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HomeMy WebLinkAboutMiscellaneous - 145 COLONIAL AVENUE 4/30/2018 145 COLONIAL AVENUE L 210/107.6-0135-0000.0 �l i Lot& Street �,�� f ""1�rn Map/Parcel 1076 113-:5- CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit#_ Plan Approval: Date: Cf a Approved by: a/.�7c c-,c. Designer: Plan Date: z/z/S/1 7 Conditions: 6k5arM,5pWr- (SRA0/k.,6 - /4 Water Supply: Town Well Well Permit: Driller: Well Tests: Chemical Date Approved Bacteria IDate Approved Bacteria II ,Approved Plumbing Sign-Off: Wiring Sigh--ga: Comments: Form"U" Approval: Approval to Issue: <2ES NO Date Issued By: Conditions: AA Final Approval: All Permits Paid? NO ' Well Construction Approval? YE NO Septic System Construction Approval? NO Certification? YES NO Other YES NO Any Variance Needed? YES NO FINAL BOARD OF LTH APPROVAL: DATE: - APPROVED BY: 11 f SEPTIC SYSTEM INSTALLATION Is the installer licensed? NO Type of Construction: REPAIR New Construction: Certified Plot Plan Review NO Floor Plan Review NOS Conditions of Approval from Form U YES Issuance of DWC permit: TN�O DWC Permit Paid? 6� DWC Permit # 16)0 Installer: � �,���S 4e_;,— Begin Inspection: YES NO Excavation Inspection: Needed: Passed: By: 1.7 l Construction Inspection: Needed: As Buil Plan Satisfactory:: S� YE S: e-s 11 F_s /&-.1,/d Approval of Backfill: Date: 3713y: i Final Grading Approval: Dater By: _ Final Construction Approval: Date: By.- Certificate y:Certificate of Compliance: Approval: Date: <,�r� Commonwealth of Massachusetts RECEIVED City/Town of lug System Pumping Record Nov12 Q�3 Form 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 1. System Location: Left/Right front of house, Le ighf rear of ho ft/right side of house, Left/ Right side of building, Left/Right front of building, a Right rear of building, Under deck Address City/Town state Zip Code 2. System Owner. Name Address(if different from location) City/Town State Zip Code F Telephone Number B. Pumping Record 1. Date of Pumpingpat --- — 2 uantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yep No If yes, was it cleaned? ❑ Yes ❑ No. 5. Condition of System: OT�( jAA 6. System Pumped By.- Neil y:Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. LocatiqaAv4ere contents were disposed: G AD Lowell Waste Water 4SignDate t5form4.doc•06103 System Pumping Record•Page 1 of 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, May 29, 2009 11:12 AM To: 'cosmo.p.destefano@us.pwc.com' Subject: Septic- Building Application Sign-Off- 145 Colonial Drive Attachments: SKMBT_60009052910520.pdf Hello, Here is the letter that Susan spoke with you about. Paine& Z)ee& ' . Pamela DelleChiaie Health Department Assistant TOWN OF NORTH ANDOVER Health Department 1600 Osgood Street Building 20;Suite 2-36 North Andover,MA 01845 978.688.9540-Phone 978.688.8476-Fax pdellechiaie@townofnorthandover.com-E-mail http://www.townofnorthandover.com-Website Notes: If copied to BOH Members-Reference Copy Only-no response requested at this time From: noreply@townofnorthandover.com [mailto:noreply@townofnorthandover.com] Sent: Friday, May 29, 2009 11:52 AM To: DelleChiaie, Pamela Subject: Message from KMBT 600 1 Commonwealth of Massachusetts City/Town of FR7L�'S stem Pum in RecordY p� 9 Form 4 DEP has provided this form for use by local Boards of Health. Other forms mgt used;�but the,-,,-, information must be substantially the same as that provided here. Before Aingthis=l€&mt ,`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 � y computer,use only the tab key Address to move your �•.x-`�' cursor-do not City/Town State Zap Code use the return key. 2. System Owner: Name law Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record l C 