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HomeMy WebLinkAboutMiscellaneous - 137 CHRISTIAN WAY 4/30/2018 137 Christian Way i v r i Fr Lot & Street Cir #,,� 1'M�4-e-t` Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permity /03 (,. Plan Approval: Date: Approved by- Designer: y: Desi ner: r i ` � ��r.,�,�� � Plan Date:_�/� Conditions: Water Supply: Town _ __ Well Well Permit: _.Driller: We11---Chemical Date Approved .� Bacteria I Date-Approved Bacteria II - Date Approved Plumbing.Sign-Off: : Wiring Sign-Off: Comments: �• : tiLL Form"L"' Approval: Approval to-Iss e: YES ` NO 9/M Date Issued kl,q By; r Conditions- Final Approval: All Permits Paid? YES NO Well Construction Approval? YES NO Septic System Construction Approval? YES NO Certification? YES NO Other YES NO Any Variance Needed? YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: ' � w • lb r � , SEPTIC SYSTEM INSTALLATION Is the installer licensed? YE NO Type of Construction: iREPAIR New Construction: Certified Plot Plan Review C_YES NO —Floor Plan Review NO _— Conditions of Approval from Form U YES NO _Issuance of DWC permit: NO _DWC Permit Paid? NO - -DWC Permit# Installer: U 60u Beginlnspection:_ �. ES NO Excavation Inspection: ._Needed: —Passed: zwZ _ By: .-Construction Inspection: Needed: As Built Plan Satisfactory: YES- _\,Approval of Backfill: Date: p By: -Final Grading Approval: Date: �/ U v By: Final Construction Approval: Date: rf -By. i ~/ Certificate of Compliance: Approval: Date: Commonwealth of Massachusetts z City/Town of . 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. A. Facility. Information 1. System LocatioL Ridfron�hou , Left/Right rear of house, Left/right side of house, Left/ Right side of buil g, Left/Right ron of building, Left/Right rear of building, Under deck Address •� �� �� � �Y ,a ���� City/Town State 2. System Owner. T� JUN n 12015 Name' -TOWN OF.NORTN ANDOVER HEALTH DEPARTMENT Address(if different from location) City/Town Telephone Number r • B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons , 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes 0,,W If yes,was it cleaned? ❑ Yes ❑ No, ' 5. Conditio of stem` 6.- System Pumped By: Neil.Batesbn F5821 Name Vehicle License Number Bateson Enterprises Inc' Company 7. Locati ere contents-were disposed: 7CSL SQ Lowell Waste Water Sign Haul Date t5form4.doc-06/03 System Pumping Record•Page 1 of 1 Ot NORTM, 6556 ti _ 9 - Town of North Andover ;'-•.; >.• HEALTH DEPARTMENT ,ys�CMUSt< r CHECK#: DATE: LOCATION: H/O NAME: CONTRACTOR NAME: -- Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type. $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5lnspector $� Title 5 Report $ ❑ Other:(Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink- Treasurer Q Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments L� 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Neil J. Bateson cursor-do not Name of Inspector use the return key. Bateson Enterprises Inc. Company Name 111 Argilla Road Company Address Andover MA 01810 Citylrown State Zip Code 978-475-4786 S115 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant t Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ FFROECEIVED JUL 2 9 2013 ❑ Needs Further Evaluation by the Local Approving Authority TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 7/23/2013 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 a Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Citylrown 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: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 � 1 Commonwealth of Massachusetts R. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M " 137 Christian Way Property Address Theodore Knight Owner Owners Name information is required for North Andover MA 01845 7/23/2013 every page. CityTrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *'This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) 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 '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage wage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown 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 the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown state Zip Code Date of Inspection D. System Information Description: Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Yes 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current 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? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped last year, owner Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Measured tank Reason for pumping: Inspect tank&outlet tee Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every 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: 14 years old, 10/27/1999, as built plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): 4" PVC through wall , 3" PVC in house, no leaks visible Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'x 5'x 4' Sludge depth: 3" t5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 23" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 18 How were dimensions determined? Tape Measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumped septic tank. Inlet tee ok. Outlet tee ok. Depth of liquid at outlet invert. No evidence of leakage. Spruce tree should be moved, inlet cover under tree. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts up Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 or 17 Commonwealth of Massachusetts -- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. CityrFown 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.): D-box level&distribution equal. No evidence of leakage. Evidence of carryover, pumped d-box to clean. Cover broken, replaced. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts upTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owners Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 1 field 24'x 38' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil ok.Vegetation ok. No sign of ponding to surface. Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurfaoe Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityfrown 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•3113 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 Forth-Not for Voluntary Assessments 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately C rt l a oJ3Px 1(0 a� 33r �1 ,I t5ins•3/13 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 137 Christian Way ,p Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 Summary Record Card generated on 7/11/2013 3:11:57 PM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-104.D-0186-0000.0 Parcel Id 16874 137 CHRISTIAN WAY EXT THEODORE & SUSAN KNIGHT 137 CHRISTIAN WAY NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1.02 Acres FY 2013 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until THEODORE&SUSAN KNIGHT Owner 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 ANGELO,RICH Previous Customer Inactive 7/10/2008 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 LARRY GUTOWSKY,JR. Previous Customer Inactive 1/7/2010 137 CHRISTIAN WAY EXT NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 17864.0-137 CHRISTIAN WAY EXT Last Billing Date 4/10/2013 3170529 03 Cycle 03 Active UB Services Maint. Account No.3170529 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 1 1 9.18 l/ WTR WATER 01 ALL METER SIZE 92.27 /1 UB Meter Maintenance Account No.3170529 Serial No Status Location Brand Type Size YTD Cons 34658473 a Active ERT HH b Badger w Water 0.63 0.63 1000 Date Reading Code Consumption Posted Date Variance 6/13/2013 1085 a Actual 65 186% 3/14/2013 1020 a Actual 23 4/22/2013 -19% 12/12/2012 997 a Actual 28 1/9/2013 -76% 9/12/2012 969 a Actual 118 10/15/2012 199% 6/12/2012 851 a Actual 39 7/16/2012 58% 3/13/2012 812 a Actual 25 4/14/2012 -34% 12/12/2011 787 a Actual 37 1/17/2012 -65% 9/13/2011 750 a Actual 115 10/13/2011 208% 6/7/2011 635 a Actual 35 7/20/2011 35% 3/7/2011 600 a Actual 25 4/13/2011 -56% 12/8/2010 575 a Actual 58 1/12/2011 -73% 9/9/2010 517 a Actual 223 10/15/2010 100% 6/8/2010 294 a Actual 109 7/15/2010 179% 3/9/2010 185 a Actual 27 4/14/2010 257% 1/5/2010 158 f Final Bill 3 1/5/2010 -34% 12/11/2009 155 a Actual 17 1/12/2010 -39% 9/8/2009 138 a Actual 27 10/15/2009 -45% 6/9/2009 111 a Actual 46 7/20/2009 165% 3/16/2009 65 a Actual 20 4/29/2009 -27% 12/8/2008 45 a Actual 25 1/20/2009 -10% 9/10/2008 20 a Actual 20 10/10/2008 -100% 7/8/2008 0 n New Meter 0 10/10/2008 -100% Commonwealth of Massachusetts City/Town of 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. A. Facility Information 1. System Location:0/Rightdront of hou-`?Left/Right rear of house, Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/Right rear of building, Under deck Address s i40 VJa o c-y-kA Ai v�0 Q 'e-C Cityrrown State Zip Code 2. System Owner. c Name Address(if different from location) Citylrown State Z 2�- ip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: canons 3. Type of system: ❑ Cesspool(s) 9- ptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes L y'"No If yes, was it cleaned? ❑ Yes ❑ No, " 5. Condition of System: 6. System Pumped By. Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location a contents were disposed: Lowell Waste Water Sign a Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °r< 137 Christian Way Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Summary Record Card generated on 7/11/2013 3:11:57 PM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-104.01-0186-0000.0 Parcel Id 16874 137 CHRISTIAN WAY EXT THEODORE & SUSAN KNIGHT 137 CHRISTIAN WAY NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1.02 Acres FY 2013 UB Mailing Index Name/Address Type Loan Number Active/lnact. From Until THEODORE&SUSAN KNIGHT Owner 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 ANGELO,RICH Previous Customer Inactive 7/10/2008 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 LARRY GUTOWSKY,JR. Previous Customer Inactive 1/7/2010 137 CHRISTIAN WAY EXT NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 17864.0-137 CHRISTIAN WAY EXT Last Billing Date 4/10/2013 3170529 03 Cycle 03 Active UB Services Maint. Account No.3170529 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 1 1 9.18 1/ WTR WATER 01 ALL METER SIZE 92.27 /1 UB Meter Maintenance Account No.3170529 Serial No Status Location Brand Type Size YTD Cons 34658473 a Active ERT HH b Badger w Water 0.63 0.63 1000 Date Reading Code Consumption Posted Date Variance 6/13/2013 1085 a Actual 65 186% 3/14/2013 1020 a Actual 23 4/22/2013 -19% 12/12/2012 997 a Actual 28 1/9/2013 -76% 9/12/2012 969 a Actual 118 10/15/2012 199% 6/12/2012 851 a Actual 39 7/16/2012 58% 3/13/2012 812 a Actual 25 4/14/2012 -34% 12/12/2011 787 a Actual 37 1/17/2012 -65% 9/13/2011 750 a Actual 115 10/13/2011 208% 6/7/2011 635 a Actual 35 7/20/2011 35% 3/7/2011 600 a Actual 25 4/13/2011 -56% 12/8/2010 575 a Actual 58 1/12/2011 -73% 9/9/2010 517 a Actual 223 10/15/2010 100% 6/8/2010 294 a Actual 109 7/15/2010 179% 3/9/2010 185 a Actual 27 4/14/2010 257% 1/5/2010 158 f Final Bill 3 1/5/2010 -34% 12/11/2009 155 a Actual 17 1/12/2010 -39% 9/8/2009 138 a Actual 27 10/15/2009 -45% 6/9/2009 111 a Actual 46 7/20/2009 165% 3/16/2009 65 a Actual 20 4/29/2009 -27% 12/8/2008 45 a Actual 25 1/20/2009 -10% 9/10/2008 20 a Actual 20 10/10/2008 -100% 7/8/2008 0 n New Meter 0 10/10/2008 -100% Commonwealth of Massachusetts City/Town of 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. A. Facility Information 1. System Location:0/Right ront of hou�Left/Right rear of house, Left/right side of house, Left/ Right sided building, Left/Right front of building, Left/Right rear of building, Under deck Address 0A C,s taon VJcc kk(-4--A AOcao Q 42A- Cityrrown State Zip Code 2. System Owner. c Name Address(if different from location) Cityrrown State Zip Code ate- 3 Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) 9-1 ptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes D-wo If yes, was it cleaned? ❑ Yes ❑ No. 5. Condition of System: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locationnbe a contents were disposed: Lowell Waste Water Signit e Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Christian Way ,p - Property Address Theodore Knight Owner Owner's Name information is required for North Andover MA 01845 7/23/2013 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Summary Record Card generated on 7/11/2013 3:11:57 PM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-104.D-0186-0000.0 Parcel Id 16874 137 CHRISTIAN WAY EXT THEODORE & SUSAN KNIGHT 137 CHRISTIAN WAY NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1.02 Acres FY 2013 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until THEODORE&SUSAN KNIGHT Owner 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 ANGELO,RICH Previous Customer Inactive 7/10/2008 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 LARRY GUTOWSKY,JR. Previous Customer Inactive 1/7/2010 137 CHRISTIAN WAY EXT NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 17864.0-137 CHRISTIAN WAY EXT Last Billing Date 4/10/2013 3170529 03 Cycle 03 Active UB Services Maint. Account No.3170529 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 1 1 9.18 1/ WTR WATER 01 ALL METER SIZE 92.27 /1 UB Meter Maintenance Account No.3170529 Serial No Status Location Brand Type Size YTD Cons 34658473 a Active ERT HH b Badger w Water 0.63 0.63 1000 Date Reading Code Consumption Posted Date Variance 6/13/2013 1085 a Actual 65 186% 3/14/2013 1020 a Actual 23 4/22/2013 -19% 12/12/2012 997 a Actual 28 1/9/2013 -76% 9/12/2012 969 a Actual 118 10/15/2012 199% 6/12/2012 851 a Actual 39 7/16/2012 58% 3/13/2012 812 a Actual 25 4/14/2012 -34% 12/12/2011 787 a Actual 37 1/17/2012 -65% 9/13/2011 750 a Actual 115 10/13/2011 208% 6/7/2011 635 a Actual 35 7/20/2011 35% 3/7/2011 600 a Actual 25 4/13/2011 -56% 12/8/2010 575 a Actual 58 1/12/2011 -73% 9/9/2010 517 a Actual 223 10/15/2010 100% 6/8/2010 294 a Actual 109 7/15/2010 179% 3/9/2010 185 a Actual 27 4/14/2010 257% 1/5/2010 158 f Final Bill 3 1/5/2010 -34% 12/11/2009 155 a Actual 17 1/12/2010 -39% 9/8/2009 138 a Actual 27 10/15/2009 -45% 6/9/2009 111 a Actual 46 7/20/2009 165% 3/16/2009 65 a Actual 20 4/29/2009 -27% 12/8/2008 45 a Actual 25 1/20/2009 -10% 9/10/2008 20 a Actual 20 10/10/2008 -100% 7/8/2008 0 n New Meter 0 10/10/2008 -100% Commonwealth of Massachusetts qjMMq City/Town of 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. A. Facility Information 1. System Location:o/Righ#int of houLeft/Right rear of house, Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/Right rear of building, Under deck Address Via:, K)0C--V-kA 90ca(O Q 42,4- Cityrrown State Zip Code 2. System Owner. c Name Address(if d event from location) CitylTown State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) [-S ptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ YesQ' lh'o/ If yes, was it cleaned? ❑ Yes ❑ No. 5. Condition of System: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc' Company 7. Location a contents were disposed: Ca LLS Lowell Waste Water Sign t e Haule Date t5forrn4.doc-06103 System Pumping Record•Page 1 of 1 • J Gf MORTN 0 j•` r`' c9 Town of North Andover HEALTH DEPARTMENT "s to CHECK#: AW DATE: LOCATION: 4� ' H/O NAME: CONTRACTOR NAME: Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ �iTitl Report $ ❑ Other:(Indicate) $ �--A Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer COMMONWEALTH OF MASSACHUSETTS l EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION'K- �' i �r n v s� TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_137 Christian Way_ _North Andover_ RECEIVED Owner's Name:_Richard Angelo_ Owner's Address:_137 Christian Way 2008 North Andover,MA 01845_ APR 2 8 Date of Inspection:_4/15/2008_ TOHHEALLTH DEPARTMRTH DEONTER Name of Inspector:_Neil J.Bateson_ Company Name:_Bateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ _Andover,MA 01810_ Telephone Number:_(978)475-4786 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority 1 Inspector's Signature: &ra-iLx� Date: _4/15/2008_ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments: ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner:_Angelo_ Date of Inspection:_4/15/2008_ Inspection Summary:Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_137 Christian Way_ _North Andover— Owner:_Angelo_ Date of Inspection:_4/15/2008_ 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 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance, "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 Pages 4 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_137 Christian Way_ _North Andover— Owner:_Angelo_ Date of Inspection:_4/15/2008_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: — _No_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool — _No_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _No_ Liquid depth in cesspool is less than 6"below invert or available volume is'/z day flow. _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ Any portion of the SAS,cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _No_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone I1 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_137 Christian Way_ _North Andover_ Owner:_Angelo_ Date of Inspection:_4/15/2008 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Yes_ Pumping information was provided by the owner,occupant,or Board of Health _No_ Were any of the system components pumped out in the previous two weeks? _Yes_ Has the system received normal flows in the previous two week period? No Have large volumes of water been introduced to the system recently or as part of this inspection? _Yes _ Were as built plans of the system obtained and examined? _Yes_ _ Was the facility or dwelling inspected for signs of sewage back up? Yes Was the site inspected for signs of break out? _Yes_ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum _Yes_ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No _Yes_ _ Existing information. _Yes_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_137 Christian Way_ _North Andover– Owner:_Angelo_ Date of Inspection:_4/15/2008 _ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15;203 440 Number of current residents:_4 Does residence have a garbage grinder(yes or no):_No_ Is laundry on a separate sewage system(yes or no):_No_ Laundry system inspected(yes or no): Seasonal use:(yes or no):_No_ Water meter reading:_Yes_ Sump pump(yes or no):_No_ Last date of occupancy:_Current_ COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):— Water meter readings,if available:— Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:_Pumped last year,owner_ Was system pumped as part of the inspection(yes or no):_Yes_ If yes,volume pumped:_1500_gallons--How was quantity pumped determined?_Measured tank_ Reason for pumping: _Inspect tank&tees_ TYPE OF SYSTEM ,X_Septic tank,distribution box,soil absorption system Single cesspool_Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information 9 years old,10/27/1999, as built plan_ Were sewage odors detected when arriving at the site(yes or no):_Nc Title 5 Inspection Form 6/15/2000 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner:_Angelo_ Date of Inspection:_4/1.5/2008_ BUILDING SEWER_X_ (locate on site plan) Depth below grade:_18"_ Materials of construction: _cast iron _X_40 PVC other Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.) _Partially finished cellar unable to see pipe leaving foundation,3"PVC in house with no leaks visible_ SEPTIC TANK: X Depth below grade:_6" Material of construction: X_concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions:_10'x 5' x 4' Sludge depth:_2"_ Distance from top of sludge to bottom of outlet tee or baffle: 25"_ Scum thickness:_4" Distance from top of scum to top of outlet tee or baffle:_8" Distance from bottom of scum to bottom of outlet tee or baffle: 17"_ How were dimensions determined:_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc._Pumped septic tank.Inlet tee ok.Outlet tee ok.Depth of liquid at invert.No evidence of leakage._ GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction: concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner:_Angelo_ Date of Inspection:_4/15/2008_ TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX X_ Depth below grade _2011 _ Depth of liquid level above outlet invert:_0_ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.) _D-box level&distribution equal.No evidence of leakage. Evidence of solid carryover,pumped d-box to clean._ PUMP CHAMBER:_(locate on site plan) Pump in working order(yes or no):, Alarm in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): _ Title 5 Inspection Form 6/15/2000 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner:_Angelo_ Date of Inspection:_4/15/2008_ SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type _Leaching pits,number: _ Leaching chambers,number: Leaching galleries,number: _Leaching trench,number,length: X Leaching field,number,dimensions: _1 field 24'x 38'_ Overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):—Soil ok.Vegetation ok.No sign of ponding to surface. _ CESSPOOLS: Number and configuration:— Depth—top of liquid to inlet invert:— Depth of sludge layer: Depth of scum layer:_ Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Title 5 Inspection Form 6/15/2000 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_137 Christian Way_ _North Andover— Owner:_Angelo_ Date of Inspection:_4/15/2008_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building House Driveway Garage Water Meter Septic Tank 1 2 A to 1=20'6" Ato2=27'6" A to D-Box=35' Bto1=13'7" D- Bto2=16'8" Box B to D-Box=25'2" Title 5 Inspection Form 6/15/2000 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner:_Angelo_ Date of Inspection:_4/15/2008_ SITE EXAM Slope_No_ Surface water_No Check cellar _Dry_ Shallow wells No Estimated depth to ground water _4'_ Please indicate(check)all methods used to determine the high ground water elevation: _X_ Obtained from system design plans on record-If checked,date of design plan reviewed:_10/27/1999_ 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:_as per design plan_ Title 5 Inspection Form 6/15/2000 11 Summary Record Card generated on 4/10/2008 2:23:46 PM by Lisa Evans Page 1 Town of'North Andover Tax Map # 210-104.D-0186-0000.0 137 CHRISTIAN WAY EXT ANGELO, RICHARD P. &ANGELO, Since Jan 2004 137 CHRISTIAN WAY NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1.02 Acres FY 2008 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until ANGELO, RICH Payor 137 CHRISTIAN WAY NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 17864.0-137 CHRISTIAN WAY EXT Last Billing Date 3/28/2008 3170529 03 Cycle 03 Active UB Services Maint. Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 1 1 9.18 1/ WTR WATER 01 ALL METER SIZE 104.98 /1 UB Meter Maintenance Serial No Status Location Brand Type Size YTD Cons 47963490 a Active ENC FR.RT NEPTUNE NEPTUNE w Water 1 1 0 Date Reading Code Consumption Posted Date Variance 3/10/2008 1836 a Actual 26 4/11/2008 5% 12/12/2007 1810 a Actual 27 1/22/2008 -74% 9/6/2007 1783 a Actual 86 10/12/2007 105% 6/19/2007 1697 a Actual 51 7/20/2007 98% 3/15/2007 1646 m Manual estimate 25 4/16/2007 -3% 12/12/2006 1621 a Actual 25 1/19/2007 -71% 9/13/2006 1596 a Actual 81 10/20/2006 73% Trouble Code:03 6/19/2006 1515 a Actual 56 7/10/2006 88% 3/8/2006 1459 a Actual 22 4/17/2006 -1% Trouble Code:03 12/22/2005 1437 a Actual 27 1/17/2006 -74% Trouble Code:03 9/21/2005 1410 a Actual 97 10/14/2005 94% Trouble Code:03 6/28/2005 1313 a Actual 53 7/15/2005 101% 3/30/2005 1260 a Actual 31 4/5/2005 -12% 12/14/2004 1229 aActual 26 1/14/2005 -71% Trouble Code:03 9/27/2004 1203 a Actual 109 10/8/2004 109% 6/23/2004 1094 a Actual 37 7/30/2004 94% Trouble Code:03 4/16/2004 1057 a Actual 34 5/17/2004 0% Trouble Code:03 12/17/2003 1023 n New Meter 0 12/17/2003 0% • Tel: (978)475-4786 s Fax: (978)475-5451 BATESON ENTERPRISES, INC. Excavating-Water& Sewer Lines-Septic Systems&Pumping Service 111 Argilla Road Andover,Mass. 01810 Title 5 Inspection Report Property Address: 137 Christian Way, North Andover Owner: Angelo Date of Inspection: 4/15/2008 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. Neil J. Bateson Bateson Enterprises, Inc. COMMONWEALTH OF MASSACHUSETTS Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS � d DEPARTMENT OF ENVIRONMENTAL PROTECTION K` O� I� SV'y TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_137 Christian Way_ _North Andover_ Owner's Name:_Jeff Palumbo_ Owner's Address: 137 Christian Way_ North Andover,MA 01845_ Date of Inspection: 2/26/2003_ Name of Inspector:_Neil J Bateson Company Name: Bateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ —Andover,Ma.01810_ Telephone Number:_(978)4754786_ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper fimction and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Inspector's Signature: Date: 2/26/2003_ The system inspector shall bmit copy o this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:_137 Christian Way_ _North Andover— Owner: Palumbo Date of Inspection:_2/26/2003_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of i l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_137 Christian Way_ _North Andover— Owner: Palumbo Date of Inspection: 2/26/2003 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 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 su_rface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner• Palumbo Date of Inspection: 2/26/2003 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _No_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool No_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _No_ Liquid depth in cesspool is less than 6"below invert or available volume is less than''/2 day flow _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _No_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _No_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone H of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_137 Christian Way_ _North Andover— Owner: Palumbo Date of Inspection: 2/26/2003_ Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Yes _ Pumping information was provided by the owner,occupant,or Board of Health _No Were any of the system components pumped out in the previous two weeks? _Yes _ Has the system received normal flows in the previous two week period? No Have large volumes of water been introduced to the system recently or as part of this inspection? Yes _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _Yes_ _ Was the facility or dwelling inspected for signs of sewage back up? _Yes_ _ Was the site inspected for signs of break out? _Yes_ _ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper Was of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Yes _ Existing information.For example,a plan at the Board of Health. No Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance_ is unacceptable)[3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 137 Christian Way_ —_North Andover— Owner: Palumbo Date of Inspection:_2/26/2003_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_440_ Number of current residents:_4 Does residence have a garbage grinder(yes or no):_No_ Is laundry on a separate sewage system(yes or no): No_ [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):_No_ Water meter readings:—Yes_ Sump pump(yes or no): No_ Last date of occupancy:— Current-COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:_Pumped two years ago,owner_ Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1500_gallons--How was quantity pumped determined?_Measured Tank_ Reason for pumping:_Inspect tank&tees_ TYPE OF SYSTEM _X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 4 years old. 10/27/1999. As built plan. Were sewage odors detected when arriving at the site(yes or no):_No Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way- —North ay__North Andover— Owner: Palumbo Date of Inspection:_2/26/2003_ BUILDING SEWER(locate on site plan)X Depth below grade:_24"_ Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.):_4"PVC thru wall to septic tank.3"PVC in house.No leaks. SEPTIC TANK: X locate on site plan) Depth below grade:_12"_ Material of construction:—X—concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 10'x 5'x 4' Sludge depth —4"_ Distance from top of sludge to bottom of outlet tee or baffle: 21"_ Scum thickness:_6" Distance from top of scum to top of outlet tee or baffle:_6" Distance from bottom of scum to bottom of outlet tee or baffie:_1711 _ How were dimensions determined: Subtract scum&sludge depth to tee length._ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Pumped septic tank.Inlet tee ok.Outlet tee ok.Depth of liquid at outlet invert.No evidence of leakage._ GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): • Page 8 of l l OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ North Andover— Owner: Palumbo Date of Inspection: 2/26/2003_ TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X (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.):—D-box level&distribution equal.No evidence of leakage.Evidence of carryover,pumped d-box to clean._ PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): • Page 9 of 1 I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover— Owner:_Palumbo_ Date of Inspection: 2/26/2003_ SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: _leaching trenches,number,length: X leaching fields,number,dimensions:_1 field 24'x 38'_ 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 ponding to surface._ CESSPOOLS: (cesspool must be pumped as part of inspectionxlocate 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover— Owner: Palumbo Date of Inspection:_2/26/2003_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. House Driveway Water Meter A to 1 =21'6" Septic Tank Ato2=27'7" 1 2 A to D-Boz=35' B to 1=41'6" B to 2=33' D-Boz B to D-Boz=34'3" 38' IF 24' Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_137 Christian Way_ _North Andover_ Owner: Palumbo Date of Inspection: 2/26/2003_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_4 feet Please indicate(check)all methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed:_10/27/1999_ 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:_As per design plan_ 1• W ' �Ct ¢SI F,Jr l`1 �[�'j� �]��,y�Iiif [ 0{ 4 •w" 6. 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W., �kpmo— .: 1 r%"'�'•F i C�- J u.,4r('�{L`1�,1•I"' ' 1 tt'iIr;ISIC,'11 f t�;t I I hl A�l. k+r >`'' • I�:[�',H t C`Q OiTI'l"'YCf rr It S 6L {. ,.a. {' 1 ; -17 , �pp i i•�l k r 1l�I"�' �' � l�1� O ®1Qi1 Q+� Q O �+r 7 ?. Ir11 1 l>t y' � ' {1,l I It''.•5f! i 1 I • �1, ;c1 1 }II ,I� N n[` 1 11F�.yF�t Ctl i�r ITVk{V�,`�irE11`N C'�t(I�F)l1+�1 t � ,1,1�, "j, 'i '•,�s !',. 'i I---='i :Ji�. �1•D• 'i �`:,�F Q 11A V C. '�?� � r 1'_y, 1�f��r.. !. IQ. 41C 11t41'IE ry v 1 Tnn R 'UdQ 2IIMNF HINON SLS6 S99 SL6 ZF3 tfi :ST 11HZ C0/!Z/Z0 r� Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 137 Christian Way, North Andover Owner: Palumbo Date of Inspection: 2/26/2003 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. Neil J. Bate on Bateson Enterprises, Inc. Address�� 7 . �-t�(�lS�-t� _ IvAy Title of Fire Page _ of Date File Open: --_ Date file ciosed: Doc Document/Action Title Date of _ action Refer to other Purpose of i�ocumecnt/Action and notes Document/ document/ CW u m. --- Action De a►fimen€ ------------------ Board of Appeals - Board of Heal h Plann�F g Board ; Cons eruatiion Commission — Building De partrnen�t �---- TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD n 1 4 M DATE: SYSTEM OWNER &ADDRESS SYSTEM LOCATION (exam ple: left front of house) �31 c moi.,.