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Miscellaneous - 110 DUNCAN DRIVE 4/30/2018
r � ` W n d F+. i /1/I�l�v amt //� V 1 �✓G^ 0 110 D UNCAN DRIVE TS-2004-0825 Project Detail Report Printed On:Mon Mar 01,2004 Project Name: Septic System GIS#: 15986 Project No: JS-2004-0825 Owner of Record BARBAGALLO,JOSEPH J,JR Map: 1104.13 Date Submitted: Jul-25-2003 120 DUNCAN DRIVE Block: 1172 Status: Open NORTH ANDOVER,MA 01845 Lot: lWork Category: Work Location: 1110DUNCANDRIVE Zoning: JProposed Use: District: land Use: 101 JProposed Use Detail Subdivision (13C) Description Septic System Comments: of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2004-0040 2/28/04-COC Issued. Mailed to Joe Barbagalio at 120 Duncan Drive. He will be moving in this coming weekend. 7/25/03-DWC Permt issued to Dave Maynard Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: DWC-System Constructio BHP-2004-0301 Jul-25-2004 SIGNED OFF JS-2004-0825 Construct-Complete s GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 1 of 1 Lot & Streeter ?" �.� r'/ /c_ `s 1 ( Map/Parcel C l7�), CONSTRUCTION APPROVAL Has plan review fee been pai Y� NO Permit# Plan Approval: Date: Approved by: Designer: J �l3i�P/�C � �� Plan Date: Conditions: Water Supply: Town ell Well Permit: Driller: Well Tests: Chemical Date Approved Bacteria I Date Approved Bacteria II Date Approved Plumbing Sign-Off: Wiring Sign-off: Comments: Form "U" Approval: Approval to Issue: YES NO Date Issued By: Conditions: Final Approval: All Permits Paid? YES NO Well Construction Approval? YES NO Septic System Construction Approval? YES NO Certification? YES NO Other? YES NO Any Variance Needed? YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: SEPTIC SYSTEM INSTALLATION CONDITIONS: Is the installer licensed? YES NO Type of Construction: NEW REPAIR New Construction: Certified Plot Plan Review YES NO Floor Plan Review YES NO Conditions of Approval from Form U YES NO Issuance of DWC permit: YES NO DWC Permit Paid? YES NO DWC Permit# Installer: Begin Inspection: YES NO Excavation Inspection: Needed: Q, Passed: By: V V Construction Inspection: Needed: As Built Plan Satisfactory: YES: Approval of Backfill: Date: By: Final Grading Approval: Date: By: Final Construction Approval: Date: By: Certificate of Compliance: Approval: Date: Commonwealth of Massachusetts City/Town of Merrimac RECEIVED System Pumping Record Form 4 JAL.L 2 0 2012 DEP has provided this form for use by local Boards of Health. Oth rT $pM�Aww kt he information must be substantially the same as that provided here. efietmtuls �aYs,f�rmu-fch ck with your local Board of Health to determine the form they use. The System umping ecor mus a submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When _.. filling out forms 1. System Location: on the computer, use only the tab: s✓f© �C.i d� �Gt ✓i 6 key to move your Address cursor-do not ^/�, � ,,I ve r M,A use the return t /Town key. Ciy State Zip Code 2. System Owner: Name faun Address(if different from location) City/Town State Zip Code q -37,S-- :36 7S' Telephone Number B. Pumping Record / _?7 I.2 1. Date of Pumping Date ^ ` 2. Quantity Pumped: calions �w 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: &I � 6. System Pumped By: Name Vehicle License Number BORACZEK'S SEPTIC & DRAIN Company 7. Loc n where co nts weredispose4: Signature of Hauler Date Signature of Receiving Facility Date t5form4.doc-03/06 System Pumping Record•Page 1 of 1 of 4NORT11,� r .. w 6136 L • Town of North Andover HEALTH DEPARTMENT ,SSACM�St� CHECK#: ATE: LOCATION: n. 4H/O NAME: CONTRAC OR NAME: IL 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 $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Tittll Inspector $ �Title 5 Report $ .� ❑ Other. (Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Masslchusetts - v Title 5 Official Inspection Form v Subsurface Sewage Disposal System Form - Not for Voluntary Assessments d M 110 Duncan Drive Property Address v Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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:WhenRECUIVLOU filling out forms A. General Information on the computer, use only the tab 1. Inspector: JUN 15 a1z key to move your cursor-do not F. Paul Cardone TOWN OF NORTH ANDOVER use the return Name of Inspector HEALTH DEPARTMENT key. Septic Compliance, Inc. G Company Name 447 Boston Street Company Address Topsfield Ma. 01983 City/Town State Zip Code 978-681-0726 978-407-1808 3294 Telephone Number License Number B. Certification 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 ❑ Needs Furthe,- va ion the Loc Approving Authority �ector's Sig 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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: ® I 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•11/10 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 M 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts _ W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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 'h day flow t5ins•11/10 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 M10 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. Cityfrown 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 ❑ ❑ 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Duncan Drive M Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 _ 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•11/10 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 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gPd)) Private Well 120' from system Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied Commercial/Industrial Flow Conditions: Type of Establishment: N/A 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•11110 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 110 Duncan Drive M Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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: According to the owner pumped two years prior to inspection. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Pump truck tube Reason for pumping: Due for routine pump 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•11110 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 110 Duncan Drive M Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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: House and system are 8 years of age, on file at B.O.H. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 120' feet Comments (on condition of joints, venting, evidence of leakage, etc.): All in good condition,no evidence of any leakage. Septic Tank (locate on site plan): Depth below grade: 30" Brought up to grade with concrete riser. 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: 10'x6'x5'10" Sludge depth: 5" t5ins-11/10 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 M 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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 Scum thickness 3" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Septic Dip-Stick and tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): We recommend tank be pumped on a yearly basis,tee's in good condition,structural integrity appeared to be good,liquid levels were good, no evidence of any leakage. Grease Trap (locate on site plan): Depth below grade: N/A 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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: N/A 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-11/10 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 110 Duncan Drive M Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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 Level was good and even. 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.): Ran water through box distribution was equal, box was level,heavy duty box was used,no solids carryover,no leaks in or out of box. 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.): N/A Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Duncan Drive M Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 5 ❑ leaching chambers number: ❑ leaching galleries number: - ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ 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.): Good No None No Grassy front yard area. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Duncan Drive M Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. City/Town 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: N/A Dimensions -- - Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)-. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 & G G G� 3 �4 rEyct. �«�a 10 DUIVf1� 1V -Z) RIVE � s b z NORTH lk ----------- IN s 71 o -semi 0C-i7' / 4/5 --J/30 f 00 iq OFN OF H F r � w 1 r E' b T f f. f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. City/Town 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 where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Ur MAILKIALS AND 51UKAGE UI- LQUIPMLN I UVER LEACHING AREA PROHIBITED AT ALL TIMES. 10) SYSTEM AREA SHALL BE STAKED AND FLAGGED FROM DATE Or INSTALLATION UNTIL CERTIFICATE OF COMPLIANCE ISSUED. 11) ALL PIPES ARE TO BE SCH 40. SOIL TEST DATA_ TESTS CONDUCTED BY : JOE BARBAGALLO DATE: 6/20/00 TEST WITNESSED BY: CARLTON BROWN PERCOLATION RATE(S): 12 & 5 MPI DEEP HOLE f 1 DEEP HOLE 1 2 0" 128.90' p" 130.90' A F.S.L. 10YR 3/2 A F.S.L. 10YR 3/2 3" 128.65' 3" 130.65' Bw FSL 7.5YR 4/6 127.40' Bw FSL 7.5YR 5/6 129.40' 18" 181) C FSL 10YR 5/6 34" 126.07' C SL WITH STONE 125.90' 10YR 5/6 PERC C2 FSL WITH STONE 124.48' 2.5Y 5/6 PERC ROOTS 059" - ROOTS 090" � 98" 120.73' 104" 122.23' ESH WT 0 59" 123.98' ESH WT 0 92" 123.23' ESIGN DATA PLAN SHOWING 4 BEDROOMS X 110GAL = 440 GPD PROPOSED SEWAGE DISPOSAL SYSTEM SAND LOAM CLASS 2 12MPI — LTAR=.56 440/.56 = 786 S.F. 5 LEACHING PITS WITH 4' OF DOUBLE WASHED STONE SCALE: AS SHOWN DATE: 3-11-01 BOTTOM 12.67' X 48' = 608 S.F. REVISED: 5-30-01 REVISED: 7-4-01 SIDES 2(1.83X48')+2(12.67'X1.83') = 222 S.F. TOTAL = 608 + 222 = 830 S.F. OWNER: BARBAGALLO CHILDREN REALTY TRUST 830 S.F. X .56 = 464 GPD 120 DUNCAN DRIVE NORTH ANDOVER, MA 1,500 GALLON SEPTIC TANK NO GARBAGE GRINDER LOCATION: MAP 1048 LOT 172 ;��v11Nys DUNCAN DRIVE NORTH ANDOVER, MA DESIGNER JOSEPH J. BARBAGALLO R.S. y o� 1 WESTWARD CIRCLE yc7v3fA�o�'v' NO. READING MASS. TEL 664-4983 2 OF Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 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: 59"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: 7-4-01 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: All liquid levels were good,basement was dry, no sump pump, checked soil logs on file. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 110 Duncan Drive Property Address Joseph Barbagallo Owner Owner's Name information is required for every No. Andover Ma. 01845 6-9-12 page. Cityfrown 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 l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 North Andover Board of Assessors Public Access Page 1 of 1 NORTH rth Andover Boars of Assessors O�+•..ae i�1ti MIN � p ii +s 1SS.