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Building Permit #789 - 33 CRICKET LANE 6/1/2007
BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONAV Permit NO: 0 Y Date Received 5 �� x I DESCRIPTION OF WORK TO BE PREFORMED: H 7 Identification Please Type or Print Clearly) CI3 6 416 T ia�-�� OWNER: Name: n y & D/k-T,1A 1, e1 =sa, Phone R19 -M -11o2� Address: tJo. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: FEE: $ OL' `t Check No.: gE s--- Receipt No.: 00 0 S11-4-- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Location 1/4/ 12` No. 772 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ MUs �Building/Frame Permit Fee $ Foundation Permit Fee $ ' Other Permit Fee $ TOTAL $ Check #� 2021 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes _ Planning Board Decision: Comments Conservation Decision: Water & Sewer Connection/S Located at 384 Osgood Street Comments Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine No Doc.Building Permit Revised 2007 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ BuHdin�r '§tion ❑ Ce, e� 1° Plan 'oWorkers Comp Affidavit �o Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract ❑ - /Elevation Plan Of Proposed Work With Sprinkler Plan And FlydFooke-eatcuiations (If Applicable) ©—*ll'i'ic Energy Compliance Report (If Applicable) _R94;ee4nn Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must.then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 �I Z O FM4 x chi o w ro w° o n44 U w a w a°' w a w w p°G co w w o°G co0 w rE o cn cn � o � o � e C.) C.3 dC W � 00000 E o � r �1 E Q C 0 ' CL m v4co Cyt-. w c" C c E H r %/� W v, Cl3 w Co a- ; _ y C C W o m �` • o nc�o � m' — N o m CCcm C OQ m g z o c o •~ o, � c n Q o m c o No _ •ate 3 COD at ID W O �rrtt .� .LIJ P— to cz`°5 z W E �90o� o �J0 CL h v • OmC S F-1 d Z w CO O F- t $ ai M 13 r6 I � cm C CO) , O .� w± CDQ H 'g m m CL t O� Ca r O a ii cmox CO2 � c O L 'p C. O CD C m C.) CL ev � C C to CO) N Y% 19 w 19 W U) Gerald A. Brown Inspector of Buildings Please p r DATE: TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION Telephone (978) 688-9545 Fax (978) 688-9542 JOB LOCATION: 44 Lg lC I< F. l l A k &-N I l /� O 21 Number street AddressW 1 a�g ,�, i 1(p,27 pilar Home Phone PRESENT MAILING ADDRESS P. O- eza. i Acl 4 Phone A-r.IYJ 2 MAA o0 l O City Town State Zip Code The cur W exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code *tion 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE_ APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF 1 HAIS6gg-954► CONSERN'XrION688-9530 IIE-U-111688-95.10 PLANNING 688-9535 North Andover Board of Assessors Pullic Access Parcel ID: 210/107.A-0214-0000.0 SKETCH Click on Sketch to Enlarge Community: North Andover PHOTO No Picture Available Location: 44 CRICKET LANE Owner Name: AMES, JOHN S LISA ANN AMES Owner Address: 44 CRICKET LANE City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 7 - 7 Land Area: 1.01 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 2786 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 556,600 519,800 Building Value: 341,400 320,700 Land Value: 215,200 199,100 Market Land Value: 215,200 Chapter Land Value: LATESTSALE Sale Price: 1 Sale Date: 11/28/2000 Arms Length Sale Code: F-NO-CONVNIENT Grantor: JOHN S AMES Cert Doc: Book: 05934 Page: 0330 http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&Linkld=809424 Page 1 of 1 r 4 v N N O O O O N N N r - � O ooU�U o N 0 aj co J (p N O m 0 m X a U U) U C t7 U N U) (p O N C " uai o (nn a S�wUG O O F- d o c ai •° T � C m O W mU 0-0 (a caa� 3 g �H�� c H W Y U CD m U oo U) 0 E `m W oo m ani o U maU y U 'D W 0 0Q o a ofJ CO) o a� N = O 0 aQr�d1L0 2 0 a a o mo o:?a c o a0H> `O m y O O ao ma)a)a)� n 0 U) F- U) in in w C7 of <D r r, O r N0 O H N r U m N o 0 6i O J L Q m O_mQ c m c a �?UiL3 E Q �HHFo- W ti O a Q O Z O 0 O � O a co o O o Q Z 2 OJ W Q' O V N Z W Z LU J O N Q' =Q wG a OZ Y¢ U J CQ _ a' c W CO) NSC) L O Q QJ�vz a o Q V, ' T" O r N 0) cc a O O N r - N N �- U 00 O Y Y 3-! i N It 0C O O N r Z `o rn } Z N •- 0 ZN � C -o �Zas 10 r OJJ ON Quo Z oo I LL Zoo Z~ +'O U. (D MM o Q y to Cl) _7 Q J �rn G.c m �mm m cn Q 0 0 0 0 Z (oc� d arr CO 0) LO— O00 LOLf) P- U�r W G a O @ v Paa t': �0- o o C o O Z U)—N U a O 0 r a a r r r M M i� Q r N N L O c6 O O) c0 (0 a, Q � ..��iio N� w U � _ JQ Cm L` gm E Z wto0 cn L �L .,-I c U Y o o - c In In <MLLM a2w00 N $y rI ,o a^*� Mta I I C� y 0 c ccMM Go Go0 t V ny ar-W N CY) CD �� O ra-I ~ n 00 0 f6 N w Qomidm y o� N N 0 cQQ mQ �'� o Ea mm FIs Z CLL ai V o } 0 m kc ,@ 0."o w m e r.+ }:m cc N mom V ��QDFo- w>- CL o *i . Z 0 Nr Q 24 rl 6 V% LO LL � n m rI P1 N v rIm X E �' yLU =LL @ UUP E�..L 7L f0 f0 U% Oo(� O 7 O O O �mC1(J•._�. �� L Omm N def MN km km m O N 7 f6 m 'U-' X E i y HmtL=WmYW co ca N MO N U�C9a U Z LM F- p uiU = = mzm >1 Z oc U o O N O O O 4) C x o a) �._ a� cncn=w2U- 2ti ` O Li Y cn away T" O r N 0) cc a aD f )6001 Ox 4_ COCNIC NlWKM ^ PUBLIC HEALTH DEPARTMENT Community Development Division CE12,7IEICATE Off' C09YPLIAUM As of: .May 24, 2007 ,his is to certify that the individual subsurface disposal system received a SA,ISFAC7'ORTINSTEMOYof the: Fuf(Septic SystemRepair By Mike Reiffy At: 44 Cricket Gane North Andover, 5WA 01845 ,he Issuance of this certiftate shall not 6e construed as a guarantee that the system will function satisfactorily. ' usan If Sawyer, REjfS1W S Tu6lic Ylealth Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com PUBLIC HEALTH DEPARTMENT Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM — INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (- constructed; ( ) repaired; (Print Name) Located at:. 