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Miscellaneous - 105 SULLIVAN STREET 4/30/2018 (2)
i 105 SULLIVAN STREET 1 21, 107.a-0010-0000.0 105 SULLIVAN STREET JS-2003-0712 Proiect Detail Report Printed On:Thu Jun 10,2004 Project Name: GIS#: 7607 Project No: JS-2003-0712 Owner of Record SHEA,BEVERLY Map: 1073 Date Submitted: May-30-2003 105 SULLIVAN STREET Block: 0010 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Septic System Work Location: 105 SULLIVAN STREET Zoning: Proposed Use: Residential District: land Use: 101 Proposed Use Detail Single Family Home Subdivision Description Septic System Comments: of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2003-0041 6/9/04-Greg Saab stopped by to drop off a check for another property,and I asked him to sign the certificate. He cannot sign,as Jon Whyman should have loamed and seeded--not hydroseeded: Greg Saab will speak to John about this. COC from North Andover will not be issued until we the engineer certification form is signed—p.d. 6/4/04-Manhole changed to 24'as requested. The Final Grade: Top grade,hydroseeded over marginal soil. Sparse grass growing. Manholes left at grade. Called Greg Saab for okay on this. 6/3/04-Jon Whyman called for a Final Grade Inspection. Please call him at:781.334.2323.-- p.d. 5/17/04-Received a call from Beverly Shea. She is looking for a COC. Told Ms.Shea we are still waiting for sign-off from engineer on certification form. We also need to verify Susan's concerns from 4/8/04. Then a final grade inspection needs to be done. 4/8/04-Susan Called Greg Saab,designer. He will call John with concerns. 1.-Tank manhole increase size to 24" 2.-Loam&Seed 3.-Check boundary wall and final grade accuracy. 4.-Clay Morin,Engineer,needs to sign Certificate form(in file). 5. -Needs a Final Grade Inspection. 3/31/04-This address needs a system final as well as a final grade. 3/31/04-Sent copy of As Built to Jon Whyman of Whyman Construction per Al's request when he dropped off 114 Marian Drive. Phone:781.334.2323. Address: Whyman Construction Attn: Jon Whyman 451 Broadway Lynnfieid,MA 01940 12/16/03-Received a call from A]Helfrey re:fact that J.Whyman thought he overpaid. Did GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page I of 3 105 SULLIVAN STREET JS-2003-0712 Proiect Detail Report Printed On:Thu Jun 10,2004 not. 5/28/03-Ck#10477,Soil Test-$200;9/26/03-Ck#10738-Design-$250; 10/22/03- Ck#10879-Design Re-Review for$50; 10/23/03-$250 pd.For DWC permit. Called Whyman. He is all set. 11/4/03-Received revised plan dated 10/30/03 adding 1000 gal.Pump chamber. Left message to send$75 for 3rd Revision. Sent to Consultant. 10/31/03-See Document link letter 10/22/03-John Wyman called--he will be coming in tomorrow to fill out application for DWC permit. 10/22/03-Plan Approved by Consultant and 3rd review payment received minus$25 overpaid from before. 10/20/03-Spoke with Engineer-they will send check. 10/15/03-New plans found on desk(hand del?)no letter,no fee. Called and left message with Eng.&Serveying Services at 978.815.7835 re:no fee. Sent plans to Consultant on 10/15. 10/9/03-Septic Plan denial letter sent. 10/3/03-E-mail sent by Consultant to H/O explaining process 10/2/03-Mrs.Shea sent a fax stating her frustration at the septic approval process. Copy forwarded to Heidi Griffin.--p.d. 9/30/03-Revised plans dropped off this afternoon. Sent to Consultant for review. Sent e-mail requesting priority review,as Mrs.Shea called again this a.m.Asking if plans could be reviewed and approved asap due to extenuating personal circumstances and cost of pumping. 9/23/03-Beverly Shea,h/o called re:status of plans. Told her that letter went out to designer and her. Mrs.Shea states that she did not receive letter. I called engineering co:Engineering& Survey Services of Haverhill,and spoke with Greg Saab. I told him that h/o has called re: status. They received letter and will work on revised plan. I advised h/o to call the engineer to check on when they would be submitting revised plans to us.--p.d. 9/15/03-Letter sent re:plans. Revised plans requested. 8/29/03-Design Plan submitted by J.Whyman Const.781.334.2323 7/7/03-Soil Test scheduled for 7/15/03. 6/19/03-h/o:Beverly Shea called to find out status of soil tests for 105 Sullivan Street. 6/3/03-Received back sign-off from Conservation. 5/28/03-Received check and application for soil testing. Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: DWC-System Repair BHP-2003-0340 Oct-23-2003 SIGNED OFF JS-2003-0712 Repair-Complete Plan Review BHP-2003-0354 NEEDS REVIEW JS-2003-0712 Plan review-REV 3 Plan Review BHP-2003-0332 Oct-22-2003 SIGNED OFF JS-2003-0712 Plan Review Plan Review BHP-2003-0299 DENIED JS-2003-0712 Plan Review Plan Review BHP-2003-0270 DENIED JS-2003-0712 Plan Review Soil Testing-Repair BHP-2003-0247 Jun-04-2003 SIGNED OFF JS-2003-0712 Soil Testing Inspection History GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 2 of 3 105 SULLIVAN STREET JS-2003-0712 Proiect Detail Report Printed On:Thu Jun 10,2004 Inspection Type: Permit Type: Permit No: Insp Date: Status: Inspector: Project No: Comment: Final Inspection DWC-System Repair BHP-2003-0340 Nov-17-2003 FULL COMPLY Dan Ottenheimer JS-2003-0712 Pump information needed. Received on 2/18/04. Bottom of Bed Inspection DWC-System Repair BHP-2003-0340 Oct-31-2003 VIOLATION Dan Ottenheimer JS-2003-0712 Pending a revised plan. See document link. GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 3 of 3 i 7179 * Town of North Andover ' HEALTH DEPARTMENT CH CHECK#: DATE: LOCATION: H/O NAME: i CONTRACTOR NAM : l� Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ BodyArt Practitioner $ O Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ Title 5 Report $� ❑ Other. (Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer �^NORrh ! O y� Town of North Andover � '•;,;o:: �r HEALTH DEPARTMENT ,SSACNUSf� CHECK#: DATE: LOCATION: H/O NAME: ` CONTRACTOR NAM Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ TrasW/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ Title 5 Report $_ ❑ Other:(Indicate) $ .007 10 .i Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer J AND S DEVELOPMENT CORPORATION J 13934 -North Andover board of health 12/9/14 105 Sullivan St No Andover 50.00 i Haverhill Bank 9613 105 Sullivan St No Andover Title 5 50.00 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w., ay'' 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not John DiVincenzo use the return Name of Inspector key. Stewarts Septic Serive Company Name 58 South Kimball street Company Address Bradford MA 01835 City/Town State . Zip Code 978-372-7471 S113386 i��v.;'� 1 ✓ Telephone Number License Number DEC 1 12014 B. Certification TOWN OF P{1:;711 At`1-t/=,< :R HEA? I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ N eds Further Evaluation by the Local Approving Authority V/1 ILI //I/ In ector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ti. 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 'In 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w„a 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/ day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a� 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No I ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w, 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4 2014 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): 440 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4 2014 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 165 GPD 9 ( Y 9 (gp ))� Detail: water meter readings Sump pump? ® Yes ❑ No Last date of occupancy: Occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 .Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ~w, 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is North Andover MA 01886 November 4 2014 required for every , page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Andover Septic Was system pumped as part of the inspection? ® Yes' ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? site guage on truck Reason for pumping: inspect tank Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts --- W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w, 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4 2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer (locate on site plan): Depth below grade: 20"feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 6"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 105 Sullivan street Property Address Gillian Kingston, Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 14.5 How were dimensions determined? Tape measure & Sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Both baffles good, no leakage. Liquid levels are also good. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): `Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Equal Dist. no solids carryover no leakage. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Ran pump from pump chamber by lifting floats manualy. Pump and alarm working at this time. * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4 2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 3-34" X 37.5' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No hydraulic failure, no ponding Condition of solids good. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 • d � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M a 105 Sulliyan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014. page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate 7whe public water supply enters the building. Check one of the boxes below: LJ hand-sketch in the area below ❑ drawing attached separately a O � r . a � Zc. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M °r 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 90" lot feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: November 4,2000 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Pulled files ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Water table at elevation 70.53 bottom of trench at elevation!4.53 4' seperation of water. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts N W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 105 Sullivan street Property Address Gillian Kingston Owner Owner's Name information is required for every North Andover MA 01886 November 4,2014 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 NO TE: SEPTIC SYSTEM AS-BUILT THE PUMP USED IS DIFFERENT THAN PROPOSED BUT IS AN APPROVED EQUAL TO THE PROPOSED PUMP. BEVERLY SHEA LOCATION: 105 SULLIVAN ROAD NORTH ANDOVER ,MA. o DATE: -10-0''� 34" 34 3 SCALE: 1" = 20' 34" `` lot 10' z 0 v, m A TO D = 26.2' (D= DBOX) N oo A TO C = 22.3' (C = SEPTIC TANK) 2 A TO E = 28.2' (E = PUMP TANK) 0 W o BTOC = 15.1' N EXISTING INGROUND 0 0 0 B TO D = 39.4' POOL a Q B TO E = 21' C o INVERT FOUNDATION = 74.20' INVERT TANK IN = 73.86' ti ►n INVERT TANK OUT = 73.61 D -BO INVERT PUMP TANK IN = 73.50' o INVERT PUMP TANK OUT = 73.25' a INVERT D-BOX IN = 75.35' A INVERT D-BOX OUT =75.18' 1 INVERT LINE BEGIN =75.08' INVERT LINE END = 75.08' BM = BOTTOM SIDING = 80.00' C E 1,000 GAL. PUMP TANK I CERTIFY THAT THE SEPTIC SYSTEM COMPLIES WITH BOTTOM/ / / / / TITLE 5, LOCAL CODE AND DESIGN PLAN. EXISTING DWELLING jp' #105P OF 1,500 GALLON TANK Clayton A. 6 � Morin .� #30969 N NIL OF HEALTH PROFESSIO AL NGINEER ». , J FM 1 8 ?0" DATE: / r GRAMC I CXZ ENGINEERING & SURVEYING ° 10 20 4 0 SERVICES p FW) ! 70 BAILEY COURT 1buft-20 R 121.70' HAVERHILL, MA. 01832 260 z8�° SULLIVAN DAD 978-556-0284 48 0 4�. o a \.,,•t �"�riT n �4 ,�. c7 �jM9} � i zw•t 1— {'~ - ev`' �,I � _ � gyp. ,,•p�.� • '' rrr� + y � �a ;Fay {� !a ry,..ldraw ;.Y .�N M .�"t,.e � �ir � � t"• Vim`, ,'� '¢ - ` - � 9^ ra ..A o � ��.�,F• ' +apt 4� f1,.3 �, � °y, n ,iy, y a�``,�•4 •�1�� .f fes.. .,,p•_';4{�� �r��� � ' CD 1 cy CD IJ i til a CD ft CL 0 , L � di � C. �r,.,� fJ. � I# ,� r t ��'v,r L ,e »r A }"`K••• Jul / �#�, � �� � tet; i � ` 'L Irl >}{•' �``� . '1` ti if� ". � i4` .* § . a ',� : �' ". CD [l X41 4+ plick (�j F r]rel r. ► ►� ``- r .� 1• "' (� fT�-_ a _ -" �J y ice' w Aw ,. 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I[�yi''yy e� .�"`«`�T_,4�i— - 1 It - y�3�!` x � �„ k� "aY�� �f� v. .♦''�.•- ,��,^.��} � �a•� -psi." �a l� ��,.� ►Erw fry.. � � `�, .~t r��.;e� T t � .gu�� �w^r.���'G x y !� • � '; I 9 �.� t fl LL v s M 1 � f Z.7/o c.r file://C:\Documents%20and%20 Settings\pdellech\Local%20Settings\Temp\NA%2�ublic... 4/27/2004 Page 1 of 1 ' Y Al owl i z f d mom. "4 i4�F , f _ b. file://C:\Documents%20and%20Settings\pdellech\Local%20Settings\Temp\NA%20Pubiic... 4/27/2004 I, Page 1 of 1 O Q .w DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Tuesday, April 27, 2004 8:58 AM To: Susan Sawyer; 'Pamela Dellechiaie' Subject: 105 Sullivan Street Sue and Pam, Here is the final inspection report Sue was looking for at the property at 105 Sullivan Street. Dan Xj Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 4/27/2004 k 0 0 "• MILL RIVER CONSULTING Septic System Management Services TOWN OF NORTH ANDOVER SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 105 Sullivan Street MAP:10713 LOT: 10 INSTALLER: Jon Whyman DESIGNER: Engineering & Survey Services, Inc. PLAN DATE: 10/14/03 BOH APPROVAL DATE ON PLAN: DATE OF BED BOTTOM INSPECTION: 10/31/03 DATE OF FINAL CONSTRUCTION INSPECTION: 11/17/03 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION X PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1500 LOADING OF SEPTIC TANK = H-10 GALLON PUMP CHAMBER = 1,000 LOADING OF PUMP CHAMBER = H-10 TYPE OF SAS = 3 Trenches DIMENSIONS AND DETAILS OF SAS: 3 trenches each 10' apart using Standard Capacity Infiltrator units. SITE CONDITIONS ❑x . Existing septic tank properly abandoned Internal plumbing all to one building sewer Topography not appreciably altered Comments: Waterline not as depicted on design plan. Needed to be re-routed around north and west side of SAS. Building sewer elevation is several feet below elevation depicted on plan. Construction ceased while new design plan with pump unit is provided. 10/31/03. Intends to build retaining wall to hold soil at driveway in order to provide a maximum of 3' of cover over septic tank and pump chamber. 11/17/03. 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1. 800.377.3044 978.282. 0014 info@millriverconsulting. com Page 1 of 4 0 O MILL RIVER CONSULTING Septic System Management Services SEPTIC TANK 0 Bottom of tank hole has 6" stone base ❑ Weep hole plugged 0 1,500 gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) 0 Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) 0 Inlet tee installed, over access port Outlet tee (gas baffle or effluent filter) installed, over access port 19 inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present 0 Hydraulic cement around inlet & outlet Comments: Two compartment tank used with effluent filter in first compartment. Riser to grade over effluent filter provided. Inlet tee not centered over tank, cast iron manhole not large enough size. Discussed with Whyman and he will correct. 11/17/03. PUMP CHAMBER 0 Bottom of tank hole has 6" stone base ❑ Weep hole plugged 0 1,000 gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) 0 Inlet tee installed, over access port 0 Pump(s) installed on stable base Alarm float working 0 Pump On/Off float working 0 Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs 0 Hydraulic cement around inlet & outlet Comments: Plan specified Myers brand pump, Liberty brand pump was installed. Documentation should be provided to confirm equivalency. D-BOX 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282.0014 info@millriverconsulting.com Page 2 of 4 0 Q MILL RIVER CONSULTING Septic System Management Services ❑ Installed on stable stone base D Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets D Observed even distribution ❑ Speed levelers provided (not required) Comments: Plastic distribution box used, cement pad poured beneath. SOIL ABSORPTION SYSTEM 0 Bottom of SAS excavated down to C soil layer, as provided on plan D Size of SAS excavated as per plan D Title 5 sand installed, if specified on plan ❑ 3/4-1 %" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices@ 5 & 7 o'clock P' ositions D Gravelless disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/concrete /timber/ block) ❑ Final cover as per plan Comments: Gravelless trench units connected and vented. CONTROL PANEL El Alarm & Pump are on separate circuits D Alarm sounds when float is tripped ❑ Location of control panel: Basement ❑ Rated for exterior if placed outside Comments: 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1. 800.377.3044 978.282. 0014 info@millriverconsulting.com Page 3 of 4 y . O O MILL RIVER CONSULTING Septic System Management Services SYSTEM ELEVATIONS Benchmark: 80.00 Rod at Benchmark: 0.88 Height of Instrument: 80.88 INVERT ON DESIGN PLAN ELEV(c1 TOP OF PIPE INVERT ELEVATION Building Sewer OUT 73.05 Septic Tank IN 72.85 Septic Tank OUT 72.60 Pump Chamber IN 72.55 Pump Chamber OUT 72.30 72.62 72.45 Distribution Box IN 75.35 75.18 75.01 Distribution Box OUT 75.18 75.36 75.03 Lateral IN 75.08 75.28 74.95 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282. 0014 info@millriverconsulting. com Page 4 of 4 Town of North Andover f NORTH Office of the Health Department Community Development and Services Division 27 Charles Street "` °+ �s:s:�• �`�' North Andover,Massachusetts 01845 �ssACHUs Susan Y. Sawyer,RENS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax CERTI FICA�IE OF CO�Vl�1'GI.,0�VC2 As of: September 9, 2004 q-his is to cert that the individual subsurface disposal system repaired('-X" — Fuf[System by ,ion Whyman at 105 Sullivan Street 9Vorth Andover, 9lA 01845 has been installed in accordance with the provisions of Title v of the State Sanitary Code and with the North Andover(Board ofWealth regulations. The Issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. jSaInT Sawyer, 1XUfS/12,5 fu6fcYfealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVE]k SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( ) constructed; ( ) repaired; located at 10 1 SLAI L L i V A/0 P©fN.f�) was installed in conformance with the North Andover Board of Health approved plan, System Design Permit# ,plan dated3` v"',Zr 2f""' 101Mth a design flow of Y`fy 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 S 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. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative Installer: Lic.#:6�Z Date: 0 0 0 Engineer: ��--- Dater- b 7 RECEIVED SEP - 9 2004 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 0 0 TOWN OF NORTH ANDOVER ° �O � p* , Office of COMMUNITY DEVELOPMENT AND SERVICES or°`� HEALTH DEPARTMENT 27 CHARLES STREET " NORTH ANDOVER,-MASSACHUSETTS 01845 FITS CHU t� 978.688.9540—Phone Susan Y. Sawyer,REHS/RS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com http://www.townofnorthandover.com June 21, 2004 Jon Whyman Fax: 781.334.4330 451 Broadway Lynn,MA 01940 Dear Mr. Whyman, The Health Department has received your faxed response to our letter sent on June 11, 2004. As the Health Department understands the situation, it appears that the loaming and final grading is being done by the homeowner.Although this may be an agreement between you and your client, please be advised that you are the licensed installer and are responsible for making sure that the work conforms to Title 5 standards in regards to the slope etc. Please do not submit your certification installation form with your signature until all the work has been completed and has been inspected by you. When the property is ready for an inspection please contact the health office for a final grade inspection. Sincerely, Susan Y. Sawyer, REHS/R Public Health Director SYS/pfd Jun 11 04 01 : 05p JohD Whaman 7813344330 P. 1 Jun la 04 01 :51p nOR>�. FIMDOVCR 970680or ; p' 1 -TOWN OF NORTH ANDOVER Offtcc of COMMUNITY DEVELOPMENT AN'ff SERVICES p•':'f;.' "p 11EALTH pEPARTMENT :;•tom t 27 CIIARLES%'t'l EL,r .•`,, NOR'fll AN1X>VL:R.MASSACIlUS1?I"1'S 01945 978.6gg.9aa0 Phone Susan Y.tinwycr,RF.piS1125 M.W.95,12•• FAX Public Wealth Directorheahlldep-141 www,luwnolitorthnndovcr.cottn Jtwe 1).,2004 Fax:711.334,4330 !on Whyman 451 Broadway I.ynn.MA 01940 Rc.- 105 Sullivan Street Dear Mr.Whyman, ,.his correspondence is in regards to the property listed above and the retest septic system instal Iation. On June rd you requested a final 93de inspect"from the health department.An inspection was conducted per your request. As you may recall,you had a couple of outstanding items that needed to be addressed prior t4 sign o0'by the Health ►)eptartment. Some items were initially discussed on site with you artd our consultant,Dan Uttenheimer last Novernbcr l7,2003_ You then had a phone discussion with me about the some of the same items ot)April 3,2004. As indicated by you,the manhole has been changed to 24 inches as per plan.However.the ProPem has been hydro spreading of a minimum of three inches of loam as aLso required per plan.The ,top coir' seeded prior n to proper spm' g r vegetation and is not acceptable by tick V smdards. present is not of sufficient quality needed to establish grope B The engineering fdm on this project,represented by Greg Saab,has also observed the site and is in agreomew in this Plan- mite.As the permit holder it is your responsibility to ace that the fugal pm>jcct meets the plan. hrW this rcuson,the health department is not able 1"siP the certificate of compliance at this time.Please contact this otfiea:at such time the property is ready for it's final inspection.Any subsequent inspoetiotn needed for this p>roPerh' will be assessed the$50 fine as listed in the signed agreement(Ice attached). In addition,after reviewing the file,it was found that you signed the installation ecrtification stating char the system had been installed in taceordmncc with the plan m►10/23/03.This statement is nOl accurate,since the permit to begin the projectwas dated that same day. A blank formis apin being provided to you for your t igrature and the engineer's sigAnture.Please return►this form properly filled out. If you have any questions re}+xrding those issaes,please contact the Health Dcpamnerat. 'Thank you for your anticipated cooperation in this matter. Sincerelyfj /Sus. Sawyer,R>Clls/R Pu iic Health Dircctor Homeowner•Severly Shea, 105 Sullivan%trcct Clayton Morin,Faginccr.7D Bailey Court.Haverhill,MA 01832—rapt:9710.689.0839 Atch: installation Cenificalion Form-13Iank Copy of Installer Project Management Obligations,dated 10/23/03 `� U-1 i « tri. 51,E ` -�� �<< S� ��w - 'o� W I vfAa Jun 11 04 01 : 14p Joh Whaman 7813330 P. 1 J. WI IYMAN CONSTRUCTION Invoice SEPTIC ANI)SITE' WORK PROFESSIONALS DATE INVOICE NO. 451 BROADWAY AVE. LYNNFIELD, MA. 01940/781-334-2,323 5/21/24)(4 4339 BILL TO IIIiVI:RI.Y SIIIiA 105 Sl 11,1 ST, N.ANIX)Vlilt MA. P.O.NO, TERMS DUE DATE SHIP DATE PROJECT 6M9300 Ifl(i ISTART DATE 5/21/2004 5/21/21104 SERVICED ITEM DESCRIPTION QTY RATE AMOUNT 5/18/2(1(14 Itotm t PRI:PIiI)AREA/IkAxat Itcm;d(ri),60/11rc 3 60.1x) 180.191 fiuMirMiin1! 1I unlgratinl Nhltil)1{13"IY)RAKE OtTI'ANI) I 45.(x) 450) PREVARC FOR IIY!)Rf)til.ta)ING IfYSEIiD LIME.FF.R'11LIZ KAND 1lYUROSIi1dU1N(i 400.19) 4110_(x) APPLIED d 0 AS- (> 30 per COSAC,4/� Y � I'1►ink you fur y4m@r Inssiness. Tptal 1625.00 0 0 TOWN OF NORTH ANDOVER 0RT11 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET ------ NORTH •'' +ON.1f�D♦f NORTH ANDOVER,MASSACHUSETTS 01845 Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdeptgtownofnorthandover.com www.townofnorthandover.com June 11,2004 Jon Whyman Fax:781.334.4330 451 Broadway Lynn,MA 01940 Re: 105 Sullivan Street Dear Mr.Whyman, This correspondence is in regards to the property listed above and the recent septic system installation. On June 3rd you requested a final grade inspection from the health department.An inspection was conducted per your request. As you may recall,you had a couple of outstanding items that needed to be addressed prior to sign off by the Health Department. Some items were initially discussed on site with you and our consultant,Dan Ottenheimer last November 17,2003. You then had a phone discussion with me about the some of the same items on April 8,2004. As indicated by you,the manhole has been changed to 24 inches as per plan.However,the property has been hydro seeded prior to proper spreading of a minimum of three inches of loam as also required per plan.The"top soil" present is not of sufficient quality needed to establish proper vegetation and is not acceptable by title V standards. The engineering firm on this project,represented by Greg Saab,has also observed the site and is in agreement in this case.As the permit holder it is your responsibility to see that the final project meets the plan. For this reason,the health department is not able to sign the certificate of compliance at this time.Please contact this office at such time the property is ready for it's final inspection.Any subsequent inspections needed for this property will be assessed the$50 fine as listed in the signed agreement(see attached). In addition,after reviewing the file,it was found that you signed the installation certification stating that the system had been installed in accordance with the plan on 10/23/03.This statement is not accurate,since the permit to begin the project was dated that same day. A blank formis again being provided to you for your signature and the engineer's signature.Please return this form properly filled out. If you have any questions regarding these issues,please contact the Health Department. Thank you for your anticipated cooperation in this matter. Sincerel Sus Sawyer,REHS/R lic Health Director Homeowner-Beverly Shea, 105 Sullivan Street Clayton Morin,Engineer,70 Bailey Court,Haverhill,MA 01832—Fax:978.689.0839 Atch: Installation Certification Form-Blank Copy of Installer Project Management Obligations,dated 10/23/03 o � INSTALLER PROJECT MANAGENI,"rT OBLIGATIONS As the North.Andover licensed installer for the construction of the septic system for the property at O S relative to the application Of dated /d v�C�/"�19_for plan by �ol� . ���'� and dated &O- with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contracto project manger, or any other person not associated with my company schedules an inspectio and the system is not ready then item two shall be applicable. 