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Home My WebLink AboutMiscellaneous - 1365 SALEM STREET 4/30/2018 (2) t _ 1365 SALEM STREET21W1_06-A-0139-0000-0 j i ij Residential Property Record Card PARCEL_ID:210/106.A-0139-0000.0 MAP:106.A BLOCK:0139 LOT:0000.0 PARCEL ADDRESS:1365 SALEM STREET PARCEL INFORMATION Use-Code: 101 Sale Price: 0 Book: 01244 Road Type: T Inspect Date: 05/27/2002 Tax Class: T Sale Date: 12/31/1973 Page: 0602 Rd Condition: P Meas Date: 05/27/2002 Owner: Tot Fin Area: 2364 Sale Type: Cert/Doc: Traffic: M Entrance: D DOHERTY, RICHARD M Tot Land Area: 1.01 Sale Valid: N Water: Collect Id: RRC MARGARET A DOHERTY Grantor: Sewer: Inspect Reas: C Address: 1365 SALEM STREET Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LOW Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 7 Main Fn Area: 1338 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE. R1 Story Height: 2 Bedrooms: 4 Up Fn Area: 1026 Bsmt Area: 1338 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1 194,277 Ext Wall: AV Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.01 47 Masonry Trim: Ext Bath Fix: Tot Fin Area: 2364 VALUATION INFORMATION Foundation: CN Bath Qual: T RCNLD: 245569 Current Total: 464,400 Bldg: 270,100 Land: 194,300 MktLnd: 194,300 Kitch Qual: T Eff Yr Built: 1983 Mkt Adj: 1.1 Prior Total: 444,400 Bldg: 259,200 Land: 185,200 MktLnd: 185,200 Heat Type: HW Ext Kitch: Year Built: 1973 Sound Value: Fuel Type: G Grade: G Cost Bldg: 270,100 Fireplace: 1 Bsmt Gar Cap: Condition: A Att Str Val1: Central AC: N Bsmt Gar SF: 610 Pct Complete: Att Str Va12: Att Gar SF: %Good P/F/E/R: /100/100/89 Porch Tvoe Porch Area Porch Grade Factor E 20 P 294 SKETCH PHOTO 21 P 244 Sq.R. habAML 14 14 No Picture 14 1 10 40 38 10 610 q.R. 338 5� B/FM 6 Sq.Ft. flable A C4-P-MA 0 25 27 26 26 14 110 y Parcel ID:210/106.A-0139-0000.0 as of 7/26/05 Page 1 of 1 North Andover Board of Assess Public Access Page 1 of 1 Parcel ID: 210/106.A-0139-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge No Picture Available Location: 1365 SALEM STREET Owner Name: DOHERTY,RICHARD M MARGARET A DOHERTY Owner Address: 1365 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: 2364 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 464,400 444,400 Building Value: 270,100 259,200 Land Value: 194,300 185,200 Market Land Value: 194,300 Chapter Land Value: LATESTSALE Sale Price: 0 Sale Date: 12/31/1973 Arms Length Sale Code: N-NO-OTHER Grantor: Cert Doc: Book: 01244 Page: 0602 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=467503 7/26/2005 ORT Town of North Andover -0 ,� k 41190 1�1ti Office of the Health Department Community Development and Services Division o 400 OSGOOD STREET North Andover, Massachusetts 01845 �9Ss�cHus�t4y Susan Y. Sawyer, REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax CE9WFICA2T600(F C09W(L'EGIAi1VCE As of: Al- ovemder 22 2005 This is to cert that the individual su6surface disposal system was Fully W. paired by ,john Soucy � At 13 65 Salem Street North Andover, 911,4 01845 Yfas 6een instaffed in accordance with the provisions of Titfe V of the State Sanitary Code and with the North Andover Board of Yfealth regulations. 'The Issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. ichele E. Grant Pu6fic Yfealth Inspector 13O;ARU(.)I ,11'PI'AI S 688-yi l.I IMILDIN(i 688-9545 (UNSIRVA IION 688-053(1 1 IGA1 A'11 r,88-O;40 PI.ANNIN(i 688-1)535 NEW ENGLAND ENGINEERING SERVICES INC September 30, 2005 R ECEIVED Ms. Susan Sawyer 0 2005North Andover Board of Health 400 Os ood Street TOWNRTH ANDOVERg HEAPARTMENT North Andover,MA 01810 Re: 1365 Salem Street North Andover, MA As-Built Septic System Design Dear Ms. Sawyer, The following As-Built Plans for the above referenced property are being submitted for approval. 1. Three(3) Copies of the As-Built Septic System Design Plans. If you have any comments or questions please do not hesitate to contact this office. Sincerely, )i�mb^e'reB'r'ot_ Assistant to Benjamin C. Osgood Jr.,P.E. 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 FINAL GRADE INSPECTION Date: Address: /LOAMED? E SEEDED? ❑ COVER PER PLAN. Other: l l �J TOWN OF NORTH ANDOVER t NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES ° �� ° p HEALTH DEPARTMENT 400 OSGOOD STREET 40 NORTH ANDOVER, MASSACHUSETTS 01845 �'ss„c„5 t� Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX healthdepttcatownofnorthandover.com WEBSITE:httD://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned certify that the Sewage Disposal System( ).constructed; (\r)repaired; by 1.o H S�c y (Prin—t Name) located at �� L,�_ S IaLe w%. S-a E' (Installation Address) was installed in conformance with the North Andover Board of Health approved plan,originally dated / a 4,L95' and last Revised on ��/ ,with a design flow of yyD gallons per day. The materials used were in conformance with those specified on the approved plan;the system was installed in accordance with the provisions of 310 CMR 15.000,Title 5 and local regulations,and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Repr a tati ignature) And-Print Name Final inspection date: 10 119 L En-gineir Representative( ignature) Ce And-Pr1ht Name Installe dWl (Signature) Date: _. JOGC And-Pri Name Engineer: (Signature) Date: ,ffCEIVED NOV 1"8 2005 And-Print Narfie TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 1365 Salem Street- Final Inspection Request Page 1 of 1 O 0 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Monday, September 26, 2005 8:00 AM To: DelleChiaie, Pamela Subject: RE: 1365 Salem Street- Final Inspection Request All set for this morning (Monday 9/26) at 9:00. Dan Daniel Ottenheimer,President Mill River Consulting,Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultin2.com dano@millriverconsulting.com From: DelleChiaie, Pamela [mai Ito:pdellechia ie@townofnortha ndover.com] Sent: Friday, September 23, 2005 3:22 PM To: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail); McBrearty Andrew (E-mail) Subject: 1365 Salem Street - Final Inspection Request Hi, Please schedule the above for a final. Call John Soucy at: 603.216.7175 Bgsf R¢gwtds, Pa#i¢Bw DaB4040e lalO Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http:/Jwww.townofnorthandover.com healthdept@townofnorthandover.com 11/18/2005 V DelleChiaie, Pamela From: amcbrearty@verizon.net Sent: Friday, November 18, 2005 4:15 PM To: DelleChiaie, Pamela Subject: 1365 Salem Street- Final Inspection Request �f 1365 Salem Const. Insp..doc Hi Pam, I thought I sent you this. I seem to be missing archived e-mails from other inspections I sent. . . can you tell me which ones you don't have from us yet? I have written up all the ones we have done, except for the last two (Gray & R.Tavern) but don't have a record of sending them out. thanks, -andy 1 �� , ,o ��e� ��° 0 DelleChiaie, Pamela From: amcbrearty@verizon.net Sent: Thursday, October 06, 2005 11:33 AM To: DelleChiaie, Pamela; Sawyer, Susan; Grant, Michele Cc: info@millriverconsulting.com; lisal@millriverconsulting.com Subject: Const. Inspections (tardy) 29 Bradford Cons .Insp.docPamela, I am sendinon inspections (29 Bradford St & 1365 Salem St. ) which were done in the last few weeks. No problems on either. I apologize for the late-ness of these, and will get the reports to you in a more timely manner in the future. Regards, -andy 1 ' Q 4 O TOWN OF NORTH ANDOVER f pOR7N Office of COMMUNITY DEVELOPMENT AND SERVICES °`''Lte HEALTH DEPARTMENT 400 OSGOOD STREET ► � <si.iiw• 4 r NORTH ANDOVER,MASSACHUSETTS 01845 �'9Ss;;CH„gt�' Susan Y. Sawyer,.REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX ADDRESS: 1365 Salem Street MAP:106A LOT: 139 INSTALLER: Soucy Septic DESIGNER: NEES PLAN DATE:7/27/2005 BOH APPROVAL DATE ON PLAN: 9/7/05 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 9/26/05 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS El Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged El 1500 gallon tank has been installed H-10 loading 2-piece construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) El Inlet tee installed, centered under access port 0 Outlet tee gas baffle installed, centered under access port IK 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present IKI Hydraulic cement around inlet & outlet Comments: Page 1 of 3 0 a TOWN OF NORTH AN ORT DOVER ,► H Oftao •1ti Office of COMMUNITY DEVELOPMENT AND SERVICES _ 3 t N b A HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged El 1000 gallon Combo tank installed H-10 loading - 2 piece construction El Inlet tee installed, centered under access port 0 Pump(s) installed on stable base [E] Alarm float working 121 Pump On/Off float working 0 Drain hole in pressure line El 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved (Visual testing. El Hydraulic cement around inlet & outlet Comments: Combo tank (see Septic notes) D-BOX 0 Installed on stable stone base 121 Inlet tee (if pumped or >0.08'/foot) El Hydraulic cement around inlet & outlets El Observed even distribution Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan IRI Size of SAS excavated as per plan 0 Title 5 sand installed, if specified on plan El laterals installed and ends connected to header (and vented if impervious material above) 0 Gravelless disposal systems: type, number and location as per plan M Elevations of laterals installed as on approved plan 0 40 Mil HDPE barrier installed ❑ Final cover as per plan Comments: 6 rows of 5 chambers each. Page 2 of 3 Q0 • TOWN OF NORTH ANDOVER cf NORTH 1 •,,,..• ,• do Office of COMMUNITY DEVELOPMENT AND SERVICES �? •�d :• �p HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845 ��.9 CHUS t Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-FAX CONTROL PANEL ❑ Alarm & Pump are on separate circuits 0 Alarm sounds when float is tripped 0 Location of control panel: Basement ❑ Rated for exterior if placed outside Comments: Could not access Basement-Try to enter at final grade inspection SYSTEM ELEVATIONS Benchmark: 100.00 Rod at Benchmark: 4.68 Height of Instrument: 104.68 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 94.99 Septic Tank IN 93.1 5 94.77 Septic Tank OUT 9290 94.49 Pump Chamber IN 92.85 94.38 Pump Chamber OUT 92.60 --- Distribution Box IN 99.31 99.34 Distribution Box OUT 99.14 99.16 Lateral 1 TOP 99.50 99.49 Lateral 1 TOP 99.50 99.47 Lateral 2 HIGH 99.50 99.50 Lateral 2 LOW 99.50 99.46 Lateral 3 HIGH 99.50 99.48 Lateral 3 LOW 99.50 99.47 Lateral 4 HIGH 99.50 99.48 Lateral 4 LOW 99.50 99.47 Lateral 5 HIGH 99.50 99.48 Lateral 5 LOW 99.50 99.47 Lateral 6 HIGH 99.50 99.48 Lateral 6 LOW 99.50 99.47 Page 3 of 3 1365 Salem Street - Final Inspection RequestO Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com) Sent: Monday, September 26, 2005 8:00 AM To: DelleChiaie, Pamela Subject: RE: 1365 Salem Street- Final Inspection Request All set for this morning (Monday 9/26) at 9:00. Dan X Daniel Ottenheimer,President Mill River Consulting, Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millrivercon_sulting.com daaQ@millriverconsultina.com From: DelleChiaie, Pamela [mai Ito:pdel lech iaie@townofnorthandover.com] Sent: Friday, September 23, 2005 3:22 PM To: Daniel Ottenheimer(E-mail); Lisa LeVasseur (E-mail); McBrearty Andrew (E-mail) Subject: 1365 Salem Street - Final Inspection Request Hi, Please schedule the above for a final. Call John Soucy at: 603.216.7175 i gag!Ragam(s, P41*00,a AN&.0401410 Health Department Assistant Town of North Andover j 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 9/26/2005 e TOWN OF NORTH ANDOVER Q NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES ►°3 �''" '�"°� HEALTH DEPARTMENT 400 OSGOOD STREET a .. NORTH ANDOVER, MASSACHUSETTS 01845 �s 4C e s��s Susan Y. Sawyer, RENS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 6-Z /� �r MAP:_ LOT: INSTALLER: DESIGNER: S / PLAN DATE: Oo cj BOH APPROVAL DA 1 'ON PLAN: ► ` / DATE OF BED BOTTOM INSPECTION: (' S DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = LOADING OF SEPTIC TANK = GALLON PUMP CHAMBER = (}(� LOADING OF PUMP CHAMBER TYPE OF SAS = DIMENSIONS AND DETAILS OF SAS: SITE CONDITIONS IBJ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer Comments: ElTopography not appreciably altered Page 1 of 4 a TOWN OF NORTH ANDOVER O Office of COMMUNITY DEVELOPMENT AND SERVICES �:•''`_` '1"°0� HEALTH DEPARTMENT t « ; 400 OSGOOD STREET , �• La. NORTH ANDOVER, MASSACHUSETTS 01845 a�crwsc Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged 11 gallon Pump Chamber Installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: Page 2 of 4 O TOWN OF NORTH ANDOVER 0 NORT► Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845CH S�cHus Susan Y. Sawyer,RENS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM/ Bottom of SAS excavated down to C soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Comments: Final cover as per plan PRESSURE DISTRIBUTION 11 inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all q laterals Comments: Elorifice size inch as per plan Page 3 of 4 O TOWN OF NORTH ANDOVER 0 NoarM Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET "►�. . NORTH ANDOVER, MASSACHUSETTS 01845 � s�cNusa� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV @ TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN —Pump Chamber OUT Distribution Box IN D-Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 6043 Date....... . .. ... .. ......... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING "SeL ACHUS ... ................................................. This certifies that .................................. 7 ission to perform ............. .. has perm wiring in the building of....... ........ ......................... at...........r/ 9 � ........... ............ .North Andover,Mass.s. ....................... s Lic.No. ........ C 7 1INSPECTOR*1� .......... .. ELE Check # `Commonwealth of Massachusetts Map-Block-Lot f *.�y�a• ,aa# 106A- -139 Board of Health ----------------------- Permit No s North Andover BHP-2005-Q268 �► .�., P.I. ti"rgr d''�i - FEE s F.I. $250.00 ----------------------- i Disposal Works Construction Permit I Permission is hereby granted John Soucy i -------------------------------------------------------------------------- j to(Repair)an Individual Sewage Disposal System. at No 1365 SALEM STREET ------------------------ -- ---------- ------------- - - - - ------- ---- -------- ------------------------------------------- --- --------------------------- as shown on the application for Disposal Works Construction Permit No. BHP-2005-026 Dated August 24,2005 ------------------ - ----- Issued On:Aug-24-2005 U FB ------ ------ -------- --------------------------------------- ---- oar of Health ........t...............................................to...............t........■....i��.t.■...... ...................... ........... .................................. o�a.�ae Commonwealth of Massachusetts 106A- Block- of Board of Health -------------------- �� • North Andover w � .,.� Certificate of Compliance THIS IS TO CERTIFY,That the Individual Sewage Dispo em (Repair) j by John Soucy _ - - - ------- ------- ------- ------- - ------- ------ -------- --------- Installer at No 1365 SALEM STREET----- i -- - ----- --- --- ----------------------------------------------------- - has been installed in ance with the provisions of TITLE 5 of the State Environmental Code as described in the application f posal Works Construction Permit No. BHP-2005-026 Dated Aust 24,2005 ----- --- ---------------------------------------- Printed On:Aug-24-2005 Board of Health ------ -------------------- - - -------------------•----------- ----- -- Town of North Andover Health Department Date: Location: esident 1,or Name of Business) (Indicate Address, if R Check#: F;7 cL Type of Permit or License:(Circle) > Animal $ ➢ Dumpster > Food Service-Type.- $ > Funeral Directors $ f > Massage Establishment $ > Massage Practice $ > Offal(Septic)Hauler $ > Recreational Camp $ > SEPTIC PERMITS: El Septic-Soil Testing Ll Septic-Design Approval $ 0 4Stic Disposal Works Construction(DWO$_ o Septic Disposal Works Installers(DWI) $ > Sun tanning $ > Swimming Pool $ > Tobacco $ > Trash/Solid Waste Hauler > Well Construction > OTHER:(Indicate) 497 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer 0 0 TOWN OF NORTH ANDOVER "OR711 iOffice of COMMUNITY DEVELOPMENT AND SERVICES �r°e', HEALTH DEPARTMENT p 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 SwCHUs 978.688.9540—Phone Susan Y.Sawyer,REHSIRS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com-e-mail www.townofnorthandover.com-website APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: � {,Zt-� 0,J>P'0 m LOCATION: HOMEOWNER NAME: )00 hen LICENSED INSTALLER NAME: PLEASE PRINT SIGNATURE: 6fs TELEPHONE# q-7ko' CHECK ONE: FULL SYSTEM REPAIR: ($250) COMPONENT REPAIR(indicate what parts): ($125) * NEW CONSTRUCTION: * If NEW CONSTRUCTION, please attach the Foundation As-Built Plan. $250.00 or$125 Fee Attached? Yes No Project Manager Obligation From Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes No + e Approval of Health Agent Date: 0 . Q y Y '4 INSTALLER PROJECT MANAGEMENT OBLIGATIONS A As the North Andover licensed installer for the construction of the septic system for the property at S:, relative to the application Of-TI/6. �T dated 8- X11/ 6�- for plans by 41. and s dated.-7 a-2– with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the j system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b Final inspection — Engineer p g eer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Unde ned Licensed Septic staller `ogDate: z = �tI— Ji i Di osal Works Const ction P it# Town of North Anov r Health-Depirrtment Date: Location: (Indicate Address, if Residential,or Name of Business) Check#: 111'e17 / �45ti Type of Permit or License: (Circle) `. ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type.-- > ype:➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ eptic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Trash/Solid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) i Health Agent Initials 536 White-Applicant Yellow-Health Pink-Treasurer o 0 Commonwealth of Massachusetts = City/Town of Number Application for Septic Disposal System � Construction Permit - TOWN OF 1250.00—Full Repair $125.00 -Component NORTH ANDOVERMA 01845 Fee Form 1 A DEP has provided this form for use by local Boards of Health if they choose to do so. Before using the form, check with your local Board of Health to make sure that they will accept it. A. Facility Information Important: When filling out Application is hereby made for a permit to: ❑ Construct a new on-site sewage disposal system forms on the Repair or replace an existing on-site sewage disposal system computer, use only the tab key ❑ Repair or replace an existing system component to move your cursor-do not 1. Location of Facility: use the return key. I Adds 67 Lot# City/Town ( State Zip Code recon 2. Owner Information N e 1 C' Addr s((if different from above) City/Town State Zip Code Telephone Number 3. Installer Information / DLV LA a7 `S Name Name of Compa OA-, Add ss 00 V'01 City own L State Zip Code T phone N ber 4. Designer Information Name Name of Company �oaedlL Address /U -, 014 et/S City/Town State Zip tode t5form1a.doc•06/03 Application for Disposal System Construction Permit•Page 1 of 3 Commonwealt of Massachusetts a F City/Town of a U� Application for Septic Disposal System Number Construction Permit - TOWN OF $250.00—Full Repair $125.00- Component NORTH ANDOVER, MA 01845 Fee Form 1 A Telephone Number A. Facility Information (continued) 5. Typ of Building: Dwelling ❑ Garbage Grinder(check if present) Other: Type of Building �"`` Number of Persons Served 2/showers Number of showers ElCafeteria ElOther fixtures Specify other fixtures: 6. Design Flow: q LID p4�� Gallons per Da Calculated Daily Flow: Gallons 7. Plan: Date of Original Number of Sheets Revision Date Title of Plan 8. Description of Soil: 9. Nature of Repairs or Alterations if applicable): p ( t5form1a.doc•06/03 Application for Disposal System Construction Permit•Page 2 of 3 Commonwealt9of Massachusetts Q City/Town of �W Application for Septic Disposal System Number a o Construction Permit — TOWN OF $250.00– Full Repair $125.00-Component NORTH ANDOVER, MA 01845 Fee Form 1 A 10. Date last inspected: Date B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage dispos system in accordance with the provisions of Title 5 of the Environmental Code and not to place system in operation until a Certificate of Compliance has been issued by this Board of Health. A hile Signature Date I' io"A proved B Na Date Application Disapproved for the following reasons: t5formla.doc•06/03 Application for Disposal System Construction Permit•Page 3 of 3 i ca!4ILivtC:!