Loading...
HomeMy WebLinkAboutMiscellaneous - 45 INNIS STREET 4/30/2018 (2) r .a '1 �9> S' S I IV/VT"Sfi 14 3»I7,9 CA Legal notice TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS �� NORTh NOTICE „�.e 1y , April 18,1988 o '� �*!.;. °o Notice is hereby given that the Board of Appeals will give t= a a hearing dt the Town Building, North Andover, on Tuesday evening the 10th day 1Ss�CHUS of May 1988,at 7:30 o'clock, to all parties interested in the appeal of Bruce and Paula Hannay requesting a variation of Sec.9,Parag.9.1 &Table 2 and Special Permit of Sec.9, Parag. 9.2 of the Zoning By Law so as to permit second story addition on existing house on the premises located at 45 Innis Street. By Order of the Board of Appeals Frank Serio,Jr.,Chairman Publish in North Andover Citizen April 21 and April 28, 1988 55095=6 February 3. 10 Walker Rd., $81,000, Gary Yenof from Edward W. Macomber, January 13. SPORTS- /ERAGE G'Toen lorth Andover BSCRIBE QDAY ! 685.5128 L0Ud1 11011ce TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS C� NORTH NOTICE �,*�■o,•�y April 18,1988 `�!ti'' `• ° Notice is hereby given that Y9 # a the Board of Appeals will give = a hearing at the Town Building, North Andover, on �' " +r• Tuesday evening the 10th day 1Ss�cHusof May 1988,at 7:30 o'clock, to all parties interested in the appeal of Bruce and Paula Hannay requesting a variation of Sec.9,Parag.9.1 &Table 2 and Special Permit of Sec.9, Parag. 9.2 of the Zoning By Law so as to permit second story addition on existing house on the premises located at 45 Innis Street. By Order of the Board of Appeals Frank Serio,Jr.,Chairman Publish in North Andover Citizen April 21 and April 28, 1988 55095=6 12.LOCATION Of ROADWAYS/DRIVES Identification of all right-of-ways and driveways,including the type of curb and gutter to be used,and their dimensions.Distances to all the nearest roadways andhor curb cuts shall be shown for both sides of any streets which is adjacent to the site. 13.OUTDOOR STORAGE/DISPLAY AREAS Identification of the location and type of outdoor storage and display areas on the site. 14.LANDSCAPING PLAN Identification of the location and landscape schedule of all perimeter and interior landscaping,including but not limited to proposed paving materials for walkways,fences,stonewalls and all planting materials to be placed on the site.In addition,all existing trees over 12 inches DBH,to be saved or removed shall be shown on the site plan.Any landscaping required by the Town Bylaws shall be indicated on the site plan in tabular form showing the amount required and the amount provided. 15.REFUSE AREAS Identification of the location of each outdoor refuse storage area,in- cluding the method of storage and screening. 16.LIGHTING FACILITIES Identification of Ink proposed illumination,indicating the direction and the degree of illumination offered by the proposed lighting facilities, including an example of the light fixture to be used. 17.DRAINAGE BASIN STUDY A detailed hydrology study for the site.Included in this study is the proposed stormwater run-off rates into the existing drainage system and its potential downstream impact on the existing drainage system. 18.TRAFFIC IMPACT STUDY Identification of existing traffic levels,along with the expected traffic impacts to occur based upon the proposed project.Projects which ac- �,puaa� ♦�ENORTy�trf e 3?,�LpRtpRgr�.q O•� ArnIL71+ a f,; 1855 • ' � CHU9t.4s TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE . . .April, 18 . . . . .19. 88 Notice is hereby given that the Board of Appeals will give a hearing at the Town Building, North Andover,on. .Tuesday. . . . . .evening . . . . . . the 10th day of . . .May. . . . . . . . . . . . . . . . 19. .88, at 7.:.3®'clock, to all parties interested in the appeal of Bruce. &. Paula.Hannay . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . requesting a variation of Sec.. .Para 9,1 &Tabl 2 q g g . of & Zoning and Special Permit of Sec. 9, Parag 9.2 By Law so as to permit.