Loading...
HomeMy WebLinkAboutMiscellaneous - 675 FOREST STREET 4/30/2018 _ 675 FOREST STREET 210/105.D-01.74-D000:O s e!!� f V / Y � e MAP # _ �o's1�_ -- LOT #_.._...._._.._....._�..... PARCEL # STREET. .:.......... .. �' C.O.N.STR.UCTI_©N_...A.RP_RQ_VAL HAS PLAN REVIEW FEE BEEN PAID' YES NO PLAN APPROVAL: DATE APP. BY..:._.__.. .................._.. . DESIGNER: A, QQ-__ , PLAN CONDITIONS __._.._._..._..._.._...__._.—_........................__.._.............................___...._..._ WATER SUPPLY: TOWN <WELL WELL PERMI _ DRILLER-----— — — ......._.........._. ,._ Q ............ . WELL TESTS: CHEMICAL DAI'E APPROVEU..._3/?3/yZ BACTERIA I DATE (11"PRUVED `( .. .„,.. BACTERIA II DATE APPROVED. .-_ _...._............._._ COMMENTS: 6`2-3`9 Z FORM U APPROVAL: APPROVAL I'D ISSUE YES ONO (oell DATE ISSUEDBY ........2_....�lj/L�DY ._ ...... __._ CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID YE NU WELL CONSTRUCTION APPROVAL YES NU SEPTIC SYSTEM CONSTRUCTION APPROVAL 1\10 OTHER YES NO 10 00 ANY VARIANCE NEEDED YES >�� FINAL BOARD OF HEALTH APPROVAL: DA TEs_............-..___..__....BYa_...._......._......_._. . SEPTIC 1 w F tsy�), r tl l_" tn.. I= IS THE INSTALLER LICENSED? YES NO ', ' TYPE OF CONSTRUCTION: EW REPAIR V i t � I! IJr a ^t ,NEW CONSTRUCTION. CERTIFIED PLOT f-Ll-lN REVIEW Yt=,, NO CONDITIONS OF A[DPROVAL YES NO =r, xIF '`° `��• '4 J (FROM FORM U) } • ISSUANCE OF DWC PERMIT YES NO t _ • . >�DWC PERMIT N0. INSTALLER:—- _ ��"--" �• BEGIN INSPECTION (9)NO: EXCAVATION INSPECTION: NEEDED: ti, 1v1�{ 11511 'i;.��," •y .1e t; ,, , t i X11 Il�t 4 •• 1'{_ + , -- __.______ _ _ . PASSED BY -- _--------------- CONSTRUCTION INSPECTION: NEEDED:_ �i10- 1: • J AS BUILT PLAN SATISFACTORYe YES: , APPROVAL TO BACKFILL: DATE: Z%h Z _.BY_._. FINAL . GRADING APPROVAL: DATE BY__ BY . . . ' FINAL CONSTRUCTION ON APPROVAL: DATE.__.______�_ _._--__J-_- T.n , 1j; Commonwealth of Massachusetts City/Town of NO VCr System Pumping Record Form 4 7M 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 PL!mping 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: RECEIVED on the computer, CD5OreS� use only the tab C. - key to move your Vb ( 7015 cursor-do not C� use the return City/Town ��c� State OW i key. HEA TH DEPARTME14T 2. System Owner: � /I +� Name ninon Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping �115-Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Wseptic 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. System Vehicle License Number Ste tic Service ny 7. Lo ere 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 A,��Y��'� 4�at1.°�( `�'4 •,}.�t�fl�fi� �^Y`� �xd !a IY+1 Ya , un+l1�irl 1tTyp �y.F r I �j i fJ5p Ai 11'x.1! I (�V�t tir(f8t�r{riV ��inV4 .r.Y 'fi 4AV�t�n(! I 't.t +fy+!• 4,+�"` tlC C 71_'YO d a, i S� i L yVb L .I:;) tYT Tr71."!�onwoailth .- Massachusetts ; ® ;r,-Olt y/Town ofNORTHANDOVER, MASSAC U ;, gyst�It�:Put> pilg Record. DEC TO 2010 Form 4 R DEP has provided this form for use by local Boards of Health. Th I be submitted to the local Board of Health or other approving auth X Facility Information Imponant "out 1, System Location: form:on the coCWW or stab key Addirm to , 0� mow your ) - Rn rlaec- cwsor•do not • yR State Zip Code use the row key, 2. System Owner LLOM Name . . Address(If different from location) Citylrown State Zip Code Telephone Number B. Pumping Record ` 1. Date of Pumping Dari 2. Quantity Pumped: Gauons 3. Type of system: [] cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): / 4. Effluent Teo Filter present? ❑ Yes ❑ No If yes,was it cleaned? Yes ❑ No 5, Condition of System 6. Syste ump id By: y Vehicle Uoense Number y 7. LmtIon wfAre