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Miscellaneous - 114 STONECLEAVE ROAD 4/30/2018 (2)
i1143rONECLEAVERGA€3 r V f a y f J North Andover Board of Assessors Public Access Page 1 of 1 NK North Andover Board of Assessors Ot iORTM�M irio � # • o� iw4. i# �i7 beano✓�S. .SSACHUSt U4property Record Card Click Seal To Return Parcel ID:210/104.B-0138-0000.0 FY:2010 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlar e Search for Parcels Search for Sales Summary Residence Detached Structure Condo 114 STONECLEAVE ROAD Commercial Location: 114 STONECLEAVE ROAD Owner Name: ADAMS FAMILY REALTY TRUST RICHARD D&JO-ANNE ADAMS,TRS Owner Address: 114 STONE CLEAVE ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 7-7 Land Area: 1.46 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2312 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 493,200 519,100 Building Value: 264,000 290,800 Land Value: 229,200 228,300 Market Land Value: 229,200 Chapter Land Value: LATEST SALE Sale Price: 1 Sale Date: 05/19/2008 Arms Length Sale A-NO-FAMILY Grantor: ADAMS Code: Cert Doc: Book: 11184 Page: 284 http://csc-ma.us/PROPAPP/display.do?linkId=1517921&town=NandoverPubAcc 7/8/2010 • � NORTF� OL O O wM• 1 '9Q COCMiC lWKM`V S SACHUS� PUBLIC HEALTH DEPARTMENT (ommunity Development Division C'FRT1TICrIE 01F C05V1PL T gjrVCE As of.- October f:October 6, 2010 This is to cert that the individuatrsu6surface dzsposaCsystem received a SA`IISTACTORT IJVSPEC7IOY of the: Fulrtspairl ft&cement of an On Site Sewage Disposa[System (13y: ToddBateson' At: 114 Stonecfeave mad 911ap-104.B; ('arcef-138. 91�ortFt Andover, 9I1A 01845 The Issuance of this certificate shaft not 6e construed as a guarantee that the system wiCC function satisfactorily. us n �Sawye , F7fS/ Pic fic iWeaCt Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com 'TOWN OF NORTH ANDOVER N0T ' Office of COMMUNITY DEVELOPMENT AND SERVICES o'•'�°_ '_'•°°A HEALTH DEPARTMENT 14�0 OSGOOD STREET NORTH ,%N DOVER, MASSACHUSETTS 01845 978.688.9540—Phone Susan Y.Sawyer, REHS/RS 978.688.8476—FAX Public Health Director E-MAIL: heal thdept,atownofnorthandover.com WEBSITE: http:;`.'wwtiv.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certi that th Sewage Disposal System ( ) constructed; ( } repaired; by (Print Name) located at l e (��A) V (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated and last Revised on , with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Z engineer Representat a(Signature) And-Hint Name Final inspection date: 2 Engineer Represe ive(Signature) �j��s On,,1 rn.H C C /d Du J2' rC� And-Prini Name Installer: e (Signature) Date: And-Print Name Engineer: (Signature) Date: `2 Y And-Print N me RECEIVED AUG 21 zolu TOWN OF NORTH ANDOVER HEALTH DEPARTMENT I i i i I i I 'i � h � pORTIi q FILE COPY ° � ` "° O 0 tx � O COCMC j_y1 SSACHUS� PUBLIC HEALTH DEPARTMENT (ommunity Development Division CERTjE.[CXrr'F OT Co _V1PL T0jrVCE As of: June 30, 2010 This is to cert that the individuafsu6surface dsposa[system received a SMISFAC` ORTIM(PEMOYof the: FutT ftair/Wsp&cement of an On Site Sewage IDisposa[System By ToddBateson At: 114 Stonecfeave Road flap-104. 3; Parcel-138 Xorth,Andover, 9WA 01845 The Issuance of this certificate shall not be construed as a guarantee that the system u41T function satisfactorily. I Susan 7 Sawyer, JEMSIR5 Eu6CuWealth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com t , SelleChiaie, Pamela From: Isaac Rowe[irowe@millriverconsulting.com] Sent: Monday, June 28, 2010 10:50 AM To: 'Daniel Ottenheimer'; Grant, Michele; irowe@millriverconsulting.com; 'Marianne Peters'; DelleChiaie, Pamela; 'Randy Burley'; Sawyer, Susan Subject: 114 Stonecleave Road Attachments: 114 Stonecleave Road- Final Inspection 6-23-10.doc; Construction Inspection Form 6-10.doc Susan, Please find attached the final inspection report for the above referenced property. The outlet invert of the pump chamber will be a lot lower than on the proposed plan in order for the force main to drain back to pump chamber. Ben should indicate what the elevation is but it will be approximately 12"above bottom of tank. You may need them to request a post LUA for the invert being less than 12"above ESHWT depending on what elevation Ben indicates on his as-built plan. On the approved plan there was a belly in the force main and this should have been addressed prior to approval. We did make a note on our plan review. So Todd Bateson did the correct thing by lowering the outlet of the pump chamber to ensure complete drain of the force main to prevent any freezing issues. Pam—I also attached a blank construction inspection form. Not too many changes compared to the previous form. Please let me know if you have any questions. Thank you, Isaac Isaac M. Rowe,R.S. Project Manager Mill River Consulting 6 Sargent Street i i AORTH 1 ! O�ttLEO 16q�0 o �, ey O a [OCMtC C.I XIWKw y1. 9 40— "Arlo �PP,�g9 SSACHUS� PUBLIC HEALTH DEPARTMENT (ommunity Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 114 Stonecleave Rd MAP: 104B LOT: 138 INSTALLER: Todd Bateson DESIGNER: Ben Osgood, Jr. PLAN DATE: 10/19/09 BOH APPROVAL DATE ON PLAN: 11/15/09 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 6/23/10 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan ® Existing septic tank properly abandoned Z Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Laundry now connected to building sewer line and laundry system abandoned. SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base NA Cleanouts per plan ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.town0northandover.com Inspedion Form June 2008 14ORTOI O�,ct�eD ra�ti ,6 Cot yCo' C"..0 IWKM y7. 4 �AONTE° 9SSACHUS�� PUBLIC HEALTH DEPARTMENT (ommunity Development Division ® Water tightness of tank has been achieved by Visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (effluent filter) ® 24" inch cover to final grade installed over outlet access port ® Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1000 gallon Pump Chamber installed Z H-10 loading Z Monolithic tank construction ® Inlet tee installed, centered under access port ® Pump(s) installed on stable base ® Alarm float working ® Pump On/Off floats working ® Separate on/off floats ® Drain hole in pressure line ® 24" cover at final grade installed over pump access port ® Watertightness of tank has been achieved by Visual testing ® Hydraulic cement around inlet & outlet Comments: CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement ® Alarm signal located inside: basement 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 t t►ORTH q D 1, 6' 6 OL O r~ � � Co' ea" •Ir O C".c MI... 7• 2 7 Ar /.Pa�y'(y 9SSAC HUS�� PUBLIC HEALTH DEPARTMENT (ommunity Development Division DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution NA Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM (General) ❑ Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan NA 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan NA Retaining wall (boulder/concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) Z Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ® Number of chambers per row: 8 ® Number of rows (trenches): 4 Comments: Total Chambers = 32 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.lownofnorthandover.com Inspection Form June 2008 NORTFt q •s• ti0 L