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Second. s.tory.addition.on. existing. hous.e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . on the premises, located at. . . . .4.5. .Innis. Street . . . . . . . . . . . By Order of the Board of Appeals Frank Serio, Jr. , Chairman Publish in N. A. Citizen on April 21 & April 28, 1988 1 Any apTieal Shall be filed OR TIS within (20) da�vs after the 04, Top, CI. date of fi- �..I op�I Imi 1.) ,-'143' Of this Notice gr fdd in the Office of the Town Clerk. PM IYU is IJ5 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS Bruce & Paula Hannay Petition #134-88 45 Innis St. N. Andover, MA 01845 DECISION The Board of Appeals held a public hearing on May 10, 1988 upon the application of Bruce & Paula Hannay requesting a Special Permit and variance from the require- ments of Section 9, Paragraph 9.1 and Table 2 of the Zoning ByLaws so as to permit second story addition to existing house located on the premises at 45 Innis Street. The following members were present and voting: Frank Serio, Jr. , Chairman, Augustine Nickerson, Clerk, William Sullivan, Walter Soule and Raymond Vivenzio. The hearing was advertised in the North Andover Citizen on April 21 and April 28, 1988 and all abutters were notified by regular mail. Upon a motion made by Mr. Vivenzio and seconded by Mr. Nickerson, the Board VOTED, unanimously, to GRANT the Special Permit and variance as requested. The Board finds that the petitioner has satisfied the provisions of Section 10, Paragraph 10.4 and 10.3 of the Zoning Bylaws and the granting of this variance and Special Permit will not derogate from the intent and purposes of the Zoning Bylaws nor will it adversely affect the neighborhood. Dated this 11th day of May, 1988. Sincerely, BOARD OF APPEALS Frank Serio, Jr.' Chairman T,-T T V 71t ID /awt -J ON MAY 1 :01 1989 N, i`&TH ANDOVER BUILDING DEPT. Any 4ppeal shall be filed oE.NGR'h'ti R CEI�FU . Within (20) days after the =3.,,�°° ''�;�� pAN4EL t ?OWN CLERKtEK E � . . date of Nfirig of this Notice 's� limas A►�i�1*+ ;••M NORtN AKQOVER in the Office of the Town ,�sgcriu9�' � Clerk. �.,..�.•{ MaY I I 12 02 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD Of APPEALS NOTICE OF DECISION Bruce & Paula Hannay 45 Innis Street Date May. 11, 1988 . . . . . . . . . . . . . . . . N. Andover, MA 01845 Petition No.. . .134-88. . . . . . . . . . . . . Date of Hearing. .May. 10, ,1988. . . . Petition of . . . . B-ruc.e ,anal, Fau1,a,Hapaay . . . . ... . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Premises affected . . . . . . . . . . .4.5. .znnls. S.t.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Special Permit & Referring to the above petition for aL variation from the requirements of We . Section.9,. . . . . Paragraph 9.1 and Table 2 of the Zoning ByLaw . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . so as to permit . . ...second. story.addition.on. existing. house. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . After a public hearing given on the above date, the Board of Appeals voted to . . . .GRAN.T . . the •Variance .and- Special. Permit . . . . . and hereby authorize the Building Inspector to issue a Permit to . . .Bruce. -and•Paula .Hannay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Signe�� C� Frank Serio, Jr. kirman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Augustine Nickerson, Clerk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William Sullivan -Walter -Soule. . . . . . . . . . . . . . . . . . . . . . . .Raymond .Vivenzio . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . Board of Appeals ` Received by Town C EYED WN C{.FRK NORTH A?TDOVER APR 12 24 TOWN OF NORTH ANDOVER, MASSACHUSETTS BOARD OF APPEALS APPLICATION FOR RELIEF FROM THE REQUIREMENTS OF THE ZONING ORDINANCE , pp Applicantf ,� + `�� ---Address 1 . Application is hereby made: IE4 # !ia) For a variance from the requirements `of SectionParagraph and Table O/ of the Zoning By Laws . Z, b) For a Special Permit under SectionLParagraph7,,,-e,1of the Zoning By Laws . c ) As a Party Aggrieved, for review of a decision made by the Building Inspector or other authority. 