Loading...
HomeMy WebLinkAboutMiscellaneous - 115 CANDLESTICK ROAD 4/30/2018 115 CANDLESTICK ROAD >)ad 210/106.A-0106-0000.0 f 41r I i Addreso -•4 �� �7�� 10/� Title of He Page of Date File Open: Date fele closed: Doc Document/Action Title Date of Refer to other PurP.ose of Document/Action and notes action Document/ document/ Num. Action Department - ----------- ------------- Board of Appeals — Board of Health-- Planning Board _ Conservation Commission — Building Departnnent FORM 4 - SYSTEM PUMPL'N'G RL' CORD Commonwealth of Massachusetts AA/N lye' , Massachusetts System Pumpi Record system Owner ystem ocatlon or tit4�- 9 5 //0 W�0, N pip(jvvA- T`,pe: Emergency ❑ Routine Cesspool: No Yes ❑ Septic `rank' No ❑ Ye_ Date of Pumping: 3l� ( Quantir`, Pumped: ��� _ g�l!ons �a�,�cz�C`3 =: S�, stem Pumped by (Company): 1 Permit Contents transferred to: Contents disposed at: (,t A:cc,wC L ISI D2te s � Pumper Signarure ` i Condition of systerT other comments: DFP APPROVED POR.'s1 • I-'10"S i Commonwealth of Massachusetts 1 N D�<lVORPH ANDOVEil/ 8DAR[)-0 . _ � � ,.. Massachusetts EAUG5 1996 f.. System Pumping Record System Owner System Location COApe4c- &J Date of Pumping: 916 Quantity Pumped: (X-1�allons Cesspool: No Yes ❑ Septic Tank: No ❑ Yes System Pumped by: V4&j L 4iO4m� License# Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector: C o,NO RTM,M 6539 , F _ 9 Town of North Andover ��.'•>:,:o:: HEALTH DEPARTMENT ,SSACHU`�f'� CHECK#: DATE: ,�. 13 LOCATION: H/O NAME: CONTRACTOR NAME: n 'km) 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) $ ❑ Title 5 Inspector $ Title 5 Report $� ❑ Other:(Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Massachusetts ' Title 5 official Inspection Form Subsurface Sewage Disposal-System Form-Not for Voluntary Assessments .e r ,3 xro Addr�ss o� r Owner parsme information is Jnv' Aa required for ' every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection form7Ej ot be any way. Please see completeness checklist at the end of the form. E, Important: . A. General Information When filling out LHEALTHDEPART� 1 2013 forms on the computer„use 1. Inspector: /” RTH ANDOVER only the tab key ENT to move your _ a r �� J• R 6,0 X cursor-do not Name of Inspector use the return N �`J— C► key. � Company Name 1 -�' -H'f d teb Company lAddress n DCityrro Stated/ I / Zip Code 7� Teleph ne 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. 1 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 Further Evaluation by the Local Approving Authority ZI/ Z/ Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 or 17 t5ins-03113 i 7 Commonwealth of Massachusetts Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • Pro erty Addr s e � V1 v/ r U •_ Owner s � N e ) Information is i' 0 j r On �j ✓'/ 3 `� 3 required for every page. C y/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: W1 0 Y15 e C 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"no/nes ined" (Y, N, ND)for t following statyements. If"not determined, " please explain. The septic tank is metal and over 20ld*or the se • tank(whether metal or not) is structurally unsound, exhibits substaltration or a filtration or tank failure is imminent. System will pass inspection if the existing talaced wit a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspeis tructurally sound, not leaking and if a Certificate of Compliance indicating that the tank n 20 years old is available. ❑ Y ❑ N ❑ ND below): Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 2 of 17 t5ins•03/13 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2.AddrG� e 0 Owner rs m nformation is I � 0'V E'�.. /I/1—� required for I State Zip Code Date of Inspection every page. ity/Town 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 plain below): El distribution box is leveled or replaced F-1Y El below): ❑ The System required pumping more th 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with a roval of the Board of Health): ❑ broken pipe(s)are repla d ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is remov d, ❑ 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 proteZfeetof h, safety or th environment. 