1. Date of Pumping . ed: p g 2Quantity� Pum p Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of c� 6. System Pumped By ! ti Ul�v1 Name Vehicle License Numb Company 7. Locatio ere contents re disposed: Signatuok;AatAer Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES o�ag''yeO'bq~�m HEALTH DEPARTMENT A 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845 CHUS�� Heidi Griffin 978.688.9540-Phone Acting Health Director 978.688.9542-FAX To: From: Fax: Pages: Phone: Date: 17 y" Re: r�D CC: SGC. ❑ Urgent ❑ For Review ❑Please Comment ❑ Please Reply ❑Please Recycle Please call 978-688-9540 for assistance with any questions. Thank you. xc: Address File Chrono File .M' HP Fax K 1220xi Log for NORTH ANDOVER 9786889542 Feb 10 2004 11:01am Last Transaction Date Time —Type- Identification Duration Pa— _ RmLl Feb 10 10:55am Fax Sent 819786882427 1:13 4 OK Town of North Andover, Massachusetts BOARD OF HEALTH Date: July 30, 1998 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( X ) or repaired ( ) by Charles Zaher at#15 Puritan Circle, North Andover, MA 01845 has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit # 849 dated September 15, 1997. The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. WA-AAcr, 13�oard of Health SS/cjp Revised: 7/20/98 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System )'constructed; ( )repaired; by � �� located at (.a was installed in conformance with the.North Andover Board of Health approved plan, System Design Permit#T dated with an approved design flow of �f D gallons per day. The materialsused were m' conformance with those specified on the approved plan;the system was installed isaccordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading-agrees substantially with the approved plan. All work is -accurately represented on the As-built which has been submitted to the Board of Health. Installer: Lic. #: Date: Design Engineer: P_S�A_ PG 9 ��S i DES/GN DATA: LOT AREA: 22, NUMBER OF R DES/GN FL Ow.. 0 DAILY FLOW.' 4 SEPT/C TANK i SEPT/C TANK i GOLEACH AREA h 0 B LT o)E ra 4 6R ® CLAS ,,: L. ) `ATE° G: Zi?,- (USE CLASS h $GAL � \� \ , AL� ���� S�N4o 440 GPD/0.51 LEACH AREA P �.5� B07TOM.• 44' a =n 4.85 S/DES.• [(44'x 1 \ \ oti �S �J s 176 S.F. f 9E USE 3-44' x ►.►�3.�"s �� TOTAL LEACH 0 /NV=174.80 (1) �\y�( /NV.=173.60 (2) _ /NV 172.40 (3) rJ�0 X OT ' 0 DEPTH h 15' �♦ 1 SURFACE r �c� 5' 00"-43" 43"--58" 58p 116'" GROUND STATIC WATT ES77MATED . WITHIN 7TH 15-9651) (3) 00A!-07" - � 07 -24 n 24�!-120'" STA TIC Wi BASE=165.0 EST/MATEL Commonwealth of Massachusetts Massachusetts Nov - 2 2004 N OF NORTN ANDOVER �tTMENT �b1iNAl�'ti p�PA System Pumping Record System Owner System Location y ✓V\t� y Caovkjc,� Date of Pumping: L l'l 04 Quantity Pumped: gallons Cesspool: No r Yes [] Septic Tank: No [] Yes [ System Pumped by: FaP, " License# Contents transferred to: Greater Lawrence Sanitary District Date: p Inspector: TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) Co6�i, j 4e DATE OF PUMPING: QUANTITY PUMPED GALLONS CESSPOOL: NO � YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: __ �� 1`'� ` i�iAY 14 2001 ! Address ,��5 �t'tionlc�L lour` Title of File Page of Date File Open: Date fide Closed- Doc Doctrme�nt/Action Title Date of Refer to other Purpose ofDocument/ A action Document/ document/ / coon and note fW u rn. ---- Action Department — --------- , Board of Appeals — Board of Heal h Plannn Board ; 9 Conservation commission - Buil-ding Departrnen . 1J�t t G. FORM 11 - SOEL EVALUATOR FORM Page 1 No. ..................................... Date...`�.-.f.�.-.°�7....... Commonwealth of Massachusetts IJoeTN Al..twaz, Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: ....W-I.LL.t.A.M.......D.U.. ......................... .. .