FpTED - t �9SSACFIUS���� PUBLIC HEALTH DEPARTMENT fommunity Development Division BM = 96.45 HR = 3.74 HI = 100.19 SYSTEM ELEVATIONS ROD ELEVATION AS-BLT INVERT ELEV DESIGN INVERT ELEV Benchmark Building Sewer OUT 5.22 94.62 93.00 Septic Tank IN 5.42 94.42 92.80 Septic Tank OUT 5.68 94.16 92.55 Pump Chamber IN 5.76 94.08 92.20 Pump Chamber OUT(2") 91.08+/- refer to as- built plan Distribution Box IN 2" 5.16 94.86 94.93 Distribution Box OUT 5.15 94.69 94.76 Lateral 1 TOP 5.18 Lateral 1 INVERT 94.66 94.66 Lateral 2 TOP 5.18 Lateral 2 INVERT 94.66 94.66 Lateral 3 TOP 5.18 Lateral 3 INVERT 94.66 94.66 Lateral 4 TOP 5.18 Lateral 4 INVERT 94.66 94.66 Top of Chamber 5.06 95.13 95.00 Bottom of Bed/Chamber 6.06 94.13 94.00 1600 Osgood Street North Andover Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.rom Inspection Form June 2008 NORTiy O V%-*ID ,6'9ti O ~ Ar 40 O�A COCM[NIWKw`y7' r1D PPP '(5 9SSAC HUS�� PUBLIC HEALTH DEPARTMENT (ommunity Development Division CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- ® Waterline 10 10 101 ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib.to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot.Area ® Reservoirs 400 400 ® Drains(wat. supply/trib.) 50 100 ® Drains(intercept g.w.) 25 50 ® Drains (Other)Foundation 10(5) 20(10) ® Drywells 20 25 'Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 4 TOWN OF NORTH ANDOVER Of NORM q Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 SRCHUS Susan Y.Sawyer,REHS/RS � / 978.688.9540 —Phone Public Health Director /6 „Zp d 978.688.8476—FAX ONSITE WASTEWATER SYS EMC NSTRUCTION N®TES yLOCATION INFORMATI - ADDRESS: ` MAP: LOT: INSTALLER: DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL.CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANK [� Bottom of tank hole has 6" stone base Weep hole plugged [ 1500 a a 7-4?V/L5 -10 loadin onolithic construe ' ightness of tan c as een achieved ( .is or Vacuum Test or Water held for 24hrs) [ Inlet tee installed, center essP ort ❑ Outlet tee (gas baffle �ntinstalled, centered under access 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent ^/ filter is present E3 Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page 1 of 6 TOWN OF NORTH ANDOVER f N°RTH ' Office of COMMUNITY DEVELOPMENT AND SERVICES 0`` � HEALTH DEPARTMENT p 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 �gss,C "S�y acr+u5k Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX Comments: PUMP CHAMBER JBottorn of tank hole has 6" stone base [� Weep hole plugged ❑ o Tank installed. Size: 000 gallon Pump Chamber installed onolithic c struction) In e tailed, centered under access port Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working Separate on/off floats Drain hole in pressure line 24" inch cover to within 6" of final grade installed over pump access port Water tightness of tank has been achieved Visual testing Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 r.. r It TOWN OF NORTH ANDOVER F ,FORTH Office of COMMUNITY DEVELOPMENT AND SERVICES F °yteo ,bgyo°p HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 " o NORTH ANDOVER,MASSACHUSETTS 01845 Wyss, NCHU`✓ Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978:688.8476-FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM- Bottom of SAS excavated down to&soil layer, as provided on plan Size of SAS excavated asp er Ian p Title 5 sand installed, if specified on plan 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peaston'e) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on,approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) El cover as per plan Comments: Wastewater System Documentation—Feb 20006 Page 3 of 6 " TOWN OF NORTH ANDOVER f por+rk Office of COMMUNITY DEVELOPMENT AND SERVICES 3 O`tTeo O tioL �'d.: ...." � � A HEALTH DEPARTMENT 41 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER'MASSACHUSETTS 01845 �'9s°"��'°e��h S�cNus Susan Y. Sawver,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals El size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 y, TOWN OF NORTH ANDOVER aF NORTH N Office of COMMUNITY DEVELOPMENT AND SERVICES 0 s T HEALTH DEPARTMENT * _ 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 "Ssa�H„Sk<{h Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 --- El -°:__.. . . ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ❑ Wetlands bordering surface water supply or trio. (in`W"atershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains(wat. supply/trib.) 50 100 ❑ Drains(intercept g.w.) 25 50 ❑ Drains(Other)Foundation 10(5) 20 (10) ❑ Drywells 20 25 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER f NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES 3 �`" °���� HEALTH DEPARTMENT A 1600 OSGOOD STREET;Building 2-36 9 "* NORTH ANDOVER MASSACHUSETTS 01845 "s � SACHUS Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6 I Commonwealth of Massachusetts Map-Block-Lot 104.B0138 a Board of Health � - a Permit No • North Andover BHP-2010-0617 °. .. ::.�.. _` • P.I. ----------------------- PEE .� wust F.I. $250.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Todd Bateson ----------------------------------------------------------------------------- to(Repair-FULL SYSTEM)an Individual Sewage Disposal System. at No` 114 STONECLEAVE ROAD -------------------------------------------- - ----------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP-2010-061 -,--Dated June 16 2010 Issued On:Jun-16-20 ------------- COPS ------ 10 - ----------------------------------- - - -- -- - -------------------------------------------------- Board of Health �4 'O°:TN Aaslication for Disposal System 1 -Construction Permit -TOWN OF TODA�S-�DATE � �' •�'' ORTH ANDOVER MA 01845 $250.00—Full Repair aa>s t•,S ,,�'" $925.00-Component S� Important: Application is hereby made for a permit to: __ When filling out ❑ Construct a new on-site sewage disposal system* �..�....�M� forms on the REC55'VE V computer,use B-Cepair or replace an existing on-site sewage disp al system* only the tab key to move your ❑ Repair or replace an existing system component— hat4UN �I 1 ZO10 cursor-do not use the return A. Facility Information key. C TOWN OF NORTH ANDOVER �� �/ J Toi✓�LG j ��R HEALTH DEPARTMENT QAddress or Lot# Cityfrown 2.-*TYPE OF SEPTIC SYSTEM*: ump 0 Gravity(choose one) ***if pump system,attach copy of electrical permit to application*** ❑Conventional System(pipe and stone system) Infiltrator or Biodiffuser(Gravel-Less) (Attach a copy of your certification to install this type of system. El Pressure Distribution S.A.S.(No D-Box)(Attach Draft Maintenance Agreement) ❑Pressure Dosed(D-Box Present)S.A.S. 2. Owner Information Name GL2�ty '. Address(if different from above) City/Town State Zip Code Telephone Number 3. Installer Information ZdA. Name � Q - Name of Compa 41r,-I'441 t 1 AGI ERPRIS ES INC• /1 l 7� LLA ROAD Address 44 444,, , W 44,, - Ct town state Zip Code Telephone Number(Cell Phone#if possible please) 4. Designer information (� Name Name of.eSPfipany��— Address Cdyfrown State . Zip Code 1 Y da", i Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page t of 2 c rorrrH Application for Septic bisposal System - /c p Construction Permit TOWN. OF TODAY'S DATE $.250.00-Full.Repair ORTH ANDOVER, .MA 01845 $125.00 -Component 9SSICNUSE� - PAGE 2OF2 A. Facility.Information continued.... 