-. , S\lz� 0�--: wccj DATE OF PUMPING: t' ' ' �76UANTITY PUMPED �7�� GALLONS CESSPOOL: NO ---�YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE /EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO. TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: q'a - -� SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) tel. l,V Ln1n.X/ V l� DATE OF PUMPING: Ja llc�u QUANTITY PUMPED GALLONS CESSPOOL: NO ES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: Town of North Andover HORTM OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES ° . A 1t 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT �SSACHUS�� Director (978)688-9531 Fax(978)688-9542 April 3, 2000 Mangano Development Comp. 36 Hillman Street, Unit 12 Tewksbury MA 01876 To whom it may concern, This letter is in regards to the Brook Farm Development, located at Christian Way,North Andover. Health Department personnel performed a septic system installation inspection at lot 3 on April 3, 2000. There was no problem with lot 3, however, concerns were raised upon observation of some of the other lots in the subdivision. Specifically, rubber tire tracks were found over the septic areas of lots 1 + 2. The exact locations of the track depressions in relation to the septic fields, distribution boxes and the septic tank were not known, however,this department is concerned for the integrity of the septic systems. At no time should a rubber tired vehicle of any kind be allowed on top of a septic system. Although the Health Department has already signed off on these properties we feel it is important to inform you of any potential problems we may observe. In speaking with the septic installer, Arthur Hutton, I recommended that, at minimum,the distribution boxes be uncovered to be sure no damage had occurred. I also volunteered to view the flow in these boxes, to confirm their findings if he so wished. In addition, these septic systems must be marked off so that this type of problem can not occur. It is obvious that many people around the job site do not understand or care what their actions could do to compromise the proper functioning of a septic system. Please note that this is only a recommendation. Feel free to contact the Health Department if you have any additional questions. 7san y, ord Health Inspector Cc: Lot 1+2 Homeowners Arthur Hutton, Installer BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NTAVIBER LOT LINES & LOCATION OF DWELLINGS LOCATION & DEMENSIONS OF SYSTEM, r INCLUDING RESERVE v TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA f/ LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION y LOCATIONS OF WELLS, DRAINS, WATERCOURSES W/N 150' OF SYSTEM ✓� LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D-BOX STAMP & SIGNATURE f/ 2VTERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW FINAL CONTOURS LOCATION & ELEVATION OF BENCHMARK USED LOCUS PLAN TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 3/11/00 This is to certify that the individual subsurface disposal system constructed (X ) or repaired () by Arthur Hutton at 137 Christian Way has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector - FORM U - LOT RELEARM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from _. Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION = APPLICANT I�Ol�e�r� ✓uq/��, PHONE98�' -7 S8 7031 - -- LOCATION: Assessors Map Number /Q qP PARCEL SUBDIVISION_ fit (C t riot �� LOT(S) 02 STREET ST. NUMBER 6 _ *OFFICIAL USE RECOM NDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED D A DATE REJECTED COMMENTS10z) TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED / DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER;.CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised M97 jm it I c-,:-p. , - '.. - 'g,'.)",� ---1 , I 41 11t�x 14 c. -lip 5A e� c Town of North Andover, Massachusetts Form No.3 I A BOARD OF HEALTH d AORTH g, 0 —19 DISPOSAL WORKS CONSTRUCTION PERMIT' Applicant N ADDRESS TELEPHONE Site Location 0,�, Permission is hereby granted to Construct Repair an Individual Soil Absorption W." Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN,BOARD OF HEALTH Fee— D.W.C. No. F isT M! A �Nl 4 i Mi Pi 5 fi U. J.",4 7 R. j k rI'-f 1:,.15 P OX 1 }Ii 'I Al, P j, A�y At z; J1 41 t 4. APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: 9 - /c �j� CURRENT INSTALLER'S LICENSE# LOCATION; L. l> l AV LICENSED INSTALLER: ✓Z G I1 J4J I oiJ SIGNATD ������TELEPHONEM CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only 575.00 Fee Attached? Yes No Foundation As-Built? Yes ✓ No Floor Plans? Yes 1/ No Approval Date: 9�G �c, fir. FbA ;/'T FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** ✓ APPLICANT �Ill 14u' nc Qyi Cp PHONE 97g�'�.5� 731� LOCATION: Assessor's Map Number /QZ/P PARCEL� SUBDIVISION F?(`601-- r'C(f'M E-&-r04-Te-r, LOT (S) STREET 1, rt-r n LUQQ &:X 1enJ10V" . ST. NUMBER 3 01 *************************OFFICIAL USE ONLY************************* ** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TO PLANNER DATE APPROVED 1 DATE REJECTED COMMENTS , r . FOOD INSPECT HEA DATE APPROVED DATE REJECTED SEP- SP O -HEALTH DATE APPROVED S7 DATE REJECTED COMMENTS 9 r00nn3 1y)QX1�- 1nclu AlnQ e-/Aan51nfN off/C PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION**************** APPLICANT ` 1 M MU' n9AQ V1 PHONE qfig--$S/-731 ) LOCATION: Assessor's Map Number Qz/p PARCEL o? SUBDIVISION i-.s70 M:S LOT (S) STREET (� h Q-tiuYi WCIQ &x1enJi0v`. ST. NUMBEROf 3 *** **** ***********OFFICIAL USE ONLY**************** * ** *** *** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOODZ_r-HEA DATE APPROVED DATE REJECTED SEP -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS W "� r p — 9f DRIVEWAY PERMIT FIRE DEPARTMENT r RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm Town of North Andover, Massachusetts Form No.2 f NORTq BOARD OF HEALTH o 0�,•"o I�,ti0 � / ti w p " s -�--• DESIGN APPROVAL FOR ,SS�1Cwu5SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Wry • Ay4b1'y Test No. Site Location Reference Plans and Specs. OJ—�a—A� r_ f/i�0 h? ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee Site System Permit No. �� 3 v4ORTH own of over TIN No.& ti O � / q �A CoCM,� y dover, Mass., ORATED F'PpGG,`�5 S SG BOARD OF HEALTH Food/KitchenPERMIT -� 9 `Ttill Septic Syste T THIS CERTIFIES THAT a of CO BUIL NG INSPECTOR ��""""""" Foundations has permission to erect.............I............. buildings on ...1pia.......#13.9 .... 'V ., IR�o;Ah ��K2-��to be occu ied as a ti FA oZ Ma l!.U.#jA!!. � p . ....d .....:................... ........................ ,..y..8�tr..w.....� 2...I3 � .. Chimney//f'�/��P�------ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ga 7� _ PERMIT EXPIRES IN 6 MONTHS �� s s p t UNLESS CONSTRUCTIO ST TS ELEC/TJRI AL �NSP CT e ou0/z�C �•Z.�� .... ........... . . ........... ....................... BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS IN PECTOR 7 Final Display in a Conspicuous Place on the Premises — Do Not Remove nah 1 41,4 F No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. 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I���IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 111111111111111111111111 111111111111111 Ill. 1111.PI'1'1'1h'1'1'1'I"1'1'1'1 III,1 IIIIII�IIIIIII � umm�umuuw uuuuuuuunm EE E8 :::: CI SII IIIIIIIIIIIIIIIIIIIII �Il�lilllllllllllllllllllllllll 1 1 ►I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII il�;;;�;�;,, Ar GENERAL.NOrEs. t- - ,.0 3s,� ...F`.ir Yr '" '.i'!• "z Awa;: .- _ u.t.+:.. .. �dralt�D.etalt�s... �. _ r=L r= ' ATJON *, 6TAND,,AR y C 3603 X14 2 1 T Csuardiii de' lls�Porches;balconies;decks �Q t,hd it, �� M C�Fssa c � �i tt� �l d.� C ode _ _ . or{r feed . oor euKsaces Toaated,more than_30-inches lbz mm) . above the I'looror•grade below shall hays guar�aila not less than -of' of':ttal�'bMwlth r r 36 inches (914 mm),h heigitk Open.sides o s a total Ise ofy�more than 30inches 0162 mm}above the floor or,grade belonr shall;have guardrails,which`shall also serve as handrails, 0 5 u riot fess than 34 Inches (864 mm} in height measured vertleallg from 10 0 �+ the nosing:offthe treads. _- Guardrail Opening Llmltatlons= 13603 _14 .2 .2 A Exc. I Guardrail opening limitations=Required guardrails on open side of staiwags,balconies,porches,decks and - raised floor areas,shall have intermediate rails,balusters or ornament aF losures which prevent the passage of an object five inches (102 mm) or more in diameter, z" Exception= Triangular spaces formed by the riser,tread and bottom rail of a guard at the open side of a stainuay may be of size to prevent the passage of a sphere six inches (153 mm)1n diameter. -_ N_ andrai : - C 3603 . 14 . 1 . 11 i landratis. Nandralls having minimum and ipq maximum heights of 30 inches and 38 inches Ci62 mm and 965 mm ), respectively,measured vertically from the nosing of the treads, `. shall be provided on at least one side of atahuays of three or more risers. Spiral stairways shall have the required handrail located = — on the outside radius, All required handrails shall be continuous f 'the full length of the stairs. Ends shall be returned or shall t�rminata in newel posts or safety terminals. lNandralls adjacent to Chlmne� C Above 5 y �:a"wall shall have a space of not less than i V2 Inches (38 mm) between the wall and the handrail. R Exceptions' {. 1_ 14andralls shall be permitted to be intem"d bg a newel _ post,at a turn. ..., O above ridge line 2. The use of a volute,turnout or starting easing shall be allowed over the lowest.tread. n D•ralnage= `TML-3604__ 1 . 3 I Drainage: Surface drainage shall be diverted to a Y storm sewer conveyance or other point of collection or away from the foundation system to avoid creating a hazard.Finished grades shall be 'j -arranged to direct surface water away from all Foundation walls,The finished grade shall slope a minimum of 1l2" per foot for a distance of at least six feet from the face of all foundation walls. Masonry Ghfmney construction= _ Chimneys to be construction using information,tables,charts and details shown in 180 CMR 3610 - CWIMNEYS,FIREPLACES AND SOLID ' FUEL--FIRED APPLIANCES. - - - - - - - - - 4-- --Chimne9-Tenn1nation= C 3610- -2.,5 I Termination. Chimneys shall extend at least two feat (610 mm) higher than any portion of the building within ten feet (3048 mm),-but shall not be less than three Feet-(914 min)above the point inhere the chimney passes through the roof. y� h t,, -mak k L - C 3603100 Exit doors=The minimum nominal width of at least one �, _ xit a p h of the exit doors required b 180 CMR 3603.10.1 shall be 36 Inches 5 r ,. - end the minimum nominal heightshall be six feet eight inches. All other :. s _ _,. shall not .. _ _. . _ �,.,,�,,,,•,_.. ��.�_ .:_.... . ... ..... _ - ---exit doara and doom lead to or from enclosed statrwa s, 4. j - th nor sbc feet a ht inches dttfo :l iaasachusett8 =.�u�f t - r r IC d ig C O e be less than 32 inches n nominal wid ., �.th : g - +c z al height` _ � �; in nom(n of ht: Exception L Existing buildings= New and replacement doors are permitted _� to be six Feet six inches in nominal height. 6I�iLt�luCs COIF =CzE� 1�L �tOT - � �..: _,.. - Interior Doors -A ' _ENDIX Application of Other Laws [3603 . 11 .21 interior Doors-All doors providing access to habitable =:r C 3601 . 1 . 