4+ (Installation Address) RECEIVED MAY 10 2007 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Was installed in conformance with the North Andover Board of Health approved plan, originally dated S -' �(I _0G, and last revised on (-?t -t2(�o , with a design flow of 4,-A v gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310. CMR 15.000, Title 5 and local regulations, and the final. grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bottom of Bed Inspection Date:',L Engineer Rep tat ve (Signature) w Du �e, And - Print Name Final Construction Inspection Date: 5- 7J'•'� �j - [�,� ,� Engineer Representative (Signature) �f L:L.. �t1, �►'C.E�y�� And - print Name (Signature) Date: d'—, Lj-07 mss.,.. And - Print Name Enginer. M Signature) Date: o CIVIL No.39840 c' NAL And - Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476. Web http://www.townofnorthandover.com AS -BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, JN,C-I;UDlNG--RESERVE, 4% z� , , f -- TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D -BOX ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW LOCATION & ELEVATIONS OF BENCHMARK USED r 5 mftm N y tt�,s.. X67 ryO O 1� 9_ coc.ucwrK■ . PUBLIC HEALTH DEPARTMENT Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: MAP: LOT: evy INSTALLER: jZL 11 r `' �� �iy DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: "-//)-7ax DATE OF BED BOTTOM INSP TION5-11e�Za�7 DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: sla51017 SITE CONDITIONS Comments: SEPTIC TANK ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered []� Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Watertightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 5 O �- 70 Z'x PUBLIC HEALTH DEPARTMENT Community Development Division ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Watertightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: DISTRIBUTION -BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution F1Speed levelers provided (not required) Comments: 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com N �N PUBLIC HEALTH DEPARTMENT (ommunity Development Division SOIL ABSORPTION SYSTEM/(General) ® Bottom of SAS excavated down to 6 in into C soil layer, as provided on plan `P Size of SAS excavated as per plan [ Title 5 sand installed, if specified on plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel -less Chambers) ❑ Brand and Model of Chamber Infiltrator Quick 4 ❑ Number of chambers per row ❑ Number of rows (trenches) ❑ Laterals installed and ends connected to header (and vented if impervious material above) ❑ Elevations of laterals and chambers installed as on approved plan Comments: CONTROL PANEL Comments: ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside ❑ Alarm signal located inside 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com U NORTJ i `T O L11"I T/ �OCMICIN.a..7' PUBLIC HEALTH DEPARTMENT fommunity Development Division SYSTEM ELEVATIONS 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com 4 INVERT INFIELD PLAN INVERT ELEV. Benchmark Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN, Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 INV Lateral 1 TOP Lateral 2 INV Lateral 2 TOP Lateral 3 INV Lateral 3 TOP Lateral 4 INV Lateral 4 TOP 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com 4 0 NORTH Q�ttL20 161ti 3� °6'��- •6 O0 O A► Y� t r AO awNt tOCMKMwtw y a_0 ATaD �.y PUBLIC HEALTH DEPARTMENT Community Development Division CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other) Foundation 10 (5) 20 (10) ❑ Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Commonwealth of Massachusetts Map Block -Lot 107.A- 0214 - ----------------------- Board of Health Permit No M * BHP -2006-0742 North Andover ----------------------- �' P.I. FEE �,"••.,�� •r" h $250.00 'I'S ..�st� F.I. ----------------------- Disposal Works Construction Permit Permission is hereby granted Mike Reilly-------------------------------------------- to (Construct) an Individual Sewage Disposal System. at No 44 CRICKET LANE ------------------------------------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP -2006-074 Dated --November 20,-2006 Issued On: Nov-20-2006 ---------------------------------- -------------------------------------------------------------- Board of Health H°Rr„ q Application for Septic Disposal System AConstruction Permit - TO�K�N OF I j b I / P -4o TODAY'S DATE J.Klill�' ORTH ANDOVER MA 01845 $ 250.00 — Full Repair $125.00 - Component Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. v �I ienan Application is hereby made for a permit to: ❑ Construct a new on-site sewage disposal system* E,Zepair or replace an existing on-site sewage disposal ❑ Repair or replace an existing system component — A. Facility Information Address or Lot # mEZECEIVED TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Nor Y 1 oyG City/Town 2.