5. Type of Building: 24 sidential Dwelling or❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issue y this Board of Health. Name - o Date Applicatio pproved By: (B d of Health Representative) Njjre Date Application Disapproved for the following reasons: For Office Use Only: 1 Fee Attached. Yes No 2. Project Manager Obligation Form Attached. yeS �. No . 3. Pump S sy tem? If sq;Attach copy ofElectrical Permit Yes No 4. Foundation As-Built. (new construction.ronly): yes No (Same scale as approved plan) 5. Floor Plans?(new construction only): Yes_ No Application for Disposal System Construction Permit•Page 2 of 2 1 . SEPTIC SYSTEM.INSTAL L.ER PROJECT MANAGEMENT OBLIGATIONS As the North Andover:licensed installer for the construction for the septic system for the property at: (Address of septic system) For plans by j (Engineer) Relative to theapplication of (Installer's name) ; And dated le G1--la ngrna -ate Dated D ocay s ate With revisions dated (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am.obligated to obtain.all permits and Board of Health approved plans p1ior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer,I must call for any and all inspections. If homeowner, contractor,project manager, or any other.person not associated with my company schedules an inspection and the system is not ready,then item hree shall.be applicable. 3.` As the installer,I am-required to.have the necessary work completed prior,to the applicable inspections as indicated below. I-understand that re&esting:an inspection,without_completion of the items in accordance with Title S and the Board of Health Re tions may.result ina W.00 fine being levied against me aiid/or my eompa_v a. Bottom iofted--Generally,this:is the first(V inspection unless..there is a"retaining wall,which should be done.first The installer must request the inspection but does not have to be present b. Final Construction Inspection—Engineer must first:do their:in for elevations, ties,etc. As-built of verbal OK(or e-mail to:healtlidept@townofnorthandover com) .from the engineer must be submitted to the Board of.Health,after which installer.calls for an inspection time. Installer must be present for this.inspection, With a pump system, all electrical work must be ready and able to cause pump.to work and alarm to function. c.. :Final Grade—Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer,I understand that only I may perform the work(other than:simple excavation)and I am required to complete the installation of the system identified in the attached application for installation: ,I further understand:that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/orrevocation or suspension of my license to operate in the Town of North Andover,significant fines to all persons involved arree also possible 5. As the installer; I understand thatI mustbe on-site during the performance of the following construction steps: a. Determination that.the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board ofHealtb staffor consultant. d. Installation.of tank,D-Box,pipes,stone, vent,pump chamber,retaining wall and other components. 6. As the installer.I understand that Lam sbl!gly responsible for the installation of the s stern as per the approvedplans. No instructions by the homeowner general contractor or any other persons shall absolve me of this obligation. Undersigned Incensed Septic Installer: (Today's Date) G'af Name .reit ee Date®� • to TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,S SAC"US� e / elm This certifies that UN . has permission to perform n - 4 2010 plumbing in the buildings of . . . . . . . : . . . HEq�THTOWN OF NDE NT V , North Andover, Mass. Fee. Lac. N o.. � ? • •' . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # / 8643 R TOWN OF NORTH ANDOVER Permit Number ` NORTH ANDOVER,MASSACHUSETTS 01845 � Rr„ Date Issued o�,,"40 ,•��o } Expiration Date � e 4 FE JUIN 1 12010 TOWN OF NORTH ANDOVER Jackie's Law — Permit A"Pli lug�`TH i DEPARTMENT Pursuant to G.L. c. 82A §1 and 520 CMR 7.00 et seq.(as amended) THIS PERMIT MUST BE FULLY COMPLETED PRIOR TO CONSIDERATION Name of Applicant� � Phone Cell Street Address City/Town MA ZIP Name of Excavator(if different from applicant) Phone Cell Street Address City/Town MA ZIP Name of Owner(s)of Property Phone Cell Street Address ' t r c- ` 04,,v //y CityiTown MA ZIP CVs� /�-�✓�n.._ �-- o Other -- Other Contact Permit Fee Received No Yes Description,location and purpose of proposed trench: Please describe the exact location of the proposed trench and its purpose(include a description of what is(or is intended)to be laid in proposed trench(eg;pipes/cable lines etc,.)Please use reverse side If additional space is needed, -4-,V,5/A- // 7�`Z S YS Tti� Insurance Certificate it Name and Contact Information of Insurer: r Policy Expiration Date: Dig Safe#: /G ;1 L/v J-7 9/ Name of Competent Person(as defined by 520 CMR 7.02): Massachusetts Hoisting License# 033 Xs-,o License Grade: ak Expiration Date: BY SIGNING THIS FORM, THE APPLICANT; OWNER, AND EXCAVATOR ALL ACKNOWLEDGE AND CERTIFY THAT THEY ARE FAMILIAR WTTH, OR, BEFORE COMMENCEMENT OF THE WORK, WILL BECOME FAMILIAR WITH, ALL LAWS AND REGULATIONS APPLICABLE TO WORK PROPOSED,INCLUDING OSHA REGULATIONS,G.L.c. $2A,520 CMR 7.00 et seq.,AND ANY APPLICABLE MUNICIPAL ORDINANCES,BY-LAWS AND REGULATIONS AND THEY COVENANT AND AGREE THAT ALL WORK DONE UNDER THE PERMIT ISSUED FOR SUCH. WORK WILL COMPLY THEREWITH IN ALL RESPECTS AND WITH THE CONDITIONS SET FORTH BELOW, THE UNDERSIGNED OWNER AUTHORIZES THE APPLICANT TO APPLY FOR THE PERMIT AND THE EXCAVATOR TO UNDERTAKE SUCH WORK ON THE PROPERTY OF THE OWNER, AND ALSO,FOR THE DURATION OF CONSTRUCTION,AUTHORIZES PERSONS DULY APPOINTED BY THE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR AND INSPECT THE.WORK FOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND REGULATIONS GOVERING SUCH WORK. THE UNDERSIGNED APPLICANT,OWNER.AND EXCAVATOR AGREE JOINTLY AND.SEVERALLy TO REIMBURSE THE MUNICIPALITY FOR ANY AND ALL COSTS AND EXPENSES INCURRED BY THE MUNICIPALITY IN CONNECTION WITH THIS PERMIT AND THE WORK CONDUCTED THEREUNDER,INCLUDING BUT NOT LIMITED TO ENFORCING THE REQUIREMENTS OF STATE LAW AND CONDITIONS OF THIS PERMIT,INSPECTIONS MADE TO ASSURE COMPLIANCE THEREWITH,AND MEASURES TAKEN BY THE MUNICIPALITY TO PROTECT THE PUBLIC WHERE THE APPLICANT OWNER OR EXCAVATOR HAS FAILED TO COMPLY THEREWITH INCLUDING POLICE DETAINS AND OTHER REMEDIAL MEASURES DEEMED NECESSARY BY THE MUNICIPALITY. THE UNDERSIGNED APPLICANT,OWNER AND EXCAVATOR AGREE TO DEFEND,INDEMNIFY,AND HOLD HARMLESS THE MUNI AND AND SEVERALLY AND EMPLOYEES FROM ANY AND ALL LIABILITY,CAUSES OR ACTIONA AND ALL AND EJ AGENTS RESULTING FROM .OR ARISING OUT OF ANY INJURY, DEATH, LOSS, OR DAMAGE TO ANY PERSON.OR PROPERTY DURING THE WORK CONDUCTED UNDER THIS PERMIT: APPLIC SIGNATURE DATE EXCAVATOR SIGNATURE(IF DIFFERENT) DATE OWNER'S SIG TORE(IF DIFFERENT) DATE: G•–to– io 2 P a g e---------------------_---___----- - _–_-__ __ _ –-----.. u . - �.. --,— a u• mac-: - �`.cTj�'�i.� -��ae' - ir•- r"1%: _ r ,-. : F.� ,. :.s-,-ate - '.�3 '_.i: :�"` �y :.� � �-xcy� 'v��. , � •'� rte. —�J�..,a—^�.��.. �.. ',�^ ;,_x�•��,s�-_-� �_. �t_ �. z:., _ �-�c-.er,� �.�1 � �rte"''���.c'=- _ ".".•a.s .mss??.,.^-;-„v.,� .:.•�,:w�f�' -_ • -�-'...... •ate*"`-^'..._�'��,..