-2y-.y.7 Witnessed By: .:.:: :U:S:A ........................................................................................................................................................................................................................................ Location Address or Owner's Name, A.C.l. RvE . Bu((tet E2 c, l AJC- L°t LOT P,�,rnl� CO""(lsgAddress.and 33 WALVffP- ROAD Telephone N T.M. io"7-5 PA2 I3S WO 2714 A-.JDoVOR-: M.A. WonDLOI SNS A New Construction uQ Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes f....fSyv Soil Ma Unit ... .Q... GtL Year Published .�.�[5.�... Publication Scale .. ck Bvr�a�P 1 pe�roti�� Drainage Class .5......... Soil Limitations ..... EYE ............................................... ....................................'0z_c.ts Surficial Geologic Report Available: No ❑ Yes ❑ Year Published .......... Publication Scale .................. GeologicMateria (Map Unit) ........�.-.................................................................................................................................... Landform ..........................-'.'..-:.................................................................................................................................................................... . Flood Insurance Rate Map: *' ZSao jg oo to B E31 Above 500 year flood boundary No ❑ Yes 200, Within 500 year flood boundary No Er Yes ❑ Within 100 year flood boundary No Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) .............Q...tai......S.AT�....... .�.t. AT..o...tii...... Wetlands Conservancy Program Map (map unit)...........-- .—................................................................. Current Water Resource Conditions (USGS): Month :rvL�/ Range : Above Normal ElNormal 2/ Below Normal ❑ ASSumrtGD Other References Reviewed: V. 9 - 6., . hAPS , ^ FORM 11 . SOIL EVALUATOR FORM Page / "-T~ | ~- ` On-site Review Deep Hole Number - I Date:�~��� -�-V Time: Weather VVaethmr 'f»p� -' Locationonsite plan) -'�t.Wgr.......YARD....................................................................................................................................... -;.L�ndW�u �u'�^ (96) ��� Surface �iy��*�' ---'_ _-__------- Slope= -`----� -.'^ ~~ƒ------------------ Vegetatio n ..................................................... Londform -- ................................................................................................................................................................................ --....... ----- �p��� Poohdonmnlandscape (sketch onthe back) --.°~..~.-'P W............................................................................................................... Distances from: Open Water Body - feet Drainage way' Z~ '± feet Possible Wet Area )00.:t. feet Property Line -.10 17.. feet Drinking Water Well .100.jc- feet Other .................................... DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) (Munsell) (Structure,Stones,Boul*ders, Consistency, %Gravel) ' � ' � � � � � ' Parent K0a1ehe (geologic) - --- .................................................... Depth to Bedrock:Depth to Groundwater: � ^. ^' Standing Water in the Hole: ---~�~.'_- Weeping from Pb Face: 'x.��w-� Estimated Seasonal High Ground Water: ` FORM 11 - SOIL EVALUATOR FORM Page 3 Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole.......` inches ❑ Depth weeping from side of observation hole............ .... inches LTJ Depth to soil mottles ...60 inches ❑ Ground water adjustment feet Index Well Number ......"'. Reading Date ................... Index well level ................... Adjustment factor ..........r... Adjusted ground water level .................................................... Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? .3CD TAVMAcLy OJJ -fflSTS lig( HAgrS 95U61uC4ZIAJ6; If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature WA� Date �° 'f FORhs 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS 1.10M Uftvf5IZ , Massachusetts Percolation Test q Time: P! .................. ................. ... Date: ..... .-_Z... ..`1..... Observation Hole # Depth of Perc ,, t ©-13 9 B SSI 2 o -7y l y Start Pre-soak t - 3y N��c�s EuL�iuE�FL�u End Pre-soak Time at 12" i I 'S Time at 9" Time at 6" Time (9"-6") 3S h iw. Rate Min./Inch 12 Site Passed eSite Failed ❑ ... .. ........1.....................0 ........................................................................... Performed By: D()1_t Witnessed By: �v SAA.( re 2D Comments: n HAYES ENGINEERING, INC. F0RI\'1 I 1 - S011, !;\ 603 SALEM STREET 1'<iPc 1 of -1 WAKEFIELD. MA 01880 ,. ,� �� (617)246-2800 , }J�~ FAX(617)246-7596 No. --- JOB FILE — Cotntn©.nwealth of Massachusetts - North Andover , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: ._Gordon .Rogers4xt..... .. ..........---- -------_---------. Date: . Witnessed By: --Susan. Ford.. ...... . .. ... . . .. . .... - - - —� LzAAde„cx owrc:.f ar%— A.C. BUILDERS La/ Address,an: �_5 /f Tckphow I No. Andover, Mass. ew Construction a Repair ❑ i Office Review Published Soil Survey Available: No ❑ Yes L7/ / (/ Year Published ._._.__�,Z /._._.. Publication Scalele.` _�O//-_�____ Soil Map Unit Drainage Class-.... Soil Soil Lrmrtatrons ----------------------------------__-•- Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) - - -- - ----- - -- ------- -- Landform. - Flood Insurance Rate Map: _. .... ...... .. ..... ... ......... - -... .. . . ._. . . Above 500 year flood boundary No ❑Yes ❑ Within 500 year flood boundary No El Yes ❑ Within 100 year flood boundan- No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ... ................__.__._____... Wetlands Conservancy Program Map (map unit) .. .. Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Norma! ❑Belc Normal `J Other References Reviewed: DEP APPROtTFn FORM 1210-1!95 i s DORM I I SOIL, FIVALUATOR FOIt11 1)'Ig ' 2 of .t Location .Address or I,ot .�r IS � ��"� FILE On-site Review Deep Hole Number. /� ..... Date:..L�... .(.tO... Time: �Ncati1 r Location Ocle tify n site plan) Land Use Q71 . _... — Slopel ro).... Surface Stones. .. . .. . o Vegetation.,A).!f 011 i . !.r!lv. ... ... _ .... . Landform.......... Position on landscape (sketch on the back) Distances from: Open Water Body .- . �T ..feet Drainage way... feet Possible Wet Area. 7/�-d- feet Property Line. . . feet Drinking Water Wel l��/ L.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, % Gravel) C/ 7,5)/9 Vn r - c - Parent Material (geologic) DepthtoBedrock: 411 Depth to Groundwater: Standing Water in the Eiplr.: g/ Weeping from Pit Face. Estimated Seasonal High Ground Water: ki 11ET APPKOV U)PO"-1 12%07!9; 603 SALEM STREET „JOB FILE WAKEFIELD,MA o168o FORM I I - SOIL EVALUATOR.hpRM (617)246-2800 FAX(617)246-7596 ,'� - rage 3 of 3 DEP"PROVM FORM.12migs Location A dress or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing.in observation hole.......P� inches ❑ Depth weeping from side observation hole...t Y. inches ❑ Depth to soil mottles ..1`>�. 