HomeMy WebLinkAboutMiscellaneous - 835 SALEM STREET 4/30/2018 (2)x
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NAP # LOT #
PARCEL # STREET
CONSTRUCTION APPROVAL.
HAS PLAN REVIEW FEE BEEN PAID? NU
PLAN APPROVAL: DATE APP. BY
DESIGNER: PLAN DAlE
CONDITIONS
���������������'�_
WATER SUPP
WELL PERMIT
.'
WELL TESTS: CHEMICAL IDA lE APPHUVEU
I UA|E UP14RUVED
BACTc�/ lI DAlE A�PKUVEU
_ _—___
COMMENTS:
FORM U APPROVAL: APPROVAL TU ISSUE YES NO
DATE ISSUED _8Y alL 4C
CONDITIONS:
FINAL APPROVAL:
ALL PERNITS PAID UO
WELL CONSTRUCTION APPROVAL YES NO
SEPTIC SYSTEM CONSTRUCTION APPRUVAL NU
OTHER YES HU
ANY VARIANCE NEEDED YES Qr!,U)
FINAL BOARD OF HEALTH APPROVAL: DAlE:MOO?-BY:��—
SEPTIC SYSIEM U�Fk
_jNS10 T
-IS THE INSTALLER LICENSED?
fi., TYPE OF CONSTRUCTION:
-
err
-
--n'NEW CONSTRUCTION: CERTIFIED PLOT PLnN REVII:W
�Jif 0-1 Ily CONDITIONS OF APPROVAL
(FROM FORM U)
IT
D
ISSUANCE OF WC PERMIT
PERMIT NO.
BEGIN INSPECTION
EXCAVATION. INSPECTION:
j. IPASSED
CONSTRUCTION INSPECTION:
44, i'll"I 1 w.,
AS BUILT PLAN SATISFACTORY:
NEEDED:
BY—
YES:
INSTALLER -tL(.Xva 1167 ro
APPROVAL TO BACKFILL: DATE:_ 13Y
FINAL .GRADING APPROVAL: DATEBY
—
CONSTRUCTION APPROVAL:
t,
DATE:
ES
NO
REPn I R
YEAS
1\10
YES
NO
.vie5
em�r
YES
140
INSTALLER -tL(.Xva 1167 ro
APPROVAL TO BACKFILL: DATE:_ 13Y
FINAL .GRADING APPROVAL: DATEBY
—
CONSTRUCTION APPROVAL:
t,
DATE:
Olt®
PNOPpr
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47L>
WILLIAM J. SCOTT
Director
(978)688-9531
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
Fax(978)688-9542
On this day, February 5, 1999, I, John Curtin, as owner of record of 835 Salem
Street, North Andover, MA, do hereby agree to connect said household into the
public sewer system by June 30, 2000. At the time of connection the existing
septic tank will also be permanently abandoned in accordance with the Mass.
Department of Environmental Protection, Title V. This agreement is binding on
any future owners of 835 Salem Street and will be disclosed at the sale of the
property if the sale occurs prior to the hook in date.
I understand that upon signing this document that I am receiving a one time
extension to the Town of North Andover Board of Health Regulations relating to
sewer connections of households. Violation of this agreement could result in
legal action and or fines as mandated by regulation.
Notary PublicOO
My commission expires:
//i aOo.3
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Na 1391
APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass. KJ 19
Application by the undersigned is hereby made to connect with the town sewer main in 1n*t Street,
subject to the rules and regulations of the Division of Public Works.
The premises are known as No. - 'o'5'o'5s.cJ�[/
'ut Street
or subdivision lot no.
Owner
Contractor
5cWe,.
Address
Address
ApcaM s Signa
PERMIT TO CONNECT WITH SEWER MAIN
The Division of Public Works hereby grants permission to 4 i't. _ ur IZ
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
Division of Public Works
By 0' Ae
See back for rules and regulations
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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 andlor landowner from compliance with any applicable or requirements.
•�•�^�-^'**"^"'"'''""*APPLICANT FILLS OUT THIS SECTION*
*
APPLICANT
I �14�
APPLICANT F^ /J l_ iJ T` PHONE
LOCATION: Assessors Map Number �_ PARCEL
SUBDIVISION LOT (S)
ST. NUMBER
STREET
..�. �.�,--- .., ..*•...,..,,"'OFFICIAL USE ONLY** ""* "-`—
RE MENDATION qF T WN AGENTS:
CON E NATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
TOWN PLANNER
COMMENTS
FOOD INSPECJ.9R-HEALTH
TIC -'(NS
COMMENTS
TOR -HEALTH
DATE APPROVED
DATE REJECTED.
