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HomeMy WebLinkAboutMiscellaneous - 1275 SALEM STREET 4/30/2018 (2) 1275 SALEM STREETN 210/106.A-0148-0000.0 t 1 e � I North Andover Board of Assessors Public Access , Page 1 of 1 „ORYN North Andover Board of Assessors Of t«•o •��O SSACN115E roperty Record Card Parcel ID :210/106.A-0148-0000.0 FY:2012 Community: North Andover PHOTO SKETCH Click on Sketch to Enlarge Click on Photo to Enlar e a. • � y 1 1275 SALEM STREET 1 Location: 1275 SALEM STREET Owner Name: JAMES,STEVEN J ROSE M JAMES Owner Address: 1275 SALEM STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6-6 Land Area: 1.01 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2574 s ft 9 Total Value: 445,900 445,900 Building Value: 238,900 238,900 Land Value: 207,000 207,000 Market Land Value: 207,000 Chapter Land Value: LATESTSALE Sale Price: 264,000 Sale Date: 04/30/1996 Arms Length Sale Code: Y-YES-VALID Grantor: STEARNS,JAMES Cert Doc: Book: 04490 Page: 0150 http://csc-ma.us/PROPAPP/display.do?linkld=1895457&town=NandoverPubAcc 5/14/2012 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Monday, May 14, 2012 11:14 AM To: 'david@sewerworks.net' Subject: I.R. - 1275 Salem Street, North Andover Attachments: 20120514104550805.pdf Importance: High To: David Chandler 978-692-4410 Dear David: Attached is a scanned copy of the file information I have for 1275 Salem Street,North Andover. Please be sure to file your application and receive your permit to become a Title 5 Inspector in North Andover with all the required information before you submit the Title 5 Report for this property. Thank you. Pamela DelleChiaie Health Department Town of North Andover 1600 Osgood Street I Bldg.20 1 Suite 2-36 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email pdellechiaie@townofnorthandover.com Web www.TownofNorthAndover.com 1 North Andover Board of Assessors Public Access Page i of 1 NORTf� rth Andover Board of Asses r O FO A i w 1SSACHU�at 26roperty Record Card Parcel ID:210/106.A-0148.0000.0 FY:2012 Community: North Andover Click on Sketch to Enlarge Click on Photo to Enla e 1 I • �t v �'♦ F 1275 SALEM STREET _____ i Location: 1275 SALEM STREET Owner Name: JAMES,STEVEN J ROSE M JAMES Owner Address: 1275 SALEM STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:6-6 Land Area: 1.01 acres Use Code: _ 101-SNGL-FAM-RES Total Finished Area: 2574 sgft l Total Value: 445,900 445,900 Building Value: 238,900 238,900 Land Value: 207,000 207,000 Market Land Value: 207,000 Chapter Land Value: Sale Price: 264,000 Sale Date: 04/30/1996 IAnns Length Sale Code: Y-YES-VALID Grantor: STEARNS,JAMES Cert Doc: Book: 04490 Page: 0150 httn://csc-nia.us/PROPAPP/disnlay.do?litikTd=1 R914i7Rz.tnwn=Nanri(-iupi.pnh A r,- c ii n ion 1,) WM Ol ._S S E S m Record Jit'• •.1��( i (�1+ ll�.�l���r•�i il•.11.+•,�r.',, �4 4 2008 Yr.. DSP h11 provided lhli form ro( -80 U ' 'pear v0 1'.Jrr,!{{OCS IO the rOCa) 13CalC; C•' noa;(n pr ,,j 1�GY�tl�tyi��.d,rj�'4A, �1'�vS�S;J;n 1 N�ti['f f i't:fC(`'s�lt!N9 C511 r(�:�. r~, Faculty In(orfr atic�r location: 11,2 .44 V14 r!wrn',' cirl,,Icin • .•�..sv;,'+i'.'�'2,;1, J, MOM wnl AQdrea' (IrdVr�rinr rpm bcaUon) I i 97� 97, 597�_.. Rumpling Rarord P�.:!Tlp! tl -7, Typo 91 ay3lsm,. Q ©99¢OOl(g) �Q pl1C Tanx r Tight TenK ✓:'`,•�,r� v• .i.. .. Y a �. 'TI Too Frfivon� Too FIlle('*p nt? y s es eanaop ..{,r�• •,;�6,r�'�Coridl�lon'Qf.gy��'m,,,'.l: • �. + y h„^r. � ,.• 11'x;\' . Sy � pt-rmpod�3y: •.��.;�'. .'`��` ; ', f ung+tw,';' :,; , ;.•,• ,, ,, �G , , it 1;1,y►ir�'fir, �� 1 f, r. (,Jr.+ji'f,�:' V0109 Uc4n}1 Np(r.4 — — , r ), ''r,'(,,•;'f. f' fM i�lt^. {����T•.�y�4;�,.1�1 ��i���t,S%t,�'`',,,i• �� 1 LOca on 8�COr1(anls'yrvry c!�Ycsvc. 'bt'n"r�.m813. OY� de�lvralorlepprOYaJsllblorm9.r.: eta -- r j,r •�'S�t;:�`l:•�i`'����I'Yi���\!'. il'nr ;i�.�!rS}�i'�••ltirr Ir.'r�" .� .. , 'r .;r.lti!Y d^•A ;,Rr!,r,;,.�• .,.;,7i,j.•rig •;'�%:'��`y. .,� - - . '•r lr� il'1.