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HomeMy WebLinkAboutMiscellaneous - 546 SHARPNERS POND ROAD 4/30/2018 (3) i Commonwealth of Massachusetts City/Town of LRECEIVED _ System Pumping. Record Form 4 N 1 5 2009 DEP has provided this form for use by local Boards of Health. � Rf b t the information must be substantially the same as that provided heck with your local Board of Health to determine the form they use. The SystemPumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: Left front, left rear, left side of house. Right front, right r r, right side of.house. forms on the - computer, use only the tab key Address to move your SL4 �-��l t�✓ � � L cursor-do not City/Town N State Zip Code use the return key. 2 System Owner: Name Address(if different from location) City/Town Statiq Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: 8 Cesspool(s) _ eptic Tank [j Tight Tank Other(describe): 4. Effluent Tee Filter present? Yes No If yes, was it cleaned? Yes No 5. Condition of System: I Y^ (1 6. System Pumped By: Neil Bateson F 5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location contents were disposed: L.S.D Lowell Waste Water igna ure of H u r Date ` t5form4.doc•06/03 ' System Pumping Record.Page 1 of 1 j Commonwealth of Massachusetts City/Town of RI VED System Pumping Record JUL 14 Z-010 Form 4 TOWN OF NOR'T'H ANDOVER DEP has provided this form for use by local Boards of Health. Other information must be substantially the same as that provided here. Before using this form, check with your local Board of Health tq 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 side of hous ht side of house Left front of house, Right front of house, Left rear of house, Right rear of house. Left re i ding. Right rear of building. Address ^ A D-r p-V) City/Town State 2. System Owner. Name Address(if different from location) City/Town Stat Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: `- 1/1 / V� 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locaf contents were disposed: G.L.S Low II W4iste VVater Signatur f auler Date t5form4.doc•06/03 System Pumping Record.Page 1 of 1 310 CMR 10.99 Forrn 5 L� ( DEP File No. 242=546 (10 be txwxsed M DEP) r�--�� Commonwealth - G: �aiJ <<> .• cily•Town North Andover "c -•i =• of Massachusetts - �- --- n- Applicant E & F Builders Common Drive off Sharpners Pond Rd. I . I Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131 , §40 ' and under the Town of North Andover's Bylaw Chapter 3.5 From NORTH ANDOVER CONSERVATION COMMISSION ; To E & F Builders (Name of Applicant) (Name of property ownerl Address P.O. Box 398, North Andover, MA Address . - - 01845 This Order is issued and delivered as follows: ] by hand delivery to applicant or representative on (date) D by certified mail, return receipt requested on _.________—(dime) This project is located at Lot 4 (House 4492) Sharpners Pond Road The property is recorded at the Registry of Northern Essex f Book Page Certificate (if registered) The Notice of Intent for this project was filed on March 6, 1991 (date) The public hearing was closed on March 13, 1991 (dale) Findings The North Andover Conservation Commission has reviewed 1he above-relerrnced notice of intent and plans and has held a public hearing on the project. Based on the Inforrnatlon availaDle:;te file NACC at this time. the . NACC has deleihi)((ed Thal the area on which the proposed work is to be done is significant to the following interests in accordnce with the Presumptions of Significance set forth in the regulations for each Area Subject to Prolec!lon Under file AWPubi;c heck as appropriate): water supplyl�// Flood control ❑`��l,� Land containing shellfish C—�/Private water supply ,t1�J Storm damage Prevention 12 Fisheries 32/Ground water supply t1J Prevention of pollution t!K Protection of wildlife habitat Total Filing Fee Submitted $250.00 State Share $112..511_.__.._ City/Town Share $137.50_ — _ (',% fer, in Py.cess of S25) Total Refund Due S City(Town Portion S State Portion S (t/z total) (iia total)