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HomeMy WebLinkAboutMiscellaneous - 73 CHRISTIAN WAY 4/30/2018//V66-4�;7 07 G t � MAP # tbh0 LOT # 11 PARCEL # CONSTRUCTION APPROVAL HAS PLAN REVIEW FEE DEEN PAID YES NO PLAN APPROVAL: DATE APP. BY ^._ _� .._-- - ---- _. . ....... .... . .......... . 36 si c/ DESIGNER : �00 ..�_. _.—�_ PLAN DA I E ._! _L.._ 7_. fovb CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT DRILLEf� WELL TESTS: CHEMICAL DACE A1-1--IRUVED BACTERIA I D(1 I E (11"PRUVED BAC ERI A II DA I E Al -:PROVED. COMMENTS: FORM U APPROVAL: f�fl q1 DATE ISSUED -- CONDITIONS: SSUED-CONDITIONS: FINAL APPROVAL: APPROV 11-0 S, BY_. ..... ALL PERMITS PAID WELL CONSTRUCTION APPROVAL SEPTIC SYSTEM CONSTRUCTION APPROVAL OTHER ANY VARIANCE NEEDED FINAL BOARD OF HEALTH APPROVAL: YES YES YES YE=S YES DA I'E: YES NO v NO NO ND NO fli] BY: • r _T9.Lj A.� ..QN IS THE INSTALLER LICENSED? TYPE OF CONSTRUCTION: INEW CONSTRUCTION: o f id C:,-:RTIFIED PLOT PLAN REVII CONDITIONS OF APPROVAL (FROM FORM U) t.� ISSUANCE OF DWC PERMIT I� DWC PERMIT NO. 32/ BEGIN INSPECTION ES NO: i YES NO NEW REPAIR YES NO YES NO YES NO INSTALLER:__ EXCAVATION INSPECTION: NEEDED: - -� -- - PASSED CONSTRUCTION INSPECTIONS NEEDEDz_............ _._.___._.__ Z w - set %..? no _ 3 �� "T�1L l �►.Stni 14Ro� �_------- ------ Qu tea wm I AS BUILT PLAN SATISFACTORY: YES: ,60'APPROVAL TO BACKFILL: DATE: 8Y�_ FINAL GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE:__�___�__.�Y �►�,,,-�-n-�,, vF E�ccaN�-to� �.� . wcs c�as�-�t� � Elm, �s t ,�� ��'tOM `tal (�, SOC- COILS 12_1 bYe ✓ ��P6v gill 4 -t�2 - C�'r-c�rt�'c �'�"' 0 w64r fgSf -0 � S 1si�K.ta'R-� dos Cil, llt*g- , 5�5 t�1 P�cgp�►�..1 . C,vn,,��ris a,�j s s- T�L� - SES �� �� 204? D OF HFA im Nol�TN �lti DOUEI � � � , P>r{ov ED DI5APPIzo vEp RF4 t,js WATER �SOwFL-f f DoT l ! GhR i 5 Ti/4/ w4y �QP�� �,�� I_ �ar�✓Jc.yN C. StPTI c SY STEA-A VEST C� 4 & 1j -*G 4% /�Pi�WIIJG o,?,7 y 4- PC/AA) DE54 GAvCI:�, 5wa30ej,��vsEn �aA-) DgiE CotIJQlr(o,k)5 DwC 3Z) StPT c c SYSTEM I J 5►A Q-,4 (IOAJ �R6 CYG��I.�TcolJ ��Y�r�cT,O,�J Mrc C1 045S C.7 F.�►� �wAC_ I,VS(�F�rlotiJ A PPROOEP P/3TC �Ty � NsTiou.Gc� _ ADDIT(o,YAL I,�J5F6 j (oNs (1= A',/) DISAP'J�ovFID FKAL APPIZVAL Da TC ,0T-CAPP)30,ly �G � v i Hoge r/ Commonwealth of Massachusetts City/Town of No Andover System Pumping Record Form 4 ' M 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 th'e 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 on the computer, use only the tab key to move your cursor - do not use the return key. ISI 2 System Location Address No Andover City/Town System Owner: Coy V�_ Name Address (if different from location) Ma State Zip Code City/Town State Zip Code 4'-7n'- Z6 Telephone Number B. Pumping Record 1. Date of Pumping 1 2. Quantity Pumped: Date Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap Other (describe): r 4. Effluent Tee Filter present? C2(-Y—es ❑ No If yes, was it cleaned? Yes ❑ No 5. Condition of System: /' J l Y[9f�c _ ;k6'01 6. 