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HomeMy WebLinkAboutMiscellaneous - 135 JOHNNY CAKE STREET 4/30/2018 135 JOHNNY CAKE,STREET 1 -_ — - - - - — - - treet /107.A-0187- 210 0000.0 - l I F I Commonwealth of Massachusetts W City/Town of No.Andover a System Pumping Record Form 4 'M 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. _ A. Facility Information Important: �� ' `� Q 2011 When filling out 1. System Location: forms on the TOWN OF NORTH ANDOVER computer, use Lir WENT only the tab key Address to move your No.Andover Ma 01845 cursor-do not use the return City/Town State Zip Code key. 2. System Owner: Q �►'YIC�_C� Cd P Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record lo1. Date of Pumping Date / 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) 24eptic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: � t--o 6. Ste Pumped By: Nr-Ek Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: St wart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Sign ture of ler Dat / Si nature f rn9 Y Facilit Date 9 t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts W CityfTown of No Andover System Pumping Record 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. c RCIEIVG� A. Facility Information Important:When APR 0 g 1014 filling out forms 1. System Location: on the computer, TOWN OF NORTH ANDOVER use only the tab JS I�e HEALTH DEPARTMENT key to move your Address cursor-do not No Andover Ma use the return key. City/Town State Zip Code 2. System Owner: Name rearm Address(if different from location) Ci /Town �' State Zip Code Telephone-Number B. Pumping Record y � 1. Date of Pumping Date T 2. Quantity Pumped: J �� Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): \ 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: I I _46 C v4r 6. System Pumped Name Vehicle License Number Ste rt's Se tic Service mpany 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signature of Hauler Date Signature of Receiving �Y Facili ` Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts RECEIVE® City/Town of North Andover A�R 10 2013 System Pumping Record TOWN OF NORTH Form 4 HEALTH DEPARTMENT� ^M 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, use only the tab I3Shrnny key to move your Address cursor-do not north andover Ma use the return key. City/Town State Zip Code 2. System Owner: Name Address(if different from location) north andover City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping ate 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) ❑ Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: Ru /1 (7av,e r� 6. SystemR sped By: Nares Vehicle License Number Stewart's Septic Service Company 7. Locatio where��contents were disposed: Stewart's e'freatment Plant, 20 So. Mill Bradford, Ma 01835 Signature of Hauler Date Signature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form �f� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s ry 135 Johny Cake St Property Address Comerford Owner Owner's Name formation is squired for every North Andover Ma 01845 8/17/2010 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 forms A. General Information on the computer, use only the tab 1. I nspector: key to move your cursor-do not Chad Jablonski use the return Name of Inspector key. Jablonski & Sons Inc. rab Company Name 167 Willow Ave Company Address Haverhill MA 01835 City/Town State Zip Code 978-360-9358 4574 Telephone Number License Number i 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 a� Inspec Signature Date The system i ctor shall submit a copy of this inspection report to the Approving Authority (Board of Health o EP) 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 1 of 17 Commonwealth of Massachusetts -- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name formation is squired for every North Andover Ma 01845 8/17/2010 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: SAS and all components in good working order. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts _ -- Title 5 Official Inspection Form Subsurface Sewage Disposal System For - _ g p y m Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is squired for every North Andover Ma 01845 8/17/2010 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh tsins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 3 of 17 Commonwealth of Massachusetts :- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is required for every North Andover Ma 01845 8/17/2010 page. City/rown 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 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: I D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts j Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is North Andover required for every Ma 01845 8/17/2010 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOTdue 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. 