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HomeMy WebLinkAboutMiscellaneous - 115 CARLTON LANE 4/30/2018 (2) a� - f 115 CARLTON LANE 210/106.0-0085-0000.0 i I i r VKM - U - L V 1 KELL+A6h 14 ORM . INS TRUCTIONS: This form is used to verify that all-necessary approval/permits from ` Boards and Departments having jurisdiction have been obtained.This,does not relieve the applicant and or landowner from compliance with any applicable requirements. #a swam r.■r■OWN■■r■r■r■.Oswego r■ONE■■rr■.rr.r...mean.■rr■■rr■OWN.r...now was.■■ APPLICANT PHONE ASSESSORS MAP NUMBER LOT NUMBER n � SUBDIVISION OA?L+CQ ' nMS LOT NUMBER STREET C��' � L, STREET NUMBER I S o■■.•■..••.■■■■■■■■.■•r.■■rr■■r■rr.r■■.r.■.r.r■rr■rrrr.u.r■■r■■■r■■rr.■r■.r OFFICIAL USE ONLY ■rrr.■■.r..r■■■■■■■■......r■rr'.r.r■rrr■■■■■■■■■■•■■r■r..r■.r..■..■■■■•■■■■r■ . RECOMMENDATIONS OF TOWN AGENTS �... .....■.■....\ .........■.. . .........■■■rr.■rr.r■■■■r■..r.r.■■r■■rr■r DATE APPROVED CONS VATTONADNMUSTRATOR DATE REJECTED �I I CONB4EN S L�O lW I l� D d.1 rg�(�O� Q e d-e l G� tia-4.1 C e u - {a al vtD rLLe�t DATE APPROVED TOWN PLANNER $d . DATE REJECTED No COC; COMMENTS 41`� DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED CONRyIENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE CERTIFIED FOUNDAT/ON PLAN LOCATED /N SCA LE/ 4-Q DATE' S.L.G/LES R.L.S. L AWRENCE a NORTH ANDOVER I 4) � w v N f 2 N oA SCnv.eN 'D Z e-K �.k Ce -e L -T- 3 i 1 0 j J I j 5 0,0 i i Mr / CERTIFY Y TH/iT THF OFFSETS SHOWN Afr E FOR THE USE OF t7FF,SE TS "SHOWN THE SUJLD/NG INSPECTOR OAVL Y, a S UG'H CON/--O YIV TO THE !J>S E IS FOR DETE RMINA TION OFZON/NG f Y L A 14'OF CONF"OR411 T Y OR NON C(91VF Oji MITY �� r� �,� o� •� WHEN OONS T,:gUC TED ;J DANIEL L. GELINAS, P.E. , STRUCTURAL ENGINEERING SERVICES SHEET NO. 579A North End Blvd. ev DATE SALISBURY, MA 01952-1738 Phone&Fax(978)465-6436 e-mail: danlgelinas@aol.com Joe Table of Contents Ck"n v., Lo-t:�i5 Section/ Subject P Se 1.0 Table of Contents 2.0 Scope: Design carrying Beams d 6 d 3.0 Design Criteria: Massachusetts State Building Code a Ed. (MSEC Colonial Drafting design drawings tN of GESUAS 0 4.0 Analysis: 4, 3 443 rA 414- File deskWpl6CO011oover 083_Colonial_Ikaft&_Alan_Camon t, e,Im,,NESS CUSTOM`printing service i-w. ss-932. NE35.M?etem rmo r,NH.WA58 H.ur. ns.ccm ��file-desktop\danlg\excell\Beam calc ss\u aced last 01 Page No. 0 cell b211 job no. Job No. ' ara center beam option A By Dan LG Date: .oads Load Trib.Dim. ft #/ft roof live 30 6.00 180 roof dead 15 6.00 90 if re 'd... M= 0 ft-# attic live 20 0.00 0 Weq.=M8/L^ 0 #/ft attic dead 10 0.00 0 place W equiv.in f172 2nd fir five 30 0.00 0 2nd fir dead 10 0.00 0 1 sr fir live 40 12.00 480 1 st fir dead 10 12.00 120 bearing wall 10 5.00 50 other Live Load other Dead Load 0 beam sr.W 40 w dead=....v total W d+1 [W live] W d+1=.......777762 [M/live]_.... 660 300 use W =Wd+1= #Ift 960.0 960.0 960.0 span ft 12.000 12.000 12.000 M=wl^2/8 ft-# 17,2601 17,280 17,280 note options... > awn Lumber LVL's: STEEL: Comment (n1a, ... ) WA Fb m be conservative N/A Fb= 1,005 2,600 22,,A96 E= psi 1,400,000 1,800,000 28;AA�A9A Re 'd... ,Sx r 'd>M(12)/Fb in 3 206.3 79.8 Delta U480<or= in 0.30 0.30 930 Ix req'd U480>...0 [D+L] 5WL^4(L^3)[12^3 384E(Delta)] ina 1,066.4 829.4 51-5 Delta L/360<or= in 0.40 0.40 0-40 Ix req'd 1-1360>--- D+L] 5WL^4(L^3)[12^3 384E(Delta)] in- 799.8 622.1 31 Delta L240<or= in 0.60 ... limit 1" 0.60 Q-.w lime Vusually Ix req'd @ L240>...@ [D+L 5WL^4(L^3)[12^3]/[384E(Delta)] in 533.2 414.7 W live load I#1ft 660.0 660.0 66" Ix req'd U480&W live> ina ^ ^ ^ 733.2 570.2 35-4 5WL 4(L 3)[12 3l[384E(Delta)] Trials/Use . b= in 6.000 3.500 w44x30 d= in 11.250 14.000 M OF Self Wei ht 27 pcf[spfJ;(45 LVL'#/ft 12.7 15.31 1 Sx=bd^2 /6 in 126.6 114.31 1L. yN fb= psi 1,638 1,814' 1 4.WiIII S Fb= psi 1,005 2,600 2000 ~ Interaction ration..W.. 1.630 NG 0.698 OK n M allow=FbSx/12[(12/d)^1/9 for. ft-3 10,600 1 24,352 lx= LVUs only] lina 711.9 800.3 2t E= psi 11400,000 1,800,000 29 988 899 Delta[D+L]=5WL^4(12^3)/384EI in 0.449 0.311 8 =U 320 OK 463 OK Delta[Live] in 0.309 0.214 =U 466 OK 674 OK Shear/columns plus ^360 ^360 but 480 prefered = 8 Rd+l=WL/2 # 5,760 5,760 (no splits/checks) psi 150 290 1¢ R allow=Fvbd2/3 wood # 6,750 9,473 %of Fv 0.85 OK 0.61 OK Comment -2x12's NG jok i garage center beam,option A,2 ply TJ-Beamw v5.55 SerialNumber.7W1164M 2 Pcs of 1.75' x 14 1.9E MicrollanO LVL Pi 4', BEAMUSA 1111 9/42001 8:21:25 PM Page 1 of 1 Build Code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED IG :n — -12'3 IS/16" Product Diagram Is Conceptual. LOADS: Analysis for Header Member Supporting FLOOR-RES.Application. Tributary Load Width: 1' Loads(psf):40 Live at 100%duration;10 Dead;0 Partition;and: TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(ptf) Floor(1.00) 660 260 0 to 12'3 5/8" Replaces SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LIVE/DEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3.50" 3.868" 4068/1686/5754 1 14.0" Detail A3 1.25"LSL Rim 2 2x4 Plate 3.50" 3.853" 4052 11680/5732 1 14.0" Detail A3 1.25"LSL Rim -See TJ SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3. -Bearing length requirement exceeds input at support(s)1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 5599 4393 9310 Passed(47%) Lt.end Span 1 under Floor loading Moment(ft-Ib) 16789 16789 24258 Passed(69%) MID Span 1 under Floor loading Live Defl.(in) 0.231 0.300 Passed(U622) MID Span 1 under Floor loading Total Defl.(in) 0.327 0.600 Passed(U440) MID Span 1 under Floor loading -Deflection Criteria: STANDARD(LL:U480,TI-1/240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code BOCA analyzing the TJ Residential product listed above. -Note: See TJ SPECIFIERS/BUILDER'S GUIDES for multiple ply connection. PROJECT INFORMATION OPERATOR INFORMATION: No Project Information available Dan L.Gelinas Copyright®2000 by Trus Joist,a Weyerhaeuser Business. TJ-ProTM and TJ-Beam"are trademarks of Trus Joist. Microllam®is a registered trademark of Trus Joist ` � garage center beam,option A,3 ply j G �a �J-Beam^' X5.55 Sepal Number.700116403 3 PCs of 1.75" X 11.25" 1.9E Microllm@ LVL ] 3EAMUSA 1111 9/4!2001 8:32:57 PM gage 1 of 1 Build Code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED n iR -- 12'315116" —� Product Diagram Is Conceptual. LOADS: Analysis for Header Member Supporting FLOOR-RES.Application. Tributary Load Width:1' Loads(psf):40 Live at 100%duration;10 Dead;0 Partition;and: TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(pM Floor(1.00) 660 260 0 to 12'3 5/8" Replaces SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LIVE/DEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3.50" 2.587" 4068/170315771 1 11.2" Detail A3 1.25"LSL Rim 2 2x4 Plate 3.50" 2.577" 4052/1697/5749 1 11.2" Detail A3 1.25"LSL Rim -See TJ SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3. -Bearing length requirement exceeds input at support(s)1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 5615 4621 11222 Passed(41%) Lt end Span 1 under Floor loading Momengft-Ib) 16839 16839 24206 Passed(70%) MID Span 1 under Floor loading Live Defl.(in) 0.284 0.300 Passed(U507) MID Span 1 under Floor loading Total Defl.(in) 0.403 0.600 Passed(U357) MID Span 1 under Floor loading -Deflection Criteria: STANDARD(LL: U480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this -software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code BOCA analyzing the TJ Residential product listed above. -Note: See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. PROJECT INFORMATION OPERATOR INFORMATION: No Project Information available Dan L.Gelinas Copyright m 2000 by Trus Joist,a Weyerhaeuser Business. TJ-ProTM and TJ-Beam"'are trademarks of Trus Joist. MicrollarrM is a registered trademark of Trus Joist. t file:desktop\danlg\exceU\Beam calc ss\u aced last .01. Page No. cell b211 job no. Job No. 0 > I arace header,option A By.Dan LG Date: Loads Load Trib.Dim. ft. #/ft roof five 30 6.001 180 roof dead 15 6.00 90 if req'd... M= 0 ft-# attic live 20 0.00 0 Weq.=M8/L^ 0#/ft attic dead 10 0.00 0 place W equiv.in f172 2nd flr live 30 0.00 0 2nd flr dead 10 0.00 0 1 sr fir live 40 6.00 240 1 st fir dead 10 6.00 60 bearingwall 10 5.00 50 other Live Load other Dead Load 0 beam slf.W 25 w dead=....v total W d+l [W five W d+l=....... 645 1[W live]-=.... 420 225 use W =Wd+l= #/ft 645.01 645.01 1 645.0 span ft10.000 10.000 10.000 M=(wl^2/8) ft-# 8,063 8,063 8,063 note options... > Gavm 6uwAw I LVL's: I ISTEEL: Comment (n/a, ... ) WAI - 7Fb may-be conservative I N/A Fb Ipsi 4;M1 2,6001 1 32rm E_ Psi 4;480,900 1,800,000. 2&888;808 Req'd... Sx req'd>M(12)/Fb in Ora-3 37.2 4 4i Delta U480<or= in 045 0.25 0-2-5 Ix req'd @ U480>...@ [D+L] 5WL^4(L^3)12^3 384E(De4ta) in4 44" 322.5 1 29.8 Delta U360<or= in 8.33 0.33 933 Ix req'd @ L/360>...@ [D+L] 5WL^4(L^3)[12^3 384E(Delta) in 31 8 241.9 Delta U240<or= in 9:-58 ... limit T' 0.50 038 Iimit-to Ix req'd @ L240>...@ [D+L] ... ... _ Py 5WL^4(L^3)(12^3]4384E(Deita)] in 2974 161.3 40 0 W live load #/ft 429 0 420.0 428.8 Ix req'd @ U460&W live> in4 5WL^4(L^3)[12"34384E(Delta)] 279 9 210.01 434 i Trials/Use .. i b= lin 8980 3.500 w4438 d= Iin 41-259 11.250 Self Weight @ 27 pcf[s ;(45 LVL'#/ft 9 0 12.3 Sx=bd^2 /6 in3 04 73.81 421 1 fb= i #QW49. 1,3101 2;394 Fb= psi 4;885 2,600 227888' Interaction ration..%... #DIW01 #DIV/0! 0.50410K 9 495 M allow=FbSx/12[(12/d)^1/9 for. ft-3 9 16,111 7-7,889 Ix= LVL's only] in 94 415.3 2441 I E= psi 4;488888 1,800,000 28;880;888 Delta[D+L]=5WL114(12^3)/384E1 in #QW8> 0.194 =U #DMO! #DIV/0! 618 OK 68-a OK Delta[Live] Iin #BPAW 0.126 984 =U•..•. #QAw. #DIV/0! 949 OK 49;7-46 OK Shear/columns plus ...