� NORTH - ' DOVE, R` SYSTEM PUM'Pf.NG R-koU > ID Irl -1—C M UwN�-R & AuoRESS w SYSTEM LO(ATIO!' (ezumpir; IIr ni c)f , S.q.l f rv) ST j ir4o D./UG1�C ve ' QUANTITY 1 UMPCo 1560 YES SEPTIC' TANK; NO r �� . . - NATURE OF SERVICE; 'ROUTINE- _ EMERCENCY }IlSrRY,\T10NS, . ` 11110 N. FULL 110 C'UYr.,IZ '.�II:A°'YY'.O:R 't�SC l3aFFLl;'S' IN Pl.-AC!'' - :. . f�VOTS LIraCFiFICLo ftuN!��,c --- -- :CXCESSI-VE80LIDS FLOODED -- SOI;IU R'RYOYER' lJ�HRR (EX%/L .m) -- - C�u.,�i kI rNTS, • i A164 AVLwer 1Jb Q,n -Cf, T�$ SF�fiIC TANK 8$tt am Ne r A n zw*e. 47 RAIZAM,g ARD, MA 01835 Uavl L �F;/•pe l� 978-372-7471 co mm" of f e a2 ` Q YPZPMT FSR TORN cp ADML58 GAIWW _ IS06 MOO /ane /907 7vi >ors f'S� 6Yi k5ao w ��✓ IE40 - 103cl��� m , ✓�r� 15,�o Sc%E-,-� ,�� 16.60 IdC ^`y (vc75 .t�' rt�6)4 /bap l66 1� Town of North Andover HEALTH DEPARTMENT f µORTk Community Development and Services Divi ��.o M 1600 OSGOOD STREET Building 20•Suite 2-36 r •�' North Andover,Massachusetts 01845 cwus� http:/Zwww.townohiorthandover.c- u (978)688-9540 Susan Y.Sawyer Public Health Director F (978)688-8476 INFORMATION REQUEST Health Department Please use this form if the Health Inspector or Health Director are unavailable to provide immediate assistance to you. Please fill out this form in its entirety to ensure an accurate and prompt response. All requests for information will be handled as soon as possible. RECEIVED CONTACT INFORMATION tlCT 12010 Date: 1 b 1 !Z / 2y t 0 TOWN OF NORTHMDOVER HSALTM OEPARnMEENT Name: --F, r..A As Phone number: t 4,q Fax number: Address: es r %e --De,. >p5-T ':3(-(z, .5 e g=�KA r INQUIR operty in question: (Please ' lud s much information as possible) el Subject: 12� �A�c�.-��tic���f ve-c�a z A l�ecl�) Inquiry: l'�,.aG �-�2 n� �- — 1�eoP •,1 (�x P (' Q �E.P-s-�� `T a�a c � d r 1 nAS�� eTC You will receive a call back within 24 hours. Thank you. BOARD OF APPEALS 688-9541 BUILDING 688.9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. , This does not relieve the applicant and/or 1� landowner from compliance with any applicable local or state regulations or requirements. law, t I APPLICANT: Phone LOCATION: Assessor's Map Number Parcel N,_ ~ Subdivision .� Lot(s) Street �e St. Number <-.. * *********************** , • . Official Use Only************************ - RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Date Approved Date Rejected Comments Date Approved Town Planner Date Rejected Comments Food Inspector-Health Date Approved Date Rejected Date A peptic Inspector-Health ejected �/ 7 Date Refected Comments . e�..� ems.... Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date 7 SUBSURFACE SEWAGE DYS.PQSAL SYSTEM XNSPEC X0 OF RTH#y, R/ 'Address of property 121G -Sr9znLs -2e`r" �e Owner ' s name 1'A�. S-rEpTrUs u� 1995' Date of .Inspection -������ PART A " CHECKLIST ;Check if the fdllowing '.have :b'een -done; Pumping information• was ,;requested .of the dwner,' occupant'; and Board `o'f, / V. Health:. ethe . system-componen .haNane: of ; ve been pum ed • for 'at leas t two weeks . and the -system has been receiving normal flow rates during that Period. . Large ,volumes •of water have -not been introduced into the A, system xecently bx as part'-of this' 'inspecti.on. As built plans have been obtained and examined. Note i-f they ar'e not' " `a�ail'able with• N/A, The tacility or dwelling was Inspected for: signs of sewage back-up. The site was inspected for signs of breakout. All system components, excluding the SAS, have been- located on the`. ` -si•te. The septic tank manholes were uncovered, o ened and the ' p interior of the septic tank was inspected for condition; of .baffles .or tees;' 'material -construction, dimensions, depth .of liquid, depth of s ,udge, depth• o•f scum.. - .•;�-he size :and location of the.-SAS' an 'the' :...: sitet:has .b.een de.terxni'ned. ,bases on. existing information "or :approximated, by.non-,intrust. q. methods. Thefacility owner (and . occupants, 'if different'.