- *TYPE OF PTIC SYSTEM*: ❑ Pump ravity (choose one) ** pump system, attach copy of electrical permit to application*** Conventional System (pipe and stone system) RECEIVED NOV 17 2006 TOWN OF NORTH ANDOVER ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification todins ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. Owner Information � n l3rrne, Name ,,smw -e, Address (if different from above) City/Town State Zip Code Telephone Number 3. Installer Information MIG�i�e l Pei/�y �' Aei M, ��r�sTIne Name Name of Company C10(a Address City/Town State Zip Code s- � // Telephone Number (Cell Phone $f if possible please) 4. Designer Information NsIme Name of Company ql)17 &n 6111d" Address WOMMIrn A& City/ToWA State Zip Code 97$-�s�-,ss� Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 °RrApplication for Septic Disposal System 4ao .a gti0 p Construction Permit - TO�K1N OF TODAY'S DATE NORTH ANDOVER, MA 01845 $ 250.00 - Full Repair • $125.00 - Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Building: �sidential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issued b this Board of Health. "e -,//r1 7 - Name' l Date Applica Approved By: and of Health Representative) I / `N a Date / / O (�-.. Application Disapproved for the following reasons: For Office Use Only: 1. Fee Attached. YPes t � f q 2. Project Manager Obligation Form Attached. I Pump System? Ifso, Attach copv ofElcctrical Permit 4. Foundation As -Built. (new construction ronly): (Same scale as approved plan) 5. Floor Plans? (new construction only): No No Noj,l No Application for Disposal System Construction Permit • Page 2 of 2 ,P 11/20/2006 12:18 9786886476 HEALTH PAGE 02/82 SEPTIC SYSTEM INSTALLER PROJECT MANAGElMENT OBLIGATZOIN'S As the North Andover &ewed instaner fot the construction for the septic syst M for the property at LJ (Address of geptic Mtem) / Relatirac to tl+c applin,ton of �gel�a1�LT � nst4llGt�s nwnc) Dated r �.;���� 1 arc Fox plans by _ A'// Da. {.8ap�ne/cr) And daoed A a vPtthrcvisioasdated it`s-.��-.mob psit revised date) I understand the following obligations for MAnagment of: toss projeM 1. As the installer, I am obligated to obtain all permits and Board of HealtbL approved plans prior to performing any work on a site. I must have the armlox , flap§�nd:its wbM ani -=k . beim done. 2. A4 axe- i0ston, T must can for. any and sill inspections. If homwwnm eonuamt, project baWAW, or My other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the neceseaq work co=pleted pxxox to tile applicable inspections as indicated below. Tunderstastd th2t reauestinv An 'ncn�ctio� wi c ro�et,�on of the items in accordans My_company. a. Bottum of Bed - Gesxerally, this is the Ent (1') inspection unless there is a retaining wail, whicb shouid be done first. The installer must request the inspection but does not have to be present b. Final C truedo nsptcti _ - E noom must fiat do their inspection for elevations, ties, etc. As -built of vetbal OK (or a -mail to: from the engineer must be submitted to the Board of Health, after which installer calls for an inspection, time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade - Ia;staller must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other Ann rzmpk occrrmanoff) and I Wn xequixed to complete the installation of the system ide ntiFtd in the attached applicatioa for iustalktion. b ut r_x and tha work c s in can masons f g de al of theme stem and/or revocation or su_ prc�frpq li to o�erato in the Town of NoWLAUdover 47aff nes to Aj j=ms inval tdao p4sss_ble 3. As the installer, I undcrstand that I must be on-site during the performance of the following constructioa steps: a. DrrezML=&0,v that the proper elevarr+vn of the a cAr adaa Am been .reached b. Ausperdan of the sand end swat re be used. C ,Final inspection by Board ofHeaftli eftffor eonsalimne d Installatroa ofra* D Boar, pipes, ,stone, vents pump chamber, jenunhW wall and other componenrs. 6. AsAe inRtalltr I understand that j,�solelY nn, eubk fol be• i„ers�lagon of the wte_m as per t ap�-oved n��ns. No instrucgcs,Siy 1:1+P l�otneoatnec. gen—conm Ab ohne me Of t'•iiS t)blipat70i7. Undersigned Licensed Septic Installer:(Today's Date) NOV 21 2006 Z d ZM-9 �WALTH OF NORTH DEPARTM ANDOVER AII!ay 'M IeBWIW 'JN S0£:OL 90 LZ AoN (blame vnnt) (Name _ RECEDE® 7 NOV 21 2006 Z d ZM-9 �WALTH OF NORTH DEPARTM ANDOVER AII!ay 'M IeBWIW 'JN S0£:OL 90 LZ AoN TOWN OF NORTH ANDOVER . TtORTk 9 Office of CO11- MI.INITY .DEVELOPMENT AND SERVICES a`" a';`y�� HEALTH DEPARTMENT 400 OSGOOD STREET fl .NORTH ANDOVER, MASSACHUSETTS 01845 �'�s�t,;,;��``� Susan Y. Sawyer, RE HS/RS Public Health Director SEPTIC PLAN SUBMITTAL FORM Date of Submission: 97j�,� —cpCo 978.688.9540 _ Phone 978.688.8476 FAX E-MAIL: healthdeptr)towndhodhandover.com WEl3S1'1'1';: http://www.townolilorthandover.com Site Location: -44 G Zl C Z A lit: Engineer:�11 AUG 2 9 2006 TOWN Ut- NORTH ANDOVER HEALTH DEPARTMENT New Plans? Yes V $225/Plan Check # t� ` (includes 1St submission and one re- review only) Revised Plans?Yes $75/Plan Check # Site Evaluation Forms Included? Yes ✓ No Local Upgrade Form Included? Yes 'N—" No Telephone #(12 )L475; ��?'S'S�� Fax #: 037J) ` 75–t cf q - E -mail: l��l�.