�=^-��.�_,•F.i�?` �-'^” •ox'�?��,<�� r �¢z. _���"=� ^� .-•-"- �Kw�A. � '�.?.~ >es�r....eF'.it. '`-. ��' �c�`�.f.,.'e ' � <';..�..�i'� �z ;rte— � � ...�`;•� %�` °Gr'�=�n-3.���;-„ ',�."•%•:: ';•ct� ��. •-?-- -✓sv^_. CONDITIONS AND REQUIREMENTS PURSUANT TO G.L.C.82A AND 520 CMR 7.00 et seq. (as amended) By signing the application,the applicant understands and agrees to comply with the following: i. No trench may,be excavated unless the requirements of sections 40 through 40D of chapter 82,and any accompanying regulations,have been met and this permit is invalid unless and until said requirements have been complied with by the excavator applying for the permit including,but not limited to,the establishment of a valid excavation number with the underground plant damage prevention system as ii. said system is defined in section 76D of chapter 164(DIG SAFE); Trenches may pose a significant health and safety hazard. Pursuant to Section 1 of Chapter 82 of the General Laws,an excavator shall not leave any open trench unattended without first making every reasonable effort to eliminate any recognized safety hazard that may exist as a result of leaving said open trench unattended. Excavators should consult regulations promulgated by the Department of Public Safety in order to familiarize themselves with the recognized safety hazards associated with excavations and open trenches and the procedures required or recommended by said department in order to make every reasonable effort to.eliminate said safety.hazards which may include covering, iii. barricading or otherwise protecting open trenches from accidental entry. Persons engaging in any in any trenching operation shall familiarize themselves with the federal safety standards promulgated by the Occupational Safety and Health Administration on excavations:29 CFR 1926.650 et.seq.,entitled Subpart P"Excavations” iv. Excavators engaging in any trenching operation who utilize hoisting or other mechanical equipment subject to chapter 146 shall only employ individuals licensed to operate said equipment by the Department of Public Safety pursuant to said chapter and this permit must be presented to said licensed operator before any excavation is commenced; V. By applying for,accepting and signing this permit,the applicant hereby attests to the following:(1)that they have read and understands the regulations promulgated by the Department of Public Safety with regard to construction related excavations and trench safety.; (2)that he has.read and understands the federal safety standards promulgated by the Occupational Safety and Health Administration on excavations:29 CMR 1926.650 et-seq.,entitled Subpart P"Excavations"as well as any other excavation requirements established by this municipality;and(3)that he is aware of and has,with regard to the proposed trench excavation on private property or proposed excavation of a city or town public way that forms the basis of the permit application,complied with the requirements of sections 40- 40D of chapter 82A. vi. This permit shall be posted in plain view on the site of the trench. For additional information please visit the Department of Public Safety's website at www,mWj'jQYLdM 31Page ► Summary of Excavation and Trench Safety Regulation 020 CMR 14.00 et seg.) This summary was prepared by the Massachusetts Department of Public Safety pursuant to G.L,c.82A and does not include all requirements of the 520 CMR 14.00. To view the full regulation and G.L.c.82A,go to www/mass.gov/dps Pursuant to M.G.L. c. 82, § 1,.the Department of Public Safety,jointly with the Division of-Occupational Safety, drafted regulations relative to trench safety. The regulation is codified in section 14.00 of title 520 of the Code.of Massachusetts Regulations. The regulation requires all excavators to obtain a permit prior to the excavation of a trench made for a construction-related purpose on public or private land or rights-of-way. All municipalities must establish a local permitting authority for the purpose of issuing permits for trenches within their municipality, Trenches on land owned or controlled by a public(state)agency requires a permit to be issued by that public agency unless otherwise designated, In addition to the permitting requirements mandated by statute, the trench safety regulations require that all excavators,.whether public or private,take specific precautions to protect the general public andprevent unauthorized access to unattended trenches. Accordingly,unattended trenches must be covered, barricaded or backfilled, Covers must be road plates at least'/."thick or equivalent;barricades must be fences at least 6'high with no openings greater than 4" between vertical supports; backfilling must be sufficient to eliminate the trench. Alternatively, excavators may choose to attend trenches at all times,for instance by hiring a police detail,security guard or other attendant who will be present during times when the trench will be unattended by the excavator. The regulations further provide that local permitting authorities,the Department of Public Safety,or the Division of Occupational Safety may order an immediate shutdown of a trench in the event of a death or serious injury;the failure to obtain a permit; or the failure to implement or effectively use adequate protections for the general public. The trench shall remain shutdown until re-inspected and authorized to re-open provided, however,the excavators shall have the right to appeal an immediate shutdown. Permitting authorities are further authorized to suspend or revoke a permit following a hearing. Excavators may also be subject to administrative fines issued by the Department of Public Safety for identified violations. Summary of 1926 CFR Subpart P-OSHA Excavation Standard This is a worker protection standard,and is designed to protect employees who are working inside a trench. This summary was prepared by the Massachusetts Division ofOccupational Safety and not OSHA for informational aspects of the standard. purposes only and does not constitute an official interpretation by OSHA of their regulations;and may not include all For f i Cher information or a full copy of the standard go to www,____ oshagov. Trench Definition per the OSHA standard: o An excavation made below the surface of the ground,narrow in relation to its Iength. o In general,the depth is greater than the width;but the width of the feet. trench is not greater than fifteen • Protective Systems to-Prevent soil wall collapse are always required in trenches deeper than 5,and are also required in trenches less than 5'deep when the competent person determines that a hazard exists. protection options include: o Shoring. Shoring must be used in accordance with the OSHA Excavation standard appendices,the equipment manufacturer's tabulated data,or designed by aregistered professional engineer. o Shielding(Trench Boxes). Trench boxes must be used in accordance with the equipment manufacturer's tabulated data,or a registered professional engineer. o Sloping or.Benching. In Type C soils(what is most typically encountered)the excavati extend horizontally 1 %feet for evon must every foot of trench depth on both sides, 1 foot for Type B soils, and%foot for Type A soils. o A registered professional engineer must design