6. System Pumped By: t Name Vehicle License Numn k Stewart's Septic Service Company Tn, ,rr^lT 7. Location where contents were disposed: Stew 's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Si aul Date nature of Receiving 1 Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 LoGATEO 1V kJ, -FE', 1-4 A � r.QoV�2 LASS Ate(--riC- (::-- �AI 3J2s�g2 Z GE�2T1�7� THAT T'H� o�FSrcTS S H a w 4.1 C�olslPC.y kr cr�-1 Sy L.A�tI S o F ►.lam -T -K A,..�.E�. be ( 41 c--- " U l L--r- U ,,T�: -T-44 ( S L---oT k-1 or %&J V -q F-csoo L� oF'F=!Z SHcw►J A�� �cC� TpE�iE. USE. cF" T1-FE.BV1V�t►.16 Z U .SPecib •,:: y bj F- dre, l.-_ \ �``✓ Ham. %-.l Go ►J ST 2.0 GT�.fl. .�y LS j(Coj q 3 (2sj42 Important: When tilling out forma on the computer, use only the tab key to move your cursor - do not use the return key. ou Commonwealth of Massachusetts City/Town of NORTH ANDOVER, MASSACHUSETTS System Pumping Record Form 4 , r DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Address% - n - — - `^ r, Citylrown State 2. System Owner. &�-F Name Address (If different from location) City/rown State Telephone Number Zip Code Zip Code B. Pumping Record 1. Date of PumpingDate '2. Quantity Pumped: ca on 3. Type of system: ❑ Cesspool(s) .rSeptic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Condition of System: If yes, was it cleaned? ❑ Yes ❑ No 6. pystem Pu d By: W am Vehicle license Number Company 7. Location where contents were disposed: Signature of Hauler http://www.mass.gov/deptwater/approvals/t5forms.htmiinspect t5form4.doa 06/03 r A Date System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts �y City/Town -of NORTH ANDOVER,-MASSACH os System' Pumping Record Form 4 TOWN OF NORTH AND 'ER HEALTH DEPARTMEN i DEP has provided this form for use by local Boards of Health. The System Pumping Record rnm 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 r7� computer, use only the tab key Address to move your - cursor - do not City/Town /Town_. _ _—. use the return y State - -- key. Zip Code Y 2. System Owner: Name Address (if different from location) - - City/Town — --___ ----- State _--__----L-! Zip Code -%yZ�----- Telephone Number — - B. Pumping Record 1. Date. of Pumping ))) ` p 9 Dat - 2. Quantity Pumped: —Ga I I /ons T pe of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Otner (describe): Effluent Tee Filter present? ❑ Yes o If yes, was it cleaned? ❑ Yes ❑ No r Condition of System: 3. 