contents were disposed: T 2 of Date httpJ1www,mass.gov/dep/wafer/approv sJt5forms.htm#inspect 15form4.dod 050 System Pumping Record•Page i of i Commonwealth of Massachusetts = City/Town of NORTH ANDOVER MASSAE~WEMS System Pumping Record TOWN OF NORTH ANDOVER ,r Form 4 HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. The System-P—ump.ing Record must be submitted to the local Board of Health or other apu.oto tr jr A. Facility Information Important: Sip - 6 2006 When filling out 1. System Location: forms on the �`1 TONIN OF NORTH ANDOVER computer,use ��� HEALTH DEPARTtvIENT only the tab key Address to move your /©� f ,�. ! �f kw r cursor-do not —! use the return City/Town State Zip Code key. 2. System Owner: Name rtQ"' Address(if different from location) City/Town — State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping 2• QuantitPumped: �D 0 lZa 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. Condition of System:. cc�d U- 6. System Pumped By: Name Vehicle License Number Company 7. Location where contents were disposed: 11 2 Ewo Signature of Hauler Aae http://www.mass.gov/dep/water/approvaIs/t5forms.htm*inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 TOWN OF NORTH COVER SYSTEM PUMPING RECORD DATE: / I'��l SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) ILI, DATE OF PUMPING; QUANTITY PUMPED GALLONS CESSPOOL: NO bl/YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE —L�EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ---- FULL TO COVER ROOTS ------ BAFFLES IN PLACE EXCESSIVE SOLIDSLEACHFIELI) RUNBACK SOLIDS CARRY FLOODED OVER OTHER (EXPLAIN) —1_ SYSTEM PUMPED BY: 'OMMENTS: 11�,NNOF ORTti Aid X17 BOARD HEAD•---T 7 2002 ONTENTS TRANSFERRED TO: Add ress -- 5 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 Town of North Andover OFFICE OF 3? y` °0 COMMUNITY DEVELOPMENT AND SERVICES p 30 School Street t ' 09 . WILLIAM I SCOTT North Andover,Massachusetts 0184500' �9ss^cMUS Director September 15, 1997 Mr. John Lennhoff 675 Forest Street North Andover, MA 01845 Dear Mr. Lennhoff: This letter is to confirm that at the Board of Health meeting on September 10, 1997, the North Andover Board of Health granted a variance to 310 CMR 15.211 Minimum setback distances, to allow a septic tank within 10 feet of a dwelling. Sincerely, —I 0� - Sandra Starr Health Administrator cc: File CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 08/20/1997 10:58 5082449501 TRITON SYSTEMS, INC. PAGE 02 y. py a pow. 3. 10 .e t 3 a, !R f ' o 9 �: ..; 0'0 ��, -•--, ,,: SIM • .. 4 s k f� l� 4 " C 3 . Q` • a 04 PROPOSED :PLOT PLAN LO 1 Fa�ES� STREET V RCO�IOND & ASSOC, .1 FE NORTH ANDOVER,' MA ENG1NEERNG A1wII) PLANNING coWSUl. ANTS ei PREPARED.FOR 82 MONTVALE AVE.. SUfTE.I JOHN LENNHOFF ONCHAM MA. 021x0 ,r�r� ruKE�1 sirttzs s -, --- NORTFt A1VOVER,.MA$SACHpStTS SA1. �' 2 ': : DATE, �1$�97 ` i C 4`1,5 41. Sot ,J. fti v . . 'Q� ;. N rte, {; v k 714 �iv, ;- . IIS MICHAEL wi. NO. 854 Iz;� ' � fi .r� • �arZ� `F } ELEVATIONS TAKEN AT TOP OF PIPE THIS IS TO CONFIRM THAT I HAVE INSPECTED THE CONSTRUCTION OF THE DWELLING ELEV.: love"19 SAID DISPOSAL SYSTEM LOCATED ON TANK IN: loco, 16' LOT V FCV-66T 5rT ' t10 &oto Ma, TANK OUT: Ipv , oq THE GRADES ARE AS SPECIFIED IN THE D-BOX IN: 1o5,gq PLANS AND SPECIFICATIONS DATED D-BOX OUT: 105.6t(sa V► s) BY MARCI-IIONDA & ASSOC., INC. * To Ilk- ..;, 1 '�sT o� M� �C.N®v.�lF�ra�� 'rF}E 5'ysTE►-� `! END OF DISTRIBUTION , I�p.S Eel (200sllAc.'i�, t4 j ®P4IZJSA w �1Zp�o LINE A: WS,4(a . (1>ll ta�,4� �}�,��, , B: i�9z : ode.-.- C ATE D: AS—BUILT SEWAGE DISPOSAL MARCHIONDA & ASSOC., INC. id: i. ENGINEERING AND PLANNING CONSULTANTS SYSTEM PLAN 7;! 