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HomeMy WebLinkAboutMiscellaneous - 45 SUGARCANE LANE 4/30/2018 (2) 45 SUGARCANE LANE 2 9 0/10&.A-0241-0000.0 r i Cr' MAR # LOT # `� PARCEL # --- STREET l�.��1-i}".....��-r:z1. CO.NSTR.U.CT_I O.N_-._APPROVAL HAS PLAN REVIEW FEE BEEN PAID? /.LS NO PLAN APPROVAL: DATE f APP. BY.... ....•/0 .... - --- DESIGNER: _-- PLAN D(--I I-E:_-/ � ._. ..__.._ CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT DRILLER.-................. WELL TESTS: CHEM I C�Al llA l E APPROVED,_....__........___ ---------- C ..._._. C I=E' IDO 1 E A1-'PRUVED BACTE A II DATE APPROVED_.__.. COMMENTS: FORM U APPROVAL: APPROVAL 1*0 ISSUE YES NU DATE ISSUED / /� oZ BY__.__ CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID _ NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL ES NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DALE: BY : IS THE INSTALLER LICENSED? YLS NO TYPE. OF CONSTRUCTION: ' REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YE='; NO CONDITIONS OF APPROVAL YES NU (FROM FORM U) ISSUANCE OF DWC PERMIT YES NO DWC PERMIT N0. loD`y INSTALLEf �_._ BEGIN .INSPECTION YES NO: EXCAVATION ..INSPECTION: NEEDED: —_— — _—_--_ PASSED /D/�/��� BY - ----— ----- c - — CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: APPROVAL TO BACKFILL: DATE: /0 �3/�Z BY FINAL GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE:__—__-_—_DY___._______�.___ Commonwealth of Massachusetts — iV]tb_ City/Town of North Andover System Pumping Record 0 x Form 4AN,ZaVER Flti DEP has provided this form for use by local Boards of Health. Other formsmay e use Suf 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 SysterrS Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, r I g o e- use only the tab t Y 1 key to move your Address cursor-do not North Andover Ma 01886 use the return key. Citylrown State Zip Code 2. System Owner: q D» Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumpingp�e r 1 2. Quantity Pumped: lions u v 3. Type of system: ❑ Cesspool(s) [Septic Tank ElTight Tank ElGrease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes .No If.yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pu By: — �Jr�U Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signature of Hauler Date Signature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 I 1 Commonwealth of Massachusetts"MASSA Ci own of NORTH ANDOVERUT Zoos It System Pumping Record .7 4 Form 4 7"S.,OF rvORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. The System Pumping Record mu,( be submitted to the local Board of Health or other approving authority. A. Facility Information - Important: When filling out 1, System Location: forms on the . computer, use3/ only the tab key Address to move your cursor-do not _- � — City/Town use the return State � --"'------- -- key. Zip Code ti 2. System Owner: Name -' - _ Address(if different from location) _..._.__..__.._._—_—._._.------------ --_---------------.._.._..._.__-___-.- '-___--- City/Town --------.. ____------ State ---------- -- Zip Code AZt Telephone Number B.Tumping Record - -- 1. Date of Pumping Date 2. QuantityPumped: � Gallons Type of system: 13Cesspool(s) 8 Septic Tank ❑ Tight Tank I ❑ Other(describe): _----- - 4. Effluent Tee Filter present? ❑ Yes Ej No If yes, was it cleaned? ❑ Yes ❑ No r 5. Condition of System: 6. y em Pumped By: Vehicle License Number Company - 7. Location where contents were disposed: Si score of tiau Date -- ----- --- _... http://www.mas§,gov/dep/water/ provals/t5forms.htm#inspect t5form4.doa 06/03 System Pumping Record •Page 1 of rt+w?t�7n��x xr�k},{ �t i ; Y f G i.C ,t!h r J tt:, , - ',• r ... , r... l� f�I"it�' i tt jib I J� T fJ b Yx k» �, { i .,�• �, hS '/�li,tat`�kf�� �' d'tr,ti +•11<�;9s i ft �r (� ; i ' j'i .' • RE'f lffi,,J! t ik T ' R jM YAtf 1 k'• I t ffA 1�4 :� f + 1)' •� t pr f 5 r ri L RFJ F �L Pv YettA 1t LL CC ,C�"jkrl i[`ifK{hf n`} �� Y• �r �' '.