4 5 6. Sy em Pumped By: ame Vehicle License Number �St, /ala jrn�. Company 7. Location where contents were disposed /1&4�6 Si ature of Hsu /% „_.,.__ Date _ --- _•_ ---- _.. hap://www.mass.gov//dep/water/ provals/t5forms.htm#inspect t5form4.doc• 06/03 System Pumping Record • Page 1 of I TOWN OF NORTH ANDOVER YSTEM PUMPING. RECORD DATE: Qvc, rr, a.. �. - v = L1.1 u rrADDRESS c� DATE OF PUMPING: SYSTEM LOCATION (example: left front of house) QUANTITY PUMPED_ Z�ZLGALLONS CESSPOOL: NO---�—/yES SEPTIC TANK. NO — YES _ J� �AI'L-R F OF SERVICE: ROUTINE' EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: 'OMMENTS: ONTENTS TRANSFERRED TO: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED O T nj R (EXPLAIN) Jyj North Andover Board of Health 120 Main St. North Andover Ma.01845 Haul Lic. #151 -OOH Install Llc. # 128-0 Date Name & Address 12/1/2000 Murphy - 16 Crossbow Lane 12/2/2000 Manzi - 72 Foster St -12/4/2000 Grifin - 240 Candlestick Rd 12/5/2000 Mcilvien - 57 So .Cross Rd 12/6/2000 Small - 440 Fosrer St 12/6/2000 Orlando - 274 Foster St 12/7/2000 Weger - 29 Barco lane 12/8/2000 Walton - 161 Bridges Lane 12/11/2000 Coflan - 73 Christian Way 12/12/2000 Orlando - 7 Laconia Cir 12/12/2000 Fitzgerald - Sharpner Pond Rd 12/18/2000 Mangano - 324 Bradford St 12/19/2000 Galea -= 1589 Salem St 12/19/2000 Johnson - 91 Boston St 12/22/2000 Senton - 1620 Turnpike St fA Andover Septic 47 Railroad St. Bradford Ma. 01835 Gallons Comments 1500 1000 1500 1500 Flooded 1000 1000 1000 1500 1500 1000 1500 1500 1000 1000 1250 Flooded December 2000 FORM U - LOT RELEASE FORM INSTRUCTION—`-': This farm is used to verify that all neclessary 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 or requirements. APPLICANT FILLS OUT THIS r=l APPLICANT�QUiI! ��Q71U1'1r Bury Cdq�r LOCATION: Assessors Nin Number l v ` ✓ SUEDIVISION STREET ChriS�iQn ���/ OFrICIAL USE ONLY PHONE HM -7 PARCEL l� LOT (S) ST. NUMEER -73 RECOMMENDATIONS OF TOWN AGENTS: I CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH OATEAPPROVED DATE REJECTED SEPTIC INSPECTOR -HEAL DATE APPROVED (�J DATE REJECTED COMMENTS _/S���V� PUELIC WORKS - SEWERMATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED EY EUILDING i ISPECTCR M DATE Revised 959; m PARTIAL S23-D.S. AS-ButL-r Lor;: 11 CH-R�SrIAN //WAY NoRVERM TH A\NDv , A OleLi5 DoT I I 9 4, -7 17 * s -F - --- .!QWgLLING ..LCILATIONS Mtnj-•- \. 3 - 5S DS ANI). 6ZT-g AC K$ FROM - D - \ 120 FROM • �cr �G�ADtNG I N. / 61 fd4 _ .... �T�Ok• d UT LFsT .. 5p S N . . --• , . Sp'x2'x2-5' <<!. • $GLtlN -CNV - - TRFnrGH r NAIL- IN TRE INV (TYP) 158.30 57. 