•v RO&o JUL'/ 14, 1'1*14'a � v. a- Z--15 Lo-T z }, I Go T r Q d Fr 11 L;NiE Ar vi 7 Y 7 15, y 4A Pomp 0 PLAT OKAfj&4 Iq&tL4 I, 1(**oASH" �rajjk 41q`-I(tvl' It AA • �'. �,....... fir,,,i �, �„ 1000 4 Q- �s Ali - -- v C�R.+ V qtr 1y ' 'tytl 20 I - �M550 KA P64M 14OU PIMA: RATE— r. r5T �khTE 4 ru RA I'&o r z4 Has V" j e7(\L Vl ►-�V to k v. � e: FOQA - U - LOT RELEASE FOIr INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT �� f- G ��n� PHONE(/7, ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER .� STREET� � �!� '�'� STREET NUMBER 1� ^J OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMIN14TRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED J DATE APPROVED SEPTIC INSPECTOR-HEALTH c DATE REJECTED COMMENTS PUBLIC WORKS—SEWER I WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONAENTS RECENED BY BUILDING INSPECTOR DATE t r , y LETTER OF TRANSMITTAL NORTH North Andover Health Department o� 400 Osgood Street 3� e•.` _ '_ '"b.d ooL North Andover,MA 01845 0 p 978.688.9540 -Phone i ! L 978.688.8476 - Fax healthdent(&,townofnorthandover.com- E-mail www.townofnorthandover.com - Website Page ofSS�CHUS� TO: DATE: Benjamin C. Osgood, Jr., P.E. 1,19s, g COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant New England Engineering Services, Inc. RE: / Phone: 978.686.1768 Fax: 978.685.1099 91- We -We are sending you: Wlan Review Letter CAPPROVED NOTA PROVED OSystem Construction Follow-Up Vther These are transmitted as checked below: Zktlor your File ®'As Required OAs Requested L'11'or Your Use REMARKS: COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed 0 0 ACTIVITY REPORT TIME 09/09/2005 15:26 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 N0, DATE TIME FAX NO./NAME DURATION PAGE(S) RESULT COMMENT 09/01 15:17 978 458 8994 01:12 02 OK RX ECM #087 09/02 08:11 816038930733 19 01 OK TX ECM #088 09/02 11:21 812032848514 40 02 OK TX ECM #089 09/02 12:38 817818903223 25 02 OK TX ECM #090 09/06 12:27 819782820012 36 02 OK TX ECM #091 09/07 09:11 819782820012 19 01 OK TX ECM 09107 09:46 39 04 OK RX ECM 09/07 10:05 978 557 8633 01:04 03 OK RX ECM 09107 14:15 17756281633 02:28 03 OK RX ECM #092 09/07 14:55 819784588994 54 03 OK TX ECM #093 09/07 16:23 816175561049 38 04 OK TX ECM 0094 09/08 15:52 819783721130 58 02 OK TX 09/09 12:47 01:25 00 NG RX #095 09/09 14:56 819784091269 02:35 07 OK TX #096 09/09 15:21 89786851099 05:17 18 OK TX ECM BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION / OUT OF MEMORY CV COVERPAGE POL POLLING RET RETRIEVAL PC PC-FAX Q 0 TOWN O NORTH AND F N VER NORTH O Office of COMMUNITY DEVELOPMENT AND SERVICES o? •` `�'° HEALTH DEPARTMENT s i + ► 400 OSGOOD STREET " ° •' NORTH ANDOVER, MASSACHUSETTS 01845 �SSACH115� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 7, 2005 Margaret Doherty 1365 Salem Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 1365 Salem Street, Map 106A, Lot 139 Dear Ms. Doherty: The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated April 27, 2005, received by this office on April 28, 2005. This approval generally is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. The 4-bedroom(9-room maximum)design has been approved for use in the construction of a replacement onsite septic system. At a regularly scheduled Board of Health meeting held on August 25, 2005 the following local variances were approved regarding the proposed septic system. 1) A reduction in offset distance between the leach bed and a wetland from 100 feet to 81 feet. 2) A reduction in offset distance between the leach bed and a septic tank from 75 feet to 51 feet 3) A reduction in offset distance between the leach bed and a septic pump chamber from 75 feet to 53 feet This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the ConseeQation Commission, Zoning Board, Planning.Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Additionally, though not a reason for disapproval, you might wish to consider the following. Pleas ' submit revised plans if you choose these options: • Using an effluent filter in the septic tank • Raise the septic tank, if possible, to provide a slope of between 2% and 8%. A slope greater than 8% may allow the water to run ahead of the solids potentially causing a backup in the sewer line • Explicitly specify the control panel to be used in order to ensure installation of pump controls which are in compliance with regulatory requirements Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. YSmcerelyer, REHS/RS Public Health Director cc: Ben Osgood Jr.,New England Engineering File OTOWN OF N ORT NORTH ANDOVER ,< Office of COMMUNITY DEVELOPMENT AND SERVICES o? •'�o- HEALTH DEPARTMENT * 400 OSGOOD STREET " °• --- ' NORTH ANDOVER, MASSACHUSETTS 01845 'sS,�M�stt Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 7, 2005 Margaret Doherty 1365 Salem Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 1365 Salem Street, Map 106A, Lot 139 Dear Ms. Doherty: The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated April 27, 2005, received by this office on April 28, 2005. This approval generally is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. The 4-bedroom(9-room maximum)design has been approved for use in the construction of a replacement onsite septic system. At a regularly scheduled Board of Health meeting held on August 25, 2005 the following local variances were approved regarding the proposed septic system. 1) A reduction in offset distance between the leach bed and a wetland from 100 feet to 81 feet. 2) A reduction in offset distance between the leach bed and a septic tank from 75 feet to 51 feet 3) A reduction in offset distance between the leach bed and a septic pump chamber from 75 feet to 53 feet This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal i ✓ requirements areOZ- These ma include review b the Conservation Commission, requ ey y Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Additionally, though not a reason for disapproval, you might wish to consider the following. Please submit revised plans if you choose these options: • Using an effluent filter in the septic tank • Raise the septic tank, if possible, to provide a slope of between 2% and 8%. A slope greater than 8%may allow the water to run ahead of the solids potentially causing a backup in the sewer line • Explicitly specify the control panel to be used in order to ensure installation of pump controls which are in compliance with regulatory requirements Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerel , Sus Y. Sawyer, REHS/RS Public Health Director cc: Ben Osgood Jr.,New England Engineering File I North Andover Board of Asses Public Access Page 1 of 1 � o MATCHING PARCELS Fiscal Parcel ID Address Owner Name Year 2005 210/106.A-0052-0000.0 1132 SALEM STREET ADAMS,RICHARD D. - — - ADAMS,JOANNE 2005 210/106.A-0050-0000.0 1155 SALEM STREET DANTONIO, SAM P SUSAN M DANTONIO 2005 210/106.A-0042-0000.0 1160 SALEM STREET HENNESSY,ANDREA J PATRICK M HENNESSY 2005 210/106_A-0043-0000.0. 