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Miscellaneous - 150 SALEM STREET 4/30/2018 (3)
�_ I5� HCl;� ��' // r \ J �I �� _ n I 4 P < �l.. `, d _.� �. �_ � Lot & Street's d Map/Parcel 3 71) A/A CONSTRUCTION APPROVAL Has plan review fee been paid: ES .-NO Permit# - 641e Plan Approval: Date: Approved by:_ / �/U _ Designer: P9--1; 6- = Plan-Date: Condit ons: Water.Supplyi: =Town Well Well Permit -Driller .Well-Tests. :Chemical Date`ApProved Bacteria I ..T ' Date Appro'ved,. --"Bacteria H� Date Approved . t; Plumbing Sign-Off: -.--. Wiring .Sign off: Comments -± -., . -7 ""- ;r Form."U" Approval:, Approval to Issue YES =- O Date Issued - _ By .r Conditions: _I1, - Final Approval All Permits Paid? YES. NO Well Construction Approval? - _. _ ..YES :. - NO Septic System Construction Approval? YES.`. NO'; 3 Certification? YES:. NO Other? _ .,\ YES NO, . Any Variance Needed? ` TYES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: r art" . _ A.— -SEPTIC SYSTEM INSTALLATION CONDITIONS: -1s N the=installer licensed? ' S O - Typeof Construction REPAIR f�" .New Construcfion - 'Certified Plot Plan Review 's Floor Pl n � - : . . � a Review 4 Conditions of Approval from Form U YES. xlssuan.ce of DWC permit NOS. _DWC�Permit Paid _ _1 AYES NO { DWC`Permit,# s fInstaller +r ,RBeginlnspection `�y = W Y Ezcavation'tlnspecf6n ti Need6dd �Passeid B Construction4lnspection -Ne77 ed'ed .wn • r 'As Built Flan Satisfactory _ ti. K j ji X '.. - ApprovaliofBackfill Date '; By: Y _ FinalGradmg Approval = Date _ F,- A;� �� �; �, ',: - =-- :wit � _.w - �-•- _ _ Final'-Construction-Approval Date:: By: Certificate-of Compliance:- Approval: Date: r Sawyer, Susan From: Sawyer, Susan Sent: Wednesday,April 02, 2014 11:04 AM To: Ciofolo, Angela Subject: 150 Salem Street;family suite Angela, Here are my comments for your file. I have informed the owner, Nancy Pace. I appreciate being included in the process. The Health Department has reviewed the application for 150 Salem Street;family suite. This home was approved for a maximum 5 bedroom (11 room home), but was built initially with a smaller number of rooms taking into account the finishing of the lower level area. There is no issue with the increase of number of rooms, as proposed. Thank you, Susan Susan Sawyer Public Health Director Town of North Andover 1600 Osgood Street Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mailto:ssawver@townofnorthandover.com Web www.TownofNorthAndover.com i 1 NORTH Zoning Bylaw Review Form �? 14 Town of North Andover Building Department 'r 1600 Osgood St. Bldg 20 Suite 2-36 �,SSACHUS North Andover, MA. 01845 Phone 978-688-9545 Fax 978-688-9542 Street: 150 Salem Street Ma /Lot: Map 37.D Lot 045 Applicant: Nancy Pace Request: Family Suite Date: March 25, 2014 Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning R-3 Item Notes Item Notes A Lot Area F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies X 3 1 Lot Area Complies X 3 1 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 1 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 1 Complies X 4 Special Permit Required X 3 Preexisting CBA W 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply X 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies X 3 Left Side Insufficient 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient I Building Coverage 6 Preexisting setback(s) 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies X D Watershed 3 Coverage Preexisting 1 Not in Watershed 4 Insufficient Information 2 In Watershed j Sign 3 Lot prior to 10/24/94 1 1 Sign not allowed N/A 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district X 2 Parking Complies X 3 Insufficient Information 3 Insufficient Information 4 Pre-existing Parkin Remedy for the above is checked below. Item# Special Permits Planning Board Item# Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parking Variance Frontage Exce tion Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate ousing Special Permit I Variance for Si n Continuing Care Retirement Special Permit X Special Permits Zoning Board Independent Elderly Housing Special Permit Special Permit Non-Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit for Sign R-6 Density Special Permit Special permit for preexisting nonconforming Watershed Special Permit X Family Suite The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department-will retain all plans and documentation for the above file.You must file a new permit application form and begin the permitting process. ui i g Depa ment Official Signature Application Received Application Deni6d Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for DENIAL for the APPLICATION for the property indicated on the reverse side: Items "Reasons for Reference 4.121 Residence 3 District FAMILY SUITE-SPECIAL PERMIT. 