1 I Application of other laws= Nothing herein contained shall rooms shall have a minimum nominal width of 30 Inches and a minimum Energy Conservation for New Construction be deemed to nullify any provisions of the zoning by-laws or ordlance of nominal height of six feet six inches. �> any nuniclpality in the Commonwealth of Massachusetts insofar as those L6,w4ise Residential E3Uild ing9 provisions deal exclusively with those powers of regulating zoning Exception- I � granted by the provisions of M.G.L..cAOA and 41. 1. Doors providing access to bathrooms are permitted - to be 28 inches in nominal width. M.A S c hec k Energy Software Minimum standards 2_ Exbiting Buildings= Doors providing access to bathrooms are y _ permitted,to be 24" in normal width. C 3601 .2 J2 Minimum standards: The purpose of 180 CMR 36 is to 180 CMR J12 provide minimum standards for the protection of Ire, limb,health,property, Safety CslazN: a Re uirements environment and for the safety and welfare of the consumer,general public, Envelope p q general public,and the owners and occupants of residential buildings L 3603 . 20 .4 .2 I Speeft hazardous locations= The following shall J1 .2. I General= To determine thermal transmittance regulated by 18 CMR 36, be considered specific hazardous locations for the purposes of glazing. 'compliance with the various wall,roof and floor-assemblies, 1. Glazin in an individual fixed of operable panel,other than in the MAScheck Software analysis must be completed, scope _ thoselocations described in 180 CMR 3603.20.4.2 items 5.and 6., 1 and the "Your Nome" UA value must be less than or equal r which meets all of the following conditions= -to the °.Required" UA value calculated by the software. 1.3601 .2 . 2 I Scope 180 CMR i,in its entirety,shall serve as the 9 administrative rec(utements of 180 CMR U. A. Exposed area of an individual pane greater than nine square feet (0,84 mm 1). Access to crawl Space 5. Exposed bottom edge less than 18 inches (460 mm) { y. above the floor. [3603s .1 I Access to crawl;spaces=Access shall be provided • to crawl spaces by an opening not less than 18 inches (451 mm) Ciur'b>� for s�eylig�,ts by 14 inches 6610 mm). . 1. All notes and details contained within these drawings are to be used Y 13&03 .20 ,5 .5 ]Curbs for Skylights All unit skylights installed -as they would apply to the house being constructed. Access to Att1G in a roof with a pitch flatter than three units vertical in 12 units [3603 .9 .2 I Access to att�s�.An opening not less than 22 inches horizontal (25� slope)shall be mounted on a curb extending at least 2...Whan plans are used in conjunction with s ecrications and any 59 mm b 162 mm)iuith read access thereto shall be four Inches (101 mm)above the plane of the roof. discrepancy occurs,the specifications will supercede the drawings. by 30 inches(5 provided to any attic area having a clear height over 36" inches (162 mm) -.3 All substitutions are the res onslbllity of the Builder. Where doors or other openings are.installed in the draftatopping, Craning p L 3603. 22 . 4 such doors shall be self-closing and be of approved materials as . 2 I Framing: Ail woad Framing members, including wood 4. All dimensions are to be field verified by the Contractor and any specified in this section,and construction shall be tightly Fitted sheating,which rest on exterior foundation walls and are less than . adjustments made accordingly. around all pipes,ducts or other assemblies piercing the draftatopping. eight inches (203 mm) from exposed earth shall be of approved - 5. Alt work shall be completed in compliance with all applicable naturally durable of preservatNetreated wood. Binding,Plumbing,Electrical codes. Any other local,state and/or scope - - - federal codes that may apply to this project shall be considered- [3603 . 10 .4 • 11 Minimum size:All emergency escape windows from Sleepers # Sills -as pat of the construction documents, p ng sq L3603 .22 , 4 .3 I Sleepers and sills=Sleepers and sills on a sleeping rooms shall have a net clear o eni of 3.3 uare feet 6: All waste materials and debris shall be removed and disposed (0530 m 1).The minNnum net clear opening height shall be 22 Inches concrete or masonry slab which is in direct contact,with earth shall of properly. (559 mm).The minimum net clear opening shall be twenty.inches by twenty be a approved naturally durable or preservative-treated wood. four in either direction. - -» 1. Numbers set within L I reference that section of the 6th Edition of ,_ - -- -- - --- - _ - - -- Except ion-� - ----- - -- ------- - ----- - ---- --Girder finds--- - -- - -- - - ------- - - the Massechubette-State Building Code.--. -- - Windows in sleeping rooms of ei iating dwellings which do not L 3603. 22 ,4 . 4 LGirder ends= The ends of wood girders entering idelines set forth in the conform to the requirements of 180 CMR 310.1.1 may be replaced exterior masonry or concrete walls shall be provived with a 1/2-inch 8. These drawings were prepared per gun e Mass_State Building Code Section L ld I for 11 2 family the dwellings. without conforming to 180-CMR 310IJ provided that the replacement (13 mm)air space on top,sides and and,unless approved naturally windows do not significantly reduce the existing opening size. durable or preservatives-treated woodis used: ' .. .r,.. - ... ...-..a.-aaa,s.y--..lay..n. �.. ... '_.r+J4r`#ww+er-a.'��NG}+R� •4a.-..�P'e'�:.-..g..r-rcm=Jgr.+ -'(rM ,y- -a..-rw_ t.'iwb•r�' .f�'s-.qMc.Gy.:.ex vim" bw.aa'. c-`.Laa- .. ..n>r +a .i,.v A.cr .-.. ... ._ . 1011 �r.S e�Z dFz 1 R Qf //� (//� 244 I+ a.. (o -.a a.� - _ I it ;<I1'� t�S7_��; 2,8«e 3" , f a ,* 610"=SL`ID1NG 3� - 1F —r --- ----------------- 2'100 � `: ay_ — X 31511 x a C!J X CA x _6T KITCHEN -5-R KF cF a r '" - Actual cabinet layout , 1 2 -30 may vary ~l. 'd' r - - — — — — — — — — — — — — — — — — — — — O ._ -- 3`41/4 1.41/4 21311 j1(oll of 4-0" 1 it A L - - VAULTED _ FAMILY ROOM v 4,0" O O xCc% 2'8" N Cn CEN 1 1 t r r - - - - - - - - - - - - - - - - - -- - - - V INEROOM ____ ___ FOYERhINI�� BOOM xP2'10' X 4'9" 2'10" X 419" Qo 216+, 216+, b- . . 21�" X 41g" 2110' X 41w°b' 2'lo" X 4'9' 2'10" X 4'9' - - - 3'0" a< � e Ir 3+6+, 616., 36 5,(o 56 36 . . 66 36 �, l90 h 13 6 I11 +, 1316++ ++ �+ i CIN _ . - 350 FIRST :-FLOOR PL 1� 11 '1 = 3 _.. _ 4 = t0 _ _ 38'Qn (o'0�� 9��n $r8'/4n 36 36 =5Z�a S � /a 51011 ! $$� x x' `a 'r. `.iviid ^�' "'�' - al �.,a...: i? •�'b.- .+. x'r ,. — — -- — 210" X 3151 2100,x.3,50 5W X 4'S" wl BEDROOM #4 CL ca 2 _ L o ' il .6.. 5 ��� JL ►� 2'4" 21 41 2141- Ya` O 4'0" SLIDING - CL CL CL = -------- 4'0" SLIDING --------' — + cv r Z cm -------- ncry 2 $ - M BEDIR 210" X 4'S" Poll X 4�5�� 2'10" X 4'S' 2'10" X 4'5" 5EVROOM #2 O 5'8" X 4'S' 6l6ii Ye" 3 (o (0,(o 3'C7 13,(o 5i(o 50 13'(o SECON PLOOR PLAN 1,4" = 1'0' 1141 - 4 1x Bottom Plate : FOUNIDATION6_5TANDARDS— Zx Band Joist Z�#5 RBbar ,� - � t>onal> h Edition� `� pj__ ns Floor_ S , -C latTon O G��M aS _ 4 .__ - 1x Jobt. ConcreteT._ __. ._ .-... Foundation FQUND�TION CsENEI��►L N07E5= -- ,: - _.. - i -2x6 P t. O r _-- 1 -2x6 K.D.SIU Cenerai= Da>mpproofing= o iu/Sill sealer : . : - . �. C 3604 ,3.11 Cseneral All permanent supports of buildigs and 03604 .6.11 concrete and meeorry foundation darrprooftng= t where ro uied to be roof 180 CMR 3604.6.2, Anchor Bolt Footing structures larger than 120 square feat In area or tan fast h height Except q �aP i'9�! * shell extend to minimum of four feat(L2 m)below rhbhad grafoundation walls enclosing de except = habitable or storage space shall be damp- :" � fop tonal) when erected on solid or othenutea protected from f Oet. .: -proofed from the top of the footing to the fIniehed grade.Masonry walls � ��� Concrete Foundation shall be dampproofed by appl l g rot less than 3/8 inch(95 mm)Portland " x 4 Walkout Fdn 3/8' 2 PO' 5111 Anchorage' cent pargN to the exterior of the wall.The pargIng shall be covered 3/8 = 10 - _. with a bituminous coating,three pounds per square yard(lb3 kg/m2)of = C 3604 .3 .la 15.The 681 plate or floor-system shall be anchored acrUlic,modified cement,Ve-inch(31 mm)coat of surface-bondrg mortar r to the foundation with 1/2-heh-diameter bolts placed 6k feet on center ;_. and not more than 12 inches from comers or other approved arrchoro, " complying with,48TH C 881 or arty material Permitted for waterproofkg 1x Bottom Plate - c Bolts shall extend a minimum of 6 inches into maeorcy or sight inches in 180 CMR 3604.62 Concrete walls shall be danpproofed by appiyhg 2x Fire Blocking into concrete.Other approved arrcFrom ehail be installed in accordance any one of the above listed dampproofing materials or any oris of the u r, wth manrfactiuer a epecificatbns.SRI platen shell be protected waterproorN materials lisead In ISO GMR 360462 to rhe exterior of Insulation =r . a 4 against decay where nequted by 180 CMR 3603.22.6, the wall ' 2X Fioor Joist ' AD a' 6v a0Opening Protection= Sleepers and Sills= Center Beam Lally Column Gap Plate 4n 1 C 3603.5 ,11 Opening Protsetlon=O en a fron a rtva a ar a fasten to Center Beam p „g p 9 a9 L 3603,12.4 ,3] Sleepers and 6111son a concrete or nasorry Blab == directly into a room used for sleeping purposes shall not be parmtted, -which b in direct contact with oath shall be of approved naturally rtt(n, Other openings between the garage and dwell shall beequipped with ingdurable or preservatNe-treated wood Is used. Lally Column 3/4" = I'O" ether solid wood doom not less than 13/4 inch(45 mm)in thickness Y or 20-mute fine-rated doors.Self closing devices and fire restive Girder Enda' F Center Beam B �" Slab Ste down rated door frames are not required-Alt'doore openings between the p garage and the dwellig shall be provided with a raised sill with a minimum L 3603.12.4 .4]Girder ends=The ends of wood girders entering height of four Inches, exterior masorry or concrete walls shall be provided with a 1/2-inch (13 nm)at spaces on top,,sides and and,unless approved naturally durable or preservative-treated wood Is used. 4'-O" 4'-0" r C 3603.5.27 Fire Separatiorr•Tha garage shall ba separated From t t�,fi' t the nesidenca and is attic area by rtmsane of minirrumn 5/S troch U6 in rF-N l Eg mnsglD 4 COLU -11�L :s7PACING Basement ' = Q type X gypeun board applied to the garage side.Wherever this attic ��gg 4 cr area ie contlrruoue between the garage and the dwelling a rtastop of window - `0 5/S inches(16 mm)type X gypeum board with a minimum of Oros coat TRUM Z - #5 Rebar` �+ 4e. aD compound and tape shall be used to form a banter to separate the _� . TRM 1130 pag-, (optional) _ n garage and dwelling. � P 90 SF L z# - - a" or Io' Floor Surface= Psi �o Pff - C 3603.5 .3 I Floor Surface=Garage and carport floor surraoes - =` shall be constructed of concrete or other approved noncombustible Concrete One Story Two Story Three Story - mmaterfeL Stab on grade construction shall be n accordance with the O Foundation -� C Step Footing N Tac, provisions of 180 CMR 36085.The minimum floor thioknees shall be 312/ inches.The area of floor used for parkig of automobiles or other COLUMN SPACINGS UNDER GIRDERS _e 6'-O" 1'-0" vehicles shall be eloped to facilitate drainage toward the naln vehicle- I Table 3405-6 I antnj/ext doonnay. Wax (maxi Girder size - '' � ' a' = Basements, Cellars and crawl Spaces-- 3 - 2 x 12 W - 24 U! - 26 W - 213 W - 32 Keyway a — - Fb = 1000 ' b n 0 0 '� L 3603,6 ,S .21 Basements,cellars and crawl spaces All baeenants, -spaces. t0'-3" 9'-10' 9'-6" 8'-il" .n .