-from" owner'). were provided with information on the proper maintenance of SSDS. i 'SUBSURFACE SEWAGE DISPOSAL `SYSTEM 'INSPECTION FORM' PART B SYSTEM INFORMATION , FLOW CONDITIONS .�, ,I•�:.re'sident��.al' . ;number, of bedrooms' 2 number oaf :current" re`s"idents' .. °` .garbage %:gacbder` `.des oz • no' laundry ,connected to system, yes or no seasonal. use, yes or 'no If `nonresideritial, . .calculated flow: Wt:er meter .readings, if available: Last' datb' of occupancy' GENERAL INFORMATION Pumping records and 'source, of information: _ .System pumped as part of inspection, yes or no f y.es, volume pumped • .•Reason•,for pumpin i. U d�• eCGiVS� 1 11) 2 -Type of system , Septic tank/distribution box/soil absorption system. Single cesspool overflow cesspool Privy - 7Shared system --(yes or no) (if yes, attach previous inspection ' i7ecords:; -if any) ;"Other.. ..(ek, P1Ain) ; Approximate age' 'of all components. Date instakled', 'if •'known.. Source of ' information:' Sewage odors detected when 'arriving at the site, yes or no g. �.-,.) SUBSURFACE .SEWAGE DYSPOSAL SYSTEM INSPECTION FORM { PART -B -SYSTEM INFORMATib* coatibued S E PTI C•:TANK ovate, on .Sit.e depth' be low•'grade material, of, construction: . _concrete metal ..�. 'RP other(explain). '. dimensions: b0. a q ;,s'1udge.`depth• ; distance xomr. toga or sludge to bottom of outlet . tee or baffle � scum `�th.ac}tziess• .. • � .. . . .. 74 d?s`tance; 'frpm 't'op of; 'scu_m to top of outlet tee or baffle �. . ! d'X'stancs fxorri.,bottom off. 'scum to bottom o�f .out`1•et� tee or baffle comments.; (r •ecommendation for pumping•,..condition of inlet and outlet tees ox •.b•affles; depth} Qf. liquid :.1•evel in relation to outlet , invert'," structural' integrity,,' evidence of leakage,-. :recomm'ndations .for repairs, etc. ) DISTRIBUTION BOX; (.locate ..on site• plan) p. liquid- level - .�• - depth- of. above° outlet invert . . • (note -:If Leve! and d.i`stribution is equal, evidence `of solids carryover, e,V deuce A.I .of. .leakage into .or out .of .boa, •recommendation- .for. repairs ' etc.. )" • . cv S U �� 7• CJ( ...�� ]� Rz L,V. t PUMP" CHAMBER: ..(locate,.on 'site . plan) pumps in `worki"ng order,- yes or -no Comments'.-: (note .:Condation of .pump ,chamber, condition of pumps -and appurtenanoes, recomfnen at ons for. maintenance or •repairs, etc. ) 10 ' SUBSURFACE ,SEWAGE' DISPO;SAL'° SYSTE i xN PECTION FORM pART:'B SYSTEM INFORMATION acbtinued' SOIL 'A'BSORPTION 'SYSTEM (1.'oca a on "ii-ite�_plan, -.if possible; 'excavation riot required, but may be appto "ximated by non-intrusive methods) I`f .nat` determ�ned" to be present',, °explain r Type. _ .__ lea'chin'g pits and number. :IeaChing chambers Arid"n'umber '. ..leaching galleries and number leaching trenches,• number, length . Teaching fields, number, dimensions ,ci��n ,°i'�' o y d o'verfl'ow cesspool., number T •.Comments: • ;(note?'eondit.ion ' of .soil, , signs of hydraulic failure, , levet 'of- pondixig, cvndxtian° of• veOt,ation, recommendations .for maintenance° or repairs.fetc. ) /Ga/• •`pry° 'A�tJf•� �F�/•4y�2� .. � _ - .CESSPOOLS: (locate;:on`Site plan) : . number a" nd 'con figurat.ion 'depth' ,top of liquid to inlet invert depth"-of solids layer- ,depth':�bf -scu'm layer ;d'ii�els`ians of cesspool matetral.s of construction Andic`ation of jroundwater iniow :(cesspool'.must•be °pumped as part ;of 'inspection) - comments:.. I6 (note .conditior,,.•.of .soi°l , signs :of hydraulic failure,--level of ponding; c0nd'itn of vegetation, reciommendations, for -maintenance -or repairs,etc. ) ,. PR TIVIX locate.:on -si ( te plan) . . mate •a'ls `of construction di-men°sV6ns depth, 'of solids Comments; (hote••condition •of soil, signs of hydraulic failure, - level of'pondin(j; conciit �on of vegetation, recommendations ' for maintenance or repairs,etc. ) SUHSUF. CE. 