2. As the installer I am required to have the necessary work completed prior to the applicabl inspections as indicated below. I understand that requesting an inspection,. withou completion of the items in accordance with Tile 5 and the Board of Health Regulations ma: result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be dons first. Installed must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OK from engineer must be submitted to Board of Health, after which installer calls fol inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in.the attached application for installation. I further understand that work by others unlicensed to installseptic systems in North Andover can constitute reasons for denial of the, system, and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. U gned Licensed Septic Installer Date: Disposal Wo r s Construction Permit# TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The ndersigned hereby certify that the Sewage Disposal System ( )constructed; The by �' ���w► �r�s r��;1 dr� located at was installed in conformance with the North over Board of Health approved plan, System Design Permit# ,plan dated , with a design flow of gallons per day. The materials use were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CAIR 15.000, Title S 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. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative Installer: Lic.#: Date: Engineer: Date: TC" ?ir-OF NORTH r�I'iDG"•. 74 30A% OF HEALTH FEB 1 8 20r ! ` CONDENSATE • F t Yj LCU 15 LCU15/LCU20-S IE40-Series 1IESO-.Series Condensate Plumps 4/10 hp 2"Solids-Handfing 2"1 Discharge 1/2 hp 2"Solids-tlantlhng 2"Discharge Vlfrit u S, Heighl:6-11A" Llernllh:ll-lig" Features: Fr'tiures: For reineval of condensate troth AIC •Heavy cast iron construction -Heavy cast iron construclion with Ntq pmenl,high eflicienty furnaces,ice •Vortex style Impeller made of corrosion 2-vary semi-open'HYTAEVirnptAlor rrokers,drinking fotmtains,dehurnidifiers resistant high temperature polymer 9 Oil tilled,thenmally protected motor crud other equipment."Completely automatic with a safety switch to shut down equipmment •Oil tilled,thermally protected motor -Permanently lubricated Waringr, in ft. tavern of f ailure. •Purnanently iutiricated bparing5 •All slainles±;stoat fasteners Both Modes Feature: -All stainless steel tastenery and -Stainless;steel rotor shaft -Nigh impact f'oly$W.fte lank rotor shaft -10'UL approved power cord with -3 intake holes -10't1L approved power cord with quick-dist DnnGct design—st)ndard •3/0'0.D.outlet quick-disconnect dosign--standard (20'atad 30cords atso waibbh.) •Guilt-in check Ove (20'and 30'cads also available) •Mercury-free float with series plug ctrl •Wall mourns -Mercury-Iree That with series plug on automatic models -Stainless*.�:l shalt autowlic models •HYtR[t^�s a rcpl,tercd trallta�l lrk of Model LE4ltltt DuPont Polders 'LCU20-S F'aaturr Satcry WWI Option 115V 13,E Manual(no switch) Model WI M Model LE41A 115V.,12a.Nkinual(no smildi) 115V..13a,Automatic Madaf LE51A 115V.,12a,Automatic Model LE521W 208-23OV.,G.$n,hrlanual(no switch) LCU15 11/50 I frj) Model M2A 1•r:RFORMMICC 2013->?30V-,6_8a,Automatic 1-RFORMANCE CURVE e t 1725 RPM >r MRFUIRR+ANCE CUM(E N 1550 RPM d LCUZo-S(r/:30 hp) PCRF0MVVWCFro M x � N . 1•• '1 m R 1. � � e 1 FP n 0 a W 70!O v0 4n Ap!Oro 90 t0E IR1170 tE1 n R 30 w W St! M rte ro vtr U.S.Galiwl5 Po taK.-air U.S.Galk)ns i'er Minn"! T 'd 0eeiPisee18L uea94tn uoP d12t:T1 ir0 22 uec u TOWN OF NORTH ANDOVER O NaRrH Office Of COMMUNITY DEVELOPMENT AND SERVICES 0 o m HEAL'T'H DEPARTMENT 40 ~^ 27 CHARLES STREET =` • NORTH ANDOVER, MASSACHUSETTS 01845 "Ss�cHus�`9 Heidi Griffin 978.688.9540—Phone Acting Health Director 978.688.9542—FAX November 24, 2003 FILE Clayton Morin, P.E. Engineering& Surveying Services 70 Bailey Court Haverhill, MA 01832 RE: Septic Design Plan, 105 Sullivan Street, North Andover Dear Sir, It has come to our attention that during the construction of the onsite wastewater disposal system you designed for the property at 105 Sullivan Street a different pump was utilized than on the most recent version of the design plan. Construction inspections confirmed the suitability of the pump in terms of its ability to transmit wastewater from the pump chamber to the distribution box. However, other pump parameters such as its curve,4 ability to transmit solids, and the operating point have not been provided. Prior to issuance of a Certificate of Compliance please ,,,/provide a complete set of pump details, including calculations and depiction of the operating point for the Liberty-brand used onsite to the Board of Health for review. Sinc el Brian LaGrasse, Health Inspector cc: file I Page 1 of 1 O DelleChiaie, Pamela From: Dan Ottenheimer[info@milldverconsulting.com] Sent: Monday, November 24,2003 8:38 AM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 105 Sullivan Street a-mail#2 Heidi, Brian and Pam, On this job the contractor used a different pump than on the design plan. I would encourage the Town to send a letter along the lines of the attached document and to consider withholding the Certificate of Compliance until the adequacy of the pump has been confirmed. I have also attached the Construction Inspection form which notes this and would kindly ask that the version of the form sent in the earlier e- mail be disregarded. Dan Daniel Ottenheimer,. President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millrlverconsulting.com info@millriverconsulting.com 11/24/2003 Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@ millriverconsulting.com] Sent: Friday, October 31,2003 11:21 AM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 105 Sullivan Street Heidi, Brian and Pam Attached please find the bottom of bed inspection report for the septic system being built at 105 Sullivan Street. The leach area was properly excavated. You should note that the elevation of the building sewer pipe exiting the house is about 3' lower than what is provided for on the design plan (I will refrain from editorializing here). This now means that a pump chamber and pump will need to be incorporated into the design. We have instructed the septic installer to not perform any construction beyond placing the sand at the bottom of the leach area until a new plan has been completed and approved which shows the pump and pump chamber details. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 info@millriverconsulting.com 10/31/2003 Page 1 of 1 a o DelleChiaie, Pamela From: Dan Ottenheimer[info@milldverconsulbng.com] Sent: Thursday, October 30,2003 3:36 PM To: 'Pamela DelleChiaie' Subject: RE: 105 Sullivan Street-Bottom of Bed Inspection Request All set for tomorrow(10/31)at 8:30 a.m. Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester,MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 info@millriverconsulting.com -----Original Message----- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com] Sent:Thursday,October 30, 2003 2:23 PM To: Daniel Ottenheimer(E-mail) Subject: 105 Sullivan Street- Bottom of Bed Inspection Request Importance: High Hi Dan, Another request... Please call Jon Whyman at 781.334.2323 to schedule a Bottom of Bed inspection at 105 Sullivan Street. Thank you, Pam Pamela DelleChiaie, Health Dept.Assistant Town of North Andover Community Development& Services 27 Charles Street North Andover, MA 01845 pdellechiaie@townofnorthandover.cont Tel. 978-688-9540 Fax 978-688-9542 10/30/2003 i 4 TOWN OF NORTH ANDOVE BOARD OF HEALTH Ia i jjI 6 Location /DJ �l����/� v/✓' Permit # Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers Disposal Works Constructio $ Soil Testing $ 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 $ f, 7094 c" " Health Agent White - Applicant Yellow - Dept. Pink - Treasurer Commonwealth of Massachusetts Map-Block-Lot 1073-0010- Board Of HealthPernrit No------------ North Andover -BHP-2003---0340 ---- ----------- ----- P.I. FEE F.I. $250.00 ----------------------- Disposal Works Construction Permit Permission is hereby granted J_-Whyman Construction - ------------------------------------------------------------------------ to(Repair)an Individual Sewage Disposal System. at No SULLIVAN ----105----------------------------STREET------------------------------------------------------------------------------------------------------------------------ as shown on the application for Disposal Works Construction Permit No. BHP-2003-034 Dated October , FILE ----------------------------------------------- Issued-On:Oct-23-2003 Board Of Health ............................................................................................................................................................................... Commonwealth of Massachusetts Ma - e1_= t 107.B-0010- Board Of Health ----------------------- North Andover Certificate of C iance THIS IS TO CERTIFY,That the In ' ual Sewage Disposal System (Repair) by ___J:Whyman_Constructio ------------- -------- ------------------------------------------------------------------------ Installer at No 105 SULLIV ET has been install * accordance with the provisions of TTTLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. BHP-2003-034 DatedOctober 23-2003 --- ----------- --------------------------------------------------- ----- Printed On-:-Oct-22-2003----------------- ------------ -- Board Of Health APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: /Z L2_ L03 CURRENT INSTALLER'S LICENSE# LOCATION: �L7 �i>i-�iy�4�ti1 ,ST/z�--Z—r ' LICENSED INSTALLER: w N ►-r. 6►J s T-r?--j c-11 1J SIGNATURE: TELEPHONE#7 S 33 Z3 Z 3 CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. v L `� Administrative Use Only $ .00 Fee Attached? Yes No Foundation As-built? Yes No Floor plans on file? Yes No Approval Date: O Q MILL RIVER CONSULTING Septic System Management Services TOWN OF NORTH ANDOVER SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 105 Sullivan Street MAP:107B LOT: 10 INSTALLER: Jon Whyman DESIGNER: Engineering & Survey Services, Inc. PLAN DATE: 10/14/03 BOH APPROVAL DATE ON PLAN: SELECT SYSTEM TYPE X GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER I COMPONENT SUMMARY FROM PLAN GALLON TANK= 1500 LOADING OF SEPTIC TANK = H10 GALLON PUMP CHAMBER = na LOADING OF PUMP CHAMBER = na TYPE OF SAS = 3 Trenches DIMENSIONS AND DETAILS OF SAS: 3 trenches each 10' apart using Standard Capacity Infiltrator units. SITE CONDITIONS Date & Initials Inspections ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer 10/31/03 MRC 0 Topography not appreciably altered Comments: Waterline not as depicted on design plan. Needed to be re-routed around north and west side of SAS. Building sewer elevation is several feet below elevation depicted on plan. Construction ceased while new design plan with pump unit is provided. 10/31/03 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282.0014 info@millriverconsulting.com Page 1 of 5 I 0 0 ~ MILL RIVER CONSULTING Septic System Management Services SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, over access port ❑ Outlet tee (gas baffle or effluent filter) installed, over access port ❑ 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 ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, over access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1..800.377.3044 978.282.0014 info@millriverconsulting.com Page 2 of 5 - a a MILL RIVER CONSULTING Septic System Management Services ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM 10/31/03 MRC 0 Bottom of SAS excavated down to C soil layer, as provided on plan 10/31/03 MRC 0 Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 '/" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete/timber/ block) ❑ Final cover as per plan Comments: 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282. 0014 info@millriverconsulting.com Page 3 of 5 Q � MILL RIVER CONSULTING Septic System Management Services PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: I 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282.0014 info@millriverconsulting.com Page 4 of 5 o 0 0 MILL RIVER CONSULTING Septic System Management Services SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV Al TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282.0014 info@millriverconsulting.com Page 5 of 5 e 0 O MILL RIVER CONSULTING Septic System Management Services TOWN OF NORTH HANDOVER SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 105 Sullivan Street MAP:107B LOT: 10 INSTALLER: Jon Whyman DESIGNER: Engineering & Survey Services, Inc. PLAN DATE: 10/14/03 BOH APPROVAL DATE ON PLAN: DATE OF BED BOTTOM INSPECTION: 10/31/03 DATE OF FINAL CONSTRUCTION INSPECTION: 11117/03 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION X PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1500 LOADING OF SEPTIC TANK = H-10 GALLON PUMP CHAMBER = 1,000 LOADING OF !PUMP CHAMBER = H-10 TYPE OF SAS = 3 Trenches DIMENSIONS AND DETAILS OF SAS: 3 trenches each 10' apart using Standard Capacity Infiltrator units. SITE CONDITIONS D Existing septic tank properly abandoned D Internal plumbing all to one building sewer D Topography not appreciably altered Comments: Waterline not as depicted on design plan. Needed to be re-routed around north and west side of SAS. Building sewer elevation is several feet below elevation depicted on plan. Construction ceased while new design plan with pump unit is provided. 10/31/03. Intends to build retaining wall to hold soil at driveway in order to provide a maximum of 3' of cover over septic tank and pump chamber. 11117/03. 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282.0014 infoL@millriverconsulting.com Page 1 of 4 Q o MILL RIVER CONSULTING Septic System Management Services SEPTIC TANK 0 Bottom of tank hole has 6" stone base ❑ Weep hole plugged FAI 1,500 gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) O Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) Q Inlet tee installed, over access port Outlet tee (gas baffle or effluent filter) installed, over access port Q 19 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: Two compartment tank used with effluent filter in first compartment. Riser 11.0: grade over effluent liter provided. Inlet tee not centered over tank, cast iron manhole AA d.i'77tS f!i!l !4#I vL \.r#!i.%YVi l Ji Li,r. i..itaIV YJJ\riI Q{titt i 9 Y i 1)F i p#4A8! CMIU M-- Efllf! PUMP CHAMBER Lai C)(.)SLUM U( fdd!E5 [16.7(1' ld!S 0., ZRU[le UdZiC ❑ Weep hole plugged (H-10 or H-20) (Monolithic or 2 piece) Pump(s) installed on stable base rXI Pump On/Off float working ❑ inch cover to within 6'of final grade installed over Water tightness of tank has been achieved _f I__ nE #___ Comments: Plan specified Myers brand pump, liberty brand pump was installed. -,.-«=-ft--'—.- _�;s�'= r'=--�;s=:�= �-� �^•-:'_..-:-' tee. - z___..._. z;�_`.-::_T::�::�j. D-BOX toll free 1.800.377.3044 978.282.0014 info@millriverconsulting.com Page 2 of 4 0 0 KILL REVER CONSULTING 1-1 Is-a"e- on s' -- L-i CI L 11 U LC2 W 101 1tv liciou Ct Hydraulic cement around inlet& outlets L-1 Speedleveiers provided (not required) SOIL A BSORPTION SYSTEN' %a I%a 9 &—two provided on, plar, LLI Title 5 sand installed, it'specified on pian M 41014!nil f---- 1 L-1 Ilu Iij-, kficclouilicl UVUUjV VVC1,j110U OLU11V 134.31C1j10U veritt-A ;U 11 111fVt:fV1VUP 111caullcal C11juva) LnJ uraveiiess disposai systei ns: type, number and LLI tievations of laterals installed as on approved pian SAF A.- Uzi i-wat 111 Z)V U i i va VVIlVit [BaCU tzp Mlip0m Ra tea for exterioritplaced outsiae --------------- ----- ---- toll free 1.800.377.3044 978.282. 0014 infoOmillriverconsulting.com Page 3 C f 0 I sr�.�. �. w.�.�._w_�.l•p� /mow sq�s� wi.4i��/�� G�P•J FL Rod at. 'Bencinnia-int.: 01.98- 9daV'ER3 ON DEvIGA!PlA!!i ELEV C&TOP OF F'Er^c aiivc s s—' P'^ CL evim . r`. oepucc 1,anK 1114 f G.11�i p+.3 Fes" 7-AA ESE a`_ �n dtn fir. 'L+n sts Ar Dustinbution Box 141 .�..,., ,.