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Home My WebLink AboutMiscellaneous - 145 FOREST STREET 4/30/2018 145 FOREST STREET t �' 210/106.A-0178-0000.0 MAP #, -- LOT PARCEL # ----------_--_-- STREET.... ... C.ON.STRUCTION... APPROVAL. HAS PLAN REVIEW FEE BEEN PAID? YES NU PLAN APPROVAL: DATEv� --.� z------- ANP. BY DESIGNER: --,,-'-", 0 hrl� /�S�'�'L --�-- PLAN Df-I I . ,/ �9 _......._..... CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT DRILLER WELL TESTS: CHEMICAL DA I E 1`11 PRUVEU BAC:I ERIA I DII I E tII PRUVED 81DlgZ BACTERIA II DRI E APPROVED CONI7IENTS: /M�NGANES�� sfJiv�i �R�� riGN . Al&e b RLMb.uy FORM U APPROVAL: APPROVAL IU ISSUE �YLSNU DATE ISSUED_ 7 l � _----- ....BY-----� .._......... CONDITIONS: FINAL APPROVAL: ALL PERi"1ITS PAID YES 110 I WELL CONSTRUCTION APPROVfL YES t•IU SEPTIC SYSTEM CONSTRUCTION flPPRUVfIL YES hll) 01-HER YEAS t lU ANY VARIANCE NEEDED YES NU FINAL BOARD OF HEALTH APPROVAL: ',it .• «ir;L:' SEPTIC_ S-YSIE(`t_INSTALLA. IQ.N �> _ r IS THE INSTALLER LICENSED? YES NO r . I•j1!1 .� �� .!tl ;; ' t� .•' TYPE OF CONSTRUCTION: REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES 140 CONDITIONS OF APPROVAL YES NO (FROM FORM U) ISSUANCE OF DWC RERMIT YES NO 1, DWC PERMIT NO. — � INSTALLER __._._. � „•'i'` '• ''+` BEGIN INSPECTION �NO EXCAVATION . INSPECTION: NEEDED: ro PASSED 'BY ---'------- -- -- — . fi '� •?lir '� _,i.,'.': l CONSTRUCTION I NSPECTION NEEDED:s _........... .----_---..__...__..___ a[i¢rM ' _ ' •el;,!';,I' 111 �• r` � -_.—_...__.—_.—._"___.. _._—..--_-__..__-- .— '� ' AS BUILT PLAN SATISFACTORY: YES: APPROVAL TO BACKFILL: DATE:—_p�13d l q�_._BY— FINAL GRADING APPROVAL: DATE DATE: .BY FINAL CONSTRUCTION APPROVAL: N\F LOT 25A 205.00' 37.15' N\F LOT 24A LOT 26A 03�i \ m 49.58' 204.24' N\F LOT 27A co P W UL a. j . 9 a i� 117.49, TEMPORARY CONST.ESMT. Si 136.43' 5LOPf 2�QU//FiFU4FNT FOREST S T. (150) X = 150 - = . .... ... ... . . . ..... ...... . DES/CSN ELElV.4T/ON AT.. .. ... . .(TOP OF 570NE) EX/5T/N EMWT�ON 47 .. ... .. _ zFjIFl/.4T/ON.5 f DENS !N AS BUILT ,45 451112 T /N1 P/PE OUT 01`1100E / S$. 30 /5 9.0 7 INV. G/PE INTO T4M' /s 7.gp /$g�2 SU� -SU�F,4C'E D/SPOS�1� /NV. F/PE OUT OF TANK 5YSTEM INV PIPE INTO D. BOX / S-7,SV 157,Beq / V P P �N N / E OUT OF D. BOX AINVEND OF P/PE /�® dpoae- )J FOR w4TE2 EL EV,4 T/ON �i L L�,�-� /.:�i4 02..e. T�� ,4 VE2,46E STONE ,SC.4L E �� r DATE.- ,06-PTH ,4T ReO55 /voTE.' 7-1116 PLAN is Ivor ,4 wQ,e2QN7-Y ClIRISTIQ NSEN SER G/ , IAIC OF THE SYSTEM BUT Q k1,6-121F1"7-1ON 1&0 WMMER 5T/3,55T RAVERRILL,MASS. Of THE LOCATION OF TWE Ea'/ST/NQ ST�2UCTU2ES. Town of North Andover, Massachusetts Form No.3 Ot NORTAI BOARD OF HEALTH ) ',..o 9 Z F 9 *�'�+::.e•:�"`�# DISPOSAL WORKS CONSTRUCTION PERMIT • ,SSACMUSEt . �r Applicant Ul., NAME ADDRESS TELEPHONE Site Location (,�A 1 Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. { CHAIRMAN,BOARD OF HEALTH � dCn a Fee D.W.C. No. MUM Wfl TOWN OF NORTH ANDOVER 120 Main Street North Andover, MA. 01845 685-4775 NORT1r � � P t • SSACMUst� August 5 , 1986 Mr. Charles Foster, Building Inspector Town Office Building North Andover, MA 01845 Re: Lots 24A, 26A, 27A, 28A Forest Street Dear Mr. Foster: Per the North Andover Conservation Commission' s Order of Conditions for wetland crossings on lots 24A, 26A, 27A and 28A Forest Street,common driveways were requested to minimize wetland filling. Prior to the issuance of any foundation or building permits , Forbes Realty must receive Special Permit approval from the Planning Board under Section 2. 30 . 1 Common Driveways. Your cooperation in this matter is appreciated. Sincerely, PLANNING BOARD Erich W. Nitzsche, Chairman EWN:nrs Enclosure cc: NACC Board of Health , Christiansen Engineering Forbes Realty Trust t j,rcti� +•. fin t• '=j �: ZMEFile No. 242-349 ,per (To be provided by OEQQ ',.•�' \ North Andover tM'r.t tf+•• Commonwealth cityrrown of Massachusetts Forbes Realt}� TrL Applicant r �Ar t��rl.,'.e k • • ',' •:' Order of Conditions �f Massachusetts Wetlands Protection Act G`L. c. 131, §40 r4'w' ' and under the Town- of North Andover Bylaw, Chapter 3.5 A & B North Andover Conse•r_vation Commission Fro FORBES REALTY TRUST . FORBES REALTY TRUST To 401 AndQve��r,-P r Applicant) (Ns no of property owner) t. � (Name of APP ) Same North};+2E North Andover, Mass . Address ..;, Address $ This Order!s issued and delivered as follows: q. (date) 1 `v O ,by hand delivery to applicant or representative on by certified mail,return receipt requested on .lune 20, 1 9$6 (date) Lots 24-28 Forest Street North Andover, MA o., This project is located a "r The property is recorded at the Registry of Northern Essex r Book 1882 Page 206• p',;,•.Y.,. Certificate(if registered) ;J J_•,• The Notice of Intent for this project was filed on April 2 3, 19 8 6 (date)' June 4 1986 (date) The public hearing was closed on 7: ' Findings The North Andover Conservation Comm. _has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based or *the information available to the NAC . _at this time, the NACC has determined that 3 the area on which the proposed work is to be done is,significant to the following Interests In accordance with ; ,. ..� the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act(check as appropriate): i .. Public water supply ($ Storm damage prevention i tl_,i•; Prevention of pollution Private water supply Groundwater supply O Land containing shellfish rf trot 0 Fisheries . fjf Flood con - 3 ' ORDER OF CONDITIONS 24-28 Forest Street- DEQE #242-349 y 12. The work shall conform to the following plans and additional ;. conditions : a. Notice of Intent submitted by Forbes Realty Trust prepared by Christiansen Engineering Inc. , dated April 1986 revised June 1986 Fifty-Three (53) Sheets . r. b. Plan entitled "Overall Site Plan of Land in North Andover, ` r4}x MA. of Lots 24-28" Prepared by Christiansen Engineering Inc. , dated April 22, 1986. One (1) Sheet. C. Letter from Christiansen Engineering Inc. , to NACC dated May 21, 1986. One (1) sheet. d. Untitled overall Plan of Salem/Forest Street Lots . Undated and Not Label6d. ` Y'3'',• e. Plan entitled "Alternative 3 Overall Site Plan of Land in North Andover, MA of Lots 24-28" prepared for Forbes Realty Trust. (Dated incorrectly) April 22 , 1986. i. �yv;` One (1) sheet. f. Plans as part of Wetland Evaluation and Replacement Plan ' .;.. by Christiansen Engineering Inc. , Three (3) sheets . Undated. Labeled Figures 1,2, and 3. -, , g. Subsurface DisposAl System for Henneth Hyde by Christiansen Engineering dated April 1 and April 8, 1986 Seven (�) Sheets } .` h. Letter from Forbes Realty to NACC dated 5/19/86. ,r i. Letter from NACC to Forbes Realty dated 5/20 /86. Letter from John Simmons , Planning Board, to NACC ` 11k'-�.:1_'`'" dated 5/12/86. 13. The .driveways shall be redesigned to use two common driveways _4..� from'Forest Street. Plans shall be submitted to the NACC for ` k ••'` review and approval prior to construction. A 14. Prior to any construction on the site the offsite drainage wl from Area 6 shall be resolved to the satisfaction of the NACC � and Highway Surveyor, i.e. , the culvert under Salem Street shall be opened or replaced, or the extent of flooding on the upstream' side delineated if it is to remain Mocked. _ r PLAN REVIEW CHECKLIST ADDRESS A,6,,V 2�6- 1-ez5l� ENGINEER GENERAL 3 COPIES STAMP LOCUS L-` SCALE CONTOURS PROFILE �� SECTION BENCHMARK ELEVATIONS SOIL & PERC INFO �/` WETS. DISCLAIMER ,�,-� WELLS & WETI ANDS Well d t5S -, ? WATERSHED DISTRICT DRIVEWAY-t---- WATER LINE DRAINS RESERVE AREA (/ SCH40 t/ SLOPE SEPTIC TANK / MIN 1500G. y . 17 INVERT DROP GARB. GRINDER_') (+200% EDF) 25' TO CELLAR !/ MANHOLE TO GRADE ELEV GW D-sox - ReX, q ho/e .7 # OUTLETS_3 FIRST 2' LEVEL STATEMENT INLET 157,50 - OUTLET 1,5733 (2" OR . 