^360 ^360 but 480 prefered9 Rd+l=WL2 # 3,225 3,225 Fv'2 (no splits/checks) psi 458 2901 44,408 R allow=Fvbd2/3 wood # 9 7,613 %of Fv #BI4101 #DIV/0! Comment N/A I ICH � ' v garage header,option A,2 ply —' Number,00„ 2 Pcs of 1.75" x 9.25" 1.9E Micro11=8 LVL TJ-Beam- Y5.55 Serial BEAMUSA 1111 914/2001 8:28:28 PM Page,of 1 Build Code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED n [21 10'3 1 Product Diagram Is Conceptual. LOADS: Analysis for Header Member Supporting FLOOR-RES.Application. Tributary Load Width:1' Loads(psf):40 Live at 100%duration;10 Dead;0 Partition;and: TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(plf) Floor(1.00) 420 220 0 to 10'3 518" Replaces SUPPORTS: INPUT BEARING REACTIONS(Ibs.) WIDTH_ LENGTH LIVE/DEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3.50" 2.253" 2169/1182/3351 1 9.2" Detail A3 1.25"LSL Rim 2 2x4 Plate 3.50" 2.25" 2159/117713336 1 9.2" Detail A3 1.25"LSL Rim -See TJ SPECIFIER'S I BUILDER'S GUIDES for detaii(s):A3. -Bearing length requirement exceeds input at support(s)1.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 3243 2662 6151 Passed(43%) Lt.end Span 1 under Floor loading Live De .(in)) 8103 8103 11204 Passed(72%) MID Span I under Floor loading 0235 0.250 Passed(U511) MID Span 1 under Floor loading Live Defl.(in) Total Defl.(in) 0.363 0.500 Passed(U331) MID Span 1 under Floor loading -Deflection Criteria:STANDARD(LL:U480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"olc unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. ailable. Check Not all products are readily with your supplier or TJ technical representative for product availability. av - JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. THIS ANALYSIS FOR TRU -Allowable Stress Design methodology was used for Code BOCA analyzing the TJ Residential product listed above. -Note:See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. I� PROJECT INFORMATION OPERATOR INFORMATION: No Project Information available Dan L.Gelinas Copyright*2000 by Trus Joist,a Weyerhaeuser Business. TJ-ProTM and TJ-Beam"'are trademarks of Trus Joist. Microllam®is a registered trademark of Trus Joist. k fde:desktop\danig\exceU\Beam calc ss\u KWed last 16.01 Page No. cell b211 job no. z Job No. Beams-option B By.Dan LG Date: Loads Load rib.Dim. ft #Ift i Froof live 30 6.00 180 roof dead 15 6.00 90 if req'd... M= 0 ft-# attic live 20 0.00 0 Weq.=M8/L" attic dead 10 0.00 0 place W equiv.in f172 2nd fir live 30 0.00 0 2nd fir dead 10 0.00 0 1sr fir live 40 12.00 480 1 st fir dead 10 12.00 120 bearing wad 10 0 other Live Load other Dead Load 0 beam slf.WZ 50 w dead=....v total W d+I 1Wlive W d+I=....... 920 FW live =.... 660 260 use W =Wd+I= #/ft 920.0 920.0 920.0 span ft 24.000 24.000 24.000 M=(wl^2/8) ft-# 66,240 66,240 66,240 note options... > SawR 6w LVL's: STEEL: Comment (n/a, ... ) IN/A Fb may be cor ervative steel beam Fb psi 4;886 2,600 f 22,000 E= psi 1 4,400,900 - - 1,800,000 : 29,000,000 . Req'd... : Sx r 'd>M(12)/Fb in 79" 305.7 36.1 Delta @U480<or= in 8:60 0.60 0.60 Ix req'd @ U480>... [D+L] ... ... 5WL^4 L^3 12^3 384E(Delta) in 447_44 6,359.0 394.7 Delta L/360<or= in G-W 0.80 0.80 Ix req'd U360>...@ [D+L] ... ... ... 5WL^4(L^3)12^3]4384E(Defta)] in° 6,434.8 _ 4,769.3 296.0 Delta L240<or= in 4-28 ... limit 1" 1.20 1.20 limit to Ix req'd @ 1_240>...@ [D+L] ... (1"usually 5WL^4(L^3)[12^3]/[384E(Defta)] in 44_9" 3,179.5 197.3 I W live load #/ft 660.01 660.0 660.0 Ix req'd @ U480&W live> in° ... 5WL^4(L"3)[12^3/[384E(Delta)] 5, 3 4,561.9 283.2 j Trials/Use b= in Donal 7.000 w14x30 I d= in 44-Ml 24.000 SeIF Weight @ 27 pcf[spf];(45 LVL'#/ft 1 52.5 Sx=bd^2 /6 in3 8:81 672.0 42 fb= psi #DWAA 1,183 18,926 Fb= psi 4-,095 2,600 22,000 Interaction ration..W.. #BANAL #DIV/0! 0.455 OK 0.860 M allow=FbSx/12[(12/d)^1/9 for..ft-3 9 134,807- 77,000 Ix= LVL's only] in 9 8 8064.0 291 j E= psi 4;498889 1,800,000 29,000,000 Delta[D+L]=5WL^4(12^3)/384EI in #9PAV 0.473 0.814 = U.. #BIWB! #DIV/0! 609 OK 354 OK Delta(Live]= in #BANAL 0.339 0.584 =U..... #BA/A! #DIV/0! 848 OK 493 OK Shear/columns plus .^360 ..^360 but 480 prefered .^360 Rd+l=WL2 # 44-,G40 11,040 11,040 Fv'2 (no splits/checks) psi 450 290 14,4 R allow=Fvbd2/3 wood # 8 32,480 %of Fv MWO #DIV/0! 0.34 OK Comment WA OK,4-2x18's ok,see next sheet dell.Too much I Itor options q�2k St Bm St Bm d B5 Steel option B option B option 3 W=Wd+l= #fft 920.0 920.0 920.0 TO span=- ft 24.000 24.000 24.000 M= ft-# 66,240 66,240 66,240 note options ... > STEEL: STEEL: STEEL: Comment (n/a, ... ) n/a Fb psi 22,000 22,000 22,000 E= psi 29,000,000 29,000,000 29,000,000 R 'd ... Sx req'd>M(12)/Fb in 36.1 36.1 36.1 Delta @U480<or lin 0.60 0.60 1 0.60 Ix r 'd @ U480> ...@ [D+L ... 5WL"4(L"3) 12"3 384 in 4 394.7 394.7 394.7 Delta 1-1360<or= in 0.80 0.80 0.80 Ix req'd Q L/360>...@ [D+Ll 0.0 5WLA4(LA3)[12A3]q384E in 4 296.0 296.0 296.0 Delta @U240<or= in 1.20 1.20 1.20 limit to Ix req'd @ L/240>...@ [D+L] 0.000 0.000 1"usually 5WL^4(L^3) 12 A 3Y[384E in 4 236.8 .<V 236.8 .<1" 236.8 .<1" W live load #fft 660.0 660.0 660.0 Ix req'd @ 0480&W live> lin 5WL^4(L^3)[12"3/[384E(Delta)] 283.2 283.2 Trials/Use b= in jw1 2x26 MUM w10x39 d= in Self Weight @ 40 pcf #/ft Sx=bd^2 /6 in 33.4 35.3 42.0 fb= psi 23,799 22,518 18,926 Fb PSI 22,000 22,000 22,000 Interaction ration .. %... OK ( 1.082 NG 1.024 NG 0.860 OK M allow=FbSx/12[(12/d ft-3 61,233 64,717 77,000 Ix= ^1/9 for LVL's only j in 204.0 245.0 209.0 E= psi 29,000,000 29,000,000 29,000,000 Delta[D+L]=5WL^4(12^3 in 1.161 0.967 1.133 ! = U..... ####1 248OK 298 OK 254 Delta[Live]= in 0.833 0.693 0.81 =U..... ####; 3461 NG 415 NG 354 NG Shear/columns plus "close enough Rd+I=WL/2 # 11,0401 11,040 11,040 Fv'2 (nos lits/checks)psi 1 14,400] 14,400! 14,400 R allow=Fvbd2/3 wood # of Fv OK JOK OK OK Comments: increase increase size U 5?� ---------------- 6571W� cell ae287 St Bm St BM 86 Steel option B option B option W=Wd+l= Wt 920.0 920.0 920. span= ft 24.000 24.000 24.000 M= ft-# 66,240 66,240 66,240 note tions ... > STEEL: STEEL: STEEL: , e Comment (n/a, ... ) n/a Fb= psi 22,0001 22,000 22,000 @ E= psi 29,000,000 29,000,000 29,000,000 Req'd ... : E Sx r 'd>M(12)tFb lin 36.1 36.1 36.1 Delta @U480<or lin 0.60 0.600.60 Ix r 'd @ U480>...@ D+L ... 5WL"4(L"3)[12"3 384 in 394.7 394.7 394.7 Delta @U360<or= lin 0.80 0.80 0.80 Ix r 'd @ U360>...@ [D+Lj 0.0 5WLA4(LA3)[12 A 3Y[384E in 4 296.01 296.0 296.0 Delta @L240<or= in 1.201 1.20 1.20 limit to Ix req'd @ U240> ...@ [D+L] 0.000 0.000 1"usually 5WL^4(L"3)12 A 3K384E in 236.8 .<1" 236.8 .<1" 236.8 .<1" W live load #/ft' 660.0 660.0 660.0 Ix req'd @ U480'&W 1iV#> in 5WL"4(L^3) 12^3 384E(Delta 11 283.2 283.2 283.2 Trials/Use @... b= jin w12x35 w14x30 w10x49 1d= Self Weight @ 40 cf Sx=bd"2 /6 45.6 42 54.6 fb= 17,432 18,926 14,558 Fb= 22,000 22,000 22,000 Interaction ration .. 96... OK 0.792 OK 0.860 OK i 0.662 OK M allow=FbSx/12,[(12/d 83,600 77,000 100,100 Ix= ^119 for LVL's only] 285.0 291.0 272.0 'E= 29,000,000 29,000,000 29,000,000 itDelta[D+L]=5WL^4(12^3 0.831 i 0.814 0.871 L [ =U..... I ####1 1 347 OK 354 OK 3311-1 Delta[Live] lin 1 0.596 0.584 0.625 =U..... #### 483 OK 493 OK 1 461 NG Shear/columns plus ^close enough Rd+l=WL/2 j# 11,040 i 11,040 11,040 Fv•2 (no splits/checks)psi 14,400 14,400 14,400 I R allow=Fvbd2/3 wood # 1%of Fv OK OK OK JK i Comments: ok ok Ok G�0 D.5a uJI 10 w k2. J 1 garage center beam,option B -F, 4-I �-V TJ-Beam^' Y555 X70011116403 4 PCs of 1.75" x 24" 1.9E Mlcrollam® LVL BEAMUSA 1111 9/4/2001 7:29:24 PM Page 1 of 1 Build Code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED n �n e 24'315/16" Product Diagram Is Conceptual. LOADS: Analysis for Header Member Supporting FLOOR-RES.Application. Tributary Load Width:1' Loads(psf):40 Live at 100° duration;10 Dead;0 Partition;and: TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(ptf) Floor(1.00) 920 260 0 to 24'3 5/8" Replaces SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LIVE/DEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate- 3.59' 5.014" • 11191 13727114918 1 24.0" Detail A3 -1.25"LSL Rim - 2 2x4 Plate 3.50" 5.005" 11168/3721/14889 1 24.0" Detail A3 1.25"LSL Rim -See TJ SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3. -Bearing length requirement exceeds input at support(s)1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 14714 12108 31920 Passed(38%) Lt end Span 1 under Floor loading Moment(ft-Ib) 88262 88262 132502 Passed(67%) MID Span 1 under Floor loading Live Defl.(in) 0.496 0.600 Passed(U581) MID Span 1 under Floor loading Total Defl.(in) 0.661 1.200 Passed(U436) MID Span 1 under Floor loading -Deflection Criteria:STANDARD(LL: 1-1480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o1c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code BOCA analyzing the TJ Residential product listed above- -Note:See TJ SPECIFIER'S 1 BUILDER'S GUIDES for multiple ply connection. Pro ��TAIs PROJECT INFORMATION OPERATOR INFORMATION: No Project Information available Dan L.Gelinas Copyright m 2000 by Trus Joist,a Weyerhaeuser Business. TJ-Pro—and TJ-Beam"'are trademarks of Trus Joist. Microllarrg is a registered trademark of Trus Joist. A 09f __]file:desktop\danlglexce111Beam calc ssW)dated last 8_91r.01 Page o._ a cell b211 job no. Job ara header ' o on B 13y: n LG Date: Loads Load rib.Dim. ft. #/ft roof live 30 6.00 180 roof dead 15 6.00 90 if req'd... M= 0 ft-# attic live 20 0.00 0 Weq.=MB/L^ 0 #fft attic dead 10 0.00 0 place W equiv.in f172 2nd flr live 30 0.00 0 2nd flr dead 10 0.00 0 1sr fir live 40 6.00 240 1st flr dead 10 6.00 60 bearingwall . 10 5.00 50 other Live Load other Dead Load 0 beam slf.W 50 w dead=....v total W d+l [1N IN W d+l=....... 670 five]_.... 420 250 use W =Wd+l= M670.0 670.0 670.0 span ft 17.000 17.000 17.000 M=(vel^2/8) ft-# 24,204 24,204 24,204 note options... > LVL's: STEEL: Comment (n/a, ... ) WA Fb may be conservative N/A Fb= 4;995 2,600 /, 22.999 E= 4_11499 999 1,800,000 29 999;999 Req'd 8-9 Sx req'd>M(12)/Fb in3 28 111.7 4" Delta @U480<or lin 943 0.43 0.43 Ix req'd @ U480> ...@ [D+L] ... ... 5WL^4(L^3)[12^3]I[384E(Detta)] in° 2;1 -'0 1,645.9 482-2 Delta @U360<or= in 0.57 0-57- Ix req'd @ L/360>...@ [D+L] ... 5WL^4(L^3) 12^3]4384E(Defta)] in 4587-4 1,234.4 7 Delta L240<or= in 046 limit 1" 0.85 9�5 lemit-to Ix req'd @ L240>...