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Miscellaneous - 155 BOSTON STREET 4/30/2018 (3)
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Page 1 of 1 • a K NOR7M North Andover Board ofAssessors of «.o.•'Lyc maw# _ "SS,cHuSe` roperty Record Card Click Seal To Return Parcel ID:210/107.B-0046-0000.0 FY:2011 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge A{ Search for Parcels Search for Sales _ yr Summary Residence Detached Structure Condo 155 BOSTON STREET Commercial Location: 155 BOSTON STREET Owner Name: ALLEN,STEWART JOSEPH Owner Address: 155 BOSTON STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:5-5 Land Area: 0.57 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 994 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 284,400 290,400 Building Value: 92,900 .98,900 Land Value: 191,500 191,500 Market Land Value: 191,500 Chapter Land Value: LATEST SALE Sale Price: 275,000 Sale Date: 12/10/2003 Arms Length Sale Code: Y-YES-VALID Grantor: SUSAN MARTINO Cert Doc: Book: 08456 Page: 0256 http://csc-ma.us/PROPAPP/display.do?linkld=1708696&town=NandoverPubAcc 4/28/2011 II Residential Property Record Card PARCEL_ID:210/107.6-0046-0000.0 MAP:107.B BLOCK:0046 LOT:0000.0 PARCEL ADDRESS:155 BOSTON STREET FY:2011 PARCEL INFORMATION Use-Code: 101 Sale Price: 275,000 Book: 08456 Road Type: T Inspect Date: 06/17/2004 Tax Class: T Sale Date: 12/10/03 Page: 0256 Rd Condition: P Meas Date: 06/17/2004 Owner: Tot Fin Area: 994 Sale Type: P Cert/Doc: Traffic: M Entrance: X ALLEN,STEWART JOSEPH Tot Land Area: 0.57 Sale Valid: Y Water: Collect Id: RB Address: Grantor: SUSAN MARTINO Sewer: Inspect Reas: S 155 BOSTON STREET NORTH ANDOVER MA 01845 rExempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / RESIDENCE INFORMATION LAND INFORMATION Style: RN Tot Rooms: 6 Main Fn Area: 994 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: R2 Story Height:_ 1.00 Bedrooms: 3 Up Fn Area: Bsmt Area: 994 Seg Type Code Method Sq-Ft Acres -Influ-YIN Value Class Roof: G Full Baths: 1 Add Fn Area: Fn Bsmt Area: 1 P 101 S 25003 0.570 191,528. Ext Wall: AV Half Baths: Unfin Area: Bsmt Grade: DETACHED STRUCTURE INFORMATION Masonry Trim: Ext Bath Fix: 0 Tot Fin Area: 994 Foundation: CN Bath Qual: T RCNLD: 91821 Str Unit Msr-1 Msr-2 E-YR-BIt Grade Cond%Good P/F/E/R Cost Class Kitch Qual: T Eff Yr Built: 1965 Mkt Adj: SE S 150 0.00 2000 A A /50//47 1,100 1 Heat Type: HW Ext Kitch: Year Built: 1958 Sound Value: VALUATION INFORMATION Fuel Type: O Grade: A Cost Bldg: 91,800 Current Total: 284,400 Bldg: 92,900 Land: 191,500 MktLnd: 191,500 Fireplace: 1 Bsmt Gar Cap: Condition: A Aft Str Val 1: Prior Total: 290,400 Bldg: 98,900 Land: 191,500 MktLnd: 191,500 Central AC: N Bsmt Gar SF: Pct Complete: Att Str Val2: Aft Gar SF: %Good P/F/E/R: /100/100/73 Porch Type Porch Area Porch Grade Factor P 46 E 150 W 120 SKETCH PHOTO � . is 10 E 10 „ 150 Sq.Ft '" -- is 10 12 W 12 120 Sq.Ft i ,,. S= FM/B 24 994 Sq.Ftin 23 23p Z 17 s i.