�CHUSEt roperty Record Card Parcel ID :210/104.B-0172-0000.0 FY:2012 Community: North Andover IIETCH Click on Sketch to Enlarge Click on Photo to Enlarge I A� x 110 DUNCAN DRIVE j Location: 110 DUNCAN DRIVE Owner Name: BARBAGALLO CHIDREN REALTY TRUST BARBAGALLO,ANN TRUSTEE (Owner Address: 110 DUNCAN DRIVE City: NORTH ANDOVER State: MA Zip: 01845 - 1 (Neighborhood: 6-6 Land Area: 1.77 acres ,Use Code: 101-SNGL-FAM-RES Total Finished Area: 3252 sqft 1 u 'ti 4 FII, 'Total Value: 524,400 524,400 Building Value: 311,600 311,600 'Land Value: 212,800 212,800 [Market Land Value: 212,800 :Chapter Land Value: 1,ATFSTSALE{ 'Sale Price: 100 Sale Date: 08/02/2005 Arms Length Sale A-NO-FAMILY Grantor: BARBAGALLO, r Code: JOSEPH Cert Doc: Book: 9682 Page: 181 http://csc-ma.us/PROPAPP/display.do?linkld=1894612&town=NandoverPubAcc 6/7/2012 Residential Property Record Card PARCEL ID:210/104.B-0172-0000.0 MAP:104.6 BLOCK:0172 LOT:0000.0 PARCEL ADDRESS:110 DUNCAN DRIVE FY:2012 PARCEL INFORMATION Use-Code: 101 Sale Price: 100 Book: 9682 Road Type: T Inspect Date: 05/25/x3004 Tax Class: T Sale Date: 08/02/05 Page: 181 Rd Condition: P Meas Date: 05/25/2004 Owner: Tot Fin Area: 3252 Sale Type: P Cert/Doc: Traffic: M Entrance: X BARBAGALLO CHIDREN REALTY TRUST Tot Land Area: 1.77 Sale Valid: A Water: Collect Id: SGC BARBAGALLO,ANN TRUSTEE Grantor: BARBAGALLO,JOSEPH Sewer: Inspect Reas: M Address: 110 DUNCAN DRIVE Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 8 Main Fn Area: 1992 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R1 Story Height: 2.00 Bedrooms: 4 Up Fn Area: 1260 Bsmt Area: 1444 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1.000 206,910 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 33590 0.771 5,859 Masonry Trim: Ext Bath Fix: 0 Tot Fin Area: 3252 VALUATION INFORMATION Foundation: CN BathQual: M RCNLD: 311590 Current Total: 524,400 Bldg: 311,600 Land: 212,800 MktLnd: 212,800 Kitch Qua[: M Eff Yr Built: 2003 Mkt Adj: Prior Total: 524,400 Bldg: 311,600 Land: 212,800 MktLnd: 212,800 Heat Type: HW Ext Kitch: Year Built: 2003 Sound Value: Fuel Type: O Grade: AG Cost Bldg: 311,600 Fireplace: 1 Bsmt Gar Cap: 2 Condition: V Att Str Vail: Central AC: Y Bsmt Gar SF: Pct Complete: 100 Aft Str Va12: Att Gar SF: %Good P/F/E/R: ///99 Porch Tyne Porch Area Porch Grade Factor T 900 SKETCH PHOTO so0 T 900 Sq.Ft ss 1s 8 90 42 22 FMB 01-1 184 Sq.Ft FM/FU/B FM/I 23 23 1260 Sq.Ft 528 Sq. t 30 30 AM no 24 24 no Fff 20 Sq.Ft 110 DUNCAN DRIVE =•� � Parcel ID:210/104.8-0172-0000.0 as of 6/7/12 Page 1 of 1 r y Town of North Andover, Massachusetts Form No.3 o< NoerN BOARD OF HEALTH + o G f p SSACHUSE ' Applicant • NAME Site Location &162- : Permission is hereby g- - Sewage Disposal Systerr - __.. .v vi ntAL 1 H • `ff n� Fee / D.W.C. No. �� r y Town of North Andover, Massachusetts Form No.3 • NORTM BOARD OF HEALTH • iso -_ DISPOSAL WORKS CONSTRUCTION PERMIT Applicant NAME y� ADDRESS TELEPHONE Site Location z// : Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN, BOARD OF HEALTH Fee /� D.W.C. No. �� F TOWN OF NORTH ANDOVE BOARD OF HEALTH Location Permit # Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers /$ Disposal Works Construction 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 ,/ $ Health Agent White - Applicant Yellow - Dept. Pink - Treasurer a APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: 7- 0'3 - 3 CURRENT INSTALLER'S LICENSE#- Zlq LOCATION: LICENSED INSTALLER SIGNATURE•. -z �' '�� TELEPHONE#a{{«e CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only $175.00 Fee Attached? Yes v No Foundation As-built? Yes No Floor plans on file? Yes No Approval Date: Town of North Andover, Massachu$etts Form No.2 pf Moe*H� BOARD OF HEALTH ^ p 19 F w ` °•i°---- ter' DESIGN APPROVAL FOR ` p5`` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. Site Location ,�( i /� /y`G✓l <.; �,� �/}.[,L� Reference Plans and Specs. EN ' • ENGINEER 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 P Fee�S� Site System Permit No. �5L GRANT OF EASEMENT I, Ann T. Barbagallo, Trustee of The Barbagallo FamilyRealty dated November 15, 1991 and recorded at Essex North Regis Massachu in Book 3347, Page 188, of North Andover, record owner of the property located at 120 Duncan Drive, North Ani Massachusetts, grant to JOSEPH J. BARBAGALLO, JR. and ANN BARBAGALLO, the record owners of 110 Duncan Drive, North lan of land en wn as Lot 13C on a land prepared for Barco Corpora County, Massachusetts, being shtion located in North Andover, Mas: Scale 1" = 40', dated August 12, 1981 revised August 18, 1981, Fran, and Associates, Inc., Engineers and Architects," said plan being recorded with the Essex North District Registry of Deeds, as Plan 48721, the following easement is for their benefit or their successors and assigns: The Easement granted hereunder is specifically a Fill Easement solely for they Q e benefit of the installation and maintenance of a sewerage disposal system foe�hMassachusetts.^: ' m property located at Lot 13C, 110 Duncan Drive,North Ando The meets and bounds of the Fill Easement are as follows: The Fill Easement area shall commence 203.97 feet directly South of the mgst o Northerly border of Lot 13C where it intersects with Lot 13B, and shall proceed , w East 25 feet, thence turning and running North 125 feet, thence turning and running West 25 feet, thence turning and running South 125 feet to the point of beginning. 0 This Easement shall inure to the benefit of the current owners of Lot 13C, as J s s in interest. .Q well as their future successors and aJJlgn o cn I ria Ute . GRANT OF EASEMENT 1, Ann T. Barbagallo, Trustee of The Barbagallo Family Realty Trust, u/d/t dated November 15, 1991 and recorded at Essex North District Registry of Deeds Massachusetts, being in Book 3347, Page 188, of North Andover, Essex Drive, North Andover, record owner of the property located at 120 Dun and ANNMassachusetts, grant to JOSEPH J. BARBAGALLO, JR. North AnT. dover, Essex BARBAGALLO, the record owners t 1 C onuncan Dra plan of land entitled "Plan of County, Massachusetts, being shown as Lo land prepared for Barco Corporation located in North Andover, Massachusetts, Scale 1 = 40', dated August 12, 1981 revised August 18, 1981, Frank C. Gelinas and Associates, Inc., Engineers and Architects, said plan being recorded with the Essex North District Registry of Deeds, as Plan 48721, the following easement is for their benefit or their successors and assigns: The Easement granted hereunder is specifically a Fill Easement solely for the installation and maintenance of a sewerage disposal system for the benefit of the,_'_' o property located at Lot 13C, 110 Duncan Drive, North Andover, Massachusetts: , p The meets and bounds of the Fill Easement are as follows: -:;F? -� The Fill Easement area shall commence 203.97 feet directly South of the most o Northerly border of Lot 13C where it intersects with Lot 13B, and shall proceeeendln East 25 feet, thence turning and running North 125 feet, thence turning and g d running South 125 feet to the point of beginning. West 25 feet, thence turning an 0 This Easement shall inure to the benefit of the current owners of Lot 13C, as well as their future successors and assigns in interest. Co o . cn LLL iii �'{�I /-'����'�•��'y`� �l/l/�.�-- �r 1 �1�`'�� Y Signed this !. day of February, 2004. The Barbagallo Family Realty Trust Ann T. Barbagallo, trustee COMMONWEALTH OF MASSACHUSETTS Essex, SS. ��� ��-� •Z.c���l On this day of February, 2004, before me, the undersigned notary public, personally appeared ANN T. BARBAGALLO, TRUSTEE of The Barbagallo Family Realty Trust proved to me through satisfactory evidence of identification, which was a Massachusetts Driver's License with picture, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that she signed it voluntaril. for its stated purpose. W Notgry Public My Commission Expires. 1 IG _ ESSEX NORTH REGISTRY OF DE aS LAWRENCE, MASS. R f� "v A TRUE COPY: ATTEST: R!'GtSTER OF DECf Town of North Andover cf NORTH O ffice of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 October 12, 2001 Joseph Barbagallo,R.S. 1 Westward Circle North Reading,MA 01864 Re: Lot 13-C Duncan Drive,North Andover,MA 01845 Map 104B Parcel 172 Dear Mr. Barbagallo: This is to notify you that the revised plans dated 07/04/01 for Lot 13-C Duncan Drive have been approved. However,please notice that item#7 under"Notes" is incorrect and needs to be changed Because of the well,the site is a nitrogen sensitive area. A waiver from The North Andover Minimum Requirements for the Subsurface Disposal of Sanitary Sewage CMR Section 9.04,to allow the reserve area to be less than the four-foot minimum distance to the active leaching area is granted. With this variance,the plans are approved. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, Sandra Starr,R.S., C.H.O. Health Director cc: Barbagallo Children Realty Trust File SS/aem BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 TOWN OF NORTH ANDOVER DIVISION OF .PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845-2909 J. WILLIAM HMURCIAK,DIRECTOR, P.E. Timothy J. Willettf H�RTN Telephone (978) 685-0950 Stc7ff'F.figineer 3?�1fy�. ��� Fax (978) 688-9573 6 9 October 18, 2001 "3s�CH„SE�� Ms. Heidi Griffin Town Planner 27 Charles Street ' North Andover, MA 01845 RE: Site Plan Review— Lot 13C Duncan Drive Dear Ms. Griffin: The Division of Public Works has reviewed the above referenced plan by Neve Associates dated October 10, 2001. We have the following comments. 1. The existing driveway to lot 13B Duncan Drive will become a common driveway for both lots. A"driveway and utility easement" is needed by both lots, so that both lot owners have access to (and be responsible to maintain)the driveway. No such easement appears on the plan. 2. Town water is available in this section of Duncan Drive. Even if a water service is not installed at this time, it appears that the logical place to install the water service for both lots would be in the existing driveway. The driveway and utility easement mentioned above will allow either or both lots to install a water service in the driveway in the future. Very truly yours, Timothy J. Willett Staff Engineer CC: Bill Hmurciak Sandy Starr Town of North Andover NORT►I �f SSIiD i°�� Office of the Director Community Development and Services Division 27 Charles Street ''}.' �'" IDAAiED `fi 5 North Andover,Massachusetts 01845 CH„S�tt Telephone(978)688-9531 Di0sion Director Fax(978)688-9542 Henri Griffin MEMORANDUM TO: North Andover Planning Board FROM: Heidi Griffin,Community Development&Services Director RE: Lot 13C Duncan Drive Access Other Than Frontage Common Driveway Special Permit DATE: January 13,2003 The applicant proposes a common driveway to access Lot 13c via an existing paved driveway on Lot 13B. The driveway from Lot 13B will then be expanded upon approximately 250 feet. An access other than frontage special permit is required as access to Lot 13c will need to be provided via the existing driveway on Lot 13B. Lot History It is important to briefly review the history of these parcel(s)to understand how it is this application came before the Planning Board. An Approval Not Required Plan was endorsed in 1983,creating the two lots. At the time, each lot contained 1.77 acres(Lot 13C),and 1.33 acres(Lot 13B)respectively. In 1987,the town rezoned this portion of town so as to require a minimum lot area of two acres,thus making the lots non-conforming in many areas, including lot area,lot frontage,lot width and contiguous buildable areas required. Any grandfathering the lots were eligible for under M.G.L. Chapter 40A Section 6 and 9 expired when the owner did not apply for a building permit for Lot 13c in the required time frames. As such,the applicant applied to the Planning Board for the same applications currently pending in front of the Planning Board approximately one year ago;they were asked to withdraw based on the fact they did not meet current zoning,which they did on or about December 19 of 2001. Simultaneously,the applicant then requested and received the following variances from the Zoning Board of Appeals on 11/12/2002 in order to become eligible to apply to the Planning Board again: Lot 13B Variances Received • Variance to allow 1.33 acres vs.required 2 acres of Lot Area; • Variance to allow 50%continguous buildable area vs.required 75%contiguous buildable area; • Variance to allow a lot width of 50' vs.required 100';and • Variance to allow 150' of frontage vs.required 175' of frontage. BOARD OF APPEALS 688-9541 BL;ILDING 688-9545 CONSERVATION 688-9530 HEMJH 688-9540 PLANNING 688-9535 Lot 13C Variances Received: • Variance to allow 1.77 acres vs.required 2 acres of Lot Area; • Variance to allow 50%contiguous buildable area vs.required 75%contiguous buildable area; • Variance to allow 45' of lot width vs.required 100' lot width;and • Variance to allow 150' of frontage vs.required 175'. Finally,the applicant has received an Order of Conditions from the Conservation Commission dated January 14, 2002. Staff Review: It appears adequate erosion control,via hay bales and filter fabric has been provided for the newly proposed paved driveway. However,the land has a definitive slope as the topography varies from elevation 124 to an approximate 130 to access the newly proposed 4 bedroom dwelling. This elevation variation necessitates the construction of a retaining wall at the end of the proposed driveway. As the entrance/egress will be via an existing paved driveway,it appears it will not affect the neighborhood,and will not create a hazard to vehicles or pedestrians. However,a site visit should be conducted to ensure this as the plans do not depict the site distance to adjacent driveways and/or roadways. Also,the applicant will need to provide easements pertaining to the rights of access for and agreements pertaining to the maintenance of the driveway. Finally,wetlands do encompass a good portion of Lot 13C's frontage making the shared common driveway access via the existing driveway a logical option to be eligible for an access other than frontage special permit as access through Lot 13C's frontage would have extensive wetland crossings. Staff Recommendation: The applicant should submit the above requested documentation,relative to easements for access and a common driveway agreement. The Planning Board should conduct a site visit to see the proximity of this driveway to adjacent driveways to ensure the granting of the special permit is in conformance with the intent of the bylaw. I would recommend continuing this application until the February 4,2002 meeting to provide ample time for the site visit and requested documentation. Also,as the applicant inadvertently did not submit the plans to VHB,this will provide for a more thorough review of any drainage impacts the driveway may have. Although not required, the applicant should also provide a copy of their approvals from the Board of Health ascertaining the proposed septic tank has been approved for a 4 bedroom dwelling as depicted on the plans. Feb 27 04 10:58a NORTH RNDOVER 9786889542 p.2 0 4r TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System(instructed; { )repaired; by �� / ' l located at / /0 was installed in conformance with the North Andover Board of Health approved plan,, System Design Permit.# ,plan dated /-/L/-d ,with a design flow of-9-Y—Ogallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000,Title 5 and local regulations,and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative Installer: Lic.#: Date: Engineer: zicei��o Date: 2 Z '.. .1c . BOFF NORTH ANut, " ?r#OF HEALTH - f MAR - - . J Feb 27 04 10:58a NORTH ANDOVER 9786889542 p.3 INS'T'ALLER PROJECT MANAGEMEYT OBLIGATIONS As the North.Andover licensed installer for the construction of the septic system for the property at--Z _,: 2/�✓l « �� relative to the application oVX,&&&!f dated 3! �/ for plans by JQf �i6�lXl/,�C���4 ani /x e T7' dated with revisions dated— I ' 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,contra( project manger,or any other person not associated with my company schedules an inspec 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 applic. inspections as indicated below. I understand that requesting an inspection,, wit} completion of the items in accordance with Tile 5 and the Board of Health Regulations r 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 d fust. Installer^inust request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection,for elevations, ties, etc. As-buiii verbal OK from engineer must be submitted to Board of Health, after which installer calls inspection time. Installer must be present for this inspection. With pump system all elects 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 on site. 3. As the installer I understand that persons or companies not associated with my company rr not perform the work required by my company to complete the installation of the syst, identified in the attached application for installation. I further understand that work by otht unlicensed to install septic systems in North Andover can constitute reasons for denial of t system, and/or revocation or suspension of my license in the Town of North Andover p) significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the follow i. construction steps: levation of the excavation has been reached. a) Determination that the proper e b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff um chamber, retaining wall and oth d) Installation of tank; D-box, pipes, stone, vent, pump g components. 5. As the installer I understand that I am solely responsible for the installation of the system per the approved plans. No instructions by the homeowner,general contractor, or any oth persons shall absolve me of this obligation. Un signed Licensed Septic Installer 1l Ct,� Date: Disposal Works Construction Permit # 0 MAR - i 2f TOWN OF NORTH ANDOVER µORtf{ Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT { 27 CHARLES STREET ` . NORTH ANDOVER, MASSACHUSETTS 0]845 SSA US Heidi Griffin 978.688.9540—Phone Acting Health.Director 978.688.9542—FAX lY X1 To: � „ / From: Fax: Pages: W4111- Phone: Date: Re: CC: ❑ Urgent ❑ For Review ❑ Please Comment ❑Please Reply ❑ Please Recycle Please call 978-688-9540 for assistance with any questions. Thank you. xc: Address File Chrono File �e� '-QIP Fax K 1220xi Log for NORTH ANDOVER 9786889542 Feb 27 2004 10:59am Last Transaction Date Time Type Identification Duration Pages Result Feb 27 10:58am Fax Sent 89786864444 1:12 3 OK ANcG s ��t 44 f'-e 33,x ,, LL z fr; Cinx l nr 13o- i tj NO K 6 p 3 TOLadid OF NORTH AIVi30`R/ j r BOARD OF HEAa T H i. DU /VC,49 / 7 +,D R V i. 3 .,...�..,,.�..�.,-:.ns.-...�..•<.�:...�,•...:r ,,._,..,...,.,.�...,,..�.,._.,......^.amu:«.........,.,..,.r.. ..,_,._��_,_M,..x...:�,.-...�:..�...-..,rvr .,..-.....,,��>h..... .,....-,..-.,....,-.a,,,,- .,,� ^^ ^' •�. Town of North Andover QE NOWrit 411.1° br�Q Office of the Health Department F? Community Development and Services Division 27 Charles Street ` ^� North Andover,Massachusetts 01845 1SswCHUs� Susan Y. Sawyer, RENS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE February 28, 2004 This is to certify that the individual subsurface disposal system constructed (X) or repaired ( ) by Dave Maynard at 110 Duncan Drive has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations.. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily, Y.Sawyer,R /RS- Public Health Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 No. COMMONWEALTH �T��T g ¶ ( egg T FEE OF SETTS Board of Health, Aj® t t h A tudd u er, MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct(/Repair ) Upgrade( ) Abandon( ) - wComplete System ❑Individual Components Location D w N ( g n p • Z Owner's Name t A R g-46-ff(-b -2//4,04FA) k , 7. Map/Parcel# 'i (S Address 1 'Zv 1)u n Co-,-, 1D r 1 v C Lot# Telephone# 9 7 1?> -fig& -q,�,a---)- Installer's Name Designer's Name a&SF P K RA R 4---ACZ-o Address Address i W F 5 T- w A-" CR, Telephone# Telephone# - (,6q-y JE-3 Type of Building W E L t I N Lot Size �7 l i 'S 7S sq.ft. Dwelling-No.of Bedrooms LA Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) y`'i L7 gpd Calculated design flow LlLfe-> Design flow provided y 5 y gpd Plan: Date -d Number of sheets oZ Revision Date Title Description of Soil(s) S A N ID Y LOA- ( 10 -f 2 c, ct L• 5-16 LU Soil Evaluator Form No. Name of Soil Evaluator�O- W164610 DateG '^ of Evaluation�/ ��U 00 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections No. FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System -•-r" 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 COMMONWFALT14 OF MASSAC14USETTS Board of Health,�-p T T , MA. DISPOSAL SYSTEM STEM C®NSTRUC ION 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. 'orm 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health . Detach - Return lop voucher with Nayment . . uetacn _ - ; : AMEMENT APp1 ICAl., MOST BE RECE.IW[i0;BY.. H ASSESSORS OFF IC! W tA-TE11,HAN 021Q1;J20b0 Interest at tti rate df 14 per annum w11 accrue vn i.::: overdue ohtsfrow.thexdue: 04te : '. payment 1s::: e dee reverse Side: for A.j. . nal :A orma: 1q :� McR 404.E '81 k 0X72 Lv1..0000, €ocai:ibm 0 IaIINCAN DRIVE EibO REAL ESTAT£{ Land (ac); 1.830 81 * ..I Res:�xemptn ti "; 468 E 6XAB Cred:: TO. Tax Val: `1QU,60I Land italue; Tot1 Value: 100 600; Ell 20ob Tax : 1 4;99 98: 101AL TAX 1499 % pe:edfL; a1. 4620:'215 *Other .id; 21010..0017200000 .: FEB 01 `200Q AFtOEiNT 393 08 : Oe cr3ption Class '' Valuatiotr . .. MAY i11� X000 AMOUNT'' 898 50130 130 100':600PRIflR A..QVNT f3I€d ED 1 i 106 Y 80 :. TAL TABES t�AII3 1.106 88 ; EXEMP�IONIABA...vf T 000 ::: (}%� PRIOR AMDbN1 S OI ERDUE b 00 BARBAGACLO GHILOREN REALTY TRi)ST If�TERE5::: 0YA(V ANNE fi 8AR8AGALW:- TR 12Q Dl1NCAN'DRIVE110UNT D MAY 01 2084 393 07 . NOV ANDOVER MA::01848 ; 1111111111111111111111111111111111�11111111111111111111111111111111111111111111111111111111111 FISCAL YEAR 2000 REAL ESTATE TAX BILL MAKE PAYMENTS TO THE COMMONWEALTH OF MASSACHUSETTS BILL NUMBER 468 RE TOWN OF NORTH ANDOVER NORTH ANDOVER Loc: 0 DUNCAN DRIVE P. 0. BOX 124 OFFICE OF THE COLLECTOR OF TAXES Id: 104.6 0172 0000.0 N0. ANDOVER, MA 01845 Based upon assessments as of Jan 01 1999 your tax Deed/Legal : 4620 215 M-F 8:30-4:30;5/1 TO 7:30PRor the fiscal year commencing July 1, 1999 and ending Land Area: 1.830 (aC) TAX 688-9550/ASSR 688-9566 June 30 2000 on the described property is as follows 1. 4TH:PAYMENT i RECEI PT Ui�UCHER Tax Rate per 11000 of valuation Desc. Amount Interest 4th Asmt Amount Interest '�01AL TAX ;1,4,99 95 RES 1 OPN 2 COM 3 IND 4 PRIOR 1,106.88 0 f-B G. :2000 AMOU.N1 :: 393.08: 14.91 14.91 17.88 17.88 4-TAX 393.07 0 MAY 01 ObO A...QNl 393.0:7 :: .::PRiOR AhlQtIIC ., U..P.............::......:1.100.................... 