@ [D+Ll — 4 +sdally 5WL^4(L^3)[12^3]/[384E(Defta) in° 4;958:9 822.9 544 W live load #/ft 428-9 420.0 4248 Ix req'd U480&W live> in° — 5WL^4(L^3)[12^34384E(Delta)] 4,'� 1,031.7 6" Trials/Use I b= in 9-099 3.500 w44ac39 d= in 44--25Q 16.000 Self Weight @ 27 pcf[spf];(45 LVL'#!R 94 17.5 Sx=bd^2 /6 in 49 149.31 42 fb= I psi #O0W90 1,945 6_.844 Fb= I psi 495 2,600 2299 Interaction ration..%... #00401 #DIV/0! 0.748 OK 944 M allow=FbSx/12[(12/d)^1/9 for. ft-3 9 31,338 7:7 999 Ix= LVL's only] in° 48 1194.7 284 E= psi 4;499989 1,800,000 29,998099 Delta[D+L]=5WL^4(12^3)/384EI in #90V490 0.586 9449 =U..... I #90V/90 #DIV/0! 348 OK 4�OK Delta[Live]= in #00491 0.367 9-994 =U..... #91a/�90 #DIV/0! 556 OK 24"OK Shear/columns plus ...^360 ^360 but 480 prefered9 Rd+l=WL2 # 595 5,695 5685 Fv'2 (no splits/checks psi 4_9 290 44499 R allow=Fvbd2/3 wood # 9 10,827 %of Fv #DNF #DMO! 0.53 OK Comment NIA o garage header,option 8, 17 feet TJ-BeamTM v5.5"Se'l Number:7001164M 2 PCs Of 1.76" x 16" 1.9E MiCr011arn® LVL BEAMUSA 1111 9/42001 7:27:00 PM Page 1 of 1 Build Code:146 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED n n m 17'315116 Product Diagram Is Conceptual. LOADS: Analysis for Header Member Supporting FLOOR-RES.Application. Tributary Load Width: 1' Loads(psf):40 Live at 100%duration;10 Dead;0 Partition;and: TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT Uniform(pff) Floor(1.00) 420 250 0 to 17'3 5/8" Replaces SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH LIVE/DEAD/TOT. PLY DEPTH DETAIL OTHER 1 2x4 Plate 3.50" 3.993" 36391230015939 1 16.0" Detail.A3 1.25"LSL Rim 2 2x4 Plate 3.50" 3.982" 3629/2294/5923 1 16.0" Detail A3 1.25"LSL Rim -See TJ SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3. -Bearing length requirement exceeds input at support(s)1,2.Supplemental hardware is required to satisfy bearing requirements. DESIGN CONTROLS: MAXIMUM DESIGN CONTROL CONTROL LOCATION Shear(lb) 5825 4825 10640 Passed(45%) Lt end Span 1 under Floor loading Moment(ft-lb) 24747 24747 31114 Passed(80%) MID Span 1 under Floor loading Live Defl.(in) _ 0.380 0.425 Passed(U537) MID Span 1 under Floor loading Total Defl.(in) 0.620 0.850 Passed(U329) MID Span 1 under Floor loading -Deflection Criteria: STANDARD(LL:U480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate. -Not all products are readily available. Check with your supplier or TJ technical representative for product availability. -THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Code BOCA analyzing the TJ Residential product listed above. -Note:See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection. � -1%OF gfgs�� t �y INA. 3 ST RA PROJECT INFORMATION OPERATOR INFORMATION: 9F No Project Information available Dan L.Gelinas AL "} Copyright m 2000 by Trus Joist,a Weyerhaeuser Business. TJ-Pro^'and TJ-BeamTM are trademarks of Trus Joist. Microllam®is a registered trademark of Trus Joist. ® colonial Drafting . 918 .85 1 . -l330 EEO-Lill - Rear Pleyation rj-------- -------' - ------- '_--___-__J, -------------------- --------------- - -------- ----'- ---------- I 5arton Residence moliff 115 Carlton Lane _ North Andover, MA 0 .1045 I MM jP �d -� �- ' o °ch ,aft Elevation Cara a /6creen ve10 Dec Addition = ° r--------------------------------- 1 Nous: ----------------------------------- 1. All dimensions to be field verffied and changes made accordingly. 2. For additional infoatfon see 'Notes,5peds,t Details'. rnr 3. Drawing print out date; 09/12/01 Notes Standards & Details Material Specifications: General Notes: Doors L 4Wnd--- C:a-aqe Door: 9'0" wide x Z'O" high Indicates emo{,e Detector location Exter for Wall Finish \� S/d/ng: To match existing lam f ng 1, All substitutions and/or deviations from 6M. i - 2 x 6 (P,T,) 4 1 2 x 4 w/sealer these plans are the responsibility of the Stud Lengths. S'O" contractor. Foundation 2. All dimensions are to be field verlffed by A?7chors: 1/2" Dia, anchor bolts with �> the contractor and any adjustments made 1'-0" minimum embedment accordingly. a 6'O"O,C, wd la. 10" Conc. wall, a'01- 3, '0"3, Numbers set within [ I reference that 10" dp x 20" w footing, section of the Toth Edition of the Massachusetts State Building code. Roof Rakes: Flush 4, Property Zoning, Dimensional Set Backs, Returns- Plain Septic/Title v issues, etc., are the RooFing: Composite Roofing responsibility of the owner. Sofrlt Overhang: 10" Under/ayment: No. 15 Felt Window Grille Window grill pattern and configuration per Sheathing window manufacturer specifications, Fxter/or LUa/I: 1/2" Plywood Floor: 3/4" T4Gc Plywood Roof: 1/2" Plywood Windows To match existing Continuous Barried Ridge vent 2x Fire Blocking Ridge 5oard H--- 2x Floor Joist I x 8 Collar Tlee. 2x Nailer Plate 940 O.C. Roof RaPtem Steel Center Beam (2) - Layers 5/8" Type-X wallboard wrap around _-_-_,-_-_-___ Steel Beam UL #L524 2x Nailer Plate R id J e 15 c and G arag e 6 is e l Beam Plan. 13024b _ MColonial F - - - - - - hrafting i 6.0.. 6,0�� 9-18 .85 1 . 1330 6,0�� 6,a� I I - 2'10' x 4'S" 2'10' x II 4'5-- -------------------------------- ------------------------- ------- ---- --- ---------- --'---------------- -- ------------ 10IFoundation wall , - O`9 Ln X Garage/Nouse Entry Door 11 - H 8" Step down O Garage Existin ' C'4 31/2' dia. Garage ' 3 1/2" d ia, ' Lally W12 x 35,W14 x 30 or W10 x 49 — — y — ' ' Lail Column � ' ;Post — - - - - - - - - - - - — O —� ' Post Steel 15eam or (4) - 13/4" x 24" LVL ; ; `V I ' ;II , — — — — — — — — — — � i 3 1/2" dla, Header'. (2) - 13/4 x I6° LYL Lally Column 16'0" x TO' Overhead door ------ ----------------------------------------------------� ------------------------------------------------- Bottom of frost wall footing 4'0" below grade (min,) 3 1/2" dia. Lally Column 24b : n ara oundation12'0' 12'0° U4' = 1'O° 24'0 I. All dimensions to be Field verified and changes made accordingly. j 2. For additional information see ."Notes,5pec's.d Oetalls". 3. Drawing print out date 09/10/01 Notes Standards & Details Framing Plans: Stairway: Foundation Plan: Bearing_L3�O�r-,2. ]_ The ends of all ,Joists, �t�i�uzac�lUlc1�#�L3_�Q�1�L]= Stairways no � beams or girders shall have 1 1/2" (min.) of less than 36" in clear width, �QOL$_tCfa-C_e 136Q3 =_,3 - Garage floor bearing on wood or metal and 3" (min) on surfaces shall slope to facilitate drainage masonry, Ine_C�anc!LLeera L �O :13_2� toward the main vehicle entry/exit doorway. Riser height 8 1/4" max., Tread depth 9" min. DetlUng and Flo chee I 3605.2.6.11 Tolerance between adjacent risers: 3/16", EQu+ndati n Sill Plate$ 4 1 - 2 x 6 Notches in the top or bottom of joists Total riser dimension tolerance: 3/0" (P.T.) 8 1 - 2 x 6 (K.D.) with sill sealer. 1/2" shall:Not exceed I/6 depth/joist dia, (min.) with 5" (min.) embed. Spaced 12" No greater than 1/3 the depth/joist 1321L]_ 4 nosing shall from end and 6'0" O.G. Not be in the middle 1/3 span, not extend more than 1 1/2" beyond the face Notch depth at the ends of the member: of the riser below. Garag_el�czuee Eritry��or [ 3605.1 ] : Not exceed 1/4 the joist depth, . Openings from a private garage with either Guar call rpetaile 13603.14.2.1 ] : solid wood doors 1 3/4" thick (min.) or �{o1es���QS,_2.� ] : Shall not be closer than Raised surfaces 30" min, 20-minute fire-rated doors with a 4" min, sill 2" to the top or bottom of the joists, or Guardrail height 36" min. height. adjacent hole or notch_ Hole dia. 1/3 the Open sides of stairs 34" min. depth/joist max, Garage 1=lnfah - l=ire Se��#Lo_o��603.5.2 1 : �ar�i1 O�eninra Limitations 5/8 inch (minimum) Type X gypsum board RLc-g_e__ aard__L36Q8.2.3 ] : Ridge board 1_3603.14.2.2 4 Exc. ] applied to the garage side, shall be at least one-inch nominal thickness G=uardrails shall have intermediate rails which and not less than the cut end of the rafter, prevent the passage of an object 5" or more in dia. Exception: Triangular spaces formed by the riser, tread and bottom rail of a stairway to prevent the passage of a sphere ` 6" in dia. Handrail Grit Size 13603.14.1.2 1 Circular cross section: 1 1/4" min. 4 2" max., Other shapes, perimeter: 4" min. 8 6 1/4" max,, Gross-sectional: 2 5/0" max, Handrails 13603,14.1.1 1 : Having 30" min, 4 38" max. height measured vertically from the (max) (maxj Minimum Uniformly D istrbuted nosing of the treads, shall be provided on ' Live Loads (lbs. / &q, ftJ at least one side of stairways of 3 or more _ _ I Table 3603 . 1 .3 1 risers. Q X LIVE _ u S E LOAD Oaf) 'Anchors bolts or Balconies and decks b0 ----- App'dEquivalent _ _____ Garage6 (pa6eengercarooeiy} 50iI 30a 38" high AU cs (roof elope 3/12or lees,no storage) 10 Attics (limited storage) 20 handrail ( tV.) See note "Shc Anchorage" C 3604 . 10 1 Livings Areas (except sleeping rooms) 40 sleeping Rooms 30 Stats 40(2) Guardrails and Handrails ) Anchor 5 o l t 5 ac in wile concentrated load at"pow alo top) 200 Noce 34" high (lnina (2) Stair treads shall be designed for a single concentrated Stair Guardrail 36" load of 300 ibis, over an area of four square inches. PL Horizontal Design Dead Load Guardrail Plan: 13024b Design Dead Load = 10 lbs.per square foot a d ra i l /C t�a nd ra i l I Tables 3605 . 2 . 3 . la, 3605 . 2 .3 . b 4 3605 .2 .3 . is 7 Colonial - - - - - - .� 1�raf t Ing (D 0 61On 6�OII FJIlO��4u 978 ,85 1 , 1330 � �� 0/4' 41 �-� I v � I Deck II �0 0 I 31211 {-vOA 3vQ It �v011 tvZi _ 7 OO 77 O I 3O° I Id x 6 Post (typ.) -------- I Screened - --_----- - Existing - Jamil fn-Porch i -4 . o I I , I I I I 1 1?�rJ24b = Main Floor Plan I 1 II I 6�01I V4' 24 VI Noteel- I. All dimensions to be field verified and changes made accordingly. ! 2. For additional information see "Notes,Specs.4 Details". 3. Drawing print out date= 0`1 (mColonial. Drafting 1318 ,85 1 . 1330 1 I � x x 4 v m Double 2 x 8 Ledger with (2)- 3/8' dia. lag bolts aQ 16" O.G. m Nail Plywood Roof Sheathing x mCa with B6 nails Q 4' O.C., Cn m I - -- both 2 x 8 Ledger Boards 1IT FrrI I --------- , I - 1 I - : ------- --- C) -----=--p I --------- , `" --------- I I - ------- -- i I 1 1 I I 312" il'S" 3'2' I Garage Door Header (2)-13/4" x 16" LVI_ 6 2 x 10 Ridge Board All members are 2 x 10 6 Vol O.C.