17 FT) LEACHING 100' TO WETLANDS 100' TO WELLS 325' TO SURFACE H2O SUPP 35' TO FND & INTRCPTR DRAINS 4' TO S.H.GW 4--` 2% SLOPE 4' PERM. SOIL BELOW FACILITY MIN 12" COVER FILL? (25' if above natural elevation; 101if below) , TRENCHES MIN 660 FT2 SLOPE (min . 005 or 6"/1001 ) >3' COVER? - VENT SIDEWALL DIST. 2X EFF. W OR D .(MIN 61 ) L-- IS RESERVE BETWEEN TRENCHES? E5 IN FILL? ✓ MUST BE 10' MIN. 2--- BOT X LDNG + SIDE X LDNG = TOT (L x W x #) (G/ft2) (DxLx2x#) FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP LQ( 1 SUBDIVISION LOT(S) 26 PERMANENT ADDRESS ASSIGNED BY D.P.W. STREET APPLICANT ]/�.9 /�2 2e7 PHONE 8 1�Z3 DATE OF APPLICATION Z TOWN USE BELOW THIS LINE PLANNI G BOARD DATE APPROVED TOO"PEARkK DATE REJECTED CONSE VATION COMMISSION 1 A A as �- DATE APPROVED JZ- CONSERVATION -CON ERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVI;u HEALTH SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Ilealth Boards , the Conservation Commission prior to the issuance of any building pennl.ts for the subject lot. This form sliall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Y 0 L- COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: Fo R E sT ST. Owner's Name: SIMONR c1iA2\ Owner's Address: i LA.� t-o 2 EsT' S;-t. N . A^92yE2 Date of Inspection: b 1 t ci J o t Name of Inspector:(please print) G c cLv^, C Os cocci -U'2. Company Name: 04f•- 2tNG- Mailing Address• (v R Ee C.}1 w o� D2,wE Telephone Number. ct7 8- 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 4,of the time of the inspection.The inspection was performed based ori my training and Werience.in the proper,futiction and maintenance of on site sewage disposal systems.I am a DEP .approved system inspector pursuant to Section 15.340 of Tide 5(310 CMR 15.000). The system: ---*'Passes. Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: / ceo 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. 77, Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A PROPERTY ADDRESS:145 Forest Street CERTIFICATION(continued) North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: 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'oompletibn of the replacement or repair,as approved by'the Board of Health,will pass. lAriswer 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,exhibitssubstantial.infiltration.or eicfiltration 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 11 { J C OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A PROPERTY ADDRESS: 145 Forest Street CERTIFICATION(continued) North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 C. Further Evaluation is Required by the Board of Health: Conditions exist which require finther evaluation by the Board of Health in order to determa if the system it failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 15.303(1)(b)that the stem is not functioning in a manner which will protect public health,sa and the environment: r _11 s7pool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated dor a salt marsh .. 2. System will fail`-unless theard of Health(and blic Water Supplier,if any)determines that the system is:functioning-in a manner`t�►at protects the ublic health,safety and environment: The system hasa septic tank ana'spil a/*rption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a sur water supply. The system;has a septic tank ar}d'SAS and the SAS is within a Zone 1 of a public water supply. _ The system:ha&a septic /tank and SAS and the SAS�i\thin 50 feet of a private water supply well. The system ha&ais tank and SAS and the SAS is lean 100 feet but 50 feet or more from a private water supply%ye 1**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP ceit' ed laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from llution from that facility and the presence"of ammonia nitrogen and nitrate nitrogen is equal to or less than pm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this fo 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: 145 Forest Street North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 D. System Failure Criteria applicable to all systems: You must indicate`yes"or`Sno"to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ,: X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool N Liquid depth in cesspool is less than 6"below invert or available volume is less than''/z day flow �( Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high ground water elevation. Y Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X 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. -f 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 ukrogen;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.] N t�(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: gTpo�be c idered a large system the system must serve a facility with a design ff f 109000 gpd to 15,000 You must indicate eit�fi' "or"no"to each of the following: (The following criteria apply to a systems in addition to the c ri ' above) yes no the system is within 400 feet of a surfs g water supply _ the system is within 200 f a tributary to a drinking water supply the system is 1 in a nitrogen sensitive area(Interim We Protection Area—IWPA)or a mapped Zone II of lic water supply well If yo�eZction red"yes"to any question in Section E the system is considered a significant threat,or answered "yesabove the large system has failed.The owner or operator of any large system considered a si ificant at 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 r 4! OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM :. y PART B =• `, ' CHECKLIST *'Y 'ROPERTY ADDRESS: 145 Forest Street. North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 , t• + 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:6r: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: Yes no 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)[3 10 CMR 15.302(3)(b)] 7`Y Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C PROPERTY ADDRESS: 145 Forest Street SYSTEM INFORMATION North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 FLOW CONDITIONS RESIDENTIAL u Number of bedrooms(design): !_ Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: Z Does residence have a garbage grinder(yes or no):NO Is laundryon a separate sewage system(yes or no):nJ O [if yes separate inspection required] Laundry system inspected(yes or no):= Seasonal use:(yes or no): /gyp Water meter readings,if available(last 2 years usage(gpd)): Lk3 Fr_t^ Sump pump(yes or no):AD Last date of occupancy: C r-c rcr CONEMIERCIAIJMUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trapi 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: I o�1 q G s EA 2 i a P2E��a:S lTL E 5 Was system pumped as part of the inspection(yes or no): AjD If yes,volume pumped: pallons—How was quantity pumped determined? Reason for pumping: 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) _Tight tank _Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: �+5 &ii-T )flit o 101 ;QQIQA Were sewage odors detected when arriving at the site(yes or no):AO 4 d. Page 7 of 11 *"' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PROPERTY ADDRESS: 145 Forest Street North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron V40 PVC_other(explain): Distance from private water supply well or suction line: 30' Comments(on condition of joints,venting,evidence of leakage,etc.): aRIPE 4.19E p1Cw 9A,�;EM.El�9 i SEPTIC TANK:_(locate on site plan) Depth below grade: to Material of construction: ✓concrete metal_fiberglass__polyethylene _9ther(explain) 3 :tank is metal list age:_ Is age:confirmed by a Certificate of Compliance(yes or no):-(attach a copy of certificate) Dimensions: 15 0o C:-A i-L.oxjS Sludge Distance from top of sludge to bottom of outlet tee or baffle: 39` Scum thickness: 9 ' _ Distance from top of scum to top of outlet tee or baffle: Distance from,bottom of scum to bottom of outlet tee or baffle: ` _ How were dimensions determined: M C A 5 o R e +< Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): -TAW It-, C0t..) T %AJ c-,;-) CJN O 116U GREASE TRAP: IV 4ocate on site plan) Depth below grade:_ Material of construction: concrete metal_fiberglass___polyethylene_other (explain): Dimensions: Scum thiclmess: 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 umpingComments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): e y' Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS _ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM '� PART C SYSTEM INFORMATION(continued) , PROPERTY ADDRESS: 145 Forest Street North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/ol TIGHT or HOLDING TANK:AIP, (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: Qallons 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: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: b" Comments.