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HomeMy WebLinkAboutMiscellaneous - 1525 (Lot 3) Forest Street 1525 (Lot #3) Forest Street (� - .� North Andover, MA 01845 F, IN r i } 'UPC 14081 fix' r MA9'�a� H i 1 North Andover Board of Assessors Public Access Page 1 of 1 �J NORr� North Andover Board of Assessors 1q on '•" .SS C U Jaiproperty Record Card Click Seal To Return Parcel ID :210/105.B-0002-0000.0 FY:2008 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales ! Summary Residence Detached Structure ~' Condo 1525 FOREST STREET EXT Commercial Location: 1525 FOREST STREET EXT. Owner Name: FINOCCHIO,MICHAEL&GIANNINA Owner Address: 1525 FOREST STREET-EXT. City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6-6 Land Area: 2.03 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 3673 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 856,300 987,500 Building Value: 720,000 844,000 Land Value: 136,300 143,500 Market and Value: 136,300 Chapter Land Value: I I LATEST SALE Sale Price: 300,000 Sale Date: 03/21/2004 Arms Length Sale Code: G-NO-PARTIAL Grantor: SCOTT D ROTH Cert Doc: Book: 08767 Page: 0!5LJI http://csc-ma.us/PROPAPP/display.do?linkld=1180784&town=NandoverPubAcc 10/30/2008 Common wefth of Massachusetts Title 5 Officizif Inspection For * RECT,, P(j owlSubsurface Sewage Dispos#,System Form-Not for Voluntary Asse SO.ents 1525 Stonecleave rd A.K.A.1525 Forest St Ext DEC 0 8 2008 Property Address Mike Finocchio TOWN HEALTH n DEOF t' TMENR T Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. '"'p°'a"t A. General Information When filling out forms n fo s o the ��pQg computer,use 1. Inspector: iS only the tab key R to move your N. Timothy White � cursor-do not use the return Name of Inspector key. HomePro Northshore Company Name 75 Glen Street Company Address Rowley MA 01969 Citylrown State Zip Code (978) 948-8428 S12015 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority l 11-1-08 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title V Form•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. Citylrown state Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: I. ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: na ❑ 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 Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. Cityfrown State Zip Code Date of Inspection t B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: na C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. . ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: na D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 i i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 ' required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title V Form•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is required for North Andover Ma. 01845 11-1-08 every page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for everypage. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 110-550 3 Number of current residents: Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage (gpd)): well 9 ( Y 9 Sump pump? ❑ Yes ® No Last date of occupancy: still occupied Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ' ❑ Yes ❑ No Water meter readings, if available: i Last date of occupancy/use: Date Other(describe): Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is required for North Andover Ma. 01845 11-1-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: last pumped may 07 information from owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons 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: 3 years old information from owner& plans Were sewage odors detected when arriving at the site? ❑ Yes ® No Title V Form-12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts REM Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is required for North Andover Ma. 01845 11-1-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): 36in Depth below grade: feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 30ft from incoming water line to outgoing sewer I Comments(on condition of joints, venting, evidence of leakage, etc.): joints&venting good condition no evidence of leakage Septic Tank(locate on site plan): Depth below grade: 30in with riser&cover at grade feet Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- I I Dimensions: 10 ft long -5ft deep-5ft wide- 1500 gal Sludge depth: tin Distance from top of sludge to bottom of outlet tee or baffle 32in Scum thickness 3in Distance from top of scum to top of outlet tee or baffle 7in Distance from bottom of scum to bottom of outlet tee or baffle 17in How were dimensions determined? rulers& measuring rod Title V Forth•12107 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): tank was not pumped -inlet tee&outlet tee good condition -liquid at bottom of outlet invert no sign of leakage in or out of tank-tank in good condition filter clean Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of lastum in � r g Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): na Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Title V Forth-12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): na I "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): d-box was level-distribution was equal-no sign of solids carryover-no leakage in or out of d-box good conditoin- 19 in below grade- 16x16in inside depth 13in Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No I Title V Forth-12/07 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is required for North Andover Ma. 01845 11-1-08 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): 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: ® leaching fields number, dimensions: 1 field 39x24 936sq ft Cl overflow cesspool number: innovative/alternatives Elystem Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): dry sand soil-no hydraulic failure- no ponding -system was under front lawn left of driveway Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer I' Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): na 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.): na i Title V Forth-12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. City/Town State Zip Code Date of Inspection I D. System Information (cont.) 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. ' ) w U— S ,5 n� L i 13 5� (3 I Title V Form•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 1525 Stonecleave rd A.K.A.1525 Forest St Ext Property Address Mike Finocchio Owner Owner's Name information is North Andover Ma. 01845 11-1-08 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: lift feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ 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: I You must describe how you established the high ground water elevation: i from plans eshgw 11 2i groundwater at 136 in Title V Form•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 Town of North Andover NORTH Office of the Health Department 3: •'s' ° Community Development and Services Division 400 OSGOOD STREET ", s`.�•r+ North Andover,Massachusetts 01845C SAHU4 S Susan Y. Sawyer, REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax C��2�'ICA2E O F C0�I�14',GI.AWCE As of: 9Yarch 16, 2005 This is to certify that the individual subsurface dsposal system repaired ' — FulfSystem by (Bob,4mor I. _ at 1525 .Got 3> Forest Street �xT North Andover, 911A 01845 has been instatted in accordance with the provisions of metre v of the State Sanitary Code and with the North Andover Ooard of Yfeatth regulations. The Issuance of this certificate shalt not 6e construed as a guarantee that the system Witt function satisfactorily. S n 7 Sawyer Tu6lic Yfealth Director ` BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( )constructed; ( )repaired; by located at was installed in conformance with the North nd ver Board of Health approved plan, System Design Permit# , plan dated , with a design flow of �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. II Bed inspection date: A J04- C hog r )e S 0g 'z14 � Engineer Representative Final inspection date: Ile /0q G A a V I P s Q Q1-0 k Engineer Representat ve Installer: `� ' .�'� Lic.#: Dater r Engineer: Date: I i i r OA o 4gomwR a o y' i HANCOCK ASSOCIATES #10413 March 8, 2005 North Andover Health Department Ej) 27 Charles Street North Andover, MA 01845 MAR 200 TOWN Cir ov riTr :, n Attn: Susan Sawyer HEATH DEPARrr1IEN f�. Re: As-built Certificate of Compliance Lot 3 Forest Street Dear Ms. Sawyer: I hereby certify that the sewage disposal system installed by Bob Amor on Lot 3, Forest Street(Tax Map 105B, Portion of Lots 1 &2) was installed as shown on the enclosed as-built plan. The approved design flow is 550 gallons per day. Enclosed are two copies of the as-built plan for your use. Please note that portion the reserve area is located under the driveway. In no way were the in situ receiving soils disturbed during construction, the driveway will be relocated on top of the existing leach field if the field has to be replaced. This letter is submitted as a substitute to fulfill the requirements of Certificate of Compliance signature on DEP approved form 1255, Rev 5/96. Please note that the issuance of a Certificate of Compliance shall not be construed as a guarantee that the system will function as designed. Should you have any r questions, please call me. Very truly yours, O K E�WJINEE G ASSOCIATES ctxv V " Vac av V. alac P.. .jgtAr2 �jW3 34036 1 / Principal 'P civil � Enclosure Pomp, �c cc: Mike Finocchio Bob Amor DANVERS OFFICE: BOLTON OFFICE: 185 Centre Street, Danvers, MA 01 923 626 Main Street, Bolton, MA 01 740 Phone: (978) 777-3050 Fax: (978) 774-7816 Phone: (978) 779-6767 Fax: (978) 779-2228 HSA@hancockassociates.com bolton@hancockassociates.com www.hancockassociates.com Page 1 of 1 Dellechiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Monday, August 23, 2004 1:25 PM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie' Subject: Forest Street Sue and Pam, Attached please find the inspection report for the septic system constructed at Lot 3 Forest Street, now known as 1525 Forest Street. Aside from the situation with the ledge in the SAS which you addressed, no problems or issues were identified. Dan Mill River< consulting Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting,com info d�millriverconsulting,com L r L IIt 8/23/2004 0 0 TOWN OF NORTH ANDOVER f NOQTH Office of COMMUNITY DEVELOPMENT AND SERVICES 3 �-• __. �� HEALTH DEPARTMENT 27 CHARLES STREET +"� .