�.i., ,...J i I i I y` toil free 1.v800.37-1 3044 .978.282.0014�� info@millriverconsvlting.com p'^7� 4 of 4 � e I 0 9 4 ,nl-o 0 0 0 (`tiI O i 0 0 . . ' TOWN OF NORTH ANDOVER NORTH 37/.1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 4 M 27 CHARLES STREET # Z qAAi6A Mme` NORTH ANDOVER, MASSACHUSETTS 01845 "SSgCN�s�< Heidi Griffin 978.688.9540—Phone Acting Health Director 978.688.9542 —FAX October 22, 2003 Beverly Shea 105 Sullivan Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 105 Sullivan Road,Map 107B, Lot 10, North Andover, Massachusetts Dear Ms. Shea, The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by Engineering& Surveying Services dated August 28, 2003, revised September 22, 2003 and October 14, 2003 and received by this office on October 15, 2003. The design has been approved for use in the construction of a replacement onsite septic system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection which did not meet the acceptable criteria in the state regulations. The time period for which this plan is valid may be reduced by the North Andover Board of Health in the event an imminent health problem such as sewage backup into the dwelling is occurring. This approval is subject to the following conditions: 1. 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, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2. 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 and/or imply compliance Y ance with anof the aforementioned requirements. e i 1' 3. In accordance with the approval issued to Infiltrator Systems Inc. by the Massachusetts Department of Environmental Protection dated February 21, 2003, only a Disposal Systems Installer who has been trained by the company may install the Infiltrator units in the soil absorption system. This will need to be demonstrated prior to issuance of a Disposal System Construction Permit. 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 might have.. Sincerely, Heidi Griffin, Acting Health Director encl: List of licensed septic system installers cc: file Engineering& Surveying Services I Page 1 of 2 Pamela DelleChiaie From: "Dan Ottenheimer"<info@milldverconsulting.com> To: "Heidi Griffin"<hgriffin@townofnorthandover.com>; <blagrasse@townofnorthandover.com>; <pdel lechiaie@townofnorthandover.com> Sent: Thursday, October 02, 2003 5:19 PM Subject: FW:septic design plan Copy of e-mail I sent to Ms. Shea. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014.or 1-800-377-3044 fax: 978-282-0012 info@milldverconsulting.com -----Original Message----- From: Dan Ottenheimer[mailto:info@millriverconsulting.com] Sent:Thursday,October 02, 2003 5:18 PM To: 'bshea@mccollisters.com'; Heidi Griffin; (blagrasse@townofnorthandover.com); (pdellechiaie@townofnorthandover.com) Subject: septic design plan Ms. Shea, Our company has provided the staffing and support services related to on-site wastewater for the Town of North Andover since August of 2003. 1 am in receipt of your recent communication to the Town and wish to provide as much guidance as possible to you at this stage. My understanding is that due to several factors it took some time for the septic plan to be completed by your septic designer. Our company reviewed the first submission and as you probably saw found a number of items which were in need of attention. Many of them were drafting corrections which have been resolved in the more recent submission. I have spoken with Mr. Greg Saab who works for Mr. Clayton Morin, P.E. this afternoon regarding this design. Just so you are aware, the key point which was not addressed from the earlier plan review was the requirement in the state regulations to use trenches (which are long and narrow means of disposing of the wastewater) over the field (which is wider and flatter) which was specified. This item is important because the science and the regulations indicate improved wastewater treatment occurs underneath leach trenches. Mr. Morin's revised septic plan indicates that he is proposing to use a leach field because it would avoid a pump. Our review of the 10/3/2003 Page 2 of 2 M G O design indicates plenty of room exists for trenches to be installed either with or without a pump. We are not sure why this was not addressed in the plan revision and have left it with Mr. Saab to consider this once again. We anticipate hearing from them shortly. Your letter of concern over the time and expense involved here is legitimate. I trust you will understand that the Town wishes to make sure that the septic system which is installed at this house will properly treat and dispose of the wastewater from the house for dozens and dozens of years. This is in the interest of the future owners of this property as well as the health and environment of the Town. Proper wastewater treatment and disposal is achieved by assuring a septic design is in compliance with the regulations, that the septic system is constructed in accordance with all regulations, and that the property owner maintains their septic system properly. Thank you for your attention to this matter and I anticipate your septic designer will complete a plan in compliance with the regulations and it will be able to be constructed shortly thereafter. Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 info@miIlriverconsuIting.com � I 10/3/2003 � o F N ANDOVER HEALTH DEPART,03:33 PM 10/0212003-0400, SEPTIC SYS To: N ANDOVER HEALTH DEPART From: Bev Shea<bshea@.rnccollisters.com> Subject SEPTIC SYS Cc: Bcc: Attached: GOOD AFTERNOON , I AM WRITING THIS LETTER TO SEE IF I CAN GET A LITTLE HELP HERE. FIRST OF ALL I HAVE BEEN ATAXPAYER IN NORTH ANDOVER ALL MY LIFE AND A RESIDENT OF N ANDOVER. I WAS HAVING TROUBLE SINCE LAST MAY WITH MY SEPTIC SYSTEM. SINCE MAY 1 HAVE BEEN FOLLOWING THIS PROCESS ALONG. I HAVE SEEN PAYING TO HAVE MY TANK PUMPED OUT AND REEMED OUT ETC TO THE TUNE OF ABOUT$3500. THIS IS A HEALTH ISSUE FOR ME, I WOULD LIKE TO GET MY SYSTEM FIXED. IT WAS NOT KNOWN TO ME WHAT A PROBLEM THIS WAS GOING TO BE. I HIRED THE CONTRACTOR MR. WYMAN AND HE CONTRACTED HIS ENGINEER TO HAVE THE PIANS DONE AND SUBMITTED TO YOUR TOWN PERSONNEL. ALSO FOR THE PLANS IT WAS 2200. AND ABOUT 20,000 FOR THE SEPTIC 1 HAD TO TAKE A LOAN OUT FOR. THIS IS ABSOLUTELY A MESS. HERE I AM CALLING EVERY WEEK TO SEE IF THEY WERE WkCK FROM YOUR ENGINEER. NOW THE PLANS WERE RETURNED WITH THINGS TO CORRECT, WHICH IS FINE, NOW ANOTHER TWO WEEKS OR SO. I CANNOT BELIEVE THE PROCESS I HAVE TO GO THRU_ I CANNOT GO THRU THE WINTER WITHOUT A REPAIR TO MY SEPTIC. I DONT KNOW IF ANYONE IS AWARE OF THIS, I UNDERSTAND YOU CANNOT DIG AFTER A CERTAIN TIME OF THE YEAR_ WHAT AM I GOING TO DO WHEN THINGS BACK UP, GET AN OUT HOUSE FOR THE YARD. i CANNOT BELIEVE THIS PROCESS. i JUST WANT TO HAVE MY SYSTEM FIXED AND WHATEVER I NEED TO DO PLEASE ADVISE ASAP. I AM RUNNING OUT OF TIME AND MONEY, IF YOU COULD HELP ME OUT OR ADVISE ME THE NEXT STEP. I SEE ALL AROUND CONTRACTORS PUTTING IN 50 HOUSES ALL APPROVED, HOUSES CONDEMNED IN NORTH ANDOVER FOR NOT FIXING THEIR SEPTIC. ALL I WANT TO DO IS HAVE MY SYSTEM FIXED COULD YOU PLEASE ADVISE ME WHAT TO DO NEXT, IS THERE ANYWAY SOMEONE CAN HELP TO MOVE THIS PROCESS ON I REALLY CANT WAI R WEEKS. SlNCEREL BEVERLY SHEA 105 SULLIVAN ST N ANDOVER MA 01845 PHONE 978 681 0743,WORK 978 664 9300 Printed for Bev Shea <fbshea rncc011isters.com> _ 1 Tnnrdi sx�.T.si�r�ro��w YVA WST CO/ZO/0' Page 1 of 1 Q p Pamela DelleChiaie From: "Dan Ottenheimer"<info@millriverconsulting.com> To: "Heidi Griffin"<hgriffin@townofnorthandover.com>;<blagrasse@townofnorthandover.com>; <pdellechiaie@townofnorthandover.com> Sent: Monday, September 15,2003 4:40 PM Attach: Sullivan#105 Plan Reviewl.doc Subject: 105 Sullivan Heidi, Brian and Pam, Attached please find the plan review for 105 Sullivan Street. I know an attorney was asking about this at the end of last week and I wanted to get it to you as quickly as possible. The design says Sullivan Road but all our sources indicate it is Sullivan Street which is what we said in the letter. Please check an official map and correct us if it is actually Road. I do not have Sandy's soil notes but anticipate they are as described on the plan. Feel free to corroborate yourself or send me a copy of the Meld book if desired. Otherwise, the plan is basically missing some typographical matters to help guide the installer and provide clarity for compliance with the regulations except for the possible need to re-design the soil absorption system to use trenches instead of a field. Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com I i 9/23/2003 o --- Town of North Andover O`�tota*a'9.Vo Office of the Health Department Community Development and Services Division 4k s 27 Charles Street " North Andover, Massachusetts 01845 �9ss T."