(U.N.O. All members are 2 x S Q 16" O.C. (U.N.O.) 1 13024b Floor Fra 130 24b = C e it na lit o o f F rain iia 1/4" = 110" 1/4" = i'0' NoteB: 1. All dimensions to be field verified and changes made accordingly. 2. For addhional information see "Notes,5pec's.E Details", 3. Drawing print out date- 09/12/01 Colonial 2 x 10 Ridge Board (92Drafting --- 9�18 .85 1 . X330 Roof Framing 2 x 8 aQ 16" O.C. Decking I 2 x S 6 1611 O.G. Fascia Soffit � ' I I 4x6Post Screened ' In-Porch ' See Overlay Deck Detail drawing Steel Ream For additional information _ Taper cut 2 x 4 (PT.) 0 1611 O.C. 2x (0Rim sloped 2x10 (P.T.)Q Iro" O.G. " Railing Garage Door Header - U112 x 35,W14 x 30 orUJ10 x 41B (2)- 13/4" x 16" LVL 6teel Beam or (4)- 13/4" x 2411 LVL Beam Post 161011 wide x 110" high overhaed door 2 x 4'(P.T) 6 16" O.C. Garage Exterior wall 0 M I - 2x6 (P.T) 4 I - 2x4 Sill with anchors bolts --- Taper cut 2 x 4 (PT.) 16 O.G. a e 10" Foundation Sloped 2 x 10 (PT.) 10" x 20" '_ a� 16 O.C. I continuous e footing I Notes= 13024b -- Serstion - I 1. All dimensions to be field verified and changes made accordingly. 2. For additional information see "Notes,Specs.6 Details". - 3. Drawing printout date= 03/12/01 i b Venting detail for space below decking T 4 G Decking venting strip Rubber roof membrane T 4 G Decking Metal drip _- edge cru r� i b Joist i-langer treated floor ` Tapered, pressure t 3/4" PI wood (P.T.) sheathing Joist (align over ceiling ,joists) y .: creates level porch floor �; 4 �.- - Self-adhering rubber roof membrane .000 2 x 10 (F, TJ'W 16" O.C. d ceiling Joist for drainage Overlau DDetaip I - isometric view N.T.S, y i Plan. 13024b ® Colonial Drafting . 918 ,85 1 . 1330 Existing Elavations M-11 Elr oc� oo ❑ 00 00 00 00 { Rear Elay-ation 302 = � i�lote5• 1. All dimenabns to be rield verified and changes rade accordingly. 9 2. For additional Wormat(on we 'Notes,Specs.d Details': 3. Drawing print out date= OW12/01 NORiM 6976 �?♦-. 09 • Town of North Andover ` '- HEALTH DEPARTMENT CHUstt CHECK#: DTE: r _wri, LOCATION: H NAME: noit CONTRACTOR NAME: Type of Permit or License:(Cseck 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) $ L#2 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer NOPTM 6976 F?��.r• • t9 r aidiidh • : - Town of North Andover •^O ig% t ,°.. HEALTH DEPARTMENT ,SSACNU`+t4 1 CHECK#: DTE: 711oll-14 LOCATION: H/O NAME: " CONTRACTOR NAME: ' b QL== E�i/ 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 $ ❑ TrashlSolid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ 1 ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ; ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ v Title 5 Report $ a ❑ Other. (Indicate) $ 9 l i Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Massachusetts " Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: When filling out A. General Information �--�----_ - -� h ,*r•ra•_•'^�'-:..�°-- forms on the ` ' ;'•�. = ;;�, computer,use 1. Inspector: C only the tab key to move your Neil J. Bateson AUG 19 2014 " cursor-do not " Name of Inspector k use the return I' TOWN OF NORTH AN VER key. Bateson Enterprises Inc. HFAI ru MCnA ,T.,�,._ Company Name VtLA 111 Argilla Road Company Address Andover MA 01810 City/Town State Zip Code 978-475-4786 S115 Telephone Number License Number B. Certification I certify that I have personally inspected the se - information reported below is true, accurate an ispection was performed based on my training and expe on site Ssewage disposal systems. I am a DEP approv I to of Title 5(310 CMR 15.000).The system: ❑ Passes ® Cor ❑ Needs Further Evaluation by the Local } r Inspe rs ignatur OQ�M_110, 4�1' The system inspector shall submit a copy of Board of Health or DEP)within 30 days of completi m or has a design flow of 10,000 gpd or greater,t ie report to the appropriate regional office of the __,-...__owner and copies sent to the buyer, if applicable, ar.,..L„v approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 1 of 17 s � Commonwealth of Massachusetts l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments " 115 Carlton Lane Property Address Tom Nolette Owner Owners Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the M computer,use 1. Inspector: F only the tab key t to move your Neil J. Bateson p AUG 19 2014 k cursor-do not Name of Inspector use the return TOWN OF NORTH ANDOVER key. Bateson Enterprises Inc. Hl=a,_TN nron� Company Name 111 Argilla Road Company Address Andover MA 01810 Citylrown state Zip Code 978-475-4786 S115 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 4 8/12/2014 Inspeci6r'stignature Date I The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ® N ❑ ND(Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Foran-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 12 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D-Box Replacement D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than '/day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•3113 Tige 5 Official Inspection Forth: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 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes'or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (if they were not available note as NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 600 t5ins-3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Yes Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Title 5 Official Inspection Forth: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 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped 2012, owner Was system pumped as part of the inspection? ® Yes ❑ No If yes,volume pumped: 1500 gallons How was quantity pumped determined? Measured tank Reason for pumping: Inspect tank&tees Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: 28 years old, 8/7/1986, as built plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.8feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting,evidence of leakage, etc.): 4"PVC through wall, 3" PVC in house, no leaks visible. Septic Tank(locate on site plan): Depth below grade: .8feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'x 5'x 4' Sludge depth: 4" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is North Andover MA 01845 8/12/2014 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 29" Scum thickness 4 Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? Tape Measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumped septic tank. Outlet tee ok. Depth of liquid at outlet invert. No evidence of leakage. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts . 1,09 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owners Name information is required for North Andover MA 01845 8/1212014 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: -- Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins.3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert -112 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.): D-box level&distribution equal. Evidence of leakage, has corrosion holes. evidence of carryover, pumped d-box to clean Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5in3-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yY 115 Carlton Lane M Property Address Tom Nolette Owner owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 2 trenches 56' long ❑ 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.): Soil ok.Vegetation ok. No sign of ponding to surface. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Foam-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately wak"r u ' A t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette Owner Owner's Name information is required for North Andover MA 01845 8/12/2014 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 4 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 1/11/1985 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: Design plan ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: As per design plan test pit data Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 115 Carlton Lane Property Address Tom Nolette _ Owner Owners Name information is required for North Andover MA 01845 8/12/2014 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 .am—\ vv�r�� wr rvvcatU I VI IVI4�5CtCi(IllSeilS City/Town of System Pumping Record Foffn 4 DEP has provided this form for us&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.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility. Information 1. System Location: Left ig/Riggiitfiront of hou Left/Right rear of house, Left/right side of house, Left/ Right side of building, Le of building, Left/Right rear of building, Under deck Address City/Town State Tip Code 2. System Owner. Name' Address(if different from location) Cky rows State Zip Telephone Number B. Pumping Record 1. Date of Pumping date 2. Quantity Pumped: Gallons , 3. Type of system: ❑ Cesspool(s) 9- eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes If yes, was it cleaned? ❑ Yes ❑ Na 5. Condition of System: 6. System Pumped By.- Neil y:Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc- Company ncCompany 7. *ion - nts-were disposed: Lowell Waste Water Date t5torm4.doC 06/03 System Pumping Record•Page 1 of 1 Town of North Andover Tax Map # 210-106.C-0085-0000.0 Parcel Id 17721 115 CARLTON LANE THOMAS & KAREN NOLETTE 115 CARLTON LANE NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 kesidential Size Total 1.07 Acres FY 2015 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until THOMAS&KAREN NOLETTE Owner 115 CARLTON LANE NORTH ANDOVER,MA 01845 BARTON,ROBERT P.