•`'+ NORTH ANDOVER, MASSACHUSETTS Ol 845 �'"SS�C„Us Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX ADDRESS: Lot 3 Forest St also known as 1525 Forest Street MAP: LOT: INSTALLER: Robert Amor DESIGNER: Hancock Associates PLAN DATE:4/2/2004 BOH APPROVAL DATE ON PLAN: 4/7/2004 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 8/19/2004 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE Gravity Distribution COMPONENT SUMMARY FROM PLAN GALLON TANK = 1500 LOADING OF SEPTIC TANK = H-10 TYPE OF SAS = Field DIMENSIONS AND DETAILS OF SAS: 24' x 39' SITE CONDITIONS ❑Existing septic tank properly abandoned ®Internal plumbing all to one building sewer ®TopographyZTopography not appreciably altered Comments: Contractor is aware reserve area is under driveway and spoke with owner about not excavating this soil. SEPTIC TANK ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ® Inlet tee installed, centered under access port ® Outlet tee gas baffle and effluent filter installed, centered under access port Page 1 of 1 0 0 TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES Fr era` °�Oop HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX ® 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ® Hydraulic cement around inlet & outlet Comments: No water in take but monolithic tank and looked in good shape. D-BOX ® Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: Hydraulic cement To Be Done SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan ® 3/4-1 '/2" double washed stone installed ® 1/8-1/2" (peastone) double washed stone installed ® laterals installed and ends connected to header (and vented if impervious material above) ® Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ® Elevations of laterals installed as on approved plan ® 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Moved part of SAS due to ledge - 18' between farthest lateral SYSTEM ELEVATIONS Benchmark: 100.00 (Set by contractor, verified against spike at oak tree BM 93.42) Rod at Benchmark: 8.76 Page 2 of 2 I O 0 TOWN OF NORTH ANDOVER t eoRTH Office of COMMUNITY DEVELOPMENT AND SERVICES o? HEALTH DEPARTMENT 41 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01 845 �'ss;;C U t� 1 Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX I Height of Instrument: 108.76 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 104.25 Septic Tank IN 104.05 105.02 Septic Tank OUT 103.80 104.78 Access Box IN 103.28 103.50 Access Box OUT 103.28 103.50 Distribution Box IN 102.82 102.95 Distribution Box OUT 102.65 102.80 Lateral 1 HIGH 102.60 102.63 Lateral 1 LOW 102.40 102.42 Lateral 2 HIGH 102.60 102.63 Lateral 2 LOW 102.40 102.42 Lateral 3 HIGH 102.60 102.63 Lateral 3 LOW 102.40 102.42 Lateral 4 HIGH 102.60 102.63 Lateral 4 LOW 102.40 102.42 Page 3 of 3 -`'FORMU - LOT RELEASO _ �. NORM INSTRUCTI ONS: This form is used to verify that a ll n ecessary approvals/permits als/Pe r mit s frBoards and Departments s havin Junsdictionhave been obtained. This does not retietheapplicant and/or landowner from compliance with any applicable or requirements. **********************-*****APPLICANT FILLS OUT THIS SECTION APPLICAf� .• .. ` -- - � PHONE LOCATIO. : Assessor's Map NumberlrL,. - .PARCEL SUBDIVISION y- LOT(S) STREET : ST. NUMBER t>,+ y , ,,. _ , , t r• ., �?�.'.. *** OFFICIAL USE ONLY****************** ** RECOMMENDATIONS OF TOWN AGENTS: 'CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS t TOWN PLANNER DATE AP DATE REJECTED COMMENTS FOOD INS . CTOR-HEALTH DATE APPROVED fifl, •,/ DATE REJECTED % NU, 1�`r zSET CTOR- EALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR ' DATE —._ Revised 9\97 jm 0 TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT �7AND SERVICES0� HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01.845AC qO 4Ssacaus�'� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdept(a�townofnorthandover.com www.townofnorthandover.coin Hancock Associates Charles Ogden,Project Engineer 185 Centre Street Danvers,MA 01923 March 23,2004 Re:Lot 3 Forest Street Dear Mr. Ogden, This correspondence is in response to your request for modification to the approved septic plans,for the lot listed above,dated March 15,2004.After reviewing the file,and speaking with you,the following determination has been made.The request to modify the plan and have the driveway placed over the reserve area has been approved under the following conditions. 1)Three copies of a revised plan must be submitted showing the change in location of the proposed foundation,the new proposed septic tank location,etc.If there are no additional changes as stated in the request, this plan can be assumed approved upon submission. There will be no additional fee for this modification since a major review is not necessary in this case. 2)The parent material under and around the reserve area must not be disturbed.The engineer must meet with the site contractor to discuss how to install the driveway without permanently damaging the parent material. As site work has already commenced,this must be done immediately. 3)The engineer must stake and rope off the area of the primary leach area.It must remain roped off throughout the driveway and foundation construction phases,the leach field installation and during the home construction.As in all subsurface disposal installations,at no time is this area to be used for stockpiling or at no time may heavy rubber tare equipment be driven over any portion of the leaching or tank areas. In addition,it is understood that as a condition of this approval,you as the engineer are taking responsibility for the oversight of the site and septic contractors,as their work may relate to the septic system.Your final As-Built must show all impervious surfaces and include a statement that you"...certify that the soil conditions under the driveway have not been disturbed and remain suitable for the future use as a leach area". If you have any questions or comments regarding this correspondence,please contact the health office. We anticipate your plan submission in a timely manner.The modified plans must be submitted and approved before a foundation permit will be approved by this office.Thank you. Sincere S n Sawyer, REHS/RS blic Health Director FORM 11 - SOIL EVALUATOR FORR1 Page 1 of 3 No. bate: 5 �� Commonwealth of Massachusetts )Qor AAA /", Massachusetts Soil Suitability Assessment ofor On-site Sewage Disposal Performed By: GkcLrleS 051.en- kekncocy"" En9tineer�nq �ssflc�q�e� Date: Witnessed By: Card Aon��w� —N,�v�avve� &-ares a� Kc-'04h oke + I. tr n Address or Loi'- A '�rorp`i'pJ4- 4reziOwrct's Num. La/ Address,aid C.DIA Sl'or�eG leave.. l20o.a p .� Tcko*m t q A•d\� L 3 or'e� cs r D � � B x � �, �A tq21 ew Construction Z Repair ❑ 89-7_ 90S4 Oftice Review Published Soil Survey Available: No. ❑ Yes L`�J Year Published el �q�1 Publication Scale 115,8Unit r Soil Map nit GGD Drainage Class w��� o �'nc Soil Limitations -- CAOS=' wr-4.0-m Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes ❑ Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No EJ Yes ❑ Wetland Area: National Wetland Invent- Map P (ma P unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal E]Below Normal ❑ Other References Reviewed: DEP APPROVED FORM•1270719S , W ' HANCOCK ASSOCIATES #10413 March 15, 2004 North Andover Board of Health 27 Charles Street North Andover, MA 01845OF �. a t Attn: Mr. Brian LaGrasse :4EA e K Re: Lot 3 Forest Street MAR 116 2004 Map 105B,Portion of Lots 1&2 t North Andover, MA Dear Mr. LaGrasse: Attached, please find a copy of a Site Modification Plan for Lot 3 Forest Street. This project is currently under construction. Our client has asked us to revise the locations of the proposed house,pool and well due to ledge found on-site;these new locations are shown on the plan. Furthermore, the proposed house has been raised four(4) feet to avoid the ledge. We have also revised the position of the driveway, septic tank and associated grading due to the revised house location. (The septic leach field and reserve are have not changed. In order to access the garage at its new angle, the-'driveway location has been revised and now crosses the reserve area. If in the future the reserve area needs to be constructed, the driveway can be relocated to cross where the primary leach field is located. The grading over the septic tank maintains appropriate cover. Please review these modifications and let me know if you have any questions or concerns. Thank you. Sincerely, HANCOCK ENGINEERING ASSOCIATES Charles R. Ogden, Project Engineer CC: Mike Finocchio Project File#10413 DANVERS OFFICE: BOLTON OFFICE: 185 Centre Street, Danvers, MA 01923 626 Main Street, Bolton, MA 01 740 Phone: (978) 777-3050 Fax: (978) 774-7816 Phone: (978) 779-6767 Fax: (978) 779-2228 HSA@hancockassociates.com boiton@hancockassociates.com www.hancockassociates.com o 0 LETTER OF TRANSMITTAL HANCOCK 25 Years of Excellence ASSOCIATES Providing Land Surveying, Civil Landscape Architecture and 185 Centre Street, Danvers, MA 01923 Engineering, p Environmental Services Since 1978 Phone (978) 777-3050 Fax (978) 774-4205 www.hancockassociates.com TO: Q-YA,-N- &C,,rd of qeO,14h DATE: 3 IS O JJ07BO,- 21 C�Nckle, 54-e e-' FROM: Charles Ogden dor ) Avlj-er MA ®1849 RE: 3 r-Orm-k s4"t� [ATTN: Drl-A L-C, wV'gSSe. • We are sending you: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order COPIES DATE NO. DESCRIPTION 1 31151ol NIo�; ���a��e•� Oer- A,10Si Modl 4'Cfi' t0'\ 916w\ G?F �yQF }�s 6V • These are transmitted as checked below: ❑ for approval ❑ Approved as submitted ❑ Resubmit copies for approval i ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: COPY TO: SIGNED: (LIJ If enclosures are not as noted,kindly notify us at once. r 1 O HANCOCK Engineering Associates 235 Newbury Street Danvers,MA 01923 (978)777-3050 Fax (978)774-7816 Bolton, MA (978)779-6767 Boston,MA #10413 (617)350-7906 October 23, 2003 North Andover Board of Health 27 Charles Street North Andover, MA 01845 Attn: Mr. Brian LaGrasse Re: Lot 3 Forest Street Map 105B, Portion of Lots 1&2 North Andover, MA Dear Mr. LaGrasse: We have received your review letter for the proposed septic system design plans for the above site. The installation permit for this system has by law been granted since the Board of Health did not act upon it within the 45 day period(MGL chapter 111, section 31E). We do not believe that there is one comment in your letter that would preclude this system being installed by a competent licensed septic installer in accordance with Title V. The comments provided do not change our design they merely clarify what a licensed installer should already know. However, we have revised the Sewage Disposal System design plan to make these clarifications. Specifically, we have changed the plans as listed below. 1. The outlet tee does in fact indicate the fourteen-inch(14") dimension below the flow line on our 1500 Gallon Monolithic Septic Tank detail on sheet 2. 