DATE APPROVED
DATE REJECTED_
DATE APPROVED
DATE REJECTED_
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRJVEWAY PERMIT
FIRE DEPARTMENT
DATE
RECEIVED BY BUILDING INSPECTOR
N° 1391
APPLICATION' FOR SEWER SERVICE CONNECTION
North Andover, Mass. J 19 11
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.y,5 c (/
, Street
or subdivision lot no.
Cyr1�i`e-1
Owner
Contractor
"5cwe,
Address
Address
Ap s Signa
�_
PERMIT TO CONNECT WITH SEWER MAIN
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..
Division of Public Works
By
Inspected by
Date
See back for rules and regulations
Page 4
Minutes: June 26, 11097
306 iViarbleridge Road -
Albert Merrrill, owner, was present. Mr
the $1,000 tie-in fee.
386 MarbleridQe Road-
_ a
MerrilI stated that he also has a problem';
George & Eleanor Gaiiey, owners were present and stated that it will cost them}
Mr. Osgood asked if septic system is working okays YIr. Galley stated he has �`
problems for 42 years - it is pumped and is not in the watershed. Mrs. Gaile s X _ y
had no;...
they are 74 and 75 years old and when they ie their children can handle this.
d
want to stay out of it. Ms. Starr stated that a septic inspection is needed. They
835 Salem Street:
The owners, John & Jody Curtin: were present and stated that their house is four 4
old with a four (4) year old septic. Mrs. Curtin stated that theyjust bought the hou �'
thev do not have the monev to do this. Mrs. Curtin stated that she realizes if the
house they will have to tie-in but the septic system is only four (4) years old. y se A%;
*.
The Board Members understood and told them that the Board, in cases such as this
usually gives them five (5) years to tie-in. Mr. Osgood stated that the Board will get' :`':
touch with them.
30 High Food Wav• „#
t
77442_
Mr. Ron Siergiej, owner, was present and stated that he is presently in financial hardship'.
and was unaware of the S 1,000 fee until he walked into the meeting tonight. Mr. Si
stated that his recent divorce and was awarded custody of his children ages 5 '/. and 2 YL.
Mr. Siegiej stated that he would like to request a little more time. Mr. Osgood stated that;
this is what the Board needs to know - we're not here to give anyone a hard time.
Siergiej stated for the record a notice was sent to him about a vear ago and his wife did y
not forward it to him. Mr. Osgood stated that as long as the Board knows the situation`a 4
we'll deal with the situation. The Board Members agreed to give him time.
Dr. Rizza recommended sending a letter to the Board of Selectmen. Mr. Osgood stated. _
that is a very good idea. Mr. Osgood suggested sending a letter statin that the Board of
Health is having a very difficult time because they re trving to get people to tie-in to
sewer and this fee is an impediment to the public health and this Board will be willin916
meet with the Board of Selectmen to discuss it. Mr. Osgood stated that this is a fee that
the Board of Selectmen instituted - not the Board of health.
N2 2271
ORT
0
Date...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
'114�wul' � �-, r -
This certifies that .. � ............ �:- ................................................
has permission to perform ...... z ... ........
--7 :e-.
wiring in the building -of .. ........ .............................................
...... ........................ . North Andover, Mass.
Fee Lic. NP.��!, .... . .......
INSPECTOR
W/23/99 10:45 25-00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
TB C0MV0AE'f)L2Ht0,T'MA_5,TACHVS= -Office Use only
DEFARTMEI TOFPUBIICSAFM Permit No. 7/
BOARDOFFIREP OIVREGUTATIO1�Sn7CMR12�A0 —'
Occupancy & Fees Checked
U4VPPLICATTONFOR PATO PEff0RMELECrIRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE wiTH THE MAssAcHussTs ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) s �o`l Q �(�'1 St r
Owner or Tenant _� C) L) `�
Owner's Address SG. q -y-, ?--
Is
_Is this permit in conjunction with a building permit: - Yes MNo (Check Appropriate Box)
Purpose of Building �i �0.J"�� �y Utility Authorization No.
-v
Existing Service
Amps /
Volts
OverheadQ
Underground a
No. of Meters
New Service
Amps /
Volts
Overhead [=
Underground
-_�
No. of Meters
Number o;1"eeders and Ampacity
Locatict and Nature of Proposed Electrical Work
No. of Lighting Outlets
j
No. of H,cE Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures j
Swimming Pool Above
Below
Generators
KVA
`ground
and
Flo. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipala
Other
No. of Dryers
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
IrstrartceCo� Ptasua lothen marratscfMass�GeneraiLaws
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FIRM NAME I..,o3seNa
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Telephone No. PERMIT FEE
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OFFICE WILMINGTON PLANT
(508) 664-3101 CUSTOMER'S COPY (508) 658-3602
HEFFRON MATERIALS -
A DIVISION OF HEFFRON ASPHALT CORP.