2 . a ) Premises affected are land--_and building() _numbered 7 � -------•---S t r e e t b) Premises affected property with frontage on the North ( ) South ( " ) East ( Wes t ( ) side Street , and known as No.___ --- Street . c ) Premises affected are in Zoning Districtand the premises affected have an area of/Q //�? square feet and frontage of 3,�2 feet . 3 . Ownership a ) Name and address of owner ( if joint ownership, give all names ) : Date of Purchase Previous owner�rs iv�L�Yf� iSZ b) If applicant is not owner , check his/her interest in the premises : _Prospective Purchaser Lesee Other (explain) 44 Size of proposed building:' 31/ _ front; ,?,g feet deep; Height '2 stor ies;,llZ. 91 feet . a ) Approximate date of erection: b) Occupancy or use of each floor : c ) Type of construction: S . Size of existing building: 37 -__feet front ;.29 feet deep; Height —stories ; ,'27JL /.feet . a ) Approximate date of erection: A?/o-- b) Occupancy or use of each floor : 41 0'" r c ) Type of construction: L✓�� 6. Has there been a previous appeal , under zoning , on these premises? /�/� If so, when?—_—_-- . ., � , � � O � Y �r ,p 1� cr � � , 7; Description of relief sought on this petition 'Vi7e� car B. Deed recorded in the Registry of Deeds in Book - Page y Land Court Certificate No. Book Page �0 arc; • ..•;: The principal points upon which I base ,my application are as follows : .(must be . stated in detail ) ! ' I agree to pay the filing fee, advertising in newspaper , and incidental expenses* Signat e of Petitio ergs Every application for action by the Board shall be made on a form approved by, the Board . These forms shall be furnished by the Clerk upon request . Any communication purporting to be an application shall be treated as mere notice of intention to seek relief until such' time ;as it is . made on the Z. official application form. All information . called for by the form shall be furnished by the applicant in the manner ' �herein;:prescribed . 1 Every-application shall be submitted with a list of ''"Parties In Interest" • which list shall include .the petitioner , . abutters , owners of land directly opposite on any public . or private street or way, and abutters to the abutters ;within ' three hundred feet ( 300 '. ) of the property line of the petitioner as they appear . on the most recent applicable tax list, notwithstanding that the land of any such owner is located in another cit or town, the Planning Board . of the city or tows, . and the Planning Board ofd': . every, abutting city or town. :•' r" :r'`;; *Every applicatioy shall be submitted with an application charge cost in the amount of $2.5 . 00. In addition, the petitioner shall be' responsible for any and all ,posts involved in bringing the petition before the. Board.'.:., Such- costs shall include mailing and publication, but are not necessarily;:''.:;��„ '7, � limited to these . Every application shall be submi.tted with a plan of land approved by the Board . No petition will be brought before the Board unless said plan has been submitted . Copies of the Board ' s requirements regarding plans are attached hereto or are available from the Board of Appeals upon request . LIST OF PARTIES IN INTEREST Name Address ` /'C/�i t`✓ G/�� 1�?Io1,, 17el ro7 n J S !� (�,�� ��J��✓ J ���.� .`n����^.�o�'t���"`� 'Vii' lo dditional sheets if ' necessary) • ? (,"`fin' _ � ••: ,.•, ,.': ' /2 PY, t F/NU-1ry\ry f OFFICES ICES OF: o< rJ'Ow tl of 120 na�11►1 Sireet t n AI'I>I.AI_S' 1 i1UI�TI� ANDOVER North A►1►I<l�er. B lI1.I)ING NIDSSi1ChL1SCt(S 1845 C)NSFRVATION SSec" ges 1)1\'INION OF ((i 1 7)(3,95-4775 HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAI WN 11.1'. NFII.tic ,N, 1 )II tl:( "I'( )1 t April 4 1988 Robert Nic.etta Building Inspector, re= 45 Innis Street Proposed addition A dye test conducted on March 28 1988 andl reinspected March 30 1.988 showed no apparent overflow of the Septic System at this site. This office will allow the Hannays to construct the second story addition, as long as the resulting number of bedrooms does not exceed three. Sincerely .Board of Health anitarian C.c. Bruce Eianuay 45 Innis Street North Andover, Mass . ,,1 k, •f�;II, i . "T ?,y `rf '.