2. A third access port has been added at the center of the tank lid on the 1500 Gallon Monolithic Septic Tank detail on sheet 2. 3. A note [7] stating the requirements of the Zabel effluent filter approval has been added as follows to the 1500 Gallon Monolithic Septic Tank detail on sheet 2. [7] Inlet and outlet manholes must clearly note (either with non-degradable paint or other permanent identifiable markings) the system is equipped with the Zabel Al 800 filter. In addition, note [2] has been reworded as follows to clarify which risers are to be brought to within 6"of final grade: [2] The outlet manhole must have a childproof riser to finish grade. All other manholes shall have risers to within 6" of final grade. Division of Hancock Survey Associates,Inc. < 0 North Andover Board of Health October 23, 2003 Page two 4. The proposed grades shown on the plan view and graphically on the profile view clearly show that at least 0.9 feet of cover is proposed. A dimension has been added to the profile proposing a 12" (9"min.) distance from the top of the tank to the finish grade line. 5. The distribution box detail has been clarified by removing the inlet tee since it is not required. 6. The contours on the adjacent lot are directed slightly toward the subject lot in such a way that any surface water would not run onto the adjoining property. In order to exaggerate this, we have added a drainage swale to the plan view on sheet 1. 7. The profile on sheet 2 has been revised to graphically show the replacement fill extending six(6) inches below the bottom of the Bw horizon, with a note pointing to this area as follows: Excavation and replacement soil shall extend 6"below the Bw horizon. 8. The outlet location of the foundation drain is in fact shown on the plan view at the westerly end of the proposed dwelling. The foundation drain is proposed to outlet at the surface in this location. 9. We are not proposing trenches in this instance because a trench system would add additional height or area. There is no additional area available due to shallow to bedrock areas, and wetland and property line setbacks surrounding the proposed location. A higher trench system would require either a pump or the entire area from the leaching area to the septic tank to the house, including the front and rear yards to also be higher. Hancock Engineering has designed many systems as leach fields in order to avoid unnecessary fill and pumps. Some of these systems have been proposed in North Andover, others have gone to DEP for review. Neither the North Andover Board of Health nor DEP has ever required us to redesign one of these systems to incorporate trenches. Please see the attached sketch showing a 6"x 3' trench system(the length required for these trenches extends into the area of T-3-00). 10. Note [3] on the 1500 Gallon Monolithic Septic Tank detail was intended to specify that the tees be accessible. We have clarified the note by rewording it as follows: a. [3] Extend inlet and outlet pipes so that tees are located directly beneath access manholes. Please review these revised plans as soon as possible. If you have any questions or concerns regarding these revisions, please do not hesitate to contact me. Thank you. Sincerely, HANCOCK ENGINEERING ASSOCIATES Charles R. Ogden, Project Engineer CC: North Andover Conservation Commission Mill River Consulting Project File#10413 Mike Finocchio I I I \ 11 \ 'n, 9 O \ �" '05 015 0 106 ` O r + / jr o s P 0 � \ 0 0 oh oa r oJohs sw , �v O a TOWN OF NORTH ANDOVER ffice ek AND SERVICES HEALTH DEPARTMENT 2! CHARLES S 1.1\Gli 1 �+�bq i A . t4Tl9 NORTH ANDOVER. MASSACHUTSETTS 01846 Heidi Griffin 978.688.9540—Phone Acting Health Director 978.688.9542—FAX October 15, 2003 Vaclav Talacko Hancock Engineering Associates 235 Newbury Street .Danvers, MA 01923 Re:Lot 3 Forest Street,Map 10513,Portion of Lots 1&2 I Dear Mr. Talacko: The proposed septic system design pians for the above site dated July 10,2003, have been reviewed. Unfortunately,the plan cannot be approved as submitted. The following items are in need of attentionrior to plan approval: p 1. The outlet tee must be indicated to extend 14"below the flow line. (3 10 CMR 15.227) 2. Three(3) access ports are required to be built into the tank lid, and only two are shown in the tank detail. 3. The septic pt tank must have the inlet and outlet risers labeled in compliance p ance with the Massachusetts DEP approval for use of the Zabel effluent filter specified on the design. In addition please indicate which risers are to be brought to within 6"of final grade. (3 10 CMR 15.228) 4. The septic tank must have a minimum of 9"of final cover. Please specify this to provide clarity for the disposal system installer. (3 10 CMR 15.228) 5. Please clarify the distribution box detail to indicate whether an inlet tee is or is not required in this instance. (3 10 CMR 15.232) 6. Please provide for a drainage swale to divert surface water from the adjoining property where the fill is within 5' of the property line. (3 10 CMR 15.255) 7. Please indicate the excavation of the impervious material must extend 6"into the suitable natural soil horizon. (NA 9.02) 8. Please depict the outlet location and receptacle for the foundation drain. 9. Trenches are to be used as the soil absorption system mechanism whenever possible. Please use trenches in this instance or explain why they cannot be utilized. (3 10 CMR 15.240) 10. Inlet and outlet tees must be located underneath the access ports of the tank and it is not clear from the plan that it is required. (3 10 CMR 15.227) t 0 C r Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure the protection of public health and the environment of North Andover. Sincerely, j Basan LaGrasse Health Inspector cc: Applicant:Michael Finnochio, 68 Hood Street#1,Lynn,MA 01905 Owner: Scott Roth, 10 Lunt Street,Newburyport,MA 01950 CD&S Dir. L File Paan7.nfl Page 1 of 1 Pamela DelleChiaie , From: "Dan Ottenheimer"-.info@millriverconsutting.com> To: "'Pamela DelleChiaie'"<pdellechiaie@townofnorthandover.com> Sent: Tuesday,September 30, 20038:52 ANI Subject: RE:Lot 3 Forest,Street Weil have,it done by the end of this week. Dan Mi11.River ConsWtiing__ Septic System Management Services 5 Blackburn.Center Gloucester,MA 01930-2259 978=282-0014 or 1-800-377-3.044 fax:978-282-001.2 info@millriverconsulting:com -----Original Message----- From: Pamela DelleChiaie,.[mailto:pdellechiaie@townofnorthandover.com] Sent: Monday,September 29, 2003 3:58 PM To: Daniel Ott4enheimer{E-mail) Cc: Griffin,,Heidi, - Subject:.Lot 3 Forest Street Importance:-High Hi Dan, I just got a fax from Charles.Ogden at Hancock Engineering. He is looking for a response on the septic plans. This is the one that we couldn't find the file on right away when we were retrieving files after Sandy left. I Just deft them a message-saying it was being worked on, and that we would be back-in touch with them. lfyou have an approximate idea when it will be done, I can call and tell them. Thanks, Pam Pamela DelleChiaie, Health Dept.Assistant Town of North Andover Community Development& Services 27 Charles Street North Andover, MA 01845 pdellechiaie@townofnorthandover.com Tel. 978-688-9540 Fax 978-688-9542 9/30/2003 O O LETTER OF TRANSMITTAL HANCOCK 25 Years of Excellence ASSOCIATES Providing Land Surveying, Civil Engineering, Landscape Architecture and 235 Newbury Street, Danvers, MA 01923 Environmental Services Since 1978 Phone (978) 777-3050 Fax (978) 774-4205 www.hancockassociates.com TO: �5pr t-tv� 1 �� of �Tea� DATE: 2Q o?j ]JOB #: f 0 13 2� CL�VS S+,reJ FROM: Charies Ogden rV'0V-VhAv1,*r vv 4 olv/5 RE: Lo� J F;rt"'t ATTN: s We are sending you: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order COPIES DATE NO. DESCRIPTION f7vr'dEtc •, Z. rlt F 3 0 ZOQ3 ® These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: COPY TO: SIGNED: If enclosures are not as noted,kindly notify us at once. Q HANCOCK Engineering Associates 235 Newbury Street Danvers,MA 01923 (978)777-3050 Fax (978)774-7816 Bolton, MA (978)779-6767 Boston,MA #10413 (617)350-7906 September 29, 2003 North Andover Board of Health Community Development 27 Charles Street North Andover, MA 01845 -7 Re: Lot 3 Forest Street Extension Michael Finocchio, applicant 30 2003 Dear Board Members: Our office submitted Sewage Disposal System Plans for Lot 3 Forest Street Extension to the Board of Health office on August 1, 2003. As of the date of this letter, we have not received any communications from the Board as to an approval, disapproval or request for more information. Could you please let us know the status of this review? Sincerely, HANCOCK ENGINEERING ASSOCIATES Charles R. Ogden, Project Engineer CC: Michael Finocchio Scott Roth Project File#10413 Division of Hancock Survey Associates,Inc. r 4 a LETTER OF TRANSMITTAL HANCOCK 25 Years of Excellence ASSOCIATES Providing Land Surveying, Civil Engineering, Landscape Architecture and 235 Newbury Street, Danvers, MA 01923 Environmental Services Since 1978 phone (978) 777-3050 Fax (978) 774-4205 www.hancockassociates.com TO: �, �v��p,�jr e,( G� I a DATE: el 103 JOB #: (o+3 FROM: Charlie Ogden RE: I wear • We are sending you: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order COPIES DATE NO. DESCRIPTION C r • These are transmitted as checked below: ❑ For approval ❑ Approved as submitted Resubmit copies for approval PP ❑ P ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment PRINTS RETURNED AFTER LOAN TO US REMARKS: TC) NOF N1Z—R ri ,k-EO,fER/ EO/1,7D OF HEALTH i AUG ( ?ORI COPY TO: TSIGNED: If enclosures are not as noted,kindly notify us at once. Hair-09-OQ 13:45 North Andover Com. Dev. 508 688 9542 P. 01 SEPTT' PLAN SUBMITTAL FOF�I LOCATION:-- L oC NEW PLANS: YES A225 /Plan ✓ REVISED PLANS: YES S 60.00/Plari SITE EVALliATION FORMS INCLUDED: YES NO DATE: I O DESIGN ENGINEER: Ho,ncoc►< to Ine.ec-,n Rssoc4+es L3S 0t%j*vn3 S rce.i-, anuers, MA 007-3 DATE TO CONSULTANT: *If you want your plans expedited, please submit four plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in place, route to the Health Secretary. i 1525(Lot 3) FOREST STREET JS-2004-0831 Project Detail Report Printed On:Fri Oct 15,2004 Project Name: GIS#: 8557 Project No: JS-2004-0831 Owner of Record Finocchio,Michael KoerK o'.'q... Map: lOS.B Date Submitted: Mar-04-2004 68 Hood Street,91 sBlock: 0003 Status: Open LYNN,MA 01905 Lot: Work Category: Work Location: 1525(Lot 3)FOREST STREET Zoning: Proposed Use: District: ��J+,>+• *"' land Use: Proposed Use Detail Subdivision ��►cNus Description Septic Plan Review;Well ConstructionComments' of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2004-0041 10/15/04- Note to file for Lot 3 Forest or 1525 Forest St. Note to file for Lot 3 Forest or 1525 Forest St. 10/13/04 Impromptu inspection of final graded area of septic system found a set of dual wheeled tire tracks across the septic field area.They were sunken in 4-6 inches. 