�'. Lw. OF NORTH ANDOVER f, SYSTEM PUMPING RECORD AU2001 I pi d�'"'� �r'A'�{—^,{.r�{ 't`11��i�.fs���p�d, ifl'tt lrp '�.ff.•!k`+�'t`'1 Via` �'H .''• �� !. "'ss+...ee...� ,.:.arse,•� �,.a �;. , .) .)war ,. �l�� �NRN.•1},�lary,t{�► ! r � - � , ' CI� � _ '. SYSTF,M O TEM LQCATIONSYS F �$•e�� �_ yyyi. �. !'� //l ' 4iPle•k't fi ogt of bones) •��j 2 ; ,1��TM b,�+11rcr' r,r1� ��(t!lljfl' d '•�1► �Tf . � .•arty,, , � .; '— r ,�; ' I:• ,: :�f�lljit�d-.?�'!���1-qf ia'AR n 1 ���,1,`�'Fv!�t�bd�J � ,.ft�iV Y t a.w' r .r - .- .. -- r i• �rF • QUANTITY rUMPED�Sb� GALLONS OL•. NO e f } • . C T t YES S , NO ANK• ._,., YES T re+ ilr `' ekf'i�,iT i��4w 't 7}'•( '•t1' , { 1 ;;} i� r , 1 �_ ' res F„f 1 E Ji► OF,.SERVI ROUTINE GEN { ,r ��I�i'�tk ��.o�1ti� t{+q�,•1 1�`�f,-�t •J= r'� �”' 1 �"'�' '��f^tRet , - ..... •, OOD iddo IO � HEAVY N TO COVER , GREASE. >, ► +�n}� �;``' ROO -- BAFFLES IN PLACE hus'rk iijr + 7 f �:f ' EXCESSIVE S LEACHFIELD RUNBACK _ r IVE$OLID FLOODED - SOLIDS C y\/vyR 4J-:r'. �,1J t ") I w�'�f•+.�.+.•fws. OTHER(EXPLAIN) • ��•4 �j+ }`+11+`��'}'47� J.�i`�:,�i k<.�fy.f,�y I, 1,'.'. 9 - Jif, t{ � ��� # }y i -TIM � T�v ���'i J tit �7 • ,c 4�,+. T i '- ; Jd , t1) x s�k� }{d{t ✓ y h •.. r+ti!• � �.,:+�ir1J�,q.;^7.�,t Jed i�„1� 1 r'.1 r ' � _ - - , i r 14 "M77 - S it tl I t �'t f•,FP �#,fa•t II f'�c�i T��.'Cf��� F + r r�. s ,�P� , V` f ' 1 Commonwealth of Massachusetts -� - W City/Town of No Andover dEI��® a System Pumping Record '.r.-;E ,233 Form 4 �M To"OF NORTH ANDOVER H ��TF DFPAf 6 -%'7 DEP has provided this form for use by local Boards of Health. Other formsnay be-used 9-%'7 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-subinittd0go the local Board of Health or other approving authority within 14 days from the p!jmping date in accordance with 310 CMR 15.351. '- A. Facility Information Important:When filling out forms 1. Syto ation: on the computer, use only the tab2 - key to move your Address ` cursor-do not No Andover use the return' Cityrrown State Zip Code key. 2. SysOwner: t lfia Name icn¢n 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 ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cloaned? ❑ Yes No 5. Condition of System: 6. Syste Pu ped Byk. � `.— Name Vehicle License Number Stewart's Septic Service Company 7. Lo�itents were disposed: tent Plant, 20 So. Mill Bradford, Ma 0183 Signatur f Haule Date Signature of Recei ing F Ili ty Date t5form4.doc•03106 System Pumping Record•Page 1 of 1 4 RECEI , S E 7 2005 YS'TL1�1 PUMP1iyC-i TOWN OF NORTH ANDOVER �Y�1' r►� � R & ADDRESS_."_____. _' " ^Y - -- - _ HEALTH DEPARTMENT ool� o� DATE of pyo �-�� --_.__ _.�..... �.-.-•... .._-_ y L4 SA rUK� ON 3tRvlc� KUV'f`11� Udait � � tfOC}tj G�NUlT1UN �'UL: [U Lo � G SSIV6 301,Ip$ __. t Loop RUN n�w SOL toC,RRRYq'+ A ()T� GR EXPLAIN byf _ �'UMMtNT�. vlr l L�h O fk. N�sIbKK:aJ t FORM 4-SYSTEM PUMPING RECbR CURRIER SEPTIC & DRAIN SERVICE 107 FOREST STREET;MIDDLETON,MA 01949 (978) 774-2772 COMMO 9E�A,-LTH OF MA ACHUSETTS MASSACHUSETTS SYSTEM PUMPING RECORD SYSTEM OWNER: SYSTEM LOCATION: /6 DATE OF PUMPING: !