►1,�IJfi Cyi�OL. GoM Homeowner Name: dcal 0 A" 0 7 OFFICE USE ONLY When the submission is complete (including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ . opy File; Fozward to Consultant ➢ Enter on Log Sheet and Database TOWN OF NORTH ANDOVER NpRT#q Office of COMMUNITY .DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 3'Ss";CHU Susan Y. Sawyer, RENS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX September 26, 2006 Steven Eriksen, R.S. Merrimack Engineering Services, Inc. 66 Park Street Andover, MA 01810 Re: Wastewater Treatment and Dispersal System Plan for 44 Cricket Lane, Map 107A, Lot 214 Dear Mr. Eriksen: The proposed wastewater system design plans for the above site dated August 16, 2006 and received on August 29, 2006 have been reviewed. Unfortunately, they cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item. 1. Please retain a wetlands scientist to assess the possible wetlands resource area which was identified in the rear of the parcel during soil testing. Additionally, please provide the North Andover Conservation Commission's confirmation of this data 2. Please clarify if the design is or is not intend to provide for the use of a garbage grinder in the dwelling 3. Please provide for a design which accounts for the correct separation between the bottom of the soil absorption system and the estimated seasonal high ground water based on the percolation rate observed of < 2 minutes per inch. Please also clarify the notation on the design plan to clearly reflect this. 4. Please clarify orifice size in the piping of the soil absorption system (25 1) 5. The design plan indicates the use of an effluent filter inside the primary (septic) tank. This is generally advisable, however please indicate to the installer the brand and model to be used, and please indicate for the owner the required annual maintenance (227) 6. Please indicate the distribution box outlets are to be at the same elevation as each other (232) 7. Please describe the method to be used to abandon the existing on-site wastewater system (354) 8. The entire parcel, especially the southern property boundary, is not depicted. (220 and NA 8.02j) This may be shown on a separate sheet if desired as this information is not integral to the design 9. Please indicate that the building sewer is to have watertight joints and is to be laid on a continuous grade in a straight line (222) 10. Please clarify the notation regarding a primary (septic) tank effluent filter. If one is to utilized, it must be a brand and model approved for use in Massachusetts. Additionally, annual maintenance is required and should be indicated on the design plan so the owner can become aware of this necessary task (227) 11. Please provide buoyancy calculations for the tank (22 1) 12. Please specify proper base beneath the distribution box (221) 13. Please indicated the required placement of magnetic marking tape or comparable means around the on-site wastewater system (22 1) 14. Please provide additional topography of the existing ground in the vicinity of the proposed grading towards the southern portion of the soil absorption system 15. Please provide for inspection port(s) in the soil absorption system (240) 16. Please review the request for a Local Upgrade Approval. As indicated in the regulations, there are a series of reduced design standards which may be requested in specific order using the Local Upgrade Approval process. It is not apparent that some of the other design standards may not be amended to allow for the gravity flow system. In addition, simply providing a gravity flow system versus a pump system is typically not a reason which provides any type of public health or environmental equivalent to a complying design. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Since , usan Y. Sawyer, REHS/RS Public Health Director cc: Owner File Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer [info@millriverconsulting.com] Sent: Wednesday, September 27, 2006 12:32 PM To: Grant, Michele; Lisa Kozel LeVasseur; Marianne Peters; DelleChiaie, Pamela; Sawyer, Susan Subject: 44 Cricket Lane plan review Attached is plan disapproval for 44 Cricket Lane. Major concerns are the design is not based on 5' from SAS to ground water, that an inappropriate LUA is being sought, an incomplete description of the topography, and a potential wet area on the site. Minor concerns are also numerous. Dan Z I Daniel Ottenheimer, President Mill River Consulting, Inc. On -Site Wastewater Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com dano@millriverconsultina.com 9/28/2006 0 MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL (978)475-3555,373-5721 • FAX (978) 475-1448 • E-MAIL: merreng@aol.com October 24, 2006 Susan Sawyer Public Health Director 1600 Osgood Street Building 20, suite 2-36 North Andover, Ma. 01845 RE: 44 Cricket Lane Dear Ms. Sawyer: P!