PLANT: SALEM ST. RT 62 WILMINGTON, MASS. 01887
P.O./JOB NO.
- I -
DATE
� -2 -7
DT
ow
ffLIr' REb TO
THIS I COMPANY IS
OTt$V
iNOMNSIBLE4
FOR ANY DAMAG S
EYO.ND Ttl
SCREENED WASH
' fq�;OFI
E
.11, USHEO.
, .
BANK
SAND SAN
leG I EL
GRAVEL
PEA 1 /2
11/2"
10%
STONE STONE
N
TREATED
SAND
7
TONS
GROSS
TARE
NET
TOTAL
DRIVER
SWORN WEIGHE
REC'D BY H164139
BRADY BL7BVtjV0RUS LOWLCLV,,�
Town of North Andover, Massachusetts
BOARD OF HEALTH
Form No.1
-* I - - . , , , �6 - I -I-
130 19 C, 0
APPLICATION FOR SITE TEST I NG/I NSPECTI ON
Applica
Site Lo(
Engineer
Test/I nspection Date and Time
Fee
CHAIRMAN, BOARD OF HEALTH
Test No.
- qq
S.S. Permit No.-D.W.C. No. C.C. Date-Plbg. Permit No.
Town of North Andover, Massachusetts Form No.1
tAORTH BOARD OF HEALTH
ED 6 0 19
0
APPLICATION FOR SITE TESTING/INSPECTION
TED
CHUS
62,
Applicant
NAME ADDRESS TELEPHONE
Site Location
Engineer
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
15 CHAIRMAN, BOARD OF HEALTH
'--� 11�
Fee Test No.
S.S. Permit No.-D.W.C. No._______C.C. Date-Plbg. Permit No.
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,AORT#1
Town of North Andover, Massachusetts
BOARD OF HEALTH
DISPOSAL WORKS CONSTRUCTION PERMIT
Form No. 3
q--, 9 9.�—
Applicant 'NW—Ah' - M F14W -
UNAME ADDRESS TELEPHONE
Site Location.. 3 'kt�
Permission is hereby granted to Construct V,,) or Repair (
Sewage Disposal System as shown on the Design Approval S.S
Fee toD
) an Individual Soil Absorption
No.
CHAIRMA911�6AITO-6F HEALTH
ir,
D.W.C. No. 5409-
J �
FAF,
TOWN OP NORTH ANDOVER
BOARD OF HEALTH
Location '46-A 1
Permit
Food Service $
'NgVN
Retail F 10 $
Limited Retail SO% �\\e loci
Seasonal
$
Disposal Work*QE-rtallers
$
Disposal Works Construction
$
Soil Testing-
$1
Design Approval Permit
$
Dumpster Permit
$
Burial Permit
$
Swimming Pool Permit
$
Animal Permit
$
Recreational Camp Permit
$
Well Construction Permit
$
Funeral Directors Permit
$
Massage Establishment License
$
Massage Practice License
$
Suntanning Establishment
$
offal/Trash Hauler
$
Other
$
6o.,-
0 *14 4 0
/k,
Hed�tb Agent
White - Applicant Yellow - Dept. Pink - Treasurer
Town of North Andover, Massachusetts Form No. 3
poRTM BOARD OF HEALTH
Of S�.ao .a,h0 19
1� 9
DISPOSAL WORKS CONSTRUCTION PERMIT
,S$ACMUSES
Applicant
Permission is hereby granted to Construct V1-1) or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
CHAIRMA r
A D F HEALTH
Fee D.W.C. No. 565-
i
FORM U
TOWN OF NORTH ANDOVER
LOT RELEASE FORM
SUBDIVISION
ASSESSORS MAP
SUBDIVISION LOT(S)
PERMANENT ADDRESS ASSIGNED BY D.P.W.
STREET,.
APPLICANT C� f�Fjr'�) Zr , PHONE
DATE OF APPLICATION 12 1<7 z
TOWN USE BELOW THIS L1NE
1 �
TOW LANNER
CONSERVATION COMMISSION
�
ci�, 47
CONSERVATION ADMIN.