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts • : - 1 Title 5 Official Inspection Form sl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name formation is required for every North Andover Ma 01845 8/17/2010 page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of theoil S Absorption on S stem (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): no design Number of bedrooms(actual): 4 available DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): na 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts N ---�_ Title 5 Official Inspection Form n Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name formation is required for every North Andover Ma 01845 8/17/2010 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Attached Detail: Sump pump? ® Yes ❑ No Last date of occupancy: Occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? F1 Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 6 official Inspection Form;Subsurface Sewage Disposal system•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is y North Andover required for ever Ma 01845 8/17/2010 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 3/20/2009 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: na gallons How was quantity pumped determined? na Reason for pumping: na 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•09/08 Tale 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts a -^ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is required for every North Andover Ma 01845 8/17/2010 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: System is the original system, home was built in 1984 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1811eet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: na feet Comments (on condition of joints, venting, evidence of leakage, etc.): Watertight at foundation, pipe is cast iron and not PVC as previously stated Septic Tank(locate on site plan): Depth below grade: 12 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: na years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10.5'x 5.5'x 5.5' Sludge depth: 2" 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a„ 135 Johny Cake St Property Address Comerford Owner Owner's Name information is required for every North Andover Ma 01845 8/17/2010 page. CitylTown 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 31" Scum thickness minimal Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? measuring tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No sign of hydraulic failure or ponding Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts -� Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is required for every North Andover Ma 01845 8/17/2010 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 below9 rade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No i Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): x Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 11 of 17 Commonwealth of Massachusetts a - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 135 Johny Cake St Property Address Comerford Owner Owner's Name formation is required for every North Andover Ma 01845 8/17/2010 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 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.): Box is level and distributin equally 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .'� 135 Johny Cake St Property Address Comerford Owner Owner's Name information is required for every North Andover Ma 01845 8/17/2010 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: 2-41 i ❑ 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.): No sign of hydraulic failure or ponding_ i 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts ,ONO. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name formation is required for every North Andover Ma 01845 8/17/2010 page. CitylTown 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•09/08 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 •'` 135 Johny Cake St Property Address Comerford Owner Owner's Name information is required for every North Andover Ma 01845 8/17/2010 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately bUp 7n f A � z�^ , t L'J Cr t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts ---- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 135 Johny Cake St Property Address Comerford Owner Owner's Name information is North Andover Ma 01845 8/17/2010 required for every page. City/Town State Zip Code Date of Inspection D. System information (cont.) Site Exam: i ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 3611eet 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: Date Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) Accessed USGS database - explain: You must describe how you established the high ground water elevation: Depression in yard. Soils test at 150 Johny Cake performed 12/4/2006 by Bill Dufresne and witnessed by R. Burlet Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Summary Record Card generated on 8/20/2010 