10/15 Susan Sawyer left a message for the installer,Bob Amor,about the violation. Also called the owner and discussed blocking off access.He stated he thought it was the portapotty truck.He will tape off the area and speak to the company.He is now aware that any warranty from Bob Amor could be null and void due to this issue. 8/10/04-Bob dropped off F.A.B.And took permit and approved septic plan. Requested a bed bottom for Thursday,8/12/04. Sent e-mail to Susan.--p.d. 8/10/04-Pending Foundation As Built to scale-1=20'. 4/7/04-Septic plan dated 7/10/03 and received on 4/5/04 was approved by Susan Sawyer. Note: Brian states that if an installer comes in for a DWC,they are all set,and it can be signed off. 3/4/04-Application for Well Permit by George Henderson. Approved by B.LaGrasse. 11/25/03-Plan Approval by B.LaGrasse S+.J 10/29/03-Rev. l submitted. Reviewed by B.LaGrasse ,� 8/15/03-Plan Denial 8/1/03-New Septic Plan submission from Hancock Engineering Sent to Consultant Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: DWC-System Constructio BHP-2004-0571 Aug-10-2004 SIGNED OFF JS-2004-0831 Plan Review BHP-2004-0311 Nov-25-2003 SIGNED OFF JS-2004-0831 Rev. 1 Plan Review Plan Review BHP-2004-0310 Jan-15-2003 DENIED JS-2004-0831 New Plan Review Well Construction BHP-2004-0309 Mar-04-2004 SIGNED OFF JS-2004-0831 Well Construction GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page l of 2 —� ----- . Map-Block-Lot { Commonwealth of Massachusetts 105.B-0003- Board Of Health Permit No North Andover BHP-2004---- - P.I. FEE F.I. $250.00 i Disposal Works Construction Permit { Permission is hereby granted Robert T Amor --_.__ to(Construct)an Individual Sewage Disposal System: at No 1525 of 3 FOREST STREET ------------ - a as shown on the application for Disposal Works Construction Permit No. BHP-2004-057 Dated August 10,2004- Issued On:Aug-10-2004 ��IBo d Of Health _... ----------- _ ...... .................. . ........... .................. .......................... .. ......................... ............................................. ..... . - - 0 O TOWN OF NORTH ANDOVER NOR*H Office of COMMUNITY DEVELOPMENT AND SERVICES o2 .-t - "6°~°_ HEALTH DEPARTMENT } 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01.845 CH S Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdept@townofnorthandover.com www.townofnorthandover.com APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: LOCATION: �G �J� .� �D� ✓'� -/'l LICENSED INSTALLER NAME:_ J PLEASE PRINT SIGNATURE: TELEPHONE# �I CHECK ONE: FULL SYSTEM REPAIR: COMPONENT REPAIR (indicate what parts): * NEW CONSTRUCTION: * If NEW CONSTRUCTION,please attach the Foundation As-Built Plan. $250:00 Fee Attached? Yes No Project Manager Obligation From Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes ,/�ila41,76 No Approval of Health Agent Date: AV CO 0 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer fort e construction of the septic system for the property at /' cf //S'R' ' relative to the application of zd /���� dated ��/ o ans by 2lr and dated �� with revisions dated I understand the following obligations for management of t7tis project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company.. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b Final —inspection Engineer must first do their inspection for elevations ties etc. As-built or P g P verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. I Undersigned Licensed Septic Installer Date: Disposal Works Construction Permit# NUMBER COMMONWEALTH OF MASSACHUSETTS BHP-2704-0309 North Andover FEE $125.00 Board Of Health George Henderson ----------- NAME Lot 3 FOREST STREET --- ------------------------------------------------------------------------------------------------ ADDRESS IS HEREBY GRANTED A PERMIT Well Construction This permit is granted.in conformity with the Statutes and ordinances relating thereto,and expires---------------March-04,-2-006----------------unless sooner suspended or revoked. March 04,2004 ------------------------------------- Board Of ----------------------------- -- -- ------------- Health ------------------------------------- ----- - ----------- ----------------------------------------------------------------- i 0f oT'" ky r -CC;•�`a OF fl H. r'�- `` f<�r `_ 3� ', •' °oma Sfl�,.i3 =„y-..� � �j .1, BAR I � .�,s ••E�� .4 .- _ T�-` BOARD O F HEALTH 7 G►--a . r_s S�" SAC � OR'�H ANDOVER, MASS. ...- LICATION FOR WELL AND PUMP PERMIT Permit # Date J A permit is requested to: drill a well ' install a pump - LOCATION: Lot # 3 .J Owner/"Ir CNA 61- �j bCc 4 i a Address (off /-)OOP S-�• vu ,� Tel (n 17 - 727- 71 ° v,e Well C6ntrctr °��Lf,/,✓j c s., Add. M i J�d• Tel Pump Contrctr S' -� Add. Tel WELLS (^10 be completed at time of pump test. ) , Type of well Q�tt l -�t� Use �� 1.2. 1'-k.C- .•3. a Diameter of well Size of casing Depth of bed rock - � `� Depth casing into bedrock 4-( Z Seal been tested? Yes (X ) No (_) Date of test r Depth of well Z o - Water-bearing rock Gr"-tl 1`r-e-) Depth to water 17 Delivers GPM for z 1-4-Eve-'S . (how long?) Drawdown 60 5- feet after pumping_�L hours at GPM Date of completion 3 '- Signatur of well contractor PUMPS (To be filled in before installation. ) Name & size of pump 4DI-) P ,type Sloeo&,f.- LB i� Size of tank Pump delivers O GPM Pipe used in well: Cast iron (_) Galvanized (_) Plastic (n ') ( (off P S �. Sleeve- used to protect pipe? Yves (_) No (?C ) Type well seal BAK-6L Date 2 ~0 -� Sig ure of pump installer Date water analysis report submitted to Board of Health �- O Plumbing inspector Wiring inspector Board of Health Massach�is Department of Environmental ManagOt Office of Water Resources 129663 TYPE OR PRINT ONLY Well Completion Report 1.WELL LOCATION GPS (OPTIONAL) LATITUDE LONGITUDE. Address at Well Location: ' Property Owner: Subdivision Name: Mailing Address: City/Town: A/4 City/Town: ��✓ Assessors Map Assessors Lot #: 1— NOTE: Assessors Map and Lot#`mandatory if no street address available Board of Health permit obtained: Yes Not Required EJPermit Number 7 Date Issued 3_Y 2.WORK PERFORMED 3. PROPOSED USE 4.DRILLING METHOD C9f New Well ❑ Abandon Domestic ❑ Irrigation ❑ Cable ❑ Auger ❑ Deepen ❑ Recondition ❑ Monitoring ❑ Municipal 25 Air Hammer t=0❑ Direct Push ❑ Replace ❑ Other ❑ Industrial ❑ Other ❑ Mud,Rotary ❑ Other 5. WELL LOG Cr Unconsolidated Consolidated 6.SITE SKETCH(use permanent iaadmarks Hrith-distances) H PermeabilityT– An Z < >. — ` From (ft) To (ft) High!ow c m Other Rock Type sty M e 6---'* O 3 14 0,, Z (-Eos-e v .�Aa� 7.WELL CONSTRUCTION 8.CASING Total Depth Drilled 0-5 � From (ft) To (ft) Casing Typerarid Material Size O.D. (in) Well Seal Type Date Drilling Complete Ll Z' l' 17 R 9. SCREEN From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter 10. FILTER PACK/GROUT Z ABANDONMENT MATERIAL 11.ADDITIONAL WELL INFORMATION ti.,. Developed? Yes EJ No From (ft) To (ft) Material Description .: Purpose Fracture Enhancement? C Yes ❑ No Method J. Disinfected? 9 Yes . F-1No 12.,WELL TESTDATA(PRODUCTION WELLS) 13.STATIC.WATER LEVEL(ALL WELLS) Yield ,Jime Pumped 'Drawdown to Time Recovery to Depth Below Date .Method (GPM) (hrs`&min) (Ft. BGS) (hrs& min) (Ft. BGS) Date Measured Ground Surface (FT) 3--ro-2y t� ►F 1 ��5 ��S 59r" �u ! 3- Z- O 14. PERMANENT PUMP(IF AVAILABLE) 15.NAME ADDRESS OF PUMP INSTALLATION COMPANY ) Pump Description Tau�bS S•S- J'J tVt��Q$I Horsepow r Ct fA • 0CLiV C° '+-C •'`�� Pump Intake Depth (ft) Nominal Pump Capacity (gpm) �k�Or2� 1� f 15. COMMENTS 17. WELL DRILLER'S STATEMENT IThis well was drilled and/or abandoned under my sd ervision, according to applicable,`rules and regulations, and this re ortis complet nd c rr c Cm the best of my knowledge. LC I Driller: ,l Supervising Driller SigQnature: gistra tion #: Firm: C _/'41-�1 �-- 4f1 �r�- t t� i e� Date: 3 �z d Rig Permit#: I I NOTE. Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY .03/12/2004 17:14 97869200 THORSTENSEN LAB C PAGE 01 -9AV""dM g:17� jfte. 66 LITTLETON ROAD,WESTFORD, MA 01888 (978)692-W95 FAX(978)692-0023 1-800.649-TEST Report Number 90691 Report Date: 3/12/04 Client: Sample Information.: Mike Finocchio Lot#3 Forest St, 68 Hood St. N.Andover,MA Lynn MA 01905 Sampled by: Rollins Staff Date Received: 3/11/04 Date Sampled: 3/11/04 Certificate of Agwyl a Test Parameter EPA Limit R� lts Total Coliform(P) 0 0 perl00mil Fecal Coliform/E.coli(P) Absent Absent per100nd Calcium Not Spec- 23.7 mg/L Copper(S) 1.3 a0.02 mg/L IzOD(S) 0.3 0.29 m9AL i Magnesium Not Spec. 5.9 mg/,L Manganese(S) 0.05 0.05 mg/L Potassium Not Spec. 1.0 mg/L Sodium See Note 15.4 neg/L Alkalinity(S) Not Spec. 94.0 m$2 Ammonia-N Not Spec. <0.03 mg/L I Chloride(S) 250 5.9 mg/L Chlorine Not Spec. 0.08 mg/L � Color(S) 15 7.5 CPU Conductivity Not Spec. 229 umhos/em Hardness Not Spec. 83 mg/L Nitrate-N(P) t0 0.25 mg/L Nitrite-N(P) 1 -<0.01 mg/L Odor 3 1 TON pH(S) 6.5-8.5 7.5 SU Sulphate(S) 250 13.9 mg/L Turbidity Not Spec. 2.6 NI'U i Sediment pos/rreg neg I Legends: (P)=Primary EPA Standard,(S)-Seeondaey EPA Standard,#=Exceeds EPA Limit, TNTC—'foo Nuwerous to Count,*—Background Bacteria Noted, Exceeds Advisory Limit Sodium Advisory Limits,Mass.-20,NH-250. This water sample as submitted,meets EPA guidelines for the parameters listed above.The quality of this water is accepted as POTABLE according to EPA standards. Massachusetts Cer4fication#MA048 ichael P.Car on,for Thorstensen Laboratory Inc. f CBOARD OF HEALTH, 1A� NORTH ANDOVER iVYASS: 1�84���, 978-68'8-940 ' ��} r a JL 20 r t� i� APPLICATION FOF � - __� DATE: Tune- 2$3 Zoo f LM A'P - pq p of 2 (por4-i LOCATION OF SOI. TESTS: ht 2, Forest Street OWNER: Scott Roth TEL. NO.: 978-887-9254 ADDRESS: 66 Stonecleave Road, Boxford, MA 01921 ENGINEER: Hancock Engineering Associates TEL.NO.: 978-777-3050 CERTIFIED SOIL EVALUATOR: Charles R. Ogden Intended use of land: Residential Subdivision ingle Family Horne Commercial Is This: Repair testing Undeveloped lot testing y s In the Lake CocEchewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land o tvnership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan l 3. Fee of$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of S75.00 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 tw,o percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Wi&.in 45 days of testing, a scaled plan(no smaller than P-100') shall be submitted to the Board e; Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted: Please Do Not Write Be T s . e _ I .A. Conservation Commission Approval: -- Date Received: C eck Amount Check Datc: 6-11-1996 9:42PM FROM P. 2 Q / a s arss •■ � S fP�'r :.c SMAECKEAYE S7^ WILW 30 t 7�[IT• / 4 LOT 1 _ - T p° sf S�t M.MVV4 a r 68d�ito*SS aatr C rK f CUM It 8 PIM An see %% d RUMC sam 4 �, / 1 4=32 SAG pyo Lor J a sorerxvw ! �� / _ SK NAL40M smAUW sane i 'alar � / t NEl'!