BOARD OF HEAL
HEALTH SANIT IAN
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT
WATER CONNECTION-QYi7�c
FIRE DEPT. <✓cl c; f��i?c� lz% �� �/
RECEIVED BY BUILDING INSPECTION
PATE AE'PROVED AT-Z--
DATE
REJECTED
SATE APPROVED
DATE REJECTED
I'E APPROVE11)
VE REJECTED
4 /� /q
DATE
1
I (--e 17 i
7/y 2 -
q�
This form shall be signed by the agents of the Plati\iiig incl llealtli tlonrds,
the Conservation Commission prior to the issuance of\any building; perml.ts
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
DATE�o�
Sheet of
BOARD OF HEALTH
TOWN OF NORTH ANDOVER
SUBSURFACE DISPOSAL DESIGN REVIEW
FEEA,�o PERMIT # DATE RECEIVED___,/'
APPLICANT /I.r I��lo ASSESSOR'S MAP
ADDRESS PARCEL #
LOT ##
ENGINEER STREET
ADDRESS
PLAN DATE _ 41,oalel'
CONDITIONS OF APPROVAL:
APPROVED —y- "9/0 �// AQP
DISAPPROVED
REVISION DATE 11h o
%g
oz
� . v
REVIEW CONTINUED
SHEET OF
DATE L) v1
Sheet of
BOARD OF HEALTH
TOWN OF NORTH ANDOVER
/ SUBSURFACE DISPOSAL DESIGN REVIEW
FEE PERMIT # Vro�� DATE RECEIVED
APPLICANTUir �2l ASSESSOR'S MAP
ADDRESS PARCEL #
LOT #
STREET
ENGINEER
ADDRESS J
PLAN DATE REVISION DATE
CONDITIONS OF APPROVAL:
APPROVED
DISAPPROVED
G �� oq. a ,�
0�
Cc Gf% F/ALO �� 13l- Y��L T� (/1/A
/.
�v �i5%/416. "./NZ SP14" #4 V"
!I Ir , A
PLAN REVIEW CHECKLIST
ADDRESS � ENGINEER
GENERAL
3 COPIES STAMP 1/ LOCUS L---- SCALE CONTOURS
PROFILE SECTIONy' BENCHMARK ELEVATIONS SOIL
& PERC INFO WETS. DISCLAIMER WELLS & WETLANDS
WATERSHED DISTRICT1t/6 DRIVEWAY WATER LINE DRAINS
RESERVE AREA SCH40 SLOPE
SEPTIC TANK
MIN 1500G.� ! .17 INVERT DROP L GARB. GRINDER(+200% EDF)
25' TO CELLAR !/ MANHOLE TO GRADE ELEVO/C GW O/C
D -BOX /
# OUTLETS FIRST 2' LEVEL STATEMENTy INLET 9 7.0 --
OUTLET= (2" OR .17 FT)
LEACHING
100' TO WETLANDS 100' TO WE/LLS ,-- 325' TO SURFACE H2O SUPP �
35' TO FND & INTRCPTR DRAINS V" 4' TO S.H.GW / 2% SLOPE t�
4' PERM. SOIL BELOW FACILITY V MIN 12" COVER ✓ FILL? (25' if
above natural elevation; 101 if below)
TRENCHES
MIN 660 FT2 SLOPE (min .005 or 6"/1001) >3' COVER? - VENT
SIDEWALL DIST. 2X EFF. W OR D.(MIN 61) IS RESERVE BETWEEN
TRENCHES? IN FILL? MUST BE 10' MIN.
BOT X LDNG + SIDE X LDNG = TOT
(L x W x #) (G/ft2) (DxLx2x#)
PITS
MIN 660 LEACHING GW MIN 4' BELOW BOTTOM MANHOLE/PIT
EXCAV 2x EFF W OR D 12"-48" STONE SURROUNDING
BOT + SIDE x LOAD = TOTAL
FIELDS
qoo �p x
MIN LEACHING PERC RATE FASTER THAN 20M/IN t-� GW MIN 41
BELOW BOTTOM OF FIELD L,-' PIPE ENDS JOINED W/NON-PERF. PIPE?_::�--
DIST LINE SLOPE .005? >3' COVER - VENT SCH 40,,>C'y
MIN 12" COVER v,-' L x W = T x LDNG > DESIGN FLOW? !--
3
3
Insurance Adjustment Servlce.`4-1 ° T , N
435 King St.,
Littleton, MA 01460 j App 6 fir"
(978) 952-6966
Fax (978) 952-2459` `
UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 3B
Date: April 9, 2004
TO: Board of Health/Building Inspector
" vAr, Myl b Ieq S
RE: Insured: David & Monica Eckman
Property Address: 835 Salem St.
North Andover, MA 01845
Date of Loss: 4/2/2003
Policy Number: HMA1614017
Type of Loss: Water
File or Claim Number: 14574
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable.
If any notice under Mass. Gen. Laws, Ch. 139, Sec. 38 is appropriate, please direct it to the attention of the
writer and include a reference to the captioned insured, locations, policy number, date of loss and claim or file
number.
Thank you for your cooperation.
Ver)yrruly
Mike Atri
Adjuster
Ext. 111