8... �' 3'A� :TA*E5.1�A. ... : <::::7.106 8$ . BARBAGALLO CHILDREN REALTY TRUST InXEI1PTIUNfABATEM9ENT b;0'0 . ANNE T BARBAGALLO, TR PIIR AMINr aEiz�u b.Il6 120 DUNCAN DRIVE ;� C:;:;>;:»;;;:> :.;:<;;; ; ; :> ::::::::::::::::::::::O:.1:00:,.,.. ; � X. NORTH ANDOVER MA 01845 'A :OM, > � 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 FISCAL YEAR 2000 TAX: This tax bill shovis the amount of real estate taxes you owe for fiscal year 2000 (July t, 1999 - Jure 30, 2000) The tax snov n in this bill is based on assessments as of January 1, 1999. The bill a.so shows betterments, special assessments and other charges. PAYMENT DUE DATES l INTEREST CHARGES: Your prelimirary tax was payable in two installments if preliminary bills were mailed on or before August 1, 1999. The I!rst payment was due on August 1 1999, or 30 days after the bills were mailed, whichever was later; and the second payment was due on November ,, 1999. However, 4 preliminary bilis were mailed after August 1, 1999, your pre["mirary tax was payable it full on November 1, 1999, or 30 days after the bills were mailed, whichever was later. Your preliminary tax is snowri on this bill as a credit against your tax,ircludir;g betterments,special assessments and other charges, If tax bills were mailed or,or before December 31, 1999, the balance remaining is payable in two equal installments. Your first payment is due on February 1, 2000. Your second payment s due on Miay 1, 2000. However: ;,.f tax b',Is were mailed after December 31, 1999, the entire balance remaining is due on May 1; 2000. or 30 days after the bilis were mailed, wlhichever is later. If your payments are not made by their due dates, interest at the rate of 14% will be charged on the amount of the payment that is unpaid and overdue. If tax bids were mailed on or before December 31, 1999, interest will be computed on the overdue first payments from February 1, 2000 and on overdue second payments from May 1. 2000 to the nate payment is made. If tax bii'Ps were mailed after December 31, 1999, interest will be computed on overdue remaining payments from Way 1, 2000, or the payment due date, whichever is later, to the date payment is made. You will also be required to pay charges and tees ncurred for coilect on it payments are not made when due. Payments are considered made when received by the Colfe_ctar To obtain a receipted bill, enclose a self-addressed stamped envelope and both copies of the bill with your payment. INQUIRIES: If you have questions on your valuation or assessment or on abatements or exemptions, you should contact the Board of Assessors. If you have questions on payments, you should contact the Collector's Office, FORM FYCJ N4 RE NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm@netway.com Date � � a Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/ Qf ie- /2<7 /24 j)Gri// Assessors Map /04?5 , Lot Dear Members of the Board, Please be advised that Noonan &McDowell, Inc. has reviewed the plan dated fe-v fsrf:> 7/¢/Q by It is our opinion that the proposed design-w-41 meetsthe requirements of Title 5 and the North Andover Board of Health `By-Laws"if 7t7 / S S v (o �� -- /� /P 17- 7_2r7 — T 2r7 t,-Ic-- 7- 2 ..SLS/�,�"� /�-�►--�''�� Respectfully, John L. Noonan, P.L.S.-P.E. G:office/forms/tonarev Land Surveyors Civil Engineers Environmental Planners CHECKLIST FOR NORTH ANDOVER N&M Job 1770/ SEPTIC SYSTEM PLANS �� The following is a checklist that incorporates all Title 5 and local regulations for septic plans. Tj/f� (3fF G�LL O Name of Applicant: Name of Designer: ;7-0 0 /*T/7 Plan Date: i / Revision Date: 5 3 Q _ O / Date of Review: G / S/o Property Address1Z 1917V'.'/C'fWnJ /lir 1 v E- Map: /0-f B Lot: /-7-Z- BOH ZBOH Reviewer: _r/ �- ✓yoow s¢et/ Type of Plan ew r upgrade): �- Q�sit ✓ivy,-a�� Number of Bedrooms in gpd)Garbage Disposal Allowed: General Information: N.A.=North Andover Septic Regulations Other numbers refer to Title 5 _ OK Problem N/A Street nu/ er map/lo 0 4)(u) Max4imum-seal of 1 "=40'for plot plan-220(4) Maximum scale of 1 "=20'for profile and component details-220(4) v� Legal boundaries of the facility being served-220(4)(a) �- Names of abutters from recent tax map- NA 8.02j Number of bedrooms,design calcs.,-NA 8.02i Name&address of record owner&applicant- NA 8.02k Name&address of designer-NA 8.021 Holder and location of all easements-220(4)(b) Date plan drawn&any revision date- NA 8.02m �- All dwellings and buildings,existing and proposed-220(4)(c) Location of all existing or proposed impervious areas-220(4)(d) All distances on site plan-NA 8.03a-c Elevation of proposed driveway-NA 8.02t �— Location and elevation of foundation drain-NA 8.02y Location and dimensions of the system incl.reserve(new const.)-220(4)(e) �- Limits of excavation of leach area on site plan-NA 8.02z 1G Locus plan-220(4)(t) (Not to scale) North arrow-220(4)(g) Existing and proposed contours-220(4)(g) Locations and logs of deep holes-220(4)(h) Locations and logs of percolation tests-220(4)(i) Date(s)of soil testing-220(4)(h)&(i) Existing grade elevation of each deep hole-220(4)(h) `�- Elevation of percolation tests-N.A. 8.02n Name of approving authority representative-220(4)(h)&(i) Name of soil evaluator-220(4)0) --- Soil logs and perc test logs match BOH records Locations of waterlines,drains,and subsurface utilities-220(4)(m) 7/ Observed and adjusted g.w.elevation in the vicinity of the system-220(4)(n) Complete profile of the system to scale-220(4)(o),NA 8.02c Cross section of leaching facility-NA 8.02w (Not to scale) Location of benchmark(s)within 50-75 feet of facility-220(4)(q) Note listing all variance requests with proper citations-220(4)(p) Local upgrade approval request form submitted-403(1) Original R.S./P.E.stamp,signature&date-220(1)&(2) If P.E.,discipline specified within stamp. MGL C. 112 s. 81M --�� sfc.supplies(w/in 400'),pub. wells(w/in 250'),pvt.wells(w/in 150')-220(4)( Location of watercourses,wetlands,wells,etc.Win 150'of system-NA 8.02r Wetland disclaimer-NA 8.02s 1 RLS lan reference certification required(prop line setbacks)-220(3) Plan contains Designer's certification statement Use approvals/standards checked for I/A system-DEP docs., , a 2 Perc.rate>30 MPI-not allowed for new,LUA for upgrade-245(1)&('3) f Perc rate>60 MPI-must use modified tight tank or UA technology-245(4) v�Proposed system qualifies as"shared"system-002(definitions) v Flow is over 2,000 gpd-No R.S.allowed-220(1) y Design flow was set in accordance with code-203 `Existing system location and note on proper abandonment-354 Leaching facility at least 1' above Base Flood elevation-NA 9.05 All piping Sch 40 minimum-NA 10.01 ��- Basement floor minimum 1'above groundwater elevation-NA 5.04 1� Foundation drain present with elevation-NA 8.02y On-site Soil and Groundwater Review OK Problem N/A Proper deep observation hole logs on plan-220(4)(h) All deep holes and peres shown,including aborted tests-NA 8.02n Soil evaluation forms submitted within 60 days of field work-018(2) Proper percolation test log-220(4)(i) Ample deep observation holes in primary disposal area(minimum 2)- 102(2) Ample deep observation holes in secondary disposal area(minimum 2)- 102(2) _rte Ample perc testing(one in each disposal area,3 in prim.>2,000 gpd)- 104(4) x--- Deep hole testing conducted within two years-NA 7.05 Hole Identification Numbers: ground elevation el. c/ acceptable soil el. y Leach facilitv invert el. ground water el. !� refusal el. 4--- bottom bottom of leach facility el. thickness of acceptable soil ��- before&after soil R&R separation to groundwater separation to refusal soil class v perc rate ✓ loading rate J septic tank below g.w.table. (yes o pump tank below g.w.table (yes o 11 in fill ✓ -255(l) Setback Distances(Given in feet) 15.21 1 YES NO Is the lot in the Lake Cochiewick Watershed? NA 6.00&5.02 n OK Problem N/A Septic Tank Leach Facility d� Property line 10 10 Cellar wall 10 20 2 y 3 Inground pool 10 20 'Slab foundation 10 10 Deck,on footings,.etc. 5 10 Waterline 10 10 y Private drinking well 75 100 / Irrigation well 75 100 l/ Wetlands 75 100 Public well 400 400 Wetlands bordering surface 150 150 water Supply or trib.(in Watershed) Trib.To Surface Water supply 325 325 -^� Reservoirs 400 400 Tributaries to reservoirs 200 200 Drains(wat.supply/trib.) 50 100 c� Drains(intercept g.w.) 25 50 Foundation drains 10 20 C— Drains(Other) 5 10 C/ Drywells. 20 25 Downhill slope 15'to 3:1 slope w/o barrier Building Sewer OK Problem N/A Grease trap required for certain uses(check 230 for details) Gam— Pipe diameter listed(4"minimum)-222(1) Pipe schedule listed-222(3) Pipe cast iron or Sch 40 PVC-NA 11.02 Watertight joints specified-222(3)&(4) Pipe laid on compact,fin base-222(5) Pipe laid on continuous grade in straight line-222(7)@ Cleanouts precede all changes in alignment and grade-222(8) f Cleanout provided every 100 feet-222(8) ./ Manhole at any 90 degree alignment change-222(8) C/ Invert elevation at building: . - Invert elevation at septic tank: Length of run: Slope: (minimum of 0.01 -0.02 desired)-222(6) 10'offset to private well or suction line-222(2) 3 4 Septic Tank OK Problem N/A Tank is accessible-228(3) No structures above tank—(228(3) Tank can accommodate both primary&reserve—NA 9.04 200%of flow(required&provided given. 1500 min.)-220(4)(f)&223)(1)(a) �— 2-3"drop from inlet to outlet-227(5) Minimum of 4'liquid depth-223(2) 'r— 3"air space above teestbaffles(minimum)-227(4) �— ,9"air space above flow line(minimum)-227(4) �--- Tees are not to be replaced by baffles-227(1) Tees extend 6"above flow line-227(1) _,ter l Inlet tee extends 10"below flow line(minimum)-227(6) Outlet tee extends 14"below flow line(more for deeper tanks)-227(6) Gas baffle installed on outlet-227(4) Access manhole cover above center of tank&each tee(except 2 compart)228(2) 3-20"manholes-228(2) -�— 1 childproof,24"riser/manhole Win 6"of final grade if<1000gpd-228(2) Inlet and outlet tees on center line-227(1) —tG Soil compaction below tank specified(if soil is non-native)-221(2) 6"of<=3/4"stone beneath tank specified-221(2)&22 8(1) If> 1,000 gpd AND not a single fam.dwell.must be 2 tks or 2 comp.-223(l)(b) If plan specifies disposal must be 2 tanks in series or 2 compart.tank-223(l)(c) Buoyancy calcs.required if tank at or below water table-221(8) Tank is watertight-221 (1) 9"of cover over tank(minimum)-228(1) H- 10 loading(min.)-H-20 if traffic-226(3) Top of tank<=36"below grade-221(7) All pumping to tank(if applies)in accordance with-229 Tank is set to keep old system in service during install if possible Distribution Box(Check here if not present: ) OlProblem N/A Inlet elevation: Outlet elevation: 0.17'drop from inlet to outlet(minimum)-232(3)(b) 6" sump(minimum)-232(3)(e) All outlets at same elevation-232(3)(b) --- Outlet pipes laid level for first 2 ft.