��`g �cw�se Sandra Starr Telephone(978)688-9540 Public Health Director Fax(978)688-9542 September 15,2003 Clayton Morin Engineering&Survey Services 70 Bailey Court Haverhill,MA 01832 Re: 105 Sullivan Street,Map 107B,Lot 10 Dear Mr. Morin: The proposed septic system design plans for the above site dated August 18,2003 have been reviewed. Unfortunately,the plans cannot be approved as submitted. The following items are in need of attention prior to approval: 1. Please provide the full legal boundaries and abutters of the property being served. This may be accomplished on a separate sheet if necessary due to the parcel size. (3 10 CMR 15.220 and NA 8.02j) 2. Please provide the distances from the septic tank to the property line and from the soil absorption system to the property line. (NA 8.03a-c) 3. Please provide the location and elevation of the foundation drain. If there is no drain,please make a statement to that effect on the plan. (NA 8.02y) 4. The existing septic tank and SAS must be located on the plan and a note requiring that they are to be properly abandoned. (3 10 CMR 15.354) 5. Please specify a compacted firm base for laying the building sewer. (3 10 CMR 15.222(5)) 6. On the septic tank, manholes brought to final grade must be secured to prevent unauthorized access. Please describe how this is to be accomplished. In addition, the detail,plan view and profile view appear to indicate a different number of manholes to grade. Please clarify this so the disposal system installer knows how many manholes to grade are to be provided. (3 10 CMR 15.228(2)) 7. The inlet tee to the septic tank must extend 10"minimum below the flow line. (3 10 CMR 15.227(6)) 8. The inlet and outlet tees must be located directly under the manholes. (3 10 CMR 15.227(1)) 9. A note is required eq regarding the method for providing a watertight tank. (3 10 CMR 221(1)) 10. The septic tank loading must be stated on the plan. (3 10 CMR 15.226(3)) 11. Soil compaction is required below the distribution box when the soil is non-native. Please indicate this for the disposal system installer to implement during construction. (3 10 CMR 15.221(2)) 12. Trenches are to be used as the soil absorption system mechanism whenever possible. Please use trenches in this instance ore lain why the cannot be utilized.xP Y Y ized. (310 CMR 15.240) BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 0 0 r 13. A vent pipe is shown on the plan view but not the profile view. Please clarify this incongruity. Additionally,the soil absorption system vent must be through the same pipe as the distribution system and must be protected from precipitation and animal entry. Please provide construction details to demonstrate the methodology to be used to achieve this. (3 10 CMR 15.241(1)(a)&(b)) 14. The distribution lines must be connected with a solid pipe and the plan must so specify. (NA 15.01) 15. There is no label or description of the cover material over the soil absorption system. (3 10 CMR 15.240(9)) 16. Plan Note#16 is not complete. Though not a reason for disapproval,you are encouraged to consider that you may be able to reduce drainage and fill issues with use of an impervious barrier in compliance with the Massachusetts Department of Environmental Protection Policy BRP/DWM/WPeP/G02-1. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sin erely Brian J. LaGrasse Health Inspector cc: Homeowner CD&S Dir. mile i Page t of 1 0 0 Pamela DelleChiaie From: "Dan Ottenheimer"<info@milldverconsulting.com> To: "'Pamela DelleChiaie"'<pdellechiaie@townofnorthandover.com> Cc: "'Heidi Griffin"'<hgriffin@townofnorthandover.com>; "'Brian LaGrasse"' <blag rasse@townofnorthandover.com> Sent: Friday,August 29,2003 1:07 PM Subject: RE: 105 Sullivan Street Ok. Let me know if I need to do anything other than the usual plan review. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com -----Original Message--=-- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com] Sent: Friday, August 29, 2003 12:51 PM To: Dan Ottenheimer Cc: Heidi Griffin; Brian LaGrasse Subject: 105 Sullivan Street Hi Dan, I will be sending a Plan Review for 105 Sullivan Street in the mail today. The engineer is: Engineer is: Engineering &Surveying Services, 70 Bailey Court, Haverhill, MA, 978.815.7835 and John Whyman is the contractor. I know that there was a problem with John Whyman an installer in the past. He provided the check for the plan submittal, however. I will go ahead and forward the plans for review and talk to Brian next week. Thanks, Pam 9/8/2003 �J Town of hdr'th Andover, Massachusetts -11 Form No.2 c� MooTM BOARD OF HEALTH •;�o o 19 F w o p asy ---- •'`* DESIGN APPROVAL FOR $AcmuS``� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant z Test No. PP p Site Location Reference Plans and Specs. E GINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee Site System Permit o Q SEPTIC PLAN SUBMITTAL FORM LOCATION: ( () S7 dpi NEW PLANS: YES $ 25.40/Plan Check#: ()73 v (Includes 1 sr Re-Revs n y) REVISED PLANS: YES $ 60.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO DATE: DATE TO CONSULTANT: E/-( L E 2(,JC- SL)ao G- n�G �a2vcck DESIGN ENGINEER: &aZ�-G-- SA A-43 Telephone#:a7C"> 8(37— 7,93 5 OFFICE USE ONLY When the submission is complete (including check): 1. Date stamp plans 2. Complete the P:"._';`: DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM form 3. Attach file and route to the Health Director for review TOWN OFid0�s t" iii TU, `R/�'I nor OF No. [ ) O FEE COMMONWEALTH Of MASSACHUSETTS Board of Health, NO 2T/t A/)i20 U n;-MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair(p4"Upgrade( ) Abandon( ) - O'Complete System ❑Individual Components Location ® Sty./71 1/Z, d Owner's Name Map/Parcel# /r) 7 Address Lot# /D Telephone# Installer's Name p�v (�Y N"l /lJti Designer's Name JE:- S S Address Address 70 g f�/L�u �T H/�✓ Pi l Telephone# '79 —3 t3 a 3 Telephone# 5—— '793 3J— Type f , Type of Building Lot Size Q94T/�2-f-- sq.ft. Dwelling-No.of Bedrooms f Garbage grinder Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) yLib gpd Calculated design flow Lf ga Design flow provided gpd Plan: Date 9-'� $— a '�— Number of sheets Revision Date Title Pro D K of T��GP Sema t� 0 i/ "F�� -ice Description of Soils) �Aj Soil Evaluator Form No. Name of Soil Evaluator G�Cq ��'� Date of Evaluation 7 DESCRI TION OF REPAIRS OR ALTERATIONS AJ e yj (5-6® al vvxt�,,\o ,.,,IA -Lo xSo �e The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees tn' t to place th ystem in operation until a Certificate of ompli C has been issued by the Board of Health. Signed Date Z Inspections No. FEE (` N ¶"ALT14 OF TSETTS Board of Health, �T, MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector: Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. FEE ( NW F MASSACHUSETTS T Board of HeeaTlth, CONSTRUCTION T T , MA. DISPOSAL STEM Permission is herebyranted to; Construct( ) Repair ) Upgrade ) Abandon( ) an individual sewage disposal system g P Pg g P Y at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health No. [ ) O FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, No JE7 f 4A)120 u P,-,-MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair(0-1"U'pgrade( ) Abandon( ) - l9'Complete System ❑Individual Components Location 15 4 I Vlih d Owner's Name e Map/Parcel# Address Lot# Telephone# Installer's Name �� (�YN,.I -V&) Designer's Name 4, S� S Address Address 70 Telephone# '7 ( - 3 (3 a 3 Telephone# 8/57- -2933J— Type /57— '7933f-- Type of Building Lot Size g9jee z-f- sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( )MC1 Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) yLlbgpd Calculated design flow t+19 Design flow provided gpd Plan: Date Number of sheets 2 Revision Date / Title PSD © w urfo�CP_ �eWGc tS o s ��m i e! Description of Soils) /— /� Sail ���'� Z` �/Qu tP�� LOpr•-t �y r. Soil Evaluator Form No. Name of Soil Evaluator ��� �J�i Date of Evaluation *7_/5-_o3 DESCRI TION OF REPAIRS OR ALTERATIONS AJ e UJ (;Q® cd V'AD✓\ C(9 �-C, V JA o X ,{o The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees t Lt toplace th ystem in operation until a Certificate ofompli ce has been issued by the Board of Health. Signed Date I � Inspections No. C®MMO WEALT14 OF MASSACHUSETTS FEE Board�o1f,Health, , MA. CEit TIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector: Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. FEE COMMONWEALTH NWL F MASSACHUSETTS T Board of Health, , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health LOC C,OL i L )N T iNIE ll � 71 iME: i,6" E_ TIIME: E =i ISI,r•� i �.�'.=.v .:�.:r. INV f i _ 3 ' f 1 .i , I t ti Town rth Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH 19 APPLICATION FOR SITE TESTING/INSPECTION SACHUS�S�y Applicant ` " "z NAME ADDRESS TELEPHONE Site Location Engineer ! NAME ADDRESS TELEPHONE i Test/Inspection Date and Time ! CHAIRMAN,BOARD OF HEALTH Fee Test No. mac% + d /2 7; S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. 1 � 't.