElSubmit copies for distribution > Cis requested ❑ Returned for corrections ❑ Rdfurn corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: RROOUCT 739 1�A'Ln5{b .Grolp.hl—011M to 0—hi014E TOLL FREE I-SM 225&W 11 enclosures are not as noted.kindly nofity us of once. t I i I I - i � } '7,4 I - I - i -- - r 2/'----- IT j I e, ,p l ��i— - �—._�-- - - - -- - - - s -: P ' -- - - -- - I S� (✓ 1 - I Commonwealth of Massacliusetts 4,,-�Q�—Massachusetts System Pumping Record System Owner System Location U llate of Pumping: ( � -/ Quantity Pumped: gallons Cesspool: No it i— Yes L) Septic Tank: No U Yes L System Pumped by: Fare4oet �1rfa,0' aw License# Contents transferrred to : Greater Lawrence Sanitary District Date: _ Inspector: Commonw alth orMassachusetts � • f�� , Massachusetts stem Purning Record System Owner Location L4 Date of Pumping: — � Quantity Pumped: f �J gallons Cesspool: No �... Yes U Septic Tank: No U Yes L� System Pumped by: FRt`e'lo t Sit&vvw4 License# Contents transrerrred to : Greater Lawrence Sanitary District Date: Inspector: I 1 NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS $25 . 00 TOWN. of .......N.O-RTH--ANDOVER----------...................... -------------------- ............ This is to Certify that -Skillings...,&...Sons........................................................................ NAME ........26.9----P-rortor----Ri-1-1...Road-r---- ----RvH-a................................................................ ADDRESS IS HEREBY GRANTED A LICENSE For .................Well Drillinq Permit - Lot #2 Boxford Street ............................................................................................................................................... ........................................................................................................................................................................ . .......................................................................................................................................................................... ............................................................................................................................................................................ This license is granted in conformity with the Statutes and ordinances relating thereto, and expires......December...31,....1.9-93------------ ess sooner s end rA e . . . . . .. ..... ... ... ... ........................... ------- ....... ...... ------- ................... .... Y---2-Z.+---------------------------------19--93 ............. .... ------ .............. -------- ..... ------ . ......... ................. ......... - - ------------- - FORM 433 HOBBS & WARREN, INC. Town of North Andover , Mass . c + ( Dat ... ___ e � ?ermi t APPLICATION FOR WELL & I'UI1P I'LR11I'r � � cation . is hereby made for permit to drill a well ( ) . Application pP nade to install (_) a pumpsystem'. Lot / _ocacion : Address _e � S l Address 1 �/aiVA,)Cl Tcl . �wncr F�r�t �G S Address ,�� ��r/ ///fes/ / `� /��Icl .�; - E4,c ,1e11 Contractor Lfi �r✓yf .crump Contractor Address Tel '.-;ELL CONTRACTOR ( To be completed at time of I)LImp test ) used for T pe of Well �,ir,�s icr Y l� Size of Casing_ Diameter of Well l Depth of Bed Rock Depth casing into Bedhock Yes (_) No (_) Date. of Testing Was Seal Tested? r o-f tl-=� — Well Ended ill Wlla.t' Ntaterial Depth Delivers Gals . Per Min . for 4 he Depth to Wa ter- .— ( hours Drawdown a feet: t GPM Leeafter pumping______ --_ , Date of Completion ign -ure I-1 Contractor cX X ;c . .. .. .. IP INSTALLER (To be,- L-'ilicd in before insta7. Lation ) d PUi . hemp rype Use Size & Name Pump -- Suter Pump Delivers__ GPM Si. r,e of ] rrnlc rial Used in Well : Cast Iron ( _) Gnl v�11i zcd (_) I,IaSr- ic p, pe Mat e ( _1 We11 Pit ( _) or Pitless Adapter ( _) Seal Was sleeve used to protect Pipe? Yes ( _) 1�0 ( _) 'lype or Name SJe11 Date C',.c) J I)cni:t7 Date %•later analysis repor-t submitted to 1t0'_'rd of liealtlz Do _z release � eleaiven tD owner of record & "Ids . Insp 111111th Inspector Commonwealth of Massachusetts assachusetts RECEIVE® OCT 1 9 2004 system P in Record TOWN 1 EALLTH'DEPARTME TER System Owner \ I System Location C Date of Pumping: Quantity Pumped: ( 500 gallons Cesspool: No [ Yes [] Septic Tank: No [] Yes [ System Pumped by: &&"w License# Contents transferred to: Greater Lawrence Sanitary District Date: 1-o— o Inspector: Commonwealth of Massachusetts City/Town of � System Pumping Record y` Form 4 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 Important: When filling out 1. Syst mLocation: —C CJ's forms on the computer,use only the tab key Addr to move your (4& S 16':::::) cursor-do not use the return City/Town State Zip Code key. 2 System Owner: _I� v Name 11 Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No 5. Cond'tion of System: orn� � V� 6. Syst m Pumped By: Name Vehicle License Number Company 7. Locationr 'cor ntents di pd: ..... -�7 Sign re of a er Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 ICommonwealth of Massachusetts City/Town of a System Pumping Record NOV 15 X091 Form 4 TOWN OF NORTH ANDOV DEP has provided this form for use by local Boards of Health. Other 61 Rrdbwi information must be substantially the same as that provided here. Before using this orm, 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 Locatio . Le /Righ ont of hous , Left/Right rear of house, Left/right side of house, Left/ Right side of bul Ing, Left/Right front of building, Left/Right rear of building, Under deck Address Cityrrown 1 G Stahel/ \1 Zip Code 2. System Owner: Name Address(if different from location) Cityrrown Stan&[_ / ^Q Zip Code Telephone Number B. Pumping Record �C 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Conditionoystemv- � 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location where contents were disposed: .LAS., Lowell Waste Water Sign toe 4 Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1