•� ..e •� which arms not used as habitable,occuplable space,and crawl aces, one - aother than crawl spaces used as an underfloor plenum,shall be ventilated " 11 " u 1 -#5 Reb -{ t Anchors bolts or by opentnge in exterior foundation walls,by Operable IsMows or by approved Tw story l-8 l-4 1-1 6-8 (optional) App'ci qivms, ualent - -- mechanical reaOpenings or openable windows shall be located as near E as practical to provide cross ventilation The openings shall be covered Thus story Concrete Footing -See note 'Sill Anchors e" t 3604 .3 ,la I with corrosion resistant smash rot less'than 1/4 inch(6 nam)nor more than Column-sizes -4' x 4" or 3 1/2' diameter steel 9 -- - roved setmeenIng 1/2 itch(13 rm)in any dinectbn,or other app _ ,anchor Bolt provides for equivalent ventalatlon except then when openable windows arts Footing Size=2'-6' x 2'-b' x i'-3'd used for basement or callar vsntalatiom etardard whdow se"Ons may be From: Table [ 3605 ,2 .3 ,3b I Lcz)D Spacing Plan useda.this corrosionion resistant mash. Concrete Fdn 3/5' , I'O" N T.S. .. ,.:a:..' ':r-,. ..,.:,... ..v..,..�...�..re-.am+..'.wY.A-.�K't�v�9Y•a.---WY.�'yfi""-i+e v.;4.a�:k,sW+3Y..nYt.xw.` II,011 6O 74 _, _.. ._.r - `- ��„„ :.•) ..-.�.:'i - �:. r.._s. t`YC x. _ _ Ap '�i to ..s 'g - r. -- ----------� ------------;---------- ---------------- z --_- --- -� •7 _ - - s s . !,�.. ate_... ».:lr .!. ZF�t - _ ' --------------- - -- 1 ,, _. ----- - FOui�lDAtl4>�t: j P - ------------ 1. 1 8 or 10 Concrete Wall / 8V Pour(+/ ) -. O ; i 10'-deep x 20' wide continuous footing ----- ------ --------- 1 ' 'Y F SGS T4Y "FY L3f' 'f1 - ` --- _ r- 'P 1 Dampproof exterior surface : '=s `--------- -�--- -�-- -r- ' °► _ . _ 2 _ - .. ; �� � C-sARAGE FINISH all ; -�4" Concrete Slab 1 All wood constructed walls and � vJ 6 x 6—elb welded wire Fabric X f . - - ce1i to have 5/S" ty e ' � i� placed at mid-depth of the slab. - rated�Wallboard installed ' t 1 ' I II 1 I1 I cl O Bil.-NeI 1 1 P 61211 1O 60 (00 60 60 1011 _ I , M O I I ca N\9 O 1 . 11 �— 1 I 3113/4 1 x ' I o - 1 1 1 1 1 1 K ' BEAM POCKET `� - -7-�I I 3 -2 x 12 Center Beam (twp 4". Concrete Slab mil ; M - O 6" W x 6' DP x 9" µ - ,_ . " - Slope 1/8" per foot s Shin beam with steel ' 3 1/2 Dia.Lall Columns 1 shims or hard brick _ — _�.'r.. � II � � y � � 1 I ' (1 Req'd) With 2 6 sq,x 13 dp, footing I E 05 rebar each wau,bottom 4 t o t (min) Step down into Garage r i (9 req'd) minute fire door t ' — - — = 20 (min.) x ; I I o I III - V` 1 1 •P - - r-------- , — 1 I tl 1 P' - - 51611 t / ;---------- --------------------------------- 1 P � 1 P► t--- --; ------------------ 1 , , 1 - � r------------------------------------ L ------------------------------------1 1 1 - 1 , , I • 1- _O - ctil - 1 ------------------------------ _ I3'611 111011 38'0 FOUNoATION FLAN�_ 141 = � _ 1/4" = I"O" Rush framed Baa o = _M LLU O — All members are 2 x 10 art 16" O.G. All members are 2 x 10 Q I6' O.C. Flmr-T FLOOR FRAMINa 55COND FLOOR FRAMING VON .i'O' V8° = 1'011 [ fit If I I 0 _ C IIIIIIIIIIII = I 1 1 1 1 1 1 I V I I I I I I I Il I 112 Ridge 511 flush framed Be i m I .100I - IIIIIiIII � II � � � II a4 I F111111 ,111Ilush Framed Be tilir Lower Roof FranIng Ridge,Hrp t valley Rafters are 2 x 12 All members ars 2 x 1019 16" O.C.NN.OJ ___All members ars 2 x 10 �1 I6' 4�C,v.NAa -- -. ..--- -— ---- -- ___ ----___ . _ _ . -- -- R -00E--FRAMING--- � -- - P1OO Continuous Baffled Ridge Vent � 80�801 . �A PA .. * i w 2 x f1 Ridge Board ........ ..... i x 8 Collar Ties gal 48!l.0,C.- e ROOFING Composite Roofing _ Building Paper Sheathin _ 2x10 a��b O.C. Attic1 10 _ - - - -- EiLING -Fascla Board z . 2 X 8 6 Ib" O.G. Insulation Overhanging soffit with venting � n � s 0� U7 m o0 FLOOR — o 0 3/4" Sheathing _ r - -;:._ A 2X10 � Vol, O.C. Second r WALL 1 ll - _ Siding,At Barrier,Sheathing 10 2x4 0 16' O.C. or 2x6 6 16 O.C. V : insulation,Vapor Barrier � o , Z�� 1/2" Wallboard r p co A cA e . FOO __u w 3/4" Sheathing cA �_ 2 X 10 6 16' O.C. ao Insulation C5 LL First --- _ - -- 1 - 2x6PT., 1 - 2x6 K.D. Continuous S11 Gasket -- - Anchor Bolts or apprv'd equal Center Beam -s 3 1/2" Dia. l-ally Columns ow FOUNDATION 8" or 10" Concrete.Wall / 8`0' Pour (+/-) -= 10' deep x 20" wide continuous Footing Dampproof exterior surface T s s 4" Concrete Slab - _o Basement 1/4" = 1`0" W220801 � LL 2 4 � r n - Continuous Ridge Vent- 2 e t�_ -- ' 2 x 12 Ridge Board X. - ROOFING Composite Roofing _ Building Paper Sheathing CEiLING 2 x 10 0 16" O.C. 2 x S Q16' O.C. R30 Insulation insulation f=ascia Board VaFor Barrier I/2' Wallboard. Soffit with venting m � O Oz Ln ° _._ - WCL C — 00 Siding,Air Barrier,Sheathirxj FL—R 2x4 6 16 O.C.or Zx6 SCJ 16 O.G. 3/4" Sheathing Insulation,Vapor Barrier 7 2 X 10 I? 16 O.C. UZ" Wallboard Insulation SiLL f=ist -- I - 2X6P?., 1 - 2X6KD. s 1 Continuous Sill Gasket s Center Beam Anchor Bolts or approved equivalent 3 V?'.Dia. Latly Columns e FOUNDATiON r e 8" or 10" Concrete Wail ! &'0" Pour 10" deep x 20" wide continuous footing 4" Concrete Slab Basement Dampproof exterior surface - - - _� s .a FAMILY. ROOM -SECTION . - 1/4" =1'O" �v s Stairway Width r • 13603.13.I I Width Stalvays shall not be Iess than 36 Inches(914 mat) TWO L' STAIRS in clear width at all points above the the permitted handrail height and R 9'. m 1 n I mum below the required headroom height.The minimum width at and below the kiffa�+ iNM 4 tread handrail height shall not be less than 32 inches(813 ant)where a handrail is M I N GcTION DF-TAII a R-A E Z installed on one side and 28 trochee(111 mm)where handrails are provided on both sides. - Mass, 5 Code Treads and Risers -��_ Edition: C 3603.13.2]Treads and rieera The naxtnum riser height shall be a I/4 _. inches(210 rel)and the minkrum tread depth shall be nine Inches(229 nn) The riser height shall be measured vertically betrueen leading edges of the h� adjacent treads.The tread depth shall be measured horizontally between the vertical planes of the foremost projection of adjacent treads and at a right Y � angle to the treads leading edge.The walking surface of treads and landings r of a stairway shall be stoped no steeper than one unit vertical In 48 arils @ a hortzontal (A slope).The greatest riser height within any flight of stairs shall not exceed the smallest bg more than 3/8 inch(95 mm)and any two qk Cie successive Mars shalt not deviate bg more than 3/I6-Inch to height.The ric 2x Header 2x Floor,Joist = 2.2x Header greatest tread depth within ang flight of stairs shall not exceed the smallest by none than 3/8 itch(55 mm)and " two successive gads shall cA 1 - I not deviate in depth by nor! than 3/16-inch. I u ,90 u c 12T99 ■ 3. Nosing Profile • „ 2 x 12 Stringers y I 1 C 3603.13.2.1 I Nosing prorlle=A nosing shall not extend more than Z x 4 Fire Blocking 1112" beyond the face or the riser below. I Placed parallel with stringers ' r CQ r a0 :' - Headroom : Q, Q1 Qk I C 3603.13.3]Headroom= nu The mhhm headroom In all parts of the 2 x 4 Studs!beyond) _ stairway shall not be less than six feet six inches(2032 min)eeawred -- m I „� vertically from the sloped plane adjoining the tread nosing or from the floor wrface of the landing or platform. ��. J IN Header j 2x Floorjoist Im 2-2x Header C 3603.5 .3]Access to crawl spaces=Stairwayy headroom clearances shall �.. be h accordance with the provisions of 180 CHR 3603.133. W 1 �t (n = 2 x 4 Studs F i r e s t 0r r i ng : s._ aD m cA W 1 G�eyond) I _°_ t 3606 .2.71 Firestoppirg=Firestopping shall be provided to cut off all concealed draft opening*!both vertical and horizontal)and to form an cA - effective fire barrier between stories,and between a to oto and the roor 2 x 12 Stringers p 2 x 4 Fire Blocking space-F�+eetopphg shall be provided Inwood-F1rame construction In the folloming locations= K2. Ca , Placed parallel .-: at OC 1 „ with stringers 3. In concealed spaces,between stat stringers at the top and bottom Cn I 1 of the nut. 2x Header _,. Guardra 11 Data i s 2x Header �-�-2x Floor,Joist ,., . ________ 13603.14 .Z.1]Guardrail details•'Porches,balconies,decks or - Center Beam raised floor surfaces located more than 30 laches 0162 mm)above the ofloor or grade below shall have guardrails not less than 36 inches Q 1 (914 mil in height.Open sides of stairs with a total rice of more than 30 inches(162 mm)above the floor or grade below shall have guardrail, I u 1 which shall also serve as har>drags,not Ices than 34 inches(864 mat) I I in height measured vertically from the nosing of the treads. r Ca 1 I G , Lally column meyord) l u a r d r a i l Gee ming Lim11ations = 2 x 12 Stringers 13603.14 .2.2 t Exc.]Guardrail opening IinRatbna Required 1 h ym tread :g° a guardrails on open side of stairways,balconies,porches,decks and raised I floor areas,shall have intermediate rage,balusters or ornamental closures ater.ert the passage of an object five inches(1O2 ern) or moreIn ddiameter. a Exception=Triangular spaces formed bg the riser,tread and bottom rag of a guard at the open side of a eta"nay be of siza to prevent W `p the passage of a sphere six inches 053 min)in diameter. X O X CAI= N s SEPTIC PLAN SUBMITTAL FORM LOCATION: -/L.t./)/ 2-7 NEW PLANS: YES $125.00/Plan REVISED PLANS: S/ $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES NO DATE: DESIGN ENGINEER: 122, X/11 DATE TO CONSULTANT: *If you want your plans expedited, please submit four plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in place, route to the Health Secretary. Town of North Andover f NORTH , OFFICE OF 3�0`�t t o ,e 6QO COMMUNITY DEVELOPMENT AND SERVICES10 27 Charles Street `• ° "; North Andover, Massachusetts 01845 �9q°^^•.o �''`cy WILLIAM J. SCOTT 9SSACHuS�� Director (978)688-9531 Fax(978)688-9542 November 16,1998 Atlantic Engineering&Survey 97 Tenney Street Suite 5 Georgetown,MA 01833 RE: Christian Way Extension/Brook Farm subdivision Dear Mr.Halloran: This is to notify you that the proposed septic plan for Lot 2 Christian Way Extension/Brook Farm has been disapproved for the following reasons: 1. Septic tank manhole to within 6" of finish grade missing. (310 CMR 15.228(2)) 2. Both septic tank and D-box missing 6"stone bases. (310 CMR 15.221(2)) 3. In"General Notes" section there needs to be a statement that"No garbage grinder is allowed." 