�4UANTITY PUMPED: (��J GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES SYSTEM PUMPED BY: CURRIER SEPTIC & DRAIN SERVICE CONTENTS TRANSFERRED TO: e!5iz S1� DATE: ' 30 �9 INSPECTOR: BQF tlD1) APIDDVi:R%'as - 91999 91999 fdb � N O R T H own of �` 6Andover O No 4 ,2 2, A `4GI t4u' DRIVEWAY ENTRY PERMIT" �K�� � er, Mass. 11�le T. lip C . SHE iCK BOARD OF HEALTH PERMI LD THIS CERTIFIES THAT........... . �t -^�� BUILDING INSPECTO has permission to erect tf-AIJ.matbl..+..... buildings on .� .S .!..!':'l?'!:�� Rougho'�ZA 7� y ,-400 j to be occupied as. ! 1. .�� ...1r !k ..• •: � "...`r*� Chimne1 •••• •• Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in_. PLUM ING I)VSPXCTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspectiop #8ft" fdkft ' o� /. y i� B.C. 8•S 114. . Buildings in the Town of North Andover. REGULATED BY PARA. VIOLATION of the Zoning or Building Regulations Voids this Permit. ��a �� E R M I EXPIRES I R E S I N 6 01 PAID '�� ELEC ICA ECTOR Rough �' BU�LDANLESS CONSTRUCTION STA TS Service ' .� PERMIT FOR FRAME/ Final �O FEE PAID4�`�6' S °°°°°°°°°°°° °°°°°•...•••• ..••..,••BUILDING INSPECTOR DATE. GAS INSP CT9R i C Permit Required el� l0 OCCtI �Ltl�C�l11 ffc�l/ c�LI'' 5O c upa 7 .i q P1 g ;L Display in a Conspicuous Place on the Premises IRE DEPT. Do Not Remove Burner l • ii1 No Lathan to Be Done Until Inspected and Approved by Smoke Det. t Lathing I l Building 66--dc,ILi S Inspector DI�IA�'XiL�- "AS BUILT"SEPTIC SYSTEM ti r TbPOP 148.5 Ifo' h7j Exisri !1 F�w�.1p774.� N 1 D-BpX 14' 14 � 33•+ j � 35 f� 1"-4" X 0" . 0,W.WT-i4Q30 m iv N � m SEP�� 77�1K, UJrLero 143.2! 3 Lx--QyCAa PITS. TDI'.PITS=140.75 PITS t30T PJT 5¢137.75 +I 1 hereby certify that the premises shown on this SetbackS.Shown I hereby artily that the dwelling(s) on this plan Islam located plan is not located within a flood hazard area as approximately as shown hereon and that It compiles with the shown on De artment H.U.D.Federal Insuranoe On this plan a/9 P zoning set backs of the Town/City of,00• / tJtx}VefZ. Ma. Administration Maps. for the deterlml- when constructed. 25D cxJB G�l p g nation of Zoning By 5 E PT"► e- " I,•S 7J u t(7r l`,ornmautty Number requirements Registered Land Surveyor Jdinti utioa WU U"f - 15. 1983 only. �Q• County SH or Deed Reference Registered Orofesslonal Engineer i- .: ROSEM Book 5?:d9 Page 9 rO .(` RobERT M.gilt& ASSOCIATES, INC. SC81e: Plan Ref renes CIVIL ENCaNEERS SURVEYORS ate wdy„L.Lowstf,wui6 ouw•(ap)452-4.sto date: \l-Its- Book ,Z P,Q. '►ti.,. ..�'`" 3 8 4 54B �TOCSARcAAJ6- AS-BUILT CHECK LIST and FINAL INSPECTION Proposed Elevations As-Built Elevation House 1-0- Tank - fTank IN 143, 64 Tank OUT /4,5 '39 113,27 13 27 D-box IN 14e 8 D-box OUT 140 , /46). M Trench Invertsd Line 1 /3 9,lO Line 2 Line 3 Line 4 Bottom of Exc. 7 Stone OK? ✓ D-box checked? t/ Pipes cemented? °�'� 02/03/1997 00:30 5083736611 STEWART/ANDOVER PAGE 03 JUL 7 MY-41, A?VWvr-r 1Jb MOsn St CT's SEMC TANK SMaCE 47 RAITAM grpjMr JVe fillA nnzv:i- SWNM, MA 01835 Um v l �L )G1-Q614 978-372-7471 } mmm OF e o2Cr3Q MiR I MY FXPM FIM TM CF AM= ��OC3 /Uuo ✓ /907 S� t Q,.,-t ,��- s�S� �d 6' 7v 1 103 -bd& 1&0 ✓(� 15,50 S,c/P'elll'lob 1660 ✓6�r� t 6� ISA 160 r � MORTGAGE PLOT PLAN &•45" 4 N M 1 642 Z4' 14' 14' 33'� 14' N L.OT �4$ 45,5(All t, f ; �y ` `1�0 � ' f f3.GU 3�pp I I hereby certify that the promises shown on this Setbacks shown I hereby certify that the dwellings) on this plan Is/aro located plan la not located within a flood hazard area as approximate) as eroon and hat it complies with the