/IEb W Ii NOONAN & McDOWELL, INC. FIELD NOTES LAND SURVEYORS, CIVIL ENGINEERS 25 BRIDGE STREET, SUITE 6 BILLERICA, MA. 01821-1023 SHEET-OF TELEPHONE NO. (978)667-9736 FAX NO. (978)671-9565 PROJECT NO.: 7 0/0 STREET- Fo Oe- E'S CREW- A."Cpgv A-v of7l-- BILLING GROUP: TOWN: DATA FILE. DATE.- TIME: WEATHER: TEMP.: ...... ..... L ------------- ------------- ------ it J_...J_ ----------- ........ - ---------- -T J .......... ---------------------- ---------- IANC O CKQ Engineering Associates 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 O 12 Farnsworth Street ❑626 Main Street DATE 0 (go .108 NO. (P,16, Boston,MA 02210 Bolton,MA 01740 ATTENTION '{ //..��. 1,� ,,r (978/))779-6767/�,,/� r 9 1 j TO (7� i 1�A0 14A �-C.�� E-JCF� RE: O� A 1'�f7f'C-�T S�y`2.CJ1 0,ork , MA of-64S WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION I 2400 0`61 g ')Oil— I9VALU,A--roe_ 50ZM$ THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: If enclosures are not as noted,kindly notify us at once. (b-1 1-1996 9:Al PH F RC M c P. 1 0 Al \ O C Survey Assodates, Inc. FACSIMILE LETTER 235 Newbury St., Danvers, MA 01923 DATE: 1 L-1 10 l PROJECT NO. ATTENTION: S Af-An COMPANY: �O FAX NUMBER: f (9 S .941- FROM: a� SUBJECT: TOTAL PAGES INCLUDING THIS COVER- DISPOSITION/ OVER:DISPOSITION1 REQUESTED ACTION: ❑ Original to follow by mail ❑ As requested ❑ For your use ❑ Please review/comment ❑ Please call me MESSAGE: \oe, ow ?..o l _.... . ATTACHMENTS: COPY TO: Please call us if this fax is not clear and complete: Voice (978) 777 3050 Fax (978) 774 7816 The information contained in this communication is confidential and is intended only for the use of the addressee. Unauthorized use, disclosure or copying is strictly prohibited. 11197 HAl`TCOCI� Engineering Associates 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 13 12 Farnsworth Street O 626 Main Street DATE JOB NO.// y r� Boston,MA 02210 Bolton,MA 01740 7 Z pl (617) )3qq50-7906 //�� 1 �2 (978)7r79-6767 �/ ATTENTIO TO "IJFJG.�� FJ`� I'�CA�Y'tr1 RE GI 2j Gc,✓�es� See�- WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ oW�,eAUp — 4,,� 6't1 01 I_.a"a THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS t e,)Wy12(, W ,n 1 COPY TO n SIGNED: If enclosures are not as noted,kindly notify us at once. HANC O CIS Engineering Associates 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 12 Farnsworth Street 626 Main Street DATE JOB NO. l Boston,MA 02210 Bolton,MA 01740 TI�� C3 12 ©o ATTENTION� (978)779-6767 TO Ala -9 4 : 4xyzz 2a� DF �LTff RE: 67 ryEZZ- WX7-# OqA WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION OUP 6011- ZE6r 3 THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval f 6or your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS_LZ L� <�L�;1S D _ /-� l�PGt� ,� "lam h 1, .. 4e v G1GG:� /^ Q g � COPY TO SI if enclosures are not as noted,kind/ not"Ausone . HANC®CK Engineering Associates 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 Ll 12 too JOB NO.CO-T6712 Farnsworth Street ❑626 Main Street U' Boston,MA 02210 Bolton,MA 01740 ATTENTION (978)779-6767 TO AyOoyer O e kk ��, RE: 01 S+b— WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION MAN ( I i .j THESE ARE TRANSMITTED as checked below: ❑ Fora approval ❑ Approved as submitted ❑ Resubmit co ies for approval PP PP P ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: if enclosures are not as noted,kindly notify us at once. -DETACH HERE. . . . . DETACH HERE - - DETACH HERE - DETACH HERE - - - - - DETACH HERE - - - - - DETACH HERE. SEE REVERSE SIDE FOR IMPORTANT INFORMATION Interest at the rate of 14t per annum will 7349 RE accrue on overdue payments from the due date until payment i m nt s made. . A. o' ,R g{ G ��5 ; i'7R�f?LL;1t7'�`%`??'?'% t .:.:....:.........:...:.:::.:..... ......................:......477_7" ROTH, SCOTT D Loc: 0 FOREST STREET Parcel Id: 105.8 0002 0000.0 This form approved by the Commissioner of Revenue 2000 QUARTERLY REAL ESTATE MAKE PAYMENTS TO THE COMMONWEALTH OF MASSACHUSETTS 7349 RE �_ TOWN OF NORTH ANDOVER NORTH ANDOVER Loc:e�"�FT BEET P. 0. BOX 124 OFFICE OF THE COLLECTOR OF TAXES Id: 105.8 0002 0000.0 NO. ANDOVER, MA 01845 Your Preliminary Tax for the Fiscal Year 2000 Deed/Legal: 04072 0033 N-F 8:30-4:30:11/1 TO 7:30PM beginning July 01 1999 and ending Jure 30 2000 Land Area: 2.86 (ac) TAX 688-9550/ASSR 688-9566 on the property described is as follows: First Amount Interest Second Amrnmt InterestNX �EIRT Q 3 1-TAX 21.02 0.00 2-TAX 21.02 0 TFtfO P}1E11I41 T�t1( .# Ptl tilt N3 $t Sc ROTH, SCOTT D MARY L ROTH lliN'f 66 STONECLEAVE ROAD u T t BOXFORD MA 01921 AMOI]t�T FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 No. Date: o ID 0 Commonwealth of Massachusetts AviJow( ` , Massachusetts Soil Suitability Assessment -for On-site Sewage Disposal Performed By: Ckn-6e5 Ogden- IAC ncoc1, gni r wles Date- 8�3o�ot Witnessed By: 'oln�n Neov�aro —N,AnJover- boa(-a of L=wft Address or P?E'-'Q 1; 0-='s Nsme. 4,10 Addres:.ares Tekoom pew Construction VRepair ❑ Office Review Published.Soil Survey Available: No ❑ Yes Year Published loth 1 Publication Scale 1.s _ �c I� ° Soil Map Unit Drainage ClassSoil Limitations - SioP$- Say—{c cu SloneS Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: 2Spaq — DOto 1 1'vn�, p � l�l�� Above 500 year flood boundary No ❑Yes [a Zee, � G Within 500 year flood boundary No ErYes ❑ Within 100 year flood boundary No EfYes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month Range :Above Normal ❑Normal ❑Below Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 FORM - SOIL EVALUATOR I;OItM P29C 2 of 3 Loi No. , On-site Review - Deep Hole Number T= I --01 Date:. 30 01 Time:,lfje';We ' Weather wajeol Location (identify on site plan) Land Use (LESI detn ia.I Slope M —10% Surface Stones_ y Vegetation _ woods-- ,pwte,S, M�,DleS , Landform Position on.landscape (sketch•on the back) . Distances from: Open Water Body.> 0O feet Drainage way. feet Possible W ? Wet Area o0 --(._ feet Property Line ..J?o.. fdet Drinking Water Well y. oo feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Textured Soil Color Soil Surface(Inches) (USDA). (Muns to Mo of Other ng (Structure,Stones Boulders, Consistency, % Gravel) lJ W C �Jt IoYk 3 32 "1aSSi � ve IFTIW�le, ��SYksl� 1 4tle ho rock �'etia G1L s-oo Co I Z C SL Parent Material(geologic) t sp we_ DepthtoBedrock: 60,)e- Depth 'tOv12Depth to Groundwater: Standing Water in the Hole: t„t®�� Weeping from Pit Face: _ Estimated Seasonal High Ground Water: 32 e ` • Y, KEY --- SAfl6 .� Y'Ifle. DEPAPPROVEDFont 12/.07/95 LS Loo ^y 5anc) I 5L S�L 5,;If :Loan FORM& SOIL EVALUATOR 1,,Oltl\4 Page 2 of 3 Lot iso. —�- E7,orots ►Joi-A, AAA""er- - On-site Review - Deep Hole Number s Z -ol Date:. 30 1 Time:_LJ0-;;a0 + Weatherdear Location (identify+on site plan) Land Use —2e.5,dev��ia ( Slope (%) "101 Surface Stones= very / Vegetation _ woods- aiK, .o�KP-5 ktS Landform om1ii1ve_ Position on landscape (sketch'on.the back) Distances from: Open Water Body. 100 feet Drainage way. feet Possible Wet Area ? co feet Property Line ..2.Z2 - fget Drinking Water Well y. Q 0 feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil TezturOIL Soil Color Soil Surface(Inches) (USDA). (Munsell) Mottli Other n9 -(Structure,Stones Boulders,Consistency, % Gravel) -7.5 YeP SL to'm 410 gt_ MasSt 30-tet C SL 2, 5Y51+ I-AQ rI rc�T aK�U�A� ru�t,Ye Parent Material(geologic) p ,1 , Goo_' �`[ DepthtoBedrock: ✓one p Depth io Groundwater Standing Water in the Hole: Weeping from Pit Face: n� _ Estimated Seasonal High Ground Water: ZLP" KEY S r7anc� ine. UEP APPROVED FOR��f- 9S q 5 � L5 LoaMJ :• 12/071ari$L. $;L` Silf-'`LoAr� c GogrSC. FORM0, SOIL EVALUAT oR I<oRnI I'agc 2 of 3 Lot iJo. -2 �� S�'ree , �jo� Agar - On-site Review Deep Hole Number T—__3 -01 Date:. 3o I Time:_100-11411 :- Weather luaLI�� dear- Location (identify,on site plan) Land Use 2251 dein Ufa I Slope M 22=10-1, Surface Stones Vegetation Landform VIA 0f-N1 Position on landscape (sketch bn The back) Distances from: Open Water Body.> 100 feet Drainage way. feet Possible Wet Area _>0_o feet Property Line ..?.Zo.. fdet Drinking Water Well _LL,0_0 feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) SDA). (Munsell) Mottling •(Structure,Stones Boulders,Consistency, % Gravel (� S L-- t o YIR 3/3 T i �jfu� P mo-ss,ve sL Z 5Y'Y+ Mass;, I✓;r,4 q"�g 4,-r roc 11; • rhavv�• .vp���� ule�2� AA I Parent Material(geologic) � y��3' �CyD,� �� DepthtoBedrock: ✓10v�'�, OjS Depth io Groundwater Standing Water in the Hole: wqWeeping from Pit Face: \03" _ Estimated Seasonal High Ground Water: Sty" KEY DEP APPROVED FORA. 12(07195 LS = L,•oc m :sa"a $L 50.85 l-iMIvry 5;L 511 f LOa.n O FORMO- SOIL EVALUATOR I; oitnj rage 2 of 3 Lot No. - On-site Review - Deep Hole Number T—_A -01 Date:. 30 I Time•..100-)moo Weather W�rkor Location (identifyt on site plan) .Land Use —R2yi deet�►A .lop' ' Se (%.} '—Ib/ Surface Stones•� ve�i •�� Vegetation 60L A�rte5 MaDleS Landform , VyiorT% Position on landscape (sketch'on.the back) Distances from: • Open Water Bo P Body.--l---o0 feet Drainage way. r feet Possible Wet Area > oo feet Property Line _2.Z0.Z0flet Drinking Water Well -1-JO-0 feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface(Inches) (USDA). (Munsell) Mottling (Structure,Stones Boulders, Consistency, % Gravel) IoYk3I3 L°. ?Oy : '"1oSSivG� ver� I ' SSL-. tol.'t(u Mass;�¢ Of-ft to- SL SY�I Ma Ss; ria �i rfe+ Q'np Olf- Parent Material(geologic) ` � � r 1 0 DepthtoBedrock: Aov)e 0�S. Depth io Groundwater:v ou dwater. Standing Water in the Hole: /►fiJ Weeping from Pit Face: Estimated Seasonal High Ground Water. ZO" KEY S Sand Fine- VEP APPROVED FORM• 12/0719S LS L.00^u, .5anc) 5 L Sandy Lizw� 5�,L Sill- -Loam •C e o or`Se,. s I~ORMQ- SOIL EVALUATOR I; oliM P29C 2 of 3 Lot No. 2 'o res Skr ee ),1 erg. 1�nd��Qr' - On-site Review - Deep Hole Number T 5 -01 Date:. ILO-121 Time:.,1130-30 * Weather wa�� dear Location (identifyI on site plan) _. .,Land Use 2251 dev► ►a Slope (%) `'-10/ Surface Stones=vent Vegetation 1he,5 Mit he C, Landform. , Position on landscape (sketch"on the back) . Distances from: Open Water Body_> od feet Drainage way. feet Possible Wet Area -L 00 feet Property Line .. ?Zo . flet Drinking Water Well > 00 feet Other DEEP .OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture4• Soil Color Soil Other Surface(Inches) (USDA (Munsell) Mottling (Structure,Stones-,'Boulders Consistency, % Gravell to @ Z16 M0..V"vt v. 5 'Z(b e> SL ►O'`/u Ma�S,,rQ y \Je� ro�(c� cobl� a� bo�E�(z+s Parent Material (geologic)_ SQh�ct ®per t��� p�S ---tet DepthtoBedrock: ✓40v)e Depth io Groundwater.