(note:Tbox is level-and;distribution to outlets equal,any evidence of solids carryover,any evidence of' leakage into or out of box,etc.): of 2. PUMP CHAMBER: 1�(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.): l ♦ f � Page 9 of 11 R fy S yy OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ti PART C `'f SYSTEM INFORMATION(continued) :'= PROPERTY ADDRESS:145 Forest Street ;' ' North Andover,MA '` OWNER Simona Chari " DATE OF INSPECTION: 6/19/01 SOIL ABSORPTION SYSTEM(SAS): (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: t-,-5',)L— T n,C- ?QQ4-t S leaching fields,number,dimensions: overflow cesspool,number: innovativelalternative system Type/name of technology: Comments(note condition of soil,signs of hydraulicfailure,level of ponding,damp soil,condition.of vegetation, etc.): 2E A O r -5 Y- TE M t—g-4:-u_5 dao 2 MAL— N O TtC N o 1 N 1, -P AAA P ca Q N 'i1�i10N' CESSPOOLS:Mff_(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:M(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.): I n A � Page 10 of 11 v, OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C �. SYSTEM INFORMATION(continued) PROPERTY ADDRESS: 145 Forest Street North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 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. '.`3c r�N 9� 0 }-1ou7� Nk �3 'h ;�.d4 Y Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C PROPERTY ADDRESS: 145 Forest Street SYSTEM INFORMATION(continued) North Andover,MA OWNER Simona Chari DATE OF INSPECTION: 6/19/01 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water`�t`t�`r feet Please indicate(check)all methods used to determine the high ground water elevation: ~ Obtained from system design plans on record-If checked,date of design plan reviewed: 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: SG} "42.5 % D"C AM w PITErl 41' 5'61 IA./ C O4tJ15N Sr- I L 2A S r Sj�7 5 L-o P r 5 DC> AJ�✓ ib w��A N D i egty FEt T �w v4 T�w�' 1 5 (o' !-o...,E Z 'T"t-(►�N s;jstr ►�1. NEW ENGLAND ENGINEERING SERVICES INC October 10, 1997 North Andover Board of Health Town Hall Annex School Street North Andover, MA 01845 RE: TITLE V REPORT 145 Forest Street. Enclosed is the Title V report for 145 Forest Street,North Andover, MA. The system passes our inspection. If there are any questions please call me at my office, 686-1768. Yours truly, lenjam:C. Osgood Jr., E.I.T. President 33 WALKER RD. - SUITE 22 - NORTH ANDOVER, MA 01845 - (508) 686-1768 �,�� y CO's IAONXXTALTH OF MASSACHUSETTS �y EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON. 111A 02108 61:•292-5500 WILL1A*if WELD TRUDY COXE Sccrcur% Govcmo: ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A CERTIFICATION Property Address: P'''I�OvpCP— Address of Owner: Date of Inspection: �1��//y� (If different) Name of Inspector: BENJAMIN C. OSGOOD JR. ' I am a DEP approved system inspector pursuant to Section 1S.340 of Title S (310 CMR 15.000) Company Name: NEW ENGLAND ENGINEERING SERVICES, INC. l Mailing Address: 33 WALKER ROAD, NORTH ANDOVER, MA 0 184 5 Telephone Number: 508-686-1768 i CERTIFICATION STATEAENT I cenify that i have personally inspected the sewage disposal system at this address and that the information reposed below is true. accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper funaron and maintenance of on-site sewage disposal systems- The system: _PLasses t _ Condrtronalh Passes I _ Needs Further [%alwtion By the Local Approving Authority _ Fails Inspector's Signature: Date: /6 / The Svstem inspector shall bm;t a copv of this inspection report to the Approving Authority,within thirty (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 oifrce of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the bgryer, if applicable. and the approving author;,) INSPECTION SUMMARY: Checq B, C, or D: ' AI SYSTEM PASSES: �I have not iound any information which indicates that the system viol.tes any of the failure crite:is u defi:te�! in 310 CN 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: BI 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 pus. Indicate yes, no, or not determined (Y. N.or ND). Describe basis of determination in all instances. If'not determined%explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating (hat the tank was insulled within twenty(20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked. structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pus inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART A CERTIFICATION (continued) Property Address: 117 f O e5 Owner: / s-4 / • /A9 Qo✓!l2 Owner: S�jrj�/l/ Toch Date of Inspection: /D Bj SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health;. Describe observations: broken pipets) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health) broken ptpe(s)Iare replaces obstruction Is removed t I I 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 the public health. safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING i1N A MANNER WHICH WILL !r ROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRON 0ENT: Cesspool or privy Is within 50 feet of a surface water Cesspool or pr1.-�- is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD aOF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a suriace water supply. I The system has a septic tank and'soil absorption system and the SAS is within a Zone I o(a public water supply well. ` _ The system has a septic tank and soil absorption system?and the SAS is within So feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but SO feet or more from a private water supply well. unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER (r.vi..d 04/2s/17) a.y. 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ,c CERTIFICATION (continued): Property Address: /�5 tOe�S r S/. ��• r`BdP.e Owner: Date of Inspection: DJ SYSTEM FAILS: You must indicate either -Yes' or -No-as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 + r Static I+qu+d level in the distribution box above outlet rinvert due tolan overloaded or clogged SAS or cesspool_ — I — I Liquid depth in cesspool is less than 6- below invert or available volume is less than 1/2 day flow, — + — Required pumping more than 4 times in the last year MOT due to clogged or obstructed pipe(s)- Number of times pumped _. Ant ponion of the Soil Absorption Svstem, cesspool or privy is below the high groundwater elevation Anv portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. t t Any port+on of a cesspool or privy is within a Zone I of a public well Am pon+on of a cesspool or privy is within 50 feet of a private water supply well Anv 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for + col+iorm bactfria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: I I You must indtca>e either -Yes- or -No-as to each of the following: + The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No ` the system is within 460 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 11 of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (r.via.d 04/35/97) rag. 