HomeMy WebLinkAboutMiscellaneous - 99 GLENNCREST DRIVE 4/30/20187��
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BOARD OF HEALTH
146 MAIN STREET
TELEPHONE# (508) 688-9540
APPLICA TION FOR ABA NDOA:k f E, NT
OF SUBS(-RFACE DISPOSAL SYSTE'd
(SEPTIC SYSTEM)
Pursuant to Section 310 CMR 13.334
of the State Environmental Code, Title V
Name
Address
Contractor I ired for work:
Name
Address rbc? A A
Phone
Phone
Date for scheduled abandonment I l '-r-3 -9 q2
The septic system at the above address has been abandoned according to
Title V specifications.
Signature of antractor
Method of septic tank abandonment (check one). () removal (} sandfill
(crush ( ) other
Name of Offal Hauler
This form must be returned to the North Andover Board of Health
PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH
REPRESENTATIVE'S USE ONLY.
Inspecting Agent Date
FORM U - LOT RELEASE FORM
7i -e_ la
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and ^impartments 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 SECTION T
(,/APPLICANT ��� ��t ��� ��r PHONE
iV LOCATION: Assessors Map Number PARCEL_
SUBDIVISION
v$TREET i %� L%lam N % ^,_'.; -,�� `
ST. NUMBER 1 f.
"OFFICIAL USE ONLY
DATIONS OF TOWN AGENTS:
ATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECT HEALTH DATE APPROVED
/% DATE REJECTED
TH DATE APPROVED
DATE REJECTED
COMMENTS
iv/ 1A-- 16l),
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
JUEA ELECTRIC COMPANY, INC.
ELECTRICAL CONTRACTORS
589 Chickering Road • No. Andover, Massachusetts 01845
(508) 683-8831 s Fax: (508) 689-8784
TO Mr k "irs R.M. Trela
Sg Glencrest D;:,
No. Andover. :lA 01845
ORDER NO. B99-7-5/2
DATE
Nov W. 196
Checked defective pump for amperage anc, wired new
pump and checked system.
Check power and connections to sewage pumps
and disconnect one feed to pump one and remove
wire from coil to jogging relay.
2 Service calls -
S '�)6.0G'
S 90.00
R J. Salemme Plumbing & Healing
50 Boxford Street
"1dQ North Andover, Ma 01843
S08-686-0820
BILL TO:
Aft. & Mrs. Trela
99 Glencrest Dr.
North Andover, Afa 01845
DESCRIPTION
Try to repair pumps and piping butfound that
one pump was no good and the piping for the
Other pump was broken. Remove both pumps
.Install the pump that was working and
completdy repipe it 4A new check valve and
pressure clamps
Labor 16 man hrs.
Materials
77tank you for your business.
TOTAL
Invoice
DATE INVOICE #
9/29/96 1344
AMOUNT
720.00
75.55
79.5.5.5
SHIPPING
BILLING
PURCHASE Q
J�C SERVICE
lectr 0tor ser
vice
206 NORTH STREET, NORTH READING, MASS. 01864, (508) 664-3121
TO _ "sem y 7-.4�'/A
Received by
�P�
i Date Shipped Via Customer P.O. No. rj�r L Terms
inval Date Salesman Gemsco Job No.
/6 ,?� p?'6 —� Exe
Quantity nog, �;.,,; .. �� ax
Warranty void without this sales receipt.
A finance charge of 1.5% per month will be charged to all balances over 30 days.
/z0 T?3,r
Price
System Owner
Commonwealth of Massachusetts
Massachusetts
WN OF NORTH ANDOVEI
BOARD OF HEALTH.
AUG 5 1996
System Pumping Record
System Location
--/ Date of Pumping: �� �� Quantity Pumped: (GQ) gallons
Cesspool: No Yes ❑ Septic Tank: No ❑ Yes
System Pumped by: 64%`P&W 454ni License #
Contents transferrred to : Greater Lawrence Sanitary District
Date: Inspector:
System Owner
Li�7(e,UR
Commonwealth of Massachusetts
Massachusetts
System Pumping Record
System Location
Date of Pumping: — C 9 fI::, Quantity Pumped: ( Cts— gallons
Cesspool: N Yes ❑ Septic Tank: No ❑ Yes
System Pumped by: 64&4" &*014" License #
Contents transferred to : Greater Lawrence Sanitary District
Date: Inspector:
System Owner
Cl-
Cr tnmanwealth of Massachusetts
Massachusetts
System Pumping Record
Systern Location
99
Date of Pumping:. (c) -4 l —q,G Quantity Pumped: gallons
Cesspool: No Yes ❑ Septic Tank: No d Yes
System Pumped by: Saw" 45a&'rA� License #
Contents transferrred to Greater Lawrence Sanitary District
Date: Inspector: