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�niversal'48023 LITHO IN U.S.A.
Commonwealth of Massachusetts 70R�ER
City/Town of
System Pumping Record JUL~Form 4 TOWN OF HEALTH
DEP has provided this form for use by local Boards of Health. Other fo ms'R12y+eci44 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.
A. Facility Information
1. System Location: Left / Right front -of -house, L -eft -/Bight rear of house, Left / right side of house, Left /
Right side of buildin / Right front of building, Left –Right rear of building, Under deck
Addres/� 1
2. tirn
Name
Address (if different from location)
Cityrrown
B. Pumping Record
1. Date of Pumping
3. Type of system: ❑
iffier (describe):
Date
Cssspool(s)
`"VA
State
Zip Code
State Zip Code
Telephone Number
— 2. Quantity Pumped
Septic Tank.
D*00
Gallons
❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes [I-116If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of Syste
6. System Pumped By:
Neil Bateson
Name
Bateson Enterprises Inc
Company
.7. Locationyhem.,contents were disposed:
L S. Lowell Waste Water
F5821
Vehicle License Number
Date
t5f6nn4.doc• 06/03
System Pumping Recons •Page 1 of 1
Sawyer, Susan
From: Sawyer, Susan
Sent: Wednesday, April 18, 2012 4:45 PM
To: 'stenbringert@comcast.net'
Subject: options discussed
First option — get an estimate to hook home into sewer and abandon the septic tank and drMell ** Note you have
already paid $1000 for the permit**
Second option
If Mr. Bateson does a Title V inspection. He will submit it to the BOH. Pass or fail the Health Department will
require a tie into sewer. You could get an estimate and propose to the realtor to put $$ in escrow (usually 1.5 times
the amount estimated), but the tie in should occur as soon as possible to free up the money.
15.305: Deadlines for Completion of Upgrades
(1) If a system is failing to protect public health, safety, welfare or the environment as set forth in 310 CMR
15.303(1) or 15.304(1), the owner or operator shall upgrade the system within two years of discovery unless:
(a) a shorter period of time is set by the local Approving Authority or the Department based upon the existence of an
imminent health hazard; or
(b) the continued use of the system is permitted by the local Approving Authority in accordance with the provisions
of an enforceable schedule for upgrade. Bases for continued use include, but are not limited to, proposals to connect
to a sanitary sewer or shared system. A fiscal commitment to the sewering plan or shared system plan, together with
an approved facility plan where appropriate, proposing connection or replacement of the failing system within five
years, and an enforceable commitment by the owner to perform interim measures (for example, regular pumping)
shall accompany any such local approval. Such approval shall expire in five years or upon the failure of the applicant
for such approval to meet interim deadlines set forth in the enforceable schedule for upgrade and the plan. The
Department may by specific written approval authorize the local Approving Authority to allow a longer period of
time, where the municipality has provided the Department a proposed implementation schedule for design and
construction and has made a demonstrated financial commitment to the construction schedule. The Department may
revoke any such approval if the approved schedule is not met.
Third Option
If you want to be excluded from the Title V inspection, see (b) below. This binding agreement must be put on the
deed unless there is a buyer who can sign the agreement with the Board members. (Note the Board of Health meets 1
time per month. Requests must be in writing 10 days before the meeting. )
15.301: System Inspection
(4) Exclusions. Inspection of a system is not required at the time of transfer of title of the facility served by the
system in the following circumstances:
(a) a certificate of compliance for a new system has been issued by the Approving Authority within three years prior
to the time of transfer and system pumping records demonstrate that the system was pumped at least once during the
third year; or
(b) the owner of the facility or the person acquiring title has signed an enforceable agreement with the Approving
Authority to upgrade the system or to connect the facility to a sanitary sewer or a shared system within the next two
years following the transfer of title, provided that such agreement has been disclosed to and is binding on the
subsequent owner(s);
http://www.mass.gov/dep/service/regulations/3 10cmrl 5.pdf
Above is the state regulation link.
I Hope this helps sort out the options. Note that tying into sewer gives prospective homeowners additional latitude for
additions or changes to the home.
Good luck
Susan
Susan Sawyer
Public Health Director
Town of North Andover
1600 Osgood Street
Bldg. 20, Unit 2-36
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email ssawver@townofnorthandover.com
Web www.TownofNorthAndover.com
APPLICATION FOR SEWER SERVICI
Nortl
Application by the undersigned is hereby made to connect with the town sewer,
subject to the rules and regulations of the Division of Public Works. I J
T131
he premises are known as No. CJ (7f d/
Z
Address
or subdivision lot no. or
Owner
Contractor Addr
Applicant's
�a
Vn L in SAC, t>
EA`L?i4� !
p
PERMIT TO CONNECT WITH SE'
79:,_�
The Division of Public Works hereby grants permission to
to make a connection with the sewer main at
Street
subject to the rules and regulations of the Division of Public Works..