protective systems for 20'in depth, all excavations greater than continued 4 P a g e ----- • Ladders must be used in trenches deeper than 4'. o Ladders must be inside the trench with workers at all times,and located within 25'of unobstructed lateral travel for every worker in the trench. o Ladders must extend 3'above the top of the trench so workers can safely get onto and off of the ladder. • Inspections of every trench worksite are required: o Prior to the start of each shift,and again when there is a change in conditions such as a rainstorm. o Inspections must be conducted by the competent person(see below), • Competent Persons)is: o QVable(i.e.,trained and knowledgeable)in identifying existing and predictable hazards in the trench,and other working conditions which may pose a hazard to workers,and o utho 'zed by management to take necessary corrective action to eliminate the hazards. Employees must be removed.from hazardous areas until the hazard has been corrected. • Underground Utilities must be: a Identified prior to opening the excavation(e.g.,contact Dig Safe). o Located by safe and acceptable means while excavating. o Protected,supported,or removed once exposed. • Spoils must be kept back a minimum of 2'from the edge of the trench. • Surface Encumbrances creating a hazard must be removed or supported to safeguard employees. Keep heavy equipment and heavy material as far back from the edge of the trench as possible. • Stabllity of Adjacent Structures: o Where the stability of adjacent structures is endangered by creation of the trench,they must be underpinned,braced;or otherwise supported. o Sidewalks,pavements,etc.shall not.be undermined unless a support system or other method of .protection is provided. • Protection from water accumulation hazards: o It is not allowable�for employees to work in trenches with accumulated water. If water control such as pumping is used to prevent water accumulation,this must be monitored by the competent person. o If the trench interrupts natural drainage of surface water,ditches,dikes or other means must be used to prevent this water from entering the excavation.. Additional Requirements: o For mobile equipment operated near the edge of the trench,a warning system such as barricades or stop logs must be used. o Employees are not permitted to work underneath Ioads. Operators may not remain in vehicles being loaded unless vehicles are equipped with adequate protection as per 1926.6016 . o Employees must wear high-visibility clothing in traffic work zones. @)( ) o Air monitoring must be conducted'in trenches deeper than 4'if the potential for a hazardous atmosphere exists. If a hazardous atmosphere is found to exist(e.g.,02<19.5%or>23.5%,20% LEL;specific chemical hazard),adequate protections shall be taken such as ventilation of the space. o Walkways are required where employees must cross over the trench. Walkways with must be provided for crossing over trenches>6'deep. y guardrails o Employees must be protected from loose rock or soil protective barricades, through protections such as scaling or 5 P a g e .— ). l �,p NORTfi q ` I" 1" O (tUED 16' tiO c LK«l�wK OC T O� [ .�aCK q �9SSAC HUS���� PUBLIC HEALTH DEPARTMENT (ommunity Development Division Date: September 10,2009 Address: 114 Stonecleave Road Re: Application for12 x 12 addition Dear Mr. Adams: Your application for an addition at the above address has been reviewed by the Health Department. Unfortunately,the application was denied on September 10, 2009 for the following reasons: 1. x Missing information 2. x Passing Title 5 inspection of septic system required 3. ❑ Location of structure not acceptable unknown at this time 4. x Undersized septic system unknown at this time To address the problem(s): If#1 is checked,please supply: a. Floor plan of existing and proposed addition—all rooms b. Certified scaled plot plan showing house, septic system in relation to the proposed addition If#2 is checked: a. If the homes size is approved, have the septic system inspected by a certified Title 5 inspector to determine its location and whether it is operating properly: b. Tie-in to municipal sewer If#3 is checked: a. No permanent structures shall be placed on any part of the leaching area or over the septic tank If#4 is checked: Once submitted, the floor plan of the home will be reviewed along with any additional information. The assessor records indicate a 3 bedroom home until 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com other information is submitted it can be assumed that this septic system was built for a maximum 7—room home. If the floor plan shows greater that 7 an upgrade may be required, therefore please do not conduct the Title V inspection until the size of the septic system is evaluated For more information regarding the regulations regarding subsurface disposal systems,please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, Susan Sawyer,REHS/RS Health Director . Cc: Building Department File 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com DelleChiaie, Pamela From: Isaac Rowe[irowe@millriverconsulting.com] Sent: Friday, November 06, 2009 11:49 AM To: 'Daniel Ottenheimer'; Grant, Michele; irowe@millriverconsulting.com; 'Marianne Peters'; DelleChiaie, Pamela; 'Randy Burley'; Sawyer, Susan Subject: 114 Stonecleave Road Attachments: 114 Stonecleave Road Disapproval Letter 11-6-09.doc; 114 Stonecleave na.pdf Susan, Please find attached the disapproval letter for the above referenced property. I have also attached Randy's field book notes from the soil testing because the logs on the plan were inconsistent with our notes. They are seeking an LUA for the reduction in the offset to the ESHWT and the reason on the LUA form is"there is no other location on the lot'. This is not a good reason but I am not sure how easily this LUA is granted by the BOH. I just wanted to point this out to you. Overall the design is good just a handle full of drafting errors. I guess Ben is back on his own??? Please let me know if you have any questions. I will be sending along the Rea Street review later today. Thanks, Isaac Isaac M. Rowe,R.S. Project Manager Mill River Consulting 6 Sargent Street i f I f )AX 07 4 o '2 iFEW—7 s v� d� lam. d NORTH s s ♦ i .^ # i �o _ _ e • o SSACMUS� Health Department November 6, 2009 Benjamin Osgood, P.E. P.O. Box 932 Newburyport, MA 01950 Re: 114 Stonecleave Road(Map 104B, Lot 138) Dear Mr. Osgood: The proposed wastewater system design plan for the above site dated October 19, 2009 and received on October 20, 2009 has been reviewed. Unfortunately, the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item. 1. It appears that there is an easement(30' ROW) on the eastern portion of the lot. Please indicate the holder of this easement(3 10 CMR 15.220(4)(b)). 2. The soil logs on the design plan do not match the Board of Health records on file. We have included a copy of the field book notes for your reference. Also the soil colors are missing for all the horizons in TPI and TP2—C2 and C3. 3. The percolation test data indicated on the plan that only 15 gallons of water was used during the presoak. Title 5, 310 CMR 15.105(6)requires 24 gallons of water have to be added during the presoak in order to assume the percolation rate is <2 minutes/inch. 4. Please provide a benchmark within 50 to 75 feet of the system components (3 10 CMR 15.220(4)(q)). 