+ri a ����.�0�� f , i I TO moi•. {` •� � , . — r i _M� IL •tt 14, • !a ,;! �R�CAI►'�l- � Fr2r Cel gm`bn�.:: .��v � Fdl 'c�f { ', "�'1•r• �"{\� !.0�� j9 73-'3l3 40 IT: c turd .k � � • N art to ZQ 2 `�^►_��C � 1� '' `� , . � �, ,�' • . ��_ �.•�. o. � �"�(t,, . •.X34 � '��� ,,�►�� ,gip 14 8� _ �' � , � �9 z.��;, : ��,. �, •' f Cut 42 —_ e Palcus /1a Q�tp �„ ^ G�n� l�Z 4 9d i ,C , t► RGlGl�(lpU (7/ri9pf�. 1 �.V R��AISRMo n L C•S L a Q z WL AEt G 3.1 a qy Cu�E(L S,`. 1 MCA.-Z' C 43.S- Rl�L :cr�. a4zi e, £s1ti9 ; u. 1176 UA _LU 3,�=c� : 1 .. i ', ,�:� �• .a :,•fir 2d b E- ' 2eF ea5 19bz t,c z�� ; 1 1 J Ip 43 _ --------- i - ----.t -z. � 'A r• �: x_.' D •;.� ��••v ,�;�:�b.'� � y p� � `'f�. 1y ��•+ ;,;� �, p>4 hR g is � 3c e t t.':.,k r F '( �* q► ;� Jta�� 2 + `C.` uiel �i;I • ,. � • :,s. ,,,rte`Z� i. t t ��r C .,��� �y� \•I 11.�, uOLA �tT�. 5ti , r1.0 NAS_ }'-i-r �-�/ ''.�� �•�'' i•� s � d 4.t►i Gb„O;Q' �� iai� ,, •yam t . xii AY •34 art r. . \ u' Safi � I.+ ',�*Xi� � � `1� � Z � ���t. �lam• � til '.t... - x ��•.P 'j -�f •.\,. ��!` � r.� ' +`p�'J i .� •Irl. �•�[ 'r• F �� � �+:; � ,� �� •� .1•;- .{ , +, �'�, �*ti•�y 'y.�•.'s�.��'. ,a- fi,ryNC,'+��'�F-,✓,.7ilN�- ,:�t�:- - e'S •�- 1 . .' fj .. •���t il,+.r r ''' � < C .•ham �� r 32638. Sheet 2. Subdivision Plan of'Land#7North4ndover. Scale 80 feet to an inch. AUG, 20,/9/3. Ernest W 8ranch, Surveyor 0' o• o• i ° 30• ° (;. pea a �°• °' g o o Ca'Y�n 0• 3 0 0 o c n f� Z65 N 2 0• o o c o 3 2 0 0• o 0 0 o b 0 p1 0 0 0 0 Zbo 261 ,30• 0 0 o c 5 8 ZSg 3 3 3p. oN �' p.01 3af c 00 0 " ' 25 0• r s 3ap1 $o a o - 256 2 30• °' 254' 255 3a 30 T o ' 30 p ro:�'` J ',o4,.`r° 1o3.2 • N o yl 252 253 30 30- - ' Q 50 °' a+ a� 249 250 2 30. 3°' io3 20 M N loo. W 8a NW Z.fai 3°• a rM W 3p• 30 " *10 loo. `^"^ M . ,," 100• 0 99 50 W 3pIh9.o2 3p. 30 �° •:� ^�, p _ <�• 30• 3°' 186 185 1a4N cn�,� o M o _9 loo. "' 100. 8 .50 "- o0 30• 8� «i oe"w V r.. 34 ISS I 4o. o !� 19°� c O Mci 0 100. 100. `^ °0 T �gg' o _ } DO cb 30• i I00. 100• `.n � o CS.o aA 30. 0 3° 1og'� ` u M eo'. ^ o 30. 3 th ,rA + loo• "' 100• n, Y R 30 r. N�,°4► 103'7° c Z7.8 j11.8`� a 100.5'7 V W ` M en I 0 /00• 100• r. 1Z ci 10 O M� N w 11?P N wo ��N en 14.88 N tl M N. M M M + 1 � w wL Ns 103 33 o rn 100- 100• cn M c 116,10 . o Z 89.20 N `� M m i 0 w 96x5 o M c100. 100. qq w 117$ N� / 1162 S 7 vCM]S 77.83 loo. a, 100• 116.60 o a' B «� o h1 c N e 70.26 M100. 100. M l 11,100 10o. M 100• K1 o I1y93 N 9 o 4 62.68 I -••, '� o `fit c a, W 6p..�1 _ �. N' ,Q �' /00.28 ' 5`5.10 o- 100.8 9q. go N o L - 7 ST.WQLgCE O /00. F61°S6 100.28 100. M 3• O o 110 N '^ rn b 100• 9 �j3 o IM o N 621 100. rn s a /00 ry°+ 4 10636. /Op• ° ap 104 a0 £• 0 1 3 N t /00. M zin b /OO• �°pQ 41 Copy of part of p/an j filed in p LAND REG/STRARON OFF/CE s_ AUG. 28.1913 Scale of this Plan 80 feet to an inch 3 5 C.8.Humphrey, Surveyor for Court PLOT PLAN 45 Innis Street North Andover, Massachusetts Scale: 1" = 30' Buyer: Bruce Hannay December 19,1980 V ,Defer to Certifcate of Tf/e /Yo. 6543,. ono' Land Cour l a/an X26 3 3. 197 0% 3 , br Q. sheds I S? 7352 70 L � fie W75 /96 - 200, 1. 1, pryelll�''Q � LOTS 209-20S 3 5 74• �O 31 o\a lao.b7 G T NOTE: This is not a survey and is to be used for mortgage purposes only. N.B.- Do not use offsets for establishing lot lines for"the erection of fences, walls,hedges, etc. Of I hereby certify that the building on this property i8 located as shown on plan and complied with the zoning set back `Y requirements of the Town. of Ndrth Andover when constructed. N0T APPLICABLE.TO FLOOD FLAIR ZONINGx t= ` h't b .a ��X+=t C)M MINEE dNG SF.RSiIC1$S,INC » � .JM1/V ICKlYt7eL kii�W3, w .. LAWRENCE MASSACHUSETTS Board of Appeals Town Office Building �� p"� �•.� -.4R, � ' North Andover, Mass. 01845 12MAY ..