-r'EIVED O C r 2 4 2006 H ANDOVER HEAL Frl DL:F RTMENT We are in receipt of your review letter dated 9-26-06 for the above referenced site. We have revised the plan in response to items 1,3,4,5,6,8,9,10,13 & 15 of your letter. With regard to item 2,7,9 & 12, these items already exist on the plan and were missed by the reviewer. With regard to item 8, a separate plan is submitted herewith which shows all property boundaries. With regard to item 11, this is not required as the septic tank is not within the water table. The bottom of tank elevation has been added to the plan to demonstrate this. With regard to item 14, this issue no longer exists since the system has been moved away from this area. Lastly with regard to item 16, we respectfully disagree with you in that 15.405 clearly states that economic feasibility of the upgrade cost should be considered. In this case the only L.U.A. being requested is from the bottom of the S.A.S to the E.S.W.T from 4.0 ft. to 3.9 ft.and to deny this request would be unjust. Granting this request would eliminate the need for a pump saving the home owner approximately $ 3000.00. We feel we have adequately addressed your concerns and request to be placed on your next B.O.H. meeting agenda to discuss the requested N.A. waiver and plan approval. V•. Very truly yours, MERRIMACK ENGINEERING SERVICES, INC. a William Dufresne, Project Manager MERRIMACK ENGINEERING SERVICES INC. Engineers • Surveyors • Planners g 66 Perk Street ANDOVER, MASSACHUSETTS 01810 (978) 475-3555 Fax (978) 475-1448 TO WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via ❑ Shop drawings ❑ Copy of letter ❑ Prints ❑ Change order ❑ Plans ❑■ LETTER OF TRANSMITTAL DATE JOB NO. fro. -fib ATTENTION RE: G � UT 2 7 2006 TOWN OF NORTH HEALTH DEPARTMENT ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION r l C -c" THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ For your use ❑ As requested REMARKS ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO io eel r- I,mer :7Eq S 0-A-0 FlIMSA ` C24 SIGNED: If enclosures are not as noted, kindly notify us at once. 0' -COLD ,bx'ryO� 0 .1 11'0 ��iy� !y •y' T O'O COCwc.YWKa _�' PUBLIC HEALTH DEPARTMENT Community Development Division October 30, 2006 John Ames 44 Cricket Lane North Andover, MA 01845 RE: Septic System Design, 44 Cricket Lane, North Andover, Map 107A, Lot 214 Dear Homeowner, The North Andover Board of Health has completed the review of the septic system design plan for the above referenced property, submitted on your behalf by Merrimack Engineering Services, dated, August 16, 2006 last revised October 24, 2006. The design has been approved for use in the construction of an onsite soil absorption system (S.A.S.) for the existing 4 -bedroom dwelling. At a regularly scheduled Board of Health meeting, held on October 28, 2006, the board voted unanimously to allow the variances as listed on the plan. Local upgrades 1) Distance from S.A.S. to Estimated seasonal high water table from 4 feet to 3.9 feet N. Andover variances 1) Distance from S.A.S. to BVW from 100 feet to 51 feet This plan is valid is valid for two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. During this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid. This approval is subject to the following conditions: 1. The attached DEP Form 9b must be submitted by the homeowner to the appropriate Regional Office of the Department of Environmental Protection; Bureau of Resource Protection, Mass DEP NERO, 205B Lowell. Street, Wilmington, MA 01887 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe or imply compliance with any of the aforementioned requirement. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you may have. 7's , /f. Sawyer, REHS/R.S Public Health Director Encl: list of licensed septic system installers Form 9b Cc: Merrimack Engineering Services 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com hnportant: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key- 00 ey-0ISI Commonwealth of Massachusetts - City/Town of /y, Local Upgrade Approval ..