p on this plan are p shown on Department H.U.D.Federal Insurance zoning set b a of the Town i f 0• E SUA Administration Maps. for the determi- when conal ed. Lync28 0010 8 nation of zoning By Community Number requirements RegisteredlandSurveyor 11185 only. i�'�X 110 • County aL��p�ZN OF Mgs�9� R. r Deed Reference Fes' y ROBERT Register Professional Engineer r MICHAEL -� Book 326' Paged Glu y No.2&887 RobERT M.Bill& ASSOCIATES, INC. scale: �=40' 9¢CISTEP�° CIVIL ENGINEERS•SURVEYORS Plan Reference of 199 2 l��o SURVE��S � 1298 ata t aaW st.towdl,K"L maw•197)asz-asto date:10- 15,97 Book Page JB I (a I 8 A k 6® NO R T1-r 1 I i own of ` oAndover No. DRIVEWAY ENTRY PERMIT E- N er, Mass., Se`PT� �� 199Z � � NAoR P�`\ ,,' le I BOARD OF HEALTH PERMI LD � I i2e A' t THISCERTIFIES THAT...........�1. ........ ..... ..................1`!. ................ m r 4�- 4� ''`T� t! ",•� BUILDING' 1/INs�c'0 haspermission to erect .... ... ........ buildings on ....... .. ..... .. ........ .. ... .. .......... .... r Rougn C - � ** � Chimney�� ��� � to be occupied as...��.10+4or.1! *!L ..l�w�', �rl .. ': �.. �..`r.. � J 7 .... ...� .... .. .... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in_. _._ P1UM ING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the InspectiorP� f8WV&W[d0Ad o M7 % 1 Buildings in the Town of North Andover. REGULATED BY PARA 114.8-S. B.C. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. 480 PAID � .k ELEC TRICA �ECTO'RPLRMI� EXPIRES IN 6 MOpg ^ Rough PERMIT FOR FRAME/BUILDANLLSS CONSTRUCTION STARTS Service�� Final /D BUILDING INSPECTOR DATE. GAS INSP CT9R O ne Permit Ike Occupy Required to OBuildin ��e.Y ctr��rr �> 9 �1 g Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner yy� No Lathingto Be Done Until Inspected and Approved by Smoke Det. �l 6(' GII LZ p BuildingInspector 5Z q/4 ;( xu �'1t�is ka eciaur� x� �r=j,zrh gar;§ t a � �; x� �( ��f#�y q„,P'{r4,A�rt aa,•kZ`ti'gilX'Yi'ti'.,�@s.,��Pfa°t�xx r„4 tnSixfix>Pv,{,'.§,'a�n'Ae),,dr�'rF'J''.Y(+'�e.'lr,}s+3yts#fS4,S,tm',^n<K`14 i;ixl.''y i P}yq�s.'}U}++iGi'dr,�. v5Erv Fr�`gs��dkY. :i.',u{arKs4t�'�'z�F'r a+'at.,'^.e.a,'T�4L�vsr-f,��sZt;ti,xk'#�3rh%F"},35�';rifi.-•yiifi.k'iSySsz„�'4b'"a,1?,.:4'}.s.{x�v�'(g4tG}'T°ri�'k.4s+;r*{d.zd3$ef? ..Nx,yM'Y4;�',,r•,.s`rts^t(�5�a ri`�3,Pxyve k�+t��°6,qqfizrat.,'wYfl5,:r;.t..•{`s"' s,aYX t NINE [ 4� •rikIT 's 4 y - - r! ,',{{°dr1� vA `M.t .,�... �v r.;p,:r"�{h.+t >i.4 r1'Pr :'�{fr t i,hs. rr �'`t«� •J,a��J#i rrc �" ..y wt �iyMPjiY'�#,L ,}�I"41', _ ''iro�, 'yy >' sa$Y'+, tE.PwaR,r, { ,{• it t+L,.. 4µ._` x. h, +ri#xr ,r rd''ittt ar{l >5 �e'T Sy-. sA' !fjt L ,. y.'�' t .tyT 'riR",awe " ,J aY 7�t} Y'• + $ '1• y�.}e" 'k {.t Fa" �'t.. � vra r* " t �.IrLt. FORM U IAT RELEASE FORM � i ,g;'ir r'a sX ry�,sts � a;'y Y I 2'' f ,. .�•{ az a ?r,": s I Ia^+:S .• ♦ y"� f'r�^,f+i Mr.,,."., 1} �^T 9t�y U,,,}'#�'k+. xT,4 (k- t,J, INSTRUCTIONS:" ".,,:This form is ,used to verify' that all necessary De- approvals/perm from"B and.Departments :having jurisdiction yt; y pE,:x r h ,:_This. does not 'ielieve the applicant and/or. have been obtained. '``' rY+ landowner ;from compliance, with any�apphcable'`local or state law, . , ¢ regulations or requirements �tiTfi ,rt. 4z _ +r "^• NY.1 t?++of 4+V'f a a t . 45,***********Applicant fills out this section***************** of Y'�r. ss £ ; b 2'., s t at ` ; 'Ts +�, �� � y € t• j3i3 t y F y P14a a�lr? >' APPLICANT , a t h � A I LOCATION: $ �d�/,� a Parcel yyg� j _ Assessor's Map Number ' Subdivision ' yeti = 1 Lot(s) 3 , �st5 - z � - i h_.i•9 a� x r Street ' 4 '`` f(lG�f�2N£ � ,�� °". St Number 4S bqt� t5i� -, , ;rr y ,_ - ;.. - �_. ..:. ri #.i'F.