62 MONTVALE AVE., SUITE '`.,e, ;.. IN STONEHAM, MA. 02180 �'.a ;:r 1�otLT1.� /,a�IDove(z MA. (617) 438-6121 =i Lo g�c AS PREPARED SCALE: �``_ �' DATE: Co t ' RED FOR ( �q2 j 1�1 p atJpOv M & A FILE No.. 351 -C 1 All . ; r Fk i i I i! i '�ii "8YiII6iL'ii'l.:::t:.'�'td•-:9t•••"' -FSLBfiCi1'^�T'"CSiii"iLT'•'II9i r -- ae�.Vfl�F:iSi'JI.T�9{LR��W1tYcititi' :.'n •u'.al.^•.ifae.-ti_ -.•:ii%. 42.5' 1(.,C) L�� , b E�; 51j. .O G :x I II 7- LLT 13 aS) MICHAEL I I `..• IROSATI sry + No. �5q t lz a T . C � _I ELEVATIONS TAKEN AT TOP OF PIPE THIS IS TO CONFIRM THAT I HAVE INSPECTED THE CON.$TRUCTION OF THE DWELLING ELEV.: SAID DISPOSAL SYSTEM LOCATED ON TANK IN: loco lis LOT V FCV.f,ST 5541' - �40 &4Dooexya., TANK OUT: 10�, , 09 THE GRADES ARE AS SPECIFIED IN THE D--BOX IN: log,gq PLANS AND SPECIFICATIONS DATED D-BOX OUT: tog.6ZBY MARCHIONDA & ASSOC., INC. * TollC EAST of R� 1GW o vj lE.Qq ` q E 6yfTE►-4 END OF DISTRIBUTION LINE A: WS.4to (All I.%ms, ���L�MA1baG w �tzo�o% D: A DATE AS-BUILT SEWAGE DISPOSAL MARCHIONDA & ASSOC., INC. SYSTEM PLAN IENGINEERING AND PLANNING CONSULTANTS Irl 62 MONTVALE AVE., SUITE I STONEHAM, MA. 02180 (617) 438-6121 , _ ! LOT rwes t�-c ^S PREPARED FOR ��: C( "` SCALE: � 4.p HATE: Lob� � 2 0ove2. M & A FILE No.: 1 -01 I^;'• rwoaasmos�.ara-�mrnrm�� }ac�ma�.•ms '. , l2 i.c I i 08i20r1997 10:58 5082449501 TRITON SYSTEMS, INC. PAGE 01 John Iennhoff A 675 Forst Street North Andewer, MA 01845: (508)244=9500 work (509)683-1820 home e-mail jlennhr f@tritonsys:,com p , FAX TRA►.NSI ION r Fax Addressed To: Sandra Marr ....'i Fax Nei h er Of Party: . 88 .95w 2 ' Fax Sent John Lennhoff z ; Date And Time Of Transmission:: $/20 11;00 1,IVI Number Of Pages Transmitted Inciudin Cover. Page: .3 . IF 1HA MUSSIM IS INCOMP � ALL ESQ$ 4 9 3[D Dear Sandra, ' Thank you For taking the time to meet with me this past Monday.. orn ng concerning the approval of the plan for an addition to my home at 675:Forest Street. K I have attached the updated septic plan frdm'1Vlarchinda'& �lssaciates that�Mes:the" '{ relocation(if the septic pipe that you.requested ` D®es this drawing satisfy your requirements for approval of.our building permat? Please let me know tf there is an tbin else that I can do. I can be reached at 2504200 x 145. Thank . ora poi; our, y' g . Y. �' time and assistance. . Regards, John Lennhof f � y � 3 L z' Yi i i s J 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: C rz-,i (0 Phone LOCATION: Assessor's Map Number l )_6 Parcel Subdivision Lot(s) Street !S-T S St. Number 75 ************************Official Use Only************************ r / 7CO ' IONS OF TOWN AGENTS: 2 Date Approved U l Conservation Administrator . Date Rejected Comments Date Approved . . �fio wn Planner'nner ; Date Rejected r � Comments J J Date Approved ! Food Inspector-Health Date Rejected t/4 — L.��� Date Approved Septic Inspector-Health Date t Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT AD RESS (ASSIGNED BY D.P.W. STREET � � APPLICANT i�- PHONE DATE OF APPLICATION TOWN USE BELOW THIS LINE PLANNING BOARD DATE APPROVED TOWN PLANNER DATE REJECTED CONSERVATION COMMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOW OF HEALTH,( bAI rl ��, I' DATE APPROVED f_ L HTAifiH S NITARI DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building; permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Town of North Andover, Massachusetts Form No.2 f 'AoRTh BOARD OF HEALTH 9 DESIGN APPROVAL FOR as""t5`t SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No { LAD Site Location Reference Plans and Specs. L ENGINEER DESIGN DATE Permission is granted for an.individual-soil absorption sewage disposal system to be