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: S v s /1, QvC h ISG i•�ti Date of Inspection: /o // / 9 -7 Check if the following have been done: You must indicate either "Yei or-No- as to each-of the following: Yes No _ Pumping information was provided by the owner• occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as pan of this inspection! i 1 As built plans have been obtained and examined. Note if tlhey ares not availab;e with N/A. i The iacility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste now. The site was inspected for signs of breakout All system components. excluding the Soil Absorption System, have been located on the site. �. The septic tank manholets were uncovered, opened. and the interior of the septic tank was in1pected for condition of baffles or tees. material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. t/ The size and location of the Soil Absorption System on the site has been determined based on: The facility owner Land occupants, if diiferent from owners were provided with information on the proper maintenance of Sub-Surface Disposal System. _ Existing information. Ex.tPlan at B.O.H. I i _ Determined in the field (d any of the failure criteria related 10 Part C is at issue, approximation of distance is unacceptable) 11 5.302(31(b)) I (r.v1••d Ol/7 S/17) Y.O. 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION-FORM PART C SYSTEM INFORMATION Property Address: /,(/j -f—oe96 S�. /�• "T4 Uu✓e<,— Owner: aac oc ,,.q /t/ Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: R.p.dJbedroom for S.A.S Number of bedrooms:_ Number of current residents: Garbage gror.der(yes or no?:� Laundry connected to system (yes or no): Seasonal use (yes or no):—dz Water meter readings. if available (last two (2) year usage (gpd): GV/1 LL- Sump Pump (yes or no):1(� Last date of occupancq-:a��6/r/ I I ` I I COMMERCIAUINDUSTRIAL: Type of establishment: Design f)ow: ' gallons/dav ' Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (ves or no)_ Non-sanitary• waste discharged to the Title 5 system Lyes or nol_ Water meter readings. if available Las[ date of o•-cupanc-% t , , OTHER: (Describe! Last date of occupancy. GENERAL INFORMATION; PUMPING RECORDS and source of information ' A/ot ,Q System pumped as pan of inspection: (yes or no) k&S If yes, volume pumped /S_�gallo�s T ) Reasop for pumping 1/lSOoc7Z, `or(. nQ TYPEOFSYSTEM Septic tank/distribution box/soil absorption system Single cesspool Oyerflow cesspool Privy Shared system(yes or no) (if yes. Ittach previous inspection records, if any) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known)and source of information: 5 t/B9�S L Sewage odors detected when arriving at the site: (yes or no) &11 (revised 01/2S/27) sage 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: /y5 -rpjeeS f Owner: S---o't 000h 4-c i.9 ry Date of Inspection: /0 1110-2 BUILDING SEWER: / (locate on site plan) Depth below grade: Material of construction: cast iron k"'40 PVC —other (explain) Distance from ovate water supply well or suction lir� Diameter Comments: (condition of joints venting./evidence of leakage, etc.) �A �T�04 f–'ovts�rT�,�ti SEPTIC TANK:_ (locate on site plant Depth below grade: 1p v! Material of construction: P,"concrete _metal _Fiberglass _Polvethylene _other(explatn) If tank is metal, list age _ Is age confirmed by Certificate of Compliance -(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bonom'of outlet tee or baiflte:_�`` Scum thickness:_ Distance from top of scum to top of outlet tee or baffle.�_ Distance from bottom of scum to bonom of outlet tee or baffle: �� How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, stru4tural integrity, evidence of leakage, etc.) 7r-,9,,i k Z'S �� 674u0 -10 0� �`�- I �- 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 bonom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid leve) in relation to outlet invert, structural integrity, evidence of leakage, etc.) 4 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / SYSTEM INFORMATION (continued) Property Address: �`�S fvL/'��Sr Sf� /�/• �CYOIfQ/Ii Owner: Sus I-Aj C 4 CC 11 Date of Inspection: TIGHT OR HOLDING TANK: r'Tank must be pumped prior to,or at time, of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal_Fiberglass _Polyethylene —other(explain) Dimensions: Capacm: gallons Design f!o%� gallon/da. Alarm level Alarm in wording order Yes. No I I Date of previous pumpsng: Corpments: (condition of inlet tee, condition of alarm and float switches, etc.) ' DISTRIBUTION BOX:_ (locate on site plani Depth of liquid level above outlet inven 4 Comments: (note ii level and distribution is equal, evidence of solids carryover evidence of leakage into or out of box, etc.) :D —L OX �4 ilPe`f V-000 4ti;4 Q. �i`°•t I I I PUMP CHAMBER:_ (locate on site plan) Pumps in working order: (Yes or Not Alarms in working order(Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (r.vi--d 0{/25/97) rag. 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: /V5 �0 00/1-Z's (S/t 101 �,COdF''r-_ Owner: _5�6,_< G Cove ti r¢c,`A/V Date of Inspection: / O SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present. explain: Type: leaching pits- number:_ leaching chambers. number:_ leaching galleries. number: leaching trenches. number,length: ' l ! leaching fields. number, dimensions: ! ! ! overflow cesspool. number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) 6 CESSPOOLS: _ (locate on site plan) Number and configuration Depth4op of liquid to inlet invert: Depth_of solids layer: , t Depth of scum layer: Dimensions of cesspoo!: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as pan of inspection) ` 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.) (r.vi..d 04/25/97) P.O. 1 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / "SYSTEM INNFORMATION (continued) Property Address: l�{� �a E°��f S�• �4"• /�'"'��'� Owner: <",5 e-.,, Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (locate where public water supply comes into house) tip u- CZ LUN �- ADO r�onl I I I t i t Dec-K y8 oo G(i t_ J ff.� Ic [� L9d pt= f (r.vi..d 04/2S/97) a..._ o ..r 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Properly Address: /q:�, /—O east- S�. 1v• OTS�Klvt� Owner: v� G "U Date of Inspection: ,/ , � Depth to Groundwater 7 Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abuning property observation hole. basement sump etc.) Determine it from local conditions Check .v!th !ora! Board of health I I ! Checi. FEMA Maps Check pumping records ! Check local excavators. installers Use USGS Data — S C4 IV AI _ ' Describe your o"In .words ho%, you established the High Ground—ater Elevation.,(Must be completed) J 2S R`lrLc le.� T/2rrE n G rZ drS/�!� 9 )v le r3-.t, (_a o w/t O"r Afi:Z 4 I l (r. 1..d 04/75/,7) 9.9. 10 of 10 DATE yZ Sheet Of r BOARD OF HEALTH i RSC D TOWN OF NORTHANDOVERv� - SUBSURFACE DISPOSAL DESIGN REVIEW FEE_ PERMIT # `✓' Z- APPLIC DATE RECEIVED ��LG --_-�� ANT r ASSESSOR'S MAP ADDRESS PARCEL # i1�- LOT # 710 ENGINEER 1ST%. ] < c�'/ STREET G6CL�7\ ADDRESS _t(e2 PLAN DATE REVISION DATE /Z� Z CONDITIONS OF APPROVAL: APPROVED DISAPPROVED X st1: k�i\ ' t � St �� s �t rola, S+6j t 0 i►��iw,� i C) 4� o F DATE 4 Sheet of / BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE_ PERMIT # 5 I Z DATE RECEIVED � 2 2 APPLICANT r ASSESSOR'S MAP ADDRESS PARCEL # LOT # ENGINEER STREET ADDRESS PLAN DATE REVIS 3A ' Z ION DATE CONDI`.rIONS OF APPROVAL: APPROVED DISAPPROVED X 00 d,.z \1 i'Ew , �� Eti-s�-t C-�.