• lV,f_.>- y -i-L 4 s .. :. ; '' ****Official Use "Only************************ RECOMMENDATIONS I OF TOWN AGENTS ae` a.I+ �• ~ �)(f 'p Mi Date Approved h k. Conservation Administrator f>"� _: Date Rejected jgj R", 1 i � l S eta CommJw ents - t y..'�'S ; 4' k l t i+' .'Fit f t• - c� Date Approved CJ' :. To Planner' ' ''Date Re j ected a�att r� Comments 9� 9� " Date Approved � Health Agent -; Date Rejected till s' Comments +Jr' x - Public Works -sawar/water connections .ut k driveway permit .♦ ZSS v rd bvi nAf ve+d� g�pro v ed &���/9adu x+ �` -i Jwr- Fire De artmentCAI f Received by Building Inspector Date f� Town of North Andover, Massachusetts Form No.3 BOARD OF HEALTH • NORTI{ Ot t �to ra 1ti ^ �nq 1 9 7 """"�`•`�j DISPOSAL WORKS CONSTRUCTION PERMIT • S., CMUSEt Applicant NAME II ADDRESS TELEPHONE ,,p� Site Location QT `i n XL4 &,aaLa-A «-I1,J : Permission is hereby granted to Construct ( /rRepair ( ) 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. to OR`9,�� °a2*'+C��f. 0 � ' ;e x „' Townrof Nor h q�ndoveoF M„ assachusetts� M TM" BOARD OF HEALTH :: am' �. b,, ':DESIGN APPROV L FOR IIIA gy- .� .> �... .,.- i�"" •- -�'�i, :;'c�."�i. y�`.ter.., yam .�,;# w�,�. - rj1.0SEWAGEDISPOSA°LS' A YApDft ant "� 4V estNo " r, p Iry WW q ro to, ° RfencPlaRo n an Spec e ra t a ;'-'EN.GINEEER�€ - DESIGN S x=',as4�; i+'�,`�'e�sz' LL `��..�. �� � � �5+"1"�• -"OR rL' E5 - 'Permislcit► fdra�nindlvil' soItlonse, :agellSposal �ystertt^tq ,elnstaJed livi, in` aeardancNW e itl egulatlons d BbaY'' of af�th� n ,cam Fee SIWSystem Pe.rmrt Nod `. � r4 e � z pQ ter ' x x z tr r >r I. v� ;a+e try�1�:yT�'t' �^�.. ..'+ ,X,.. i ✓� � � �'S±tel Y•Yj.fin: 'F THOMAS E. NEVE ASSOCIATES, INC. ������ 0� MUS Engineers - Land Surveyors - Land Use Planners 447 Boston Street US Route #1 TOPSFIELD, MASSACHUSETTS 01983 DATE JOB NO. (508) 88p7-8586 1 �Z S FAX (508) 887-3480 ATTENTION SANoY 5_rAIR RE: TO ,5AN0-Y STAR R (13ot_\Ro of Hg�4it_'rMM] 1��vISi®rJ5 Iro SS® Le-� 34 N o R T r-1 A N Do-d�R -i'o W N l-I/�!s s.- 13 Nop,Pr'1,4 Arvoo--jER MASS. > WE ARE SENDING YOU 51 Attached ❑ Under separate cover via the following items: ❑ Shop drawings [9 Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 4 'n9Z 5-1187 SI=P T Ic= 5YSTEM DE5icVs-.3 1—Q i 34Qi SUC_vAROAt­IE L#,X THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted R Resubmit 4 copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS PI--e^5F— Fit-4D Etjot_oS):D 4 Ppjss-rs of ,HE RE-viSF_o 5V>7ic ZI,-YSTF_Ni 0E-SiCat,3 Folz THF_ A30NIr. R Fr_gE0c_iZD Lo-T. 0t-ja w T'►aF_ Prt»TS SHOWS 1 V4 a RFIV I SIC>05 Yoo REQUES'TE,D I-a1Csr-� L-iGri-1'rep. T_ HAyI_ Pi-o-rreft> 'T'HE 13REA14 OT F_L_-F_VAT10l'.! � i46.5t;) ARoLani® -rHe AREA itJ Que6ricx0. PL-Ense- k)oTE THAT TyAe STgaPesT sL_eQF. 4.3 MA 7-HAI- ARF-A IS A -7 s M ( 14 : 21 Ti �4►5 5L-oPF- f;,9) A '® SO r 2/14 �1.4a. /®i TH1S PoItJT T HIS. 13r1?1EA14'00T F_L_F_q^Tl00 1:> Z4' Flofw -r 1-i 1- eoc,,e- of = He- 5,Y:s T-_-F_ M , 5o 5kap(,00 T IS MET. AtN`! QuSS-noaS o9t Ppoe1_1sm5 PLZA511E G-ALIL -17HAN14 Yoy fro It `e0kire 71r-n'E. COPY TO SIGNED: PRODUCT 240.2 �Inc.,Groton,Mas 01471. If enclosures are not as noted, kindly notify u�once. PLAN REVIEW CHECKLIST ADDRESS "7 ENGINEER GENERAL 3 COPIES �� STAMP LOCUS SCALEy CONTOURS L� PROFILE �� SECTION BENCHMARK ELEVATIONS c� SOIL & PERC INFO WETS. DISCLAIMER X WELLS & WETLANDS WATERSHED?,Vo DRIVEWAY (Elevations) WATER LINE z DRAINS SCH40 SLOPE' TESTS CURRENT? C� SEPTIC TANK ., MIN 150OG. 1// . 