- , �� , Form 913 ) 5 9 DEP has provided this form for use by local Boards of Health if they choose to do so. I".V I V The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information 1. Facility Name and Address John Ames Name 44 Cricket Lane Street A00ress North Andover City/Town 2. Owner Name and Address (if different from above): Name City/Town MA State Street Address State 01845 Zip Code Zip Code - -- Telephone Number 3. Type of Facility (check all that apply): X Residential ❑ Institutional ❑ Commercial ❑ School 4. Desion flow ner 31 n CMR is; 9n -A• 440 5. System Designer: 66 Park Street Address B. Approval 9130 Steven Erikson Name Andover City/rown 1. Local Upgrade Approval is granted for: Reduction in setback(s) — specify: ❑ Reduction in SAS area of up to 25%: PE x RS MA State, ZIP SAS size, sq. ft. i reduction 44 Cricket Lane 9b 10.30.06.doc • rev. 5/02 Local Upgrade Approval• Page 1 of 1 Commonwealth of Massachusetts City/Town of b Local Upgrade Approval Form 9B B. Approval (continued) x Reduction In separation between the SAS and high groundwater: Separation reduction 1 feet ft. Percolation rate 11 min./inch Depth to groundwater 3.9 ft. [j Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): Distance from SAS to BVW from 100 feet to 51 feet List variances granted requiring DEP approval: N. Andover Health Dept. Approving Authority Susan Sawyer, Director 10/30/06 Print or Type Name and Tftle ature Date 44 Cricket Lane 9b 10.30.06.doc • rev. 5/02 Local Upgrade Approval• Page 2 of 2 Commonwealth of Massachusetts City/Town of V-V� U Local Upgrade Approval Form 9B DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information 6nportant: when ming out 1. Facility Name and Address forms on the computer, use John Ames ordy the tab key Name to move your 44 Cricket Lane cursor - do not Street Address use the return key. North Andover MA 01845 City/ToMm State Zip Code VQ 2. Owner Name and Address (if different from above): Name Street Address Cityrrown State Zip Code Telephone Number 3. Type of Facility (check all that apply): X Residential ❑ Institutional ❑ Commercial 4. Design flow per 310 CMR 15.203: 5 System Designer 440 gpd Steven Erikson Name 66 Park Street Andover Address City/Town B. Approval 1. Local Upgrade Approval is granted for: Reduction in setback(s) — specify: ❑ Reduction in SAS area of up to 25%: ❑ School PE x RS MA state, ZIP SAS size, sq. ft. % reduction 44 Cricket Lane 9b 4.30.07 • rev. 5/02 Local Upgrade Approval* Page 1 of 1 Commonwealth of Massachusetts Cityrrown of Local Upgrade Approval Form 9B B. Approval (continued) x Reduction in separation between the SAS and high groundwater. Separation reduction 1 feet ft. Percolation rate 11 min./inch Depth to groundwater 3 ❑ Relocation of water supply well (explain): ft. List local variances granted not requiring DEP approval per 310 CMR 15.412(4): Distance from SAS to BVW from 100 feet to 51 feet List variances granted requiring DEP approval: N. Andover Health Dept. Approving Authority Susan Sawyer, Director Print or Type Name and Tide 4/30/07 Date 44 Cricket Lane 9b 4.30.07 • rev. 5102 Local Upgrade Approval* Page 2 of 2 MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS LAND SURVEYORS PLANNERS 66 PARK STREET • ANDOVER, MA 01810 • (978)475-3555,373-5721 • FAX (978) 475-1448 • E-MAILlnfo@merrimackengineedng.com April 25, 2007 Susan Sawyer Director of Public Health 1600 Osgood Street Bldg. 20 Suite 2-36 North Andover, MA 01845 RE: 44 Cricket Lane Dear Ms. Sawyer, RECENLED MAY 0 1 2007 TOWN OF NOR-rH ANDOVER HEALTH DEQ�RTfv!FNT The Contractor, Mike Reilly, encountered field conditions different from the approved plans such that the actual sewer pipe invert is approximately 7inches lower. Because this is a gravity system, the entire system will be lowered by that amount. As we discussed, the current LUA approval allows for a reduction to the water from 4.0 ft. to 3.9 ft. I have sent a revised copy of the Form 9A -Application for Local Upgrade Approval reflecting a revised request to allow the system to be no lower than 3.Oft. from the estimated seasonal water table. Since construction is under way, time is of the essence. We appreciate your prompt and considerate attention to this matter. Very truly yours, MERRIMACK ENGINEERING SERVICES, INC. William Dufresne Project Manager Important When MV out tams on the computer, use only the tab key to move your Cursor - do not use ft return key. VQ Commonwealth of M>alssschuseft City/Tom of Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the some as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for time upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed In accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 314 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that Includes the addition of a new design flow to a cesspool or privy, or time addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information 1. facility Name and Address: John Ames Res Name 44 Cricket Lane Wreat noaress North Andover MA 01845 Citylrown state Zip Code 7. Owner Name and Address (If different from above): John Ames Name Wayland CWTown 01778 Zip Cods 3_ Type of Facility (Check all that apply): 21 Residential ❑ Institutional 4- Describe Facility- 4 acility4 BDRM House 5. Type of E)dsting System: ❑ Privy © Cesspooi(s) 18 Old Farm Road street Address MA stab (978) 758-8033 Telephone Number ❑ commercial © School ® Conventional ❑ Other (describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): t%rm9sl40c # rev. 7106 Application for Local UNrade Approval• Page f of 4 Commonwealth of Massachusetts C4rrown of kvForm 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. tither 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 lcxrri they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flaw of existing system: Design