'SEWAGE. DISPOSA.L-SYSTEM INSPECTION FORM TART .-B ' 'SYSTEM•.INFORMATION . continued 4K .TCH;: OP.,SEWAGE DISPOSAL,•.$YSTEM: nolude .tes. o ,at ;least two permanent reerencss landmarks or benchmarks . "'1oca:te` all wells within 100 ' 30 Zq° 0 �. D� g�X DEP.TRI TO GROUNDWATER ' depth 'to`groundwater • method"'of, determiiinat'ion or approximation:' . » 12 ,. .BUBSURFACE SEWAGt' D1SPO8AL *AY$TEM INSPECT1 ,�FOAM" -PART- C' FAILURE CRITERTA ,rhndica.te yes, ;-n4, or,. not: determined ..(Y, N, .or. ND) .. Desczibe. basis of de 'erMXna.xon 'iri 'all ' inst'an'ces': If` !'not determined", explain why. not), : .. _:, Backup of sewage •intofacility? 'Discharge...or ponding° of effluent to the surface of the ground or =`.'. ,.surface: waters? ,,/6._ •,Static' l�aqui.d }ldvel in the da:stribi tion'-box aboveout-let. invert? >. e �1;'iquid depthn cesspool' <6'i below invert " ar available ,volume< 1%2 day!, :f Iows :A ., q d;-pumpi,rig k .times or more .i.n the last.year? - number of, times pumped. Septic tank is _metal?' cracked?. 'structurall.y unsound? substantial i'.nfil'tration? substantial exfiltxation? tank fa:ilure. ,immjnent? `I_s any, portion of. the SAS, cesspool. or privy: below the . hi,gh•.groundwater elevation? within 50 feet of.':a surface water? '`thh , 1.00 Feet 'qf 'a "surf ace water .supply :or...tributary to a surface .' water 'supply? ,&Cwith; ri.;.a none z•' of• a publ is well? within :5Q , feet-of a -bordeir-ing vegetated wetland or salt marsh . (cesspools and privies' only, >at the SAS-) .7 with'i'n 50 feet ofa private water supply welly? 'Tess' than .100' :f6 et .but''greater .than 50 feet from a private.' water• suppxx well with no accepabl'e' water quality `analysis'?.. If: the. well;- r' has 'beeh "analyzed ,:to be:::acceptable; attach copy o,: weil water: analy'6 " for coliform: bactex ia, 'vol'atile' organic compounds, ammonia;'nitrogen Wand, nitratenitrogen., 'BOO' URFACE -...SEWAGE, DxBPOBAL..8Y8TEM TION :`INBPEC S .. .,;-FARM A PAR•T..•D ` . . CERTIkICATICN Name, of Inspector OOp :Company; •.Naive rN G c,eev a kkl Company Addr -M: wti.aKER. 2D„ �NpIY Iz U. 't Cat; i { t i t •'} St Cia�,etent z certi; y than XS hake, persanal'1 este ynsp d the sewage disposal th�s.:address. and 'that. the 'info atio ` m n :irepor•tecls true, .acdura�'e;andi } aompfete ;as,-,,o f time o£• in'spert i �'ha i.-nspection was=.pe d d Y�• oammendat -ons ze rd `cons?iste: t g xng :upgrade', ';maintenance and rep�i'rxare an y n w th`.my: tr`a-I.- n-g. arid= experience in:'the: o e , manit, ►`arice of on`='s�is sea puilction and z w cue d .sppsal systems.. { r { , Cys, (� i/�y� `1+e,O ��F'a1e-1 I have;r unci'„any';�nfprmat tom°which ind'�sates that the­,Sys 31 adequate . p�Atect'�publlc '.h ea,1th ox the `enviiranir nt• 'as de tEe;t a 1S { 4 'CMS 15. 3413: :�nYS`;fe.�l'ure, cr�t`er�a''not ' ,Vs .lua a j { is tithe l 'A �,IJR CI�xTERYA s �' a ted” ;. ec -ior�,,'o this had ; e. detexmineo. that,;'.t e . *ys em` .f.ai]s do "protect public':health and he :enYiranment' as defined in 3'10 [SMR 15':'3 determination �s` 03= The o's .;fox, this , form I?x'°Vi'deci` 'in the"PA�ILtJRE "CRITERIA `secti`on'of l.nspector,! s Si'gnat x.e :Rate +Or�gn 'k.to 'sy'stefi awrier '-i Jr.f ' '{r t ?; ,,7 •1`. r-c • `o i 'j- ._ -,."1r CopQs Bu er if a ' pP,licable.) .. . Approving -authority ' .... t\i.c.;. AJ6' .{:r•., ....'-f,'J. ...... ...k t- v'i tT2 f. .rte i ar` �`•.... .}. .. . .?,.. .. • QoT IG SA L e IA %fit r JOSE Fl+-1MA`R.MCRAt. -o V-S, ;`;ter ��,, ••. 1?- '� WOI 75 . , r4 ( Mit 0 Cr tot .- 2d .- ,t Lt w d , n SS Fn I L to G _ 'Ptd tart toe — .. ,i! AS 4Y, �• >a 'd.7.�J.?.:t C.t:7:"r't.'.3:.ari r3 .YrrL7L:�t s.J.Jb. ' 7,?a J;.l+_i -N..-'W-jocp TM f~ U1 .+b�, i ith�l•r t�9C�!N C F� i ,L:c��-�1'�(a .�.11t�-.v 111 •w\N.jy ♦ w / "'� _,.�.,,.» �. M. 111 u.. �. .�.'•':�.'.":s, �2" Min.Tapsail ' ' ' .