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 four feet of naturally occurring pervious material exist in 911 areas observed throughout the area proposed:for the soil absorption system? If-not, what is the depth of naturally,occurring pervious material? Certification I certify that on Nov. 1994 (date) l have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DESCRIPTION OF HORIZONS TEXTYIk7E. pvra! —,v pvriJJr a-df Jo- --VrJ SrR4VCT1WE.' M-1 COA-W errs --yeas low ^i avdc sire Few ar Trac ca"Ve*and --co0 pvtWir Jo- -yl OteNct"Wess -O rare fine -rf Pistr srW -e stone lover --st! ksak -! fine -I pyeretic -T- fJM saw --fe flit ---r! Poabry O --2 Pedlar -r cOJ&OVW wry fine srW --rfe slit low --ril strarrp -.f tawve -,t OJoar -- Jeaq eor+ee sand leas clay low --CJ rerr C040rW --rc rpvlr OJoa7-fit J~srrd —Js silty clay tow --sleJ acoPlpriJar bloat J~am arta —ifs sandy Clew Jo- --rel P—J- -� arWy JAW --+J staaw Clar Jam --ffteJ sire7Je pvlc -1W flits arW Jove --fol silty cloy --sic wasere + wry Ilse srWy low —rfil elar —c MOTTLING.• G1GiNSISTENGi A&#Waaer. Slrc C+O+L7 Net*"I, Ablet sou• LFr soil for -f M-AV fine _! /sine -r ,amilety -tirso loose -,Vi !oast -di eOPr7rr-e AIMV Pedlar -p alstinct - IllpRtir etle*r --ass rarr frJA610 --rrfr soft -es —r -w 4V-l0OU corvt prorinrne SUCH' --rs friabis -wfr filrAtir AAM -drh wry etlatr fin -Wel AP^d --on ,aplastic . -moo rex flier -,ern rtrr fare --a" ellonuy plastic -.p, extmwAr fJra-+ref! extrertly Mrd-dM piwtle -vp wry Plastic -*VP f �) 6a `C> 3332E �7 ' �,� i?lt-Kt . S.'Ylxu9 /'�•_ .Uy DEJC �T EAThNJG A;?EA X11•�'1 a - - `KITCHEN ,j . �• .' _ Q li.D r�9 J.�:; _ � 1.i• :i y. .. .. L;a�,J�a- , ~ �• `r� ::i�o I� { � ,� - •?T 'ter :t: Y -t. LIVING ROOM DINING DOOM FOYER13 12- 1 i 2 �0 RS T Al FLQOIL-:a - - _or72 A C IL RS MA�FI.i ,tMAI, - T 1 , I /VA T-17 - -- t �I ��^ � BEO �: M G ^i i s It i•'•f0 Der.•. ��i l •�: . 1 { Town of North Andover NORTH OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES O A 30 School Street ^w WILLIAM J. SCOTT North North Andover,Massachusetts 01845 �9" ACHUSE Director d September 27, 1997 Aurele Cormier AC Buiilders 33 Walker Road North Andover, MA 01845 RE: Woodland Estates Dear Aurele: This letter is to inform you that the proposed septic plans for Lot 15 Puritan Drive and Lot 22 Oxbow Circle have been approved. If you have any questions, please do not hesitate to call the Board of Health office at the number below. Sincerely, Sandra Starr, S. Health Administrator cc: Wm. Scott, Dir. CD&S Merrimack Engineering File CONSF.RVATTON 688-9530 ITFALTH 688-9540 PI ANNINQ 688-9535 ` PLAN REVIEW CHECKLIST ADDRESS_,G_ Al-__O. :4 e/7- L2 ENGINEER �? /(--, Ze GENERAL 3 COPIES �� STAMP LOCUS t-� NORTH ARROW �-� SCALE CONTOURS ✓ PROFILE � (Sc) SECTION t/ BENCHMARK L- '_ SOIL & PERCS ✓ ELEVATIONS WETS . DISCLAIMERWELLS & WETS `J WATERSHED? X/6 DRIVEWAY L,---- WATER LINE �� FDN DRAIN M&P SCH40 TESTS CURRENT? �� SOIL EVAL__&_C. SEPTIC TANK ��//' MIN 150OG L.-' . 17 INVERT DROP4-� GARB. GRINDER / O(2 comps +200) 10 ' TO FDNB/ MANHOLE `/ ELEV ✓ GW # COMPS. 1 GB D-BOX SIZE ## LINES FIRST 2 ' LEVEL STATEMENT INLET 170,33 - OUTLET 1;76.1,6 = ` 17 (2" OR . 17 FT) TEE REQ'D?/VO LEACHING MIN 440 GPD? RESERVE AREA �4 ' FROM PRIMARY? &--' 20 SLOPE �� 100 ' TO WETLANDS X100 ' TO WELLS L--' 4 ' TO S .H.GW ---' (5 ' >2M/IN) 20 ' TO FND & INTRCPTR DRAINS L----- 400 ' TO SURFACE H2O SUPP L___ 4 ' PERM. SOIL BELOW FACILITY MIN 12" COVER '--�FILL? !�15 ' ) BREAKOUT MET?_L,,-' TRENCHES MIN 440 gpd `�1/ SLOPE (min .005 or 6"/1001 ) �SIDEWALL DIST. 3X EFF. W OR D (MIN 6 ' ) ✓�� RESERVE BETWEEN TRENCHES?L- - IN FILL? `-- MUST BE 10 ' MIN. L­"�'_4" PEA STONE?6,,,-- VENT? ( >3 ' COVER; LINES >501 ) BOT J-P, + SIDE— a�9 = 79 cP_ X LDNG ��� = TOT 44.3 ( L x W x #) (DxLx2x#) (G/ft2) Copyright 0 1996 by S.L. Starr SEPTIC PLAN SUBMITTALS j LOCATION: �- NEW PLANS: YES ---� $60.00/Plan _4' REVISED PLANS: YES $25.00/Plan DATE: ?-117A7 DESIGN ENGINEER: a N a e! When the submission is all in place, route to the Health Secretary Town of North Andover, Massachusetts Form No.3 f AORT#I BOARD OF HEALTH 1ti 3?O`t". ,sa O `y / 19 . p _ CHUSEt DISPOSAL WORKS CONSTRUCTION PERMIT Applicant_ NAME ADDRESS TELEPHONE Site Location / , -,7L Permission is hereby granted to Construct or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. 