5.3 M° ao�t more � ' G/8y5 FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION �, r. ,'S T Iec ,L ASSESSORS MAP f614 )-Of SUBDIVISION LOT(S) 12 i i G r,'s'�',� n VJ PERMANENT ADDRESS (ASSIGNED BY D.P.W. STREET APPLICANT J'o k Y, �, r -; r PHONE DATE OF APPLICATION M BOARD TOWN PLANNZR CONSERVATION Tito Ce CONSERVATION BOARD OF OMMISSION TOWN USE BELOW THIS LINE r � f-?r�T tel• DEPARTMENT OF PUBLIC WORKS C(�/ DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE DA'L'E APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED I lop M 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. PO RS M �) `ROS AT 1 O N /5 M (. SF �F CJ` ca-Y� (2 Sr S P L-- 4sy s0 -b , H _��nck" L48' V614 'r- I42 ' o - 2 .99 (zw Z�se rz-vim -- - -- - 1� � Q Rees RUIL r PEED REQ►S►oN To S. S D. S. . LOT I ( GHR/571AN WAY NORTH AN-DoVE-R SCALE 1 "=40' /Vovem-asg 28, lggo tHv .1'37.9411 7&ry7-10N I ` f/► • � _" -- � ag _ � I 0 � B,q -1A1 � Y EI -L- faf 26 -6 6 x AcT,v � Ped?• ,�es� n Cirq- �71eeTt n /D BOX ccr IV0rf� 1l77,ZIover, i� w ------------ +H lro � C�1�/3T/%'► N WAY U -REvisioN To S.SD.S.Plto?o3F LoT . if GH7?/Sr1AN /\ AY NORTH ANDOVER, SCALE! I"='40' /Vovp- M-BFF. 28,1 90 • LANE ' �I l �N� 13-7.qq _ t �• �� (o IV I :, c pirUP • v W � � \ _ -56 �� N W Sy : � TRawc \ . o l6S0 �D Box ��+/1 /2J 4•x/7/ / (. / • / Indo Vero w � yD Cyd/3T/A N ,A Y 5� Pf PIS 4 betlu � �gy�✓r�YJ PjL,o2 � `�al R0,3E, T FvisIoN TO S. S D. %5 - LOT II CHR/ST/AN WAY V� 1 VO'RTH ANTDoVE-R SCALE J "=40' /`/ovP-mzFIX 28, I?qoZs I �O �I ,37.414 t _ � Tl�NTioN 3 1 I ag � rr 144 P 1, /; • •.�` p. / P r, 26 1�{{ 5� ux P� AC.r'Vf- �es[/n G77��T1ee7-t77 14� 50 . PD Box lVorZ� 4ndover, w 1'2�60 -------------- Ir TOWN QFNbZTH ANDOVER SYSTEM PUIvIPIN(} RECORD DATE b r blbM OWNER & ADDRESS - C�of'lar►/ 73 IV 6 Gnu Jove4) roG. -.A\)%Aa SYSTEM LOCATION , 14du DATE OF PUMPIN9 i - L/. QUANTITY PUMPED_ CESSPOOL NO�Y£S SEPTIC TANK NO YES L/ NATURE OF SERVICE;;,R.QVTINELEMERGENCY OBSERVATIONS: " - 000D CONDITION FULL TO COVER H$AV GREASE _ BAFFLES IN LACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS • FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY / 49111 l— --12 v O COMMENTS; CONTENTS TRANSFERRED TO ` °�S� utr.hc, Provided;hl, rprrn Ipr Sao -- ;pcp, 6 p© +:Orr.11lod to the Ipc/l Eca/c: C r nol p, p, A, Faclllty In(ort'a(lon A. r '^ 4, Sj's',9m location; �•.) ','.� la 7��j� wn ..o � .r ilddr►,� (Ir'4V(4r,Inl•rprn'b(;jVcn) l>!7//lei•— - mping Record 510 I •. �.' Oal� o! Pumpin9 ; Tipa OI by319n1;.. C999�001(9) :c Ehluanl Tae FIIIo�(.Pr'p.aenr7 [' Yp9 nip . .S Y Py'mpod 8y: l7hol n.whera o0(llanla'yrare dlypos6o: • 1'.:,:/x,11., .,,. .�,� �• :iit�,. • 8 F.�wai6r/epprovaJa/161orm�.n.�nalny�6C — . -A : JO .4' `.' Tlopnons v,m0i S0p(!c Tan^ r—' 90 'lm Ter., It y69. e7 : C'6anao% `7 res _ l� 5