17. Family Suite—a separate dwelling unit within or attached to a dwelling for a member of a household is allowable by SpecialPermitprovided: a. The dwelling unit is not occupied by anyone except brothers, sisters, maternal and paternal parents and grandparents, or children of the residing owners of the dwelling unit. y V Referred To: Fire X Health ; Police X Zoning Board X Conservation Department of Public Works X Planning Historical Commission Other Building Department j -- —T - . -- — ,�, lil • 1 I 1 I I� 1 I ' °I�p9 � 1�'.O• I n U 1 � 1 - , I L- --J -- --- R 1 sem• __ - r I-� r � ��'' I , 11 1 mc. � I u•�o:,a. , , I I I I I 5-aS } I - ----DL -FN- IFI AT ON ------------ ---------- -- ----- S's ^�"Fcs� I 1 I ' I t l L l a 3.eo3mo�noN L-._ q, 'Pf—T°TI.1:RadY mi.pound.—..S..&:MW PSI / Fmtlog S :2".)T Rea. q:2-d5 rtb°n I--- ! I I I I I i� 1 � I I�I z C°l.mv P.da:30"a 30'.10• FIrtPl.ce P.da:12"dd k waRse l0^ Rdnfnrtl°T P<rimctn I 1 ~-1� 1 1^ j •.-et• b '. 1 N 2-foa�2tonfl W inmdW uum o land vatimll WP Y msmlled in footinpr � _ 1 r-i-, Anchor bWb:InUP S".o:el bolo 6'0°t mea.,l2'0...fmlu cmnc 4=�. boa 1 1 I O W.rrrPrv° pSil°mimw-Wlu luvWWoo:WA 1 , I 1 i j- I 1 VepN.Vm:R'bdowrtrcern 1 1 I :-a I i 0 � L_I_J __ els•cor nuen 1 i i L-�� Ru®eol Fbor:/'Flw c°vcrtlr CnvYp.a Soni:NIA " I ja`df`FSB I ®•a a ae•..w•..v ccac Fi¢ I 1 Rdaf°dAg:WA Sul.&Ycv V°por Realer.WA FMI- ' __-_-_ -� Ins 1 I i r Floor.i' PCv b 61610:10 ntrc=A,eea1M Y : I I.aRq� 1 N015: I I I I ' � I � I _ LJ � I 1. mLpli 4'e PE�ATEp P_h6TIC PIF£ 1 E r tUl - { .�\ __ IL 11 .q/�ATI0.V FOR FNOPER I6 FIGIIFED - ♦ � y�J aFOR A i-m'Ne,H ele.LL FOR A Fu.L 24�rreNr. . _�^____ _� ( � ra" a Ya i � `��•'� I C 1--_ � .rr iac COapmW QL®GE PRESFNr hi T1ffi 01,E t J na"' --"• .eNEN rOW W+ra T1£<QL^.I'l OT 6 I • � i LEDrE.....L ML'T 2E PM•ffD O i0 LEpCE eY 9 t� w a. °SG�NT�iisFM�o .c•� T -1 s.• 1 I I --i � 1 REflhh¢]<•oL " I 1 FOUNDATION PLAN ate. - y•.r-e' P2C.=CTS 4 Pace Residence North Andover, MA _ PRELIMINARY DRAWINGS �� �«••6 33�%_zm DAE 8 99 11 NOT FOR CONSTRUCTION Living jpacesr '/nc. Wim. A=1TECTURAL 5ERVICE5 D G W x -Iu.na,Eu„ Rye n.+o5ew Apr-12-00 01 :08P Paul D. Turbide, PE/PLS 978-465-0313 P.04 April 12, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover,MA 01845 RE: Title V second review for 150 Salem Street Dear Sandra, (This plan was originally approved on October 15, 1999. The revised plan dated March 23, 2000 has a design change from four bedrooms to five bedrooms.) 1 find that the revised plans dated March 23, 2000 adequately address the regulations for the increase in design bedrooms from four to five. If you have any questions or comments please feel free to contact us. Sincerely Carlton A. Brown, PE/PLS Saleml50b.doc PODT itl ENGINEERING Civil Engineers& Land Surveyors One..Harris Street Newburyport,MA 01950 /� i (978)465-8594 APtlp I 2 ; { ' 1 INVERT ELEVATIONS BUILDING TIES 4" PIPE @ FDTN. 231.11' BUILDING CORNER A B C D SEPTIC TANK IN 230.88' ± SEPTIC TANK 46.3' 14.4' SEPTIC TANK OUT 230.71' DIST. BOX 72.8' 53.7' DIST. BOX IN 227.35' CORN. LEACH FIELD #1 48.9' 71.2' DIST. BOX OUT 227.15'END LEACH LINE 226.75 CORN. LEACH FIELD 2 23.2' _f2,0' 1 END LEACH LINE #2 225.77 TC _ , I f t f ; ( 0 " 1 t �R� 226 4 oo 2 SRA 234 co Z •� 1 � 2��Z S�F r 23� 23.4' ( 234 V ./•\ \ \ 22 �� � � � 22$ 226 FN�SN oRv� 22,0 \ 224 222 00 `? i \'0 A � 0 g7 AS BUILT OF SUBSURFACE DISPOSAL SYSTEM LOCATED INLA EM STREET NORTH ANDOVER, MA. (PUBLIC — ( 962 E.C.L.O. #2952) ` j AS PREPARED FOR NANCY AND JOSEPH PACE 0 150 SALEM STREET o NO. ANDOVER, MASS. 01845 of SCALE: 1"=40' DATE: JUNE 1, 2000 REV.: 8/9/2000 o KORA os cn N LOT A SALEM STREET TAX MAP 37-D PARCEL 21 SUB LOT A U Na 371 5 