�T T� �c��n�s� -r(� T��ocL ��A�.A��.o►.� s LOT OF & CIF cvAi>t,&Q J �) "off fir. s G S ID �F�Ei� ovc�L rv-A. ,.pnL oFe S �� t wel14 - o ae- vSe- > ! s 1 J to t ' �•J I A)ME File No. 242-349 . (To be provided by DEOE) City/Town North Andover Commonwealth _ of MassachusettsForbes Realtti u: Applicant Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131, §40 and under the Town of North Andover Bylaw, Chapter 3.5 A & B Fro North Andover Conservation Commission FORBES REALTY TRUST . I. 401 Andave`r SrP� _ FORBES REALTY TRUST (Name of Applicant) (Ns ne of property owner) Address North Andover, Mass. Address Same This Orders Issued and delivered as follows: .• • • • ❑ `by hand delivery to applicant or representative on (date) ❑ by certified mail,return receipt requested on June 20, 1986 (date) Lots 24-28 Forest Street, North Andover, MA This project is located a i• i i The property is recorded at the Registry of Northern Essex Book 1882 Page 206' Certificate(if registered) {, The Notice of Intent for this project was filed on April 23, '19 8 6 (date)' ` une 4 1986 (date) The public hearing was closed on J Findings ... The North Andover Conservation Comm. has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based or 'the information available to the ' NACr at this time, the NACC has determined that the area on which the proposed work is to be done is,significant to the ItIlowing Interests in accordance with the Presumptions of Significance set forth in the regulations for each Avea Subject to Protection Under the 1. Act(check as appropriate): .t j Public water supply Storm damage prirvention Private water supply, JN Prevention of pollution' E sO' Land containing shellfish Ground water supply ' �l Flood control O Fisheries 1 2 - 242-349 24-28 .Forest Stree Therefore. the NACC hereby finds that the following conditions aro 4.: � necessary, in accordance,with the Performance Standards set forth in the regulations,to protect those inter- ests checked above.The NACC orders that all work shall be performed I in accordance with said conditions and with the Notice of Intent referenced above.To the extent that the fol- lowing conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. t,y • General Conditions f rtx 1. Failure to comply wilts all'condi9+ons staled herein, and with all related statutes and other regulatory meas- ures, shall be deemed cause to revoke or modify this;Order. 2. This Order does not grant any property rights or nny exclusive privileges; it docs not authorize any injury to private property or invasion of private rights. rt 3: This Order does not relieve the permittee or any other person of the necessity of complying with all °, .. other applicable feddfal, state or local statutes, ordin;+Hees, by-laws or regulations. . 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: (a) the work is a maintenance dredging project as provided for in the Act. or (b) the time for completion has been extended to a specified date more than three years, but less than, fiveyears, from the date of issuance and both that date and the special circumstances warranting : the ertcndcd tune period arc set forth in this Order. 5. This Order may be extended by the issuing<authority for one or rnorc periods of up tpthree years each . . upon applica lion to the issuing authority at least 30 days prior to the expiralion date of the Order. `. 6. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or de- bris,including but not limited to lumber, bricks, plaster,wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts of any of the foregoing. 7_ No work shall be undertaken until all administrative appeal periods.f(om this Order have elapsed or, if - such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land `i Court for the district in which the land is located,within thechain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, I"• Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which ''. the proposed work is to be done. The recording information shall be submitted to the NACC on the form at the end of this Order prior to commencement of the work. 9. A sign shall be displayed at the site not less thin two square feet or more than three square feet in sizo ' bearing the words, "Massachusetts Department of Environmental Quality Engineering, File Number 242— 349 , 10.Where the Department of Environmental Duality Cis requested to make a determination and to issue a Superseding Order, the Conservation Commission shall tic a party to all agency proceedings I and hearings before the Department. 11. Upon completion of the work described herein, the applicant shall forthwith request in writing that a E t. Certificate of Compliance be issued stating that the work has been satisfactorily completed. 12.The work shall conform to the following pinns and special conditions: ,I ... - 3 - ORDER OF CONDITIONS 24-28 Forest Street DEQE #242-349 r� 12. The work shall conform to the following plans and additional conditions : a. Notice of Intent submitted by Forbes Realty Trust prepared by Christiansen Engineering Inc. , dated April -1986 revised June 1986 Fifty-Three (53) Sheets . b. Plan entitled "Overall Site Plan of Land in North Andover, MA. of Lots 24-28" Prepared by Christiansen Engineering Inc. , dated April 22, 1986. One (1) Sheet. y c. Letter from Christiansen Engineering Inc. , to NACC dated May 21, 1986. One (1) sheet. d. Untitled overall Plan of Salem/Forest Street Lots . Undated and Not Labeled. ' e. Plan entitled "Alternative 3 Overall Site Plan of Land in North Andover, MA of Lots 24-28" prepared for Forbes Realty Trust. (Dated incorrectly) April 22 , 1986. One (1) sheet. f. Plans as part of Wetland Evaluation and Replacement Plan by Christiansen Engineering Inc. , Three (3) sheets . Undated. Labeled Figures 1,2, and 3. R g. Subsurface Disposal System for Henneth Hyde by Christiansen Engineering dated April 1 and April 8, 1986 Seven (7) Sheets ; h. Letter from Forbes Realty to NACC dated 5/19/86. i. Letter from NACC to Forbes Realty dated 5/20 /86. j . Letter from John Simmons , Planning Board, to NACC dated 5/12/86. ,y 13. The driveways shall be redesigned to use two common driveways from'Forest Street. Plans shall be submitted to the NACC for review and approval prior to construction. ; ! 14. Prior to any construction on the site the offsite drainage from Area 6 shall be resolved to the satisfaction of the NACC and Highway Surveyor, i.e. , the culvert under Salem Street shall be opened or replaced, or the extent of flooding on the upstream' side delineated if it is to remain blocked. 6 1 j 4 - ORDER OF CONDITIONS 24-28 Forest Street DEQE #242-349 15. Prior to any construction on the site, a filter fabric r. fence or a double row of staked hay bales shall be. placed between all construction areas and wetland areas . This barrier shall be inspected and approved by the NACC prior to start of construction. This row of hay bales shall remain intact until all disturbed areas have been.mulched,- seeded and stabilized to prevent erosion. 16. Upon completion of construction and grading, all areas shall be stabilized permanently against erosion. This shall be done either by sodding, mulching according to Soil Conserva- tion Service standards , or by loaming and seeding. If the latter course is chosen, stabilization will be considered once the surface shows complete vegetative cover has been achieved. 17. All construction work shall conform to the erosion control plan and construction sequence/schedule noted Sections C and D of the revised Notice of Intent. t . 