1187 SALEM STREET HURLBURT,DONNA J 2005 210/106.A-0121-0000.0 1190 SALEM STREET ROHDE,KATHLEEN M 2005 210/106.A-0088-0000.0 1200 SALEM STREET HAJJAR,EDWARD G --- ----- --- KATHLEEN HAJJAR 2005 210/106.A-0181-0000.0 1212L-16 SALEM HANLEY,EDWARD W — ------.-- STREET DIANE L HANLEY 2005 210/1.06.A-0119-0000.0, 1213 SALEM STREET LARSON,WILLIS A GERTRUDE F LARSON 1216L-15 SALEM GUSTENHOVEN,CARL T 2005 210/106.A-0182-0000.0 STREET KIMBERLY GUSTENHOVEN 2005 210/106.A-0183-0000.0 1220L-14 SALEM NASSAR III,HENRY J STREET Page: 19 of 29 « < 11 12 13 14 15 1.6 17 18 1.9 20 > >> http://csc-ma.us/NandoverPubAcc/j sp/Ilome.j sp?Page=2&RecNo=181 9/2/2005 North Andover Board of Asses Public Access Page 1 of 1 MATCHING PARCELS Fiscal Parcel ID Address Owner Name Year 2005 210/106.A-011.8-0000.0 1225 SALEM ANDERSON,RICHARD C. -- -- STREET FURTH,MIRA A. 2005 210/106.A-0184-0000.0 1234L-12 SALEM BONTEMPO,ROBERTO M ----- - - STREET NANCY A BONTEMPO 2005 210/106.A-0185-0000.0 1248L-11 SALEM DI BLASI,JOSEPH P ----------- -- STREET LAURA DI BLASI 1253 SALEM NITZSCHE TR,EDITH M 2005 210/106.A-0133-0000.0 STREET NORTH ANDOVER REALTY TRUST OF ESSEX CNTY 2005 210/106.A-0186-0000 0 1260L-10 SALEM HU,KO-YING - STREET ANGIE S14AI-PING 2005 210/106.A-0187-0000.0 1264 SALEM VESSAL,AHANG -- —--- - STREET TAHERI,LADAN 2005 210/106.A-01_34-0000.0 1265 SALEM DINAPOLI,ANTHONY D STREET 2005 210/106.A-0148-0000.0 1275 SALEM JAMES,STEVEN J -— ---- STREET ROSE M JAMES 2005 210/106.A-0188-0000.0 1276L-8 SALEM MCLAUGHLIN,EDWARD C -- ----- STREET TERESA M MCLAUGHLIN 2005 210/106.A-01.58-0000.0 1288 SALEM DONOVAN,WILLIAM J - —----- STREET BARBARA A DONOVAN < > >> Page: 20 of 29 « 11 12 13 14 15 16 17 18 19 20 _ I http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=2&RecNo=191 9/2/2005 Board of Health North Andover Construction Summary Report-Sorted by Address Printed On:Fri Sep 02,2005 Status Type of Permit Permit No. Submitted Expires Applicant Work Location SIGNED OFF DWC-System Repair BHP-2004-0482 07/01/2004 07/06/2005 SHAHEEN, PETER G&DIANNE P S 542 SALEM STREET Open DWC-System Repair BHP-2004-0612 05/01/2003 JACKSON REALTY TRUST&CAROL 575 SALEM STREET Signed Off Septic System BHP-2003-0147 03/26/2003 JACKSON REALTY TRUST&CAROL 575 SALEM STREET Open DWC-System Repair BHP-2004-0605 08/27/2004 STRINGER,JOSEPH&LORRAINE S 1094 SALEM STREET SIGNED OFF DWC-System Repair BHP-2005-0242 07/18/2005 08/19/2005 Richard&Joanne Adams 1132 SALEM STREET OSIGNED OFF DWC-System Repair BHP-2005-0235 07/12/2005 08/12/2005 HENNESSY,ANDREA J&PATRICK 1160 SALEM STREET SIGNED OFF DWC-System Repair BHP-2005-0268 08/24/2005 09/24/2005 Margaret Doherty 1365 SALEM STREET SIGNED OFF DWC-System Repair BHP-2004-1193 11/24/2004 SEARS, GEORGE M&MARJORIE E 1580 SALEM STREET Address=542 SALEM STREET: 8 GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 0 0 Ja-Pelle a eCh1 l , Pamela P m la From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Friday, August 19, 2005 3:05 PM To: DelleChiaie, Pamela; amcbrearty@verizon.net Cc: LisaL@millriverconsulting.com Subject: RE: BOH meeting Daniel Ottenheimer (info@millr... Those three are next on our plate to tackle, however, your truly is going away for the week so there are no guarantees Andy won't be faced with a million and one bumps in the road. Therefore I took a quick glance at the variances and LUAs requested today to answer this e-mail. I am most concerned with the LUA request to the drinking well on the Paddock Lane plan. The good news it is the well serving the house in question and not a neighbor's well. Since they would be putting their own well at greatest risk, one option might be to grant the LUA with the condition that annual water quality testing be performed for bacteria and nitrogen with results copied to the health department. We'll get the detailed reviews to you as soon as possible. Dan Daniel Ottenheimer, President Mill River Consulting, Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com dano@millriverconsulting.com -----Original Message?---- From: DelleChiaie, Pamela [mailto:pdellechiaie@townofnorthandover.com] Sent: Friday, August 19, 2005 8:05 AM To: amcbrearty@verizon.net Cc: info@millriverconsulting.com; LisaL@millriverconsulting.com Subject: BOH meeting Due to 4-6 night hearings for the Board memebers for the month of September, the BOH meeting is going to be cancelled. Could the reviews for the plans below possible get done before my August 25th meeting. This way I can inform the board of our position on the variance/ LUA etc. requests. 55 Oakes_Dr v-e----s-en�p— 05 -Salem Street - sent up 8/1 1 0 o I am sure you haven't looked at 72 Paddock, but I will probably put it on ttie agenda anyway, so not to add hardship to the homeowner. sent up 8/10. Bill is asking for 70 feet to a well on site and 80 feet to the wetland. If you have any comments on that maybe you could let me know if possible. Thanks Susan Thank goodness Pam is back on Monday! ! 2 C North Andover Board of Health MEETING AGENDA Thursday, August 25, 2005 7:00 p.m. 120 Main Street Town Hall Building 2nd Floor Meeting Room New Business I. Meeting Minutes - Final Approval for July 2005. II. 55 Oakes Drive–Proposal from Thomas Hector,Project Manager, of New England Engineering to request the following: Variance to N. A. Regulation 5.02 Offset distance from wetlands to septic tank from 75 feet to 51 Variance to N. A. Regulation 5.02 Offset distance from wetlands to pump chamber from 75 feet to 56 feet Variance to N.A. Regulation 5.02 Offset distance from wetlands to a leaching facility from 100 feet to 50 feet Variance to N.A. Regulation 1.05 Allow a design based on 3 bedrooms in lieu of a 4 bedroom minimum required by the North Andover Health Bylaw. Approval of this plan requires that a deed restriction limiting the dwelling to 3 bedrooms be recorded at the registry of deeds. III. 1365 Salem Street _fit 1 Variance to N.A. Regulation 5.02 cols &_nD vz Reduction in offset distance from wetlands to an from;7�feet toX—feet. Variance to N.A. Regulation 5.02 Reduction in offset distance from wetlands to septic tank from 75 feet to 51 feet Variance to N.A. Regulation 5.02 Reduction in offset distance from wetlands to pump chamber'from 75 feet to 53 feet W. 72 Paddock Lane Local Upgrade Approval Required Setback from the SAS to a private well from 100 feet to 70 feet Variance to N.A. Regulation5.02 Reduction in offset distance from wetlands to the SAS from 100 feet to 80 feet Old Business I. Re-review of proposed Tattoo/Body Art Regulations Note: The BoardofWeafth reserves the right to take items out of order and to discuss andlor vote on items that are not Lutedon the agenda. August 25,2005-North Andover Board of Health Meeting- enda Page 1 of2 Board o(Health Members: Thomas Trowbridge,DDS,MD,Chairman,Jonathan Markey,Member;Cheryl Bar.Zak,Clerk Health Department Staff-Susan Sanger,Health Director; Debra&Ylaban,Public Health Nurse;Michele Grant,Pubkic Health In.