17 INVERT DROP l� GARB. GRINDER(+200% EDF) 25' TO CELLAR MANHOLE TO GRADE — ELEV GW D-BOX SIZE 8-3 # LINES FIRST 2' LEVEL STATEMENT INLET 149,gO - OUTLET 2 D (2" OR . 17 FT) 7 Et S v LEACHING RESERVE AREA -' 4' FROM PRIMARY?_Z 100' TO WETLANDS 2% SLOPE 100' TO WELLS 325' TO SURFACE H2O SUPPAIA 35' TO FND & INTRCPTR DRAINS C� 4' TO S.H.GW � 4' PERM. SOIL BELOW FACILITY MIN 12" COVER I-� FILL? (25' if above natural elevation; 101if below) •S�aPE ,8 R�A-KIS�y T- 7_ — TRENCHES MIN 660 gpd SLOPE (min . 005 or 6"/1001 ) >3 ' COVER? - VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) IS RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? BOT X LDNG + SIDE X LDNG = TOT (L x W x #) (G/ft2) (DxLx2x#) PU 9gry pp•�'��/3F' Int}}'�O(d�£�."yI'H{/(-�ANDOVER[� ECO uA I RECEIVED SYSTEM OWNER& ADDRESS SYSTEM LOCA rION AUG 0 9 2004 TOWN OF NORTH ANDOVER i / HEALTH DEPARTMENT supr GNbo vet., /Y)&7 . DATE OF PUMPING: '7:1 �lS. - --- -QuAN rlTv PUMPI D`. C I ,SSF'0OI.: N YES Septic 1'artk: NO YIrS NATURE OF SERVICE: R.(.)tJ'FINEEMERGENCY OBSERVATIONS: GOOD CONDI CION FULL TO COVER. HEAVY GREASE BAFFLES IN PLACE ROOTS _ LEACHFIELD RUNBACK EXCESSIVE SOLIDS ' FLOODED -..--- SOLID CARRYOVER O'T'HER EXPLAIN System Pumped by COMMEN-I'S_ 6 CON FEN I'S FRANSFI RRI L)'I O 0 PITS MIN 660 LEACHING v GW MIN 4' BELOW BOTTOM ✓ MANHOLE/PIT `'---" EXCAV 2x EFF W OR D `� 12"-48" STONE SURROUNDING BOT SIDE o2_— 6 S/x LOAD = TOTAL-74,7, 7� (L x W x #) (2 x (L+W) x D x #) CHAMBERS COVER >3 FT - VENT 5 PLAS/f A/4-b 5 ,!' FIELDS MIN 900 ft2 LEACHING PERC RATE FASTER THAN 20M/IN GW MIN 4' BELOW BOTTOM OF FIELD PIPE ENDS JOINED W/NON-PERF. PIPE? 4" PEA STONE? DIST LINE SLOPE .005? >3' COVER - VENT SCH 40 MIN 12" COVER L x W = T x LDNG > DESIGN FLOW? DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY gpm L W W Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME gpm MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1' below inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL OP. SWITCH DATEl Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER / SUBSURFACE DISPOSAL DESIGN REVIEW FEE , PERMIT # DATE RECEIVED�/ Q- APPLICANT G ASSESSOR'S MAP ADDRESS PARCEL # LOT # STREET # 'y ENGINEER ✓072 �lJ� ADDRESS old &S eoxl j dal, �iPrd PLAN DATEllT�rl - REVISION DATE CONDITIONS OF APPROVAL: APPROVED DISAPPROVED ,9 o i' C MMLNIMM Immmi© � m MMWMWQ5���� MIMMMM7IMURmsimm �f7�l��� mmmmmi nImmim"- IF49" l�ImmmmaYfr�� �almmmomoo�c� �IMWI-SIMI 1"= �MMMOAMw��� kms., rr�y 1111l�I!I111��11�111111111[1!!ltll Ifi1i11i/1el�iiili�©EIIIIIIIIIIQ�'�� IIIIIIIIIe111111N11111111111111111 nkF H.I sill I I ilillleleele 11�!'G�IIGp10111111111Ill 111111111 IIG�1011��..�IhIl111G11111111@e�l1111 IIIal I 11 11 Ill lllllllllllill 11lGIIIIGiilGlll�llllllllill llllll 1111111111111111�11111111111111111 a 1111111111111111 N 11111111111111111 11902 lilt 1�91l1�1ill il1111111111 II1111IM 1 11 11 111.IImIIIIGI GIIIIIIIIIIIL�L�zr�zall , . 111111111111111lN�l1�'e1�,IG11l1G 111 11111111111111111111llllel�llll ill Will IIIIIIIIIIe11111111111111111111111 .q�T IIIIIIIIIIIIIIIIIIIIIIIIIIIIIINII k 1111111111111111�ii111111111111111 11 IIIIIIIIIIIIIN 111111 11111111 } 11 IIIIIIIIIIIIIN 111111 11111111 11111IIIIIIIIIIINIIIIIIIIII111111 eleeleee111eleeeNllleellllelelell IIIIIIIIIINIiIINllllll111111111 11111111111111111111111 11111111 i . a _ I Town of North Andover, Massachusetts Form No. 1 01 N0RTH BOARD OF HEALTH �? kA AA- h� 6 0� � �� -19- 0 9a a APPLICATION FOR SITE TESTING/INSPECTION �9SSACHU5���h Applicant &6 60j&kS7— L�(-) �_ NAME ADDRESS TELEPHONE Site Location �� J �1A.