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HomeMy WebLinkAboutMiscellaneous - 71 LIBERTY STREET 4/30/2018SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT ADDRESS STREET '71 L i p o FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM IGNED BY D.P.W. APPLICANT H a 1L 5Lor-Uv1Lq PHONE �; F 2 5,7( 32 DATE OF APPLICATION (d p i �I ( q (9,2 TOWN USE BELOW THIS LIN' PLANNING BOARD DATE APPROVED TOWN PLANNER DATE REJECTED CONSERVATION COMMISSION touvoLtUallua "rily e DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE DATE APPROVED DATE REJECTED E)A•rE. APPROVE11) X/4z DATE REJECTED 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. Lu J (J .4 J � .J Qof7-LL cY Q O A z ulinLLN _LOT_5_ ;o4. TO c- -Avs 4— LOT 4A rA04 4 FF N Cl-- ku �AA 454.17 LOT 3 QRA� ELEVATION TO TOP OF PIPE DWEL11NG: 204.11 TANK IN: 203.31 TANK OUT: 2o3-o�. D— BOX IN: '101-50 D—BOX OUT: A zot-so E 2ot-lo B 2owll C Zol.31 D 2ot.31 END OF DISTRIBUTION LM- A 201-i3 B 4o1 -i3 C 2ol.14- D Zo 1, 12- E 201. IZ F 20 1- t'7 I "THIS IS TO 'CERTIFY THAT I HAVE INSPECTED THE CONSTRUCTION OF THE SAID DISPOSAL SYSTEM LOCATED AT LPT c, LIBERTY ST., NORTH ANDOVER, MA. THE GRADES ARE AS SPECIFIED IN THE PLANS AND SPECIFICATIONS DATED -3/i /eqBy MICHAEL J. ROSATI.- zl 7 17 In- MlClih.I.-. J. DATE AS BUILT' SEWAGE DISPOSAL SYSTEM PLAN IN NORTH ANDOVER, MA. AS PREPARED FOR MARK - (-ON',tPVA SCALE 1"=10' DATE J-(JL.Y 7,1989 MARCHIONDA & ASSOC., INC, ENGINEERING AND PLANNING CONSM,TANTS 80 MAPLE STREET R.F.D. 16 STONEHAM, MASS. 02180 UANCHESTER, NH 03103 (617) 438-6121 (603) 434-8725 31URD OF' rt6um NdTrh - j- - --A - L/ &I �h T- I/ ,4 VPU C4lJ 1 CONS 4ppl�p\jev DI 5APPK6VED Rmsorvs : �,vr to 1�ovouw6 /6ulljoi�ST-y 10 14 Dw� r CA- V4 T( J�.aC� EGT�O�J I V 5P6Tlo0 4 PPROJEP SCPI SY5"1E1ti Wsi;oU,Q1.InAJ M1L-"- AWTIOMAL 1,0-r i ot,-' j D[SApr7j'�ov6V DA C, R�/j`,� NS •� Cl 13 55 El F41L- �Yx. ry T/J 0 r- Fl PA SS `0 R)L APi'rqjwNG AUJ-+-loi�JTry (� 1 N514l t,GK _ V, } I Department of Environmental Management/Division of Water Resources WATER. W6Lt COMPLETION REPORT J WELL L'OCATIQN Address---,- City/Town ddress City/Town rr :V; G.S. Quadrangle Map Grid Location Owner r c c,mN z` evcA Address Ar", CV 'IT., WELL USE CONSOLIDATED WE{fL — Domestic ❑ Public ❑ Industrial ❑ Type of Water -bearing Rock - Other Water -bearing Zo To S � Method Drilled ''OT"` j,�� 11 From (� 2) From To Date Drilled 3/' 3)From To 4) From / �Tg 24 CASING {7 Depth to Bedrock / f/ Length Diameter Type r + z + UNCONSOLIDATED WELL STATIC WATER LEVEL Water -bearing Materials Feet below land surface 2j' Sand: fine ❑ medium ❑ coarse ❑ Date measured �� r u `I Gravel: fine ❑ medium ❑ coarse ❑ Screen: GRAVEL PACK WELL Slot# length from to_ Yes ❑ No Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to Chemical ❑ Biological ❑ Depth To Bedrock PUMP TEST 1 i Drawdown feet after pum ing ,days hours at GPM. rl r C O .: IP ` 77177. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 DRILLER y -nu �c�Tl`s., p;C. Firm Address City C Registration No. ± peretor s Signature Please print rrm y BOARD OF HEALTH COPY 25M-10-85-807101 BOARD OF HEALTH Town:of North Andover,Mass. Date — 19`� APPLICATION FOR WELL & PUMP PERMIT h made for permit to drill a well (n Application is )plication is er ide to install (_ a pump system. Dcation: Address ° ` D/S�o Tc1��6I �d3 aner Adcires ;�, ,11 Contracto Address /� �� Te1 �63_��� �"D6�/• -imp Contractor. Address :LL CONTRACTOR (To be completed at tune of pump test) rpe of Well �gelj used for Lameter of Well [�© Size of Casing 2pth of Bed Rock /Q llepth casing into Bed Rock g as Seal Tested? Yes (") No ( ) Date. of Testing Well Ended in Wha.t.Material epth e th to Water Q ( Deliver.sGals.Per Min. for 4 hours rawdown feet after pumping_ ---hours- at % `�.. GPM ite of Completion nature We C t ctor _UMP INSTALLER (To be'- filled in- before instal.l.ation) A ize & Name Pump iter Pump Delivers GPM Pump Type Use • ' f T k Si7,e o an ape Material Used in Well: Cast Iron (_) Gnl.vnnazed ell Pit ( ) or Pitless.Adapter (_) ( ) Plastic (_1 I& as sleeve used to protect pipe? Yes (_) NO(_) Type or Name Well Seal late S Q,tlat�;t�C.