&DENISE C. Previous Customer Inactive 5/112006 115 CARLTON LANE N.ANDOVER, MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 14163.0-115 CARLTON LANE Last Billing Date 6/3/2014 2100148 02 Cycle 02 Active UB Services Maint. Account No.2100148 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7,82 1/ WTR WATER 01 ALL METER SIZE 114.85 /1 UB Meter Maintenance Account No.2100148 Serial No Status Location Brand Type Size YTD Cons 29821498 a Active ERT HH b Badger w Water 0.63 0.63 963 Date Reading Code Consumption Posted Date Variance 515/2014 1429 a Actual 27 6/12/2014 -4% 2/4/2014 1402 a Actual 30 3/17/2014 -19% 10/31/2013 1372 aActual 35 12/20/2013 -20% 8/1/2013 1337 aActual 44 9/18/2013 59% 511/2013 1293 aActual 25 6118/2013 -6% 2/7/2013 1268 a Actual 32 3/13/2013 -62% 10/30/2012 1236 a Actual 74 12/13/2012 34% 8/2/2012 1162 a Actual 57 9/26/2012 99% 5/2/2012 1105 a Actual 28 6/20/2012 7% 2/2/2012 1077 aActual 27 3/14/2012 -33% 11/1/2011 1050 aActual 40 12/15/2011 -18% 811/2011 1010 aActual 48 9/14/2011 91% 5/2/2011 962 aActual 24 6113/2011 -13% 2/4/2011 938 a Actual 30 3/15/2011 -49% 11/1/2010 908 aActual 56 12/13/2010 -25% 8/3/2010 852 a Actual 76 9/13/2010 135% 5/3/2010 776 a Actual 32 619/2010 3% 2/1/2010 744 aActual 31 3/11/2010 -45% 11/2/2009 713 aActual 56 12/11/2009 14% 8/3/2009 657 aActual 48 9/11/2009 50% 5/6/2009 609 a Actual 33 6/16/2009 6% 2/3/2009 576 a Actual 31 3/16/2009 6% 11/3/2008 545 a Actual 30 12/10/2008 -40% 8/1/2008 515 aActual 49 9/12/2008 62% 5/1/2008 466 aActual 28 6/18/2008 10% 2/6/2008 438 a Actual 29 3/14/2008 -58% S�STi ED`I�� • Tgco? PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 9/8/2014 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Repair of D-Box By: Todd Bateson At: 115 Carlton Lane Map 106C Lot. 0085 ,� North Andover, MA 01845 The Is uance of this cert' te 11 not be onstrued as a guarantee that the system will function satisfactorily. 1 7 r , 'Michele iant Public Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com ii I •. •.S�+TGED7ggs • • North Andover Health Department Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 115 Carlton Lane MAP: 106C LOT: 0085 INSTALLER: Todd Bateson DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS D-Box INSPECTION: 9/2/14 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑ Contractor reports any changes to design plan ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK ❑ Building sewer in continuous grade, on compacted firm base ❑ 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 ❑ Water tightness of tank has been achieved by visual testing ❑ Inlet tee installed, centered under access port ti ❑ Outlet tee installed, centered under access port (gas baffle/effluent filter) ❑ inch cover to within 6" of finish grade installed over one access port ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon Pump Chamber installed ❑ H-10 loading ❑ 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 ❑ cover at final grade installed over pump access port ❑ Water tightness of tank has been achieved by 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 Comments: DISTRIBUTION-BOX Installed on stable stone base H-20 D-Box Inlet tee (if pumped or>0.08'/foot) Hydraulic cement around inlet & outlets V bserved even distribution eed levelers provided (not required) hedule 40 PVC Pipe Comments: I Blackburn, Lisa From: Grant, Michele Sent: Tuesday, September 02,2014 4:34 PM To: Blackburn, Lisa Subject: 115 Carlton lane Hi Leel-ee, FYI....... I did a D-Box inspection today at 115 Carlton Lane. I didn't have an inspection form with though.They will be doing Candlestick Road this week. Due to the fact that Sue and I will not be in him to send pictures. Thank you Michele E.Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email msrant@townofnorthandover.com Web www.TownofNorthAndover.com 1 • �� "� Commonwealth of Massachusetts Map-Block-Lot • 106.00085 BOARD OF HEALTH ----------------------- Permit No North Andover BHP-2014-0754 -------------- FEE $125.00 -------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Tod_d Bateson to(Repair)an Individual Sewage Disposal System. copy at No 115 CARLTON LANE ---------------------------------------------------------------------------------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP-2014-075 Dated August 22,2014 ----------------------- ----------------------------- ----------------------------------------------------------------- Issued On: Aug-22-2014 BOARD OF HEALTH Ot NORTI{, 6979, . = p Town of North Andover HEALTH DEPARTMENT cNus°� CHECK#: D TE: LOCATION: , H/O NAME: _ CONTRACTOR NAME: 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 $ ❑ Tras4lSolid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ VV Septic Disposal Works Construction(DWC) $J4- `LI Septic ep c Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Application for Septic Disposal System TODAY'S DATE Construction Permit — TOWN OF NORTH ANDOVER. MA 01845 $125©o-comRepair Important: Application is hereby made for a permit to: When filling out ❑Construct a new on-site sewage disposal system' fors on the computer,use ❑Re it or replace an existing on-site sewage disposal system` only the tab key [ ir or replace an existing system component-What? — �o to move your cursor-do not use the return A. Facility Information >> 9 key. Address or Lot# °6 w ���tiirrX- �► City/Town 2.-*TYPE OF SEPT SYSTEM*: AUG 2 2 2014 ❑Pump ravity(choose one) —if pump system,attach copy of electrical permit to application`" TOWN OF NORTH ANDOVER ➢ @]donventional System(pipe and stone system) HEALTH DEPARTMENT ➢ ❑Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system.) ➢ ❑Pressure Distribution S.A.S.(No D-Box) ➢ ❑Pressure Dosed(D-Box Present)S.A.S. ➢ ❑Does the system require an effluent filter? Yes No If yes, does plan specify make and model of filter? YES=(no further info. needed) NO=(installer must specify brand of Fi ter before DWC issuance) What is the Make? What is the 1M1odeF 2. Owner Information 1 o M lV© I2 Name ) /I S Address(if different from above) „ City/Town State Zip Code 9'7Ff 9 7S- /410 Telephone Number 3. Installer Information Name of Name "DA't1a'.ON ENTERPRISES,INC. -1/1 �h� '��4 111ARGI AddressLL VER,MA 01810 A-SL 111.4111.4 Citylfown State Zip�f!S Codea�©� Telephone Number(Cell Phone#if possible please) 4. Designer Information Name Name of Company Address City/Town / State Zip Code I Telephone Number(Best#to Reach) 111 Application for Disposal System Construction Permit•Page 1 of 2 � .pORTq Application .for Septic Disposal :System G�ri■■ej'�•1' cJ— =Construction Permit '-TOWN OF TODAYSDATE -ORTH ANDOVER' MA 01845 $.250.00-Full Repair ''��' - $125.00,-Component 5�C5 PAGE 2OF2 A. FadifIty.Information continued.... S. -Type-of BUiidinq �eidenfial 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 fn operation until a Certificate of Compliance has been Jssuedjby ®this Board of Health. Name Date i ti pprove ( oard of, alth Representative N e . ' Date Application Disapproved.for the following reasons:... For Office Use Oniy: I Fee Attached? Yes No Z.- ProjectMartaget Obligation Form Attached? Yes t/ N0_ 3.: A&=&=_M? Ifsot Attach copy ofElectrical Permrt` YN es_ o� 4. Foundation As-Built?(new constructionronly) Yes (Same scale as approved plan) P� l No S. FloorMws?(hew construction only): h yes_ No Applfc t(on for p(spo3al System: onstructlon Permn Page 2 of 2 o x As (Ad4reu off updc system) For pum by Re&teoa to tit.agplimd=of �i�Cituees IMU,* AM dued I�ted atI � , Itaa dared revised date) I undentand the fallOW149 Qb4gatlow feat cat oftWa ptcajecri I. As,&e iast&Ul I ars.oblipted W cibt miz an pen is bad"& d of Health Wmved l to Jpetfomg aqp: circ a site. lm=bmdzi '. iie .I moat tall fax strap ttitxaaa; I£howeei,�coatractqt,project or axay otherperaotz not m4odted with stay catnpaay Inspecdon and the Mt in is not ►theta item OmtWb4.SpRl czbk. 3.s• I t�.bavadie �s �c€&-- *t�d�pfofzc�the ie?itcd b, - Applicabledadmm6d 2; ed��s as ce 'IVA � & (A wpi:C aa�spa.there is a=ret ng Wil,rich sly be si t: `hiatal[C�'r4i i€fit i age st t ddiea•net have tp bGtrtt t 6. F#na �eetfest — tt3ost fc eTeti tire,etc, b llc of vt t G3K"(or e-MA.6:lhfrcsm the ha dtibmitfed *hc B „cd'afHaah#,sew '3aettt ft3riispe rite ItQcr xriiist bept far ftiaeperdtnt, pitsitp tt ; l r�ectticat�ac tk must be fta4k ad able to = pip-tticsTtid G —lbstiff&tisttmt sec ur a aapeedon she,i#tli cdingis compute: Insts er docs ooc 4. AS-the iaaWle$`I undifond th:t only 1'ts p petfotrn€leg &'(otbw IB=�Jm -' g=Wlm)ai4-I Atri•te�d iD c014piete tlig est:kOn of th a�te-M tt to 4 appt t>g,&t idstdltadon �. A�oyer cg++'tpa6ni for dei+fal eif f&:-Is �stc esti a ix+�.+�,e �vdtP 'forth And= &§Q ice io aa+atr`tra i�4bnt ,{ ' ,1t 5.. Aithe.natslltet;.r t tfdcrets ii t set ie a� n-i ttw a t2t -perEc is�gce of the foilcoaster cfian' Steps. Owing e: I�etea�a� t.��� r �eesa ottl a rx �h�•heu.t rera�he� _ . . fir. F;W&khv of9ke"sAudand st�6vw U mwA C Fiudittspevucafc `t�i tff�ttrlt d Irttrt�tJfl�t�'ar oftaar�&,IJ•$ax pY t ge e,Donchamber;rte geed other - COMJV.rr�,ctttl. 6, Iler,Imffftm no ad T. UnduWmfdilcsaW Septlelaspli= (Tpt 's D40: —�� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECE-1VED OCT 1 2 2005 TOWN OFtJOr:i H ANDOVER TITLE 5 HEALTH DEPARTMENT OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_115 Carlton Lane_ _North Andover_ Owner's Name:_Robert Barton_ Owner's Address:_115 Carlton Lane North Andover,MA 01845_ Date of Inspection:9/29/2005 Name of Inspector: Neil J.Bateson_ Company Name: Bateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ _Andover,Ma.01810_ Telephone Number:_(978)475-4786 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Is Inspector's Signature: \ Date: 9/29/2005_ 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. Notes and Comments: l ****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. Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_115 Carlton Lane _North Andover— Owner:_Barton_ Date of Inspection:_9/29/2005_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass.Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_115 Carlton Lane_ _North Andover Owner:_Barton_ Date of Inspection:_9/29/2005 C. Further Evaluation is Required by the Board of Health: Conditions exist which require finther evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**.Method used to determine distance____ **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_115 Carlton Lane_ _North Andover_ Owner,_Barton_ Date of Inspection:_9/29/2005 D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all inspections: _ No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool No Liquid depth in cesspool is less than 6"below invert or available volume is 1/2 day flow. —No7 Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ _No Any portion of the SAS,cesspool or privy is below high ground water elevation. No Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _No Any portion of a cesspool or privy is within a Zone 1 of a public well. _ _No Any portion of a cesspool or privy is within 50 feet of a private water supply well. No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or`no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply — _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_115 Carlton Lane_ _North Andover_ Owner:_Barton_ Date of Inspection: 9/29/2005_ Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Yes_ — Pumping information was provided by the owner,occupant,or Board of Health _No Were any of the system components pumped out in the previous two weeks? Yes_ _ Has the system received normal flows in the previous two week period? No_ Have large volumes of water been introduced to the system recently or as part of this inspection? _Yes_ _ Were as built plans of the system obtained and examined? Yes ` Was the facility or dwelling inspected for signs of sewage back up? Yes_ _ Was the site inspected for signs of break out? _Yes_ _ Were all system components,excluding the SAS,located on site? _Yes_ _ 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? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Yes , Existing information. _Yes_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_115 Carlton Lane_ _North Andover– Owner:_Barton_ Date of Inspection: 9/29/2005_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15.203_600_ Number of current residents:_1 Does residence have a garbage grinder(yes or no): Yes_ Is laundry on a separate sewage system(yes or no):_No_ Laundry system inspected(yes or no): _ Seasonal use:(yes or no): No_ Water meter reading: Yes_ Sump pump(yes or no): No_ Last date of occupancy:_Current_ COMMERCIAL/INDUSTRIAL Type of establishment:__ Design flow(based on 310 CMR 15.203):__gpd Basis of design flow(seats/persons/sgft,etc.): _ Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available:— Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped this year,owner_ Was system pumped as part of the inspection(yes or no):–Yes– If es_If yes,volume pumped:_1500_gallons--How was quantity pumped determined?_Measured Tank Reason for pumping: _Inspect tank&tee_ TYPE OF SYSTEM X 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) _hmovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe):_ Approximate age of all components,date installed(if known)and source of information:_19 Years old,8/7/1986, as built plan_ Were sewage odors detected when arriving at the site(yes or no): No Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_115 Carlton Lane_ _North Andover Owner:_Barton_ Date of Inspection: 9/29/2005_ BUILDING SEWER_X_ (locate on site plan) Depth below grade:_20"_ Materials of construction: X cast iron 40 PVC_other Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.) 4"Cast Iron thru wall.3"PVC in house, no leaks visible SEPTIC TANKS: X Depth below grade:_8"_ Material of construction: X concrete—metal_fiberglass_polyethylene other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions:_10'x 51X 4"_ Sludge depth: 3"_ Distance from top of sludge to bottom of outlet tee or baffle:_24"_ Scum thickness:_2"_ Distance from top of scum to top of outlet tee or baffle:_8"_ Distance from bottom of scum to bottom of outlet tee or baffle:_19"_ How were dimensions determined:_Tape Measure_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc. Pumped septic tank.No inlet tee or bate.Outlet tee ok. Depth of liquid at outlet invert.No evidence of leakage. GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_115 Carlton Lane_ _North Andover_ Owner:_Barton_ Date of Inspection: 9/29/2005_ TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass__polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOXES:—X — Depth of liquid level above outlet invert: _0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.):_D-Bog level&distribution equal.No carryover.No leakage._ PUMP CHAMBER:_(locate on site plan) Pump in working order(yes or no):_ Alarm in working order(yes or no):_ Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_115 Carlton Lane_ _North Andover Owner:_Barton_ Date of Inspection: 9/29/2005_ SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number:T leaching galleries,number: _X leading trenches,number,length: 2 trenches 56'long_ leaching field,number,dimensions:_ overflow cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):_Soil ok.Vegetation ok. No sign ponding to surface._ 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 sludge layer: Depth of scum layer:_ Dimensions of cesspool: Materials of construction: _ Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):_ PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): I` Page 10 of I 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_115 Carlton Lane_ —North Andover— Owner:_Barton_ Date of Inspection: 9/29/2005_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. House Driveway A B Water Muer I 1 A to 1=42'8" Septic A to 2=44'5" Tank A to D-Bog=61' 2 B to 1=23'3" Bto2=29'5" B to D-Bog=44' D-. Boz Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_115 Carlton Lane _North Andover— Owner:_Barton_ Date of Inspection: 912212005_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water _4'_ Please indicate(check)all methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed:_1/11/1985 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain:_ Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain:_ You mast describe how you established the high ground water elevation: As per design plan_ i= � E�`§. .�� w-'�axa � y t�. ,a_ � � fives � �x •i Acas�,r Yv ------------------- # CYCLE SERUICE PRI OR CURRENT USE r i i+ 1999-100 S S SS 5 S4x� ,zx; 4 5 �.s S @S/IS/1999 0.00 S S S 0.00 5 5 SS PiS � ��� 5 5r 0.00 I 5 1 0.floi 19 .S 3 4. ,.1 5 SS SSS ' S5 555M� r.. .r 9.8 S 500.00 88555 08/04/1999 s S. ' ♦ S. �.. 555 4. 08 ' k� 3 0.00 0.00 4Y. 00076,44; 03/08/2000 ri 1 0.00 5z 0.00 n re 55', S S54 5 S S 5 �S � . S5 yr. y 5 70-98 5S 55 s w � • ' �5 S i S 0.00 45 S S 5011/09/2000 0.00 50 109.28i it ,5 S 45 'S . 98-28 12 2001-42 OS/17/2f101 2226 2253 27 73-71 55 11.00 84.7113 2002-22 t � r_ ; 0.00 s 03/15/2002 t 107.30 0.00 pp{ Q�' d P x} 15' S 05/16/2@02 I ' 4 S 1 16 2002 12A 08/06/2001 2253 22?S 42 128.38 0.00 S.5s ES 55 S 55 80.17w2ax `y 2003-22 11/06/2002 24S9 2482 23 57M r MORE 1' ,z§.IT ^ ✓ �z-.:. Y � ;'D �' - � � r � a r s � - da `�.•y' k•i ..t: �za,ks�; � �� `�t�.. �a'°��i. ..a, "�" 3<'�� is ag woo E' r, a.a 6 r it Yc 9,13 AM Star! Service Cads-Water De GMM 10.1.71A- land Sun brie TOD� 1U Tektet 10.1.71.55 T Thursday,Sep 22,2005 09:13 AM OF z >,, 4c"Ag ''„^ �¢ltt JrpVffi I Thmu1' �?J'�t AV �n' U/S ACCOUNT HISTORY 2100148-DARTON, DENISE C. < 'w BEA15 CARLTON LN METER #1:1 2100148 isTOTAL � '�' —32 02/04/2003 S. S �i 6i4 35 n Si 4 0 85.60 0.00 2 2003-42 S � 0.00 �r S. S4 �i �1Si' . ,, < Y 55 11/07/2003 SS i � � ` i f ` 4". r.v —1 . 2 �+, REUIEU CHOICE or <ENTER) MORE HISTORY: LXX 3^ 1 r � i r 34 Start, ®5erme Cab-Water De.., GOVERN-10,1,71,4-R,J v lowet Sun 044-TOO... Telnet 10171.55 <s Vc 9:13 AM Thursday,Sep 22,2005 09:13 AM I Connection Meter Info Work Order Readm9 (.Meter reading:Serial number 07 29821498---- Date 9821498 Date Reading I onsumptiorr I VAriaticn Code Posted date ,Note, l 814l2005i 8 30 14'a 9112!2005' i Z 5/212005, 5 25 -12 a 6/812005= 3 2!212005. 2 29 -100 a 3115!2005' � 4 1113120041 !, 0 -100:n 12!17!2004; 5 1113!2004 2798 26 3 r 12/17!2004; j 6 8!10!2004 2772 28 18.a 9/2012004 Trouble Code:09 7 5!13!2004. 2744 23 -17 a 6/14/2004 Trouble Code:14 8 2/17/2004 2721: 33 0 a 4116/2004 .9 1117/20031 2688 0 0 n 11/712003 ' Add fs10dify f, r Uv 3 ...._ --_ . N Editing Existing Record(1/1) ` ►) New Save Delete Browse Exit a Tel: (978)475-4786 • Fax: (978)475-5451 BATESON ENTERPRISES, INC. Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service 111 Argilla Road Andover,Mass. 01810 Title 5 Inspection Report P P Property Address: 115 Carlton Lane, North Andover Owner: Barton Date of Inspection: 9/29/2005 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations,and I hereby disclaim any further operation of your current septic system. Neil J.Bateson Bateson Enterprises,Inc. I�I I o^ n" RECEIVED Commonwealth of Massachusetts City/Town of X13 - '1012 u,pSystem Pumping Record T!W�0��RTHANDOVER L ARTMENT Form 4 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.