- 46 Sq.Ft 155 BOSTON STREET Parcel ID:210/107.B-0046-0000.0 as of 4/28/11 Page 1 of 1 I • S�ILED 16g6 • PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 11/13/2015 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Full Repair/Replacement of an On-Site Sewage Disposal System By: James Kellett At: 155 Boston Street Map 107B Lot 0046 North Andover, MA 01845 li Issuance ofthis cexC kificathall not be construed as a guarantee that the system will function satisfactorily. chele Grant Public Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 7t D JAN 0 b 2016 }T" TOWN OF NORTH ANDOVER HEALTH DEPARTMENT PUBLIC HEALTH DEPARTMENT Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( )constructed;O repaired; By: 1 K I_I tft� (Print Name) A Located at: /�� /9,'�S�At of 10o aw H ✓Pa,2-e_ (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated 7-2.5- it and last revised on j 0._3 // ,with a design flow of 3 3 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. Bottom of Bed Inspection Date: %/ 3-- Engineer Representative(Signature) And-Print Name Final Construction Inspection Date: /I (-_ - Engineer Representative(Signature) 3 I c vt Ice VK' . l'4_ And-Print Name Installer• (Signature) Date:— And-Print Name Engineer: (Signature) '2. /D/jate:_ /�/+�J- And-Print Name 1600 Osgood Street, North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com • S�ED'`T SS' _ 606 • North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 155 Boston St. MAP: 107.13 LOT: 0046 INSTALLER: Jim Kellett DESIGNER: originally Richard Tangard/ now Ben Osgood PLAN DATE: 7/25/11 revised 9/19/11 BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: 10/30/15 see pictures DATE OF BED BOTTOM INSPECTION: 11/3/15 DATE OF FINAL CONSTRUCTION INSPECTION: 11/13/15 DATE OF FINAL GRADE INSPECTION: ' Q& SITE CONDITIONS ® Contractor reports any changes to design plan ® �xisting septic tank properly -abandoned' bandoned' ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ® Cleanouts per plan ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (effluent filter) ® 20" inch cover to finish grade installed over one access port ® Neoprene boots around inlet & outlet Comments: PUMP CHAMBER ® Bottom of tank hole has 6" stone base —took pictures ® Weep hole plugged ® 1000 gallon Pump Chamber installed ® H-10 loading ® Monolithic tank construction ® Inlet tee installed, centered under access port ® Pump(s) installed on stable base ® Alarm float working ® Pump On/Off floats working ® Separate on/off floats ® Drain hole in pressure line ® 24" cover at final grade installed over pump access port ® Water tightness of tank has been achieved by Visual testing ® Neoprene boots around inlet & outlet Comments: CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement ® Alarm signal located inside: basement Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution N/A Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: SOIL ABSORPTION SYSTEM (General) ® Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder/concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ® Number of chambers per row: 6 ® Number of rows (trenches): 5 Comments: Total Chambers = 30 FINAL GRADE Loamed s�J� F1 Seeded ❑ Cover per plan Comments: DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by ngineer and installer As-Built Plan BM = 101.06 HR = 1.71 HI = 102.77 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 9.00 93.42 95.00 Septic Tank IN 9.31 93.11 94.80 Septic Tank OUT 9.68 92.74 94.65 Pump Chamber IN 9.71 92.71 94.55 Pump Chamber OUT (2") 9.41 93.19 94.30 Distribution Box IN (4") 5.43 96.99 96.94 Distribution Box OUT 5.61 96.81 96.77 Lateral 1 TOP 5.80 Lateral 1 INVERT 96.62 96.67 Lateral 2 TOP 5.80 ' Lateral 2 INVERT 96.62 96.67 Lateral 3 TOP 5.80 Lateral 3 INVERT 96.62 96.67 Lateral 4 TOP 5.80 Lateral 4 INVERT 96.62 96.67 Lateral 5 TOP 5.80 Lateral 5 INVERT 96.62 96.67 Top of Chamber 5.76 97.01 97.00 Bottom of Bed/Chamber 96.01 96.00 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- Waterline 10 10 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot.Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other)Foundation 10(5) 20(10) ® Drywells 20 25 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws I AJ 04--L- Nf P) �f l i R �I i) i� �o Town of North Andover — Septic System - AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected and noted on the as-built plan 2) /As-built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans) 3) "/Street Address,Assessor's Map and Lot Number 4) '/ Lot Lines and Location of Dwellings served by the system 5) Locations,Elevations and Dimensions of As-built system components,includitig=reser(if applicable) 6) V//Ties to all tank openings,d-box,and leach area from dwelling or Permanent Structure ✓Setback distances are shown on the as-built plan from system components to: A Subsurface,interceptor&foundation drains _ f Catch basins ✓ Property lines M A Dwellings or other structures t�Q Private water suppl gatJ` wells Watercourses or .etia�nn 8) ✓ Locations of Wells,Drains, etland Resource Area within 150 feet of system 9 Location of wateras electric lines cable,control n gpanel (1f applicable) 10) J Location of Structures within 6 Inches of Finished Grade 11) Original Stamp&Signature 12) Location and holder of any easements which could impact the system 13) Impervious Areas;Driveways,etc 14) y North Arrow 15) ✓ Location&Elevation of Benchmark used 16) STATEMENT ON PLAN (NA 5.3) a. "I certify the locations,elevations, ties,cover material;exposed component covers etc., shown on this as-built substantially agree with the approved plan and have determined that the break out elevations,if applicable,have been met." Signature of Designer Date b. "If a STUCTURAL WALL IS PRESENT(NA 4.9)a Letter or statement on the as-built indicating the wall- was,or was not,constructed in accordance with the intended design and any manufacturer's specifications." Signature of Designer g gn Date As of:Thursday,January 14,2016 Grant, Aichele From: martin@avproworldwide.com Sent: Wednesday, November 04, 2015 8:01 AM To: Grant, Michele Subject: Garbage disposal. Attachments: FuIlSizeRender jpg; FuIlSizeRender jpg Good morning Michelle, As promised,photos of the garbage disposal,now removed from under the kitchen sink at 155 Boston St.No.Andover. Best, Martin Allen Sent from my Phone I i i v: khat= 0.Y' r x x V ,t� A M' � g .c. x ` , c 4 t k ¢ A I � d� r �S • �� ir.Ef/)- ` , Commonwealth of Massachusetts Map-Block-Lot 107.B0046 BOARD OF HEALTH Permit No ----------------------- North Andover BHP-2015-0393 --------------- -- FEE $250.