i MERRIMACK ENGINEERING SERVICES 9 T Q PROFESSIONAL ENGINEERS • LAND SURVEYORS a PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL (978) 475-3555• FAX (978) 475-1448 S � 1 INVERT ELEVATIONS BUILDING TIES 4" PIPE @ FDTN. 231.11' BUILDING CORNER A B C D SEPTIC TANK IN 230.88' SEPTIC TANK 46.3' 14.4' SEPTIC TANK OUT 230.71 DIST. BOX 72.8' 53,7 IST. X IN 227.35' DIST. BOX OUT 227.15' CORN. LEACH FIELD 1 48.9' 71 .2' END LEACH LINE 1 226.75' CORN. LEACH FIELD 2 23.2 22.0' END LEACH LINE 2 225.77' 14 ARS o,e i S. � Z MER " m i E�-ECR E• 220 •P cam" ME F (D 6 O I 0'C P poa- '� FND�j 1Nt VIN 222.O L SEE NO BIT. CONC. DRIVEWAY CID CD '' r � r N cS` CONNECT TO ° TOWN WATERMAIN AS- BUILT ' OF SUBSURFACE DISPOSAL SYSTEM LOCATED IN SALEM STREET NORTH ANDOVER, MA. (PUBLIC — 962 E.C.L.O. #2952) AS PREPARED FOR AT A ATrV A ATT1 T/1VVnTT T) A r1 1111-1114 V 1 1-i1 11.1 d V 11-3 Ki r 11 1- 150 SALEM STREET 01845 DANIEL o��,`�`•�N�FMASSgyG NO. ANDOVER, MASS. oN O KOP VOS �+ 0 » v CIVIL vii N SCALE: 1 =40'40 '. No.37752 DATE: JUNE 1 , 2000 � LOT A SALEM STREET5�� MERRIMACK ENGINEERING SERVICES PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET ANDOVER. MASSACHUSETTS 01810 TEL (978) 475-3555• FAX (978) 475-1448 AS-BUILT CHECKLIST I/ LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER t/ LOT LINES & LOCATION OF DWELLINGS OfJ NSIONS OF SYSTEM, INCLUDING RESERVE ri T LOT LINES &DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES &PERC TESTS t� ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM t� LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW LOCATION &ELEVATIONS OF BENCHMARK USED ��- Oct-15-99 08: 18A Paul D. Turbide, PE/PLS 508-465-0313 P.02 October 15, 1999 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE: Title V review for 166 Salem Street Dear Sandra, I find that the design plans dated October 8, 1999 adequately address the regulations. If you have any questions or comments please feel free to contact me. Sincerely Carlton A. Brown, PE/PLS Salem166 oc &Ale,ILI � PODT ENGINEERING Civil Engineers& Land Surveyors One.Harris Street Aewburyport,MA 01950 (978)465-8594 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 8/15/00 This is to certify that the individual subsurface disposal system constructed O or repaired (X) by George Henderson at 150 Salem Street has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES &LOCATION OF DWELLINGS LOCATIONS &DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK& D-BOX y ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW r/ LOCATION&ELEVATIONS OF BENCHMARK USED I TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (,constructed; ( ) repaired: by CED12 � ��I'J�I?�ic located at �!� � 1.EF� �7'►? G� was installed in conformance with the North Andover Board of Health approved plan, System Design Permit# , dated_ , with an approved design flow of440 gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: 5- ,71- op r7. Engineer Represen ative Final inspection date: oo 1?2 SD-WA :a— Engineer Representative Installer: Lic.#: Date: Design Engineer:'Z ,o'-`I Date: . I CG c� 11 OF,� DANIEL tiG TC KORAVOS CIVIL -0 9Na.37752 1 uG I1'0 ^^ s��� ; f an-, s � ��`.S!'� fiat e'1-�L / �� C j'l!� NSF HART 125.00' ♦J��' art—. _... ---- _.... •,.- ..,.. - _ a VENT ts�t / 7..30 {v N L � 14 < GUN(TE POOL D Z31 �1 2Z0 2 A 32 7� t gyp' X31 �� ' 29.6 ,r•: 10 DD r1 W Y% 4 GAS X52 ' I (METER ! jcow #160 • .� 9a 21 /2 STORY W.F.D. 31 ' � � T.O.F.= 234.1' f3 36 POR H � 23.4' �o 228 ` 172 x.•51 _C l ; ` Q6 ,�' Oa 226 v � ,\ � / 1 231. 7 Z •/,L�l,yg '�34 rn ( "19 n... � Tiff ., n� ` ...c. ,�• -W TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The unde.sued hereby certify that the S e wa e Dispo.al SYster. n constructed; ( ) repaired; bt-g- e n -t r s o r7 - located at 1 S D L-Sl 4&yrs S7- was-installed.in conformance with the North Andover Board of Health approved plan, Svste.n Design Pen-rut 9//23, dated -wiuh an approved design flow of_- - gLris ger day. The mate tern als used were in conforance with those speci:hed onthe approved plan; the systen was installed in accordance with the provisions of 310 CN2 15:000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative Installer: rr e-,m e!j- e` e'n al g e-rd,, Lic.T: t_ Date: Design