8:42:50 AM by Karen Hanlon Page 1 • Town of North Andover ` Tax Map # 210-107.A-0187-0000.0 Parcel Id 18014 135 JOHNNY CAKE STREET THOMAS COMERFORD 135 JOHNNY CAKE STREET NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1.02 Acres FY 2011 UB Mailing Index Name/Address Type Loan Number Active/lnact. From Until THOMAS COMERFORD Owner 135 JOHNNY CAKE STREET NORTH ANDOVER,MA 01845 LAMPASSI,JAMES Previous Customer Inactive 6/19/2007 135 JOHNNY CAKE STREET NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 14184.0-135 JOHNNY CAKE STREET Last Billing Date 6/2/2010 2100172 02 Cycle 02 Active UB Services Maint. Account No.2100172 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 92.65 /1 UB Meter Maintenance Account No.2100172 Serial No Status Location Brand Type Size YTD Cons 33530279 a Active ERT HH b Badger w Water 0.63 0.63 424 Date Reading Code Consumption Posted Date Variance 8/3/2010 769 a Actual 92 296% 5/3/2010 677 a Actual 23 6/9/2010 -8% 2/1/2010 654 a Actual 25 3/11/2010 -42% 11/2/2009 629 a Actual 43 12/11/2009 -60% 8/3/2009 586 a Actual 104 9/11/2009 267% 5/6/2009 482 a Actual 29 6/16/2009 14% 2/4/2009 453 a Actual 26 3/16/2009 -53% 11/3/2008 427 a Actual 56 12/10/2008 -54% 8/1/2008 371 a Actual 118 9/12/2008 280% 5/1/2008 253 a Actual 29 6/18/2008 -13% 2/5/2008 224 a Actual 37 3/14/2008 -66% 11/1/2007 187 a Actual 102 1/15/2008 -39% 8/2/2007 85 a Actual 85 9/14/2007 6/18/2007 0 n New Meter 0 6/18/2007 -100% 6/17/2007 5179 c Correction 42 6/18/2007 FINAL READING 2/28/2007 5137 m Manual estimate 38 3/23/2007 -38% 11/2/2006 5099 a Actual 38 12/22/2006 -64% Trouble Code:03 8/21/2006 5061 a Actual 129 9/13/2006 436% Trouble Code:03 5/25/2006 4932 a Actual 29 6/20/2006 5% Trouble Code:03 NORTH O�tt�eo OL O LAKI AORATEO,Pa��y SSAGHUS� PUBLIC HEALTH DEPARTMENT (ommunity Development Division Date: August 12,2010 Tom and Brenda Comerford 135 Johnnycake Street North Andover,MA 01845 Re: Building application for sunroom Dear: Mr. Comerford, Your application for the sunroom has been reviewed by the Health Department. The application was denied on, August 12, 2010, for the following reason as shown in italicized red only: Please note for future reference, according to our records your 9-room home currently has the maximum sized number of rooms allowed by MA DEP. The sunroom may only be made a 4- season room by also upgrading the septic system to fully comply with Title V. Feel free to call the Health Office at 978-688-9540 with any questions you may have. 1. ❑ Missing information 2. X Passing Title 5 inspection of septic system required per Title VMA DEP regulation 15.301(5) and(9). Your propertyfile indicated concerns regarding the septic system. In 2008, .2009, 2010 septic pumpers noted `full to cover", "riding high", and "massive solids" .3. ❑ Location of structure not acceptable 4. ❑ Undersized septic system To address the problem(s): If#1 is checked, please supply: a. Floor plan of existing and proposed addition—all rooms b. Certified plot plan showing house, septic system and proposed project in scale (you may pick up an as-built septic plan at the Health Office) If#2 is checked: 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fox 918.688.8416 Web www.townofitorthandover.com i �) DH �o GP rk �O SB W/ DH (FND) NOTE PLAN OF LAND SHOWING PROPOSED SUN ROOM r. N SITE IS SHOWN ON TOWN OF NORTH ANDOVER ASSESSORS 1 ao MAP #107A LOT #187 SUBDIVISION LOT #12 AND E.N.D.R.D. IN 1 BOOK #10799 PAGE #150 FOR SITE DEED. NORTH ANDOVER, MASSACHUSETTS L 3 DRAWN FOR .. THOMAS J. COMERFORD, JR. & o I HEREBY CERTIFY THAT THE BUILDING IS LOCATED ON THE LOT AS SHOWN." BRENDA J. COMERFORD 00 #135 JOHNNY CAKE STREET NORTH ANDOVER, MA SCALE: 1"=50' DATE: AUGUST 2, 2010 00rn 0 25 50 100 150 , "RRMACK ENGINEERING SERVICES t / 812110 ANDOMR YAMCMWM 01810 P1�7JM (9M) 475-MM FAX: (878) 478-1448 STEPHEN R.L.S. DATE allAft J IAOLCOM i= i LEGEND S.F. SQUARE FEET AC. ACRES SB W/ DH STONE BOUND WITH DRILL HOLE 8 (FND) FOUND W.F.D. WOOD FRAME DWELLING STY. STORY 2�5� 6 • PROPOSED SUN ROOM CK PATIO 1 Soo G0./SEpfrC ,�.,�K 2 .F DRY GARAGE D IVE O womA v #135 !1,• lGALTM DEPAR'MNI9 42' 44,501 S.F. =1 .0216 AC. n o) cl ' BUILDING PERMIT °F "° TOWN OF NORTH ANDOVER cVal ? APPLICATION FOR PLAN EXAMINATION Permit NO: DateReceived (� o� ��SSACHUS���y Date Issued: IMPORTANT Applicant must complete all items on this page ` � x!; s � � � �� '��3.�� - ��, " �„F� ;'�,z��. � -,-�� ..atm---.�-�.� •��,,�$,,,,,.7 LOCATIDN J. , _ "-r; at r r *u +�' r =•,x nW -.--sem �+�... -�. - a e PROPERTY OkVNER- IDIh + I�E'c al` YY�Gt^a�c5r k r � ) �t L �Xd}. rye; � TAT .F'a^"c 2,yy>y •�-��-�rPrJnt'� � ,� i+r-�--a* ���x .� a a..«�-�x +ter,� ,-�t...� � }tf a TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One fami Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other >' Septic W�eIIS x tFlood lam$` VU,etlands `�WatersheD�strict . IN-ater/S.ewer DESCRIPTION OF WORK TO BE PREFORMED: x Svu n Iden ' ation Ple se Type o Pri Clearly) �1 OWNER: Name: CeR /Yle� �G'c{' Phone: 6 r^ Address: Cc, a �CONTRAOR v .... , r Y�dds�<� � � c�� _� # �� � � . Aim & Superufis®ras,ConstructlonL� cense r k jExP1 ate 6 Z�� rne e'lmpro�entLicense -� .