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted lames Kellett to(Construct)an Individual Sewage Disposal System. at No 155 BOSTON STREET as shown on the application for Disposal Works Construction Permit No. BHP-201LI-COR ated September 24,2015 Y-- Issued On: Sep-24-2015 BOARD OF HEALTH I entrsy�• ) I •. Application for Septic Disposal System 0�`1 TODAY' DATE Construction Permit - TOWN OF NORTH ANDOVER, MA 01845 Q25O.000Com Important: Application is hereby made for a permit to: When filling out ❑Construct a new on-site sewage disposal system" forms on the computer,use Repair or replace an existing on-site sewage disposal system* only the tab key to move your ElRepair or replace an existing system component—What? cursor-do not use the return A. Facility ITorm t10 y key. Address or Lot# rab (boon City/Town 2.-*T PE OF SEPTIC SYSTEM*: ➢ 0o2&Pump ❑Gravity(choose one) ***If pump system, attach copy of electrical permit to application*** ➢ Conventional System (pipe and stone system) ➢ Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system.) ➢ Pressure Distribution S.A.S.(No D-Box) ➢ ❑ Pressure Dosed(D-Box Present)S.A.S. ➢ ❑ Does the system require an effluent filter? Yes No if yes, does plan specify make and model of filter? YES =(no further info. needed) NO=(installer must specify brand of filter before DWC issuance) What is the Make?7 A 6W What is the Model. 2. Owner Information Name r AXV ` M Address(if different from above) A City/Town State Zip Code Wer,)@Avffoocs7c> aJe oco44 Email address Telephone Number 3. Installer Information Sbg'_Ct? 4AO o i LA " fl�) Narpe Name of Company b sa dress City/ oMA State Zip Code Telephone Number(Cell Phone#if possible please) 4. Designer Information o i 4 6, �,a f4 n,A Name � Name of Company Y�C 171r Ales i , M6 IVA City/ own Stat ip Code pA54 � Tel phone Number(Best#to r ch) Application for Disposal System Construction Permit*Page 1 of 2 •. q 4Application for Septic Disposal System Construction Permit — TOWN OF TODAY'S DATE NORTH ANDOVER, MA 01845 $250:00-Funp neat PAGE 2OF2 A. Facility Information continued.... 5. Type of Buildinq:pResidential Dwelling or❑Commercial B. Agreement �' ` The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of lyooh Andover. I understand-Oat until a final Certificate of Compliance has been issued by f 's oard of Heal ,the al d system is not approved. 1lll�� d 7 /?, ame Date A cat' n Approve B oard o Health RepresentgAve)Ll - i5 Name Date Application Disapproved for the following reasons: For Office Use Only: Z Fee Attached? Yes(. No 2. Project Manager Obligation Form AttachedP Yes No 3. Pump System? If so,Attach copy of Electrical Permit Yes No Applicant received copy of "Electrical Inspection Notes for Septic Systems" Yes No Handout? 4. Reviewed approval letter, all paperwork received. Yes No Missing' 5. Foundation As-Built?(new construction only): Yes No (Same scale as approved plan) 6. Floor Plans?(new construction only): Yes No Application for Disposal System Construction Permit•Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: 155`b4m� (Address of septic system) For plans by 70nov,-(a (En ' er) Relative to the application of Taw t And dated (Installer's na e) ` rigina ate Datedoil -. 