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Home My WebLink AboutMiscellaneous - 643 TURNPIKE STREET 4/30/2018 (2)I IQ <s c O .Z1 6 Z c m o � C X a m m -I <C1\ Commonwealth of Massachusetts City/Town of North Andover FEB 2013 a System Pumping Record TOWN OF NORTH ANDOVER Form 4 HI_ALTH DEPARTMENT Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. SLA 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 1. System Location: Address North Andover Ma City/Town State 2. System Owner: Name Address (if different from location) City/Town 01845 Zip Code . -Praocab State Telephone Number Zip Code 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 cleaned? ❑ Yes ❑ No 5. Condition of System: x "SO � 6. Sy tem Pumped By: N-Ae' Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Ste art's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Sig ature of Haul Date Signature of Re g Facility. Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 �l�( �,. irt4e . , ,�� J'S r} tF,11 ,Hi:r��;�•f;^'��'h:%t!�IY 1; a ' r r ,t• �L 't CIri6�rl : �.rl,f� c r,,,,,, . ,r">�' . )t y� fir; -_.1_'= r1L• - - — + 1w4�Y1 DEP has provided this form for use by local Boards of Health. The tern-RUMptng-Recflrd must be submitted to the local Board of Health or otherapproving autho Ity,r A. Facility InforrtiWion .. SSP 7 2007 lnmkortant. .j, -r Vftn r>luna out 1: System Locatlon r TOWN O NORTH ANDOVER y. •^5'^ On th0 ' FI DEPARTMENT C0r11puter, use lY ✓ , ony the tab key Address to move your cursor do not -use returnClty/Town State Zip Code VY key.; Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec.313 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: Property Address: Policy Number: Type Loss: Date of Loss: Claim Number: 10/23/00 IRVING G. LUFKIN, JR. & CONSTANCE LUKIN 643 TURNPIKE STREET, NO. ANDOVER, NIA 01845 0456979 Freezing 03/15/00 182081 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, chapter 139, Section 3 B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. MPIUA Claims Division CMA00021 PATRICK J. DONOVAN ASSOCIATES, INC. Mi. and Foss Adjustments P. O. BOR 110 WAKEFIELD, MA 01880 (617) 245.5540 — FAX (617) 245-7016 December 16, 1996 Building Commissioner City or Town Hall N. Andover, MA 01845 Insured : Irving & Constance Lufkin Property Address : 643 Turnpike Street N. Andover, MA 01845 Insurer : Arbella Mutual Insurance Company Policy Number : ZC001210 Type of Loss Ice Dam Date of Loss : 2/11/96 Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned Insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. f� A am_"4— Signature OF INDEPENDENT INSURANCE ADJUSTERS of Massachusetts John DeBenedtto ''I`�Znpike fit. APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT—H(tATH ANDOVERs MASS. .1 hereby make aplica.tton for a permit for a sewage disposal installation at rnp ke tet. I will 'install this _kystem in accordance ME a1T t e ws of the Commonwealth of Massachusetts and regulations of the :Hoard of Health of the Town 0f N04-th Andover. Further, I will construct the house sewer of bell, and spigot Pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet preceding the septic tank, where the grade shall not;. exceed 2%. I will install a concrete septic tanik of -699.�- in size. A manhole (,$) permitting easy clean - Ing Will ie provITed with removable cover (s) of iron. or concrete t:t.thf n .12 cinches of the ground surface. l will provide subsurface di sraosal field with opera jointed bell and spigot Ackron pipe at :kunst 4 hashes in di.a,meter and laid in a series of trenches$ the bottom of w�ijwh k. 11 provide a minimum of 160 Lineal *r, : feet of effective absorption areaepips will be :hair �. n a 6 inch layer of washed gravel or crusted stone ranging in ;ii.me from 3A to 1 1/2 inches (dia.) and the pipes will be surrotmdPd by s1mil.,a.r material, to a height of 2. inches above the C�_Qlwz Of ;he Rice. The joints of these; pipes will be protected r"IM C108gin and before filling the trench, 2 inches of gravel t wr to ae if t� o 1/4" (da.) will be placed over the course gravel �;r sto-ne4 The disposal field will be installed at; a grade of 4 innches,Aoo feet. No single: tile .kine wi,l1 exceed 1.00 feet in length and in any case, two lines of tile will. be installed. A Uiinimum of feet willbe maintained betrweern the center Lines of the di,.snosal field trenches and the average depth of trench shall yfa�, P.xaeed 36 inches. No part of the Installation will be less than 100 feet from any private grader supply, 25 .feet from any strpam, 20 feet: from any dwelling or 10, feet from any property rine �; further agree 1% to cover onion of this installation iron ► as � X t e ins e�ct�o o� icer, as pro_vTd er"ow$ an jo incorporate a.nyadditionalre-ou rests that may be attached to the Per -11:4t. Plot plans must; he submitted with appl.i.cat,i.ono 9y 3 "} A T r ', ff C gnature o .App cant= I hereby issue the above permit for the Hoard of Health of the Town of North Andover s Massachusetts. gate ��G'L.. � e ea�te��gent� 1 have Inspected the uncovered system indicated above and find everything done -as described. nature o. I. I n pec Officer 1",� r-_olattu,a Test. not done -high ground water conditions r�_arbage Grinder.a.,�.ngid._,..a..,.,.. � ..,-...W...� May 30, 1956 Miss Mary Sheridan R.N. Health Agent Board of Health North Andover, Massachusetts Dear Miss Sheridan: An examination was made relative to the suit- ability of the soil for the sub -surface disposal of sewage on the proposed Salem Turnpike building site of Mr. De Benedetto. The soil in the area consisted of clay, no percolation test could be made because of high groung water conditions. Because of the condition of the soil and the high ground water level, it is felt that the land is unsuitable for the disposal of sewage. Very truly yours, Ernest F. Romano June 15,1956 Miss Mary Sheridan R.N. Health Agent Board of Health North Andover, Massachusetts Dear Miss Sheridan: An examination was made relative to the suitability of the soil for sub -surface disposal of sewage on the proposed Turnpike Road building site of Mr. John Di Benedetto. Because of high ground water conditions no percolation test was made. The soil in the area consisted of clay. It is recommended that a 600 gallon tank be installed with 160 lineal feet of drain pipe. In order to be above ground water in the area of the drainage field three feet of bank gravel should be placed below the crushed stone and twenty feet beyond the drainage pipe. Very truly yours, Ernest F. Romano Sl EL 2\ 6NODRS55- HIO OF „4®w DvIclyslads or lG� 1 ' U tltrf c / 5 y "A IV �. CJ t-� a a 0.4 5 ICCA-rlaev Add SIZE ..mor .s.. •aa. .ar .•ra ..rm +i® mr w wn°u' . Al t rc-' cArj&,F,.A AAtd W 1,TAPIC '" P`kor I.Of, A Ir e 12t1"� >st K 00 �� saUe �w .r► CAV,e r� 5� � c I ! , 1 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: —0 411-1 S Povx.,, (6x b"-,) c�3 (example: left front of house) DATE OF PUMPING: Ay'-Jz`�-43W&ANTITY PUMPED GALLONS CESSPOOL: NO ---VE--S SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: C, FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) i