1. System will pass unlesealth de rmines in accordance with 310 CMR 15.303(1)(b)that the systetion' g in a manner which will protect public health, safety and the environme ❑ Cesspool or privy ist of a surface water ❑ Cesspool or privy ist of a bordering vegetated wetland or a salt march Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 3 of 17 t5ins-03113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .rty A r ress Owner Information isw er's i /� O )�t�t? required for w IV / T ✓ b J every page. tityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) deterimes that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has aseptic tank and soil absorption system (SAS)andt SAS is within 100 feet of a surface water supply or tributary to a surface waters ply. ❑ The system has a septic tank and SAS and the SAS is within a one 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is ' in 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the S 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 anal y s, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presen of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other ailure 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 ❑ V 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 ❑ E� Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ )J��] Liquid depth in cesspool is less than 6"below invertor available volume is less than �5 day flow t5ins-03/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments C' e C AAd tyOwner 2 v. :t 4w—n—e 's me Information is nV-e rrequired forevery page. wn 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: ❑ rL/r Any portion of the SAS, Cesspool or privy is below high ground water elevation. ❑ EET� Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Fer 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. ❑ 10 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,fort 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.] ❑ ►[� This 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 gp,d. For large systems, you/4e dicate either"yes"or"no"to ch of the following, in addition to the questions in Section D Yes No ❑ ❑ this within 400 et of a surface drinkiing water supply ❑ ❑ tm is within 0 feet of a tributary to a surface drinking water supply ❑ ❑ tm is I ated in a nitrogen sensitive area (Interim Wellhead Protection AP r a mapped Zone II of a public water supply well If you have answered any question in Section E the system is condidered a significant threat, or answered"yes" in Sabove the large system has failed. The owner or operator of any large n E or failed under Section D shall u rade the system considered a I threat under Sectio pg system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-03113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments Pr erty Ass `/T' n Owner (`IA4 r o e5 Information is 0 ner' N me 4 / re uired for � V every page. ity/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 d ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ LJ 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? 2" ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) 2' ❑ Was the facility or dwelling inspected for signs of sewage back up? [�r ❑ Was the site inspected for signs of break out? Q� ❑ 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? This 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. L✓J ❑ 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): -S Number of bedrooms (actual): S DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): S SZ3 G'� Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 6 of 17 t5ins-03113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal Systeme Form-Not for Voluntary Assessments P71p ,111 (,rty Mg ss >r Owner U Information is n is e n required for ? ..1 every page. W/—Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes [21 No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes M No Laundry system inspected? /� ❑ Yes ❑ No Seasonal use? ❑ Yes 0 tNo Water meter readings, if available (last 2 years usage (gpd)): 6 Detail: Sump pump? ❑ Yes No Last date of occupancy: Date Commercial/industrial Flow Conditions:. Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/s .,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank pr sent? ❑ Yes ❑ No Non-sanitary waste discha ed to the Title 5 system? El Yes ❑ No Water meter readings, if available: t5ins•03113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments P o rty Ad�(e Owner, 0 l` �-1 Information is required for 0 er's � ()V State Zip Code Date of Inspection every page. li-t$yown D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: �✓ dwk0C.� Was system pumped as part of the inspection? ❑ Yes No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: 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): Title 5 Official Inspection Form Subsurface Sewage Disposal system•Page 8 of 17 tsins•03/13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Di��s""po al System Form -Not for Voluntary Assessments S (� Odle57� . XPerty Adc�e sOwnee __ 0 ( Ue Information is AOwer's � nO /required for to bevery page. own State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: ',C�0 - J�Q 14 Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer(locate on site plan): Depth below grade: Fee Material of construction: cast iron EJ 40 PVC ❑ other(explain) _ A A) Distance from private water supply well or suction line: et _/l fe Comments (on condition of joints,venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: c feet Material of construction: E2/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 q. Dimensions: Sludge depth Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 9 of 17 t5ins-03113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal S stem Form- Not for Voluntary Assessments � v < aw kroloertys 6 Owner Information is required for V State Zip Code Date of Inspection every page. D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle ' 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): S' k I r v e ry Ll U L rP L D YVl h'1.v 0 MIML Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal fiberglass ❑ polyethylene ❑ other(explain) Dimensions: Scum thickness Distance from top of sc to top of outlet tee or baffle Distance from bott of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-03113 Title 5 Official Inspection Form Subsurface Sewage oiisposat system•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments (� ✓) ro rty Ad�re s 2 Owner Information is required for g, o eve t Code Date of Inspection ti 2 T� State Zip Cdy/Town every page. D. System Information (cont,) Comments (on pumping recommendations,.inlet and outlet tee or baffle condition, structural integrity, liquid outlet invert evidence of leakage, etc.): ' i levels as related too 9 Tight or Holding Tank(tank must be p roped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Dimensions: Capacity: allons Design Flow: /Alarm allons per day Alarm present: El El No Alarm level: in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of ala/ndt switches, etc.): I *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Title 5 official Inspection Form Subsurface Sewage Disposal System Page 11 of 17 t5ins•03113 Commonwealth of Massachusetts + Title 5 Official Inspection Form ' Subsurface Sewage Dis 3osal System Form - Not for Voluntary Assessments l v1 lee, 1 C �� PoDgrty Ad r s e �o UPowner 's N e Information isD required for every page. ity/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 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.): covlde5 f �P r,. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, c dition of pumps and appurtenances, etc.): Soil Absorption System (SAS)(locate on site plan,/excation not required): If SAS not located, explain why: t5ins• Title 5 Official Inspection Form Subsurface Sewage Disposal system•Page 12 of 17 03113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments La M Nr's ess Owner e'Information is �\' eO> Y5required forYevery page. State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: leaching fields number, dimensions: ❑ 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.): w a ad y-171 '� 'e Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth -top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflo El Ye, s ❑ No Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 13 of 17 t5ins-03113 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form- NoYfor Voluntary Assessments MP o erty A�dr ss Owner U`Q ( 16 Ka U Information is wner's a � required for ' /<1 6 every page. JCityrrown 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.): i Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of h raulic failure, level of ponding, condition of vegetation, etc.): Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 14 of 17 t5ins•03113 Commonwealth of Massachusetts Title 5 Official Inspection Form t Subsurface Sewage Disposal S stem Form- Not for Voluntary Assessments w 7P1erty Asir s - Owner v� ll Information is 0 ner's a e required for ' 0 every page: ity/7own 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: 1?f and-sketch in the area below WLJ drawing attached separately i i i I eco 5T yo, �5 � r �c Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 15 of 17 t5ins-03113 Commonwealth of Massachusetts � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not.for Voluntary Assessments c lI �G�dlei�ri4 k� Pr erty 7osslqa OwnerD� r Information is 0 ner's KILme O l' .required for , V every page. ityrrown 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: A feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record a If checked, date of design plan reviewed: ae 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 USG5 database-explain: You must describe how you established the high ground water elevation: CO .10 Before filling this Inspection Report, please see Report Completeness Checklist on next page. Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 16 of 17 t5ins-03113 Commonwealth of Massachusetts Title 5 Official Inspection Form R Subsurface Sewage Dis osal System Form.-Not for Voluntary Assessments a C4 o erty�fdr ss milOwner C- U� Information is Ow er's me 0 019 5 required for ' r (� every page. itylPown State Zip Code Date of Inspection Y E. Report Completeness Checklist Q� Inspection Summary:A, B, C, D, or E checked Q✓� Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ,/System Information - Estimated depth to high groundwater LLJ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 17 of 17 t5ins•03/13 { S '1 i y. Ii �?is 4 rc !� ��,.. frn im A t �;: �.