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left 6 - ht Vont of hous , Left/Right rear of house, Left/right side of house, Left/ Right side of building, Left/Rig t fronto building, Left/Right rear of building, Under deck Address t.S `1 OC_ c� p V\ City/rown (� � SSttatee Zip Code 2. system owner: Name Address(if different from location) City/Town Sta Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑'f+lo If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System,Ajo< iva-A 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location where contents were disposed: G.L�SQ Lowell Waste Water Sig toe I Haule Date t5form4.doc•06/03 System Pumping Record•Page t of 7 '�'N Commonwealth of Massachusetts City/Town of System Pumping Record RECEIVED ;M Form 4 SCEP 2 2009 DEP has provided this form for use by local Boards of Health. Other orms maybe used, ut the information must be substantially the same as that provided h r�eo,Before using##us�'�, check with your local Board of Health to determine the form they use.The Sys emFRwrs� be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left side of house, Right side of house, Left front of hous Rig�frontofhouse, Left rear of house, Right rear of house. Address Citylrown State Zip Code 2. System Owner: Name Address(if different from location) Citylfown State �, Telephoonne,Number B. Pumping Record 1. Date of Pumping Quantity ty Pum ped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ET-No If yes,was it cleaned? ❑ Yes ❑ No 5. Condi ion of Syste 6. System Pumped By: Neil Bateson Name Vehicle License Number F5821 Bateson Enterprises Inc Company 7. Location where contents were disposed: L. .D Lowell Waste Water 5 n ur of Hault/ Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: SYSTEM OWNER &ADDRESS SYSTEM LOCATION - (example: left front of house) DATE OF PUMPING:(-e-19-61 QUANTITY PUMPED 1 5cr—> GALLONS CESSPOOL: NO YES S PTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: O�R'�OF COMMENTS: ffll CONTENTS TRANSFERRED TO: ' Address_ lib" cg 90)9M �- � Title of File Page of Date File Open: Date fie closed: Doc Document/Action Tifile Date of Refer to other Purpose of©ocume�at/Action and notes action Document/ doeunTent/ (Wum. Action De artment ------------ Board of Appeals — Board of Health Planmmn,g.Board _ ConServation Con1nlisSion — Buildin9Departmen t FORM 4- SYSTEM PLNIHL G RECORD ��ppVER1 Commonwealth of Massachusetts , Massachusetts System Pumping Record SN-stem Owner Systern Location Date of Pumping: �O r --� Quantity Pumped: gallons Cesspool: No - Yes ❑ Septic Tank: No ❑ Yes �-- License 4: S}�stem Pumped b. Contents transferred to: Date Inspector t`om 111011tiveallli of Mnssecliusells �' J v . ��� �yl�sss�CllUsellg 8yAte,,, pui11O IA Record 5y91etii t)cvItcl ------ Syslem Locallud � � lc (00a t Da(e of l ungtill Qushlily 1'Uuil►ed: f s gallons ('.earpo�tl: Nu Imo'—ti'es LJr�eplld'1'nuk; N�� �J yes ---'fes syslenl l'uitgted by: edeeddd 6rt61A41W Uceilse ('c���letits ftnUslellred lu : ��A�at(isNr�netl gritllletY 111s�i� ..�., •. Il�shea;lurc A 0 j Commonwealth of Massachusetts 144 Massachusetts System Pumping Record System Owner System Location Date of Pumping: j Quairiily Pumped: 6x gallons Cesspool: No Yes �__� Septic Tank: No I] Yes H--' System Pumped by: gcttedea sitt'ev4aeQ License# Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector TOWN OF NORTH ANDOVER/ BOARD OF HEALTH JUN 16 ig99 04130 of "IRL-1H Lor 3 Z CARLrot-J �A NdI�TM Iry►�4U�.,a�� MA, c,�Q� >Z Sc�i�PLY p �E� TGC utiJ APPRouCD O yE5 Q WO --� StPtic Sy s TE,A v E'S6, /PRzovw6 AL -joi?i-ry DI�bPPRavEp �/�IE D� scPr-c c SvSrEM i�s�,o I�T�o� EX 4V4T(O�J )tiSPE6 rotiD�rG )--Z -I -P4SS ❑ FA F�NA� !�vSpF�rjo� PP��d�ED guc- - gb ApftvJN6,4ur+to��,Ty. - - +4��IT�DNAL 1�5F� ' (ONS ()PA0'-JY) L61V60H 5T CET Plgl' ) SO HFA, PVdjL 15 1&0' FiZc (.—AWF-laJ DtS�(iPP�ov�D D,arE N�I FwAt IdPPROVAL AP��ov�G �viNo�l i�j M - t l'o:T a of Hie Norte :,ndovertMaBs SUBSURFACE DISPOSAL' DESIGN MECK LIST LOT # �2 9000 APPRO ED DATE 2- DISAPPROVED DATE Provided: IN Re sones ? No-P rA Grp - pM Iti �SE� Title V FAIL 1 Reg 2.5 T2ie submitted plan must show as a minimums " a) the lot to be served-area,dimensions lot #,abutters b location afid"log deep observation hoes-distance to ties c location anal results percolation tests-distance to ties d design calculations & calculations showing required leaching area (e) location and dimensions of system-including reserve area f) existing and proposed contours: (g) location any wet areas Within 100' of sewage disposal system or disclaimer-check wetlands mapping (h) surface and subsurface drains within 100' of sewage disposal system or disclaimer (i) location any drainage easements within 1001 of sewage disposal system or disclaimer-Planning Board files W knom sources of water supply within 2001 of sewage disposal a system or disclaimer (k) location of ash proposed well to serve lot-1001 from leaching .facility (1) location of water lines on property-101 from leaching facility (m) location of benchmark (n) driveways (o) garbage disposals (p) no PVC'to be used in construction (q) profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and j ®ther elevations l (r) m&x mum ground water elevation in area sewage disposal system (s) plan must be prepared'by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks (a) capacities-150)6 of flow, water table, tees, depth of tees, access, pumping (b) cleanout (c) 10' Brom cellar val.l or inground swimming pool (d) 2:5+' from,subsurfsae drains. Reg 10.2 Distribution Boxes (a) slope greater than 0.08 Reg 10.4 (b) sump i r Ja uary 16 , 1925 Conservat-on Corn,: ss t on ;`oral ;".Lzc'over e: Lots 32,33 Car letor. Lane "-1ss a ^. --ceting wns nel? ij_t`, Thomas !'eve of .'cve "irr O" °,to t:) 'The wetlands out `pack cor,si.st: o` szrears surrounc,o' ly a loi- sL:er ny arcL. ;;iilaec t..8 pblj-C;, of tic, T'oa 5a5 eOdf"cult , }lus grew'-o-usl y h^^rt to enforce the l0r�' offset am' the nei, re .i,la— tions nro�di it nnythin,- I :Sa, IAC t .iCli?! '.i : it i.oulr. '.10 to -fill a li-:ited .lrount of. the 1--LIun-' up to, but rot locluCli.ns- t'ic strear, L'iliCliF. i .�i Lr�)� auay from the leach ar.^.as . ?r. ;`ew, vil.L be contact-m,,, you about t.►e net. ,,ropo,ill. Very t7:ul%' yours , Inspector i TOWN OP NORTH ANDOVER, MASSACHUSETTS OFFICE OF CONSERVATION COMMISSION NORTH i TELEPHONE 683-7105 SSnCHU DATE: January 14, 1985 TO: Board of Health, Michael Graf FROM: Conservation Commission SUBJECT: Lots 32 & 33 Carlton Lane You are correct that both lots are only 50 feet from a wetland and they both do not appear to fall within your guidelines. Please let us know if they request a variance for the 100 foot set back for the septic systems since we agreed to back their request for a variance for the towns 100 foot set back in order to minimize the filling of the wetland. Enclosed is a copy of the Order of Conditions which references these lots. �0ITI0:;5 NPRTHANDOVER Y lWUS 1 OiACTION =31 LAW C_' KI/TM North Andover. FILE 242-115 L --------- -- iO • 1`;1-.__.r I sun Corpora tion ADDR SA, 451 Andover St No. Andover, :iA 01845 C-'„'i IFIHD .')SIT. UMER P 0KCT LOCA'i O L - -- i'.(dress .. Carlton Farms East Eecorded at Registry, of North Essex, 3ook 1434, 1456, PL3e 198, 92 (if r_e3isCered) ,otice of Znteht dated I;_ -ch 22 1981 ,d plans titled and dared as described in Co " iiilun 10 'i.MJ l'_...,E_. 15 155UE i, IOR (dale) _December 21 10M --------------------------- , -,t'r __ _nt to theau�.i`:.ol:ity, of !..!e .;or :i1 Andover oer i'iticinds ByLInot l-C '�iev�. 1"1 c.J � _ pd �.0oy' N1>tt(?e Of intent end15.L1S identified j -._ _ _, Lod C_Mer iD d that the area on which the proposed work is OL s 1 • u n .O �.e '.: i'.c? :LS S'7_�',11i�� C=.i?(: i�0 Cin2 O)" mare:Ci� i:;tc - 11t�:i:`St 1 � d n Una Toni 3ylaw, Section 3.5 A w B. The . :'CC Ler by- oreers that 11 :' , -,i 1p•. 0" conditions re eces 'y 'o i roj 'C sEld j,t,r,,L, -1 1 _ r shall be ilr_j 'rO_ :I .d =1.1.1 t , tCLCl>r(.'i,a `Ce x -11 1 <.:•ld 1. _Uh 0.- Notice of intent and plans C?c:;'!1 ,_ __.C' G7,,0" 2 (' ceJf .,Vre ah plans are ,.'?C`!_fied by said conditions. --------------- -------------- to comply 1'iM all co:-!Ci'_'i..-_gns Si .._i_e d '7erai_ns __yid with all 1"PT, . . =Ci ..;.Li.tMS 010 ni_114 r ' be 1'0 ra, Cho or 1MIGY AM Plivilsins; it Has not nuthorize "ay :1,javy to private ProperLy or v' 2' - FILL 242-115 i. This order does not. re.li,eve :the p0nittce 5r c ny •other person -of the necessity of co ply%ng with all oti .r applicable f ude a.l_ , state or local statures, orjinapc2s, by-laws and/or � r;egula"ions.. 6 The authorized Hereunder shall be ..ori :Meted within one V) year from the date of i.hi_s order unies it is for a alntenance dredging project subject to Section 5(9) . The cover way be extended by the issui_ : , authority for one or �idditional onc; year .periods upon application to said i_ssuiing aut'hbri_ty at least thirty (301 days prior to the expiration (late of the order or its extension. 5 . 'Any .fill used in connection with the project shall be clean fill, contaKing no rash, ,r uke, rubbish or debris , including, vi.t.hout limiting the generality of the foregoing, lumber, bricks, plaster, -.ire, lath, paper, cardboard, pipe, tires, ashes, rcef:rioerators, motor veb .cl_es or parts of any of the foregoing. 6. ::o '. ort he coo-(,-,enced "Mil 01 appeal periods have lapsed i.i oi: the Order of he Coilservatioin Co!:!il i.sGi_On Or jrr0;11 a final Met Ly- the . . •epartheilt of EnvirCtil:!ental Quality :engineering. 7, .' O 1:J _ ,ii:..ill by LnC',r=i:tiven i nail_ the ?_ilial order, with respect to Lho ltr:basod 2-_o;pc,i., has Wen reco-i.ded in the Re istry of ads Gur tn Gi skrict in Mc'h the Und is located within the I.?:=-. ii of title of the a)-i ec'i ed pro � rLy. i lne JCiCt :?C itt it'�?iitbPr L - d"i-cMg such recording shall_ be submitt =d on the format the =1nC' of t.i;l.s order Ea l.i1F issuar of W is o-L Ier ,i:7.Or to :1Ce- •L _ , ° . A s -n shall be displayed at the 5.-i_te AM less than two square _feet or mare than three square feet bo .ri;.l,_, i:i e �;Of:Ca:, =-Se:.CiiltcottS p i-}:i.;nt of Nviro? Dsntal Qual._Ly E.:g_I_neer_ g, _Ai_`:"t er242 115i. }' i1 co: :p let i_oi? of i_i'.•.e work doscri_b 'd . - :einf the apblican t all forthwith } o. iest, in . 1_ �ung, that a Certificate of ,. yl lance be _ "._.'.,;gid statin L at the work has been satisfactorily 10. he work Ball c o, rein. Lo tic i"oll_owig described plans and0, WVC ' T )y .. _ _- . .0 Colinas c' Associates `Too :osun Cort;t)i:i,.i:'•on, 'l._.7 l _ "1)__ An,- ' L 1_ L C. No ! _ - •- 7 _ _ '. _7 n rte. - . 3 - File 242-115 c. Erosion and Sediment Control Man prepared by Frank C. r Celinas & Assoc. bated January 27, 1081, revised : ay 11, 1981, two (2} sheats. � d. Definitive Plan of Land of Carlton F��rms. East, located - in ?north Andover, 1, , owner S . For')e., Rockwell, prepared by Frank C. Celinas , &. Assoc. , dat;a Nbruary 24, 1978, revised 'August 28, 1978! Ten. (10)' she ns e. "Drainage Sketch in Forth Andover, for Desun Corporation" by Frank C. Celiiias & Assoc. , dated March 27, 1981. One (1) P�sy. f. P l.ei; h L� vprn Lane PoDd Pro i_l e, located 1I1 North !1 r .0VPr, ?;'cp ]"ed IO)' 'eSLn COr,pOY.2ti.0i1 by Frank C• Gelinas & Assoc. , Watod April 2.8, 1981, one (1) page. "Notice of Intent Soil Types, Test Pits, I etla.nds, Lots , od R.04W4ys, Carlton Erns East, North Andover," by -nk C. Ge l:i_nas WAssoc. ,` revised February 12, 1981, one. (1 ) page h. "Notice of intent Dra i.,age Study, Carlton Furies , North Ani'tj\iery by F YFtn% Q Cel i_r s & Assoc, , r evised February 129 - 9319 cone (1) yulge. 