7�4 CHAIRMAN, BOARD OF HEALTH ' Fee S /.C. No.-L � �J Town of North Andover, Massachusetts Form No.3 p� Npp*H1 BOARD OF HEALTH 19 f DISPOSAL WORKS CONSTRUCTION PERMIT SSACH.1 Applicant NAME ADDRESS TELEPHONE Site Location / 7 l� Permission is hereby granted to Construct or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. `�714 CHAIRMAN, BOARD OF HEALTH Fee D.W.C. No. ` Town,of North Andove'rl Massachusetts Os ss"g °`"' "'° 2` ' I M°RTh BOARD F HE* L'_TH A It r- ,. E t - „if•. ,y ma i+ 4 '� *�� .�, ` !:. Y r ^i° { t , r t �, �,� _ DESIGN',APPROVAL�FOR s s: • i s ,CHUS`� SOIL ABSORP,TIO,N'[SEWAGE'�bISPOiSAL:SYSTEM 1�� ' 'I I 1 ,�I E Ii.�',� d� F^�� t t{�� '� � � ��a, �fi3�•.��I� � j- � �' •i � n�s. .. � �� ,t> �.. .. I .r..i4f•�1 , i`. r', '.�y{tL : �Il Applicant (Test No. I f ''II ar +� i� Stir Ski iPglt; yRft � �a '( Sr f'.. t'P #'t � Site Location } ;►ti�.:Q F a• a i 'jyPr�s$i t• dal r 11#f Reference Plans and Specs 1 , k � f° ENGINEER 3t t•l .3 1 t3 i ;`3". �cDE I N� :Dr�ATE�,J,, o��•��7�' t f tt F�f [yr � � -xp7( ,'""T•.i,i�� #�it)t�e�i#���:i€Yjr E5�'it'�t^�'�t��-�}. ��,'i . , �}}p�y�y11^^ 1 .41r f� i }.,_ .�.� F.. id 1Y p i4)tItij # j � xd. .l MM,, 1 t Y; 1:.`1 - ! , PermISSlOt1 Is+granted f0`r;an.sl 9I 1 .0 I OI ;'Absor�tlo•_ Wag �IIsposaFsysteM to,g�e^InSt�{lled. , :i, ° r 5 r I b t� F f ".i �..� t.:$.�, M r l '.'��i i II.H' i° 1. {{' , in accordance with regulato.ns of Board bf;Health: qo, �� b �y` t�� ?';.�4 ���ri�i i��Et'jy:�� �' ��� � r(�� 1 w� '4 •4.9"�� .. � 7� �a3�� c, ,1. k., !� ,3 �F'�,. ,'�;�C° * �k #'�t s:; .L,,,�,.,•r�... +�ta,d' I.t. : a � A.,e... �i '.'.�q µCHA1RMANj BOARD OF;HEALTH� 0. ,F + •' t�§rl Xt t Y '� ""t 7� :, "';��' � :t ' : � s r ':� I k° `ry�i��'k!'yna:k..a£•r n�IriBe� xr -,�•:W`,t3r4- �'�IF�'��. t rM;•� tp � �t' '� :;i i , p�fi b: 3 la � —•°to 'I� -..# iG L �,�,, � , ;M i` t n t33 s: z - ��� r �'a'�s t�x�k. �r.�'��`r'r+��Tk'..4 � ti. , `: L1f e +t}••'-�F�3 -+ t �t.. 1� a � �.�• t}� t - \/]1�/' ' Site Ssel'n Permlt�Nn Fee ' >v [2 d} '�'t, +C,'' iit�ii ,r.. f t•� �a t , - F aN, r�yt k r:;S 'F ii� d A' 3 ��+�i3 ti"'..• r*.. �'� ae '"rg a �F, si ilia, ; + ¢ � !�' a. • ', .'€1��':.¢�Yn '€�.,:Y"� >rt� �; "f �' �'� � �x�t�r ,�� a, 7 a� a"„b F'S�� ,� •� <���i�r .� {:{4 »!Y I7:?E,`+� 9J` x,v+'+ i • - ., t ,1. E + I t 'rtEf a r - , APR 28 . APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# LOCATION: ��l d Nt Gyj LICENSED INSTALLER: SIGNATURE: TELEPHONE# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT:. T_ Administrative Use Only $75.00 Fee Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes No Approval Date: PP Al� FORM II ID'P RSsTi,4 8 FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** ' APPLICANT: t� • C U U I C►' n G Phone LOCATION: Assessor's Map Number Parcel Subdivision W0QJ 10AJ Er t alts. Lot(s) Street colonid St. Number ******************** ***0 i al Use Only************************ RECO TI SOF WN Date Approved 77T7 /2 LIX Conservat on A iWrator Date Rejected Comments ��� l t 'Q • Date Approved �� _ Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved 9A Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Town of North Andover f NORTH O «ED OFFICE OF ? y`` OL COMMUNITY DEVELOPMENT AND SERVICES A 146 Main Street '* North Andover,Massachusetts 01845A,TID 00,11 y WILLIAM J.SCOTT �SSACMUS Director October 31, 1996 Mr. Aurele Cormier AC Builders 33 Walker Road North Andover, MA 01845 Re: Lots 27, 28, & 29 Colonial Ave. Dear Aurele: This is to notify you that the septic plans for Lots 27, 28, & 29 Colonial Ave. have been approved. The system for Lot 15 Puritan Ave and Lot 16 Colonial Ave. cannot be approved until waivers from the Planning Board for the 50 foot buffer zone have been granted. Lot 17 Colonial Ave. needs additional soil testing at the south end of the system. Any questions, please do not hesitate to call me at the number below. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp cc: Ed Stearns, Hayes Engineering BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of North AndoverNORTH 1 OFFICE OF ��Of c",to ,e1 6 OL COMMUNITY DEVELOPMENT AND SERVICES O 100 Y - � 146 Main Street North Andover,Massachusetts 01845 WILLIAM J.SCOTT SSAcHUS� Director August 5, 1996 Hayes Engineering 603 Salem Street Wakefield, MA 01880 Re: Lot #15 Puritan Ave. Dear Mr. Stearns: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. Reserve not 4 feet from primary (N.A. 2.23). 2. Vent is required (3 10 CMR 15.251 (11)). 3. Ends of trenches should be connected (3 10 CMR 15.251 (11)). 4. Leach area is 50 foot PRD buffer zone. If you have any questions, please do not hesitate to call the Board of Health Office. Sincerely, zz Sandra Starr, R.S., Health Administrator SS/cjp cc: Kathleen Bradley Colwell, Town Planner BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 DATE / Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW f FEE _ PERMIT # DATE RECEIVED APPLICANT �. '�jGDjeS ASSESSOR' S MAP /� � Vo PARCEL # ADDRESS atj (Uftf� LOT # /1:5— ENG INEE STREET R ���YES ��' ADDRESS PLAN DATE ��Z/,�/6 REVISION DATE CONDITIONS OF APPROVAL: APPROVED DISAPPROVED �I C" vim- 1qOlti%1 I1 tiOIl, 1-I'VALUATOR FOlol PIgc ? of Location r dd[ess or I.ot On-site Review Deep Hole Number 15 . .. Date:_�0�.. .. 1.�. Tirne: Location (identify on site plan) _........ ...... ...... Land Use ..... ._. ._ _....... . . ..... Slope (0%)... Surface Stones. . Vegetation ......... .. ... .. .. _. -.. . Landform .... .._........._. . .... . Position on landscape (sketch on the back) Distances from: Open Water Body . . . . .... .-feet Drainage way feet Possible Wet Area. .. . ... ... feet Property Line . . . feet Drinking Water Well. . .. . . 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, % Gravel) 3/3 �r l/ s/ 75/9 1s1_7 Vis yYL�r I MINIMUM OF I I i I t HOLES REOUlfiLD AT EVERY PROPOSED DISPOSAL ARE Parent Material (geologic) DepthtoBedrockI Depth to Groundwater: Standing Water in the Hp,, a� Weeping from P t Face. Oy Estimated Seasonal High Ground Water 5� D1,T A111'R0VED FORA) - 12,07:9; HAYES ENGINEERING, INC. FORi1N1 I I - SO 11, FN .\I.1 1'1,OIZ 1"O1z\} 603 SALEM STREET I'<t) c 1 or -� WAKEFIELD, MA 01880 � ,� �� FN4assa—c11iusetts"__j FRS(617)246-2800 11J►_Jl1,,L�`'—�J~ "[)OV_FAX(617)246-7596 J-E-NL7r! No. / 11996�IGt3 BILE (�O[I1n10[11�'CZltfl of M - -- North Andover , 11/1-aS=SaC - Sett S Soil Suitability Assessment for On-site Sew a e_I)isnosal Performed B),: ._Gordon -Rogerson--- -- -" -- ..--- ------- ---------------_-- Witnessed -.--- _._---------_-.Witnessed By: -- usan Ford-. .. . ...... . . . ... A.G. BUILDERS No. Andover, Mass. � ew construction NRepair 0 Office Review Published Soil Survey Available: No ❑ Yes ❑; Year Published ._.___________________ Publication Scale..____._.._._________ Soil Map Unit -----.".