& n .2. Engineer \ Q1 011.2-L , lbcs NAME AiDDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH FeeTest No. S S Permit No D.W.C. No. C.C. Date Plb . Permit No. m g Town of North Andover, Massachusetts Form No. 1 p10RTH I BOARD OF HEALTH. - 16 0 UAq 19 * r APPLICATION FOR SITE TESTING/INSPECTION 7 AERATE°PPp\.�GJ _ �SSACHUS�� / Applicant ►S'U� N�l�-t5�- . y`U t �'C� J� L. e d. . NAME ADDRESS TELEPHONE L4 1z" Site Location (-OTt.� '`�Jl h, 'L ►ti-�- -•{�-�"�- -- Engineer �-- OSe 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. TOWN OF NORTH -ANDOVER ,. SYSTEM PUMPING RECORD _ `L al t �l STEM OWNER & ADDRESS � SYSTEM LOCATION ,. _ (example; Icf( from of house) 's.10 8? U-01 OF PUMPINC: QUANTITY PUMPCDs�_C ALLU� � NO YES SEPTIC TANK: NO YES � ATURE OF SERVICE: ROUTINE EMERCENCY COOD CONDITION, FULL TO COVE HEAVY CREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK... CXCESSI-YE SOLIDS FLOODED SOLIDS CARRYOVER AHFR (EXPLA.IN) >v,), 'LM PUMPCD BY: U,-1 kl rNTS: UN,FI.,N,I' !'IzANSFEIZRED TO: lY,r/i TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD D.aTF: D �1 STEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) X/D ll:a`I'E OF PUMPING: IG S QUANTITY PUMPED �00 GALLO', Cl' SPOOL: NO Y— YES SEPTIC TANK: NO YES X NATURE OF SERVICE: ROUTINE - EMERGENCY (m.SFRV,= TIONS; GOOD CONDITION _ FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER O' HER (EXPLAIN) i PUMPED BY C'UNI NI ENTS: �.UNTE'NTS TRA NSFERIZED TO: 1 � � ' J• 'yF + .� \... (; 4�t�rA1{�Si:i�'a 6rAJ i �1J-�'cj� �,� +• ti f�i•'"", {jl{,tl�'�L'4;�r� 1,�►'r�y'rSjtf�,t,�r,;..+. + �. ,� +zi 4���♦ ' { ' t t . TRI!�N�71!•��/ +t ���� 3� 1�i�r��i�r/1�6C�/e �((., .�� W f ORT �A C�`OVER°' MAS ACHUSETTS $ ' Qm �r' rt�`)Y1�1��y '� j��y''`t T",'S`t`�.+>hY,a�•1,•:!"4i aZ;,.,i:.Y't, Y a;►t.t, t'i a'i.,l;.• ►SN 'b� \ T1 Y .r NORTH ANDOVER tC�t,, r1 rr..4t�rr t, i.'~�f'�sir:wtl {7 h.rrr� L,�t TOWNOFN Yl1•F,�+r),pg+ t i ti �:,v nNc Y •.. HEALTH F3EFARTMENT DEP,.hai provided thls�form for use by local Boards of Health, a ystem Pumping Record must ' be subinl#ed to the.1ocal6oard of Health or other approving authority. . ,... :.. .A Facility ,InfQrr>�ation . j4��,u�•/f�i�u��out .1...7 System Location. ��;� ,;�, ' ' only the tab hey Address to move your •, �. cursor.�do dot�,; :�,- ,. Ste Zip Code • 'Y�'i.•��'ttVd Q{ .�t�(� 1�., 2',1 SystemOwner, � 'rrt ',�.,. /: r . Name"',{';'�'d' !"'•.,S,i t�,l�„r:.•,,.,:,v,•.: ell ""', ''� 7i r:Address(If different from locatlon) 'e'•"'', CIV/1 oWM1ZI ;'•t, . �4. , ,'r!.:+. :/. .,.' Ali .• �/.����j—�s �• e y: .i•,,It r+ .. 7 [I � �� Telephone Number . ' -�• ��: f:\,��1�6��-P.ul�.pt,�tg��Re,�ord: .Lr• 7• ' r Date of Pumping ' 2. Quantity Pump c Date ed: :;• ,;:: "'' Gallons `,Typo of$ystem * ❑ Cesspool($) eptic Tank ❑ Tight Tank ,:,t`.`ir. ..�•rt.t'...i• 1!.:7!,i.X11.,..v ;1'r.. .. • 1Q:jOther(descrlbs) : i 1 .fl.••�...j'�r K.:i i�• fflut3 Te nt eFlle r t es Ye e r•�, N n o' If es was a s It �I •.4 c can ed? C3 sap No • ,..: '_� ':i�.ti .•iti�l•':tyJ.>,/,. '{.,,• :ly,fl.:ujy.l(1.tt ,\ 'i� .. •A' . .. - :�.•y,�.,;`i:'�;r.!' •tri+:''' 't�.:• ' •d.d� :�.• '�4t:8.-�',C•ond(, on of3ysf m'`"i::,': r� r t1 ri 41� Yt lt,�•�tl;y, a ;}r�'r.,i, f`y►� _, . • �Y 1 r 'J .y'.. i .... ' ::i:' ',d-'•f:.•iti•tY.;�}+ua;:a:•;ha1t:'!+�':;.