7 i�v cnl.2."'.:1_on )1- .. 'I. Url Ron Faros, Nond. Andover, iLS, five (�J - poses * s - - fir 7val yvrnk C. WITTZS & nGs w . L ?1 -.l_avC, to drUnage 11 . -. )' G, ._ .g.. in the i,Jlr-r'iS p7:U ?O: oC! by +_ISE' applicant will be to the \:ACC for a.pprovW if the chanSa is considered si Sni .cant; by the _'ACC, anew filing may be 12 . ,-_+ : 'J' i'l.l_C'i_ .l:J.oln (.''". E 7t r;:).L' l.:l( ):"(1 (i}'tl;.nd 104) dated ''-i 20j , 1981y sl,i.nf_'d ::y 1'?.C.i,o L. '.or D^Sl1n Corporc.tion, s n the chain W .Cl�GC7.G,;'Ct with I.:�i' �,_'"�� :r 1. (7.L ZCfYi.iC.l i.�-1o��.., i },a .. of 4102 of the TAId in '01myor, -1 3. C%li!_ t{_"Ivio11 of Oq wair . ._1_ __ tl.+i a at the outfall of wet_lAnd 104 ..hall_ be- in .i'.:(;O?"(1<.'iicwith pl-ons rnfeKredln Andition t 101 And wh l_1 Wlwin n witlet elovati_onl of 1 '-5 .5. low love! 1 , i on ,- , as t id WX -ill On oat �0 alavxLlov 144; 5 . The cap shall Q uzzWed ':a too to the WAYL,oe of a CartificKe of q ntlyj a request est ror '+: . -o;;1 of h . cap gay be ]I itiated Yr Ale 242-115 �. -y, n agenc of - y the To�,1n of Forth i n('over after- the Toy,-n ta'es custody of t.:he strLct,ire or' • 3. B}T itt e introduction of a third parity of ensineering data -dW onsttrating the validity of its removal in e_ittner case ith.e cap shy.tl f 1 not ,be rc: loved encept pursu�:nt tt rT,l-tng _id the iSSI.7.=zinCe Of a new order Of COnrt •e- J f ', jt'1e ;'.nt=l�A?�� $ Frot-fiction .',ct .::nd l .,' itions addit - ion on n Ga c': r of Coad :c,.n s ..etland Bylaw, f 1-tt ,ons Permitting removes c<tp shall not be issued without the o of the c C �,r_a.t.t.e:1 approval o` the ° ,10 ; - '���_'c on lot 18 shall not je Ater-do to , -- � - - e maintained Ll"O�ll Ste I�1�.cLi-lrul channel • the o,t,rl, ,� of. h • , sL •;ct 1l t� proposed weir to C;�ritci7 Lane. , a ver of )_UCt'i.e� i0f -if: 'o.eo:tre setback bc . i1 s1 6 0qutL Cnt Cron _ a ( rt � tOV _r 7cLC OL : Cdlth•—OverIS Lr , t _a t' ry Title VMail , 'he ex brook Toc 52n 33, ni _s , ;n d 34 shal l : ? :y , ' ? Nor" 01 ( : f Anord of N,,j , waiver is not , (;: r)C ,_•? .,:r•i: _, f or if Title V ` I_Ms 2 33 LA 34 in i-,tt l _,n ry Stye 11 _! ;'Illi (-1'.;rr,-Lt-- itl ,-., i 1' -t On l.i�e ,c r- r1 c' _tai If _'tie �'ari-aLi ons old ore ,�:C�a��LCI!-; • Lf)�;; ct�arae will not UeT} NO - c_� t �'-� _ - additional Lf o :._ce _Of j rn0nt will. bel . t.; Al- Qses ofCtljlSl :�itCi L(?'in nS shall be iu C (' Lu! ,f e?-O. ion �.- d ?_1 t t ion til )t Ce Of intent �"'1 t.1 and maintained i�nSaccorda ce all 7 y� .�_. work,ovarL ,''OWN tl i_:. -� 1. ;.;,.? l_.. .::CCI i•tt?ly :, .Ulf Of i;:�L _ • C'"iPrI-- �'-c ion Eecocnce ark , .1 .11r X11 r'i LLn� � � Y may o the 1 n I- 'io .ent of the %diviNal lovs _•_il- .1 r,_. � as �.�i1 1 (�c.�.S • f site Plan - •-. inn ,,,,;o_r-iC t,% 1 be a7 or' 5.3, is,,, filing on lots 35 r - (. k an 1. t_ S` l.-{ s • POL will be --1 t - '-t-d Prior ?t0 1 5)�'1 I 1'IO`S l f f e j,11>l>:u� _i,-1_ 17,d 1 g 24, 32, 16 a ` � teplia1 C -1fC1ifij " the "SL LOthe + : C C 5 - rile 2421115 C. Development on the -following lots pqy proceed in accordanoe with site plans referred to above providing there & no alteration within 25 feet of A wetland: 130 140 35, 36, --""- 379, 38p 40, 46� .47, 54, 56, and 57. If niteration. is , proposed �,aithin 25 feet of an existing wetland, site plans shall be subAtted to the hACC for review. D. DevelopK.ent on the remaining lots shall not require a _notice of Intent if site `pork is in accordance with the site plans referenced above. 19. Upon covpletion of the project, an afW<:_vit, signed by a Registe-red Professional Engineer, shall certify that the work has been completed in accor<'ance Vtl; this Order of Conditions. As--milt 1'1c3ns miay the re',, irul Si:O'::_lllg. a. Wetland areas filled or altered. b. Areas altered to Prov _de, compeiisitory flood storage, C. Drainage ways construct ed w1 'I._'!.i_17 100 feet of wetland area, , !� • i, . :.I.._1d 1.04 wi --o`,. control ._i... uci:il.ce, t. Qr a: _+i+_s of 1_.,2 North_ Andover Conservation r i si `;'� _ 1 Oi.,^i _;� 071 Ac_ILav2 i he --ci ".ift, to -opon and Inpact i _+ pKanKas to aMMOV c pl 1 _nc,? with this Order of canditions . 21. .' :i JC&r or Conditions s -il .,_pply to -. . y Su cssors in ' w t r The _A:n-)li cant,- any person 'aggrieved by this or. er, env c�,-ner' of land abi;t.ti ng .the lend upon which. the proposed. v-ork is o be -done, or, any . ten resi.d}ants- of the city or town in' whi.ch such ' lan-' i. located, are hereby notified of their 'right to appeal. this .order of th, Department of Environ- ;-.,,ental Quality Engineering, provided the request is trade in writing and, by cert-ified mail -to the Department within ten '(10)' days from the issuance of this order-. -- ISSUED BY NORTH ANDOVER CONSERVATION COI,NISSION On S-his '.1St day of Dccri?`�'r. 19 ' b�)ore rye personally a,)per red .',.nt' ons Gf,1vana to me known to .5e—tie person oescrJ_bec-3 in, ­nw,,?o L e _ore,,o]_ng instru:-n-e:nt -lid. ac} nowledged that he executed the s. ,]Je as his free act and n.ced . '•}, C0Tc?ission expires/;, DET:'',CH GN LINE AND SUBMIT TO THE ISSUER OF THIS ORDER PRIOR TO' CG' '1,_NCE', NT OF }r'CRK. Toi'H ^VFR COI�' FRV�.T']:n'V C'?' ;TSS1C�, (IFS _nut'h:,,:ity) =?F '. ,i%ISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT FILE T,UX!'1 R 2/..-")- HA7 BFAENN RECORDED AT THE r , If } r.ad Lhc Z1";C�=)':L .._il.t 1?`}'fi}>CJ' }17.0}l J (?S t};].S t1 anS.9Ctlon LS ?lch i.C`.,_nt- ifi e s this tl"._nS iCtton J-S r � rit)Fl� i cE.-nt -- --- ORDER OF CONDITIONS: Lots 32, 330 35, and 39 Calton Lane 242-254 a. Notice of Intent submitted by GeneralSto.:e Realty Trust, prepared by Thomas E. Neve Associates, LLC. , dated. ' January 14, 1985. Seven (7) pages. s b. Plans entitled "Sanitary Disposal Sys-em for Lots 32, 339 35 & 39 .Carlton Lane by Thomas E. Neve Associates, !. Inc, Four (4) sheets. No'. S-262-32 dated December 19, 1984 revised January 11, 1985, No. S-262-33 dated _ December 19, 1984 revised January 11,. 1985. No. S-262- 35 dated November 19, 1984. No. 'S-262-39 dated January . 8, 1985. - 13. This Order of Conditions is issued in addition to those issued under File 242-115. In fact the proposed work on lots 32 and 33 is covered by the conditions under file 242-115. r 14. Prior to any construction on the site, a double row of staked hay bales shall be placed between all construction areas and wetland areas. This row of hay bales shall remain intact until all disturbed areas have been mulched, seeded and stabilized. to prevent erosion. 15. Upon completion of construction and -grading, all areas shall be stabilized permanently against erosion. 'his shall be done either by sodding, mulching- according t+. Soil Conservation Services standards, or by loaming and seedin •. If the latter course if chosen, stabilization will be cons:.dered once the surface shows complete vegetative cover hii Teen achieved. 16. All erosion prevention and sedimentation protet-tion measures found necessary during construction by the No~th Andover Conservation Commission will be implemented at the direction of the NACC or Highway Surveyor. 17, Any changes in the submitted plans, Notice of Intent, crr resulting from the aforementioned conditions must be sub- mitted to the. NACC for approval prior to implementation. If the NACC finds, by majority vote, said changes to be significant and/or deviate from the original plans, Notice of Intent or this Order of Conditions to such an extent that the interests of the Wetlands Protection Act cannot be pro- tected by this Order of Conditions and would best be served by the issuance of additional conditions, then the NACC will call for another public hearing within 21 dais, at the expense of the applicant, in order to take testimony from all interested - --- - parties . Within 21 days of the close of saic public hearing, the NACC will issue .an amended or new Order (-f Conditions. TOWN OF /J SYST PUMPING RE RECEIVED �D '0� DATE: MAR 2 4 2005 TOW LLTH P ARTM LATER SYSTEM OWNER&ADDRESS SYSTEM LOCATION (example:left front of house) DATE OF PUMPING: QUANTITY PUMPED: GALLONS CESSPOOL: NO YES ~ SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACIFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: coNTENTs TRANsFm=D To: G.L.S.D Lowell Waste TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: c;Z. SYSTEM OWNER&ADDRESS SYSTEM LOCATION (example: left front of house) Wk DATE OF PUMPING:`j:—j,G-6& QUANTITY PUMPED i r cam_ GALLONS CESSPOOL: NO /YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: c50YL COMMENTS: CONTENTS TRANSFERRED TO: L . TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: f`f SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: QUANTITY PUMPED GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES �— NATURE OF SERVICE: ROUTINE 4 EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY- COMMENTS: Y: S. COMMENT UL CONTENTS TRANSFERRED TO: Y. i Commonwealth of Massachusetts RECEIVED City/Town of JUL 13 2007 System Pumping Record TOWN OF NORTH ANDOVER Form 4 HEALTH DEPARTMENT 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.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: p,� When filling out 1. System Location: ` o `�z forms to the -�-�11 1/ `J� computer,use only the tab keyAddress to mmove your C l f cursor-do notes State Zp Code own use the return key. 2. System Owner.VILA `�J l Name ISI Address(if different from location) City/TownStat — `_ �OCode � pphhoo" Number Telephone B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes 9-146 If yes,was it cleaned? ❑ Yes ❑ No II 5. Condit' f System: � W 6. System u nn --By: Name ^ Vehicle License Number Company �f ` 7. Locatio er contents we sposed: m,:;� . , Sign u Date [ C t5form4.doa 06103 System Pumping Record•Page 1 of 1