• Standing Water in the Hole: Y04c_ Weeping from Pit Face: "ne— _ Estimated Seasonal High Ground Water: ZVI . v, KEY --- S 6anc1 (r' (°in& VFP APPROVED FORM-12/07195 L S L.00^y 5'and 5 L 5a46 Law, tied 1 vrn c o 5�L 5;11- L C ar5�. FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Lot No. Ste+ PFJorA-, A<n9.o ` Determinatt'on for ►Seasonal Iii h Water Table Method Used: Depth observed standing in observation hole inches Depth weeping from side of tobservation .hole tfl3 inches Depth to soil mottles 20 inches ❑ Ground water adjustment .feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material :Does at 'least four eet -of naturally occurring. pervious.material.,exist .in all areas observed throughout,the.area proposed for.the.soil absorption system?.. If not, what is the depth of naturally occurring pervious material? Certification r I certify that on Oc+. l(o4 IggS (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature "rqDate 10 lot DEP APPROVED FORM-12/07/95 M' FORM 12 - PERCOLATION TEST Lot No. .. Fort_.�,� 4- COMMONWEALTH OF MASSACHUSETTS �Jor An�c j4- , Massachusetts Percolation Test* Date: 12"010.1. Time:, Observation Hole # Depth of Perc �� Start Pre-soak End Pre-soak ..Time at 12" 53 Time at 9" 'z 0+ Time at 6" , Time.W'-6") 93 in Rate Min./Inch N'linbrium of 1 percoiation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ..............................................................................� . .......................... ..................._:._ _....._ Performed By: Glias��� E7� — N�nG�c 9n9'tne.�",nj 14soc�A�e5 Witnessed By: 7o�nn Noonaon s M, A,-,Aaver gpard "DC �eo,a�k A 't Comments: .._., I 'DEP APPROVED FORM-UW/95 ' _ i FORM 11 -UL EVALUATOR FORM '7 ?Q pap Page 2or3 Location Address or Lot v4o. r-0ee—t—"3 r s )' j W , h0v Pig v � - j On-site Review _ , l Deep Hole Number�I' , Date: 1--79Z79-9-1 Time: Weather 4Z6 4eWxC- 7t7197-1 Location (identify on site plan) Land Use K-1 0 aSlope ! Surface Stones T �- I Vegetation V4l< Landform i Position on landscape (sketch on the back) . _._.. Distances from: Open Water Body �feet' Drainage w_a y feet Possible Wet Area 7140 feet Property Line feet Drinking Water Well Meet Other j DEEP OBSERVATION HOLE LOG� Depth from Soil Horizon Sol Texture Sol Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Graven /�P to�'rc �. --� �`�--nal Svc eo►tx �tx j i9 r✓ri -� rx o� - G --1,Z 3 C: 5 L Z'Srs�9' 3 z ' '� s >r Parent Material(geologic) Oa�QntoBeOrodc: Depth to Groundwater: Standing Water in the Hole: IVO/V455' Weeping Ikorn Pit Face: Estimated Seasonal High Ground Water: •� � �� DE?APPRON•m FORM_UM7115 I j FORM 11 L EVALUATOR DORM Paas 2 of 3 Location Address or Lot ido. �� I On-site Review _ Deep Hole Number 7w'0 Date: @sff 30 �✓I Time: Weather G Location (identify on site plan) Land Use �o�t� J Slope (%) —Surface Stones Vegetation "�� P/ 4!�2 010 s., r Landform Position on landscape (sketch on the back) - Distances from:. Open Water Body 7J�p feet Drainage way /" feet Possible Wet Area ,too feet Property Line feet3p Drinking Water Well '>/on feet Other i DEEP OBSERVATION HOLE LOGS Depth from Soil Horizon Sol Texture Sol Color Soil pts Surface(Inches) (USDA) !Munsell) Mottling (Structure.Stones.Soulders,Consistency,% Graven in vc -,G--r� ftp' . 7 - 3,0 GS i_ Parent Material(geologic) CapthtoB Depth to Groundwater, Standing Water in the Hole: �/d�'✓ Weeping from Pit Face_ /U FsUrnated Seasonal High Ground Water e i DEP APPRONIM FORM-t2/07lfS I FOKNi 11 - 1IL EVALUATORI 1.ORNi Page 2 of 3 e; ' 0 Location Address or Lot i-4o. I On-site Review Deep Hole Number / ' �Q.d Date:-;E/Y0/Pt Time: � ' 10 Weather e.�-��'�- � Location (identify on site plan) Land Use kV O c n Slope (%) -- Surface Stones ZVI of 8' `v Vegetation 0114 . P> ^J "'— Landform Position on landscape (sketch on the back) Distances from:. Open Water Body 21"7 feet Drainage way 10� feet Possible Wet Area >/04 feet Property Line 7o- feet Drinking Water Well_moo feet Other I DEEP OBSERVATION HOLE LOGS Depth from Soil Horizon Sol Texture Sol Color Soil OtherSurface(inches) {USDA) (Munsell) Mottling (Structure.Stones..Boulders. Consistency. % Graven Q r 5 L 10L A 44C z,sys 7. p c v t,.a�. x e. 1e t-e Y Z =G Z 7-,eC' S L /r h,�c s e e � l/ 7- 3Ys/� I I i Parent Material(geologic) Oapd�Bedrock: i. Death to Groundwater: Standing Water in the Hole: / af, Weeping from Pit Face:_ Estimated Seasonal High t"arourd Water: 3� DET APPROI*'ID FORM-1=7195 FORM IIL EVALUATOR FORM Paoc 2 of 3 - I Location Address or Lot leo. I On-site Review' PA ; I Deep Hole Number r+-`O Dater-.2? ©/ Time: Z%f57— Weather Location (identify on site plan) Land Use i2 /"'A Slope i%) — Surface Stones _- __�✓.o�/� Vegetation 'Cert 03-,5 1 Landform j Position on landscape (sketch on the back) Distances from: Open Water Body °O feet . Drainage way>/02 feet Possible Wet Area '_2110 feet Property Line ns feet Drinking Water Well 7f 20 - 9 feet Other �..-.. .---'---- - -- I I I DEEP OBSERVATION HOLE LOGS Depth lrom Soil Horizon Sol Texture Sod Color Soil Other Surface(Inches) AUSDA) (Muncell) Uottling (Structure,Stones,Boulders, Consistency, % Grave I Ir I Parent Material(geologic) G�QxoBadrodc Depth to Groundwater: Standing Water in the Hole: /I101" e Weeping from Pit face- Ave Q oVe=� Estimated Seasonal High Ground Water: DFP APPR01*1M FORM-12107195 FORM 11 - L EVALUATOR FORM 1 Paoc 2 of 3 77 o/© Location Address or Lot l4o. pr2 -T- 5 On-site Review _ Deep Hole Number 75'-Q --Date: 3Q al Time: Z% 3 3GL,; -7a Ole' Weather Location (identify on site plan) Land Use W 0049 'a Slope M — Surface Stones Vegetation 01 tL , A' e, 24FeO4 � Landform Position on landscape (sketch on the back) Distances from: Open Water Body '21&10 feet Drainage way >100 feet Possible Wet Area '>-10e) feet Property Line ✓ feet Drinking Water Well !O" feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Sol Texture Soil Color Sol pts Surface(inches) (USDA) !Munsell) Mottling (Structure.Stones,Boulders,Consistency, % Graven 14 Fs L ln)k /0 yet 414 1 v- 7- .5- 7 +=Z .5- 7 ?r�� ��'s°z 51k � y z % J / g"'/ W "r cr saw 1�'srj �;y.-3 5 i vim-- ,//�c'/mss•�L ec-• i Parent Material(aeoiogic) pegQsagdroc#• > / 3 Death is Groundwater: Standing Water in the Bole: "y a,\,/ dE Weeping from Pit Face: -�O Estimated Seasonal .High Ground water: z 8 �! DEP APPR01*7M FOR_1=7195 4 7 t� 3r o FORINt I2 - PERCOLATION TEST 1 Location Address or Lot No. 7— COMMONWEALTH COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test` Date: �'' �p�4 /" Time% z Observation Hole le Depth of Perc Start Pre-soak End Pre-soak Time at 12" , AA Time at 9' Z ' 0 Time at 6" t -7 Time (9"-6") f j Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reservee area. Site Passed Failed Q ........................................:............. Per-formed By: G ,r f � 41 r,> Witnessed By: Comments: DFP APPROVED POR.M-12/07/9S . 4 Q FORM 11 - SOIL EVALUATOR FORri1 'r Page 1 of 3 No. Lv" 7 (3 Date: co25 � Commonwealth of Massachusetts Nfl� �oJer , Massachusetts Soil Suitabilitv Assessment for On-site Sewa e Disposal Performed By: G(narle5 O-t4er1- gancccV, gincer;ng j�ssflc;g��s Date: --7d?-(,� ��e= Witnessed By: Carl1 A&MInQ 4JL — N An�cuc( 6oac•cl of Hc-o,l4t� c�tbn Add.�„a Loo- A Fin,rest S cet ower,Name. 5Co-W (,o+tn Addrat ud D 4 Tekphmx I Lot, S-��eG(e0.� F-oatl ew Construction IZRepair ❑ Office Review Published Soil Survey A\ailable: No ❑ Yes [']� Year Published -- 0$( Publication Scale 11 1 S.goo Soil Map Unit Gc D Drainage Class Lv&lk 0-yit-c-A Soil Limitations — Slone.. 1$400%C-46 Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Z5c)0-100— 0010 13 TjaE 1s-,Igab3 Above 500 year flood boundaryNo ❑Yes 2r 20 ti r L I, Within 500 year flood boundary No LJYes ❑ Within 100 year flood boundary No Ellyes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ❑Below Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR R 1; Olt N1 P29c 2 of 3 Location Address or Lot No. _� c,T STQEET �',(�►•t�;o - . On-site Review - Deep Hole Number 3-9. . Date:. 2L 04 Time:.. Weather t�or/h p cls, Location (identify on site plan) ��- Land Use -- 12e -1'iA Slope (%) _ Surface Stones— r­— Vegetation ­—Vegetation Landform Position on landscape (sketch*on the back) Distances from: Open Water Body• > o2 feet Drainage way. feet Possible Wet Area ?t aJ feet Property Line .-5b�flet Drinking Water Well 2 ( 2 feet Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) (USDA) . (Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravep ` _ 3Ab S[_ !o`{+Q /2 MGSsive� cr .b �2_'°0� y✓t,J 5l_ jo�p 4/(, r/1a4S}1C � Friable Is Z_ �, S L 2,s�r S/� M C,4f;,vim_ r)f, � Plea 4w lo'ese IAT EVERY PROPOSED UISPOZAL AREA Parent Material (geologic) e�&, N Lootp DepthtoBedrock: ✓OVY— Depth to Groundwater: Standing Water in the Hole: Oe— Weeping from Pit Face: yi o Vt•C, Estimated Seasonal High Ground Water:_ e[; , '(? �t KEY -------------- S Sand - -F �i ne. ED DEP APPROVFORn1.12/07!95 L5 L0O 3 Sant) � 5L 50.n8� )..Orir+'1. C G o arSC.- 5,L 5111- Loam I O FORM01 - SOIL EVALUATOR f,Oltn� rage 2o 3 •Location Address or Lot No. SMPrE7 �rC{PrtSt�oh On_ _ site Review Deep Hole Number CLQ_ Date:. 2(r b0 Time:- Weather luorr� p, c!�:.1 Location (identify on site plan) Land Use - Slope M) 35 Surface Stones— a Vegetation _A Landform r>e- Position on landscape (sketch on the back) Distances from: Open Water Body,2LC feet Drainage way. feet Possible Wet AreaI 1 C_ feet Property Line .. 7 Sb. filet Drinking Water Well 2 1 0 feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texturev Soil Color Soil Other Surface(Inches) (USDA). (Munsell) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) 0-3to P;1 1 ` 3t-o- 4O fid SL WA3I2 MGse,iV/e cr,�,,,.b -1�}o C, SL 2,s�r S/�. �.q01j 2,SY'1t �er� rA�!��� � 5•�-ass-� v5YA 5/8 t Parent Materiai(geoiogic) e,&,., N -\�(, DepthtoBedrock:_ (A ) 11 Depth to Groundwater: Standing Water in the Hote: 'r E'3� Weeping from Pit Face: Estimated Seasonal High Ground Water: Ciera -- KEY S So,nd & DEP APPROVED FORM-12/07/95 L 5 L mm3 50.r1J 5L ­ SaPdy -:LoamG G oa�5z 5;L Silt' Loam - FORM 11 - SOIL EVALUATOR Folml Page 2 of 3 :r Location Address or Lot No. �} FST S'S'IeET �rCvt�,iort On- - site Review Deep Hole Number -IMi(_ Date:. Zai 00 Time:.. Weather Min P. CIO, . Location (identify on site plan) Land Use Qe4aP;n laa� Slo e (%) � Surface Stones tones Vegetation - O'k'IA Landform , `M0,i-a�he- Position on landscape (sketch bn the back) Distances from: Open Water Body.