installed in accordance with'regulations'of Board of He th. jMl CHAT AN,BOARD Of 11E LTH Fee ! • Site System Permit No. / 66UTTL8ONROAD wESTFURD. MA0l00 (508) 692`8395 FAX (508) 692-0023 1'808649-T[ST � / \ Report Number: C-wps-5267 Report Date: March 20, 1992 Client: Sample Taken At: ATTN: Tom Breen Flintlock Incd . Wilmington Pump Supply Lot 1- Forest St. 639 Woburn St. N. Andover, Ma Wilmington, MA 01887 D. Kindred Builder Sample Taken By: WPS Staff On: March 18, 1992 CERTIFICATE OF ANALYSIS _______________________ � Test Parameter : EPA Max Results Units � � Coliform Bacteria (P) 0 0 per 100cc H (S) 6. 5-8. 5 7 8 SU p . Color (S) 15 5 CPU - Hardness No Limit o 139 mg/L Iron (S) . 3 0. 10 mg/L Manganese (S) . 050 mg/L Nitrates (as N) (P) 10 <0. 0_1 mg/L Odor (S) 3 1 TON Nitrites (as N) 1 <0. 01 mg/L � Turbidity (P) 5 0. 75 NTU � Alkalinity Not Specified 118.5 mg/L � Ammonia Not Specified {0. 03 mg/L � Copper (S) 1 . 0 <0. 01 mg/L � Sodium 20" 10. 7 mg/L Calcium No Limit 47. 0 mg/L Magnesium No Limit 8. 8 mg/L Potassium (S) 4. 0 7. 2 mg/L Chloride (S) 250 21 . 1 mg/L Sulfates (S) 250 27. 7 mg/L � Chlorine 0. 7 <0. 02 mg/L � Conductivity No Limit 325 umhos/cm � Sediment pos/neg neg (P) - Primary EPA Parameter (S) -Secondary EPA Parameter (may affect aesthetic qualities e. g. color, odor and taste ) NT = Not-Tested #= Exceeds EPA Maximum standard. "=EPA advisory limit, no formal limit TNTC=To Numerous to Count The quality of this water sample is accepted as Safe To Drink according to EPA standards. This water sample , as tested , does not meet some of the secondary parameters as indicated by the Q) sign. Massachusetts State Certified Michael P. Carlson for Testing Laboratory #MA04e Thorstensen Laboratory, Inc. l 1111 ll1 _ 1 11111111 In 111111111 1111111111 1111111111 l 1 / 11111 / ���� 11111111 of 111111111 _ llllil Ill _ - - liilllllll 1191111211115 mossams 1,1111111111111,11111,111, 121121111122 mumm 1 I+1 l�1111#1�1�1 1 1 11111i1111111 III111111111I 111111111111 • ���� w•��� 111111111111111111111111 ����NN}} NN 1 1 1 1#111}I}Illfl�l♦1+1 1111111111111- 1111111111111 MONO lllllllllllllleliill#1111, m t t m t m �IIIIIIIIII IIIIIIIIIli111LL ON 1 1 1 1 # 1 H I 1 !•!■�� 1111111111111111111111111. �����������II llilil♦Il,l'llllilil'IH li�iili♦il �ili� ll �i il-Illllllllllllll�ii111�1 �_ 1f101�lilil�l�l�l�l��li1 J�O Illlllllllllllllllillllll X77 11♦Ii11111111111111111i11 NO! 1OIllllllilllllllli1111I1 1,111,11111,111,1,1,111,1 I,l,l,lllll�lll,l�lllll,l 1111111111111; m m om 1111111111111111111,1,1,1, won . .��. 1111111111111111111111111, No�� MONO 1,111,1,1,11111,1,111,111 m m m� 1,111,11111111111,1,1,1,1. ++ �III�III��I�� 11111.11'1111111'111111111. m m m� 1111�I�I�IIIIli111111111�. =WON m m m� 1111111111°Ii1�111111111� m mm mom m� 1,1,1,111111111,1,111,111; ■��� 1,1111111,1,1,111,1,1,1,1 �1i1111111i11 '1'1'11'1'1'1'1°1'1'111' I!,�l�l�l�lNWHlMIM i � 5 j f ' 1 5 �Z � 20' O =C) 24' 26' 20' x 24' addition 675 Forest Street 20' x 24' addition 675 Forest Street Ito 71 5Ei-OA TA U 0 Pct g flea f �°- -+ fYof da/�i S Q� ld 1 vivo oj� 77 E-7,� 0, �' ,..ewe.........«-.r-� ..i .- •«-_.y_._.._...�_-----r ___'" .-1 _�. ..-i_ _r -. .. T � - 1 + I I I r I 1 I I III II I I I 1 I J I i 1 � I 1 i 1 , I , I I 4 + i 4 - 4 I I + + -}. -+ t I I I I # + i + + } + # + + + + + t + + a } ♦ } I ' I • r 1 i » + i 4 + 4 + } f r + # # + + i- t 4 + t + r r r + y _, i I i 3=10 J I � I I ise 1 -- �i � i 0 O !_J • I� o f -° � ftGCSsca h h. O LA) i all Y N 3` d-i 'O �o o' ci IIon 26 I � hl 6 z 1 1 I N i 1 LOT # 1 FOREST STREET - JOHN & NANCY LENNHOFF L ,i ,1-6, -�� 1 ST FLOOR - 1/4"=1' - �} - - 4'- 3'-4" G o„ t O o + O 00 0 col r Za I - 2a Z4 Q' i� 6, !, -Phcnt a O i z 7. 