1
By
� � i w
Inspected by
Date 1
3 A5 K No
See back for rules and regulation;
I
1678
APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass.
Application by the undersigned is hereby made to connect with the town sewer main in Street,
subject to the rules and regulations of the Division of Public Works.
The premises are known as No.
or subdivision lot no.
CP-kf 'v4�zr
Owner
Contractor
L'D A/ 5Ep-V 'TI D Af
r
EAL, �
I
Street
Address
PERMIT TO CONNECT WITH SEWER MAI
The Division of Public Works hereby grants permission to
to make a connection with the sewer main at
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
Street
See back for rules and regulations
Goran and Ginger Bringert
817 Salem Street
North Andover, MA 01845
May 9, 2000
Town of North Andover
Health Department
27 Charles Street
North Andover, MA 01845
Re: Your letter of March 24, 2000
To Whom It May Concern:
MAY 0 7"1
I
i
Your letter of March 24, 2000 is the first official notice we have received from the
town of North Andover, in spite of several requests to the DPW for information.
First we tried to find out why we were not notified when our neighbors were. In a
telephone conversation with the DPW we were told we were not on the list. We
do not know if there is a connection close to our house.
The short notice makes it impossible for us to plan for connection to the sewer
system as stated in the above letter. At the present time we have made
significant economic commitments for the financing of college tuition fees.
Sinc ly/
�I
Goran Bringert
Ginger Bringert
Olt --
f B
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
WILLIAM J. SCOTT
Director
(978) 688-9531
March 24, 2000
Mr. & Mrs. Goran Bringert
817 Salem Street
No. Andover, MA 01845
Re: Sewer Tie-in
Dear Mr. & Mrs. Bringert:
!D ,
o �
9
QDp�i�D 'PP i�y
Fax (978) 688-9542
The Health Department has been supplied with a list of all residences, currently on septic,
which have access to the municipal sewer system. As previously published at a Public
Hearing on March 17, 1994, the Board of Health has adopted regulations concerning the
required sewer tie-in. The following timetable concerning your property status was
adopted:
4.1 All establishments that currently do not have municipal sewer available
to them must connect to the sewer as soon as it becomes available, with a
maximum time limit of six months.
The purpose of these regulations is to safeguard North Andover's drinking water, surface
waters, groundwater and surrounding environment. Sanitary sewer is believed to be the
most effective form of wastewater treatment. A copy of the entire regulation can be
obtained at our office.
Your property is in violation of this Board of Health regulation. Please contact the Health
Department regarding this matter immediately. If we do not hear from you by May 10,
2000 your name will be placed on the regularly scheduled Board of Health meeting agenda
and placed on public notice. The meeting will be held on May 25, 2000 for discussion of
legal action including court hearings.
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Sewer Tie -In 817 Salem Street Page 2
Any questions concerning this regulation should be directed to the Board of Health at
(978) 688-9540. Additional inquiries regarding the physical tie-in and permitting process
should be directed to the Department of Public Works at (978) 685-0950. Please be
advised this Board intends to persevere in this regulation.
Yours truly,
ayton Osgood; - fad
Francis P. MacMillan, M.D., Member
d
o S. Rizza, D.M.D., Member
SF/smc
Made by
'Address
2
BOARD OF HEALTH
120 MAIN STREET
'NORTH ANDOVER, MASS. 01845
COMPLAI14T FORM
I N
Y)0d-A 1E
TEL. 682-6400
DATE—/ b
. Tel., 7 qq - 0(,,5,3
10# W 7- -7,5 - 03 ( )0
Nature of complaint
47)
(Z A�
4- D -1A &rLc ukte
I
Location Occupant <C)�0.g (lwood GfDv
Owner or Agent Address FOS SOJ-g--� St
DO NOT WRITE BELOW THIS LINE
Referred to Date of Investigation
Result of investigation6;21—/a/
Recommendations
i
NORTH ANDOVER FIRE DEPARTMENT
CENTRAL FIRE HEADQUARTERS
124 Main Street
North Andover, Mass. 01845
WILLIAM V. DOLAN
Chief of Department
T0: CHIEF%FPO
FROM: LT. SHAY
RE: 805 SALEM ST
Tel. (508) 686-3812
On 2/3/91 I responded to a complaint of smoke from
a neighbors chimney @ 805 Salem St. On arrival fairly heavy smoke was
blowing toward 817 Salem, where the complaining party lives. It also
smelled like plastic or trash. On investigating @805 we found a home
made furnace in the basement burning hardwood only. It is the only heat
in the bldg. but the owner said they are converting to oil soon. I am
unsure if the system is operating properly or is to code.