->tO-O feet Drainage way. feet Possible Wet Area -1100 feet Property Line .. a Sb.. Met Drinking Water Wellt U feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface(Inches) USDA). (Munsell) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) 0-31 ` 3J-$0 AD SL WA112 MCk ve,� Cf"J—b V �J 5 L w SO SL 2,sY 5/4 iA S`( vef� co�iral� 5 Parent Material (geologic) �Cgxv ^ 1 DepthtoBedrock: e 122" Depth to Groundwater: Standing Water in the Hole: ° Ion Weeping from Pit Face: Estimated Seasonal High Ground Water: e- S Stt KEY DEP APPROVED FORM-12/07/95 _S L oar 50'nJ L . � rr1 Ntc�(uw� 5L Sandy L0-c'm C G oa�Sse. 5,L Silt LOAM FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. FOcc,- , - Sic-+ tj An44'.14."f Determination for Seasonal High Water Table Method Used: Depth observed standing in observation hole_1__._ inches Depth weeping from side of observation hole (o inches Depth to soil mottles 55' inches ❑ Ground water adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system?. '-i ES If not, what is the depth of naturally occurring pervious material? Certification I certify that on Oc.+. IL,,, V99S (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. i Signature C Date oz DEP APPROVED FORK]-12/07/95 A. y} i FORM 12 - PERCOLATION TEST Location Address or Lot No. A 'F�oroJ I COMMONWEALTH OF MASSACHUSETTS 1Jor A-N Av,J,4v. r , Massachusetts Percolation Test` Date: 712,0100 Time:, Observation Hole # 19_S Depth of Perc 5�{-'� + I�j14 Start Pre-soak End Pre-soak {© ; 41 i) ; 2- Time at 12" 10'. 41 1) : 2-4, Time at 9" 1�} : it S+ Time at 6" 9 i �— Time (9"-6") 25 �� Rate Min./inch Aqa (3 A Nliniinum ori percoiation test must be performed in both the primary area AND reserve area. Site Passed ❑ Site Failed ❑ r �o� c roc-, ^ice io n•-, sit -3 `1 Performed By: '0jen Ngrcocx ASsocick�e5 Witnessed By: C&,,, 4,n n — &j.A4o.,er Board mC -�e�1�r�n lc, Y Comments: .� ...._ ._ • DEP APPROVED FORM-12/07/9S ' FORM 12 - PERCOLATION TEST Location Address or Lot No. A fkro t S + COMMONWEALTH OF MASSACHUSETTS DoT A��ov�r , Massachusetts Percolation Test` Date: '7 2�'Ib� Time:, Observation Hole # Depth of Perc Tisa � 41")." m i n Start Pre-soak End Pre-soak Time at 12" Time at 9" . Time at 6" Time (9"-6") Rate Min./Inch iMiniinum or 1 percoiation test must be performed in both the primary area AND reserve area. Site Passed ❑ Site Failed ❑ ..........................................................................................................................._..._.._.._._..... _ Performed By: Gh�s 1�5 E7q�n — �grGs�ck_ EnI ineer'Inq JN C\ fires Witnessed By: (���� r — DJ.A�,�a��cr'Boa�d ©� l�eal��n e►��r Comments: . ..._.._...._._ • DEP APMOVFD FORM-12VIS ' FORM 12 - PERCOLATION TEST- `r Location Address or Lot No. A fore,�,� COMMONWEALTH OF MASSACHUSETTS 1Jor*. AvJ-4ve.r F Massachusetts Percolation 'Test' Date: - Time:, Observation Hole # n Depth of Perc Start Pre-soak End Pre-soak ci , Ob Time at 12" 9 Time at 9" Time at 6" Cl : St Time (9"-6") 2U Miv\ I Rate Min./Inch C( MP Nlini,num of 1 percoiation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ Performed By: Chi-s'�eS 07 Oen En1",lee-rini AsSOC'14 re5 Witnessed By: �"j A>4over goar a mc Comments:wii • DFP APPROVED FORM-UM195 44,750-l- S.F. / AREA IN N.ANDO VER=2.86f ACRES 1.03E A CRE.5 AREA IN BOXFORD=3.28E ACRES -� LOT A PLAN NO. 7180 / / 1.60E ACRES UPLAND / 0.2J± ACRES POND (SCALED) 2 S TOR K WOOD FRAME / 1=2 DWELLING / T-11 WO / PORCH I / e P-2h''y / / r 3 T 1 T-10 � � CHIMNEY / / T-4 C T-9 e i C 2ND FLOOR / WOOD DECK ABOVE 1ST FLOOR GROUND WOOD DECK POOL LOT 56 / / PLAN NO. 7180 O / 2.55E ACRES UPLAND 1 STORY 0. 73E ACRES POND / WOOD FRAME STABLE )XIMA TE EDGE / 6p )F WA TER 4LED FROM N NO. 7180 } Q Q FORM 11 - SOIL EVALUATOR FORM Page I of 3 No. b-1 bj Date: 5 oma. Commonwealth of Massachusetts )Qo-,rin AviA�o,-,q!'-, Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: Ckclt aS Assty4R+ey Date: (on Witnessed By: Cork' o 6,0wn —N,Ahaover �- � �Pp f� �Y1�i v1�-j yt_ •-N Q,U/ �,lflt�,,pr-} L ,*.AW—s a Loo- SAO+V Add us."'d Coln S�-onec le-a.ve. Road TckpM'x i goyC. -Eora.� MA kw Construction Z Repair ❑ Q��� 89-7— g2s4 Office Review ,--,/ Published Soil Survey Available: No El Yes U Year Published Publication Scale t 5 $g-oUnitCGD Soil Map nit Drainage Class WI-11 '��.a Soil Limitations -- 51,0Df-, S'A �e ce. S S Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No 1:1 Yes ❑ Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No F]Yes ❑ Wetland Area: National Wetland Inventory Map (ma unit) ) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ❑Below Normal ❑ MAY $ Other References Reviewed: DEP APPROVFD FORM-12/0-7/95 FORM 11 - SOIL EVALUATOR l; Itn� Page z of 3 '.tom— .4: as Lot leo. A � T On-site Review - Deep Hole Number 1' Date:_51doo Time:...—. Weather Gool Location (identify on site plan) Land Use —R ,daAVta� Slope (%) JL5 Surface Stones— CoMy'—On Vegetation __ I0.wV) Landform Position on landscape (sketch'on the back) Distances from: Open Water Body. )100 feet Drainage way. feet Possible Wet Area _> loo feet Property Line .. . ±. flet Drinking Water Well -L-12-0 feet Other DEEP OBSERVATION HOLE LOG' W0\e- — A kA � de � Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, Gravel) ERY PRUR=D1SP0SAL_AKtA Parent Material (geologic) e;a,.-)L DepthtoBedrock:_ Depth to Groundwater: Standing Water in the Hole: iJ�,•�C� Weeping from Pit Face: Estimated Seasonal High Ground Water: Re�s�l 01u-e�' -{-o lar bo%A)AvC' IS;Z�, oA 11�.�,:►�L, -- KEY S 60.nd f �"nc VU APPROVM FORl.1• 12/07/95 L S Lo-­_)_) JC")J 5L 5o-n8,� LGaMMt�1�Y�: 5',L 511;` Loar,) C GoC�rSC. 0 0 FORM I I - SOIL EVALUATOR ( OItn1 Pagc 2 of 3 .c; , , Lot iqo. On-site Revie tiv Deep Hole Number 1-2_. Date:.�l_1oo Time:.. Weather Cool p,c Dov Location (identify on site plan) Land Use —_�eS�c1e����a� Slope (%) _ Surface Stones— C0,11,'1,011 Vegetation Cl.wVl Landform -- Position on landscape (ske'tc'h'on the back) Distances from: Open Water Body..*Z ),00_ feet Drainage way. feet Possible Wet Area > I00 feet Property Line .. 55nt-. filet Drinking Water Well 2j-20— feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture• Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Censis, ncy, Gravel) 49-54 SL o-(P-3/Z Ma�s��) 5�- 8l) PJ � SL lo�t� 4/t� amass��c � ��-;�bl•e. 0I- 1301 SL_ ?,5Y514 Parent Material (geologic)_ ^,� LOOS —r,I I Depthtol3edrock: �39 it Depth to Groundwater Standing Water in the Hole: t� 1'3lD Weeping from Pit Face: Estimated Seasonal High Ground Water: KEY DEP APPROVED FOR,Nt- r 12/071.95 L S L,OaMy 50-d M 5;L 54 Loa,^, . o 0 FORM I I - SOIL EVALUATOR F0 I'm P29C 2 of 3 Lot iso. � f o,^e���- 5�2,✓-�' _ On-site Review - Deep Hole Number T Date:._51_1L00 Time:.. Weather tool Location (identify on site plan) Land Use —geSielen tai Slope (°io) L_ Surface Stones— C0rv1v^ Cn Vegetation _ I0'vjV1 Landform M rye. Position on landscape (sketch'on the back) Distances from: Open Water Body. l00 feet Drainage way. feet Possible Wet Area >> 1o0 feet Property Line ..__50t�filet Drinking Water Well . I S0_ feet Other I DEEP OBSERVATION HOLE LOG' a su; �, . Noy. - d%►e- �O Depth from Soil Horizon Soil Textured Soil Color Soil Surface (Inches) (USDA) (Munsell) Mottng (Structure li Other ,Stones,Boulders, Censister,cy, Gravel) ..1 36-�O3 C Parent Material (geologic)_ ct (Anse --r"�-�_ DepthtoBedrock: �nT �F�err-ArC� Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: ►JOr,P _ Estimated Seasonal High Ground Water: -�o ����Q. bot�lc�ers s1-Zt o� Y, KEY S Sand GG T1�G DEP APPROVED FOUL• 12/07/95 L S I,•,oo ray .JlnnC� I 5L 5an8,� i-mm 'C 5;L 511fLoary C Goc��SC� o 0 FORM 11 - SOIL EVALUATOR I;OtZn1 Page z of 3 Lot No. Ora-site Review - Deep Hole Number T Date:. l_ � Time:.. Weather Cool Location (i.dentify on site plan) Land UseeA�'iAI Slope (%) - _ Surface Stones— Co^^'^^aV) Vegetation _ 10.tr�V1 Landform M j-Q_ Position on landscape (sketch'on the back) Distances from: Open Water Body.-� )oo feet Drainage way. feet Possible Wet Area > loo feet Property Line .. .(OD+- fdet Drinking Water Well -Li5_0 feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture`' Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, X Gravel) I Parent Material (geologic) n tgose —r"11 DepthtoBedrock:_ Depth to Groundwater: Standing Via ter in the Hole: t��✓} e� Weeping from Pit Face: Estimated Seasonal High Ground Water: S KEY DEP APPROVED FOR,�1• 12/07/9S L S L Oq>" 5a�d 5L 5an8y LGtitM 'C 5;L 511f Loam G Goa�Sc FORM 11 - SOIL EVALUATOR E;O1Zi\Z page 2 of 3 o Lot No. . A On-site Review - Deep Hole Number . Date:.-5 11.11 00 Time:.: Weather Cool, Location (identify on site plan) Land Use ReSi c e*% ,kt Slope (%) _ Surface Stones— Co'^✓"`a''1 Vegetation - �a.wyl Landform ,- Muria Position on landscape (sketch'on the back) Distances from: Open Water Body. 100 feet Drainage way. feet Possible Wet Area > 100 feet Property Line .. 30* fdet Drinking Water Well 1 1 0 feet Other DEEP OBSERVATION HOLE LOG' No a S� �1�tie� InoVC- - �u6 -�o Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, Gravel) 0-41 rI LL_ — -- — 4�`4S A 4 SL- Io�k31z- Mc, e ',V2) Fri0.�le to-yp- 4/ Mass I vt T7r-;aLl.e- SL z5Y514, MMINIMUM OF 2 HOLES GSs 1 I r Parent Material (geologic) e�cs+t �poc -ri I� DepthtoBedrock: Nod V Depth to Groundwater: Standing Water in the Hote: IJonJ Weeping from Pit Face: Norlt Estimated Seasonal High Ground Water: KEY S Sand '50o-,c)1 DEP APPROVED FORM- 12/07/95 S L oo.r�_) '50o-,c) 5L Sandi C Goa�S� 51,L Silf Loarl 0 0 FORM 11 - SOIL EVALUATOR E O1tM Pagc2of3 Lot i4o. _A On-site Review - Deep Hole Number 1= �0. Date: 15 l 00 Time:.: Weather _Cool p,c 1-..-.. Location (identify on site plan) - Land Use aA�ttA� Slope (%) _ Surface Stones— C01, - '� Vegetation V) Landform Mira-4_ -- Position on landscape (sketch'on the back) i Distances from: Open Water Body.� )00 feet Drainage way. feet Possible Wet Area .>100 feet Property Line Ot filet Drinking Water Well 115-0 feet Other t. I DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Textured Soil Color Soil Surface (Inches) (USDA) (Munn Color Mottling Other ng (Structure,Stones,Boulders, Consistency, Gravel) 77 1 5L lo12_ Mass;ve ) 1 3�— OtS G SL 2,5Y 51 l,5 Y2 46 2 5 Y VL Parent Material(geologic) .td.� Loo SG —r�I�— DepthtoBedrock: Nto+ Depth to Groundwater: Standing Water in the Hole: IVonl� Nom!^ — Weeping from Pit Face: Estimated Seasonal High Ground Water: KEY S Sand G e- VEP APPROVED FORM• 12l07r9S LS 5 L Sandy La�rn rtc d 5;L 511f Loar^ C Gomer Sc o 0 FORM 11 - SOIL EVALUATOR I;Ol;tt1 PagC 2 of 3 Lot No. _Ao�,�� On-site Review - Deep Hole Number �` 7 Date: --a Time:...