-232(3)(c) Pipe Sch 40-NA 10.01 c/ Number of outlets: Number of laterals: Size of outlets: Inlet baffle/tee min. 1"over outlet invert for all d-boxes-232(3)(a), Soil compaction below distribution box specified(if soil is non-native)-221(2) 6"of stone beneath distribution box specified-221(2) �— Box is watertight-221 (1) �-� Top of box<=36"below grade-221(7) Buoyancy calculations required if box is at or below water table-221(8) Pump Chamber(CQheck here if not present: ) OK Probl N A /, Volume spepif€d: 220(4)(r) Pump.onle evation- 220(4)(r u{fp off elevation: 220(4)(r) Alarm on elevation: / 220(4)(r) Number of cycles per day:-220(4)(r)(also 254(l)(d)if gravity from d-box) Minimum 2"delivery line to d-box if gravity-254(1)(c) 4 �- 5 Pressure dosed 11 if flows=2,000 gpd-254(1)(a)&254(2)(a) Cycles per day it consistent with chamber volume-23 1 Volume.caf lations include flowback volume-2') 1(2) 24.houurr storage capacity above pump on elevation-231(2) /Number of pumps: 2 if system serves>2 dwelling units-231(6) Capacity of pump(s)- gpm @ 'TDH-220(4)(r) / Pump can pass 1 1/4"solids(minimum)-231(7) �— Pump controls specified-220(4)(r) / Alarm equipment specified-231(2) Alarm is in building and powered on-separate circuit from pump-2') 1(9) Pump sequence correct(off-lead on-lag on-alan-n on)-231(8) Pump performance cure s included-220(4)(r) Manual operatinvw ch-NA 12.01 Check valve, .leeder hole-NA 12.01 1 childpr ,24"riser/manhole to final grade-2'31(5), Soi ompaction beneath pump chamber specified(if soil] on-native)-221(2) of<=3/4"stone beneath chmbr.specified-221(2 28(1), Buoyancy calculations if chamber is at or be water table-221(8)@ 9"of cover over chamber.(minimum))- (1) H- 10 loading(min.)-H-20 if tr 1 -226(')), Chamber is watertight-2 Top of chamber<=3 ' elow grade-221(7) Leaching Facility(general-complete for all designs) OK Problem N/A 50%larger if garbage disposal-240(4) - Trenches to be used whenever possible-240(6) No vehicle or imperv.area above 11 unless unavoidable-240(7);NA 13.02 Vented if under impervious cover-241 (1) Vented through same pipes as distribution system-241 (1)(a) Vent protected from precipitation/animal entry-241 (1)(b) Vent is placed beyond traffic or impervious area-24 1 (1)(c) All lines connected to vent if bed or trenches-241(l)(d) 9"cover over peastone-240(9) Reserve area provided(new construction)-248(1) Reserve 4' from primary leach area-NA 9.04 �- 4'(5'if perc rate<=2 MPI)separation to g.w.-212(a)&(b) 4'(down to 2'with variance or UA-upgrades only)of natural soil under 11. GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005-251(9) Require 5'removal and replacement if in fill-255(5) �^ Top of leach facility<=36"below grade-221(7) Com- Final grade over 11 minimum 0.02 ft/ft-240(10) Surface&subsurface drainage away from 11.-240(1 1)&245(5) Minimum design flow 440 gpd without deed restriction-NA 13.01 �- 3:1 slope where grading required-255(2) Toe of fill slope stops 5'from property line or Swale installed- (2) J Impermeable barrier if<3:1 slope or< 15 feet to_3:Islope-255(2) Impermeable barrier/retaining wall ppg ed co reW--TiA 9.02 --- Retaining wall stamped by P.E.-255(22)(b)- _ Top of retaining wall>=top of peastone elevation-255(2)(f) 10'offset from edge of leach facility to edge of ret.wall-255(2)(g) Perc test(s)done in most restrictive layer- 104(2) y` Perc test 4'below leaching elevation-NA 7.06 �-' Design flow listed and required/provided leach area given-220(4)(f) Leach pipes SCH40 PVC-NA 10.01 yd Leach pipes minimum 4"diameter except for dosed system-NA 14.04 Leach lines capped,vented,or connected together-251(9) Pressure dosing guidance followed if pressure distribution-254(2)(c), y�Pressure dosing required over 2,000 gpd or with I/A remedial use-231(1) 5 6 Leaching Trenches(Check here if not present: ) OK Problem N/A Number of trenches: Minimum of 2 trenches-NA 9.01(2) Depth of trenches(max eff.2'): -247(1) / "Width of trenches(2'min.,4'max.): -251 (1)(b) Length of trenches(100'max.): -25 1 (1)(a) Trenches are vented(when->50')-251 (11) Trenches follow contour`lines-251(2) Trench spacing 3 times effective width or depth minimum-251 (1)(d) In fill or reserveASetween trenches, 10'min.-NA 14.01&"14.03 Available lead area given(Min.500 s.f.)-NA 9.�(2) Bottof6=L x W x,## = s.f. Srd'ewall=L x x#� x2= s.f. Eff five leach area given Loading factor: Effective area=total area s.f. x LTAR = g/day `Effective area is>=design w of facility being served 2"of 1/8"- 1/2"2x washed peastone.-247(2) Trench depth of 3/4" to 1 1/2"double washed stone-247(1) Leach Fields(Check here if not present: 1 OK Problem N/A / /Number of fields: (need dosing chamber if> 1,231 (1)) Length(100'max.): -252(2)(b) Width: Total area:L x W = s.f. Minimum 900 square feet-NA-9.01(1) Distribution lines connected with solid pipe—NA 15.01 Effective leach area given Loading factor: Effective area=total area s.f x LTAR = g/dav Effective area is>=design flow of facility being.sEived Minimum of two distribution lines-252(2)(a)' 6"line separation(max.)-252(2)(d) maximum separation from edge QMeld to line-252(2)(e) 10'minimum separation between adjacent leach fields-252(2)(f) Between 6"and 12" of 3/4-4 1/2"stone beneath field-252(2)(g)&247(2) 2"of 1/8"-1/2"2x wasb;e peastone.-247(2) Final Grading OK Problem N/A Slope over leach area minimum of 0.02 feet/foot—240(10) Grading shall divert drainage away from leach area—240(l 1) Grading slopes away from dwelling 5/24/01 f./office/forms/tonackltr.doc 6 • ` 7 Tight Tank(Checkere if` not present: 1 OK Problem N/A 500%of design flow o_r,2000 gallons provided-260(2)(a) 3-20"manhole�29(2) Soil compac oh below tank specified(if soil non-native)-221(2) 6"of<- r "stone beneath tank specified-221(2)&228(1) Bi o ancy calcs.Required if tank at or below water table-221(8) ark is watertight-221(1) 9"of cover over tank specified(mini )-228(l) H-10 loading(min.)-H-20 if tr fic-226(3) Top of tank<=36"bel grade-221(7) All pumping to if applies)in accordance with-229 l AN alarm s at 3/5 tank capacity-260(2)(c) Min. 1- frame w/cover at finished grade-228(2)(f) Y round access for pumping-228(2)(g) Leaching PIIS(Check here if not present: ) OK Problem N/A _f #of pits/pit systems: (dosing chamber if>1,231 (1)) �G Dimensions of each pit or system:L W D Gi Depth of pits(max eff.2'): -253(1)(a) �l Available leach area given Bottom=L x W x#of systems= s.f. — Sidewall=L+W x D x 2 x#of systems= s.f. Total area=bottom +sidewall - s.f. �c Effective leach area given Loading factor: ✓ Effective area=total area s.f.x LTAR = g/day -� Effective area is>=design flow of facility being served Minimum of 2 pits at least 13'X16'-NA 9.01(3) Distribution for galleries/chmbrs.in trench config.-pipe every 20' (6) Distribution for galleries/chmbrs.in bed config.-ea.pipe serves<=40 s.f.-253(6) Spacing-2 times the effective width or depth(the greater)-253(1)(c) - 2"of 1/8"- 1/2"2x washed peastone.-247(2) Or 3/4"to 1 1/2"double washed stone-247(1) Each pit has at least one 20" access cover.24"CI to grade over 2,000 gpd -253(3) Surrounding aggregate thickness between 1'(min.)an '(max.)-253(1)(b) Vents,if necessary,extend under covers of pit(s)-2411(e' 5/24/01 7 NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice(978) 667-9736 Fax (978) 671-9565 Email: nm(a netway.com Date: June 18, 2001 Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/016 120 Duncan Drive Assessors Map 104B, Parcel 172 Dear Members of the Board, Please be advised that Noonan&McDowell,Inc. has reviewed the plan dated May 30, 2001, and revised June 18, 2001,by Joseph J. Barbagallo,R.S. It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health"ByzLaws"if the following is addressed: Label water line as either pressure or suction. 2) The reserve is 1 f1. from primary leaching area. Provide local variance request and note variance request on plan. 403(l)NA9.04. - Provide a note stating no tributaries within 325 ft., no reservoirs within 400 ft.,no tributaries to reservoirs within 200 ft., and no drains within 50 ft. to the leaching area. t.--4) Position D-Box to ensure two feet level on all outlet pipes. f/5) Add length of building sewer and septic tank to D-Box on profile. �$) Show over dig on profile and leaching pit detail 255(5). -,P-7) Impervious barrier retaining walls shall be endorsed by a structural professional engineer r-vo 255(2)(b). lvli�8) Any future impervious barrier should be provided for to ensure a 10 ft. distance to reserve area 255(2)(g). L,-9T Add 2"of 1/8"- %2"2x washed pea stone over leaching stone. 247(2). Respectfully, John L. Noonan,P.L.S.-P.E. &office/forms/tonarev016 Land Surveyors Civil Engineers Environmental Planners Town of North Andover NaRrk Office of the Health Department Community Development and Services Division 27 Charles Street . �=•�- North Andover, Massachusetts 01845 SACHusE Sandra Starr Telephone(978)688-9540 Health Director Fax (978)688-9542 June 21,2001 Joseph Barbagallo,R.S. 1 Westward Circle No. Reading,MA 01864 Re: 13c Duncan Drive Dear Joseph: This is to inform you that the proposed plans for the site referenced above have been disapproved and have technical deficiencies as followed: 1. Label water line as either pressure or suction. 2. The reserve is 1 foot from primary leaching area. Provide local variance request and note variance request on plan.403(1)NA 9.04 3. Position D-Box to ensure two feet level on all outlet pipes. 4. Add length of building sewer and septic tank to D-Box on profile. 5. Show over dig on profile and leaching pit detail 255(5). 6. Impervious barrier retaining walls shall be endorsed by a structural professional engineer 255(2)(b). 7. Any future impervious barrier should be provided for to ensure a 10 ft. distance to reserve area 255(2)(g). 8. Add 2"of 1/8"—.'/2"2x washed pea stone over leaching stone. 247(2) If you have any questions,please do not hesitate to call the Board of Health Office. Sincerely, Sandra Starr,R.S.,C.H.O. Health Director cc: Barbagallo Children Realty Trust file BOARD OF APPEALS 688-954.1 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm@netway.com Date l �� Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/ D/4 I Z v Assessors Map/o¢ 3,Lot Dear Members of the Board, Please be advised thatN.onan &McDowell,Inc. has reviewed the plan dated �� 3 r7, I bf -��v•s G�fr/ It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health `By-Laws" if the following is addressed: / Zit/7r-L__ �✓.f Tic U /� S f� Ti3` rc mit —s s v.�c-� / ��L SUGT /oti. T 1�10L 25779 C7 5f� LJ ✓ Q �g3�vv��S r/v i y/fi�c� GJ f 70 /t�S�� w/2 S w/.T/5'/�v Z po �*- //-.�-,p .✓ o ,T/.�iy/a 5 �/7-y i�J 3`o sz 7`v 77f�= G cwt e-- 9-) �a s� T�� "✓ f7 - 13 4 � T o �-�s v--�� Two ���-T— G- rim Respectfully, STi a r k TO John L. Noonan, P.L.S.-P.E. G:office/forms/tonarev 0Ve: /,7/G Wi1� 0:, /9 i 7 J /7L�T7�/ c— Z 7.-) M,P 1<4�- C- S! -c— Cr G� l3 Y Taz "c 7- Land Land Surveyors Civil Engineers Environmental Planners Qc- T-0 2 !��/� 2 it n �8- ��- ��,r 2 X �r99 /�rJ f��S Tm-✓�` a Vcvc �a. l Project Request Record Town of North Andover Date: �S Client Id:ToNA Card Id: ToNA Client/Company Name:Board of Health Card Tyne-Client Contact Name: Ms.Sandra:Starr Phone: 978-688-9540 Title:Director Fax: 978-68&9542` Address: 27 Charles,Street. Email: "1 Notes: it Town: North Andover State: MA Zip.Code: 01845 Other.contacts if-applicable: a Engineer/ taller t Name: S Phone:/ f:7 a- – GG 4- ¢�$ Title: Fax: Address: / PVe-rZw4rr-n c tir Email:. Notes: ' Town:—AVO Rr.�4 � �/�.