� �._�,�, �. i fz ARCHITECT/ENGINEER Azta- W48oAjPhone: (DOJ Address: 7 delVXX// Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 2�, �47.c�o FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregis ered c ntractors do not have access 0 t guaran and Si nature.of A en /Owner u natureof=contractor .,__ -w - - Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval, of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS i CONSERVATION Reviewed on Signature V01— COMMENTS,,Q/pr, �r(2 Gz azz / /I 4f HEALTH Reviewed on Signature r COMMENTS ��- 55 - �� Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street k FIREDEPAT T MENT� em �• A " . P Dumps teron site yeses no M , ; Located at 1 4 MainlStreet � a Fire Department�sia'na -"a.-*tai �+-C- ..r-. •.- 'e "?.�.- .N.v*x` .by`.a. a.! r-ti'r,c,,.+.erx�3c '°"` .._.`i,a,t56�.• ....� w� Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building. Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And . Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 a. Have the septic system inspected by a certified Title S inspector to determine whether it is operating properly: (inspector list attached) OR b. Tie-in to municipal sewer If#3 is checked: a. . Relocate the project If#4 is checked: Options a. Provide additional information proving that the existing septic system meets current capacity requirements. Please consult a professional engineer or registered sanitarian to determine the flow capacity of the septic system. b. Hire a professional engineer to design a new septic system that meets State Regulations c. Request approval of a deed restriction agreeing to always be a_-bedroom home. i. Submit a request in writing to the Board of Health identifying why the need to upgrade the septic system is a severe hardship. ii. Attend a BOH meeting to address the board iii. If approved, record the deed restriction at the registry of deeds Sincere' usan.Sa ,Public ealth Director Attached: List of approved North Andover Title V Inspectors Cc: Building Department File 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Board of Health North Andover 2009 - TITLE 5 INSPECTORS FOR THE TOWN OF NORTH ANDOVER Permit Status Doing Business As Permit No. Issued On Expires Phone CURRENT Albert lnnamorati BHP-2009-0435 01/01/2009 12/31/2009 (978)371-7014 CURRENT Benjamin C.Osgood,Jr. BHP-2009-0436 01/01/2009 12/31/2009 (978)435-1324 CURRENT Brian S.Murphy BHP-2009-0437 01/01/2009 12/31/2009 (508)947-5213 CURRENT Chad Jablonski BHP-2009-0438 01/01/2009 12/31/2009 (978)360-9358 CURRENT Charles J.Roux BHP-2009-0439 01/01/2009 12/31/2009 (978)640-9984 CURRENT Daniel R.Briscoe BHP-2009-0440 01/01/2009 12/31/2009 (978)372-2200 CURRENT Dean Dynan BHP-2009-0480 03/13/2009 12/31/2009 (508)726-9935 CURRENT Dean G.Luscomb II BHP-2009-0441 01/01/2009 12/31/2009 (978)774-4065 CURRENT F. Paul Cardone BHP-2009-0442 01/01/2009 12/31/2009 (978)407-1808 CURRENT Harold T. Lincoln,Jr. BHP-2009-0444 01/01/2009 12/31/2009 (978)369-1100 CURRENT James Boraczek BHP-2009-0445 01/01/2009 12/31/2009 (978)674-8803 CURRENT James H.Currier BHP-2009-0446 01/05/2009 12/31/2009 (978)774-6685 CURRENT James W.Wright(R.J. BHP-2009-0447 01/01/2009 12/31/2009 (978)681-5023 CURRENT John B.Nicholas BHP-2009-0448 01/01/2009 12/31/2009 (978)988-0777 CURRENT Joseph Delahunty BHP-2009-0449 01/01/2009 12/31/2009 (603)895-6305 CURRENT Lance Demond BHP-2009-0450 01/01/2009 12/31/2009 (978)853-3134 CURRENT Michael W.Reilly BHP-2009-0451 01/01/2009 12/31/2009 (978)475-1237 CURRENT N.Timothy White BHP-2009-0452 01/01/2009 12/31/2009 (978)948-8428 CURRENT Neil J. Bateson BHP-2009-0453 01/01/2009 12/31/2009 (978)475-4786 CURRENT Nicholas E. Hurlin BHP-2009-0454 01/01/2009 12/31/2009 (978)948-7441 CURRENT Patrick LeClerc BHP-2009-0483 11/18/2008 12/31/2009 (978)662-5111 CURRENT Paul J.Pisano BHP-2009-0455 01/01/2009 12/31/2009 (978)335-5661 CURRENT Peter F. Reilly BHP-2009-0456 01/01/2009 12/31/2009 (978)375-3750 ANDOVER 'Rec ), � o r d APR 0 3 2009 O�P.haJ p(ovldo0 )hl; lolm Irl ado 00 00 I 0^UI �09,CJ 01 nOgI ` 01118 IOC11 8Cd1c: c'! n0dltn pi CUtoi Ipa, 0 Syl dot ... 1'OR'NE WH ANDOVER A F a c l l l ty I n(o r M a c i o n HEALTH DEPARTMENT location; �+� (II CV{JrJnl,rpm'buUcn) 5���� I q7i n , i��eDnonl rr,m011 -- ' r;, � Fumping Ra�ord i c;26 , L'' •TYDo of eyslom,.. Co99pool(y) Sap0c Tan,, , vQ�-O',hsr (doscribs�: Ehluonl Too Flllo n �• ;rI``; :.','�' t � n0 IIy69. �8) C'sanao? @S ------------ ------------- � I ,r..i�^�Y;,,�1�,,�� �'�, �� �� II ?; ��'• �� OhIGB Joon{1 h'':,'^�J/ —. 11,1,arr.,�J�.dj, /1���,11,"i'•.I,ti 1. :' OCA I r ,, I. .I on �naie••Cor�lenla',ware dly oss0 Nx.ma .gov/dsF.