01— ay s ate (Last revised date) I understand the following obligations for management of this 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 manager,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 Title 5 and the Board of Health Regulations may result in a$50.00 fine being levied against me and/or my company. a. Bottom of Bed—Generally, this is the first (1'� inspection unless there is a retaining wall,which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection—Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OK (or e-mail to: healthdept(@townofnorthandover.co from the engineer must be submitted to the Board of Health,after which installer calls for an inspection time. Installer must be present for this inspection. With a 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. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done 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 Healtb staff or consultant. d. Installation of tank, D-Box,pipes, stone, vent,pump chamber, retaining wall and otber 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. Undersigned Licensed Septic Installer: (Today's Date) 9� J��rh�sel (( a�Print) (N igne 1 { 7 LLEf I t ! f �l September 20, 2015 MR. STEWART ALLEN 155 BOSTON STREET NORTH ANDOVER, MA 01845 508-479-4001 CELL Dear Martin: The following is a summary and detailed scope of work included under the contract agreement to install a new septic system at 155 Boston Street North Andover. Approved Plan was designed by the late Richard Tangard. Original date was July 25, 2011 and revised date of September 19, 2011. Estimate Job 155 BOSTON STREET Estimate Number 693 Estimate Amount $23,236.00 Itemized charges are shown below: Item Description Amount DIG SAFE CALLING DIG SAFE FOR UNDERGROUND NOTIFIED UTILITIES TO BE MARKED FOR EXCAVATION ERROSION PLACE SILT FENCE AND OR HAYBALES TO STOP 250.00 CONTROL ANY DEBRIS FROM ENTERING THE WETLAND BUFFER ZONE PERMIT FEE PERMIT COSTS PAID TO YOUR TOWN NORTH 250.00 ANDOVER(3 BEDROOM) TRENCH PERMIT REQUIRED BY STATE FOR ANY 100.00 PERMIT EXCAVATING PUMPING PUMPING OUT OLD SEPTIC TANK SPECIFIED BY 250.00 TANK(S) PLANS EQUIPMENT COSTS OF EXCAVATOR MOVE TO JOB SITE 250.00 MOVE BOBCAT MACHINE TO FILL IN OLD SEPTIC TANK UNDER 320.00 MACHINE DECK WITH 3/8" PEA STONE PEA STONE PROPER STONE SIZE TO FILL EXISTING TANK AS 280.00 PER TITLE V CODE EXCAVATOR MACHINE TO EXCAVATE FOR NEW SEPTIC 1,000.00 MACHINE TANK AND PUMP CHAMBER LABOR LABOR FOR JOB TO SET TANKS TO PROPER 400.00 ELEVATION STONE 3/4" CRUSHED STONE TO SET TANKS ON FOR 250.00 PROPER BASE SEPTIC TANK + APPROVED 1500 GALLON MONOLITHIC SEPTIC 1,650.00 RISERS TANK SPECIFIED BY PLANS AND STATE CODES PUMP INSTALLATION OF A 1000 GALLON MONOLITHIC 300.00 CHAMBER PUMP CHAMBER AS SPECIFIED BY PLANS ($650.00 STANDARD ELECTRICAL ALLOWANCE INCLUDED) RISERS SEPTIC TANK RISERS TO BRING TO WITHIN 172.00 GRADE 2 risers PLUMBING PLUMBING AS NEEDED FOR ANY CHANGE 800.00 MADE IN THE HOUSE ( ALLOWANCE ONLY) PIPE & ALL PROPER PIPE & FITTING AND D- BOX TO 550.00 FITTINGS INSTALL SEPTIC SYSTEM SPECIFIED BY PLANS EXCAVATOR MACHINE TO EXCAVATE NEW LEACH FIELD 1,000.00 MACHINE TRUCKING RENTAL TIME FOR REMOVING MATERIAL OUT 640.00 OF JOB SITE MEMBRAIN RETENTION MEMBRANE INSTALLED AROUND 350.00 LEACHING FIELD AS PER PLAN t LEACHING TITLE 5 APPROVED SEPTIC SAND C-33 OR 3,750.00 SAND CONCRETE SAND IS NEEDED FOR NEW INFILTRATOR LEACHING FIELD ( 200 TONS C-3 3 SAND ALLOWANCE SET BY PLANS) EXCAVATOR MACHINE TO CAST SAND INTO NEW LEACH 800.00 MACHINE FIELD INFILTRATORS ALL INFILTRATOR UNITS WITH FRONT AND END 1,100.00 CAPS LABOR LABOR FOR JOB TO SET D-BOX AND 880.00 INFILTRATORS OF NEW LEACH FIELD (SET BY