5. Please indicate the location and proper abandonment of the existing system(3 10 CMR 15.354). 6. The site plan indicates the septic tank is proposed 10' from the foundation but the profile view notes it is 25' from the foundation. Please clarify this discrepancy. 7. The scale of the profile view is not indicated. 8. The design plan indicates the use of an effluent filter inside the existing septic tank. Please indicate the DEP approved brand and model to be used and provide a statement indicating the required annual maintenance in accordance with 310 CMR 15.227(7). 9. Please provide an inlet tee/baffle in the distribution box(3 10 CMR 15.232(3)(a). 10. The system curve and pump curve appear to be labeled incorrectly. 11. The detail of the pump chamber depicts the inlet pipe entering the tank at the outlet invert (92.20') and the outlet force main leaving the tank at the inlet invert. However, in the 1600 Osgood Street HEALTH DEPARTMENT Page 1 of 1 Building 20;Suite 2-36 E-Mail: healthdept@townofnorthandover.com North Andover,MA 01845 Phone:978.688.9540 Fax:978.688.8476 f A profile view the inverts indicate the inlet pipe to be at 92.45' and the outlet force main pipe to be 92.20'. Please clarify this discrepancy. 12. In the profile view,the access manhole covers above the septic tank and pump chamber should be depicted at the outlet end of the tanks. Although technically not items for disapproval,you may want to consider the following aspects of the design: • Require the force main to completely drain back to the pump chamber when the pump turns off instead of keeping some effluent in the belly of force main as shown in the profile view. • You may want consider providing a vent for the leaching facility. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerel , usan Y. S er, SIRS Public Health Director cc: Richard Adams File pORT1i q O -fLr D O y T O�A COCMIC Wit. SSAC HUS���� PUBLIC HEALTH DEPARTMENT Community Development Division r+ November 18, 2009 , Richard Adams 114 Stonecleave Road North Andover,MA 01845 RE: Septic System Design, 114 Stonecleave Road,North Andover, Map 104B,Lot 138 Dear Mr. Adams, The North Andover Board of Health has completed the review of the septic system design plan for the above referenced property, submitted on your behalf by Ben Osgood, Jr. dated October 19 2009, last revision date November 10, 2009 received on November 12,2009. The design has been approved for use in the construction of an onsite septic system. The 440 gallons per day(max 4-bedroom or 9 room total),has been approved for use in the construction of a replacement, Title V, subsurface disposal system. This approval is valid for two years from the date of the approval in accordance with current local regulations and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. The approval includes a Local Upgrade Approval for the request a one foot reduction to the distance from Soil Absorption System to the estimated seasonal high water table from 5 feet to 4 feet. This approval comes with future restrictions which prohibit the increase in the size of the home in accordance with MA DEP regulations. Please keep a copy of the attached document for your records. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. 2. It is the.responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com t . • Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe or imply compliance with any of the aforementioned requirement Please note that this system will be equipped with a Polylock Effluent Filter on the outlet tee. This filter must be maintained annually according to manufacture specifications. Your effort to provide a properly functioning septic system for your dwelling.is appreciated. The Health Department may be reached at 978-688-9540 with any questions you may have. Sincere , usan Y. Sawyer, HS/RS Public Health Director Encl: list of licensed septic system installers Cc: Ben Osgood, Jr. P.E. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com I i l Commonwealth of Massachusetts City/Town of Local Upgrade Approval Form 913 DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information x Important:When filling out forms 1. Facility Name and Address on the computer, use only the tab Richard Adams key to move your Name cursor-do not 114 Stonecleave Road use the return key. Street Address North Andover MA 01845 r� City/Town State Zip Code 2. Owner Name and Address(if different from above): Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility(check all that apply): X Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: g4p4d0 5. System Designer: Ben Osgood, Jr.Name PE RS Name PO Box 932 Newburyport MA, 01950 Address City/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for: Reduction in setback(s)—specify: ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction 114 Stonecleve Road 9b•rev.5/02 Local Upgrade Approval, Page 1 of 2 f Commonwealth of Massachusetts City/Town of Local Upgrade Approval Form 9B M - B. Approval (continued) x Reduction in separation between the SAS and high groundwater: Separation reduction 1 feet ft. Percolation rate <2 min./inch Depth to groundwater 4 ft. ❑ Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: N.Andover Health Dept. Approving Authority X Susan Sawyer, Director f,e 11/16/09 Print or Type Name and Title x ignature Date f' 114 Stonecleve Road 9b•rev.5/02 Local Upgrade Approval, Page 2 of 2 Office of the'Building Depaar#t.men ��bej`►eo e° eyOoG Con'kniuni•l'I)ev°lop8.ent and Services f° � ell CNirles Street.. O)sh I mfjo':er, 0 84 sot m:«• y,. CHUS D Robert Niccita, (.s:n:i)('88-9 AN*(91;i7 ViiS-`142 August 5, 2003 Richard&Joanne Adams X14-Stonecleave.:Road, North Andover,MA 01845 Dear Mr. &Mrs. Adams: Upon review of the properties owned by you and located on assessors map 104B parcels 137& 138 I have the following observation. The properties in question are located in the R-1 zoning district, which requires 2 acres in area and 175 feet of street frontage. The parcels combined have slightly over the required area to be considered one(1)buildable lot. I hope that this satisfies your questions on this matter. Should you have further questions I may be reached between the hours of 8:30— 10:00 AM and 1:00—2:00 PM at 978-688-9545. Respectfully, Awwzy"'�`�" Michael McGuire Local Building Inspector ':�7'iSlk'+"d,'a �'VuC'h:fWi`:wadlhrn:7.N'Wr'i`u',:viA?.'.W:S:_tii:r^::::C'v:i:YYi•�.e............�Cs..... ...a.«...... ..�aav,....n_...,e .. / � ' r .W.."':,..lt.:....r...h•....�.,..n..:,...........ap r. .... ..........ivn w... a....................w_..ww...u..... ...... ......w ........_......._ d► � � , !g tz jplq jy ♦ 1 wt V cot got ' ►9t M'O'tlse n w3mod z. so 1 .