4. Missing elevation of the garage floor and driveway grading. (NA 8.02t) 5. Please change note in leaching area to define proposed leaching field. 6. Please justify use of field. Trenches are to be used whenever possible. (310 CMR 15.240(6)) 7. There are problems with the grading and fill required if the reserve area is used. Any grading and slope requirements should include the reserve area. Please address. If you have any questions,feel free to call the office. Sincerely, Sandra Starr,R.S. Health Administrator Cc: File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 t rORM Iz SOIL EVALUATOR FORM, Page I of 3 Date: 8/-5/,96 No. Commonwealth of Massachusetts IV, AwIDU �1�2' , Massachusetts oil Suitabr'li .Assessment or On-Site. Sewage Dis o-5 Date: Performed By: MAvis "ALAN Q•rtAn Witnessed By: XQ EWT ppK 5ARM L!�T7 orMor.t+. MRR(�Rte'• AN11CM E L-LA touuon Addrus a Q R � drus,xrd Lot� AdN 0 RVA N pov ER TcicP�/ 1111 C�ATF W ooD A� a1.EXArJ DRiA + VA 2230 New Construction ❑ Repair ❑ ' Office Review Published Soil Survey Available: No ❑ Yes Publication Scale �.1 .� 0 Soil Map Unit Year Published �--� • �AI< L3 fC ' �1f'�ondF,31�zL-�E�•-k11^•LK�EX� Drainage Class ....... W- Soil Limitations Surficial.Gcologic Report Available: No [� Yes ❑ year Published .W. ..-- Publication Scale-- Geologic Material (Map Unit) . Landform Flood Insurance Rate Map: Above 500 Year flood boundary No ❑Yes Within 500 year flood boundary'No UYes ❑ Within 100 year flood boundary No Yes ❑ Wetland Arca: National Wetland'Inventory Map (map unit) Wetlands Conservancy Program Map (map, unit) Current'Water Resource Co ditions (iJSGS): Month ------- • bovc Normal Normal ElBc1cw Normal ❑ :Above Other References Reviewed: DEP APPROVED FORM•12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. RRo)k FARINA On-Site Review Deep Hole Number 2-2-HO Date:...514921, Time::. Weather Location (identify on site plan) Land Use W0c)c-->Et Slope (%) Surface•Stones . Vegetation Landform .. QUm-WAS." PLAIT Position on landscape (sketch on the back) . . Distances from: Open Water Body G (W feet Drainage'way 4- lon feet Possible Wet Area -e—loo feet Property Line G m feet Drinking Water Well G tpC) feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, /o Gravel) t0 YK 3/e to YR 30 13 S �. 7/(o 10YR . lo M X17 Lae, lob X PROPOSLD E5191!339 HLA MINIMUM OF 2 HOCES 11ECIUIRLD AT LVO Parent Material (geologic) C:s WAr-iA DopthtaBodrock: Depth to Groundwater: Standing Water in the Hole: KJWn Weeping from Pit Face: Estimated Seasonal High Ground Water: -2-40tt Me)M-E-S -- w;p AP1'ItoVLD F0101-11107/95 r • , 1-01tM 11 - SOIL EVALUATOR ICOR&'I -Page 3 of 3 Location Address or Lot No. 12 014 ,determination ,00r ,Seasonal High ter Fable Method Used, L_J uepth observed standing in observation hole...NwQ.. inches ❑ Depth weeping from side of observation hole .......... .... inches Depth to soil mottles ..3.G::.::, inches ❑ Ground water adjustment .................I. 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 oarea pro posed for the soil absorption material sy tem?in areas observed throughout the If not, what is the depth of naturally,occurring pervious material? Certification I certify that on *atment (date) I have passed the soil evaluator examination approved by the of Envir , mental Ption anexpertise athat the bd experove aenc�e was performed byst nt wi the requiredtraining, described in 310 CMR 15.0 Signature Date M DLP APPROVLD FO F01-12/07/95 SEPTIC PLAN SUBMITTAL FORM LOCATION: 1,a% a - NEW PLANS: YES $125.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION/FORMS INCLUDED: YES NO DATE: /L'�0/ DESIGN ENGINEER: l,Z.j,r) ?"1- /L6LI/, DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. Town of North Andover r "ORT{, OFFICE OF 3�° a 4. COMMUNITY DEVELOPMENT AND SERVICES10 IK 30 School Street ; WILLIAM J. SCOTT North Andover, Massachusetts 01845 �'s S �1CHU5 1 Director FILE OUTSIDE CONSULTANT ESCROW AGREE:4ENT NORTH ANDOVER BOARD OF HEALTH Agreement is made this (DaL 0 lc1 between the Town of North Andover and on-A of l In r L' J .4 for Soil Test Plan Revie �1�"t"S --"I 11Yl�Z�1� G�'�c"yy1 KNOW ALL men by these present that the Applicant hereby provides the Town of North Andover with a check in the sum of $ e . 0 , to be deposited in an escrow account for the Town of North Andover and has deposited in an interest- bearing account as designated by the Town Treasurer to be expended by the North Andover Board of Health to insure payment to any outside consultant(s) for Soil Tests, Plan Review for the above referenced project . This agreement shall remain in full force and effect until the specified project has reached completion , _56- and of Health Chairman Applicant or Agent Date Date WILLIAM ANTONELLI 3-96 sa-log sso 392 JANET ANTONELLI �z 91 5431 FLINT TAVERN PL. BURKE, VA 22015 19 Pay to the order of eir�/UY Dollars CR�Tw.c Crestar Bank Alexandria,Virginia 688-9535 v„ rvr 1:0S60010791: 82239S9Lk-;II' 0392 146,` AIN STREET a� yi 'yl .ti.• .•... . i •i.{,>!".1r,1>. IY,Z.,4+ui.i ,,;6.5 _i: `j�.• .c. .. .. .. .. ..;nae• .,. FORM 1,1 SOIL EVALUATOR FORM Page 1 of 3 Date: No. �9 g Commonwealth of Massachusetts AlA,vDo%,� , Massachusetts Soil Suitability A�ssessrnent �'or On-site Sewa.fre Disposal Date: Performed By: MAZT114 "Al I EMAN �AIIA R 17, qPM Witnessed By: E t�OK FARM - LoT a ownu s Name. MA R(� te'RA NTOW E L-LA Loudon Addrus or $R Addrus.and N 0 RN" A N Vov ER Teleph=r 1111 C,ATzw ooc> D R ALEXAq DRiA j UA 22 07 ew Construction ❑ Repair ❑ ' Office Rcvicw Published Soil Survey Available: No ❑ Yes Year Published -V ZL- Publication Scale Soil Map Unit Drainage Class • Soil Limitations Surficial.Gcologic Report Available: No Ycs ❑ Year Published Publication Scale �- Geologic Material (Map Unit) . Landform Flood Insurance Rate Map: Above 500 year flood boundary No ❑Ycs Within 500 year flood boundary No Utes ❑ Within 100 year flood boundary No zYcs ❑ Wetland Arca: National Wetiand'Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current'Water Resource Co d Range :Above (tJSGS): Montle --�--^ •Above Normal Normal ❑I3c1cw Normal ❑ • Other References Reviewed: DEP APPROVED PORN!•WOWS FORM n - SOIL EVALUATOR I,ORM Page 2 of 3 Location Address or Lot No. SRCAK FARM — CST Q On—Site Review Deep Hole NumberDate:...?,1.3,NIS Time:.. ..11 . - Weather Location (identify on site plan) / Land Use Woo QED Slope (%) . 6 Surface-Stones . Vegetation .. Fo RR s Landform PLAtt l Position on landscape (sketch on the back) Distances from: Open Water Body G(oo feet Drainage'way <1130 feet Possible Wet Area 4k00 feet Property Line to feet Drinking Water Well <%00 feet Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stoner, Boulders, Consistency, 10 YR 8 AI S.L. 3/2- 16 /2to YR 3(, 10 YR. 10yoz 2� C s.L . 0/2 b/$ Parent Material (geologic) PRO g Ae-16L 6IYMfASH DopthtoDedrock: Death to Groundwater. Standing Water in the Hole: N W n Weeping from Pit Face: Estimated Seasonal High Ground Water: #8� M�rrfSS — DEP AI'P1t0VL•D F0101-11/07/95 DORM 11 - SOII, EVALUATOR FORM I'age 3 of 3 Location Address or Lot No. ►3��C F'AJZ M LO-r 2 ,Determination for Seasonal HiWater Table Method Used: ('Depth observed standing in observation hole...NwP... inches ❑ Depth weeping from side of observation hole .......... .... in 0"Depth to soil mottles ...3.L::..:,: inches ❑ 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 u000sed for the pervious soil b o ption material sy tem? in all areas observed thrhr ghout the area prop If not, what is the depth of naturallyoccurring pervious material? Certification �y/ I certify that on /J (date) I have passed the soil evaluator examination approved by the Dep meet of Envir nmental Protection and that the above analysis was performed by meR 15 Ot 7 t wi the required training, expertise and experience described in 310 CM • � Signature Date DL•'P APPROVLD F=N1-12/07/95 -NOV-09-98 12:48P Paul D. Turbide, PE/PLS 508-465-0313 P.03 November 9, 1998 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 120 Main Street North Andover,MA 01845 RE: Title V review for Christian Way Extension,Lot 2 Dear Sandra, Enclosed find the"Checklist for North Andover Septic System Plans" for the above- mentioned site. The following is a list of all the 'Problem' areas and deficiencies Port Engineering has found. o The fill required if the reserve area is ever used will encroach onto abutting Lot 3, and will also partially fill in a proposed swale located on the common property line. If ESHW is at 36", and the high point of the existing grade in the reserve area is 163.5',then the elevation that must be held at the start of the 3:1 slope for the fill around the reserve area is about 165.3'. (The 3:1 slope starts 15' from the system edge, but in this design the reserve is 15' off the lot line. Thus the 3:1 slope starts at the lot line.)However,the proposed grade along the property line between locus and Lot 3 in the area of the reserve is 161±'. Thus the fill will be 4.3' higher than the existing grade proposed at the property line,unless there is an impervious concrete retaining wall. Otherwise the fill will encroach onto Lot 3 by at least 15',and will also fill over a proposed swale in this area. One solution might be to show future proposed grading around the reserve area and show a proposed easement that would be conveyed right now,in which case Town Council should review the proposed easement deed for adequacy. Another solution would be to design a future concrete retaining wall to be built if the reserve area is ever used. A Professional Engineer would still have to design and stamp a plan showing a retaining wall. • One of the three access covers of the septic tank must be raised to within 6"of finish grade by riser sections of 24"minimum diameter(3 10 CMR 15. 