�✓� State: /`a Zip Code: _Ol $'G �� Proiect: Project Id: 1770 Project Title: Town of North Andover,Board of Health (JOB NO) (PROJECT NAME&STREET ADDRESS) Manager:NOW Billing Group: Billing Code:Fixed Fee, fig'© Contract.Info.Project Description for each,billing group BG/ Applicant__ /��I�/�GitGGO � i���re�t. ncc7'l cr51'�. Assessors May/n # l',a; Lot 7 'Z-- Street /2 9l�ci��c- t Type of service Office/forms/jbrqutona • Of NORTil 0 9 • s Ss�cHusBOARD OF HEALTH 6 K03 NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT ,{(/ Permit # -2,c>03-oa(3 Date A permit is requested to: drill a well install a pump �✓ LOCATION: //6 Lot #_/_7_S Owner �eeo Addressf?-oha4iea,,`/ Tel Well ContrctrL , Add. Pump Contrctr S��-� Add. Tel ********************************************************************** WELLS (To be completed at time of pump test. ) Type of well �,p�eJi Use Diameter of well Size of casing Depth of bed rock / y Depth casing into bedrock �3-�-- Seal been tested? Yes ( X) No (_) Date of test � r Depth of well Water-bearing rock Q 941'j r%� TcgreD FAQ Depth to water -v Delivers GPM for t( HRS (how long?) Drawdown 7u5 r feet after pumping / hours at $ PM Date of completion L/P -J_ �- Signature of well contractor PUMPS (To be filled in before installation. ) Name & size of pump �J�DS i k} •P• Type Size of tank wX- Z-S 1 Pump delivers 10 GPM Pipe used in well: Cast iron (_) Galvanized (_) Plastic ( x ) 110E-S ' Sleeve used to protect pipe? Yes (_) No ( ) Type well seal Date " y-� �• , Signature(/of pump installer Date water analysis report submitted to Board of Health Plumbing inspector Wiring inspector Board of Health Massachusetts Department of Environmental Management " 22776 Office of Water Resources TYPE OR PRINT ONLY ` Well Completion Report 1. WELL LOCATION GPS (OPTIONAL) LATITUDE LONGITUDE Address at Well Location: Property Owner: z Subdivision Name: / Mailing Address: u .--�- City/Town: City/Town: �_//J ! ��5 Assessors Map Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if no street address available Board of Health permit obtained: Yes Q( Not Required ❑ Permit Num�� Date Issued L? _Z 3-0-21 2. WORT( PERFORMED 3. PROPOSED USE a 4. DRILLING MET HOD 5-29-New Well ❑ Abandon EQ-Domestic ❑ Irrigation ❑ Cable ❑ Auger ❑ Deepen ❑ Recondition ❑ Monitoring ❑ Municipal fQ Air Hammer ❑ Direct Push ❑ Replace ❑ Other ❑ Industrial ❑ Other Mud Rota ❑ Other 5. WELL LOG oC Unconsolidated Consolidated 6. SITE SKETCH (use permanent+:andmarks with d.,st-n=—) Permeability T r 4.c, ` rN� N N 'C From (ft) To (ft) High Low `o CZ 0 m Other Rock Type � C We- 7_r�_ C7S�7' x kA� _ i OA`( 7. WELL CONSTRUCTION 18. CASING Total Depth Drilled From (ft) To (ft) Casing Type and Material Size O.D. (in) Well Seal Type Date Drilling Complete Q Z - 8. SCREEN From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter 10. FILTER PACK l GROUT/ABANDONMENT +ATERlAL 11. ADL)TK7;141AL WELL INFOVRXsIATID? ! Developed? IR Yes ❑ No From (ft) To (ft) Material Description Purpose Fracture Enhancement? LYYes ❑ No d' Method N YarCa - f -� C_ Disinfected? Yes ❑ No 12. WELL TEST DATA(PRODUCTION WELLS) 113. STATIC WATER LEVEL(ALL WELLS) Yield Time Pumped Drawdown to Time Recovery to Depth Below Dateethod (GPM) s & min) ( (hrs & min) (Ft. B ) D e ftsur Ground Surface (FT) 14. PERMANENT PUMP (IF AVAILABLE) j'.5.tiAMIF-1003ESS OF PU,1?1XISTALLA-1ION=IPANY ' Pump Description rO' DS �+ +�5l3�-V- Horsepower C, AA �Q`l L 1n S Co. Pump Intake Depth s`O (ft) Nominal Pump Capacity_�(gpm) ?C ry A fa . 16. COMMENTS 17. WELL DRILLER'S STATEMENT This well was drilled and/or abandoned under m upervision, according to applicable rules and regulations, and this report is complete an r to the best of my knowledge. Driller: �oLL la/S Supervising Driller Signature: ' �`Z Registration #:1 1316 1 Firm: + C-� Date: -6� Rig Permit#: NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY 06/05/20031 16:07 9786920023 THORSTENSEN LAB PAGE 02 f 66 LITTLETON ROAD, WESTFORD, hi 01886 (978)692-8995 FAX(978)692-0023 1.800.649-TEST Report Number 73684 Report Date: 6/05/03 Client; Sample Information: Joseph Barbegallo 110 Duncan Dr, 120 Duncan Dr. N.Andover MA N. Arxdover MA 01845 Sampled by: CM Rollins Date Received: 6/4/03 Date Sampled: 6/4/03 -cellific a of. sis Test Pararr�eter EPA Li gt Results Units Total Coliform(P) 0 0* Per 100rn1 Fecal Coliform/E.coli(P) Absent Absent per I00ml Arsenic(P) 0.05 0.006 mg/L, Calcium Not Spec. 51.2 mg/L Copper(S) 1.3 <0.02 mg/L Iron(S) 0.3 0.19 mg/L Lead(P) 0.015 <0,001 mg/L MagUesiUZL Not Spec_ 1.0.9 mg/L Manganese(S) 0.05 # 0.09 mg/L Potassium Not Spec. 1.4 mg/L Sodium See Note 22.0 mg/L Alkalinity(S) Not Spec. 133 mg/L Acrimonia-11 Not Spec. <0.03 mg/L Chloride(S) 250 37.2 mg/L Chlorine Not Spec. <0.02 mg/L Color(S) 15 15 CPU Conductivity Not Spec. 423 umbos/cm Fluoride(S) 4.0 0.6 mg/L hardness Not Spec. 173 mg/L Nitrate-N(P) 10 0.53 mg/L Nitrite-N(P) 1 <0.01 mg/L Odor 3 2 TON PH(S) 6.5-8.5 7.5 SCJ Sulphate(S) 250 32.8 mg/L Turbidity Not Spec. 5.9 NTU Sediment pos/neg neg Legends: (P)-Primary EPA Standard,(S)=Secondary EPA Standard,#--Exceeds EPA Limit, TNTC=Too Numerous to Count,*-Background Bacteria Noted,'=Exceeds Advisory Limit Sodium Advisory Limits,Mass.-20,NH-250. This water sample as submitted is considered SAFE to drink according to EPA/FHA guidelines. However,one or more parameters exceeds secondary limits as denoted by the#sign. Massachusetts Certification#MA04$ Michael P,Cason,for Thorstensen Laboratory Inc. TOWN bF, NORTH ANDOVER � r Location BOARD OF HEALTH �� �� ✓l�/�/�`h% i' -✓� C Permit # C s Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers $ Disposal Works Construction $ Soil Testing $ Design Approval Permit $ Dumpster Permit $ Burial Permit $ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Well Construction Permit--,-- $ Funeral Directors Permit r � Massage Establishment License $ Al , Massage Practice License �$ Suntanning Establishment $ Offal/Trash Hauler $ Other $ 6 Health Agent Uhite - Applicant Yellow - Dept. Pink - Treasurer ot HORTi , "'w , yO 9 MAR 2 S •�t� BOARD OF HEALTH _ G t..a, t�s s�; NORTH ANDOVER, MASS . DI �ti S APPLICATION FOR WELL AND PUMP PERMIT Permit # Date 3 - A "A permit is requested to: drill a well u install a pump"111-- LOCATION: " O D 1j^i C)i 1j PIZ. Lot # N' � OwnerI-OS-fer} Address / '10 AjvCAN DR. Tel 179 •- 694- 'YZz-L ca. --,cj=-Qjea� ,,.nA . Well Contrctr �� �1. �c� „.r5 �c. Add. 1Jq Ve -r /Itd - Tel "%�'_��7'Z 3ZO Pump Contrctr � +��- Add. mel WELLS (To be completed at time of pump test. ) Type of well Use Diameter of well Size of casing Depth of bed rock Depth casing into bedrock Seal been tested? Yes (_) No (_) Date of test Depth of well Water-bearing rock Depth to water Delivers GPM for (how long? Drawdown feet after pumping hours GPM Date of completion Signature o Pii PUMPS (To be filled in before installat J Name size o f pump Size of tank Pump delivers Pipe used in well: Cast iron (_) Galvani . r r Sleeve used to protect pipe? Yves (_) No Date Signature Date water analysis report submitted to Bol Plumbing inspector Wiring inspector Board of Health �ORTt/ TOWN OF NORTH ANDOVER °:`"" '• 'ko HEALTH DEPARTMENT r t is 1 27 CHARLES STREET # ' 4 NORTH ANDOVER,MASSACHUSETTS 01845 ,5 tro ¢sem s�cHus Sandra Starr Telephone(978)6138-9540 Public Health Director FAX(978)688-9542 Applications for a permit to drill a well: Before a permit can be issued, you must have your contractor submit the following: 1. Submit to the Health Department a site plan showing your house footprint and location on the lot 2. Indicate any wetlands within 200 feet of the proposed location for the well 3. Indicate the well location 4. Submit a check for $125.00 with the application Note: All submittals must be drawn to scale. Please note that you may also be required to file with the Conservation Commission if wetlands are near to the proposed well, and to the Planning Board if you are located in the Watershed District. Please turn over to fill out application w c r 1 t -i- � �� v ,�C-0 V/- cr+�✓� t-, o a.. CA\Documents and Settings\pdellech\My Documents\Wells\Well Drill Applications.doc 2003 NUMBER FEE BHP-2003-0093 COMMONWEALTH OF MASSACHUSETTS $12500 North Andover Board of Health JOSEPH& ANNE BARBAGALLO ------------------------------------------------------------ --------------------------------------- -- NSE 0 DUNCAN DRIVE ------------------------------------------------------------------------------------------------------------------------ ADDRESS IS HEREBY GRANTED A PERMIT Well Construction This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires_-_..-- December 31,2003 unless sooner suspended or revoked. ------------------- ----------------------------------------------------------------- May 23,2003 ------------------- �.>�_ - ------ ------- - ------------- Board ------ -------------- -- ------------------- ----.-- Health A 7W67 ,. fIMAR, 2�.!I� BOARD OF HEALTH7 ►-a E.�s �SS•�cHusFt .�: ,� G NORTH ANDOVER, MASS. pti 5 APPLICATION FOR WELL AND PUMP PERMIT Permit # Date 3 " 7 — O A permit is requested to: drill a well u install a pump �C LOCATION: / / O D PA. Lot # Owner,-F -eplr+ 6"8A" t�tv Address / _c pu'vLrl� � Tel `� 78 - 6�6 -- �Z zL Well Contrctr o 124;1,L)A`5 4--ldc• Add. %J'q VeLr /td Tel 9'7,Y--917"Z 3 Z Pump Contrctr Sk � '- Add. Tel WELLS (To be completed at time of pump test. ) Type of well Use Diameter of well Size of casing Depth of bed rock Depth casing into bedrock Seal been tested? Yes (_) No (_) Date of test Depth of well Water-bearing rock Depth to water Delivers GPM for (how long? Drawdown feet after pumping hours a GPM Date of comm -a-= J . Signature oKkell contractor PU1 installation. ) Nan Type Siz <1 vers GPM cpr-•,.�". r, Pipe ° - Galvanized (_) Plastic (_) Slee 60 2003 _) No (_) Type well seal Date_ gnature of pump installer Date i �s� / G _ -_ Submitted to Board of Health Plumbing inspector Wiring inspector Board of Health CHARLES M- ROLLINS C O.� INC. WARREN FIVE CENTS SAVINGS BANK 10618 WELL DRILLING CONTRACTORS BEVERLY,MA 01915 53-7163/2113 129 DEPOT ROAD, BOXP'ORD, :IIA 01921 1 Z ' ` TELEPHONE (978) 887-2320 •J S R PAYTHE ORDERER OF r z DOLLARS d z MEMO (� PNiu'r G'•TL� �'thy��}—,+f �/� — i1'0 X06 X811' �: 2 l L371638�: 16800696411' ttORTy . ' TOWN OF NORTH ANDOVER 0 �04�� .0 (g HEALTH DEPARTMENT • ` 27 CHARLES STREET + , NORTH ANDOVER, MASSACHUSETTS 01845 Ss1C HUSeS Sandra Starr Telephone(978)688-9540 Public Health Director FAX(978) 688-9542 Applications for a permit to drill a well: Before a permit can be issued, you must have your contractor submit the following: 1. Submit to the Health Department a site plan showing your house footprint and location on the lot 2. Indicate any wetlands within 200 feet of the proposed location for the well 3. Indicate the well location 4. Submit a check for $125.00 with the application Note: All submittals must be drawn to scale. Please note that you may also be required to file with the Conservation Commission if wetlands are near to the proposed well, and to the Planning Board if you are located in the Watershed District. Please turn over to fill out application 2 L-j �-)v v S-e- L.'o r- v✓ 1rig - �✓ L 14-9 `o CADocuments and Settings\pdellech\My Documents\Wells\Well Drill Applications.doc 2003 NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm(a�netway.com Date: August 9, 2001 Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover,MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/016 120 Duncan Drive Assessors Map 104B, Lot 172 Dear Members of the Board, Please be advised that Noonan&McDowell, Inc. has reviewed the plan dated 3/11/01 and revised 7/04/01,by Joseph J. Barbagallo, R.S. It is our opinion that the proposed design meets the requirements of Title 5 and the North Andover Board of Health`By-Laws." However,prior to issuing a permit for construction a certified recorded copy of the fill easement should be submitted. Respectfully, John L. Noonan,P.L.S.