flow of proposed upgraded system Design flow of facility: B. Proposed Upgrade of System 1. Proposed upgrade is (check one): 600 epd 440 W 440 ON- voluntary El Required by order, letter, etc. (attach copy) Required following Inspection pursuant to 310 CMR 15.301: date of IrupaAion 2. Describe the proposed upgrade to the system: Total aoement New 1500 gal tank, gravity flow to 2 tranches 31Nx1'Dpx�4'L 3. Local Upgrade Approval is requested fear (check all that apply): 0 Reduction in setback(s) — describe reductions: 0 Reduction in SAS area of up to 2596: SAS size, sq. fl. 0 Reduction in separation between the SAS and high groundwater: Separation reduction Percolation rate Depth to groundwater % reduction t5formWeloc • rev. 7/W Amllcation far Local Upgrade Apprmml• Pap 2 of 4 Commonwealth of Massachusetts City(fown of Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the zo a as that provided here. Before using this form, ehecic with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 124nch separation between inlet and outlet toes and high groundwater ❑ Use of only one deep hole in proposed disposal area [� Use of a sieve analysis as a substitute for a pare test ❑ Other requirements of 310 CMR 15.000 that cannot be met -- describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom c f the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The sW1 oaalueW moo be a monbar or ageW of the local approving suftwity. High groundwater evaluation determined by: Randy Burley Evaluators Name (type or p*d) signature C. Explanation Date of evaluation Explain why full compliance, as defined In 310 CMR 15.404(1), is not feasible. (Each section must be completed) I- An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Full compliance would result in use of a pump causing unreasonable financial burden 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: NA t5fomti0a.doe 6 rev, 7/08 Application tar Local Upgrade Approval* Page 3 of 4 Commonwealth of Massachusetts City/Ta wn of Form 9A - Application for Local Upgrade Approval 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. C. Explanation (continued) 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible.- None easible: None Available 5_ The Application for Local Upgrade Approval must be WCompanied by all of the following (check the appropriate boxes): 0 Application for Disposal System Construction Permit ® Complete plans and speclfiotions ® Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). El other (List), Do Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, aacourate, and complete. I am aware that: there may be significant consequences for submitting false information, Including, but not limited to, penalties or fine and/or Irnprillimment for deliberate violations_" Fodilly Owner's Signature John Ames Print Name Bill DufresraWlerrirnaack Engineering Services Name of Prepaw 86 Paris Street Preparers &wren MA 01010 PrP Code — t5rarrn9a.doe • rev, 7/01,1 Dift 4-25-07 Dela Andover c"rrown (78) 475.3555 Telephone Application for l_oml /Upgrade r4pprovela Page 4 of 4 DelleChiaie, Pamela From: Sawyer, Susan Sent: Tuesday, May 01, 2007 11:39 AM To: DelleChiaie, Pamela Subject: RE: 44 Cricket Lane He must has faxed or sent and faxed, because there is one in the file already. I already did another 9B form and placed it in the file. s -----Original Message ----- From: DelleChiaie, Pamela Sent: Tuesday, May 01, 2007 11:31 AM To: Sawyer, Susan Subject: RE: 44 Cricket Lane Importance: High A letter came in on this one. It is in your box. -----Original Message ----- From: Sawyer, Susan Sent: Tuesday, May 01, 2007 11:30 AM To: DelleChiaie, Pamela Cc: Marianne Peters Subject: 44 Cricket Lane FYI The bottom of bed inspection went fine for 44 Cricket Lane. Just as a heads up, I am copying Mill River on this. Mike Reilly may be ready for a final inspection on Friday, but as always, the engineer needs to call us before anything is scheduled. thanks Susan FW: 44 Cricket Lane - Final Construction Inspection Request DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Thursday, May 10, 2007 2:35 PM To: 'Marianne Peters' Cc: Daniel Ottenheimer (E-mail) Subject: RE: 44 Cricket Lane - Final Construction Inspection Request Importance: High Hi, Please send me the Final Construction Inspection Report. Thanks. Pamela -----Original Message ----- From: Marianne Peters [mailto:mpeters@millriverconsulting.com] Sent: Monday, May 07, 2007 9:56 AM To: DelleChiaie, Pamela Subject: RE: 44 Cricket Lane - Final Construction Inspection Request Page 1 of 2 PAMELA, THIS WILL BE DONE TODAY; I'VE LEFT MIKE A VOICEMAIL SAYING WE COULD DO TODAY; AWAITING HIS RETURN CALL. From: DelleChiaie, Pamela [mailto:pdellechiaie@townofnorthandover.com] Sent: Friday, May 04, 2007 10:57 AM To: Daniel Ottenheimer (E-mail); Marianne Peters (E-mail) Subject: FW: 44 Cricket Lane - Final Construction Inspection Request Hello, Please setup a F.C. Inspection with Mike Reilly, 978.375.4811. Both he, and the engineer, Bill Dufresne called to say it is all set. Thank you. Pamela -----Original Message ----- From: Sawyer, Susan Sent: Tuesday, May 01, 2007 11:39 AM To: DelleChiaie, Pamela Subject: RE: 44 Cricket Lane He must has faxed or sent and faxed, because there is one in the file already. I already did another 9B form and placed it in the file. S -----Original Message ----- From: DelleChiaie, Pamela Sent: Tuesday, May 01, 2007 11:31 AM 5/10/2007 r FW: 44 Cricket Lane - Final Construction Inspection Request 5/10/2007 To: Sawyer, Susan Subject: RE: 44 Cricket Lane Importance: High A letter came in on this one. It is in your box. -----Original Message ----- From: Sawyer, Susan Sent: Tuesday, May 01, 2007 11:30 AM To: DelleChiaie, Pamela Cc: Marianne Peters Subject: 44 Cricket Lane FYI Page 2 of 2 The bottom of bed inspection went fine for 44 Cricket Lane. Just as a heads up, I am copying Mill River on this. Mike Reilly may be ready for a final inspection on Friday, but as always, the engineer needs to call us before anything is scheduled. thanks Susan FW: 44 Cricket Lane - Final Construction Inspection Request Page 1 of 2 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, May 30, 2007 4:10 PM To: Daniel Ottenheimer (E-mail); Marianne Peters (E-mail) Cc: Sawyer, Susan Subject: FW: 44 Cricket Lane - Final Construction Inspection Request Please send along the Final Construction Report so that I may issue the COC. The Final Grade inspection was completed on May 23rd. Thank you. Pamela -----Original Message ----- From: Marianne Peters [mai Ito: mpeters@miIIriverconsulting.com] Sent: Monday, May 07, 2007 9:56 AM To: DelleChiaie, Pamela Subject: RE: 44 Cricket Lane - Final Construction Inspection Request PAMELA, THIS WILL BE DONE TODAY; I'VE LEFT MIKE A VOICEMAIL SAYING WE COULD DO TODAY; AWAITING HIS RETURN CALL. From: DelleChiaie, Pamela [mai Ito: pdellechiaie@townofnorthandover.com] Sent: Friday, May 04, 2007 10:57 AM To: Daniel Ottenheimer (E-mail); Marianne Peters (E-mail) Subject: FW: 44 Cricket Lane - Final Construction Inspection Request Hello, Please setup a F.C. Inspection with Mike Reilly, 978.375.4811. Both he, and the engineer, Bill Dufresne called to say it is all set. Thank you. Pamela -----Original Message ----- From: Sawyer, Susan Sent: Tuesday, May 01, 2007 11:39 AM To: DelleChiaie, Pamela Subject: RE: 44 Cricket Lane He must has faxed or sent and faxed, because there is one in the file already. I already did another 9B form and placed it in the file. S -----Original Message ----- From: DelleChiaie, Pamela Sent: Tuesday, May 01, 2007 11:31 AM To: Sawyer, Susan 5/30/2007 OW TOWN OF NORTH ANDOVERowrM Office of COMMUNITY .DEVELOPMENT AND SERVICES HEALTH. DEPARTMENT 40. 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 Susan V. Sawyer, RENS, RS Public Health Director f AUG Q 3 2006 APPLICATION FOR S6��t4ig 978.688.9540 ...- Phone 978.688.8476 — FAX healthdept@)townofnor. than dover. coin www.townof.iiorth andover.coni DATE: &�C MAP & PARCEL: I O Zi 4 LOCATION OF SOIL TESTS: 44 e2u ea --CC 1A►, -)e OWNER: A" E-7 Contact #: b %o) % APPLICANT: J12d, Q h -I E�--Z Contact #:."(. ADDRESS: �' /.Yl I!CT 1 .r ^ 'k ENGINEER: '�jP;l n 1/ j ��� Contact #:6 1�G�j��7 CERTIFIED SOIL EVALUATOR: 01LL, LZI I�K:Cezoe Intended Use of Land: Residential Subdivision Single Family Ho Commercial Is This: Repair Testing: I"' Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochicbewick Watershed? Yes No ✓ THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5" x 11 " Plot plan & Location of Testing (please indicate test nit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent: i4i�-2 Date back to Health Department: (stamp i•,): t1U� I I� h � � �'t tom-- �/ � Vl V1 , � i (,c ' 1 nor- it ecfi �e.�,evnppoyl OW m Q /4 Lomflon Owner's Name unpMarcel.-L—AVI A+ Addmsc Installer: TelNew Puq---- Repair (�_*Wctlandk> k±E`zone _Soil SymboL H,, Sol, &me16- Deep Observation Hole Jogs' Elm-ation Depth Son gr—i—ZO—Osol, Texture Soil dolor SGUMOttllog. % Gravel, Stones, ete Fral _Y41 3o C, le, v 3 7,5Y Parent Kfaterfav+ t_v, Bdr*ck=Lpv _St=ft9 Waterift the EdCL—wftPjncfMMftFac*_, T- 2 O-ZO L -(-- A Z.P cy k\-tA5%OC Pme 6�5 Date 4 percolation on Tests L Obse DeIM Stut Time Time Time Time -Rate ' - �3. 1tv, Performed 13 tuessed B Q$Tk: et&llPieA-rTaPI,; 116 OOT 04MEH , 5T I S OF %& LaAlvo AW ELEvprnoLl cF t,� r.�•� � i N� tiYSri�rt 3 -- coHPoN>iri tti. -r 4 E ��•� `ff 1 ��+ 09 �7EI.lEIEr 1 i I r, Ids I -,-'..biz 1Z "' 0"J'9 9�fl ►-lATV MicrJ G N e I N 6 E 1� '�ar �adl Rte' O H ra D �f •Dy *4 u ou v- I►,G j 'Pl.MI (LLV I orJ A L.L r�ui l n? ra 5, d.5, "r -b �/"E � M�rs11.•1u� O� �iuFTr Ai�DVG q ay 4 v -!KML4cr v, -P1.1 E Vi s. 5 �. ►9 T' �] -rk c �i� � f lk fP � Titswe-+Ift, P� Cao P00% , OH i�IJELL,y� 1 u AY f � � AS , BUILT PLAN OF - ' RECEIVED SJBS F U-RFAC-E DISPOSAL SYSTEM LOCATED 1N .. MAY 1 0 2007 4' �it�-! GIS �T L AV -4 � AS PREPARED FOR ,P��NoF �s� TOWN OF NORTH ANDOVER `�� Vl.ADiR41 HEALTH DEPARTMENT p� F3 1%h S NEMCHENOK 1 0-7A, a CIV DATE: No. sa SCALE: I -L `-1 0 MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS 0 LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 or TEL. (617) 475-3553, 373-5711