6. I ML i Pti0"� 'O I � ,3 6'=O LOT # 1 FOREST STREET - JOHN & NANCY LENNHOFF (�-.-I 2ND FLOOR - 1/4 TL,!- NL LOT # 1 FOREST �rr--REET - JOHN & NANCY LENNHOFF FRONT ELEVATION - 1/4"=1' EFT- I I i I I I R I i I II . �,...,..,... _.�r•:sz�,:�:caa:ruc^'—•�;:..�:rrmrannwx�r�vxcsrar.�..._,.�. _— ........v;_g�-'."-- ..�-cs�a2:a's:u..%.:t::s:.:t.7r".tsae mom.•=•-:sc : SI 1,+ C 4q.S 41,5' -- Ot ,a act , a L. 31 C 4 o �X 't 1?,y" ,•s 'i Illr,� O kI 6 MfICHAE1 f �� RO AT! fq0. U54 F yTi' b 'a. ELEVATIONS TAKEN AT TOP OF PIPE THIS IS TO CONFIRM THAT I HAVE INSPECTED THE CONSTRUCTION OF THE D` FLLING ELEV.: Int..-1 SAID DISPOSAL SYSTEM LOCATED ON TANK IN: loco- Is LOT V Pi::�S'r 5.'T' ' No L�1JDO M6, TANK OUT: Ips , nq THE GRADES ARE AS SPECIFIED IN THE D--[30X IN: Iog,gg PLANS AND SPECIFICATIONS DATED D—BOX OUT: (6.0 t.A'W+Sr) BY MARCHIONDA & ASSOC., INC. 4 T-D IN\E Cf K4 V-44 ter q C, T4 E SYSTE►'I END OF DISTRIBUTION COOS-TiZ..�C.'C 1N LINE A: �*S,4co (pal Uipeev C: A ATE D: i , r AS-BUILT SEWAGE DISPOSAL MARCHIONDA & ASSOC., INC. Mt, SYSTEM PLAN ENGINEERING AND PLANNING CONSULTANTS !? 40,i 62 MONTVALE AVE., SUITE I ' Irl STONEHAM, MA. 02180 '' ; �latz.Tla l�.t•1DcaW��, yt®, (617) 438-6121 L.OT AS PREPARED FOR�.1,G. SCALE: 4,p' DATE: Cd(i tip M & A FILE No.: 351 -C� 1 ff, Ph.D. (508)244-9500 Office Jahn D. Lennhof Senior Scientist (508)244-9501 Fax � jlennhof@tritonsys.com + i + TRITON SYSTEMS, INC. Technology Innovators 1 j 200 Tumpike Road Chelmsford,MA 01824 http://wyrw•tritonsys.com Department of Environmental Management/Division of Water Resources a � WATER WELL COMPLETION REPORT WELL LOC T N - GEOGRAPHIC DESCRIPTION A dr a Sl N QE W of peer/, (circle)City/To"n ✓ d,/7/ r s (road/ Well owner Address 573 1 N ® E W of (Si Ste" Imi.in to^itis/ (c rclel Board of Health permit: yes no ❑ intersect. w/ (ro t WELL USE WELL DATA Domestic Dk Public❑ Industrial ❑ Total well depth 24. ft. Monitoring❑ Other Depth to bedrock—ft. Water-bearing rock/unconsolidated material: Method drille Date drilled 8-13 "' Description��� Water•Water-bearing!z61 ones: � 1 CASING Type /��� 1) From�To C� Yp //�1 2) From To 3� Lengthft. Dia(.I.D.)�.e "in. 3) From To i Length intp bedrock ft. r y�� Gravel pack well: dia. ProtetIv wet seal: Screen: dia. Grout-El Other Slot a length from_to STATIC WATER LEVEL Static water level below land surface 3' ft. Date WELL TESTS// / Drawdownft. after pumping ^Jir. �Sr min.at _�— gpm How measured—Recovery ft. afterhr. min. LOG of FORMATIONS C ENT Materials From To Driller r 1 t Mass. Reg' t on � � t Firm Address C9 r City/Town ' D V✓. r Signature of snpervising registered well d, ler Pleaseprinctirmly BOARD OF HEALTH COPY U Ab .1. 4 Q a r S• NUM,tRR FEE # , THE COMMONWEALTH OF MASSACHU5ETTS' j TOW .. .. .: .......... ...---NORTH...ANDOVERs This is to Certify that .....Ski llings---&...Sons......I=.....................• r NAME ..259...P-roctor...H.i-1.1...Roa-d, Hollis,...N-.-H,....0.3.0.4-g............................................ ADDRESS IS HEREBY GRANTED A LICENSE or Well Drilling Permit — Lot#1 Forest Street This license is ,,ranted in conformity with the Statutes and ordinances relating thereto; and f expires......Dec-ember---3.1.,...1 9.2.-=:.------ nlcsv.sooner suspended or;revoke,& March...3.,. .. .......... .........►9-.9.2 ....... FORM 433 HOBBS @ WARREN. INC. FEE NUMi.XF.R 134�- THE COMMONWEALTH OF MASSACHUSETTS 3-0-1 ..TOWN....--.. of ......WAIR.-ARWYER.............................. This is to Certify that .....Skil-1-ings...&..Sons,....Inz...................................................... NAME ....269L---P-roctor•--H i-1.1...Road,----Holl-1-6.7...W.