-P.E. G:office/forms/1770016 Land Surveyors Civil Engineers Environmental Planners e Page 1 of 1 Lagrasse, Brian From: Dan Ottenheimer[info@mill riverconsulting.com] Sent: Monday, September 08, 2003 9:57 AM To: blagrasse@townofnorthandover.com; pdellechiaie@townofnorthandover.com Subject: 120 Duncan Drive Brian and Pam, Attached please find the final construction inspection report for 120 Duncan Drive. There was some mix up due to the use of two different surveyors-one for the septic design and one for the site plan. This was resolved with some re-calculations and a telephone conversation this morning. Please note that the plan calls for agr_adin easement to be recorded. My suggestion would be that this should be filed at the Registry of Deeds and a stamped copy forwarded to your office before issuance of the Certificate of Compliance. 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 9/10/03 INSPECTION CHECKLIST Pott SEPTIC SYSTEMS Yes NO Initials A, Bottmn of Bed 1, Excavetion to proper demos 2.. With trenches,sides of exrarrat on am bermath 11 harm. 3. Edge of wmavation specified dinmcae from foundation,etc. Cacnmextts: B. Retaining,Wall 1. Wali height and width as sed. 2. WaterPrOcfcd ....___�_. 3. Want mWinum 10'to leaching facility 4. Wall meets specifications of plait Comments; C. Building Sewer 1. Pipe diameter minima n 4 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to ra*o=.mted 'S. Sloes minimum 4.01 or I/8"per foot minimum 6. Pipe properly$ct on=4%4 firm base —z;p "- 7. Pipe laid on=nti cum wade in strai litre �7"– & Cle malts pecex all dmne in aslignment and grades 9. Manholes at any W rhmu JlA._.___ 10. 10'minitown AW to water line" .. _. Comments: D. Septic Tar>1c 1. ravel _ ._.._.�... 2. 1,500 VI minimum �. .V:._ 3. Pias ba$Xe pr mt,an outlet �V-- 4. Manbole to grade ✓ �, 5. Manholes over costa ad each tee 6. 3-20"manholes 7. In1ct tee minimum I2"acini invest 8. Outlet tee minimtmh 14"under invert 9., Outlet line camented 10, Aar sP=c 3"r)osee teen 11. 2"--3'`drop from inlet to malet 1.2, Pipe sd 13. Cossgn t base 6"of Y."c uthed stone:under tarsle 14. Tack is watertight �bi�ft'ts t c Commenu, pz) Da1icao # �rQ r� Yes NO C. Pump Cha tuber 1. If seporee froom wdr,roahpaet base with 6"of 1W stave underneath 2. Wmimum 2"pipe to cf box if gravity system 3. 20"access manbule 4. Tank teve! 3. Watertight 6. Tank size agrees with p1m sp=fhsatimrx 7. Manhole to Snide S. Che&valve and bleeder hole present 9. Alarmm in building an separate cinmit 10. Alarm functions 11. Mattrail op"ing switrfi 12. Pump delivers liquid to d-box Conuaeats: IV /4 F. Vistnbu6on Bac 1. 04M level 2. Minimum 0.Ir f21 drop from inlet to outlet 3. Mmimumb"stmtp 4. Outlet pipes show equal distnbutiaa 7- 5. Compltat base wilt 6"of stow beneath box 6. Box is Watertight 7. All litres cemORW with hydraulic caveat B. $chahrle 40 pipe Comments: d011 Q. Soil Ahwrpd h systern I. All stone double-washed_W-IK" ✓._ pen Sam Sueket test dome? 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stege bstleoth pipe 4. Dbml ution lines capped or connected together ._..� 5. Grading meds 3:1 slope 6. Minimum of 9"offill gid over system 7. Tot ofsiope stops minimum 3'iron edge of property;if not;flan swala Comments; f(V K Leah Trenches 1. Minimum 2 traNhes 2. Latah of treadles 40ve with plms. (Mohr.length 100'} 3. W146 of trawbes aglow with plan-Minimum 2';mwdmwn-4. 4.. Vent present.if<50 feet or specified S. Distance baween tr+texhes minimum Wend maximum of 6' 6. Mialmum distance Wtweerh tri 10' 7. Pipe supe minimmat 0.005 or 6"per 100` S. DqM of trend=below carnet inwrt minimum of 6", ____� Y+cs NO 9. Pips set on stable bast. I. Leach Field I. Maximum.length of fide Ito' 2. Pipe slope minimum 0.005 or P per 100' 3. Separation bebwm pipe 6'maximum 4. Pipes tonne and at ant S. Separation benveen,adjacent fields 10'xrtinim= 6. Pipes Set ort$tsblee lase 7. Maximum 4'sqpration froom edge of field to.first line S. Minimum twodisidbutiion knees 9. Mw trtum peso rate 20 mpi Comments., I Leaching Pits 1. Miaim dm inlet pipe 4" 2. eats of Concrete +.,✓ 3. Sidewwall between.I r and 48"wide ✓ '""""'"'—" 4. Aoms manhotes an each pit 5. Pipes cemented with hydraulic ceement .... Cartuadtctas;. K final Grafi I. Slope over soil absorption system minimum 0.02 2. All system campoaents awvred by at lest V soil 3. Cover sail fie,e of stones larger that 6" 4. Grading slopes avmy lkam dw iling S. No mats over system that may pond Town of North Andover E NaRTN • O stereo s ti iCn �� ?ff5fe of the Zoning Board of Appeals j •>'- `'' °��, rlv` pttav �� ��VI nity Development and Services Division _ -H `, 27 Charles Street -North Andover,Massachusetts 01845 �1 e 7 � Z2 P 4CHUs D. RdtY��t Nicetta J lt` Telephone (978) 688-9541 Building Commissioner Fax (978) 688-9542 Any appeal shall be filed Notice of Decision within(20)days after the Year 2002 date of filing of this notice in the office of the Town Clerk. Property at: Lot 13C Duncan Drive NAME: Ann T.Barbagallo HEARING(S): October 8,2002 ADDRESS:Lots 13B &13C Duncan Drive PETITION: 2002-024 North Andover,MA 01845 TYPING DATE: 10/15/02 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, October 8,2002 at 7:30 PM upon the application of Ann T.Barbagallo,120 Duncan Drive North Andover,for premises at Lots 13B &13C Duncan Drive requesting a dimensional Variance from Section 7,Paragraphs 7.1 (Lot Area),7.1.1 (Contiguous Buildable Area),7.1.2(Lot Width),&7.2(Frontage)and Table 2 to allow a single family dwelling, within the R-I zoning district. The following members were present: Walter F.Soule,John M.Pallone,Scott A. Karpinski,George M.Earley, and Joseph D.LaGrasse. Upon a motion by Joseph D.LaGrasse and 2nd by John M.Pallone,the Board voted to GRANT the petition for dimensional Variance for Lot 13B from Table 2 and Section 7,.Paragraph 7.1(required Lot Area =2 acres— 1.33 acres)relief of.67 acre,Paragraph 7.1.1.(required CBA=75%-50%)relief of 25%,Paragraph 7.1.2(required Lot Width= 100'—50')relief of 50',Paragraph 7.2(required Street Frontage= 175'— 150')relief of 25' andjor Lot 13C from Table 2 and Section 7,Paragraph 7.1 (required Lot Area=2 acres— 1.77 acres)relief of.23 acres, Paragraph 7.1.1 (required CBA=75%-50%)relief of 25%,Paragraph 7.1.2(required Lot Width= 100'-45') relief of 55',Paragraph 7.2'(ie4uired Street Frontage= 175'—150')relief of 25',as shown on Plan of Land prepared for Barbagallo Children Realty Trust showing Lot 13C Duncan Drive certified by Thomas J.Neve,P.L.S., Thomas E.Neve Associates,447 Old Boston Road,Topsfield,Massachusetts 01983,dated April 10,2002. Voting in favor: John M.Pallone,Scott A. Karpinski,George M.Earley,and Joseph D.LaGrasse. Voting against: Walter F. Soule. The Board finds that the applicant has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of this variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Furthermore,if the rights authorized by the Variance are not exercised within one(1)year of the date of the grant,it shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,it shall lapse and may be re-established only after notice,and a new hearing. Town of North Andover E Board of Appeals, OCT 2 9 27--o Walter F.Soule,Acting Chairman J - Decision-2002-024 Board of Appeals 688-9541 Building 688-9545 Conservation 688-9530 Health 688-9540 Planning 688-9535 ti INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initials A. Bottom of Bed 1. Excavation to proper depth 2. With trenches,sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation,etc. Comments: B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed 3. Wall minimum 10'to leaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8"per foot minimum 6. Pipe properly set on compact fine base - 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change 10. 10' minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20"manholes 7. Inlet tee minimum 12"under invert 8. Outlet tee minimum 14"under invert 9. Outlet line cemented 10. Air space 3"above tees 11. 2"-3"drop from inlet to outlet 12. Pipe set 13. Compact base with 6"of V crushed stone under tank 14. Tank is watertight Comments: Yes NO E. Pump Chamber 1. If separate from tank,compact base with 6"of 1/4"stone underneath 2. Minimum 2"pipe to d-box if gravity system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum 0.1T'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution 5. Compact base with 6"of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-'/4"- 1 %z" -pea stone Bucket test done? 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan-Minimum 2';maximum-4'. 4. Vent present if<50 feet or specified 5. Distance between trenches minimum 4' and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". v Yes NO 9. Pipes set on stable base. Comments: I. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6"per 100' 3. Separation between pipe 6'maximum 4. Pipes connected at end 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: J. Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12"and 48"wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH 32OF q4, ��S`ED /66,`6 OL 19 APPLICATION FOR SITE TESTING/INSPECTION ATED �9SSACHus���y Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relit-3ve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*-*********************� APPLICANT-4� PHONE% '7,f) S a' ` �' LOCATION: Assessor's Map Number � PARCEL SUBDIVISION LOT(S) 1 � STREET �r��vc cv ��zST. NUMBER //0 1-7136 ************************************OFFICIAL USE ONLY*********************************** RECOM DA IONS OF WN AGENTS: CONSER TION A N TRATOR DATE APPROVED DATE REJECTED E4 COMMENTSAa TOWN PLANNER DATE APPROVED -- DATE REJECTED COMMENTS FOOD INSIDE OR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED ` - DATE REJECTED COMMENTS ��� OV c.,a , 2,� 6' A/,p PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT Ll RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm rr, f � r THOS E:NEVE ASSOCIATES, INC. May 7, 2003 MAY 7 2003 Conservation Commission c ��✓ 27 Charles Street North Andover,MA 01845 Re: Modification Request DEP File No. 242-1109 Lot 13C Duncan Drive Applicant: Barbagallo Children Realty Trust Dear Commission Members: Please find enclosed a well permit denial from the North Andover Board of Health for the above- referenced project. After several discussions with various Town agencies, Mr. Barbagallo has agreed to install the water service. In order to minimize impacts to the wetland resource area and still try to maintain a passable driveway to the existing dwelling at 120 Duncan Drive we have proposed to install the water service along the westerly edge of the existing paved driveway adjacent to the approved utility trench. In order to maintain a 3-foot separation between the electric and water service, the water service will be located beneath the edge of the existing paved driveway. This location was proposed for 2 reasons: 1. It will allow the utilities to be installed without encroaching any closer to the wetland resource areas than previously approved. 