Engineer: J'oh> Sov�-� Date: yo -iL - g MERRIMACK ENGINEERING SERVICES, INC. 66 PARK STREET ANDOVER, MA 01810 (978)475-3555 FAX.' (978)475-1448 FACSIMILE COMER PAGE u DATE: G� NUMBER OF PAGES: (INCLUDING COVER SHEET) TO: SySAIV ro 2 1) A16A 7M /N59 � & AV. 4WCO velle FROM L°44r ccs HI&1r/.0 s COM. MENTS: Ca_e I OP _ _ T45-fl I G7"_ R�" ® NAir,l��( Qd C r e c17' A SIR ad rt? SENDING TO FAX NUMBER: CONFIRMING TELEPHONE NUMBER: FOR PROBLEMS, PLEASE CALL OPERATOR: (978)475-3555 TRANSMISSION: CONFIRM NO CONFMMATION NEEDED MERRIMACK ENGINEERING SERVICES.INC. 66 PARK STREET - ANDOVER.MASSACHLISEM 018i0 AS--BUlLT pJAN OF LAND 160 SALEM STREET, LOT A SALEM STREET NORTH�r AlVD0 VES, MASSACHUSETTS PIMA= FOR "cy & JOSEPH FACE 150 SALEM SST Ch�lS�'�"!5 Oi8�5 IYOR�'H ANDOi A DAA' AUGUST A 200 N9 mi SCALA` 1=20' p' 1 Q' 20' 40) 60' .. KWoRWCK FNCDZEMMWG 54T�IC 88 PARK ST'Rw "WV= "WACXURIs' W 01810 i North Andover Health Department • 27 Charles Street North Andover,MA 01845 • (978)688-9540 fax(978)688-9542 To: B.Dufresne,Merrimack Engineering Fax: 475-1448 From: Susan Ford,Health Inspector /4�D�a: 08/08/00 Re: 150 Salem Street Pages: 1 CC: Nancy and Joseph Pace,owners X Urgent X For Review ❑ Please Commetrt ❑ Please Reply ❑ Please Recycle Bill, This memo is a follow-up to our conversation of the afternoon of August 7, 2000 and the previously sent fax concerning 150 Salem Street In addition to the concerns about the septic trench, 1 have added concerns about the location of the swimming pool which is under construction. Our approved plan indicated that the rectangle pool was to be 27' from the leach trench, however, inspections found a kidney shaped pool which was much closer than anticipated. While conducting your inspection of the system this office requests that the location of the pool be placed on the septic as-built A certificate of Compliance will not be issued until it has been established that the pool is no closer that the 20' minimum distance to the septic trench. Thank you for your cooperation in this matter. . . . . . . . . . . . . . . . . . . . . . . . m ECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initia A. Bottom of Bed 1. Excavation to proper depth G� 2. With trenches,sides of excavation are beneath B horizon -# 3. Edge of excavation specified distance from foundation,etc. Comments: B. Retaining Wall 1. Wall height and width as specifie 2. Waterproofed 3. Wall minimum 10'to leaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 1. .Pipe diameter minimum 4" 2. Schedule 40 pipe ✓ 3. Watertight joints ✓ - 4. Inlet to tank cemented �f 5. Slope minimum 0.01 or 1/8"per foot minimum •_ / `� 6. Pipe properly set on compact firm base ((((( 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change 10. 10' minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet ✓ 4. Manhole to grade ✓' 5. Manholes over center and each tees 6. 3-20"manholes 7. Inlet tee minimum 12"under invert 8. Outlet tee minimum 14"under invert 9. Outlet line cemented 6✓ 10. Air space 3"above tees ✓ 11. 2"-3"drop from inlet to outlet 12. Pipe set 13. Compact base with 6"of crushed stone under tank 14. Tank is watertight Comments: Yes NO E. Pump Chamber 1. If separate from tank,compact a with 6"of 1/4"stone underneath 2. Minimum 2"pipe to d-box if gra ' system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level L-- 2. /2. Minimum 0.1T'(2")drop from inlet to outlet `/ 3. Minimum 6"sump ,i- 4. Outlet pipes show equal distribution L-- 5. Compact base with 6"of stone beneath box ✓ 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: r i G. Soil Absorption syste 1. All stone double- shed-'/."- 1 %z" -pea stone Bucket test do 2. Minimum 2"of pea stone a e dis 'bution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connecte ogether 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5'from edge of prop ot,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max length 100') 3. Width of trenches agree with plan-Minimum 2';maximum-4'. 4. Vent present if<50 feet or specified ✓ 5. Distance between trenches minimum 4' and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". I I y Yes NO 9. Pipes set on stable base. Comments: I. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6"per 100 3. Separation between pipe 6'maximum 4. Pipes connected at end 5. Separation between adjacent fields 10'minim 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first l' 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: I Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12"and 4\cemen 4. Access manholes on each pi 5. Pipes cemented with hydraul Comments: i I j 'K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond Form No.3 : Town of North Andover, Massachusetts BOARD OF HEALTH NORTH, O p DISPOSAL WORKS CONSTRUCTION PERMIT ,SSACHUSES Applicant AME ADDRESS TELEPHONE / Site Location Individual Soil Absorption Permission is hereby granted to Construct ( �r Repair ( ) an /fl : Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN,B RD OF HEALTH D.W.C. No.— — Fee 72) APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT `' DATE: ` °� CURRENT INSTALLER'S LICENSE# f LOCATION: I S"© 7— LICENSED INSTALLER: ��rte- SIGNATURE:- �2 TELEPHONEn v CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only 575.00 Fee Attached? Yes No Foundation As-Built? Yesiz No Floor Plans? Yes No Approval Date: ae� MAY I f INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property r at ISD Sa,/�,.. ST relative to the application of T9�`,eh e4,,s e�;_ , dated ���� � for plans by/'I1 *d-dated gI22 .2 � with revisions dated I understand and agree to the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable . 2. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed—generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final Inspection—Engineer must first.do their inspection for elevations,ties,etc. As-built or verbal OK from engineer must be submitted to BOH,after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. . c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system. identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation-or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank,D-box,pipes,stone,vent,pump chamber,retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer � 1, - - Date: 'MAY -2 FORM U - LOT RELEASE FORM �; This form is used to verify that all e --s ary approva s/p omits from• 1NS I SLC I ION.. Boards and Departments having juelieve risdiction have been obtainled-bi hordequir°�Ents. Boards � � liance with any app the applicant and/or landowner from comp II t * �FFLICA. T FILLS OUT THIS S- PHONE _1Z �S AP F L!C,-'N FARCE___���L r LOCATION: Ass2sscrs ibiap `!um�er LOT (S) )iI SUEOIVISION'�— ST. NUMEER STREET . OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED COMMENTS / a DATE APPROVED 3 TO LAN, ER DATE REJECTED r'' ? 2 COMMENTS L� � DATE APPROVED FOODINcPE OR HEA H DATER�JECTED pO CTOR-HEALTH DATE APPROVED S IN DATE REJECTED r' COMMENTS PUELIC 'NORKS ' SE�NERMA T ER CONNECTIONS CRIVEINAY PERMIT FIRE DEFAFTMENT DAT ^�•� E'f EUILDING i ISFEC T CR Town of North Andover NORTH OFFICE OF 3�0 �,t`to .e,ti°L COMMUNITY DEVELOPMENT AND SERVICES ° F A 27 Charles Street `►�o WILLIAM J. SCOTT North Andover, Massachusetts 01845 �9SSACHUS`tsy Director (978)688-9531 Fax(978)688-9542 April 21, 2000 Nancy Pace 150 Salem Street North Andover, MA 01845 Re: 150 Salem Street North Andover, MA Dear Ms. Pace This letter is to notify you that the plans dated March 23, 2000 for the proposed septic system designed to serve the dwelling at 150 Salem Street have been approved for a total of eleven rooms. If you have any questions, feel free to call the Health office at 978-688-9540. Sincerely, Sandra Starr,R. S., C.H.O. Health Director Cc: File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of North Andover, Massachusetts Form No.2 f MOrerh BOARD OF HEALTH : 3+�•., oo OG o AL 9 M 10 DESIGN APPROVAL FOR ss"C"U5`` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. 74 : Site Location 150 Reference Plans and Specs. 3 Z -INGINEER DES&N DA E Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. • CHAI RMAN,BO RD OF HEALTH : Fee lOt'4 ' Site System Permit No. /f/ ;Z- : Town of North Andover, Massachusetts Form No.2 f ,.oRrM BOARD OF HEALTH p w p DESIGN APPROVAL FOR Ar- ,SSACHUSEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM • Applicant Test No. Site Location Reference Plans and Specs. • ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. &, ARD CH EALTH Fee Site System Permit No. SEPTIC PLAN SUBMITTAL FORM LOCATION: �t 4 S�,lG`"`- Cj �) NEW PLANS: YES $125.