228(2)) • D-box must have 6" stone base. 310 CMR 15.221(2) PODW • Septic tank must have 6"stone base 310 CMR 15.221(2) ftj • In the"General Notes" section of the plan should be added the requirement that: ENGI�EEGING "No garbage grinder shall be installed". (It is stated in the"Calculations"section in the calculation of flow that the system was designed for no garbage grinder,but I feel it should be stressed elsewhere on the plan in an area that the future owner of Cita Engineers& the property can plainly see that no garbage grinder can ever be installed.) Land Surveyors , The proposed elevation of the garage floor,as well as grading on the driveway is One Harris Street required. NA 8.02T Newburyport,MA 01950 (978)465-8594 "Nov-09-98 12:48P Paul D. Turbide, PE/PLS 508-465-0313 P.04 1� RE: Title V review for Christian Way Extension, Lot Z Minor comment: On sheet one,within the leaching bed shown on the plan, is the statement: "PROP. SEPTIC". To be more accurate and descriptive,this should be changed to"PROP. LEACHING FIELD". If you have any questions or comments please feel free to contact us. Sincerely Carlton A. Brown,PE/PLS Atlantic Engineering & LETTER OF TRANSMITTAL Survey Consultants, Inc. Land Surveyors- Civil Engineers - Planners 97 Tenney Street — Suite 5 Georgetown, MA 01833 (978)352-7870 — Fax(978)352-9940 Transmittal To: North Andover Board of Health Date: 10/22/98 Job No: 9701-02 Ref: Lot 2 -Brook Farm Attention: WE ARE SENDING YOU X Attached Under Separate Cover Reports Letter Original Plans X Forms X Prints Specifications Shop Drawings COPIES DATE DESCRIPTION 3 10/2/98 Plan of Proposed Sewage System 1 10/2/98 Application for Disposal System Construction Permit CR 81-5198' Soi/ THESE ARE TRANSMITTED as checked below: For your use Approved as submitted Resubmit copies for approval X For Approval Approved as noted Submit As Requested Returned for corrections Return corrected prints For Review and comment Other * Remarks: CAVVINDOWSOESKTOMColeeds BriefcaseUransmittalABrook Fann Lot 2 Septic-BOH.wpd No. FEE COMMONWEALTH ®^L MASSAC14USETTS Board of Health, N, ANOV reM , MA. APPLICATION L®I, DISPOSAL S YST[M CONSTRUCTION PERMIT Application for a Permit to Construct() Repair( ) Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components Location jYO g,Q�q-c/f17/ST�gN W)" I_- L. Owner's Name MTB Nei LG/ Map/Parcel# 101f .- ,9,LT PF I Address llll f-grEh/pp a�, �L�(AA//J,�/� ✓/4. Lot# Telephone# -" Z_ 70$ l�3 it 2 Installer's Name Designer's Name 671,077e &rd/F it Address Address 0:-&OW AL P*WM M f Telephone# Telephone# q 74i _ 33 Z - 74d 74' Type of Building Lot Size qfo Z Z sq.ft. Dwelling-No.of Bedrooms Lt Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow(min.re uired) gpd Calculated design flow Design flow provided Y'fl gpd Plan: Date �� Z/q� Number of sheets Z Revision Date Title GOT Z — L3,Vf K FAX m Description of Soil(s) w JV Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation $ ✓� DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections No. COMMONWEALT14 OF MASSACHUSETTS FEE Board of Health, ,MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector: Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, ,MA. DISPOSAL SYSTLM CONSTRUCTI®N PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health 4VmZ rfr s 4 a}C F -�xr Ozklk �j f s T� 1 i" '� .� esi _� i • � 51,5 17 / ti T "47" L tr- 12 17 i I _ ji I i I j � � II III f I i i 1 -- --_..---- ------------ 1. ' •. i I i i � i I I I� I I• 'i i I I I i I �Ii , I ' I, , i INI --- --- ------ ---- --------- —---- i - 13, a� 01, Dp fig { � ty 6z CL/ - __ cyc'Sl i '�i1rIVY LAW OFFICES 4L GARY S. SACKRIDER ` f q 19 NORTH STREET SALEM, MASSACHUSETTS 01970 (508) 745-8850 GARY S. SACKRIDER January 12 , 1994 Ms . Sany Star North Andover Board of Health 120 Main Street North Andover, Massachusetts RE : Brook Farm subdivision Dear Ms . Star: I am writing you concerning approvals on septic system designs submitted by Atlantic Engineering in December, 1993 , relative to lots in the Brook Farm subdivision. I understand that there has been some delay due to conflicting engineering data. Please be advised that the owner of the property, Margaret Antonelli , never authorized anyone except Atlantic Engineering to enter upon the land for purposes of testing . I have only recently learned that unauthorized entry and testing was conducted last fall by an engineer who represented a potential buyer, a buyer who had an incentive to have the results come out poorly. I submit to you that illegally obtained test results cannot and should not be used by you in acting on the currently proposed septic designs . I would point out that my clients are under a purchase and sale agreement which calls for a closing on January 31 , 1994 . Therefore, your prompt action on the applications would be appreciated. Yours truly, Garyl. Sackrider cc Margaret Antonelli Bill Antonelli e ATLANTIC ENGINEERING AND SURVEY CONSULTANTS, INC. 16702- —0S33 WEST. MAIN STREET, GEORGETOWN, MASSACHUSETTS, 01833 (617) 352-7870 (617) 593-3395 SOIL LOG•S'; Locations C//1?/��/A/l l✓Ay !:XT N4gr/1 �'//Go " l� L"ot no: Dates • Tests performed bys observed by: 7 rj'i`` GRAF Pit # -'' Pit N f� Elev. Elev. 17 T 5 2r Slaty sAN�y ' Water Depth Water Depth Water Elev. Water Elev. Perculatlon data/# Perculation data/# Dates Date: Elevations Elevations Top of Pit Top of Pit Depth to test Depth to test Depth of test Depth of test .• Time Time Soak start Soak start end end . A M Average min/inches Average min/inches s �3 9ee `1 OT 2 4s Z-00 S.F - I CRA VN N eo 00b. \ 3 ill 71 i / N ,to I � l i LOT / itl Goo sF= ° /oo % CBA / I yv l� -36 Town of North Andover, Massachusetts Form No.2 f MORTIy BOARD OF HEALTH • O ,t`•o I•,� q-3 � w P • x i •++++++ ''``���°-"'-"`�����������, DESIGN APPROVAL FOR • 'ssACMUSEt� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM • Applicant -Lkk� Test No. : Site Location VLUa ASk-r Reference Plans and Specs. • ENGINEER PESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH • �ten (v 3 Fee to Site System Permit No. o;1, A TLA V11CGVGIVGG1IVY & SVR VETf ®NSV1TtA ��y INC.. Land Surveyors - Civil Engineers - Planners LETTER OF TRANSMITTAL Transmittal To:A/Lei&1P �j� Date: kz 3 �Lv Job No:� d �NOotor�2 �iT4 Ref: �dsrm A-Ve-1-1- Attention: 5 �K&Vt 5794, WE ARE SENDING YOU /Attached Under Separate Cover Reports Letter Original Plans Prints Specifications Shop Drawings COPIES DATE I DESCRIPTION --------------------------- -------------------I------------------------------------------------------------------ l-ql-9-j- ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- THESE ARE TRANSMITTED as checked below: For your use Approved as submitted _Resbmit copies for approval y For Approval _Approved as noted _Submit copies for distribution As Requested _Returned for corrections _Return corrected prints L/For Review and Comment _Other REMARKS 97 Tenney Stmt-Suite S-Georgetown, MA 01833 (508)352-7870 - (508)948-7677 FAX - (508)352-9940 Sf�Ti ------------- ------------ � �- - 76 i 5 i I v 441 / / -71 , cp �. 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Test Pit #! V - 2' Top and Subsoil 2z - SS| l !y Fine Sand 2� Qater Table Test Pi ! #2 Top and &ubsoiI J Siltx Fine Sand • 2� Qa1en Tabl « Lo! 2 Tesi Pi ! 41 ToP and Subsoil Gand-y Till az QaIer Table Test Pit #2 and Subsoil . 2z - Sz Sandx Till 2� Gater Table Lot a Test Pit #! V - 2z ' Top and SubsolI 2z - Gz Si1tZ @navel 2z Qater Table Test Pit #2 . Top and Subsoil 2" 8� ' Silex BRave1 2 Water Table 7j— s�� I Pe 'r W 14 00 aj, r tj iz , t l cB °1 / r O 5F / 5 Z00 o 0 / / 3 / / I o 00 0 1. 1 i ..t ,a y .• 'a ( - - � 0.`P �,`,` ""t.�, � �, DO "IX 3 ,� y s; •(.,, . ..,.r � .��� av �. � r ., ...f. � .x �� .J.e �� 17 ,X1" : . 13 -S•. +, - /` // - lM1. �' k -a ?,�-• ..X14 et"i.. EXT t � aR8 1 . .. r 1 � ,// �. -,. p� �;•1 aha . 1/8/99 Memo to File RE: Lot 2 Brook Farm Met with Tom Manetta on 1/7/99. After discussion agreed that Lot;Lshould be designed with a field because a costly retaining wall would have to be constructed if trenches were installed. Town of North Andover NORTH OFFICE OF ��o-I"'20 a 140 E COMMUNITY DEVELOPMENT AND SERVICES A 27 Charles Street " �O North Andover, Massachusetts 01845 �9Ssgc►+us�t�y WMLIAM J. SCOTT Director (978)688-9531 Fax(978)688-9542 February 2, 1999 Atlantic Engineering &Survey 97 Tenney Street Georgetown,MA 01833 RE: Brook Farm/Christian Way Extension, Lots 1-7 Dear Mr. Manetta: This letter is to inform you that the proposed septic plans for Lots 1-7 Brook Farm/Christian Way Extension have been approved. Please do not hesitate to call the office atthe number below if you have any questions. Sincerely, Sandra Starr,R.S. Health Administrator Cc: M. Antonelli W. Scott File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 �zr •x: 1 - - ---- - - -=-- - -- T _ _ -- - - -- 260 12 - it _ I I �r I _ --- - -- --- ----.. ..-- -- - -- -- - ---- -- +�-+-i----� -�---�--�-Imo--;-. : --�-+- ---• +-- _ � . k J 1 � Flrt'.,r l LL f�y9"iJ`i, rM�1 '0000� w sw■C-w�ii-�ii�■���i-i ,�-�w i w - w w-_�■w i� wiw�i-iwwiw �wwYw � ��w�-}i -�i�i=i-�■i�i-�■�-■{iii-������� �.h ii �i-wwii��c��■i■-wwwi®w i iiw iif:�i► wwii!�ir��w -�i■ Mmmm MW --YmYm-y■w •°° w ww-�i�i.� �iw�r�i w-ww-w! �■-i -�`i www •� -iii w �r �� �-_ �� RI ,'.... ._:.tali .,,k .._._ •._. ._ . � � _ _......_. _ _ TOWN OFbf-rj SYSTEM PUMPIN RECO DATE: 11�0'� NOV 1 9 2004 TO�,,N C�Nr`RT`" q�00VER ��;iENT SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of house) C,to UAI 14 40 Lj— 0 DATE OF PUMPING: QUANTITY PUMPED: I 150() GALLONS CESSPOOL: NO YES PTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: coNTE m TRANsFERRED To: G.L.S.D2 Lowell Waste Address-37 ,7 C*-H4157-1AA1 WAY Title of File Page of Date t=ile Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Documernt/Action and notes ' action Document/ documero Num. Action De artment Board of Appeals - Board of Health - planning Board - Conservation Commission - B�aildin� Department Commonwealth of Massachusetts City/Town of \VjSystem Pumping Record Form 4 JUN 112007 DEP has provided this form for use by local Boards of Heal h. The System Pumping Record must be submitted to the local Board of Health or other approvin �}tthorit)RTH ANDOVER HEALTF'DEPARTMENT A. Facility Information Important: When fining out 1. System Location: forms on the L computer,use only the tab key Address to move your C r7 f cursor-do not use the�retum City/Town State Zip Code .key. 2. System Owner: n6 Name Address(if different from location) City/Town State Zip Code Telephone Number .B. Pumping Record -a - tsz J. Date.of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes R-No- If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System:`�� 6. Syste Pu p By� 1 �; Name Vehicle License Number Company 7. Location where contents w re dis d: Signature f H 1 Date http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts RECEIVED City/Town of System Pumping Record APR B 3 2008 aForm 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health.Other forms may be used, but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: forms on the computer,use to move youthe tab key Address ('s Y cursor-do not Cityfrown State Zip Code use the return key. 2. System Owner: Name ISI Address(if different from location) CitylTown Stat Zip Code T T Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑� If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of Sys em��^ ✓N, pl� l 6. SyS`T P,�m�d By� 111-N Name �` �7�� Vehicle License Number Company 7. Locationne cpntenrosed: Signatur of ftutrDate t5fonn4.doc•06/03 System Pumping Record•Page 1 of 1