-H......0.3.0.4 9................................................. ADDRESS IS HEREBY GRANTED A LICENSE Well Drilling Permit Lot#1 Forest Street..__.__._.......................... For ...... - .... -Permit..-- I.......................... ..........................................I......................................................... ................................................................... ....................................................................................................................................................... .................... ....................................................................................................................... ................ ................................... This license is granted in conformity with the Statutes.and ordinances relating thereto, and expires......laecember... nlesi sooner suspended or revoked. .04 ...... .. . .. ... ............ &K .... ....... .. ........ .... .. ....... ........... ....Hax.ch---3............................ ...19-92 ................. .. .............. .........*. ...... ......... .............. . ........ .. ...... ...... .............. .... ............ ... . ............ ... ....... FORM 433 HOBBS & WARREN, INC. - Town of North Andovcr,Mass.. A. , Date 19 Permit # APPLICATION FOR WELL & PUMP PERMIT Application is hereby made for permit to drill. a well Application is made to install ( ) a pump system. Location: Address 1_aef Loa �J # • Owner J- plC Address PLS �C�( S�( ' � Ay Well Contractor �Hr Address� � ° TG AAA/ y 1 . ?— �9SOoZ - — rs Pump Contractor Address Tel.. WELL CONTRACTOR (To be completed at time of pump: .tes:C ) t �,/� r I' Well used. for, ` ^�s '�.�'' Type of Well Diameter of Well to Size of Cason f Dcpth of Bed Rock Depth :,casing nto :Bed `Rock° Was Seal Tested Yes ( ) No ( Y. Datre ,o,f T,c': t�nEg k Depth af--Well — -• Wen Ended in: Wha.C': Material Depth to Water_ Delivers Gals Per., Mxin•. fox 4 .hour.s Drawdown feet after pumping; houyrs attGPr1 L Date of' Completion 1 na c :t a 1o G r a ct,o r PUMP INSTALLER (To be• f•i1lcd in' before installation) . S i.ze & Name Pump __:_ __--_—_ ^ `Pump Type, Used . ,timer Pump Delivers GPM Size of Tank E'i. pc Material Used in Well : Cast I'r. on (_) Cal.vnni.zcd ( ) Plastic r well Pit (_) or Pitless .Adapt6r (^) l•las sleeve used toP rotect ' i e?. Yes ( ) NO(_) Type or Name Well Seal P P _ ,)ate ,4 z4��>'r►'r�ritiPt'ti�i4�Mi�ilri4iFiM►1r i4iM�M�rt�ti'ri'riMi4�rt44tti4�Yi4i��4►'ri'r►4i4�4;'ri't4ri'r1't,':tS;,Q,�,`'i��'�.�Gti't1.''iFnC:7TD����, :;'ti�F?P�"fW1H14�tt�tlk Date Water analysi.'s repor-t 'submitted to Board of Ircal't:h Date, release given tD owner of record & Bldg..' Insp Health Inspector' ® � 269 PROCTORHILL ROAD NHOLLIS,NH 0 049•(603)889-5009 WELL DRILLING PAY � 54-7000/21 14 TO THE 19 y�2 ORDER OF S OLLARS NEW HAMPSHIRE SAVINGS BANK FOR 11500 1 7 2611' 1: 21 &L, 700051: 5428 246 56911' � � -Alta<r17.�t.ccRar:s.�>rr.�.t'J.•a.1 .alaacrr_.•rlyC U3 Q C ;1 LOTS 80 z•1Z �crtS lo y� ; a 6' �tih 9, M � 1 o � ayd� JF r��A''•1 C' �(� A'i 3 R-n dl,� ��IZf��v �-•y i No. 221:50 i h � !'.1(n•... �e THIS PLAN IS IhITEMDEp FOR 7_ONI14G \ PURPOSES OFIL'f. IT WAS COMPILED v'tE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT ALL EASEMENTS, 1.1 t'! FI_',r!•, AND RLCORDS ENCROACHMENTS AND BUILDINGS ARE LOCATED .r!TI ! f?111L0111C L 0(11,.TIC`,rJ`_; C(--NFIRh:IED AS SHOWN. ALL BUILDINGS SHOWN CONFORM It! TI?-,- FILI_D. IT �:IIOtJI.I) r1OT P 1 (;mac PROPERTY TO THE ZONING LAWS OF THE IJUNICIPAI_IT`( i' 'm FOR r��C?PER? 1 L!HE (N.-TERMIN— 1'dl IEN CONSTRUCTED. 