• Town oA-jr'th Andover, Massachusetts y \--J Form.No. 1 NORTH � BOARD OF HEALTH Q��t.ED ,b q•yO � . APPLICATION FOR SITE TESTING/INSPECTION r �9SSACHU60- •, Appl i&ant NAME ADDRESS TELEPHONE Site Location 7y Engineer g NAME ADDRESS TELEPHONE Test/I nspection Date and Time 1---4ldz3 =Z4 ` 6 Za —? CHAIRMAN-,BOARD OF HEALTH -' Fee— � Test No. /4, r t S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. avtra sxef;e�s;�9� � + tip f)6 UB 02:27P Cl0l2TH gip " BOARD OF HEALTH ANDOV ' ,1tr�ASS.01845 C h NORTH 97a.4fls•A54a AppLrIC,A,TION FOR OYL TESTS �P ©� DA'1 E: `� .... IC)S7 179' LOC LTXUN OF SOIL-ps*rS: _ oW,rr>R: p ADDRESS'. TBI,.NO..�?6 S a 3 (33 Z-3� 7 EVALUATOR: YA d SOIL� rciat CBR'T1FIFi Comme e Fattut H Intended use of land: Rtisidcntial gobdtvision Sin Y Is This: Undeveloped lot testing .----- Rep�ir testing, No in the Law Cochichewiek Watershed? Yes TH1ir r-oLLOWINC.MUST BE INCLUDE Wr-M CHIS FORM 1. Proof'of land n rip(Tax bili.dead,or letter from owner permtttm6 tests) c/ two deep holes and two p olation'wsts 2, Plat plan tion. This covets the rainiirntni truC ✓/ 3. Fee of Von per lot for !'cans myja a un - required for each disposal area• l=ee of pt int Cor�,,,�.—.f.------- it Eva%atom rosy t om`gyp hole imptedans 1, �Certified So users can design septic p� Q. -only b asp pagisteared Sanitati�atts and Professiouat latiot�teats are required fs�r'na,ch septic systtsm disposal�. 3, At least twa.dcep holes olid two pet ea tan gest,at the discretim of the BOH representative. uite.at least cavo�P Kotex and at hast a�ie percalat` testing- 4. Rt m6 Mt iced for all a�iiaiortat casts within two weeks of r� Full payotettt wt11,be" submitted to the Board of Health showing the Of testing'a sc.Wrd Plan{no smaller than 1 -t�j shat!be 6. Within 45 dayslasts} ! cation of all tests(including aborted Within G0-days of tasting said evaluation form shall be submitted- at is in N.A Conservation Commission Approval: -- k Date: Date ILeceived;_ Check Antbunt: o20d. Mtec TO Jig!OF NOR TI!,ANIIOV ij/ BOARD OF HEAUFH} MAY 2 8 2003 O T LIJA 105 Sullivan Road' North Andover. Nassachusetts scale: lei _ 40' Date: Ju1ne 9, 1977 ,e ,oveTivv of cor �i �'� Ill , h Q icic ear ell owe.. ro .c%0.L D P* row'r. O. 5 IVAf& I hereby cert3 f`y' that the bud-lding on this property is located as 'lie's tdth shown on plan and comP the. Building and Zoning Laws Of the down of North Andover, CHAtMSS E. CYR CIVIL EMINM Z,p�,1FtF1+�E, MASS. , of N.B. Do not use Offsets for et estaVIiahing lot lines ► .!�'ro for the erection of fences; GYA imLUs, hedges etc. "GAM o t�PC/STr, pq` SU ..gra —' S?i�.LSi'i'i0��i� 7N3 5T 80 co/ZZ/40 0 s��asu, ' 0 06/22/03 08:18 FAX MMCCCOLLISMS _ WU044 . aVITGL PA 0620 GHORT FORM(UtDWMUAL) ti+, of -7.2 Vilverly Road, 1;orth Andover,Boom untyy,�s�b�ktes We. John E. gullivav gtre t, North Andaver,and $seas CowntY, Beverly Httsbaud."4 being. for wa idaratioa paid,and 1n fill 0°II61d�oa of No cone3derstion Ms W B,ave;lly Shea, Ipddvidually, of said 105 Sullivan Street, North Andover, s Couatlr, Masaschusetts. with wAtthft rawmao shown'as Lot numbered du land in said North Andover. with the buildings thereon. and being over, one (1) on Plan of land entit ��Court division Plan of Land in Nora► And. Robert E. Anderssm, f land shown on plan for Welltberttdr -if WWI °Anderson, Ina.. Reg. Mass.. being a subdivision o 7slc., dated November 13, 1965: dated ,Tune 13, 1966, by of Deeds as Plan No: 5580, Professional zagineer,'recorded Vith North Easelollays: s Registry said premises being substantially bounded-and described as S00''fBt:U:STi�L'Y Y-Sullivan Street; scro<etimea called Sullivan Road,, on¢ hundred twenty-one V3 anC7G/1 ,(121.70)-feet; ht and 30/100 (28.30) fest; two hundred SODTHSM by dlid Sullivan Street. ttfAIItY�eig SOUTHWEB g&F�n by ledd of Andrew X. Rossi, 3r., and Lucille N- R0881' tl aim A8/100 (260.48) feet; y lead of Trauma 0, Goodbiva' and mostly by a stone wall, is sig courses NORM y three and 65/100 (403-65) feet; tht;ffM four lenndred seven 137) feet; and NOBTNiiflST v •Lot ntaobered four (4),one hundred thirty- '5y Lot numbered two (Z), three hundred fifty-nine and 70/100 .(359.70) twit ILI as shown on said plan. end all Coatm��t3,��e"�25 equate feet, . Said premises ire conveyed subject to and with the benefit of alofar eltas$same arereststill tions, eoudi-ti-ahs and reservations of record, if any, in force and 67'plicabla. Being the sake premises.couveyed to us by deed of Walter P. Hoyt and Lillian M. Hoyt, by dead dated March 1, 1968 and records4 in said North Ecsex Registry of Deeds at Book 1101. Page 450. 77 949..hind S and seat a this..,...- Rt3nth o f une... ....:...... 19..... ..............btte--............. ........................ _... ...0 ...............I...... ................... ........... ........................ ........ .. _......... .. ....... ... ....» ........ ......................... ».. ........,:..»..:.............. ...I.................... alp pi " 7nna 9. 1977 Essex, 9s Am pei n y appeased the above named John E. Shea,.Jr. and Beverly Shea - sacl acknowledged the forgoing iastr=ant to be. thei ote me . ' � 19 P3 7sti �P G Recorded June 9,1977 at 3:40PM #4940 / (•!ndiv.MW—joint Tenants—.Tenants.in Common T=ab by the RO&dy') CHapm lsd stir—6 AS A»By CIAMM 497(W 190 g�dead twomadfoe eaootd shall aoatdn at bm aadoned+woe it the fall- n ddWA sad post affiee adba�fi ' sod a redbl o,f�,mde�aae��oma of she fna maddeodion thetvoE is da0w ae d+e a�te�19,e erase ���0e oxomb is ssaomed. The fall too" nos daU mtmm*1�a�d F� ! VaM m�ntng mom All mab mausemen+s sad m s dull ha neaoeded as yae'If-'h-deal PA000e to Comply with eaifvn d:eLL not d[mt the TA44 of aW deed.No ttgloor of dee&tan woMt a deed fot tacntdie6 nntem it h is mmPlianw with the forivammta of dab nachos. 4940 4 j cam. MASSACHUSUrrSro €SgX pF_G.OF DEEDS N _ t nwnnnouwt� ._ •:13�q-pAc� fI 6 � W Jo R. Sha,gr. aadnRw Beverly Shea t I . f _l MIT e a S �» . nt ..._.3--c clock Rcajived and mea wtah. �...,..... ! `o .�r�t WAno Tm an=07H A a DALTON, DUTOK ASOfAM A M"ff x o 12 ESSEX STREET z l POST OFFICE SM 31. Q 9 �R ANDUVER, MASSACHUSETTS 01810 g TEL 817-47b-MS 3 ¢W RETURN TO-'A 9 Ra�Ir 8 Naemr4 M-- w runummm wrApown&Rat four t sveron-M.o. Form 88I i - - - VIEVMW cnArren 407_e0" - - 'tit'� y �tt I tirl + 1� r ,ir rr � ry Z ,1 1� t,)=..1 1• + C Tb VN OF NORTH'APiDOVER ,- SYSTEM PUMp1:NG R coR-D [L� �1 I'EM UWNER & ADDRE$3 SYSTCM LOCATION ne c ("4MRIC 10 frons of hou�r) s • U I'C OF FUMf'(NCr' �s3 QUANTITY f'UMhCp I,00l 7N0'' YES SEPT1C' TANK: N0 YES ------- x ATURE OF SERVICE .':ROUTINE, EMERCEN"CY QUOD C0NUJ1'LON. h'ULL'To CUYCIZ OAF LS IN PL,ACP I O.OTS LEACHFICLD RUNUAC°K.•, C. XCESSI-YE SOLIDS FLOODED S0LI0S CARRY0YERHF.R (EXP LA.1N) u,: .....-...,. i� >1 aI l:M PUM ('Cb RYi. C•vvi"YI ( NTS UNTh,'N'I'S TRANSF CM RED To: TOWN OF NORTHANDOVER SYSTEM PUMPING R_ECOU %)Uo! 3 2003 �7�.I'EM OWNER & ADDRESS .. SYSTEM LOCATION p (eUmPle; lef( from of house) U:\TC OF PUMPINC; QUANTITY PUMPED did G'ALLu� � C . /VmSPOOL: NO: S SEPTIC TANK; NO YES � ATURE OF SERVICE; ROUTINEEMERGENCY (111.>rriY..�TIONs; GOOD CONDITION. NULL TO COYER HEAVY CREASE 13AFFLLS IN N,ACp ROOTS LEACHFIELD RUNBACK.. CXCESSI-YE SOLIDS FLOODED SOLIDS CARRYOYER :P�HFR (EXPLA.IN) >1'..>TLM PUM ( CD R Y; '/ .� 0N I k'.NT" TItANSFCIZRED TO: t PN OF k"ORTWAmi F,0. F H E A LTH 0 WN 0 o �5 A SYSTE .m PU'VIPING .j 202 --/ -- -4-T07- S I�� W�� 15 Ut' PUM �INC UA I"� 1 y U U -No -S S I"T I C TA n E G S;-- Rv!C� R 0 U"' 1 cl C D T 10 N . F IVY CREASC RUCTS LEACHFI "I EXCESSIVE SOLIDS FLOODED SOLJIDS CARRYOVER 0 z EX ?''_ P j I ! y 40 ,41 F N T,, 1 1ZAINSFCIMLD I'U : Commonwealth of Massachusetts RECEIVED City/Town of APR 2 7 2016 , . i System Pumphi6.Record TOWN of NORTH ANDOVER Form 4 HEALTH DEPARTMENT DEP has provided this form for usezby 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.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, Left/Right rear of house, Le /right side of house Left/ Right side of building, Left/Right front of building, Left/Right rear of buil Ing, ec c Address toy :-- City/Town State - Zip Coale 2. System Owner. Name Address(i different from location) Cityfrown ' state ip Code Telephone Number d f; .B. Pumping Record 1. Date of Pumping Dat ' '` 2. uantity Pumped: Gallons 3. Type-of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? Yes ❑ No If yes,was it cleaned? es ❑ No, ' 5. Condition of System: 6.- System Pumped By: Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location where contents-were disposed: G L�S.Q Lowell Waste Water Signble 9t HaulerU Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1