HomeMy WebLinkAboutMiscellaneous - 759 DALE STREET 4/30/2018 (3)I
�
Commonwealth of Massachusetts
City/Town of RECEIVE®
System Pumping Record JUNLll12
6 Form 4
TOWN OF NORTH 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 to 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/ ht front of hous Left/ Right rear of house, Left/ right side of house, Left/
Right side of building, Left / Right front of building, Left / Right rear of building, Under deck
Address
City/Town
2. System Owner.
Name
Address (if different from location)
City/Town
B. Pumping Record
1. Date of Pumping
3. Type of system: ❑
❑ Other (describe):
State
Zip Code
Stat e _ `-�
(4^- jp Fgde
Telephone Number
b ---1
Date 2. Quantity Pumped:
Cesspool(s) Septic Tank
Gallons
❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System:
L�
6. System Pumped By:
Neil Bateson
Name
Bateson Enterorises Inc
Company
7. Locatbprwhere contents were disposed:
G.L.S _ Lowell Waste Water
F5821
Vehicle License Number
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
F0 ex!
/0'*
i
310 CMR 10.99
Form 5
rte—
t - Commonwealth
�* of Massachusetts
k E G V
JOYCE. BRAC-` JAW
NORTH ANDOYCR
p i -' F r
DEP FWt4 . 242-769
(To a orom o w OEM
Giy.Town North Andover, MA
aoaiicant Anthonv C. Iii d i n
Order of Conditions
Massachusetts Wetlands Protection Act
G.L. c. 131, §40
and under the Town of North Andover's Wetlands Bylaw, Chapter 178
From NORTH ANDOVER CONSERVATION COMMISSION
To Anthony C. Didin SAME
(Name of Applicant) (Name of property ownerl
Address 544) Wit--,. Street ,North Andover Address SAME
MA, 01845 _
This Croer is issued and delivered as follows:
❑ by hand delivery to applicant or representative on `f i * `7/� (d,1�j
® by certified mail. return receipt requested on �L! ate)
This project is located at Lot "D" Dale Street
The prooerty is recorded at the Registry of Northern Essex
Book 1286 'Page 237
Certricate (if registered)
i
The Notice of Intent for this project was filed on AueuGt 2, 1995 (date)
The oublic hearing was closed on September 6, 1996 (date)
Findings
The North Andover Conservation Co mi ssi nn has reviewed the above -referenced Notice of
Intent anc zsans anc nas neic a puplic hearing on the project. cased on tree information avaiiaole to the
NACC
at this time. the NACC
has oetermined that
the area on wnicn the orcoosed
work is to be done is significant to the following
interests in accordance wan
the Presurrotions of Significance
set forth in the regulations for each Area Subject to Protection Under the
Act tc.`:eck as acoroonate): Ch. 178 prevention of erosion
and sedimentation
Pubic water suopiy
Flood control
Land Land containing shellfish
Fisheries
Private water supply
Storm damage prevention
Ground water supply
Prevention of pollution
Protection of wildlife habitat
Ch.
178Q W Ch.17
Recreation
Total Fling Fee Submitted
State Share 11? 50
Cityr?own Share $137.50
('/-_ fee in excess cf SZE)
Total Refund Due S
City/Town Portion S
State Portion S
('/z total)
('/z total)
cryo^•va
. 0!E9 . 1