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES DATE: Da \ DESIGN ENGINEER: X11 - DATE TO CONSULTANT: *If you want your plans expedited, please submit three plans and include&la J 2 stamped envelope with the correct amount of postage to mail plans to Port P , Engineering. - i n When the submission is all in place, route to the Health Secretary. t V� FORM U - LOT RELEASE FORM �j,cll INSTRUCTIONS: This form is used to verify that all—necessary approvals/permits from 1 i Boards and Departments having.jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS-2 APPLICANT �i fI PHONE(q)Z) LOCATION: Assessor's Map Number 3 PARCEL CT ► rt SUBDIVISION U()&Q. LOT (S) STREET l -_�t eAyi_ ST. NUMBER ********************* ***** *** ******O F F I C IAL USE ONLY******************* ************** vuatcizshtd D1StRlct RECOMMENDATIONS OF TOWN AGENTS: Npw NoW.e CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS OWN PLANNER DATE APPROVED DATE REJECTED COMMENTS I - FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED >=P C-1 PECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS 5 r e xn. ^� PUBLIC WORKS - SEWER/WATER CONNECTIONS � �©'-�'�� p / �- �.. �DRIVI�;NAY PERMIT it t� �� — =-94 V FIRE DEPARTMENT Q"blee U.eceezz- iTP-ec)v cc 0,-r'T1r_C1�7l PL,er-P iKIN313l e ih dkld-'-- � t RECEIVED BY BUILDING INSPECTOR DAT E zty (��A Revised 9197 jm � c (wQj�eu.��'✓) I Town of North Andover HORT►, OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 0 p 27 Charles Street :o WILLIAM J. SCOTT North Andover, Massachusetts 01845 �9SsnceHus���h Director (978)688-9531 Fax(978)688-9542 October 22, 1999 Les Godin Merrimack Engineering 66 Park Street Andover, MA 01810 Re: Lot A(166) Salem Street Dear Les: This is to inform you that the proposed septic stem plans for the i y p po p r este referenced above y P have been approved for a house with a maximum of nine (9)rooms. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. i Sincerely, Sandra Starr, R.S. Health Administrator SS/smc cc: Lewis Jones File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 SEPTIC PLAN SUBMITTAL FORM LOCATION: SAL1=1� l�h`l L. 3'7-, iii e. 21 1oT-/4 ) NEW PLANS: YES $125.00/Plan v REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: (ns-') NO DATE: DESIGN ENGINEER: �"Z 'Qi l�`11�C'�/ �,lE�a1�•�L'gJZ i�l� S'v� DATE TO CONSULTANT: 16, *If you want your plans expedited, please submit four plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in lace route to the Health Secreta T 'N OF Nf)RTFJ AND00 =FVO-ARD OF- HEALTAi L�FL' 12 1999 i • North Andover Health Department 27 Charles Street North Andover,MA 01845 • (978)688-9540 fax(978)688-9542 To: Merrimack Engineering Fax: 475-1448 From: Susan Ford,Health Inspector Date: 08/07/00 Re: 150 Salem Street Pages: 1 CC: George Henderson, Septic Installer Nancy and Joseph Pace,owners X Urgent ❑For Review 0 Please comment ❑ Please Reply ❑ Please Recycle Please be advised that at a final grade inspection conducted at 150 Salem Street, North Andover, on August 7, 2000 the following situation was observed. A large truck was found with its rear fires parked over the septic leach area. Specifically, the tires were resting directly over the middle section of the southem most trench,found closest to the house. It appeared that for purposes of the pool installation,the pool contractor was trying to get as dose to the pool as possible. I spoke with a person on site and expressed my concern. He was unaware of the location of the system. I told him that the weight of the truck could have damaged the integrity of the septic system. However, in hopes that less movement over the area would minimize any problems, I allowed him to keep the position of the truck until the completion of the job that day. Due to the concern of damage to the system,the Health Department is requesting that an inspection of this trench line be conducted by your office to determine its proper function. Please submit a letter to this office confirming your inspection. As an alternate suggestion,this office has not received the completed septic as-buil. If the as-built has a date post the date of this memo, I will consider that you are satisfied that as of that date the system is in performing as intended. Please note that until receiving confirmation of the system's proper function and an additional inspection.by this office,we will not be able to sign off on this property. It is my hope that this can be resolved as quickly as possible, as I am aware of the owners desire to move forward in this matter. Thank you. If you have any questions, please call the Health Department. i •' 4' .