The party @817 Salem would like to speak to someone
to see if there is any way to abate the nuisance. The name is Bringert
794-0653, work 617-275-0300. The stove is in 805 Salem, Kozdras is the
name 686-1538. We couldn't find any trash or such near or in stove, but
maybe the draft is insufficient. It seemed too smoky. Owner said it
seemed normal to him.
Fraternally Yours,
Lt. Charles M. Shay
"SMOKE DETECTORS SAVE LIVES"
Commonwealth of Massachusetts
Massachusetts
a
System Pumping Record
System Owner
-C<< uA- ek--V-
.8614 efi T"
System Location
TC>V, 04, L L
I 11991
Date of Pumping:. C Quantity Pumped: �')52�2 gallons
Cesspool: No"� 'Yes U Septic Tank: No �
System Pumped by: Fctado-t 5,y&t%j qm" License #
F
Contents transferrred to : Greater Lawrence Sanitary District
Date:
Inspector:
Yes �K
S
It
TOWN OF J� - vA & -
SYSTEM PUMPING RECORD
DATE. - `� �i:'.. - ,
r_ -
I
SYSTEM OWNER & ADDRESS
Nus 2 2 2003
SYSTEM LOCATION__ - -'
(example: left front of house)
DATE OF PUMPING: 6 QUANTITY PUMPED: GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
cL f � "
CONTENTS TRANSFERRED TO: 6)
TOWN OF NO TH ANDOV
SYSTEM PU ING RECO
DATE:
STEM OWNER & ADDRES
R-7, EIv8b
NOV 19 2004
-'47H ANDOVER
"ARTMENT
(example: left front of house)
�1,4o� Vouse
DATE OF PUMPING:- o `{ QUANTITY PUMPED S�
CESSPOOL: NO
NATURE OF SERVICE:
YES SEPTIC TANK: NO
ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
GALLONS
YES
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
L+
CONTENTS TRANSFERRED TO: L. S � 1)
Commonwealth of Massachusetts
City/Town of RECEIVED
System Pumping Record SEP 2 7 2007
y` Form 4
TOWN OF NORTH A DOVER
DEP has provided this form for use by local Boards of Health. Other orrt1§$hRy be T 1W th
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 submitted to
the local Board of Health or other approving authority.
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
VQ
�srn
A. Facility Information
1. Systqm
Location—� G 0k 'y
U
AV
Address
City/Town Sthte / ( Zip Code
2. System Owner:
Name
Address (if different from location)
City/Town
B. Pumping Record
1. Date of Pumping
3. Type of system: ❑
[<--6her (describe):
Date
State t-,,-.6
7 (L/6 Zip Code
Telephone Number
2. Quantity Pumped:
(s) eptic Tank
L-'J-Q�
f
Gallons �
❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes B -90 ----
If yes, was it cleaned? ❑ Yes ❑ No
5. Condition o\System:D�
r �,� .kt✓�` �/J
6. System By:
JuI
Name
Company
7. Location re c� nt �nrer�sed:
Vehicle License Number
Date
t5fonn4.doc• 06/03 System Pumping Record • Page 1 of 1
Commonwealth of Massachusetts
City/Town of
System Pumping Record
Form 4
M
DEP has provided this form for use by local Boards of Health. Oth
RECEIVED
DEC 15 2009
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
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 side of house, Right side of hous Left front of hou Right front of house,
Left rear of house, Right rear of house.
Address
City/Town
'v� S+—
2. System Owner: G r�,
Name
Address (if different from location)
Cityrrown
B. Pumping Record
1. Date of Pumping
3. Type of system: ❑
❑ Other (describe):
State
V v` a
Zip Code
UZ
Telephone Number
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 ofoSys-te
6. System Pumped By:
Neil Bateson
Name
Bateson Enterprises Inc
Company
7. Location a contents were disposed:
L.$.D Lowell Waste Water
Vehicle License Number F5821
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
�L\ Commonwealth of Massachusetts
City/Town of RECEIVED
System Pumping Record AUG •� 1011
Form 4
TOWN OF NORTH AN OV R
DEP has provided this form for use by local Boards of Health. Other f rmsEm he
information must be substantially the same as that provided here. Before using this torm, c ith 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. eft fro t of house, 'ght front of house, left side of house, right side of house, Left
rear of house, right rear o ouse, side of building, right rear of building, under deck.
�5 [ W-7 S'�-j 2 sq- V ram -
City/Town
2. System Owner:
Name
Address (if different from location)
City/Town
State
B. Pumping Record
cc
1. Date of Pumping
3. Type of system: ❑
❑ Other (describe):
Date
Cesspool(s)
Zip Code
State %8 Z* CQd�,
Telephone Number
— 2. Quantity Pumped:
Septic Tank
Gallons
❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of�teN��
6. System Pumped By:
Neil J. Bateson
Name
Bateson Enterprises Inc.
Company
7. Location where contents were disposed:
Signature
F5821
Vehicle License Number
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1