�yalei/epproYaJs/Iblorm�.nl.mpl�9pocl .Irk! 4 , 'T S S • •}'y:}�� !fir 9,py{,,�'/'��,�'{(• 1�(,1}y ��',:n::;,;.7„ , ,t(J(1 '�. �'0" ,I 'Jy"�,,'(Ar�7����/Y�''�'M>v +�YJ;111t.i:1,�1.:�•. ' �I•. ..}.(t:. VYf I:r'� �� f �J r,��lrl�:e:(�` / ,,I' 4pY,,,,1: Ap[j '� ... . '1tt11 '+, rt,i„r't',��ir 1115,1„ lilr„f7,l;rl lt;,"n,li{�'. yi P %r ci ovi DEP,.has prded jhh form for usa b I ` ba tubmltted to th0.looal'Soard of Healt' �f ;r ds °& Haalth `�h rSycem Pumpine Recorc :r,;A•:::1•a {,r;;,':;.;;;:!•!.',::; Irtaab �` ty,' ' . ::A' •III .I � T �"' Facill nforrtlor n fillln 0 i 1 r �,.ut•' ystem•�Locatlonl Vle tib re •aM' Addr _ e s Y s to move yotu • Q,(�•�Q! C�r L�- riturll.ly,,Aa;'7,, 'Yi.�•M/. 1�.Jf�.(,`.ly),(`'IJi i.I�Jt''SYcNow. TPD pde Se 'i' f ,✓fl S'' .(SLI ',� i ir. it •I /: C . ••'a`•2`,�+ '"'`�l• t��,/J�4:f\,:;l�•.�'rl5,,,lili,t�+�'1, tlM `1J 4.•/!id:l• 1 ,�, y'`' I,Y��:: Jtl�a':r�J�','r:{;'!ba.;rl� ' `";�,11, �J t•,�1 'f, , .,,til;:`I� � Name ;v'j� 1 r,,(r•��nl,:,;1,.v,t - Address(If dlf(erenC rom tocaUon) ' • •.';�. ';•�1'.�tgrrTown,.:,l;.:r. i�l ; Sial Cod �-7 Telephone Number. 'IJ'�: ` '�1 Ii l%ta Iv I}G�k�,p,,t,l�?(Ialia)jt•71 >rJ�,,l,h•', '! ' • `1 Da,t�`of Pu `�' �'�` ump d �J ,.� mp�n9 „ Daate 2'; Quantity F e . . �� Type Pf ayatem' ,., Gsllons ❑ Cesspooi(s) eptic Tenk [] Tight Tank Other(descrlba�; I � .. •', r I,,tt,{QI I%ti.,i",'I'J•Iij� �j+�hv ,tJ •� - ffl14811t T88 �t)te( � I( �`1'1s8nt?_ ❑ •1 es 0 y99 W83 It�Cl9an i .',. .J l•J f !J•t +y'Y,H i ed? ❑. Yervo • ,! ' 7,.r1't>� ; ; fiC�on}ldi�lon Qf.�VY: m;;.�„:�,.,., .. .♦ '1 >A :,., 14Vt�/(J ri 1•I'�1 i. Lw,j1.1;11,1,�Ji l:�r��'',', ! • ':w-,'+ t :r:'•:` 1YlrftJ�ll�j�rl'�{'Yill�'+:A�'�% I� I p, .. � n �.,..! --• :'i.<,: ,;y.;+�+:v.i•lp'sY:;1+t(i.'i:�,l:'111,.'1}'j:t(�`.i�'��`1:r�;i' _ P�imped6yl ',` `:.,- '.(4:���:. ';,;'.�4�'4�,i:�,'•V.•I,;:il', im�•1�`b!,i�l:i'Y' � ;'}`',�7«�`'�' •I.:'�:•,.:' "' ��' '+-r-;' ���,,�`y'y��,``jl��r ,r �. ��' ,t ,�f,�',�;'• ��a• :, VehlcJellcan�a,Number .',r li�•�j�,sl`;��,�r%�+tiµ+, �1}r'YV�r•l' S' 1 n�!" j�1',V r,,r.��•''' - 1. . y t r.'r/htit r' Y,L`rM�,iaa �� ; ,:, :,':;;'. ,.;i; •'<•,, on.�here conc�nts Vre,ra dl;3posed� - '�.. .,.. 'S,l1r'. .:.'.ill','/,yt, t7li:Jr,ldt +14.•Ji,r1t4 :Ilia„ , ' - . 1 •I'• I�'.!'Y,1 \f'':l'^t y+ 1 �Ii'r�1 ''i.� 1},(` , -�-�/ � ' .. It ./,.:5�,1 Lj%..rN II ,i.F,,��'v�♦1�1,'rl:.�r�' .f Y CI. �I , t/ t Its '•Ii .r F sl 1 i 1 1I �� S•i," N.:S';';':ii%;�,! !iv})rt'pry �'i��J.i�•'tt••'.�:'J1i�d7 r 1p,tl�,J.� � I ! .,rc t J• It Q ,.: :>•:i 4•;N o:.'';.: :'t.,'; I 1. 17rii, I Ll, .I 4>rl�' Y.I t•W . . , _ (� ,r•� �7... 41 • ',,;' , :,,,;.:,;,�1•;•t,,��;:3;.ra;'., r.S(�n+lwe olHaule , „ uC1 ' htfpJ/v�vyy,mass,goWda !itiialer/approYaJs/t6forms,htrn#Inspect Sy:lam Pumping Record pjgq , .. . / -4.`,4r 0 : Q SNORT � NIOVER "MASSACHUSETTS I Vs. Jeri fit � ,� Record ';' •:. � r�1.'�ti �� 44�,f�t i l t I �t Y iµlt✓yff t f ti�f .. .. .. DEP has prov(ded this form for use by local Boards of Health. The Syst m Pump ng R cord must ::be submitted to the local Board of lisalth or other approving authority. n :t I APR — A 2lin7 Facility Information TOWN Or NORTH ANDOVER .r r•fWhettn•fullng,out System Location HEALTH DEPARTMENT COrtlpUter,,USeI / 5 �,. only the tab key Address :'to move your. cursor do not ` use the return Clty/Town State r ; •. Zip Code ke System Owner, r Y f Address(if different from location) City/Town State / C�JpCode '�`�/ .. ,' 6 _ Telephone Number Pumping Record to f r�' + 0 Pumping . 2. Quantity tIty Pumped. Gins Type of system ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe), 4 Effluent Tee Filter present?.❑ Yes f If yes, was If cleaned? ❑ Yes ❑ No { ';; { ditlon of S st$ t vYl 3J '� r A en tt ` ' 6 Sy eitl Pumped By: r VehiGe Ucen*e Number ,1 7• L`ocaUo' where contents Were df posed: r I t i J „ f Signa Haular',1, c' Date hUPWOww mass gov/dep/wafer/ap provals/t5forms.htm#lnyspect t5foMA.doC-06/03 System Pumping Record•Page 1 of 1 ttORTH O�Sis'9ti00 0? y. 6 L J pLAK§ 9 COCMIcM.. v ��SSAC Hus���y PUBLIC HEALTH DEPARTMENT (ommunity Development Division Date: August 12,2010 Tom and Brenda Comerford 135 Johnnycake Street North Andover,MA 01845 Re: Building application for sunroom Dear: Mr. Comerford, Your application for the sunroom has been reviewed by the Health Department. The application was denied on, August 12, 2010, for the following reason as shown in red only:. j 1. ❑ Missing information 2. X Passing Title 5 inspection of septic system required per Title V MA DEP regulation 15.301(5) and (9). Your property file indicated concerns regarding the septic system. In 2008,2009,2010 septic pumpers noted "full to cover", "riding high", and "massive solids" 3. ❑ Location of structure not acceptable 4. ❑ Undersized septic system To address the problem(s): If#1 is checked, please supply: a. Floor plan of existing and proposed addition—all rooms. b. Certified plot plan showing house, septic system and proposed project in scale (you may pick up an as-built septic plan at the Health Office) If#2 is checked: .a. Have the septic