11 oil Th!E (31,111-DING IS NOT LOCATED IN AN j Es;TAf!I_IS11ED FLOOD hIAZARD AREA. n 7.Or11r1G; R l REQUIRED SETBACKS: FROhIT: 3D' SIElE: 30 REAR: 20 "+'a�-rrir...rr,..arx'rn+Baa.•+scT✓ncv:.tsr-•n:��sanart�vacrnmc:,•¢ay�,o . CERTIFIED PLOT PLAN ' MARCHIONDA & ASSOC., INC, •'1C1t'�T•)•1r'-.�vac.r.r.7[t res:-.:.111vu�::71:�-10••..teR1L'.c.:.•ZCsrTar.,�.,.�_-- ' ENGINEERING AND PLANNING CONSULTANTS I II 62 MONTVAI.E SUITE I AS PREPARED FOR STONEHAM, IAA,AVE., 21 B Fl:!I)'Noc--� r (617) ,138__6121 FILE h;o.: 355 oy SCALE: DATE: 14•Z1.g? � -err: :v.srxa-.am.s._ame.rs,�ara:rrt�. ynyaK.a.-r r_ i � a - TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE Id-o�lo, SYSTEM OWNER&ADDRESS SYSTEM LOCATION DATE OF PUMPING �e'2 QUANTITY PUMPED JV(V � S � CESSPOOL NO ZYES / SEPTIC TANK NO YES NATURE OF SERVICE: RbUTINEr/ EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO.COVER HEAVY GREASE BAFFLES IN LACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY c/ L COMMENTS: f CONTENTS TRANSFERRED TO C�-)D WELL DATABASE ADDRESS: AGE OF WELL: ,5 ` WELL DRILLER: -<< e � WELL PERNfT r: WELL LOCATION: WELL-PERIMIT DATE: 3 - `7 DEPTH OF WELL: --TYPE OF WELL: a.. ,DRILLE b. DUG c. OWN TYPE OF WATER BEARING ROCK: WATER ANALYSIS DATE. _ HIGH MANGANESE: Y N HIGH IRON: Y N OTHER CONTAMINANTS: WELL DATABASE A ADDRESS: ` .. AGE OF WELL: WELL DRILLER: ? WELL PERNfIT 4: ; WELL LOCATION: WELL PERMIT DATE: DEPTH OF WELT: TYPE OF WELL: (a:. DRILLED ) b. DUG UNKNOWN TYPE OF WATER BEARING ROCK: WATER ANALYSIS DATE: HIGH MANGANESE: Y N HIGH IRON: Y N OTHER CONTAMINANTS: Y N . r NORT1y BOARD OF HEALTH i � * i • 120 MAIN STREET NORTH ANDOVER, MASS. 01845 TEL Ext632 or 33 SACHUS September 27, 1990 George Richardson Stowers Associates 13 Pine St. - P.O. Box 92 Methuen, Mass. 01844 Ref: Lot 1 Forest Street North Andover, Mass. Dear George: I have completed the review of the subsurface disposal plans p for Lot 1 , Forest St. , dated 9/90 . Before the approval can be given, the following concerns must be addressed and plan deficiencies made. 1 . Deep hole test results are incomplete. Information shall include dates, elevations, who preformed & witnessed tests, and- soil profile. Same with percolation .tests. 2. Size of system - the design is based on 3 bedrooms. If a dwelling is based on less than 4 bedrooms than floor plans of the proposed dewlling should be submitted to the Board of Health for review. Please be advised that the Board of Health considers a den or study as a bedroom. I would recommend designing for a 4 bedroom dewlling. 3. A have submitted all the information available to me on this site. The percolation tests which were witnessed by myself on 7/9/80 are enclosed and I have shown their location on a copy of your plan. This is the only information that I feel confident about. As you are aware, the Board of Health or its agent assumes no responsibility for the test results performed or for any conclusions based on these results. 4. Previous soil test revealed that ground water was as close as 61 ft. below the ground surface. From a site inspection and the previous agents notes this test appears to me to have been dug to the east of the percolation test Pl. According to the topograghy submitted, the existing ground elevation under the easterly end of the proposed trenches and what appears to be the approximate location of the soil test is approximately 127. 50 . This indicates that con i. . ground water could be as high as elevation 121 . 0 . Therefore, to assure that the bottom of proposed trenches is at least 4 ' above the water table, the bottom of the trench should be at least at elevation 125. 0 . 