•w v� tt LQ t➢Yt nv OtC DYt e of I �, c* z► � Ott oat tat � e rt Qh ry Oct ♦ tet dW&VO ag " " ss eac ♦ yet z wt ¢rt zst trL ar sm a0a 4, iLl O► N i Oct •# iCL 9Et rt BBJ�I».BDBd$U2dp, � �� p opt 9Yt LGI� IS dl LY 6S M �rozl r i 4S L1t 94 ob SIZ o� L to 7A $r I SLI rit cit Llt� YLl I ♦ �` ` "/m'0./ fZ ye/ V9 8L C? h► N 00 r{t LA � so''g• e � ♦ ` y`4 Lot L{L Ot 8L - oe 90 ~ LOL aj 001 K Ctz ,� ♦ goio{ o� 09 + Lot so � • 40t ! YOz 1 Bit QL{ � 4 � 9 AL � YDt c°°p e0 OB s°b`t►e{ a cot ° of a is 29 Awa eat fil QeL ,.A+ ' COy a oL ! rL tx + � z'it e► et � a� w a tot u m w t LL ry co ws i zat ri °L i4 L>at ret * LO 461 cot vw XvlW C9 ot{ Y Commonwealth of Massachusetts RECEIV 7 City/Town of No. Andover n r 1) 1 Form 9A Application for Local,Upgrade Approval TO',VN OF NORTH Ai ,. DEP has provided this form for use by local Boards of He8lth-T0thr&A6 s may be used, but the information must be substantially the same as that provided here. efore usmig this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer,use Richard Adams only the tab key Name to move your 114 Stonecleave Rd cursor-do not Street Address use the return key. No.Andover MA 01845 Cityrrown State Zip Code vl 2. Owner Name and Address(if different from above): Same as Above �O Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility(check all that apply): Z Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Single Family Dwelling 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ® Conventional E] Other(describe below): 6. Type of soil absorption system(trenches,chambers, leach field, pits,etc): Leach Field Form 9A Application for Local Upgrade Approval •rev.7106 Application for Local Upgrade Approvals Page 1 of 4 e Commonwealth of Massachusetts City/Town of No. Andover Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: 440 gpd Design flow of proposed upgraded system 440 gpd Design flow of facility: 440 gpd B. Proposed Upgrade of System 1. Proposed upgrade is check one): Po P9 ❑ Voluntary ❑ Required by order, letter, etc. (attach copy) ® Required following inspection pursuant to 310 CMR 15.301: Unknown date of inspection 2. Describe the proposed upgrade to the system: Replace leach field and system components 3. Local Upgrade Approval is requested for(check all that apply): ❑ Reduction in setback(s)—describe reductions: ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction Reduction in separation between the SAS and high groundwater: Separation reduction 1 ft. <2 Percolation rate min./iinch Depth to groundwater Form 9A Application for Local Upgrade Approval •rev.7/06 Application for Local Upgrade Approval*Page 2 of 4 Commonwealth of Massachusetts City/Town of No. Andover Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well(explain): ❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater ❑ Use of only.one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Randy Burley Mill River Cons. 10/7109 Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: No other location on the lot 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: An alternative system is not cost prohibitive. Form 9A Application for Local Upgrade Approval •rev.7/06 Application for Local Upgrade Approval*Page 3 of 4 L s Commonwealth of Massachusetts City/Town of No. Andover Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: No other adjacent is available 4. Connection to a public sewer is not feasible: Public sewer is not available in the area. 5. The Application for Local Upgrade Approval must be accompanied by all of the following(check the appropriate boxes): ® Application for Disposal System Construction Permit Complete plans and specifications ® Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide roof that affected abutters have been notified pursuant to 310 CMR 15.405(2). p P ❑ Other(List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." Facility er's Signatur Date Benjamin C. Osgo Jr. P.E. (Agent for Owner) Print Name 10/19/09 Date P.O. Box 932 No. Andover, MA Preparers address City/Town 01950 (978)686-1768 State/ZIP Code Telephone Form 9A Application for Local Upgrade Approval •rev.7/06 Application for Local Upgrade Approval*Page 4 of 4 L TOWN OF NORTH ANDOVER noRrk Ot s�•o x•'1'1. Office of COMMUNITY DEVELOPMENT AND SERVICES o�•`.r °oA HEALTH DEPARTMENT 1600 OSGOOD STREET;BUILDING 20; SUITE 2-36 ' NORTH ANDOVER,MASSACHUSETTS 01845 �'SS;Cku 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdepi@townofnorthandover.com WEBSITE:http://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM RECEIVED Date of Submission: D�'rp �D , 2�0 R 0 C T 2 0 2009 Site Location: 114 . �&Ofdmve_ d. TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Engineer: _3Mi6_01A 0- 05000d, New Plans? Yes 1/$225/Plan Check# (includes 15`submission and one re- review only) Revised Plans?Yes $75/Plan Check# / �� Site Evaluation Forms Included? Yes_IZ No Local Upgrade Form Included? Yes v,--' No Telephone#: - p Fax#: E-mail: bPnk h1')n osg oodAQ orn[_ sf net' Homeowner Name: jUlQtZI S OFFICE USE ONLY When the submis ' n is complete(including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ ('�/ Copy File;Forward to Consultant ➢ y Enter on Log Sheet and Database R 9=1VE� m � Commonwealth of Massachusetts w Cityrrown of 0 C T 2 © 2009 Form-1 I - Soil Suitability Assessment for On-Site Sewage Dis , obsah�NORTH AND HEALTH DEPARTMENT MassDEP has provided this form for use by on-site professionals and local Boards of Health.Other forms may tse used, but the information must-be substantially the"same as provided here. Before using this form, check with your local Board of Health to - determine the form they use. A. Facility Information �i w H4*ZD APA^,-,S Owner Name t!Y ,.,EcLE-,4ue- 112Q Street Addmss MaplLot# ,. �olL l7+( �I►,+�Ou t/1 i1�1 f>L..,. . p�.g�il-S City r. Slate ZIp Code t7 Z B. Site Information , 1. (Check one} ❑ New Construction ❑ UpgradeRepair 2. •Published Soil Survey Available? O.Yes [] Ho If yes: ��� �`��� �1 1 C ` rYear Published, Publication Scale Soil Map Unit �d��RL��y��G+crC Of�����'4l t5 (o'rr�tAGFA� •Soff Name t Son Limitations 3. Surf dal Geological Report Available? [] Yes P1 No if yes: Year Published Publicalion Scale h1ap Unit LO Geologic Materia! m Landform M 4. Flood.Rate Insurance,Map Above the 500 year flood boundary? QS Yes ❑ No Within the 100-year fthod boundary? ❑ Yes JK No .Within the 500-year:flobd(Boundary? ❑'Yes 9L No Within a velocity zone? ❑ Yes Moo N 5. Wetland Area: National Wetland Inventory Map, .. Map Unn Nance m Wetlands Conservancy Program Map rdaP Unit Name CD N t5lorml1.doc+rev.10107 Form 11—Soil Sulrabllity Assessment for Onsite Sewage Disposal •Page 1 of s m m Commonwealth of Massachusetts w fi CityrFown of Fora 11 - Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information (Continued) l 6. Current Wafer Resource Conditione•(USG5): '' Range: Above Normal ❑ Normal ❑ Below Normal MokhrYear 7, Other references reviewed: C.-On-Site Review (minimum of two' holes required at every proposed primary and reserved disposal area) yd <1 . Deep Observation Hole Number: - Dais time weather `r 1. Location Ground Elevation at Surface of Hole: Location(identify on plan): �"� L� r " - 2. Land Use 3I� YT.4� mow.. L si L woodland,agricullwal field,vacant lot,etc.) Surface Stones Slope(%] ,. _ �'Z4�� ate-"amu✓r>r�+� �'L,4r,�1 •, 5E� �c..4�v ,. - -Vegetation Landlorm Position on Landscape(attach sheet}>IS 3. Distances froth: Open Water Body TYfeet � Drainage Way feet Possible Wet Area Z " feet feet m Property Line _ Drinking Water Well feet �t Other �rtC'f"' ��`s 4. Parent Material: . � Unsuitable Materials Present: ❑ Yes No If Yes: ❑ Disturbed Soil ❑ Fill Malerial ❑ impervious Leyer(s) ❑ Weathe'redlFracturied Rods Bedrock S. Groundwater Observed: ❑ Yes NO /l if yes: Depth Weeping from Pit Depth Standing Water in Hole q�. Estimated Depth to High Groundwater: po ;riches elevation, N 01 W CD N i N t6formt1.doc•rev.70,+07 Form 11 —Soil Sullabfllty Assessment for on-Site Sawage Disposal -Page 2 of B m m Commonwealth of Massachusetts Cityf town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number; r Redoximorphic Features Coarse Fragments Depth(In.) !loll Norizoni Soil Matrix:Color- (mottles) Soil Texture %by Volume Solt Solt Layer Moist Munsell) (USDA) Consistence Other Depth Color Percent Gravel Cobbles 8. structure (Moist) yStonesVa- 4/4 -36rr 7�� - S Additional Notes: co m M rti LO N - co 0 N 00 t6form1l.dec rev. 19107 Form ii-Solt SuilabllityAssessment for On-Site Sewage Dlspusar •page 3 ore m m • a v m Commonwealth of Massachusetts CitylTown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) /ef7 na 1v-'a10 Deep Observation Hole Humber: Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): .. ;. 