18. All erosion prevention and sedimentation protection measures found necessary during construction by the North Andover ` Conservation Commission will be implemented at the directidn of the NACC. 19. Any changes in the submitted plans , Notice of Intent, or resulting from the aforementioned conditions must be sub- mitted to the NACC for approval prior to implementation. If the NACC finds, by majority vote, said changes to be significant and/or deviate from the original plans , Notice of Intent or this Order of Conditions to such an extent that the interests of the Wetlands Protection Act cannot be protected by this Order of Conditions and would best be 4 served by the issuance of additional conditions, then the # NACC will call for another public hearing within 21 days , at the expense of the applicant, in order to take testimony :. from all interested parties . Within 21 days of the close '7 of said public hearing, the NACC will issue an amended or new Order of Conditions . 20. Any errors found in the plans or information submitted by the applicant shall be considered as changes and procedures outlined. for changes shall be followed. - 5 - ORDER OF CONDITIONS 24-28 Forest Street DEQE #242-349 ~ " 21. The provisions of this Order shall apply to and be binding upon the applicant, its employees , and all successors and assigns in interest or control. 22. In addition .to the requirements of Condition No. 11, the applicant must submit a letter, from a professional engineer certifying compliance with this Order of Conditions . Said letter will certify, but not be limited to the following: a. "As-Built" elevations of all drainage ways constructed within 100 feet of any area subject to the Wetlands Protection Act. i• t . b. "As-Built" elevations and grades of all filled or altered Wetland Areas . C. Distances to all structures and alterations within 100 feet of any areas subject to the Wetlands Protection Act. An "As-Built" topographic plan of all areas within the jurisdiction- of the Wetlands Protection Act must be submitted s when a Certificate of Compliance is requested. 23. Members of the NACC .shall have the right to enter upon and inspect the premises to- evaluate compliance with this Order of Conditions. a 24. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 25. Issuance of these conditions does not in any way imply or certify that. the site or downstream areas will not be subject to flooding, storm damage, or any other. form of damage due to wetness . 26. Written progress reports on the construction activities at the site shall be submitted to the NACC. 27. - A surety performance bond or letter of credit running to the f Town of North Andover shall be provided in the amount- of $12,000.00, which shall be in all respects satisfactory to Town Counsel. and the North Andover Conservation Commission and shall be posted with the Treasurer of the Town of North Andover before commencement of work. Said bond or letter of credit shall be conditioned on the completion of all .<< Conditions hereof, shall be signed by a party or parties satisfactory to the Conservation Commission and Town Counsel, 6 - ORDER OF CONDITIONS 24-28 Forest Street DEQE #242-349 and shall be released after completion of the project, provided that provision, satisfactory to the Commission, has been made for performance of any conditions which are of a continuing nature. This condition is issued under the authority .of the Town of North Andover Wetlands Pro- tection Bylaw. .28. The NAC.0 shall be notified of any lot line or lot number changes with a copy of a plan showing these changes , prior to any construction act:i_v:i.Ly on these lots . 29. No utilities for these houses shall be constructed under or through any wetlands on the site. �y s y i i tl _ 7 _ DEQE #242-349 Lots 24-28 Forest Stree! North -Andover Conservation commission Issued By t natures) i i • This Order must be signed by a majority of the Conservation Commission. + On this 18thday of June 19, 86 , before me personally appeared Guillermo J Vicens to me known to be the person described in and who executed the foregoing Instrument and acknowledged that he/she executed tl the same� Is/ tee act and deed. .--� January 15 1993 `'• Notary Public Tracy A. Peter My commission expires The appilwinf,the owner,any person aggrieved by this Order,nny owner of land abutting the land upon which the proposed work Is to bed:na or any ten residents of the city or town in which such land Is located ore hereby notified of their right to request the Department of Environmental Quality Engineering to Issue a Superseding Order,providing the request Is made by certified mail or hand delivery id" ' the Department within ton days from the date of Issuance of this Order.A copy of the(equos.l shall nl the same time be sent by certified y ' mall M hand delivery to the Conservation Commission and the nppllcant. 1. i Commission Detach on dotted line and submit to the North Andover Conservation prior to commencement'olwork. �'`i.y .»....•»« . ...................««.»....................................................................................................................................................... ». Issuing Authority Tr. Forest Street4Lots 24-28) North (� Please be advised that the Order of Conditions for the project e Andover 1 Flo Number het been recorded at tho Roplotry of — - J and hbeen noted In the chain of title of the effected property In accordance with Goneral Condition a on as • t 9 It recorded land, the Instrument number which Identifies this transection Is ' ,•.. r It registered land,the doCUtnent nUtrlber which Identifies this transaction Is Applicant. •• Signlrture e�- MUM WH TOWN OF NORTH ANDOVER 120 Main Street North Andover, MA. 01845 685-4775 LOT S NORTH �/ 2�2 ,6 / 3r _- .•e OL p T 57 ST 7 Zx V :.t SACNUS ''f 't 1 a'IJS 1 August 21 , 1986 L5sve—_ J>w(f P44A I- 13P, Mr. Charles Foster 9Q55N 'r w4NC 1c)O7TMP—�6 5//YI TZP Inspector of Buildings Town Hall Building 120 Main STreet North Andover, MA 01845 Re: Lots 24A, 25A, 26A, 27A, 28A Forest St. /Common Driveways Dear Mr. Foster: The Planning Board members spent some time at the August 18th meeting discussing the proposed plan of Forbes Realty to construct two common driveways off Forest Street to serve lots 24A, 25A, 26A, 27A and 28A. It is apparent that there is a difference of opinion regarding the definition of what constitutes a "Common Driveway" . ` Therefore, the Planning Board is placing the matter on the September 8th agenda for further discussion at that meeting and requesting all parties to be present. In the interim we would anticipate that the representatives from Forbes Realty will withhold application for building permits and delay construction on all of these lots . Sincerely, PLANNING BOAR Erich W. Nitzsche," Chairman EWN:nrs cc: Board of Health Conservation Commission Fire Dept. Forbes Realty Trust Christiansen Engineering Highway Surveyor Selectmen � ,,a�, t P � �,NhfN6 BOQflO DA3'aW� .N OT NOR 'CI1 ANDOVER T,-1 ' . K AS SAC HUSETTS � t IiORTri .�.t,��;UV:�t o� JUL 9 2 12 ' '87 Mo 0 ."j'slidAbb� Any appeal shall be filed D .- within (20)days after the date of filing of this Notice In the Office of the Town NOT--ICE OF DECISION Clerk. Date. . June 290. 1987. . . . . . . . . . . . . . Date of IIearing 416.4/27. .541.8.48.7. Forbes , Petition of . . . . . . . . . . . . . . . . . . . . Trust, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Premises affected . . . . Lots 25A, _. . , . 28A and23A, 24Aand26A:Forest Street_ Referring to the above petition for a special permit from the requirements ofthe . . . . . . Section.2.30.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . so .as to permit . . . . . . . . . . .two.[2] .common driveways. . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . i After a public hearing given on the above date, the Planning Board voted to . .grant . . . . . . . . .the Common.driveway .Special. Permit. . . . . . . . . . . . . . . . . . . . . . . . . based upon .the following conditions: [see attached] Signed Planning Board Members John L. Simons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . John J. Burke Michael P. Roberts Paul A. Hedstrom of N°RrM OFFICES OF:' Town of 120 Main Street \ APPEALSNOWMANDOVER North Andover, BUILDING ;;^i::? a0+ 0 9f•`' ! , � .;rr Massachusetts 01845 Uly SBCMU9E4 a SION OF (617)685-4775 CONSERVATION f� HEALTH n I 1 ;; PLANNING PLANNINt � d6MM' UNITY DEVELOPMENT 4AR6 ZASAN, DIRECTOR ' ra June 29, 1987 Any appeal shall be filed Mr.. Daniel Long Town Office Building within (20) days after the North Andover, MA 01845 date of filing of this Notice Re: 1)Lots 25A, 27A, and 28A Forest Street in the Office of the Town Common Driveway Special Permit Clerk. Conditional Approval 2)Lots 23A, 24A, 26A Forest Street Common Driveway Special Permit Conditional Approval Dear Mr. Long, The North Andover Planning Board opened the public hearing upon the two (2) applications of Forbes Realty Trust on Monday April 6, 1987 in the Town Office Meeting Room. The hearings were duly advertised in the North Andover Citizen on March 19 and 26, 1987. The following members were present: April 6, 1987 - Erich W. Nitzsche, Chairman; Michael P. Roberts, Vice Chairman; John L. Simmons, Clerk; John J. Burke. The petitioner seeks two (2) Special Permits under Section 2.30.1 Driveways of the North Andover Zoning Bylaw, which requires a Special Permit for a driveway servicing more than one lot. The premises are known as Lots 25A, 27A, and 28A Forest Street, and Lots 23A, 24A, and 26A Forest Street. The lot is situated in the Resdential - 2 (R-2) zoning district. Said lots contain an area of at least an acre up to three acres and a frontage of 150 feet or 50 feet. At the hearing, Mr. John J. Burke read the legal notices for both public hearing special permits. Mr. Nitzsche disqualified himself as an abutter. Upon a motion made by John J. Burke and seconded by Michael P. Roberts it was decided to continue the public hearing until April 27, 1987 at 8:00 p.m. A group of abutters present at the meeting had not been notified. Their address were accepted and any further notices will be sent to them. . k 2• At the April 27, 1987 hearing continuance, Christiansen Engineering described the property and explained that the plan shows 2 common driveways designed to service 6 lots on Forest Street. It was noted that a COVENANT running with the land must be submitted to the Planning Board prior to a decision. Board members present (John J. Burke, John L. Simons, [Erich W. Nitzsche disqualified from discussion] , Michael Roberts, Paul Hedstrom) voted to continue the hearing to May 18, 1987. At the May 18, 1987 hearing continuance Chairman Nitzsche passed the chair to.M. Roberts and disqualified himself. MO'T'ION: By Paul Hedstrom to approve the application subject to planner drafting a decision with conditions. SECOND: John J. Burke. Unanimous in favor: John Burke, Michael Roberts, John Simons, Paul Hedstrom, abstain - Erich Nitzsche. 1. A covenant running with the land shall be submitted to the Planning Board for recording by the applicant. This must be done within 20 days from the receipt of the decision. 2. The common driveways shall be clearly marked with permanent stone markers placed at the entrance to the driveway designating house numbers to be engraved on every side of the marker. This shall remain clearly visible from all directions of the street. 3. Upon completion of the driveways, house construction and landscaping and prior to issuance of an occupancy permit, the applicant shall request a letter of compliance from the Planning Board accompanied by a certification and as-built plan from the project engineer who prepard the plan stating that the work has been completed in accordance with the submittal plans, approval of other town departments and this conditional approval. 4. The common driveway easements shall be shown on plan to be recorded at the Registry of Deeds and referenced in the deeds as easements. All conditions shall be listed on said plan. a. The applicant shall comply with any NACC orders of conditions. ry �- iy� ', N ri LSI- -' D J k 3. 6. The applicant shall supply the Planning Board with the original recorded copy of the decision and submit a copy to the the Building Office as well. In granting the Special Permit requests, the Planning Board, +9 pursuant to Section 10.31 - Conditions for Approval of Special Permits of the Zoning Bylaw, find the following: a. The proposed common driveways are appropriate locations for such use due to the extensive wetland between the dwelling location and Forest Street. b. The driveway, as proposed, with the required changes, will not adversely affect the neighborhood, provided all conditions are adhered to. c. There will be no nuisance or hazard to vehicles or pedestrians by construction of the driveways. d. Adequate and appropriate facilities will be provided for the proper operation of the proposed use, specifically by means of a recorded maintenance agreement. Based on site visits, the public hearing process, and testimony from town boards and departments, the proposed common driveways are in harmony with the general purpose and intent of the Town Zoning Bylaw, specifically Section 2.30.1. Sincerely, -� P Bord 7 Paul Hedstrom, Member An cc: Division of Public Works ��, Conservation Admin. =_'? Asst. Building Insp. �f=T Health Sanitarian �. Assessor Police Chief Fire Chief c ' Applicant 1" Engineer File ' • � jib✓ �� / • • A -oE Filo No. 42-314 (To be provided by OEOE) •� N(21-th An rinvnr Commonwealth c+cyiToWn of Massachusettsnppl;cant Forbes RealtU Trust Order of Condi'.ions Massachusetts Wetlands Protection Act c. 13111,514 0 _ vd uuder the Town - of North Andover Bylaw, Chapt�-,r 3.5 A' & B" From -WORTH ANDOVER CONSERVATION COMMISSLON To FoNbes Really Tr )st (Name of Applicant) (Na no of property owner) 401 Andover';8treet• Address ' N Andover XfA n)R45 Address r This Orders Issued and delivered as follows: ❑ Eby hand delivery to applicant or representative on (date) ❑ by certi(led mail, return receipt requested on Decembei- 11, 1985 (date) - This project is located a LOT 27� FOREST STREET The property is recorded.at the Registryof North Essex 1882 •206• Book Page a j Ailifl,c* ate(if'registered) • October, •1•, 1985 date The Notice of Intent for this project was filed on (date) The public hearing was closed on -November 20, 1985 (date) Findings � NA CC has re iewed the above-referenced Notice of Thi Intemt and plans and has held a public hearing on the project. Based or the information available to the NA C C at this time, the NACC has determined that the#area on which the proposed work Is to be done Is significant t the ollowing Interests In accordance with the Presumptions of Significance set forth in the regulations for,each A a Subject to Protection Under the Act(eheck as appropriate): C4 Public water supply !$1 Storm damage prevention Private water supply Prevention of pollution *ground water supply ❑ Land containing shellfish Flood control ❑ Fisheries I ti • ORDER OF CONDITIONS: Lot 27 FOREST STREET 242-314 12. The following tnformation was- submitted by the applicant: 1. Notice of Intent of Forbes Realty TrustYPhepared by Christiansen Engineering, Inc. /Dated 10-1-85/Seven ( 7)..pages. 2. Cover letter and drainage calculations prepared by Christiansen Engineering, Inc. /Dated 11-20-85/Fifty-Eight (58) pages. 3. Cover letter and drainage calculations prepared by Christiansen Engineering, Inc. /Dated 11-26-85/Four (4) pages. 