-_ ._____--_.._. Drainage Class-....._---. ...... Soil Limitations Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) .. .... . .......... - - - ---- - ----- Landform. -._... - - _---------- ---- Flood Insurance Rate Map: ... . .... .... .. .. .. ... . .. .... .. - -... .. . . . .. . . Above 500 year flood boundary No ❑Yes ❑ Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes i Wetland Area: National Wetland Inventory Map (map unit) ... ..... ...... Wetlands Conservancy Program Map (map unit) . _ .. .. .... .. ....... .. Current Water Resource Conditions (USGS): Month Range -Above Nomlal ❑Norma! ❑Belc Normal Other References Reviewed: DEI'APPKO%-FD F(IHN1 - 1't07!95 PLAN REVIEW CHECKLIST ADDRESS ENGINEER GENERAL / J 3 COPIES STAMP L� �� LOCUS c/ NORTH ARROW SCALEy CONTOURS t� PROFILEe—'-'� SECTION ✓/ BENCHMARK �� SOIL & PERCS ✓ELEVATIONS WETS . DISCLAIMER L----WELLS & WETS WATERSHED? J//O DRIVEWAY (E1ev) WATER LINE FDN DRAIN Q/c. SCH40 TESTS CURRENT? �- SOIL EVAL SEPTIC TANK MIN 150OG ✓ . 17 INVERT DROPy GARB. GRINDER (+200% EDF) 25 ' TO CELLARaC- MANHOLE ELEV GW # COMPS . D-BOX SIZE # LINES ,5 FIRST 2 ' LEVEL STATEMENT INLETJ7/,,J'�5� - OUTLET//lo. = 1116 (211 OR . 17 FT) TEE REQ' D?V3 LEACHING / ✓ ERVE AREA 4 ' FROM PRIMARY? 2% SLOPE MIN 660 GPD. RES � /� 100 ' TO WETLANDS 100 ' TO WELLS f4 ' TO S . H.GW (-, (5 ' >2M/IN) 35 ' TO FND & INTRCPTR DRAINSG�� 325 ' TO SURFACE H2O SUPPy� 4 ' PERM. SOIL BELOW FACILITY MIN 12" COVER FILL? if above natural elev; 101if below) BREAKOUT MET? C",LIQ 5 TRENCHES 1� . 3X EFF. . 005 or 6 100 SIDEWALL DIST MIN 660 gp d SLOPE min / ) W OR D (MIN 6 ' )_t,_� RESERVE BETWEEN TRENCHES? L,---IN FILL? L-----)MUST BE 10 ' MINL,�4" PEA STONE?VENT? _ (>3 ' COVER; LINES >50 ' ) 16 = TOT / �� LDNG (OCOI BOT �o?,� + SIDE CoJZS X (L x W x #) (DxLx2x#) (G/ft2) Copyright C 1995 by S.L. Swrr V / I GLl It i 3g 4 � - -.--& C. eat, 3 ra rU Ir� aril--- &V �S Z ____—_.... - T�lI �An�r� 0A,, .� Town of North Andover, Massachusetts Form No.2 NORTH BOARD OF HEALTH O c 41 DESIGN APPROVAL FOR s �CHUSES SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM I . I • Applicant �� Test No. M . , ' Site Location WT In— Reference -Reference Plans and Specs. ENGINERR 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 V Site System Permit No. g L1 r 1 .o ot `.._ `_ aver � m No. 19 q� s - over, Mass., A? - LAKE 'DA_COCH ICHEWICK TE S E BOARD OF HEALTH .T T Food/Kitchen ERMI Septic System 1,5BUIL ING INSPECTOR THIS CERTIFIES THAT....................................�..,....�........... ..�.�..��.�.j=-...�.......................... �.d...... F has permission to erect.....................I.................. buildings on ........ ........5...�U..IQ./v..�A/......./.f.J> ...... tobe occupied as .......................................... . .....Z..!4 . ?.f�-. .......... ! 'L/..... y/.............................................. Chimney provided that the person accepting this permit shall in every respect conform to the ters 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. PLUMBINP INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ug Final PERMIT EXPIRES IN 6 MONTHS ELECTRIC INSP CTO ' UNLESS CONSTRUCTION STAR R---g;]s --; � ................. .... ... . .. '+Servi _S,i✓i��/� " BUI ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. Commonwealth of Massachusetts 1VE0 City/Town of 7OCT r15 Q1System Pumping Record Form 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 tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health or-oth6r approving authority. A. Facility Information 1. System Location: Left�Side Right side of house, Left front of house, Right front of house, Left rear of hous , ir of hou Left rear of building. Right rear of building. Address L City/Town State Zip Code 2. System Owner. Name Address(if different from location) Cityrrown Stat Lo aa- Telephone Number B. Pumping Record 1. Date of Pumping Quantity p g 2.Date Q t ty Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes Q-No If yes, was it cleaned? ❑ Yes ❑ No 5. ConditiooffSyst 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locatio re contents were disposed: G.L.S. Low I to Water Signature of Ha er Date t5form4.doc-06/03 System Pumping Record.Page 1 of 1