• Covet- 1p; u o shed a5lonet/8 38 , 6 4"Perfor6ad Orangaberg . / �, I "1 Absorption Aran I�2 51 ----> 5' 21/1 Z01 a ABSORPT ON BED END SECTION � 1i1 CID r Proposed Ftnlsh 13radQ .y Y / VZ" Mets Cover 1000 Gallon n" 3� 6 Boxt SephcTcnk Ia°° : Oe G .,)toaPoon0atJ��od•a O Ny � o� eod $vOS gl 's.dtTtlrv0,jGtT5s.r..p0.11 , ItOe/ �l© DISPOSAL SY T-EM PROFILE Win `' "''�''aE7QyC waterta e N0wAl'F-1Z E•NCovh1T'M6-tG10 . p15T, 5` AssORPTIOIV AREA= 9O0 1 tit Lti u i IL S` � �11 ABSORPTION BED PLAN OBS. HOLE PERC. HOLE PERC RATE TEST DATE `I + A eep 12" LOA M 1�'' LOAM J sJa'S0,t". hh1p a PERC TEST ` YIN Sot I. SATQZATf;:t7 15 Mtr1. �. { OR,T�;A11D1 3 b e • •N. _ S E S Record :,,, t{J,��,;� �,t.,,• ,: AUG — 4 2008 DEP has provided Sv lorrn for Sao w,yT� o al oaraa Of Hoa D9 11 0(Tll{{Od IO U19 local Scar(" C'' n0a,(n or T Uhl J TH'ANDd\b1 ;a,rn . 0 A. Facility Inforr�atic:� •„r`t'r�a., P.:'n, oil 1, SySl9m IOCeUOn, ' wm . �� "J'�t5� � H.•in,J' . m Owr ,SySl9 .. •,9., ,,_i.,•. ., � r �hd r r ' (If 001011)l (M lQuU0n) 7o,9rr..^e , „roper - Pumping Rarord -- 1. Cas cf P�mpjn� TYPe Pl syalam; 0 �699p001(9) 25vpllC T enk r7 T19 hl Tangy . .,'•�]''O;��ar (describe); -- Etfluenl Tae FI1Ia r'�senr? � Yes n'c (P eanac? yes -. .. .. r'.,',.` ,' Gr;JtPi,'•,JI_�%�J� ._,i. ,.i'1l'.L��'r�'•r 6,;. Sy Pimped By;'�•. -- ;,-::-,,,v,,rv4,��j�j�('. ��� [• �Y ��'' gar ,� � +�r„�",'��'4.f'/,�i'��,`Vftii'1�1`�. {1���Y�'°v��/di.l�t���ijf/yf�•,1�,�,���. . / , l' LOCA on wnar r 8 CO�lenls were c'9r05ec: } r - � � mass, o v/ e — � g daF.�walar/ap�rova�s/Ib(orm9 r:�,rr;�s�ec! d � Srr,al�1 Y[��r.Iti�JC Irt11„ r7t ,I I �y } 1 i� r I :T1bYYN OF NORTH 'AN,.'D0VE R . SYSTEM PUMpL�(G EC`0 Jar 11 0Y(N�R & ADDRESS „ SYS TEM—G( ATIO w c� (Nzam�le i r, , ti.. sq/ern ST- o v I*r)4;1-r N /V.d ove< q UF,PUMPINC,': QUANTITY PUMPID knoo _ YES SEPTICTANK : NO -\TU.KE OF SERVICE, 'ROUTINE EMERCENCY , '4 �lll.>rfiY;�rloNs; „ ��� ` ; G'U,VD C:U�?UITION, h'ULL TO COYER IRA`'YY' JEASC'':' BAFFLES IN P'LACI — -- -- RUOTS,;,; LEACH FIELD kUNJACr. CXCESSWE SOLIDS FLOODED 50LIDI� CARCiYOYER `11J�HRR (EX ('I,A.IN� - - -- - PUMA co Y' r r � u�''►!'i;�!��',,I;�,,;��LR�A�NS.�CIZ�I?1;�� 'ro VZ/V0(173( OV:JV JV60/00011JICWHh.I/HI'i1)UVCF, I-HUC p0 leer AN16veT 12.6- 4. �Jb G��n 9+. START'S SEPTIC TW �tVltM 47 MlLRW-gip Ne OrIP, A nnd/er BRADPM# Mh 01835 978.372-7471 Le- # ,� OF I Y 'Y' FOR TARN OF' i1A V-4 /9v7 S� le,.n ,St / ✓fes-(, // cow �/o4L, 103 �JeIC c� m f� ✓ 150 /gyp 166 /bap 646 qs su rd4,7e, 1� Town of North Andover HEALTH DEPARTMENT NORTH Community Development and Services Divi 1600 OSGOOD STREET Building 20; Suite 2-36 D'T'TED North Andover,Massachusetts 01845 CHU http://www.townofnorthandover.con p (978)688-9540 Susan Y.Sawyer F (978)688-8476 Public Health Director INFORMATION REQUEST Health Department Please use this form if the Health Inspector or Health Director are unavailable to provide immediate assistance to you. Please fill out this form in its entirety to ensure an accurate and prompt response. All requests for information will be handled as soon as possible. RECEIVED CONTACT INFORMATION OCT 12 2010 Date: 1 o f 17- / 2y t VVMOFROM AWDMffR Name: — MAS A� u2 - 1-u ss l� -i LL C. Phone number: 4 l 3 . Dq4 S x 44 S`1 Fax number: Address: 1�res5 a�e )�. Vy �s7 SP2 ��E� c� �l INQUIRq;=;:;;much information as possible) Subject: �e-c�-� ����e �!�IaeEw,) Inquiry: l—oz P You will receive a call back within 24 hours. Thank you. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 FORM .0 - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary �\ approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state� to law, regulations or requirements. **Applicant fills out this section***************** APPLICANT: Phone �o X( Y LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street St. Number ************************Official Use Only************************ RECOMMEENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved . , Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved �✓,,,���f 7 7 Septi Inspector-Health Date Rejected Comments i :Public Works - sewer/water connections driveway permit Fire Department Received by Building Inspector Date s ORTr SUBSURFACE. SEWAGE DISPOSAL, ,SYSTEM INSPEC IO Address of property G Z" r 514LEvt, ' Sfu r owner �`s name �"t. 1 sTtnt�s Y 3 1 1995 Date of Inspection -1►��15 PART A CHECKLIST Check if the following .have,be"en ,done: Pumpa.ng information was requested of the owner, occupant; an, -,Boa of Health None, of thesystem`'.comp.one`nts `have been pumped_ for 'at least two' weeks ,a-nd the system has'_.been receiving �normal flow rates. 'during `that period. Large volumes of water have not been. introduced into the s stem ,recently Y .,ox. as part`' ofthis: inspection.. F As built plans have been obtained and examaned. Note if they. are ':not available with N/A; The :f,ac'ility or dwelling.:was inspected for signs`- of sewage back-up The site was inspected for signs of breakout. ✓n All system components, excluding the SAS, have been located on the site. The septic tank manholes. were uncovered, opened, and the interior of the septic tank was inspected for condition` •of .baffled or gees, material: of •construeti.on, dimensions de th :of li id de th 'of P � , P sludge, depth, o` scum.. The si ze and location of the SAS on ;thesate:has been: determined based:' ori a existing information: or :approximated :by non-intrus�,vs;':nethods.' The facility, owner' (and occupants, if different :from owner)- were provided; with information on the proper maintenance : of:. SS DS..- f 8 SUBSURFACE SEWAGE DISPOSAL`"SYSTEM IAtBPECTION''FORM PART B SYSTEM INFORMATION FLOW_ CONATTIONS If re'side.ntial } 3 vl number of bedrooms Z number of current residents 7 garbage �cgrinder; :,yes °r no. unary connected to system-yes -dr- no seasonal muse, yes or no ?f nonresidential, . cad cul ated' flow: Water meter :readi.ngs, ` it available ; Lv�rer�' La'sil date , of occupancy GENERAL INFQRMATION Pumprng records and source of information: S stem . : y pumped as part of inspection, yes or no if :.yes, .volume pumped Reason for pumping r ecuvse w��) e �, Alb c e-- Type 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) .6th r (explain] Approximate age of aI1 components Date installed, i`f known., Source of information. st=alle� 19 3 Sewage `odors detected when : arrung .at the site, yes or no 9 SUBSURFACE ..SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC,.,.TANK': C locat(i.z on site plan) depth below 'grade material of, construction concretemetal „FRP" other(exphain) dimensions:.' xr �t y`- c� sludge:depth , ., d.istance from "top of sludge to bottom of outlet, tee" or baffle . scum thickness 7' distance from top o'f scum to top of.* outlet tee 'or- baffle' " -,-- x distan"ce fr,om. bottom of: `scum to bottom of out'Iet'l tee-or. baffle Co`mment's (recommendation' for p"umping, condition of Inl.et and outlet tee's oe' baff Ies; depth of liquid ,lev.el 'in relation to outlet invert',' .structural integrity, evidenc'e. of leakage;. re'commendatons forepairs, ' etc. ) i�N K is i rv" croy C) PE .. 4�-t Cr c%Lass , Fr4 E DIS,RIBUTION BOX, } (locate on;sate-TI an) depth, of l-quid:'1eve1 "above, outlet invert" Comment . (note 'if Level and distributiom is equal.; evidence of solids carryover,. . dence of`.leakage ,into orout of box, recommendation for. repa�.r's , -etc..) r�' Qi..G X ff PCO lC a7 C)k/1/' N PUMP C HAMBER: (.locate on,.. plan) PUMPS in working order, yes or no Comments. (note cond�tion";o,f .pump 'chamber., . condition o.f 'pumps ."and" appurtenances, . recommendat ons; for maintenance or ,repairs;etc ") r SUBSQRFACE SEWAGE DISPOSAL SYSTEM INSPECTION' FORM '.PUT,: SYSTEM-.INFORMATION "coatiaued' 84ID ABSORPTION. SYSTEM -(SASy : ocate on ;site'.pl°an, if possibl'J :excavation not:: required, . but may be .pprox`,mated by non-zntrusiv.e methods) " If 'determined,,: to be present'., explain:. Type leaching pits a'nd -number F reaching chambers anCnumber, leaching : gal le.rie.s. and `.number. 