4. "Overall Sitp Plan in North Andover, MA of Lots 23 - 28"/1-1repared for Mr. Kenneth Hyde%Prepared by Christiansen Engineering, Inc. /Dated October 1, 1985/0ne (1) sheet. Work is proposed within the following resource areas: Buffer Zone Bordering Vegetated Wetlands Bank Land Under Waterbody & Waterway Land Subject t6 Flooding (Bordering & Isolated) 1 ' DECISION : For the reasons se.t forth below, the Commission denies this Notice of Intent, without prejudice, due to lack of information. REASONS: 1. The applicant failed to adequately, identify the individual wetland resource areas, - - and their boundries, ,on the submitted plans. This information is essential in determining the impact of this proposal on specific resource areas, and in determining specific performance standards necessary to protect the interests of the Act. 2. The submitted drainage calculations were found to be deficient injhe following _._ respects: a. No elevations are given in the calculations, and the potential for backwater effects between the various wetland/ponding areas has not been `addressed. b. Discharge elevation relations, for the "ponds" in the calculations, are not fully described, nor have the effects of inlet and outlet controls been addressed. c. The sensitivity, of the results, to the assumptions on existing storage areas, has not been addressed through a detailed analysis of the available storage (versus elevation) characteristics of the project site. 2 - a ' ORDER OF CONDITIONS: LOT 27 FOREST STREET 242-314 d. The impact of the very large wetland areas; assumed (e.g. , nearly ons third of "Area 311. is assumed to be d,`w41tlan.d) on the runoff characteristics of the individual "sub-areas" has not been'considered (e.g. . should area 3 have, r�Qre runoff since 113 of'its area is wetland). e. The impact of the increased runoff from area G on the site or abutting properties was not addressed. Given all of the above items, the adequacy of the proposed additional storm runoff storage is not well documented. 3. The applicant, failed to submit a detailed sedimentation and erosion control plan necessary to prevent the siltation of..adjacent bordering vegetated wetlands. Also, no construction sequence wasl�provided to show that erosion control measures and construction scheduling will be compatible. 4. No plan was Submitted to detail the replacement.of lost Bordering Vegetated Wetlands as required in Section 10. 55, 4b, 1-7. In general, the NACC feels that the information submitted with this Notice of Intent is inadequate and: A . Does not overcome the presumptions of significance for any wetland resource areas. , B. Does not meet.the performance standards (as required in. 310 CMR 10.00) for any wetland resource areas. C. Does not allow the Commission todetermine the impact of this project sufficiently enough to issue an Order of Conditions. � 3 - 242-314 NORTH ANDOVER' • Issued E3y_T Conservation Commission -• Signatures) Ission - - --- 'This Order must bo signed by H.majority of the Conservation Co . On this 11th day of December 19-_ g,5 before me personally appeared , to me known to be the Y ,: person described in and who executed the foregoing Instrument and ackno 'led ted that he/she executed +'rt the same as his/her free act and deed• - - Notary Public My commission expires The applicant•the owner,any person aggrieved by this Order,any owner of land abutting the land upon which the proposed work is to.,'_, be done or any Ion residents of the city or town In which such land Is located are hereby notified of their right to request the Department i of Environmental Quality Engineering to Issue o Superseding Order,providing the request Is made by eortlfied malt or hand delivery to suance of this Order.A copy of the roquesl shall at iho samo time be sent by eorblied the Department within ton days from the data of is mail or hand delivery to the Conservation Commission and iho applicant. • , n^1 Detach on dotted line and submit to the ...... ... »..»..... .......................prior to commencement of work. •:r:'. .! ............................ .................................................. ....... ......:............ ' Issuing'Aulhonty - ---- To or of Conditions for the project at Please be advised that the brd • and , Filo Number has been recordo.d at the Registry of has been noted in the chain of tido of the affected proporty In accordance with General Condition 0 on , 19--- { if recorded Ian d. the instrument m..nber which Idenlifies this transaction Is If registered land•the document,Niornber which idontYlos this transaction is it,•,. 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C •:A• . >7• •,�� ys tt� It tt� ?? 71+ -;i,rti t� .e ?t � 1� � �•r ur 'l�`y1 tl t- 'i _ �r j+�. . ' r i, 4 t 1 � { ll t � ` ' , ''�� y +.cE' urt• r. ,,1��1 f else �',t � ft \'� !}�� l ?�` •. ��, + `,, 1 �� t�t�i.�si?� 1 � t � -A� ; , t ..........,.,.,.a..`,.a..1�al.,x..,.�n.ua.{..+.aaW`.:,.�{Cia:cw�.•i:i'�%��✓ NUMRF.R FEE THE COMMONWEALTH OF MASSACHUSETTS _$25. UU TOWN of ..........Hose_..mpoALFR............................... ' This is to Certify that LaRacque...Wel.1.s............................................................... NAME f•, .................2-44A..Haven---St-ee-t-y...Readims-,-...MA...0.1-8b7............................................. ADDRESS IS HEREBY GRANTED A LICENSE • -----_.. ... Well Drilling•-•Permit ___ 26A Forest Street ............ ` For ...................... ._.-------•.._-•..--• ----••---....---••......... ...................... ...•--?----_---•--------_-•---•-•----_------- -_---- .. ............................... ••--•--...----•--....---•------......---...-••--•--------...--•-- This license is granted in conformity with the Statutes and ordinances relating thereto, and expires-December'---31-o ---1.9.92................�t�lesa sooner a i0 r /...__. ....._lYi..0• ................ ........July---8................................19---922 .. ....... ....... ............ ----------------- ....... ......... . .. .............................. b FORM 498 HOBBS & WARREN. INC. __ S Bi® amine 16 EAST MAIN STREET, P.O. BOX 1153,GLOUCESTER,MASS.01930 TELEPHONE: (508)281.0222 FAX: (508)283.3374 Certificate of Analysis La Rocque Well Report No.: 28302 244 Haven Street July 28, 1992 Reading, MA 01867 Re: Well Water Analysis Sample Description: Samples of water identified as Barletta, Lot 26,Andover. Sampling: Samples delivered by Steve Murray of Northeast Environmental on July 22, 1992. Findings: Results Guideline" Total Coliform Bacterial Count per 100 mL . . . . . . 0 0 pH Value . . . . . . . . . . . . . . . . . . . . 8.01 Slightly Alkaline Hardness(as CaCO3, mg/L) . . . . . . . . . . . 213.8 Very Hard Sodium Content (mg/L) . . . . . . . . . . . . . (41.7 20 Chloride Content (mg/L) . . . . . . . . . . . . . 63.5 250 Iron Content (mg/L) . . . . . . . . . . . . . 3.9,' 0.3 Manganese Content (mg/L) . . . . . . . . . . . ./0`.15_ 0.05 Nitrate Nitrogen Content (mg/L) . . . . . . . . . . 0.24 10 Nitrite Nitrogen Content (mg/L) . . . . . . . . . . <0.02 1.0 Copper Content (mg/L) . . . . . . . . . . . . . . <0.02 1.3 Methods: Standard Methods for the Examination of Water & Wastewater, 17th Edition, 1989. *Guidelines are based on the recommended maximum levels of the Mass Department of Environmental Protection Agency's 310 CMR 22.00, "Drinking Water Regulations". Remarks: Although the Sodium content detected exceeds the recommended level, 20-50 mg/L is considered tolerable for people who are not on strict salt-restricted diets. The Iron and Manganese levels detected can cause taste, color, and/or staining problems, and also cause decreased well efficiency due to incrustation of the well screen. Filtration is available to correct these levels. By: John Marletta Lab Director JM/dn Mass. Certified Labs MA026 and MA123