� • • • • • • • • • • • • • • • • • • • Town of North Andover, Massachusetts Form No. 1 NORTH qA BOARD OF-HEALTH p SLED /6 'YO pL U l 1 J / FO } * i- ' APPLICATION FOR SITE TESTING/INSPECTION SACHUS��y - Applicant NAME �,' /ADDRESS �.' TELEPHONE Site Location ��U4 ) Z�//[��i'.�C.. •mss-" Engineer ✓ L� ii1 �✓ NAME //�� ADDRESS TELEPHONE Test/Inspection Date and Time 1906 3f. l99`1 i A7&4- CHAIRMAN,BOARD OF HEALTH Fee o��7-`� Test No. S.S. Permit No. /l D.W.C. No. C.C. Date Plbg. Permit No. D C' W t0 ��•i �Ind--�-�(�-�--�-�-f--I�' ! I .j. I CL n4 ow LTI j I � fI If VIII - —_. f S OD tom__ Ln ,_. )'sops ?YMO-f 2 -- 0 N " r i r r i -� --■� - �- --ME-- - --MM MM -�■-- _ _ gym_:_ -' ------ _ - � - � : _: : �_�-�- a FORM 11 - SOIL EVALUATOR FORr%q Page 1 Date..::.�.f..' `fi.... No. Commonwealth of Massachusetts Massachusetts foil Sl�>ir�h>iliry Assessment for On- SCwnF�SlIOSIII Performed By: ...C.15.S.....6.<1JA1.A.:......................................................... WitnessedBy: .::: P.L.E'T h. ..: -fX✓hl :::::::::-....:::::::::::.:::.:,::::::. _ : .. .::.::.::::::::::::. ::..:::....::::..::::::::.:: ................................................................................................. Location Address ar Jj6xT To *166 SAGE f--A 5T anrr�w �l./�k.i�S TOf jos Address.and �� A rek�r -r.mz�3� D }�SZTv�,t vF Q Zi �o Ah1bDv��, I�ll4. Oi84S New construction Repair ❑ Office Review Published Soil Survey Available: No El Yes Year Published .11 ..� Publication Scale .�...� 4a Soil Map Unit . .F-°t.g 'k Drainage Class W..0..... Sod Limitations ...�QA.UIF.......�AEu r� T-.S........." HAp,�,To..N�... Surficial Geologic Report Available: No ❑ Yes ❑ Year Published ....'�^ Publication Scale .. .......................... GeologicMaterial (Map Unit) ...................................................................................... Landform .......-f................ ...................................................................................................................................._............. Flood Insurance Rate Map: -7&60 q g &o& G Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No ❑ Yes ❑ Within 100 year flood boundary No ❑ Yes EI TCvvv�F r�oR,,Arai RD OF,EA-LTH Wetland Area: �-- .................. National Wetland Inventory Map (map unit) ...........................................f.......... ......., F,.,�...`. ...999 Wetlands Conservancy Program Map (map unit)............-------�....................� ....... .. I Current Water Resource Conditions (USGS): Month AU6u.S Range : Above Normal El Normal 2sJ Below Normal ❑ ASSur�ED eferences Reviewed: Other R �� � FORM I1 - SOIL ENIALUATOP, pORM Page 2 Qn-site Review Deep Hole Number -I..i..Z..... Date: Time: Weather ..... ...........I...... Location (identify on site plani SL:F........ ..................................................I....................................................................................... Land Use --Y-A-C&JL�-- ........................... Slope M -�'. Surface Stones JJQ4a............................................................ Vegetation ....QWAMD.......... . .................................................................................................................................... Landform -77=.................................................;................................................... ............................................................................ 12 Position on landscape (sketch.on the back) --- . ..... . . Distances from: open Water Body -q t feet Drainage feet Possible Wet Area feet Property Line ...LI.O.-J.- feet Drinking Water Well .100-t. feet other ........................................ DEEP OBSERVATION 1101 LOG Texture Depth from Surface Sail Horizon -;� Soil Coto Soil Mottling Other Sail Texture r (USDAl (Munselli (Structure,Stones,powers, Unohesi Consistency.. %Gravel) 0"--1 if A 10,4 a 313 LOO'S f5- -7 1.- 1 469 1 -9 07WI- TD I BALI, l0-;/0 <;.c� GS F-40T-S: Te) 0 ©,-g., A Fs L lDyQ3f 3 CCOS6- �f.-2 i I. B L),oSf5t no 6-RA V,Ra I 21'- 100Z'' C rtaM -114 f>4+Cj!-, Td i i OZ 0 0/o 6 eA V, S;-v �6 s IZooTS Tb 04. Ar Parent Material (geologic) ......T a ............................................................ Depth to Bedrock: ..P/ ........... paghlo Groundwater: Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: ' r FORM 11 - SOEL EVALUATOR FORM Page 3 Deterintr Kpavo-1 er Ta e Method Used: ❑ Depth observed standing in observation hole.. inches ❑ Depth weeping from side of observation hole...— inches ❑ Depth to soil mottles inches ❑ Ground water adjustment .. feet use 1141" 1 10Z., Index Well Number .....– Reading Date Index well level ................... Adjustment factor Adjusted ground water level .......—.... .----.-- nepth of Naturally •ccurrmg pervi o s 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? yds If not, what is the depth of naturally occurring pervious material? Cer i ti 'cation 1 certify that on - v- g (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 Date FORM 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS WOM H AWOOVEZ Massachusetts Percolation Test Date: Time: ....A.JI................ Observation Hole # P_ Z Depthofof Percrt I g y 3Lt,t 10 � 4 Start Pre-soak (� 1 o r y-1 End Pre-so.ak . 00 Time at 12" a 00 11 : o 'Z Time at 9" Time at 6" Time (9"-61 ( C✓ Rate Min./Inch N1i1.l, 1 S-Mii.(, Site Passed Site Failed El ] �,J A Performed By: Witnessed By: SII ........... . ...................... Comments: _._. .. .............. _. ...................... .......................... .... NORTH ANDOVER BOARD OF HEALTH j AUTHORIZATION FOR SOIL TESTS LOCATION ENGINEER TEL# PAID DATE TO PORT Lot A(166)Salem Street Les Godin(Merrimack) 978-475-3555 Yes 8/5/99 f I RECEIVED 1999 BOARD OF HEALTH TEL. 688-954 E NORTH ANDOVER, MASS. 01845 NORTH ANpOVEA CONSERVATION CoMtAISSION APPLICATION FOR SOIL TESTS DATE: L'- LOCATION OF SOIL TESTS: ' Lr'o S�(.l✓ t �'—�T' Assessor's map & parcel number: MAF 37-D PAIL Zi OWNER: TEL. NO.: ADDRESS: (o(o �AC�t� S(' L12 F4JcD vF� t"IA - Di 04 EZ ENGINEER: 1v CWi HA6JG : i=L G, TEL. NO.: g70--L47S- SSSS CERTIFIED SOIL EVALUATOR: LI✓5 6 r,A l N Intended use of land: residential subdivisio sln ie fa ily home ommerciat Repair testing Undeveloped lot testing X N. A. Conservation Commission Approval: THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: S e65c1�-- 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of2� 75.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least tw&,deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than V-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. 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T ..X, a,'.`_ rlYs�i,`-tH r'? - e*'• A _.�«, � .: :4`+ � Wig. "� i ,.(n"*.�'° t.�"���� > ;� �¢t ^,}� �>✓""-'=Y .�.,�.. '. , s as '` a. r, �'.• _} 1'; -�� J L�'r7� ,. �f#a f` , ��-,P-.. n•� W a >N 5 kP S st .r :r p'C :y, _ i ,�fSh.,..J �' �� -A' '•�' a i-.-{, � r ,�` t,� �"'`,"�. `far 'i '�•., , i if. zr iti ap. .y#'✓ ,V r►%} :$+., , _ .al �L\ Commonwealth of Massachusetts City/Town of RECEIVED System Pumping Record Form 4 AUG 26 2010 wM DEP has provided this form for use by local Boards of Health. Other formt�t�y 1404 ib ,TI3lJbftVER information must be,substantially the same as that provided here. Before si our local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health oFotfter.approving authority. A. Facility Information 1. System Location: Left side4tbouse, Right side of house, Left front of house, Right front of house, Left rear of hous ght rear of ho eft rear of building. Right rear of building. Address S2,j k_A� Cityrrown State Zip Code 2. System Owner: Name Address(if different from location) City/Town Sta � Cro�p�e Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes 0 If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of$ystem:�� 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location contents were disposed: L-S-D Lo II to Water Signature f H I r Dat t5forrn4.doc•06!03 System Pumping Record•Page 1 of 1