•--/"fig �'i " .....::... i ellA I . • I A h op f •' r A - Wv apiEburoFrn,:itc 1NV GtPE IntTO O PDX 1� S"1 r iNV Dl P---OUT D 1PX iQA 4 1NV FND OF-PIKE ,( a i t L r` FK2AtSSC .Ef It tA'S �aS9ixG1!A?'ES ove C N 6 : C t: j} ,,r t • SUMMW Reoord Conti OWN SW of 191MO1310.1264"by Moto n Mck&y P"s i I Town of North Andover Tax Map # 210-106.A-0106-0000.0 � ParC91 Id 17251 115 CANDLESTICK ROAD MOE1 HOWARD � 115 CANDLESTICK ROAD N.ANDOVER, MA I 01845 Glass i0i Single Family Property Type 1 Residential I Zanin02 1 Rea?dentleal Zen!»g3 1 Residential C Slze Total 1.46 Acres FY 2013 UB alllna Index Neme/Addrsss Type Loan Number Activellnact, From Until MOE,HOWARD Payor I 115 CANDLESTICK ROAD N.ANDOVER,MA I 01845 IB Account Malnt. Account No Cycle 0-ccupant No-me ActiveAnactive Bldg Id.17623.0-115 CANDLESTICK ROAD Last Ogling Data 411012013 3170294 03 Cycle 03 Active US 39ro,'lces Mallet. Account No.3170294 Service Code Rata Charge MuldplledUsers MISCFEE ADMIN FEE 0,636/8 7.52 11 WTI?DATER 01 AIL METER SIZE 114.47 11 UB Meter Maintenano Account No.3170294 Berle!No Status l_ocatlon Brand Type Size YTD Gana 36207050 a Active ERT HH b Badger w Water 0.63 0.83 357 Data Reading Code Consumption Posted Date Variance 311322013• 356 a Actual 27 422,'2013 0% 1211112012 329 a Actual 26 118/2013 4% 9/1312012 303 aActual 26 10116/2012 1% I 8/12/2012 277 a Actual 26 7116rz012 4% iI 3/1412012 252 a Actual 26 4214/2012 11% I 12/12/2011 226 a Actual 23 1/17/2012 -2% 811222011 203 a Actual 25 10/1312011 2% 6/7/2011 178 a Actual 23 7220/2011 -2% 31ffi,12011 1w sActtta{ 23 4113/2011 5196 j 12/9/2010 132 a Actual 47 1/12/2011 3% 1 911012010 85 a Actual 48 10/16RO10 75% 61712010 37 a Actual 26 711612010 18% l 31312010 11 a Actual It 411412010 -100% i 1/23/2010 0 n New Meter 0 4/1412010 -100% 1/23/2010 4539 r Replacement 12 4114/2010 13% 1228/2009 4527 aAlival 21 1/12/1010 8% 9/812009 4-506 m Manual estimate 20 10115/2009 0% ON LIST FOR UPGRADE, 6/8/2009 4485 m Manuel estimate 25 71 2009 15% 'ASG I 3!1&12009 4461 m Manual estimate 25 4/29/2009 -1% 1 MSG 171922008 4436 a Actual 24 irOr2009 902008 4412 a Actual 27 10/10/2008 9% 6/612008 4386 a Actual 24 7/16/2008 4% 3!712008 4381 a Actual 22 4/1112008 8% 121111'2007 4339 a Actual 23 1/Mc00€ =13% 916.'2007 d316 a Actual 22 10112rz007 4% 8/18=07 4294 a Actual 26 7/2022007 8% Allan Marques From: McAuley, Maureen[MMcAuley c@townofnorthandover.comj Sent: Tuesday,June 18,2013 14:29 AM To: allan@acdesigninc.com Subject: FW:Water Usage for 116 Candlestick Road Attachments: 201306118i Ol i.pdf Attached please find the water usage record for 115 Candlestick Road North Andover. The consumption is measured in cubic yards. Maureen McAuley North Andover Water & Sewer Dept. 384 Osgood Street North Andover, MA 01845 Phone 978.685.0950 Fax 978.688.9573 email ffncauleygtownofnorthandover.com Web www.TownofNorthAndover.com 5 Please note the Massachusetts Secretary of State's office has determined that most email$ to and from municipal offices and officials are public records. For more information phase refer to: http://www.sec.state.ma.us/ire/pr-eidx.h'Lr,,. Please consider the environment before printing this email. 1 s r t LOT 16 3f X30 5 " j y t iSD© 434 L ly a PTC* A K ` 0� L? �r? OW G. i, t r 4 i r l { i 4 1 r 2 o , 1 E L.F.-VA-r i atA V. IOT 1 INV L.1Eg IKTo.� etQx l )NPim 7uT— { l o, AN ofcv i 1; b c-,&t-M 1'" - G�yi G�.AT�; o jf 4- !fes t C2A,K VC. C.C�Et_.t N A.S A S 5vG t AT ES r �►.SC�iNEL�S L�. 1-1(TE�GT` ) �� �r /. :� �' 1', I \� 1, I '1 i i / SOIL PROFILE & PERCOLATION TEST DATA co Town/City. No.&Street �Cc,,-, ��/'�C� Lot No. Loc./Subdiv. ✓ ,' ,-,- i ,., W4fe/Plan Owner Investigator �/�0 V", r Observer SOIL PROFILES-DATE 0 1' E ev. 36 Elev. 3' Elev. 4'Elev. 0 77 0 0 0 b' 2 2 2 Z 26 � 3 r 3 3 4 - 4 4 - - 4 5 5 5 5 1 . 6 . 6 6 7 7 7 8 8 - 8 -- 8 .9 9 9 _ 9 10 .10 10 10 Benchmark Location - Elevation Datum Percolation Tests-Date &1.27177 Pit Number 1 2 3 4 5 Start Saturation Soak-Mins. Start Test-Time Drop of 3"-Time 2 ,3 Drop of 6"-Time Mins.lst 3"Dro Mins. 2nd 3"Dro , Notes & Sketches on Back Frank C. Gelinas & Associates, -North And. I' ' r j j z 200 . 