system inspected by a certified Title 5 inspector to determine whether it operating properly: (inspector list attached) OR b. Tie-in to municipal sewer If#3 is checked: 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fox 918.688.8416 Web www.townofnorthandover.com a. Relocate the project If#4 is checked: Options a. Provide additional information proving that the existing septic system meets current capacity requirements. Please consult a professional engineer or registered sanitarian to determine the flow capacity of the septic system. b. Hire a professional engineer to design a new septic system that meets State Regulations c. Request approval of a deed restriction agreeing to always be a_-bedroom home. i. Submit a request in writing to the Board of Health identifying why the need to upgrade the septic system is a severe hardship. ii. Attend a BOH meeting to address the board iii. If approved, record the deed restriction at the registry of deeds Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, Susan Sawyer, Public Health Director Attached: List of approved North Andover Title V Inspectors Cc: Building Department File 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com aSS _ G�►� c�. ��c� .. .... 12G Cs E/2 R/CA q R .L>s _. (�/e — _.. —a-f—L -A-,2 G _ co •0A o O f ��;• f tilln� ora com4mlo o � oy - � y lI' r y7S'�26 FORM U - LOT RELEASE FORM 7 i r INSTRUCTIONS: This form is used to verify that all necessaryprovals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ******************APPLICANT FILLS OUT THIS SECTION* APPLICANT PHONE_. Z/ LOCATION: Assessor's Map Number PARCEL. SUBDIVISION LOT (S) STREET ST..NUMBER USE ONLY********* RECO ' NDATIONS OF TOWN AGENTS:Z CONSERVATION ADMINI TRATOR DATE APPROVED DATE REJECTED COMMENTS i fd 41a. TOWN PLANNER DATE APPROVED (/(t' �`. DATE REJECTED j 6C 1\1&4-T COMMENTSA4I v FOOD INSP CTOR-HEALTH DATE APPROVED DATE REJECTED TIC PECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS C PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT • FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR ` DATE 40 x e I North Andover MIMAP 135 Johnny Cake August 4, 2010 A-018 101.4 01 ::....._,.. ...... 107.4-0200 l?' -' :- . .: , 0194 1 A-019 107.A-0181 •:•.. - 107.4-0191 •`L- 107.A-0199 106. 0 107.A-0190 107.A-0182 107.4-0189 107.A-0196 -- I, .. 107.A-0198 •'�='=';G .:_.�.••:: �lft.::__'•;_I; si., I, 107.A-0183 -- Sall - . 107.4-0227 ,� __..:•Ddu•:.•_: { `'�ltr.i::_ 107.A-019', 107. 0184 �� Ut .`.._ .___.:- ;•.:..:;i' 1o7.a-olss Bohr°' ..-_•. :::�-:•::-._. •.:�.::_••�,c�� 107.A-0152 .yi,. _: •.i,. 107.A-018.5 =--=:' • illli f 107.A-01.51 107.4-0187 .; 107.A-0186 107.A-0105 107.4-0104 :: '107.A-0009 107.A 0 I' 107.A-0106 107.4-0139 is== 107.A-0119 --d; vJdr:`":::"' 107.A-0011 107.A-0107 _:_:_.-••• f 107.A-0102 107.A-0108::... 107.A OO,S2 S03.1;0118 1 7.A-001 107./A-0018 107.4-0101 107.A-00. 101.A-0117 107.A- ''•;, 107. 1164 -Rall Une Interstates Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Interstate Meters Data Sources:The data for this map was produced by Merrimack- Major Roads NORTH Valley Planning Commission(MVPC)using data provided by the Town of Roads North Andover.Additional data provided by the Executive Office of Ce Easements ,�,, ♦tt�• a��00 Environmental AffalrslMassGIS.The information depicted on this map Is Trails 3' L for planning purposes only.It may not be adequate for legal boundary O •�•-• la deflnitlon or regulatory Interpretation.THE TOWN OF NORTH ANDOVER 0 MVPC Boundary MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING 0 Municipal Boundary < THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY At i ^ i OF THESE DATA,THE TOWN OF NORTH ANDOVER DOES NOT ❑Parcels ^o # ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF U Hydrographic Features .y '0e�e��c'� �j THIS INFORMATION --Streams ,SSAeMUSet Wetlands 0 Exempt Lands 1"=183 ft ,�, North Andover MIMAP 135 Johnny Cake August 4, 2010 tti` r 74 - r �[. r -' r� t . ''v r b i rz C) I � t p h Q7.A-0 x <u I, 1 Interstates Interstate Major Roads - Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Roads Meters Data Sources:The data for this map was produced by Merrimack t NORT1r 9 Valley Planning Commission(MVPC)using data provided by the Town of Ci Easements C t�`e o e.N� North Andover.Additional data provided by the Executive Office of C3 MVPC Boundary ? et c G Environmental Affairs/MassGIS.The Informatlon depicted on this map is C7 Parcels >t L for planning purposes only.It may not be adequate for legal boundary O p definition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING i Plow"W !, THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY •s ,^, i OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT ♦ o'+41 ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION SSACMUS� 1"=183 ft ^�° r` �17f ! ��t rrir � '/ \ 1�ttidi'" jMl y3b ae =t } ':1 + +, ��W� r•,rte ,� :�r �:.�{:a� �["���� ' ��` '�`' .}� F I � ¢ '+' '►�!} CVA, +:. 