� .....4., o is & Alfred Sciuto 25 Waverly Road North Andover, MA 01845 Any appeal shall be filed within (20) days after the -3�•� �• TOWN ` �: �.■���„ dao!: pRTN date of filing of this Notice �• lass ; •� pQµpoVER in the Office of the Town �;�SgeHu9�' f Clerk. '►•,.r•-' MaY 1102 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD Of APPEALS NOTICE OF DECISION Bruce & Paula Hannay 45 Innis Street Date May_ 11, 1988 . . . . . . . . . . . . . . . . N. Andover, MA 01845 Petition No.. . .134-88. . . . . . . . . . . . . Date of Hearing. .May. 10, ,1988. . . . Petition of . . . .$'ruc.e ,and. Fau14.Hannay. . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Premises affected . . . . . . . . .4.5. .Inni-s. S.t,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Special Permit & Referring to the above petition for a variation from the requirements of Me . Se,c.t,ivn.9.. . . . . Paragraph 9.1 and Table 2 of the Zoning ByLaw . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . so as to permit . . ...second. story.addition.on. ,existing. house. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . After a public hearing given on the above date, the Board of Appeals voted to . . . .GRANT . . the •Variance •and. Special- Permit . . . . . . and hereby authorize the Building Inspector to issue a permit to . . .Bruce -and-Pau-1a .Hannay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f���tgtt C� Frank Serio, Jr. hairman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Augustine Nickerson, Clerk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William Sullivan . . . . .Walter Soule. . . . . . . . . . . . . . . . . . . . . . . .Raymond .Vivenzio. . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . Board of Appeals Board of Appeals Town Office Building North Andover, Mass. 01845 2-5 V2 Doris WaverlAlfred Roadciuto 425 North ,Andover, MA 01845 P�. Legal Notice TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS . �f NORTH NOTICE ? �,,�.u 1ti April 18,1988 o Notice is hereby given that the Board of Appeals will give p a hearing at the Town Building, North Andover, on ;D .re * Tuesday evening the 10th day 1Ss'�CHUS of May 1988,at 7:30 o'clock, to all parties interested in the appeal of Bruce and Paula Hannay requesting a variation of Sec.9, Parag.9.1 &Table 2 and Special Permit of Sec.9, Parag. 9.2 of the Zoning By Law so as to permit second story addition on existing house on the premises located at 45 Innis Street. By Order of the Board of Appeals Frank Serio,Jr.,Chaimian Publish in North Andover Citizen April 21 and April 28, 1 1988 55095=6 1 IL i ,ORTN i t OL A O L t r - t �1ss�cHustt TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS aIeL--;,t--7q 2r Date: Dear Applicant: Enclosed is a copy of the legal notice for your application before the Board of Appeals . Kindly submit $ )/e--0 ` for the following: Filing Fee $ Postage $ Your check must be made payable to the Town of North Andover and may be sent to my attention at the Town Office Building, 120 Main Street , North Andover , Mass . 01845. Sincerely, BOARD OF APPEALS Audrey W Taylor, Clerk r , .r y ° r-/r r ,�ot da�4 jY e.i ;�t l,• + .t r Commonwealth of Massachusetts 'City/Town of NORTH ANDOVER MASSA HdSg - ' 10 System Pumping Record NOFNORTHANDOVER y p g HEALTH DEPARTMENT Form 4 DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. _A.•Facility Information Important: Men filling out 1. System Location: forms on the 7nn ,i S computer,use only the tab key AXrT. to move your cursor-.do not use the return CI ty own State Zip Code, key.. 2. Sy tV wner Nania Address(If different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. ' Date of Pumping Date Quantity Pumped: 7G.1ion, 3. :Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank Other(describe): 4 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. Sys em Pumped By: N meVehicle— Icense Number ompa y 7. . Location where Conten were dlspos d: �l r_�rVJ Ig at o Hauler4MQDate http:/Avww.rmass.gov/dept.water/approvals/t5forms.htm#inspect t5form4.doca 06/03 n.. System Pumping Record•Page 1 of 1