5. The Building Department requires a footing drain for all new construction. The dwelling is required to be 35ft. from the leaching trenches and 25ft. from the septic tank. 6. Top of proposed foundation elevation and drive way elevations should be shown on the plans. The plan submitted should reasonably reflect the proposed grading to be done around the dewlling and septic area. I am also concerned that surface water from the road may pond between the septic system and road. The area in the vicinity of the septic system will be higher than the road and the driveway may act as a dam if not constructed properly. Please detail some finish grade contours in this area. Since we usually require a detailed grading plan at least around the dwelling this plan is often used as the grading plan for the Conservation Commission. 7 . Top and subsoil removal shall be shown on the plan view. Also, a note specifying the removal and type of replacement material required. 8. Note Added: The bottom of excavation shall be inspected and approved by the Board of Health prior to the placement of any replacement material. 9 . Please show the location of the footing drain outfall and the Town Assessors map and lot number. 10. A plan review fee of $60 . 00 should accompany the set of plans when submitted for review. Should you have any question regarding this matter, please do not hesitate to call. 1 Sincerely, Michael Rosat Health Agent/North Andover STOWERS ASSOCIATES, INC. REGISTERED LAND SURVEYORS MASSACHUSETTS &NEW HAMPSHIRE PINE STREET GEORGE M. RICHARDSON METHUEN,MASSACHUSETTS HUGH F. DUNKLEY REGISTERED LAND SURVEYOR 617-685.5262 REGISTERED PROFESSIONAL ENGINEER MAIL ADDRESS:P.O. BOX 92,METHUEN,MASS.01844 REGISTERED LAND SURVEYOR Hugu=.t 30 , 1 ?% 126-A Pleasant Valley Street Methuen , Mass . 01844 Re ; Anna. Gilbert Forest Street North Andover Dear Att'y Fitzgibbons ; This litter i in responce to a. recent inquiry .by Mr . Kenneth Daher regarding the status of a. septic design for Lot 1 , Forest Street North Andover which he is supposed to , obtain from Mrs. Anna. Gilbert, Please be advised , as of this date , this office has NOT received the test pit or percolation testda.ta. for the .desired lot, In order for us to attempt to design a septic system on the afore mentioned lot we NEED a WRITTEN report from the REGISTERED person making the tests. This I,.JRITTEN REPORT must contain the following data 1 . The =.o i 1 log and water i s l e data of two test pits which are within the area of the proposed septic system. 2. The percolation test data including the depth of the hole , saturation time , time drop from 12" to 9", time drop from 9" to 6" . 3. A plan showing the location of the test pits and percolation test . this data must be contained in a report which is stamped by a person with an appropriate registration , REGISTERED ENGINEER, REGISTERED 'SANITARIAN, ETC. Septic system plans ( and Conservation plans, if required) are not designed overnight , nor are they normally approved overnight . Appropriate time period needs to be maintained to allow for +; ju i r I ng the necessary approval for a. building permit . If you have any questions feel free to contact me . , our r Trul : , ')� YM George M. Richardson Stowers Associates Inc . Vl— COD CH � SE71 SEP Q 8 ar� a 2008 OEpho (QYldd 1)14 loraN E EKN D Py s . A. i-aclllry Inf Ownr �. .. •�,� I� . �/ �dre�� (II dV(�r►nl rcm bcauc�; l :8,:Pumping Regord - -- rol,'mpInn - pl , lar, Ta^A 1 G. EMv.onc Tao FII4a('p(Qson'? = oy axC a`I�'�S'��'"f ��.�� Y1�'• •1L,.�i{�t„ 'r,ti�,f'.r/c'J,,� (� , YOfll'"B .J' — _ - ,:• �,;:. :,'�.,;r � ,t � �,r ,/;�� ,ply✓l'j^� �� 7. .ou Gn whao nh ware fir. ' r�^ Y.•'ry-�-ry maw --