(i"'ay1'`I� • i...,•. ,Pum ed ti• :vr: :: y..c.:;>u•,, r.:4 •' +i'. a�ri�,14 iF'i1'T; :r ':'�' ''i'�+a y lir r.,;i": Vehicle Ucen L. ie Number t ' �',i• �'} Y'S 7 ,. ,,,tit'•1. 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't p t �-:a e_ ' .. - h SEP J X01 C0111m011WC'altfl Of MaSSachuSettS TOWN OF NORTH ANDOVER City/Town of NORTH ANDOVER, MAS System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submltted to the local Board of Health or other approving authority. _A..Facility Information Important: When filling out I. System ocatlon: forms on the computer,use rn to m the tab key to r move your cursor do not _ use the return CI n State QCode• key.. 2. m Owner. nil Name Address(if different from location) %/—Town State zip Code Telephone Number B. Pumping Record 1. Date of Pumping Da 2. Quantity Pumped: cellons 3. ,Type of system: . ❑ Cesspool(s) Septic Ta k ❑ Tight Tank {] Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. ",Pumped By: I N me CompanyVehlGe License Number 7.: Lo o wh co ten w r disposed: O Slpna of Ha er Date http:/Ayww.rhass.gov/deptwater/approval&/t5forms.htm#lnspect t=' t5fom14.doa 06103 " System Pumping Record•Page 1 of 1 i r I 'I North Andover Board Of healt J&S Development dba VILecel „ - - 1600 Osgood St Stewart's Septic Building 20 Suite 2-36 Andover Septic AUG -5 2011 North Andover ma 01845 58 South Kimball Street Bradford, MA 01835 TOWN OF NORTH AN DOVER HEALTH DEPARTMENT Date Name & Address Gallons Comments 6-Jul Murray 274 Foster st 1500 Good Chad 7-Jul Noel 1532 Salem St 1500 Good Chad 11-Jul Shih 46 Oxbow Cir 1500 Xsolids T Chad Haggar 651 Turnpike St 1000 Good 14-Jul Ferris 128 Bridges St 1500 Xsolids Bruce 18-Jul Greenberg 480 Sharpener Pond Rd 1500 Good Frank 19-Jul Grinaldi 415 Winter St 1500 Good Frank 27-Jul Winter 459 Salem St 1000 Good Chad Hartford 296 Boston St 1500 Good Chad 29-Jul Dinalie 45 SS 'rgar Cane Lane 1500 Good Bruce Hannay 451nnis St 1000 Good Bruce Paradise 280 Gradville Ln 1000 good Bruce Commonwealth of Massachusetts City/Town of No. Andover System Pumping Record Form 4 'IM Spy`e 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important: When filling out 1. System Location: forms on the computer,use 45 Surgar Cane Ln only the tab key Address to move your No. Andover Ma _ cursor-do not use the return City/Town State � key. 2. System Owner: Dianlie AUG -5 L011 VQ Name TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record -- 1. Date of Pumping 2. Quantic Pumped: p g y p Date Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. m Pumped By: r-LA -AC Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: C`Stewart's Pre-treqtWnt Plant, 20 So. Mill Bradford, Ma 01835 Signature of auL' ' Date �� / Signature of RecdadAlity Date • t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts City/Town of No Andover S 9 �vrZ I System Pumping Record TOVV,\,OFryC NM B Form 4 SALry° PAR, rM�Nr R 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Loc tion_ on the computer, use only the tab key to move your Address 11jCL_1 cursor-do not r _ use the return NO a.ndo��er — ��.. — - key. City/Town State Zip Code 2. System Owner: V%A1 tot Name rehun Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record Avffl4 1. Date of Pumping TV De 2. Quantity Pumped: a ons 3. Type of system: ❑ Cesspool(s) [/Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of Syst m: / 1 6. Syst�;&d By: Name Vehic a License Number Stewa 'S'Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signa re o Date Si ure of Receiving Facility ate t5form4.doc•03/06 System Pumping Record•Page 1 of 1