+peaor;Pamela DelkChiaie, Health Department Assistant I 0 0 Discussion I. Title V Inspector Licensing- continued until October II. Isolation and Quarantine Correspondence Note: The Boardof 0eafth reserves the right to take items out of order andto discuss araC/or vote on items that are not fistedon the agenda. August 25,2005-North Andover Board of Health Meeting-Ag—en da Page 2 of2 Board of Heallh Members: Thomas Trowbridge,DDS,MD,Chairman,Jonathan Markey,Member;Cheryl Barctiak:,Clerk Health Department SlafF Susan Sa"er,Heallh Director, Debra Rillahan,Public Health Nurse;Michele Grant,Public Health Inspector,•Pamela DelkCbiaie, Health Department Assistant w _' Town of North Aridaver HEALTH-DEPARTMENT 27 Charles Street ��'��® North Andover,MA 01845 978.688.9540 healthdep0ownofnorthandover.com JUL. 2 8 2005 70HEALLTH DEPARTNv1 ER OF NORTH T SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: ooh SITE LOCATION: I,3 SGt l2�M �free� -ENGINEER: e w E-qqLned �vt kv%ae ri Qry% / NEW PLANS. YES $225.00/Plan�— V ,oo�3 Check#: G (Includes I and one Re Review Only) REVISED PLANS: YES S 75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO /V Telephone#• q $ 6 8 6- 7 e $ Fax#:__ Rel (.85= 1O`jq E-mail: ee 0.a 1.Com HOMEOWNER NAME: fiolfTlkrei OFFICE USE ONLY When the submission is complete(Including check): 1. Date stamp plans s and letter 2. Complete and attach Receipt 3. Copy �File• Forward to Consultant n 4. Enter on Log Sheet and Database Comm'onwea th of � Massachusetts City/Town of /\Jc)4h Aydcver W Percolation Test Form 12 G M Syey`v Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with Impothe local Board of Health to determine the form they use. Whe n filling out want. A. Site Information Whe forms on the computer, use Margaret Doherty only the tab key Owner Name to move your 1365 Salem Street cursor-do not use the return Street Address or Lot# key. North Andover MA 08145 CitylTown State r� 24 Zip Code Contact Person(if different from Owner 9 688-26 � Telephone Number B. Test Results 6/8/05 4:00 7/12/05 9:00 Date Time Date Time Observation Hole# PT1 PT1 B Depth of Perc 32"/16" 40'718" Start Pre-Soak 3:50 9:03 End Pre-Soak 4:05 9:18 Time at 12" 4:05 9:18 Time at 9" at 10" 4:35 9:48 Time at 6" - 10:41 Time (9"-6") - 53 MIN. Rate (Min./Inch) - 18 MIN. PER INCH Test Passed: ❑ Test Passed: Test Failed: ® Test Failed: ❑ Perc test 1 performed by Thomas K. Hector, witnessed by Daniel Ottenheimer, Mill River Consulting Test Performed By Perc test 1 B performed by Benjamin C. Osgood, Jr., witnessed by Andrew McBrearty, Mill River Consulting Comments: t5form12.doc•06/03 Perc Test•Page 1 of 1 o: FORM .11.- SOIL EVALUATOR FORM Page 1 of 3 No. 1,T�a. 1I3 Date: Commonwealth of Massachusetts Jl1o��l,� srover , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal o TPI TPa. (�. 1 (T?1 TPS' Performed By: an�¢ ►�n.. ...C�.59o0 .\... .�.$)� ..�e61br i Date: ?��aIOf...(Tflo Witnessed By: Pwie.1..... ? #end►e��ne.��.. .n4f ..1'1.....l re—vi kll._ t Dada,Address or 50.1 a INS S F Ceet Address Num.id , Aox ar'c'h' b Ae A y La f . A)or4 aver JulA T f IM,, S0.1-04% 5!' A)or+t� Ahd overt /A A 0t8LEr ew Construction ❑ Repair Office Review Published Soil Survey Available: No ❑ Yes �! Year Published -11-01..... Publication Scale I kif � ..$t..o Soil Map Unit AC_ , . Drainage Class fP.ppr.... Soil Limitations ... gfa'�Q...:6...ra fo.lk Surficial Geologic Report Available: No ET Yes ❑ Year Published „N...w.N..,.,.. Publication Scale GeologicMaterial (Map Unit) ............................................................................................................. .-_ ............ Landform. ............................................................................................._..............................----.. ................ Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes ❑ Within 500 year flood boundary No []Yes ❑ Within 100 year flood boundary No ❑Yes N Wetland Area: National Wetland Inventory Map (map unit) .} ........... .....................................__._...._........... _ _.._ . Wetlands Conservancy Program Map (map unit) .......,. .A..................................__....__...........--- -Curr6nt Water Resource Conditions(USGS): MonthQ vy► 0200. Range :Above Normal NNormal ❑Belcw Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 - o 0 FORM 11 = SOIL EVALUATOR I<ORM Page 2 of 3 Location Address or Lot No. � (�� ICM �i'te'}, Aor+k lover On-site Review p �F� 6 8/0 3'ov Dee Hole Number :.:. : .::. Date:w..... w:,-...:.5 Time:.:...:..�--:: Weather Afr 8 Location (identifyQn site plant � eS1 .:.�t'taa`..:.:. . Ilrope (%) ..-,- ,.�la Surface Stones .and Use :...Y:. .. ::::...:..: ...::.....:::.... :..::: Vegetation ,. S.S::...:.:...:.::.:w..:::.:.......:... ..:. : ._�N..::. .:::..:..:.:..:.. .:...::.,:::.,.. .,.:..:,..�.::k._.�.k,:h_�. n:...--:v LandformARM,",ILA Position on landscape (sketch on the back) Distances from: Open Water Body .01... !k feet Drainage way.1,09 - feet ' PossibleMet Arta ,:�?�...... feet Property Line ....:fir: feet Drinking Water Well ALSO feet :Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Sol color c..:1 0`uo; V... Surface.0fiches) (USDA) (Munselq Mottling (Structure,Stones,Boulders,Consistency, R6 Gravell 1� Fill- thr- 70 131 50 .13 d IoYK . S VoYQ 6 Cis IMM 56tick close ry &A eu IS% t, - � - i�'S�C•rt+v tQ, .?J baS�d oh ray e rMl 'OSED DISPOSAL AREA Parent Material(geologic) Ia��oA Depthto8edrock: Depth to Groundwater. Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: �.5. DEP APPROVED FORM-12/07/95 :FORM 11 = SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. �3(o_S Sal er,% areet I 10 over On-site Review Deep Hole Number . ..: Datek �.1aS ea Time:.::l._.1..�:�. F.M 7 Location (identify o site plan) the Land Use Ci5::.::.eAd;a.t_.. Slope (%)'._i:; % Surface Stones ..::... . ..: Vegetation :.�?::�5,5:.:::.:..� .. ........ . . ..�.. _ Landform ... i'r�ni~.::. ::.:::::. .. . .... ..... .......:.� .._:..:.......:n.....v.:::...m.._..:.:.:._..�.:.......-..�.......:..:.. ...... ....... ... :.:..:...:::....:.:.:.:..,_...... .. ....:.. ::.:.::.::...:::::::.,..:: :::.:::.,...:::::::,::::.,....:........v....... : Position on landscape (sketch on the back) ..: off .. �� Pe,::,,.,,H:..n:.