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C' �k/ �, w '• .� 7 7.f''r� ''l ;...ilt�, i.h�'L i St �i J��� i '~ .1 �,qw.',.�,., rr,,�t�� ,' ';4.y .rt i�`t�, r i r• z. i� S�,yy-� r s,�it k�t•.� �r S� �}iy i�','S t� r 'i •}I , �" "Mf"t t '..'•"r it '�`R� i J t� � '{"i�'• - t`�,` i �J.�l�r r� 1+�{ i �� �VflREScheck Software Version 4.3.1 Compliance Certificate Project Title: Sun Room Energy Code: 2009 IECC Location: North Andover,Massachusetts Construction Type: Single Family Conditioned Floor Area: 192 M Glazing Area Percentage: 83% Heating Degree Days: 6322 Climate Zone: 5 i Construction Site: Owner/Agent: Designer/Contractor: 135 Johnny Cake Street Tom Comerford Arthur Watson North Andover,MA 01845 135 Johnny Cake Street A.F.Watson General Contracting North Andover,MA 01845 3 Edgemont St. 978-761-0570 Derry,NH 03038 comerfordb@comcast.net 603-661-5360 afw56@comcast.net li Meft Mum Floor 1:All-Wood Joist/Truss:Over Outside Air 192 38.0 0.0 5 Wall 1:Wood Frame,16"o.c. 180 19.0 0.0 2 Orientation:Unspecified Window 1:Wood Frame:Double Pane with Low-E 150 3.000 450 SHGC:0.00 Orientation:Unspecified Ceiling 1:Flat Ceiling or Scissor Truss 192 38.0 0.0 6 Project Title:Sun Room /02/10 08 Report date: Data filename: Untitled.rck Page 8 4 ClREScheck Software Version 4.3.1 Inspection Checklist Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:3.000 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Outside Air,R-38.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. M Corners,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Project Title: Sun Room Report date: 08/02/10 Data filename: Untitled.rck Page 2 of 4 ` Vapor Retarder: Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification and Installation: Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. Materials and equipment are identified so that compliance can be determined. Li Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. LI Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Duct Insulation: Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: L1 Building framing cavities are not used as supply ducts. All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). ❑ Duct tightness test has been performed and meets one of the following test criteria: (1)Postconstruction leakage to outdoors test:Less than or equal to 15.4 cfm(8 cfm per 100 ft2 of conditioned floor area). (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 23.0 cfm(12 cfm per 100 ft2 of conditioned floor area)pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 11.5 cfm(6 cfm per 100 ft2 of conditioned floor area) when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 7.7 cfm(4 cfm per 100 ft2 of conditioned floor area). Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. LI For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). i Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. Ll Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: C] HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an on/off heater switch. 0 Pool heaters operating on natural gas or LPG have an electronic pilot light. Ll Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Project Title: Sun Room Report date: 08/02/10 Data filename: Untitled.rck Page 3 of 4 ` Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage<=15 (d)50 lumens per watt for lamp wattage>15 and—40 (e)60 lumens per watt for lamp wattage>40 Other Requirements: Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement'C). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. I NOTES TO FIELD:(Building Department Use Only) I Project Title: Sun Room Report date: 08/02/10 Data filename: Untitled.rck Page 4 of 4 �J( 2009 BECC Energy Efficiency Certificate Ceiling/Roof 38.00 Wall 19.00 Floor/Foundation 38.00 Ductwork(unconditioned spaces): RiT@jBftWMQ MM7 Window 3.00 Door .( .. MOM Water Heater: Name: Date: Comments: The Commonwealth of Massachusetts c I Department of Industrial Accidents , h Office of Investigations 600 Washington Street U e Boston, MA 02111 s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lellibly Name (Business/Organization/Individual): ��` 1 S�� V �yU 6ouT Address: o �. W City/State/Zip: C C r ry <2�6O3 Phone #: 6�9 Ar�an employer?Che4thappropriate box: Type of project(required): 1. I am a employer with 4. ❑ I atn a general contractor and I 6. ❑New construction employees(full and/ore).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer thatis providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Le,L,'—'Ss Policy#or Self-ins. Lic.#:l Expiration Date: Job Site Address:/ .1 IllNy OCt 7- City/State/Zip: Pl/�pk Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby c rti ins a e eijury that the information provided above is true and correct.