2. 't.andUse (e.g.,woodland,agricultural field,vacant tot,e1c.1, Surface Stones Slope(%) q Vegetation Landform Position on Land cape(attach sheet) � z 3. . Distances from: Open Water Body 7 e?f Drainage Way � � Possible Wet Area feet P ~ Property Line � feel feet Water Well �� Other ' Xet 7.5 4. Parent Material: � � � Unsuitable Materials Present: ElYes Qa No if Yes: ❑ Disturbed Soil ❑ Fill Materiel a impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: Yes [� No,„ if yes: Depth V&eping from Pil Depth Standing Nater in IW& Lo Estimated Depth to High.Groundwater: inches elavalion CD m m m N m N' N pi m m N 00 15forml1.do6 rev,10107 Form 1 I—Soil SullabitityAssessmant for On-Site Sewage Dlsposai •Page 4 of a o� 9 CD Commonwealth of Massachusetts w - ChyfTown of Form I I - SoU Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: Redoximorphlc Features Coarse Fragments Ball Horizon Sell Matrix:Color- [Rwtt168) Depth(in.} Soil Texture %by VolumeSolt So11 Layer Moist(Munsell) UBfyA} Structure consistence Other ( Depth Color Portent ravel obbles 8 (Moist) Stones - Qtf FZ Ufa- s4 All 114 a Add(tional Motes: 7r m m co Ln `y N T m CD CV OD t51orm1 i doc•rev.70l07 Form f 1—Sol!Suilabliity Assessment for OnSlle Sewage Disposal •Page 5 of a N rn T 9 m I\_ Commonwealth of Massachusetts w Cityrrown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Fl Depth observed standing water In observation hole A. B. inches inches t3. ❑ Depthweeping from side of observation hole A•Inches Inches Depth to soil redoximorphic features (mottles) A O B �' Inches Inches • � Groundwater adjustment(USGS methodology) A. 13. A Inches triches 2. `IIndex well Number Reading Date Index Well Level Z d .. ~ Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of.naturally,occurring pervious material exist in all areas observed throughout the area proposed for the soil Lo absorption system? AYes 0 NO .. m b. If yes, at what depth eras it observed? Upper boundary: Inches Lower boundary: I inches ._ Df>t-1h� 2- 00 an m CD CJ OD ISforml l.doc•rev, 10!07 Form 11—Soil Sultabildy Assessment for do-Sile Sewage Disposal •Page a of 8 L a� CD co Commonwealth of Massachusetts w City/Town of Form 11 - Soil SuitabilityAssessment for On-Site� Sewage Disposal F. Certification certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further oertify that the results of my soil evaluation,as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. Signature rSoll Evaluator _ Date Typed or Printed Name o6SoihEvaluator l License fk Dale of Solf Evaluatof Exam Name of Bo!o of Health Vones Board of Health Q • Note.: In aomrdance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with PercolaWn Test Form 12. LO m v m m u� co v . N T N t C'jt5formf t.doc rev.1Urp7 Form 11—Soil Sultabllity Assessment lox On Site Sewage Disposal •Page 7 of 8 m m co Commonwealth of Massachusetts W City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: Q . z . . ,t, o`0 cn N CV CTI m CD cv co l6►orml l.doc•rev. 1 Q007 Form If—5ail phabiHfy Assessmenl for on,si a wage Dispose! •Page 8 of 8 m m 09128/2009 22:59 17813340115 TANGARDR PAGE 06 t Commonwealth of Massachusetts ` r CitylTown of Percolation Test Form 12 Percolabon test results must be-submitted with the Soil Suitability Assessment for On-site Sewage Disposal,DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here_ Before using this form,check with the local Board of Health to determine the form they use, t'"p°"� when Mingout A Site Information. forms on the computer,use only the tab keyOwner Name to move your usecurrtat th- et Street Address or Lot#m use Uhe return - key- CdY/Town _ � zip Cove Contact Person(rf different from owner) Telephone Number ' B. Test Results /'0/7f r Q to Mme Date Time Observation Hole# —� Depth of Perri Start Pre-Soak End Pre-Soak Time at 12° Time at 9" Time at 6" Time(9"-8' — Rate(Min./Inch) T Test Passed: Test passed:: F-1est Failed: g Test Failed: ❑ 0 rme By: Z X ( ) m Wrtnessed By: Tz�_rm _� o 0 � tD m Comments: -zi o - i t5f0rr12.tl0o•06/03 Pere teat-Page 1 of 7 TOWN OF NORTH ANDOVER °t N°RTH Office of COMMUNITY DEVELOPMENT AND SERVICES or•`�� ° HEALTH DEPARTMENT ' 400 OSGOOD STREET '� . •`` NORTH ANDOVER,MASSACHUSETTS 01845 ;'SSC S Susan Y.Sawyer,REHS,RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX healthdeptntownofnorthandover.com www.townofnorthandover.com APPLICATION FOR SOIL TESTS DATE: c. o? U MAP&PARCEL: LOCATION OF SOIL TESTS: `1 le Uh DG l aa k6- AeUr,L. OWNER: Contact#: APPLICANT: D.c.1', AISCA,VvX r Contact#: ADDRESS: ENGINEERmy- o 1. rt Contact#: J CERTIFIED SOIL EVALUATOR Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: In the Lake'Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) Ih ➢ &5"x 11"Plot plan do Location of Testing(please indicate test nit sites on the plan) ➢ Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). Y Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line ff� N.A. Conservation Commission AAgPWVa.l Date: 1 Signature of Conservation Agen Date back to Health Department: (stamp in): '-'-P�5 r�o I— an wrvar�ls cJf ivV ( l r � O .O a� cs ASSESSORS MAP 104B GEORC BO PARCEL 138 ASSESSOR AREA=63,691.5 S.F. 1°S\ a4, 264.8' y g- .ti o cJs�o sb� 4( ASSESSORS MAP 104B PARCEL 137 * AREA=43,570.7 S.F. s 2 STY W.F.D. . 31.3' 0 96 I- �Q F N/F AULUS & SYLVIA SASSO DK 9485 PAGE 124 ZS MAP 104B PARCEL 136 * 150.00' (TOTAL) DO NOT CONFORM x_109,69' 46 WS IN AREA AND FRONTAGE R-310.00 J ON GROUND SURVEY NrINFFRINf; nN R/11 /nF WPM . � 11 j,.ei �o� ,•��Ge�� yI ��A, f �'xG„ �e sraa- f 6:0 S c2- i121 -13 ,�- 36 Qw I f �v rR t� iT 7 3a Ld i �s s"f's-� j 3-0 0� s/r �✓ O: C A, /oyR2� SL -rig 6 y3Dlo I YOJ i `s v/K rl I P 3 1/0 G: �s„�� �3�• ��y�r�� /YAG /.�,p� G.-�. P � ��z YO of f .1111 4i Caf co� T log , / S P Y3 i I , � I , i i I I I i i i Page 1 of 1 DelleChiaie, Pamela From: Marianne Peters [mpeters@millriverconsulting.com] Sent: Thursday, September 21, 2006 9:37 AM To: Dan Ottenheimer; 'Lisa Kozel LeVasseur'; Marianne; Grant, Michele; DelleChiaie, Pamela; Sawyer, Susan Subject: Stonecleave Rd &Wintergreen Drive scheduled Sept. 29 The following 2 soil evaluations have been scheduled for Sept. 29th 114 Stonecleave Rd @ 9:00 a.m Then over to Wintergreen Drive, immediately after Stonecleave 0 1 1 Marianne Peters Mill River Consulting 2 Blackburn Center Gloucester, MA 01930 978-282-0014 ph 978-282-0012 fx www.millriverconsulting.com 9/21/2006 i b -ID ,9 --2 MLS A 2 i 0 ,7 L ve Id p } r From Pa Ws desk � V � r sell� 3 D i � v