2. It will allow us to maintain access to the existing dwelling located at 120 Duncan Drive during the installation of the utilities. We_believe that the addition of the water service, as shown on the enclosed plan, will not have any adverse impacts on the wetland resource area. The limit of work line/erosion control line location has been maintained as shown on the approved design plan. At this time we ask that you modify the existing Order of Conditions to reflect this plan as the plan of record. We look forward to meeting with you on May 14, 2003 to discuss this issue further. • ENGINEERS • LAND SURVEYORS • • LAND USE PLANNERS 447 Old Boston Road U.S. Route#1 Topsfield, MA 01983 (978)887-8586 FAX(978)887-3480 Conservation Commission Page 2 , May 7, 2003 Thank you, in advance, for your anticipated cooperation in this matter. Sincerely, THOMAS E. NEVE ASSOCIATES,INC. John M. Morin, PE Executive Vice President JMM/kmm Enclosures cc: Joe Barbagallo Board of Health 2074MoC.doc May 07 03 02:25p NORTH ANDOVER 9786889542 p.2 Town of North Andover f M° Office of the Health Department Community Development and Services Division * _ L 27 Charles Street North Andover,Massachusetts 01845 Sandra Starr Telephone(978)688-9540 Public Health Director Fax(978)688-9542 May 1,2003 Joseph Barbagallo 120 Duncan Drive North Andover,MA 01845 RE: Well Permit Denial for Lot 13C Duncan Drive Dear Mr.Barbagallo: The North Andover Board of Health unanimously voted to deny your application for a well permit at their meeting on March 27,2003. As stated at the meeting and in the minutes,the permit was denied due to previous groundwater contamination and past site usage. There is town water service available on Duncan Drive and the Board of Health has determined that it is in your best interest from a public health standpoint to utilize the existing infrastructure. If you have any questions,please feel free to contact me at any time. Sincerely, Sandra Starr, Public Health Director Cc: Board of Health 4ile julie Parrino,Conservation Administrator BOARD OF APPEALS 688-9541 BUILDING 633-95-45 CONSERVATION 688-9530 HEALTH 6923-9540 PLANNING 688-9515 )pV4 uo s-lit-IOU C1J {:,rynIoul i njOOj 611'uDog { '.."'L. r{•a t SIF!-_ � i. ! {b q t ^y r uiila � +. l�l• 1 � k��� �` rr RIX 171, 1-4 e CCCDDII �. j�+f.r ice,`Pvy�+iy41609 {+,',• kn o '� r- 'T4� ,W�ir f ii ,ix 1 r,., ru f �f rill rmLn N ul O A €,,t+�S �, r r dig N t ', .a O rm cC S+T 7 {ip Ax T rm ;tom L , "f-.v"1 �+il�`rf; IU+, .Ja H O .� �., o�i�1 , a �� zIt Ir"{+� t{FAY O Lu O g ilt �2' !_� ;s rl�lfr r•'I �}rt,j��� ,i t r,- �. m W 4fi-OL�LOFO 1"" i STREET OR SUBDIVISION . . . . . . . . . . . . • • • •.• M.0 PARCELgj2L.QT- _ ENGINEER °'s•�(• . . f�.R . . . . .'. . . . . . . . . . OWNER .cf:05,c- P�f. . .8AR8A,GA GLo cj"R COMMONWEALTH OF MASSACHUSETTS Percolation Test Date:Jtun(E 9Lo a- o Q o Time: .. I�7.'...M......'........ Observation Hole # Depth of Perc S3 Start Pre-soak l0 . �S- 10:3 2- End End Pre-soak / U.' 3 O !O.'Z� 7 Time at 12" /O. 3v o : �f 7 Time at 9" 1 0•' �f 9 � as Time at 6" Time (9"-6") Rate Min./Inch Site Passed _e Site Failed ❑ ....................................................................................................................... Performed By: �0_5,5,R14 ,Y9RR)3 r-A// O �•S- Witnessed By: t 0. TO A ,-Ro Wi(/ Aog r" �itrG/�v�-E/e/err Comments: 7- STREET OR SUBDIVISION . .DL1.1VC61'0( . P9.. . .. . . . . . . . . . ... . . . MAP. . . S' ENGINEER . . . . . . . . . . . . . . . OWNER On-site Review Deep Hole Number ..../........................ Date:..G"..1.0 -�600 Time: -A.41.- Weatherc'q-4- ........................................ Location (identify on site plan) ....... .................................... ...........-............................. ...................................................................... Land Use -..D..W.A.AAJA.a........... Slope Surface Stonet ............................................................... Vegetation .�E.0.5..... ............................I................................................................................................................................................. Landform ................................................................................................................................................... Position on landscape (sketch on the back) .....,.A'.17..'.....I........................................................................................................................ Distances from: Open Water Body .... feet Drainage way feet Possible Wet Area ................ feet Property Line ...qO....... feet Drinking Water Well .19.0. . ' feet Other .. .......................... DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) (Munsell) (Structure, Stones, Boulders, Consistency, % Gravel) 3 'e. .5, 4. 16 YR 31Z /11 a Z 8 911 C-5-4 YA$ Ci R,(/d 131-0-: C-A t4-Ai cA 4 4 R S'4- /6 YR-V/,( 19 e (;:A 414 CAI f9/2 Y'Q "A 1=91A 84,c 7.5'Y713 GRAA/ u.LR Parent Material (geologic) ............................STDepth to Bedr .. ...................................................... oick: ................. Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: ...a....... Estimated Seasonal High Ground Water: STREET OR Stf�bIVISION /y l�Yli../�. Gl72. buN�l�N R; , , , gyp; -P 4WCEL:QtUr07 ENGINEER c%,OSL F/f ,afiR� G/�,L�a . . .S :. . . . . . . . . . . . . OWNER a4 C3. On-site Review Deep Hole Number ....iZ........... Date:G.'.A071d°Q p Time:.. Weather C L AR Location (identify on site plan) ......y.ES...................................... .................................................................:.. .................................................... Land Use ...�.�+!�A44/N.0 ............. Slope (%) .•�2...... Surface Stones ........... S Vegetation ......7`R. .E. .. ........................................................................................................ ......................................................................... Landform .... ....................................................................................................................................... .............. Position on landscape (sketch on the back) ............................................................................................................................. ........................ Distances from: Open Water Body .../ A..... feet Drainage way.......NAT. feet Possible Wet Area ...........:..... feet Property Line .#.!;k....... feet Drinking Water Well .L.D..O. 4' feet Other ... .......................... DEEP OBSERVATION HOLE i Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) (Munsell) (Structure, Stones, Boulders, Consistency, % Gravel) 3P 6YR312 G �'�ipe4E �2/A 134C- 5 34C' 13w �c�S•L • �•sYR �`/ �' G�e/�•,vuL�R 5ro&e �0YR �IG �1S�MGLrG,e"I..,/v �•sY/t I-XIA 81 r G RA4AIC(L5 ,Q . Parent Material (geologic) ......:.......5.....L..'.... $.. 0 //�C............................. Depth to Bedrock: .. ........ Deoth to Groundwater: Standing Water in the Hole: ...:.?....... Weeping from Pit Face: .0........ Estimated Seasonal High Ground Water: .... q.�. . 111�i1��`�i��i��11 11111111111111 NN11�1111 IN 1111 ., 1111111 11 • _ . :.4,x, ,,_.. IIIIIIIIINII` -�In1u�'IIl • ' AV ,• 111111rr1�1111rIN11i1111111111111 • . -_. ;'� IIIIIIIIIIIIIIIINIIu111N1111111 1 _ _ �. 11111111111 N�11111111E . IIIIIIIcr�ii� 'M,I!�E �;1;r1o11111111111 • ~ 1 111/111l,�,i ��MIC. �111111III//11 1 IIIIIIii�/i ii r1�11111111 '` 11111 =��� IIIIIIn11111111®11111111111111 • _ 111NN�NNN 1 +;.--. .. _ IIIIIIu11/111 11111 INIIII INNIIInilllil 11111 1111111 r . 111'tr�!! I!' !1�1'.'111111 1 NIN fop Cllr^�f 111 NNINNIIt. 111��11� IIN IIIIIIINIIE�ININII 11 • 1111 11111MENNEN 111111 IIIIIN 11111 11 1 Jun-20-00 12: 57P Paul D. Turbide, PE PLS 978-465-0313 P.03 - I 1 1 ' I I i o i I ` I T--7 - - - -- - ---- - - r-- - . i I BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: D0 MAP &PARCEL: La2o _ Z t LOCATION OF SOIL TESTS: b,tr b a!lo u`! en e TI-u ft OWNER: L /. e, TEL. NO.: LO 7- /3C- ADDRESS: Zigg — Caw A � �w�v 616— ENGINEER: . o /�,����'��t� TEL. NO.: CERTIFIED SOIL EVALUATOR: p 6�P r R Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: / Repair Testing: Undeveloped lot testing: ✓ / In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. iiAY 15 Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 4 4 MAP & PARCEL: "1ba� Z LOCATION OF SOIL TESTS: f3Qr bAqz 1140 Chi,,'! rPh C,ea Tluft OWNER: C �. e TEL. NO.: 6 e6 -Vc2c" - L-o r /3,f- ADDRESS: ENGINEER: s�o� /�„n/� t'���i TEL. NO.: CERTIFIED SOIL EVALUATOR: f 6� Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped lot testing: ✓ / In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). - 7. Within 60 days of testing soil evaluation forms shall be submitted. N19t , 5 Please Do Not Write Below This Line _ N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: Board of Health 5lorth Andover,?lass SUBSURFACE DISPOSAL DESIGN CHECK LIST LOT # 13 C. 'D2- APPROM DATE Ca �7/�i� DISAPPROVED DATE G Provided: Reasons: Title V FAIL Ob Reg 2.5 The submitted plan must show as a minimum: a) the lot to be served-area,dimensions lot # abutters b location and log deep observation Mes-distance to ties c location and results percolation testa-distance to ties design calculations & calculations shoving required leaching area location and dimensions of system-including reserve area existing and proposed contours g) location any wet areas within 1001 of sewage disposal system or disclaimer-check wetlands mapping (h) surface and subsurface drains within 100' of sewage disposal system or disclaimer i) location any drainage easements within 100' of sewage disposal system or disclaimer-Planning Board files 3) known sources of water supply within 2001 of sewage disposal e system or disclaimer location of art proposed well to serve lot-1001 from leaching facility 1 location of water lines on property-101 from leaching facility location of benchmark driveways o garbage disposals p no PVC to be used in construction q) profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Mer elevations (r) maximum ground water elevation in area sewage disposal system s) plan mast be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks (a) capac t es- 50% of flow, water table, tees, depth of tees, access, punging (b) cleanout Wd)C 101 from cellar wall or inground swimming pool �5, from subsurface drains Reg 10.2 Distribution Boxes slope greater than 0.08 Reg 10.4 b) sump 4 1 Suteurface Design Check List Page 2 its y FAIL OK Leaching Pits Leaching pits are ferred mere the installation is possible Reg 11.2 a) calculations leaching area-minimum 500 sq ft 11.4 b) spacing 11.10 0 surface a 21 11.11 1d) cover erial qe) R�x2 splash pad f) tee t elbow g) no ends in pipe from d-box to pipe Leaching Fields Reg 15.1 ) no greater than 20 minutes/inch area-minimum 900 sq ft 15.4 ) construction of field 15.8 ) surface drainage 2 % 3.7 je) 201 from cellar gall or inground wAndng pool Leaching Trenc s Reg 14.1 a) /sp�aeing-4 leaching area-min 500 sq ft 14.3 b) in 6 ft with reserve between 14.4 c)].4.6 d)14.7 e)14.10 f) ge 2% Downhill Slope -slope y x = to be shown) b) y/x X 150 = (to be shown) s Reg 9.1 a) app ;na 9.6 b) s d-by power