- Si nature: / 2 Date: Phone#: 6 6� (6 � 5��0 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as'a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02.111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.govEdia i v 1 i 6 � t� n �y 5 t��! i MAR - 2 2005 -o\jER TOWN pF NpEPAR�pjH `vMEN� HEALTH If s' t � t t �l� RFS Mq Tp�C�FN 2 2006 yo�ART�iF"��r �vr ? e i l I s \ r x i r I�. i MAR `Z 2005 TOWN OF NDEppRTM NT R HEALTH i Bat 135 Johnnycake Street Page 1 of 1 DelleChiaie, Pamela From: C Susan Northam [snortham@napd.us] Sent: Wednesday, February 27, 2008 8:09 AM To: DelleChiaie, Pamela Subject: RE: Bat- 135 Johnnycake Street Good morning Now we'll wait and see the results. When 1 hear I'll call you if you hear call me Thanks SusieQ -----Original Message----- From: DelleChiaie, Pamela [ma i Ito:pdellech@townofnortha ndover.com] Sent: Tuesday, February 26, 2008 2:14 PM To: Susan Sawyer Cc: C Susan Northam; Rillahan, Deb Subject: Bat - 135 Johnnycake Street Hi; As I mentioned earlier; Sue Northam called in regarding a bat that was just captured by a pest control company at 135 Johnnycake after being in the home for a period of one week. The family is concerned about possible rabies exposure. I The homeowner, Brenda Conniford has brought the bat over to Andover Animal Hospital for rabies testing. If you need to call the h/o, her number is 978.687.0280. BBSf R¢gaads, Pawl&DBBB040.4 ai¢ Health Department Assistant Town of North Andover 1600 Osgood Street Building 20,Suite 2-36 North Andover,MA o1845 2978.688.9540-Phone 978.688.8476-Fax httpj/lHTy_.townofnorthandover.com healthdept@townofnorthandover.com I i i I I I 2/27/2008 North Andover Board of Assessors Public Access Page 1 of 1 1-1d ,IORTy Town oti' W0 !'1.:[dor{ ,. $o�>of, Assessoxs 0 k r �sewuse Property Return to the Rome page click on logo Record Card Parcel ID:210/107.A-0187-0000.0 Community:North Andover SKETCH PHOTO New Search Click on Sketch to Enlarge Click on Photo to Enlarge Sales Summary Residence Detached Structure. Condo Commercial Y Comparable Sales 135 JOHNNY CAKE STREET X Location: 135 JOHNNY CAKE STREET Owner Name: LAMPASSI,JAMES J THOMAS COMERFORD Owner Address: 135 JOHNNY CAKE STREET City:NORTH ANDOVER State:MA ZIP:01845 Neighborhood:8-8 Land Area:1.02 acres Use Code: 101 -SNGL-FAM-RES Total Finished Area:2478 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 584,600 610,300 Building Value: 357,500 371,400 Land Value: 227,100 238,900 Market Land Value:227,100 Chapter Land Value: LATEST SALE Sale Price:327,500 Sale Date:01/13/1994 Arms Length Sale Code:Y-YES-VALID Grantor:.BELL,MICHAEL Cert Doc: Book:03960 Page:0015 http://csc-ma.us/NandoverPubAcc/jsp/Home jsp?Page=3&Linkld=1181876 2/27/2008 Town of North Andover f NORTH Community Development and Services Division Office of the Health Department e p 400 OSGOOD STREET North Andover,.Massachusetts 01.845I-so S Susan Y.Sawyer,REHS/RS sacNuSe� Public flealt-h Director (978)688-9540-.Phone (978)688-9542-Fax Date: , Address: 1 ::Y(9 North Andover,MA 01845 Coal<,e_ �� J Re: Application for: 31`�( GGm PCt S I Dear: ( . m�(t✓� t Your application fora.Bur 16-AN fUrni at 1v�hn� �-h � as been reviewed by the Health Department. The application was denied on, .�g (� ,ate 2004 for the following reasons: 1- Missing information 2. Gds Passing Title 5 inspection of septic system required 3. ❑' Location of structure not acceptable 4. ❑ Undersized septic system To address the problem(s)- If#1 is checked, please supply: Floor plan of existing and proposed addition-all rooms b. Certified plot plan showing house,septic system and proposed project in scale If#2 is choked: a. Have the septic system inspected by a certified Title 5 inspector to determine the size of the system and whether it is operating properly: OR b. Tie-in to municipal sewer If#3 is checked: a. Relocate the project If#4 is checked: a. Provide additional information proving that the existing septic system meets current capacity requirements. Please consult an engineer to determine the flow capacity of the septic system. Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, c � Re ewer Cc: Building Department File 130ARD OF APPGAL.S 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE: 68,9-9543 PLANNING 688-9535 I r� ^, > i .. r t 1 �{' --- ._.. � I Commonwealth of Massachusetts = City/Town of North Andover System Pumping Record 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, T / use only the tab key to move your Address cursor-do not North Andover use the return CitylTown State Zip Code key. 2. System Owner: A AL Name moan Address(if different from location) City/Town State Zip Code Rio 60 - �a©a Telephone Number B. Pumping Record i 1. Date of Pumping uantity Pumped: Date Gallons 3. Component: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Observed coMndition f component pumped: Il e�c 1 o W 6. Sys u .fed UUP Name Vehicle License Number Stewarts Septic 58 So Kimball St Brad ord Ma Company 7. Location where contents were disposed: 0 so mill ford m // Si ature of Hauler Date ignature of Receiving Facility(or attach facility receipt) Date t5form4.doc•11/12 System Pumping Record•Page 1 of 1