1 tu I , 1 p1ric.TANK r ti • a 1 f c , 1} • �w+wyw.-r+�•-,'-. .^••�"'Y ry 1�+1, _ .. �4 f. y��_uw.Me•°'�"+/'t•^`�"uw'-4.+Mk-.rVw...+-o��r rt.w.+_,w.•iMr+r++:.^M•.-«y +aef4rsww.n•Aw.M.r.y�.aylieF�_►..�- _ - n �, r ' IMV Plo Q TIDFWSE LIOIT r�.�y P► ©uT�FT' atj� ��& B7 1 tai V GIPS l A1T�j D 13ax ,�t"3 , .w*�_�. �J V U R.P' F. ID I ts G�DE OUT d PS1ox INV_--Nd Wit~ it 730 COV, MA • 20 n,o. � Imp f I I �;' �-� �;��� r► -1 i f �� r F ,o { } j Lc r fl � Q r � R / (SAL c� eATia TA S K f ry __ ---_-- f � . i 1►. f ` 11 0q / 1 R V X l , D � 1+ S T/ 7 4 0,A D 1 r ` - �. E V A i 0 46 tm i j INV-..PILE. 1bCL4a mwi&, a {k�tf fhl r4t,�TdFr�V_ !a 19 7- INV lit -�l .EL610%1 r uMv VI n.F�..0l.l3:-D.einx L06 ,41 No. A M 4 . ' ' i SGML •t'�_20 r,>A-r a t. w F 2A,t�1 S�. C, st .a,N rx7v�,� �`r. r�,l-c�.ls.r�t cnc►�E-z2. or-Ell SuiLr-Ac.E DI SP' OAL. SYS7E.M 4�N o� LOT ! CAWDLE STICK COAD tAQRTH A NDovE'p t MA . P 1Z E PA4ED F 07- 22 IUCQR�� r�tve HA\/F-PHcLL 0 t 630 r pp EtVC,lt�+E ERS AtrLD AszC Nl'[ E C't S F; �dit'TH ANDOvEROGFlL� Reoz-1L ,�`. � r; {�OFt'T4-1 A.1V0OvE.R.,MA . O1$g5 9 'Or ,: DESIGN DATA ALCULAMOKS OI OBSE -TIONS $Y. G QA WITt1E54 !LCuSt+(w& _t 'I PERCOLATION -TEs-r Ko. +. Z 3 4 5 C>A-T6- 8(2-771-77 i4o t 'To o-'E�EVAT`ioN �{� `�: C� �_ PE C . awrroM- ELevAz toN 1 ©a,C) REe?daep SA?URAT10N -M1K- t s -- J 12" ��-9 DROP- MiNs . II { — i 9„ DR.op -M1Ns. 17 - pp_szc .Rt',-TE -MIN. _ CotitFtRMtPl.C� I SOIL. PROFILE-DEEM PtT No. I 2- 3 4 s - DATE TOP-ELE VATION -T©PSOII J Q- _(= 8 0 -10 1 SUBSOIL 1 1-f0 PARENT SOIL - 1 ;to G 1, -To { r WATER-T"AaLE ry ' VEL ' I L ,+ B oN E,/ i 'fi(Ir L 'Tt LL MC WATER, No WAT E.2 REP05A,L {-%E /FVSA4-- CO.) a WATER TAF3L, E LEvATION 1301"TOM E LEVAT10N . CD' I cz,40 BUlL0lNC,-TYPE ...� X 1 �Q GAL. JUNIT - S`Q GPD Flow GPD Flow X is = `. _GPD USE I a C GALS EPT%r- -TANK LEACH I NC-� ARE A IS-0 G-Po Flow x t .4- S P: GAL.= 13 F-D u S E I U (op S F 0-0/ ' TYPE 4 My PC. (TYP) SIDEYVALL AREA SF x _ G-ALS.� SF - GPD BOTTOM AREA -.--_SF- x GALS.1 SF e GPD TOTAL PIT LEACHIPIG CApAC.%TY _ _ _ _ _ _ _ _ GPD /PIT C- P,D FLOW ;_ -GSD/'PIT= P11S READ. USE—PITS 7REINCHES SIDEWALL AREA �SF�LFx_ GAIs 'SF = Ga�.(t_IN.I`T. BOTTOM AREA SF/LF x GALS/SF - GAL. LIN.FT. -TOTAL-MENC1-1 LEACHING CAPACITY _ _ _ _ _ GAL LIN .�:T. GPD FLAW �AL�LI>�l.fit".= �L.F.-TRENCHES RECD. USI` 1..F NOT ES �__ i �LL�VL1TtUI`•f SC-K�bVL�- Pl..umbtty Ptpe Qpws'. S NOTA: &LL ELSVATtONb 2SFeit- To lboTT'DM d `Jt-_P-r►c_ Tah►t .""&Tr ' ,4- OF PtVE (INVESZ') C_ 5 8 p r t G Tst v. Our LST D Q.yrrt. C��,t COuTLE'T G F•,�s. G R.AQE CCZ> N ousE _ �3r_ a W p ft. GRa r,F_ cco • � � _ N 1 t6 � S� 47/10 O' •Q PE2 I`T t 4 pEQ Fr — t C ® E_ 4 .F ' PEQOe&TED 131TVMINOV6 F ' 3 � FICiEQ. PIPE �Gt�PPED �HDL� pisr2 . Qox NDN- oER;70M"A F_ r?E2;ro2 rED LE&C-14 I M G 13 16. LIMIT L! Ne. w PL & N OF L &Ac wtKG hep N0 sC-kL.s E L EV LKl-1 0 k! S C !-I E D U L. E _ � Ecu MAR S#'\KE Pmr E'>oXRVD ST 104 3-7 � IJSG-S PLUMBERS PIPE C %�YJEt.I_ - 10 9.4 Q' K�OTE . ALt, €Llr=VArtott5 REt`-ER I1�lVERT OF PO''E . I SEPTIC~ ANI< INLET �U9.lQt�..� S cpTtC TANK CUTLET - D 1 sc: B O Y TN L=.7 10 8.41 ' E D t S_'_r_BOY, G U- L'F-`fi' S sAso tit. t\*kTsR`TARS.E - 1 a3.Od ---Access MANNO LES -m wt'THtt.r 4 "Ot` Ftmtsti cTRADE _ l - LAVER UNTREATED 4-"c� L:T€ES SU1LDlntG P,�Pi...R . , -.02 Nitta.—a•. 4'T�tWEm_ E2" lvt N. COVER ul ST Qa *: . 2 �" 2 S-TO N E 1" ~ I o o �Cj'I q {`f2 S TO N E GAL. Copus le F ALL STW-4E saALL II __ .4 2J; 53 c -Typic-4,L LE4ct4tmg e � tai-L E- A# 1�0C� :Sct-tEMATiG oNLi - AOR. St-re: LA,-iou-r Set- QCT, T l r - a t=lNtyN GQ4pE �GQ�S3BD d2>r1 ---•� d• PfiLF02d"(Ed r5%T. PIPE COttER LOAM i"2" t�AtN. � -' •�••i y •.''•. mow. ��•• �.� .ate• 5��...r�. . ..•:�;'��• • •'•t�•~�,�i+•ii � •i••'��1 •f�i�iaM►i s �. rs �� _ Iz STO H E '.