—. Weather Cool p,c1 Location (identify on site plan) Land UseAekAV%al Slope (%) Surface Stones— Vegetation _ 0"-d V) Landform -- Position on landscape (sketch on the back) Distances from: Open Water Body � )oo feet Drainage way. feet Possible Wet Area > loo_ feet Property Line .. .40t fdet Drinking Water Well -Li-5-0 feet Other DEEP OBSERVATION HOLE LOG* Hole, — Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, X Gravel) .l —�� V 32— cot C Parent Material (geologic) n�.� (pnse 7-,'I�_ DepthtoSedrock: Depth to Groundwater: Standing Water in the Hole: 10"C� Weeping from Pit Face: Estimated Seasonal High Ground Water: Re�v�a� comer 40 +ZC of r..aGksn — KEY S Sind F c DEP APPROVED FORM- 12/07195 LS Loom_) 5c%"1c) 5L 5ar'8'� LtxlM C GoNr'SIC 5 L Sill- LUar, FORM 11 - SOIL EVALUATOR I;01 m Page 2 of 3 t �QQr� Lot No. A On-site Review - Deep Hole Number T` Date:_Sk I_cc Time:.: Weather Cool Location (identify on site plan) - Land Use ReSiAe*,4t0.3Slope Surface Stones- C�^^✓^a''1 Vegetation —dawn Landform Position on landscape (sketch'on the back) Distances from: Open Water Body__ 100 feet Drainage way. feet Possible Wet Area -> 100 feet Property Line .. )5} fdet Drinking Water Well LL-5-0feet Other t� DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texturev- Soil Color Soil Surface (Inches) Other(USDA) (Munsell) Mottli ng (Structure,Stones,Boulders, Consistency, Gravel) . 1 SL Ic, P.3/z McLssiv2) Fria��e 8 - 31 4P s L 31-15 C SL 2,sYs/4 Miss w �r��5� 11 Parent Material (geologic) '1�C 1p$4� 7_11 Imo_ DepthtoBedrock: TJO t '4 t'r ^^rn-e O Depth to Groundwater: Standing Water in the Hole: QD Ng Weeping from Pit Face: Estimated Seasonal High Ground Water: Re�.�s�1 due -�-0 1�.�a�. bou Ia;e,►-� 'S tZE of rno,c�l,^.�, - �U(�r e..14.I�q�-;.;._ ;''��cl. KEY S 6 .nd ��nL DEP APPROVED FORM- 12/07/95 L S L oo m Sand � �I � � r✓1 MC-�1 vr-; 5L 5a^8,y I-Mm C G o arSC 5;L Silt Loa,,/) fo 0 FORM 11 - SOIL EVALUATOR FO%N1 Page 3 of 3 r atio„ A Fla. Lot No. Determination for Seasonal High Water Table Method Used: Depth, observed standing in observation hole 13Co inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles 43 inches ❑ Ground water adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on Qct. I1a. 19g5 (date) I have passed the soil evaluator examination approved b the Departmentof 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 lu X00 DEP APPROVED FOR:Ni-12/07/95 Mt o - o FORM 12 - PERCOLATION TEST Lot N o. Y'�'5 'roCe_S}' G+Ttd.� COMMONWEALTH OF MASSACHUSETTS N6r�n A-\r�over' , Massachusetts Percolation Test` Date: Z° Time:, Observation Hole # Depth of Perc 21 +-Z2 = 51 Start Pre-soak End Pre-soak 3 2� Time at 12" Time at 9" 3�35 . Time at 6" Time (9"-6") Rate Min./Inch s Mil s Nlinhnum of 1 percoiaiion test must be performed in both the primary area AND reserve area. Site Passed U Site Failed ❑ Performed By: C�,Nr�eS 0,Jen t�s1rG�:'�. Enq�ne�`m� fissoua�e5 Witnessed By: Garl-Ort ,� ��o�+ �ha��ee� ;��> - til•A��o.�� 90H - Comments: . . ,............_. ..._..N...� .,.w.w.__ �_ ..._.� w......,....... .�__ _� __..-.. .._-�...�..........� Mw.- -_ .....,..._ • DEP APPROVED FORM-12/07/95 O HANCOCK JOB Engineering Associates SHEET No. of 235 Newbury Street,Danvers,MA 01923 n— (978)777-3050 Fax(978)774-7816 CALCULATED BY G� DATE 511 LP /1LD 00 ❑12 Farnsworth Street ❑626 Main Street Boston,MA 02210 Bolton,MA 01740 CHECKED BY DATE (617)350-7906 (978)779-6767 SCALE �O—r —TO SCALE .......... TQvvQCF _ a - P 0 .. 0 0 0. LEU E ........ ouTG KoP b 11T `j ........... ..... ... ......... / 1 l i T. T 7 1 . .. Z f P-I ® � r _... ....... ...... ... 6__. .. .. _.......- -N �T-7 o 0 ) t f. - ?, ...... TELL i ...... �� `` . SToNEGLEA �$o�cFoRD� PRODUCT 204-1 ISinale Sheels1205-1 IPaddedi 0 0 -DETACH HERE- - . • . DETACH HERE - - - - - DETACH HERE - - - - - DETACH HERE - - - - - DETACH HERE DETACH HERE- SEE REVERSE SIDE FOR IMPORTANT INFORMATION Interest at the rate of Ift per annum will 7349 RE accrue on overdue payments from the due date until payment is made. l I �1NT 0 ire 11IElfr � . 1 3— A �� ilil`11IiE 1$/+g1�1993 �t 0� ROTH, SCOTT D Loc: 0 FOREST STREET Parcel Id: 105.B 0002 0000.0 This form approved by the Commissioner of Revenue 2000 QUARTERLY REAL ESTATE MAKE PAYMENTS TO THE COMMONWEALTH OF MASSACHUSETTS 7349 RE TOWN OF NORTH ANDOVER NORTH ANDOVER Loc:B�-�F � rREET P. 0. BOX 124 OFFICE OF THE COLLECTOR OF TAXES Id: 105.B 0002 0000.0 NO. ANDOVER, MA 01845 Your Preliminary Tax for the Fiscal Year 2000 Deed/Legal: 04072 0033 M-F 8:30-4:30:11/1 TO 7:30PM beginning July 01 19% and ending June 30 2000 Land Area: 2.86 (ac) TAX 688-9550/ASSR 688-9566 on the property described is as follows: First Amount Interest Second Amount Interest 1-TAX 21.02 0.00 2-TAX 21.02 Q T(it€ � 1 �f FAX ROTH, SCOTT D : MARY L ROTH -Q 66 STONECLEAVE ROAD BOXFORD MA 01921 }IblE�1PCT is 117 1 Miscell eous -Purch se CDs Free -Mail - ee hat/M.B. -Li s - Lin s Site J­ -Cop f _.. -Cop rig t -Sta /Cre "ts Fee _ ac_k -E- ail Us -N w G-Book s d G-Book j.; ' r http://www.angelfire.com/or2/LyriesNow/Directory.html 2/29/00 O BOARD OF HEALTH 0 NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: March 13, 2000 IMAP & PARCEL: Map 105B, Lot 2 LOCATION OF SOI. TESTS: Lot 2, Forest Street OWNER: Scott Roth TEL. NO.: 978-887-9254 ADDRESS: 66 Stonecleave Road, Boxford, MA 01921 ENGINEER: Hancock Engineering Associates TEL.NO.: 978-777-3050 CERTIFIED SOIL EVALUATOR: Charles R. Ogden Intended use of land: Residential Subdivision ingle Family Home Commercial Is This: Repair testing Undeveloped lot testingy s In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of$275.00 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 wades. GENERAL INFORMATION _ I 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line i we-4t-d' av N.A. Conservation Commission Approval: ( 'eQ� � af,111 Date Received: Check Amount: _ Check Date: _ 1 'f11� �IIilIilNiii �1 ' � IIIIIINOIIIII IHIMIMI Ii11111111111111111111111�1 11 . . - t IIIIIHIIIIIILCN��'5��� -� IHIII��II�i®1111!!1! 111 S�11111111HE IIHlhl�ii • - � - 111 Ili�11111111l,�i1N111��";wa��!111 � a ll IIIh ,NNIN111 1116"'1103 l • ��; !11101111111111W11 111NPi�I � �, 1111111111111111®1 11111.�11i■■.., 1�1 �i1E in11NN _�J1111111NE'� � BrilliIIIH�IIHIMIn11111111:� 'fir12]III INN INNEW ilRN Iliiiil INE 1011 mall gnu ° � �: IHIIIINH INI ILII _ IIIHIIHIHII 111 HIIIIIIII� � • NIN�nnI1HE`�����:� 111 H���.E�1111 l M'O i %it = LOU r r i J • • • S r + r r � n C �� �—������I�i�i��—�5. —�S♦tib rr-r■■rrar■■r�rrrrr ■�� --��s-r— `i��www �■�� - - -rrr �■EM ZN W Uum ter- r-�i rmr rrr� .�rr■m m mmr r-r __s si MONE ..-. s s _s-sas:--:_sssss�ss ---■■ rrrrrrr rrrrr�- � rr� rrrsrr-r�■rr-rr �- s=s-ssssssssss-ssss� rr�i �issi-s��-�w-= rssr s-s - - -'�-srr �■ 3 a 1< 0 i O T1- j - + -- ► a il ' C 14 ! 1 i'�.-�T� t ..� �T"r�--1 � �.__-1.-. 1 i -- T 77, i II tt ! May-01-00 04: 12P Paul Q Turbide, PE/PLS 978-465-0313 P.01. Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Carlton A. Brown Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 465-0313 Date May 1, 2000 Pages Including This Cover Page: 5 Comments: Sandy, Enclosed are the results of the pert test done by Hancock Survey at Lot A Forest Street (by 66 Stonecleave Road, Boxford). The area by the horse barn was tested first. There was extensive fill in this area, and interlocked boulders kept the backhoe from going down into the C horizon to the required depth. A second area by the house was next tested. Only one deep test pit (T6)had an adequate depth of C horizon and only one pert test was performed next to Test Pit T6. It is my opinion that this area will probably be adequate, but a mid-size to large excavator must be used to get down through the boulders. (The backhoe just did not have enough power.) I would like to charge for three(3) extra test pits ($150.00) for atotal of $400.00. I believe that Hancock Survey will be scheduling another day to finish the testing. I would like to have a total of at least 3 test pits in the area of the leaching bed and another pert test. I imagine that our fee would be another$250.00 for the future testing. Thanks Carlton LOC A 71 ^.TION T � C T",T �O -1 01v1 J E=T. C1 _ lirvlE .A T COARD OF HEALTH Q NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 7k&) MAP & PARCEL: /OSs- a i 13 LOCATION OF SOIL TESTS: 6d �c S i �r OWNER: S c-o T Q o-T-a TEL. NO.: 9 l ADDRESS: !o G sYM-EeC. & jf o9o Ap,, 2E(z,,x E02D, Mfg Z HAr300eK 'pflrjv&A) ENGINEER: C qmw-C4 OGS ,. End 6��►�r.F R�a�� TEL. NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision ingle Family Home Commercial Is This: Repair Testing: Undeveloped lot testing: JUL In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$275.00 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 two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: NaRTh Town Of North Andover William J. Scott Community Development & Services Director • • 27 Charles Street ' (978) 688-9531 ----• •''' North Andover, Massachusetts 01845 ACNus Fax 978-688-9541 Board of May 2, 2000 Appeals (978)688-9541 Building Charles Ogden Department Hancock Survey Associates (978)688-9545 235 Newbury Street Danvers, MA 01923 Conservation Department (978)688-9530 Re: Lot A Forest Street Health Department Dear Mr. Ogden: (978)688-9540 Three additional test pits needed to be performed on Lot A Forest Street. There is Public Health a charge of one hundred and fifty dollars ($150) for each additional test pit for a Nurse total of four hundred dollars ($400). (978) 688-9543 Please send a check made out to the Town of North Andover and mail it to Board Planning of Health, 27 Charles Street, No. Andover, MA 01845. Department (978) 688-9535 If you have any questions, please do not hesitate to contact this office. Sincerely, Sandra Starr, R.S., C.H.O. Health Director HANCOCK Engineering Associates ' 235[Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)7747816 L3 12 Farnsworth Street ❑626 Main Street DATE roe No. Boston,MA 02210 Bolton,MA 01740 Z 5(t� t`97�3 (617)350-7906 (978)779-6767 ATTENTION TO (V or4� A l lir &,tJ J 4eoP� RE: LV-� L- r-. (- ` S � 27 c6g les sem- - )\)a(-N AnaoAEe MR 01b4_9 WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items_ ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ 25 of ►slo ■%rVvjv OF NO JUL 2 6 ) THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: If enclosures are not as noted,kindly notify us at once. lD�{(�T Scale—' I'' 4,o' ��5 �03 eRe 3� FOS r pCC`T (PUBL IC pAS,3,4 AN NO- FST (PUB /� C J (P4 AN NoG�e-4Se AN FROM FL (tio RECORD WIDTH) TREE T ° 780) MER1°1 S S c Fj O O� r 2 OF `SFF li'��T � o� SINE /p� N Fjgl �o �`O S � 27 X34' . 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