1:eaching trenches.;, number, ` length Teaching fields, -number, ' dimensions „.f �ir�,2 �r�a,�� �o Xy � o.uerl'ow ce'sspgol, number Comments. (note` cond. tion``of soil; signs ;of hydraulic failure,,level af; ponding, conda.ton of vegetateori; recommendations '.for maintenance or repairs,etc ) SAI 777777 CESSPOOLS (locate ort site plan) number;.and contiguraton depth"'top-,: o.f liquid to inlet invert. depth`..of sol 'ids- layer depth of scum 'layer dimens ons :0f cesspool materials of construct`i.on indl.cation--` of .grounda wter r pflow.' (cesspool must "'be pumped as— cesspool past ',of inspection) ` 7`; Comments (n.ote conaition` of soil: signs of hydraulic failure, 1evel:'of ponding, condition :of vegetation, recommendations 'for maintenance •Or repalrs;etc. ) PRIVY ('locate- on:'site;•.plan;j • E { materia'ls =of construction . dimensions: depth `of s6rids' . Comments note 'condition '. of soil ;. signs of hydraulic failure, level of ponding; ( .. Y . . condition of vegetation', recommendations for maintenance or repairs,etc.. ) p. SUBSURFACE 'SEWAGE DISPOSAL.,,SYSTEM INSPECTION;FORM pART B SYSTEM ,'INFORMATION ..cont nued SKETCH OF `.SEWAGE DISPOSAL :SYSTEM: include ties to at;,least two pe rmanent,,references :landmarks or benchmarks Iocat•e: all• well's within 100 ' 3n A-2 c .A. r-tC L0 D gaX DEPTH' TO GROUNDWATER t depth to groundwater method of determination or '`approximation: rUD 016 fz 4 PH 12 . BUHSURFACE SEWAGE•':DISPOSAL SYSTEX INSPECTION, FORM PAR T­` FAILURE JORITERIA Lndzcate yes, noor not determined,'.. (Y, N, ,or ND)- . Describe. basis of determanat'ion ,`in ,all .i"nstances If` !'notdetermined" explain why: not. Backu` of sewa a dnto facility? ..11L�. .: P g y:• D g P g 9.. �.scnar a or and n of effluent to the of 'the round or . surface: waters? ; hx , _ SM1tatic liquid level in the dintribut�on' box° above outlet invert? L"iquid depth �'n cesspool <6" below invert-,oz .avaXlabl`e volume< 1/'2 day .f 1 ow?: f Required pumping A- times or more in> the last year' number of;, times'-pump ed Septic tank is meta . cracked? structurally `-unsound?.. substantial i:nfiItration. substantial: exfiltration? tank failure imminent' -s any portion: of ;the SAS cesspool: or privy:. below. the high' groundwater elevation? .� w-ithin "50 .feet of :a surface water?` .; within 100 feet of a surface water..s' p' or' tr'but ' to a surface waterrsupply? within a Zone ` I of- a `publ,ic well'. within 50 feet of: a bordering vegetated wetland or salt marsh :cesspools and "privies`' only,, no`t the 'SAS) ? within 50' feet , of .a private water supply. welly than 100 feet; but grea er than 50 feet from "a private water f supply we11 with no acceptable`°-water quality 'analysis? If, the well ut has been` analyzed to be acc6pt'able,, attach copy' of. well water "analyse. for oaliform bacteria, vol'atsle organic compounds, ammonia nitrogen and nitrate n itrogen. r .> :..'.,. .. r .�t r -. .. N.. . - , 9S 13 ,SUBSURFACE ,SEWAGE,'DISPOSAL :SYSTEM 'INSPECTION :FORM ` '•PART D CERTIFICATION . . Name of Inspector ,Q�njc2n-�,'n `: �' J,� oo� 1 . .� _ , < Company Name c...;.: � �� ,vG, . , :, ., Company Addre9s` 3 wIsL k t �z 6 ,� q.v qp ,2 fig; 4� Y3` 3 F: �. .Certa fa catYon S,�atemerit .. ; �° _ ,, , , "t > , ii' �4 t,.i:. 