�•:.�_•• •+,_:.».�.•:• I::--Wo-:•i= 1, ..•� •���.• ZA. J'• t "'; •w• ;�4.�► • /•�— t Vi' -STONE y N 1QJ GO &sE 5A t4D ' Z: r — s / Aq .._ i 2 = ZO`- © �' Crzoss SE-CTIQ14 of LC- c v I H G I3E-D NO SL&L.E Ln NOTE: &I-L STONE• rO t5E WA, SKED • I Board of Health , North AndbverjMMs. SEPTIC SISTEK INSTALLATION CHECK LIST LOT DATE DI PROVED ERVV ATI OK' �L f�iasons r c- 1. Distance Tot a. Wetlands b. Drains o. Well --<,,20 Water Line Location 3• No PVC Pipe 4. Septic Tank a. Tees - Length & To Clean Oat Gowers b. Cement Pipe to Tank On Both Sides of Tank 5. Distribution Box a. Covers do Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flow f 6. Leach Field or Trench a. Dimensions f b. Stone Depth c. Capped Ends d. Clean Double Washed Stone 7. Leach Pits a. D3.�snsions b. Stone Depth c. S ash Pads d. Xws e., Cement Pipe to Pit - Both Sides f. Clean Double Washed Stone j8. No Garbage Disposal 9. Final Grading Inspection 10. Barricading Cowered S3rstem 11. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regar&to Perc Test d. Elevations e. Water Table SUBSURFACE DISPOSAL SYSTEM CHECK LIST 4 NORTH ANDOVER BOARD OF HEALTH AP OVER DATE PROVIDED DISAPPROVED DATE TIME REASON EW, t i 3• �� ��� �IA �� G 1� . Title 5 Reg. 2. 5 Fail OK The submitted plan must show as a minumum: the lot to be served (area,dimensions,lot #,abutters) (Planning Board files) location and log of deep observation holes-distance to ties location and results of percolation tests-distance to ties design calculations & calculations showing required 1 leaching area location and dimensions of system (including reserve area) I f) existing and proposed contours (g location of any wet areas within 100' of the sewage disposal system or- disclaimer (check wetlands mapping) surface and subsurface drains within 100' of sewage ti disposal system or disclaimer ation of any drainage easements within 100' of sewage disposal system or disclaimer (planning board files) ' --grown sources of water supply within 200' of sewage disposal system or disclaimer ocation of any proposed well to serve the lot (100' ' from leaching facility) i ` �`16cation of water lines on property (10' from leaching facilities) - + (m) location of benchmark a Q - driveways yo- garbage disposers o- PVC is to be used in construction a profile of the system (elevations of basement , plumbers pipe septic tank, distribution box inlets and outlets , distribution field piping and any other elevations) j -,__4x_)----maximum ground water elevation in area of sewage disposal system ( s)__plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Septic Tanks Reg. 6 (a) Capacities - 150% of flow, water table , tees , depth of tees , access, pumping, Cleanout (c) 10' from cellar wall or inground swimming pool (d) 25' from subsurface drains I North Andover Subsurface disposal system check list - Page 2 {ail OK Dis ibution Boxes Reg.10.2a) Slope 'greater than 0.08 Reg-.10.4 (b Sump Leaching Pits Leaching pits are preferred where the installation is possible Reg.11 .2 (a) Calculations of leaching area (minimum 500 S.F. ) Reg.11 .4 (b) Spacing Reg.11 .1 (c) Surface drainage 2% Reg.11 .11 (d) Cover material Leaching elds Reg.15.1 (a) No reater than 20 minutes/inch Reg.15.1 (b) Area (minimum 900 S.F.) Reg.15.4 (�l Construction of field Reg.15.8 d) Surface drainage 2% 1 Reg. 3.7 (e) 20' from cellar wall or inground swimming pool Leaching Trenches Reg.14.1 . (a) Calculations of leaching area (min. 500 S.F. ) Reg.14. 3 (b Spacing (4 ft. min. 6 ft. with reserve between) Reg.14.4 (c Dimensions 14. 5 Reg.14.6 (d) Construction Reg.14.7 (e) Stone Reg.14.1 (f) Surface drainage 2% Do hill Slope (a) Slope y/x = (to be shown) (b) y/x X 150 = (to be shown) PUMP Reg. 9.1 (a) Approval Reg. 9.6 (b) Stand-by power 1 