•:.._ . Distances from: Open Water Body o0 ., feet Drainage way-1,00-0 feet Posslble.Wet Area ::.: ......:.: feet Property Line — ._,.::. feet Drinking Water Well >J50:. feet Other DEEP OBSERVATION HOLE LOG! Depth from Soil Horizon Soil Texture Soil color Soil per Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, 96 Gravel) 0 (o ala I !d � ` AO `fl- Go 60 -.1 toya� o�`0 15Ebl-e5 5313 MINIMUM OF 2 HO -MMIROXT ITS EVERY PRO DISPOSALARLA Parent Material(geologic)_ w .` ;0r. ►�� DepthtoBedrock: J` Depth to Groundwater: 'Standing Water in the Hole: Weeping from Pit Face: tl Estimated Seasonal High Ground Water: DEP APPROVED FORM-12/07/95 :FORM 11 = SOIL EVALUATOR FORM • .. 4 .. Page 2 of 3 Location Address or Lot No. �3(0,� (�y� � of � ,nc�ve.r- On-site Review Deep Hole Number .�.01-: Date:.H�-.g fps :pa r $O �:��-�. Time:.:4::.:.:..:.. Weather tAr Location (identify o site plan) .:..:.::::....::: Land Use ... : . :1 ..: ►...1 , .:.. .:.. Slope (%) -J-%P Surface Stones v.,.v..: .:.. : ..::.... :..... Position'on landscape (sketch on the back( -. U4d .., �.7►,c�,e,,.::,.� ..w,.,_.,-, a- Distances from: Open Water Body x:91 ;,. feet Drainage way..(. :, feet ' Possible'.Wq Area,:µ:.105*feet Property Line — feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG! Depth fromSolt Horizon Soil Texture Soil color Soil Other Surface(lciehes) (USD/) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, 96 Gravel) -. l - 67. G s IoYR S/ . l0!a ot.5 - 54-�� S S. 10%D 7.5YFL PROPOSED DISPOW AREA Parent Material(geologic) _Aplat"os, T% DepthtoBedrock: Depth to Groundwater: 'Standing Water in the Hole- -72Weeping from Pit Face: Estimated Seasonal High Ground Water: -I DEP APPROVED FORM-1210719S Y o FORM 11 - SOIL EVALUATOR FORM Page- 3 of 3 Location Address or Lot No. X365 SA�� i'eef,A� � er Determination for Seasonal High Water Table Method Used: Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole................... inches Depth to soil mottlesinches(19 TPX. rPs8) ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor ................... Adjusted ground water level ........................................................ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Ye S If not, what is the depth of naturally occurring pervious material? Certification 1 certify that on 11 q JOY (date) I have. passed the soil evaluator.examin.atio.n approved by the Department of Environmental Protection and that the above analysis waserformed b me consistent with the required training, expertise and experience P Y described in 310 CMR 15.017. to � r aS Signature Da DEP APPROVED FORM-12107195 O O Page 1 of 1 DelleChiaie, Pamela From: Lisa LeVasseur[lisal@millriverconsulting.com] Sent: Thursday, July 14, 2005 10:19 AM To: Sawyer, Susan; amcbrearty@miliriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: Perc for 1365 Salem Street Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.m-illriverconsulting.com 7/14/2005 'Ge11 C� i 1 ;Snob 0c7 0 fic aq6 I I n I ' S� ;b : ,,6 0 i 1 er ��W 0 Town of North AneioveF_ Health Department Date: 2 � f _ Location: /�i.:�� QGp_- (Indicate Address,if Residential,or Name of Business) Check#: Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ S 'c-Soil Testing $ c-Design Approval $ Dispo s Constructz ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) Health Agent Initials 932 White-Applicant Yellow-'Health "Pink-Treasurer f 0 . 0 NEW ENGLAND ENGINEERING SERVICES INC July 22, 2005 Mrs. Susan Sawyer North Andover Board of Health 400 Osgood Street R C'°x V E North Andover, MA 01845 JUL 2 S 2005 Re: 1365 Salem Street,North Andover,MA TOWN OF NORTH ANDOVER Septic System Design Submittal HEALTH DEPARTMENT Dear Mrs. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. 2. 2 Copies of the Form 11-Soil Evaluator Sheets. ( .) 3. (2)Copies of the Form 12-Percolation Test Sheets. 4. (1)Letter requesting to be included on agenda for next BOH meeting. 5. (1) Copy of Septic Submittal Form. 6. Check for the Town approval fees. If you have any comments or questions please do not hesitate to contact this office. Sincerely, Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-.NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 0 . 0 IN, NEW ENGLAND ENGINEERING SERVICES INC July 28, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 RECEIVED Re: 1365 Salem Street, North Andover, MA JUL 2 8 2005 Local Bylaw Variance Request TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Dear Ms. Sawyer, The purpose of this fetter is to request that the above referenced property be included in the upcoming Board of Health meeting agenda to discuss the following Local Bylaw Variance requests: Local Bylaw Variance 1. Reduction in offset distance from wetlands to a leach bed from 100 feet required by North Andover Local Bylaw to 81 feet. 2. Reduction in offset distance from wetlands to septic tank from 75 feet required by North Andover Local Bylaw to 51 feet. 3. Reduction in offset distance from wetlands to pump chamber from 75 feet required by North Andover Local Bylaw to 53 feet. This request pertains to the plan entitled, "Proposed Subsurface Sewage Disposal System, 1365 Salem Street North Andover, MA, Assessors Map 106A, Lot 139," dated July 27, 2005, prepared by New England Engineering Services, Inc. If you have any questions or comments, please do not hesitate to contact this office. Sincerely, l Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 J Page 1 of 1 E. i DelleChiaie, Pamela From: Lisa LeVasseur[lisal@millriverconsulting.com] Sent: Monday, June 20, 2005 11:19 AM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: 1365 Salem Street Soils Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultin2.com 6/20/2005 moi. i ! k -_� 4 s ,5 s,f OC 7 p 7y 0 Y -610 -rw AA 10,,E DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, June 22, 2005 9:07 AM To: 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: Sawyer, Susan Subject: 47 Evergreen Drive-Soil Test / 1312 Salem Street- Perc/Deep Hole / 1365 Salem Street- Perc/Deep Hole Importance: High Hello, Kim from NEES dropped off an application for the above yesterday aftexnoonwhricb-I-w'lla`be faxing soon. She also had a note about one more deep hole and perc test for 1312 Salem Str and 1365 Salem Street eeded for those sites, and can it be scheduled the same day as above? I also have a question as to whether the requests for the additional deep hole/perc test(s)would be considered an additional charge, or if these would be included as part of their initial applications? Please let me know asap. Tx. P ARM&A w D¢B.467.4iai¢ Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townoftiorthandover.com healthdept@townofnorthandover.com 1 1 1365 Salem Street- Soil Test ofication Page 1 of 1 Q DelleChiaie, Pamela From: Lisa LeVasseur[lisal@millriverconsulting.com] Sent: Tuesday, May 31, 2005 12:08 PM To: DelleChiaie, Pamela; 'Daniel Ottenheimer(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: 'Osgood-Ben-(-E= ' Subject: RE: 65 Salem Stree -Soil Test Application All set. They'll do 1365 in the morning, after 1312. Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www,millri_verconsulting.com -----Original Message----- From: DelleChiaie, Pamela [ma i Ito:pdellech ia ie@townofnorthandover.com] Sent: Tuesday, May 31, 2005 10:13 AM To: Daniel Ottenheimer(E-mail); Lisa LeVasseur(E-mail); McBrearty Andrew (E-mail) Cc: Osgood Ben (E-mail) Subject: 1365 Salem Street- Soil Test Application Hello, Steve was just in, and dropped of an application for above. This is four houses down from 1312 Salem Street, which is scheduled for June 8th. Can you schedule this for the same day? will be faxing the application to you. Barring any issues from Conservation, this should be okay. Thank you. Pwtiy¢Ba D¢�B¢L�l6iAi¢ Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax htlp-://www.townofiiorthandover.com healthdept@townofnorthandover.com 5/311/2005 4 Town of North Andover Health Department Date: Location: /J10 �,✓J'��.�' r (Indicate Address,if Residential,or Name of Business) Check#: Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: o;i4tic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Trash/Solid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) g Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer t t f • j t LETTER OF TRANSMITTAL North Andover Health Department a� No oTh 400 Osgood Street ► a! •�6*a �oL North Andover,MA 01845 }O �••' 978.688.9540 -Phone by 978.688.8476 - Fax COC„C,„wK„ healthdent(a,townofnorthandover.com -E-mail �q °RATED www.townofnorthandover.com - Website Page / of SS'4CNu5Ei TO: DATE: Daniel Ottenheimer COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting RE: Phone: 1.800.377.3044 or 978.282.0014 Fax: 978.282.0012 We are sendin ou: oil Test OPlans or Review L7 Other ill in below) These are transmitted as checked below: OFor Review and comment OAs Requested Required OFor Your Use 9 s 9 REMARKS: COPY TO: .� .41 COPY TO: COPY TO: SIGNED: . TRANSMISSION VERIFICATION REPORT TIME 05/31/2005 09:33 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 I DATEJIME 05131 09:32 FAX NO./NAME 819782820012 PAGE(S) DURATION 0:00:58 RESULT OK MODE STANDARD ECM i I I DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, May 31, 2005 10:13 AM To: 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: Osgood Ben (E-mail) Subject: 1365 Salem Street-Soil Test Application Hello, Steve was just in, and dropped of an application for above. This is four houses down from 1312 Salem Street, which is scheduled for June 8th. Can you schedule this for the same day? I will be faxing the application to you. Barring any issues from Conservation, this should be okay. Thank you. $¢gl R¢gwPds, pA�e�A neeeBe�s�afe Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com I 1 • BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS j DATE: 5 MAP&PARCEL: d LOCATION OF SOIL TESTS: 3 6S J;�Irlel� -r7 II OWNER: / � l'��J DO ,Q TEL.NO.: ADDRESS: S-T - We( 4111U7)lvk e ENGINEER: Ari�w rc viLnerA Gua rut-w-1 y( TEL.NO.: CERTIFIED SOIL EVALUATOR: Intended use of land: Residential Subdivision gle Family Home Commerciale Is This: Repair testing _ Undeveloped lot testing Upgrade for addition In the Lake Cochichewick WatershedT Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) O 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes.and two percolation tests required for each disposal area Fee of$360.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. / Please Do Not Write Below This Line N.A.Conservation Commission Approval: 1 Date Received: Check Amount: Check Date: I o � og 1 ' s • a X62 � � . � �. �� ,�� l,� •�� 1 {t4s -Ala, t, 138 A10 6 t 5 � 157 t� G NEW ENGLAND ENGINEERING SERVICES,INC. 7905 "town of North Andover F b 8/2005 Soil testing 1365 Salem Street,North Andover 360.00 I Checking-Banknorth 360.00 LETTER OF TRANSMITTAL NORTH North Andover Health Department of T%.90 , '�q► 400 Osgood Street 3'� b�< _ '.. '^6"° mot North Andover, MA 01845 978.688.9540 - Phone640 978.688.8476 - Fax �0$16 C««� -,..'� healthdeptntownofnorthandover.com - E-mail �''9s""*'D www.townofnorthandover.com - Website Page / of SACHt1`�� TO: DATE: Daniel Ottenheimer COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting Phone: 1.800.377.3044 or 978.282.0014 RE: � Fax: 978.282.0012 We are sending you: oil Test OPlans or Review 0Other ill in below) These are transmitted as checked below: OFor Review and comment OAs Requested 9s Required OFor Your Use REMARKS: CO O: , COPY COPY TO: SIGNED: I i i i TRANSMISSION VERIFICATION REPORT TIME 05/31/2005 09:33 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 05/31 09:32 FAX NO./NAME 819782820012 DURATION 00:00:58 PAGE{S} 04 RESULT OK MODE STANDARD ECM t DelleChiaie, Pamela I From: DelleChiaie, Pamela Sent: Tuesday, May 31, 2005 10:13 AM To: 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: Osgood Ben (E-mail) Subject: 1365 Salem Street-Soil Test Application Hello, Steve was just in, and dropped of an application for above. This is four houses down from 1312 Salem Street, which is scheduled for June 8th. Can you schedule this for the same day? I will be faxing the application to you. Barring any issues from Conservation, this should be okay. Thank you. 8a8f Ragw�dg, Pa�IraBw DaBQaL�llfwfa Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 8.688. 97 954o-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 1 C-) f BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: �� MAP&PARCEL: �1� 3 LOCATION OF SOIL TESTS: 1f iQ .N OWNER, �` � TF.Ii. •: y ADDRESS:_/ Sl�1 �f/r - /t�d1?7# ENGINEER: l kqwqVt(g gfua ok-kpu VU L TEL.NO.: CERTIFIED SOIL EVALUATOR: C OS 1"c)() 7e— lL l G Intended use of land: Residential Subdivision tgl2,-F mily Home Commercial Is This: Repair testing _ Undeveloped lot testing Upgrade for addition T In the Lake Cochichewick WatershedT Yes No THE FOLLOWING MUST BE INCLUDED WrrH THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. / Please Do Not Write This 'ne N.A.Conservation Commission Approval: ��(4��ftc/-� 1/Y Date Received: Check Amount: Check Date: I V U- (p DYc-11LVl� � � pvp g 1 162 pits :f-.♦. �ous� `^ • (wEiLA9p oT :3 7th 12"6 • �- lot • l 55 r r l .5 7 . C;4 � I L V l �• cl, TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: I f SYSTEM OWNER& ADDRESS SYSTEM LOCATION _ (example: left front of house) fl DATE OF PUMPING: . I / [ QUANTITY PUMPED ,$'0-b GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES M a NATURE OF SERVICE: ROUTINE_�L EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE -BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER, OTHER (EXPLAIN) SYSTEM PUMPED BY: _` �Ly e i t to T z N � '� 11 �— �i L .COMMENTS: . ( CONTENTS TRANSFERRED TO: -e- �,� }-�� Qos�i`ic.fi• '