4 i . ji P}Z �b, }" .,. I' c�rrtaFr�.'that rtI'� ave, personally inspected the sewage` disposal syst.em *at A'' thls address and that the �a:nformation reported zs true, accurate „and °r ,> " complete as$ oi.f 4the ti1. fie; of inspection Thensp?ctin was performed and r any reG .1'. - data ons rregard,�ng1. upgrade, maintenance and repair <ar1.e;'� 4„"ar `«',s,4 dy, , '1 ,A r i, ` constistent°1. Nw�th ymy :traz_n3.ng sand"`exper�ence i%n the proper ;function and x '' { " 1. man�tenalj�nce of on s.ltssewage'illdisposal systems. A6'�11 t Y r f y r 1, ,q Che one E> a n' Y f F ''f s k r i s ;.. i - �. f i fi r I shave snot' fqund anynformatxon which nd�,cates"that the system 'fai ' `ta adequately protect rpubl c �t�ealth ' or :.the enviro�iment as, defined ink° r �„ I.310 CMR }15:303. "Any4 failure cr tear 4' ,,, �', is not evaluated are Fas state`d� y the �, AILUFtE CRTTER A sect` n t In io of: his form �,: ' , i. l r ♦. t - T !Ft b. r .. ,.l + I have determ1ned khat:: the , system fads to protect public health and ' 'r the envy ranment as" defined; i. 3'10 . . 15. 303.:., The.bests :for this ' determ�nation `a s% provided in t2ie FAILURE CRITERIA se:ctzon" of chis' form $ 1 . ., r Inspeetoris Signature r y ' - g j''y 4 7 j'St:r ti i r{ x c t ,r i r J, :&'-;,lu'i.�., �,.;.", -,,"��'� 11--/ -, . -,..'-L .- t y t.c Date j .- _:, 0�4, , F ��, r I..r'z i z t S r-' ./ �� .�� F' r j a !!! . `'pr;�gi.nal :6 'sys.tem owner „. 3 i F J _y {7 Al. Y 4 b 1 . �'" s �- if _ fys.v rI r�e�._a :.. r �. ,, -, # c N! b s t i s r x t �` { + 7: Copiesrto ,AI.Buyer (if :applicable) tApprov�ng ,auth`ority1. M Y: „' . ..nt^ .. r 1. 11 1. 1. i K; 1 r .. .t }" . ., �.t' . % t ( t n6y t -. 4y, YC 4 H ^ l A 4 s f r 4 ,fir , ',. C tz 2'4 c4 mnti • oq' r u h',w ' :r t r,, r t St ! �r� t ` k w y !. ,(' 1. z t {to .r i { � �+' ,t '� r !. r z t �i An . ,w 1 ar r 1�1Y 1.r aa. n t'" c"ll ._ 1-. L t. 6 y i ! fr t Y"r, y.r:A �yV } .., r4 '..° r.'S. " '4 t " :� i't t .�� ,. � �� �, M � :fro.. ,i';5, :.�� a�� : ,. IFAVM Loi' 1�Ss SMtF� M ST N oRTM TI— V f \V �C-�, M4SS, �- ScALF— 1``-U4' MAP-CH 1%191" .� APPR.ax Ts$r AAVZA { f 1 W l_ aT 1 W � 75 � N l2 +� r � tiu a TV 0 ?.�� ff cA FlowS�L►N�, *Z.0 1 lt1 a } , woo — _ 1e.l Ga�W►J � 9S SEPTAL _ �, + ' �?a 'p4�i1;'E'1f p,850Tt`?'tlaN 3 r,l .p ..,,�.�xa:�-...�.-��J7-:s-•,., ;.'�r..� .:.�'�-�yam;r;- ..rte ✓�.�. ....:.�.:.:n.+ js 190, N071-:- S A L E S ►=,Tib CE"�?`ilF`( Tu+ �Y�T Y� AS k-'T F L.E v. =IQ 0.0 • y -• R— IZ!, MIr1.Topsail Cover a°o o o a s ago 000 VWa shed PeaVone%/81=3/8° e e °e° �vv°o,a°a Ci� 4 Perfaru+lgd0r4ngeberg 19 Washed CrushedS}one3/4"-11/2" 4 Absorption Area ZOO 5/ •21/Z;► o ABSORPTION BED END SECTION � a o Ck s .1 -j Z 7 f�r P"Postd Flr„sh C3rpde y. '" fl Z 0- pti+ ����I,To Cover a l000 Gallon go% 1 1soo�000c eo - IWV.GS/0 SephGTank �" to°oO0Qj0OdO0 0001 P 6G IO°o°ooiio�oial 0 �T°� 7 `=� IVJv OVovd dVoa�t1301TOsLt DISPOSAL SY T-EM -PROFILE ;+n 4 M1n.gbore wa+ertable N0wlah, . 1-7NCovMTg2.S p X151 .1- T)15T, 30# 5` T A$SORpT1ON AREA= 9OO �• �� L0I �o �a 5� 30" ABSORPTION BED PLAN OBS. HOLE PERC. HOLE PERC RATE TEST DATE 7 ► v tr�� lio, prep 12'1 Loa, hNo 1�- L�l�r1 r-SvBSrx�. 40 PERC TEST SYS So16 S AT Q Z rATr-.v 1'314111. ¢LAM&L 7-V C,LAC,t&4 12-1, -` " ' Q MORTGAGE INSPECTION BAY STATE SURVEYING ASSOCIATES 234 CABOT ST., BEVERLY MA LOCATION t .NC�211...!PtN ���, } M/�.t� . NOTES: SCALE + I" x yD FT. DATE . I •This is a Mortgage Inspection survey and not an..• .....'" -�'"" instrument survey, therefore this plot Ian is for REFERENCE , . G' S'................... p .�S•� >C ., -i11C7 D(S7� mortgage inspection purposes only. • • •• •-••••-- -• -- • -. ... ....._. •This survey is based on survey marks of others. ••••... •• .. . - • Bushes, shrubs, fences and tree lines do not To -(VIO ,4•_ N ��o�KF_ -��C` •-•-. necessarily indicate property lines. -• t' • In my professional opinion the building(s)are not located The location of the building(s) as shown, either complied with the local zoning set backs at the time of construction or is exempt in the special flood hazard zone, as defined by H.U.D. p from violation enforcement action under Mass. G.L. Title VII •is recommended commendedsto dete mine prop. lines. rument survey Chapter 40A Section 7. •Offsets shown are approximate by tape survey. N Z0, D�1�l ESS EM E-N 5,F V,_RX C- 0 2 \9 v N Pk o po sFI-) � �, (POLI \ \\ f Z'w0 S-Dj 3q,,z3 ROM F'J+ No. %09J Iger ��C F. F„