•.P.�.ne • TD��� ��,r�,arr�rr� �;e'ri':,c.::,,.ic1c ,ate Water analysi•s s repor-t ubmitted to Board of Iieahth ate release given tD owner of record & Bldg. Insp }lealth Inspector ., . Water Work~ Laboratories, Inc. 9 8DElm Hill Avenue ° P.[}.Box G87 * Leominster, Massachusetts 01453 ° (508) 5341444 ° 1-800LAB-0094 (In Mass) Name : Skillings & Sons Inc Sample Location : North Middlesex Const Address : 269 Proctor Hill Road Lot 4A Sharpneis Pond Rd N Andover City : Hollis Sampled By : Skillings & Sons Inc State : Nh Zip Code : 03049 Invoice No : 38929-445 Attn : Date : 03/29/89 PO No. : W -198 WATER OUALITY TEST RESULTS [P] Primary Standard [S] Secondary Standard TESTS RESULTS LIMITS Coliform Bacteria [P] 0/100 4/100 ml Fecal Bacteria [P] NT 0/100 ml Standard Plate Count NT 200/100 ml Arsenic [P] ND 0-0.05 mg/l Sodium [S] 4.60 0-250 mg/l Copper [S] 0.01 0-1 mg/l Iron [S] 0.03 0-0.30 mg/l Lead [P] ND 0-0.02 mg/l Manganese [S] ND 0-0.05 mg/l Magnesium 5.10 0-200 mg/l Calcium 31.40 0-200 mg/l Alkalinity [S] 82.30 NO LIMIT Chlorine ND 0-0.05 mg/l Potassium 0.84 0-250 mg/l Chloride 5.10 0-250 mg/l Hardness 116.10 0-160 mg/l Nitrate [P] ND 0-10 mg/l Nitrite ND 0-1.0 mg/l Ammonia ND 0-0.1 mg/l Sulfate [S] ND 0-250 mg/1 pH [S] 7.60 6.5-8.5 Conductivity 170.00 0-550 Color [S] 5.00 0-15 cu Odor [S] ND 0-3 TON Turbidity [P] 0.90 0-5 NTU Comments NT - Not tested ND - Below level of detection for this parameter For those items tested, this sample meets the following EPA criteria for drinking water : [ X ] Primary [ X ] Secondary [ ] Neither Reported By : Eric J. Koslowski Date : 03/31/89 TOWN OF NORTH AN -DOVER SYSTEM PLTiVIpING RECORD DATE l\,c'rr?.,. r . � 1 "I" v vv IN Ex & ADDRESS �✓o, �n�bv�U , SYSTEM LOCATION (example: left front of house) Ort � DATE OF PUMPING: /9-/q- c/ QUANTITY PUMPED a�) % L�GALLONS CESSPOOL: NO ✓ YES SEPTIC TANK: NO _ YES 1ATURE OF SERVICE: ROUTINE _._ EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE -- FULL TO COVER ROOTS BAFFLES IN PLACE --- EXCESSIVE SOLIDS ACHFIELD RUNBACK SOLIDS CARRY FLOODED OVER OTHER (EXPLAIN) SYSTEM PUMPED BY: :OMMENTS: - T 20 U ~'TENTS TRANSFERRED TO: FORM 4 • SYSTEM FU Y,NG RECOR.r, Commonwealth of Ma sachusetts kl Ak :. a1QP , Mas achtssetis. , Svstenr Pumvita Record �islt 1 Uwncr UbQ V -k\,3 (System Location ass" � � �p u ���-G'��►� Type Emergency O Routine G --I Ce55ps )I' No `O Yes O SI.ptic Tanl;; No ❑ Yrs Dzle r 'Pumping, y'� �Quantiry Pumped: I? BOR.AGZEK'S S� step• Pumped by (Company): _ _ Permit Conte is transfe-ted to: Com. its disposed at: n Pumper Sienarure��� e Conc :tion of syste,Wother comments: Commonwealth of Massachusetts City/Town of System Pumping Record r` Form 4 DEP has provided this form for use by local Boards of H Ith information must be substantially the same as that provi local Board of Health to determine the form they use. Th S the local Board of Health or other approving authority within 1 accordance with 310 CMR 15.351. ''IIhN 1 1 ?n.4, Ether forms may be sed, but the ereA fore,t�sing`tb orm, check with your s m �Pt� IRtmrd must be submitted to 4 days from the pumpinq date in A. Facility Information , -Aej/ be w�l� Important: When 0 , 0 & ✓ �/< . .- filling out forms 1 on the computer, use only the tab key to move your cursor - do not use tha return key. System Location: `7/ 1t bei Address Cityrrown System Owner: Name S�— rG ve c Address (if different from location) City/Town B. Pumping Record M State ye Zip Code StateZip Code �.e-- 6 - 3sa� Telephone Number 1. Date of Pumping Date' 3 � - I r 2. Quantity Pumped: Ste} Gallons 3. Type of system: ❑ Cesspool(s) XSeptic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other (describe): 4. Effluent Tee Filter present? ❑ YesxNo 5. Condition of System: If yes, was it cleaned? ❑ Yes ❑ No 6. System Pumped By: Name Vehicle License Number Company 7. Location where jeegA tents were disposed: r v D Signature of Hauler-/ Signature of Receiving Facility Date Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1