ENGINEERED PLANS) EXCAVATOR MACHINE TO SET FINAL GRADE OF SEPTIC 800.00 MACHINE SAND AROUND ALL INFILTRATORS IN FIELD EXCAVATOR MACHINE TO BACK FILL AN INSPECTED 800.00 MACHINE LEACHING FIELD AND TANKS WITH CLEAN USABLE (ONSITE) MATERIAL BOBCAT MACHINE TO SET ON SITE MATERIAL TO 240.00 MACHINE ROUGH GRADE FOR LOAM LOAM LOAM FOR ALL DAMAGED AREAS TO BE 1,000.00 PREPPED FOR SEEDING (ALLOWANCE BY PLAN) BOBCAT MACHINE TO SPREAD OUT LOAM FOR SEEDING 480.00 MACHINE HYDROSEED HYDROSEEDING ALL LOAMED AREAS FOR 600.00 FASTER AND PROPER GROWTH STUMP DESTUMPING 3 STUMPS TO BE DUG OUT AND 450.00 REMOVAL REMOVED OFF PROPERTY EXTRAS ANY UNFORESEEN OR ADDITIONAL WORK WILL COMMENCE AFTER RECEIVING WRITTEN OR VERBAL CONFIRMATION OF THE EXTRA WORK REQUIRED EXTRA SAND ANY APPROVED SAND OVER ESTIMATED AMOUNTS IN PROPOSAL WILL BE BILL OUT AT $24.00 PER TON INSTALLED DUE TO INCONSISTENCY OF EXISTING C LAYER THAT MAY REQUIRE ADDITIONAL MATERIAL. DAMAGE ANY UNAVOIDABLE DAMAGED CAUSED TO FAULTY OR OLD CURBS, WALKWAYS, AND DRIVEWAYS CAUSED BY HEAVY EQUIPMENT NEEDED TO COMPLETE WORK SHALL BE TREATED AS A SEPARATE REPAIR AT HOMEOWNERS EXPENSE (PLYWOOD WILL BE USED ON TOP OF DRIVEWAY FOR EXTRA PRECAUTION) ENGINEERING ANY AND ALL EXTRA ENGINEERING FEES ACCRUED TO FEES COMPLETE JOB WILL BE AT HOMEOWNERS EXPENSE LEDGE ANY LEDGE OR ROCK OVER 1 CUBIC YARD SHALL BE FACTOR REMOVED TO INSPECTORS AND OR ENGINEERS SATISFACTION AS AN EXTRA EXPENSE TO BE DETERMINED COLLECTIONS ANY AND ALL LEGAL AND OR COLLECTION FEES DUE TO COLLECTION OF MONEY FOR WORK COMPLETED SHALL BE AT THE HOMEOWNERS EXPENSE PAYMENT 1/3 ESTIMATE AS DEPOSIT AT START OF EXCAVATION, SCHEDULE 1/3 ESTIMATE TO BE PAID UPON DELIVERY OF APPROVED SAND, FINAL PAYMENT TO BE PAID IN FULL ON DATE OF COMPLETION. ALL EXTRAS ARE TO BE PAID ON DATE OF COMPLETION OF EXTRA WORK AGREED UPON. WARRANTEE THIS SYSTEM CARRIES A TRANSFERABLE WARRANTEE FOR FIVE YEARS THAT COVERS ANY FAILURE OR DEFECT IN THE COMPONENTS OF THE ENTIRE SYSTEM. EXCLUDING ANY FAILURES CAUSED BY ABUSE OR NEGLECT SUCH AS ABSENCE OF YEARLY TANK PUMPING, HEAVY WATER OR GARBAGE DISPOSAL USAGE, OR ANY HEAVY EQUIPMENT OR VEHICLES OR SYSTEM, OR ANY OTHER ABUSE NOT PERTAINING TO THE STANDARDS USE OF THE DESIGNED SYSTEM. AGREEMENT I HAVE READ AND UNDERSTAND THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS. THEY ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO BEGIN PROJECT SPECIFIED ABOVE IN CONTRACT.(PLEASE SIGN BELOW) James R. Kellett Itt Excavating Date ,� r Stewart Allen H eowner Date Q k • North Andover Board of Health Meeting Minutes Thursday— September 24,2015 7:00,p.m. 120 Main Street,2nd Floor Selectmen's Meeting Room North Andover,MA 01845 Present: Thomas Trowbridge,Larry Fixler,Edwin Pease,Susan Sawyer,Michele Grant(2 members out) I. CALL TO ORDER The meeting was called to order at 7:05 pm. IL PLEDGE OF ALLEGIANCE III. PUBLIC HEARINGS IV. APPROVAL OF MINUTES Meeting minutes from June 25,2015 and August 27,2015 were presented for signature. MOTION was made by Mr.Fixler to approve the minutes for June 25,2015,the motion was seconded by Mr.Pease,all were in favor and the minutes were approved. MOTION was made by Mr.Fixler to approve the minutes for August 27,2015,the motion was seconded by Mr.Pease,all were in favor and the minutes were approved. V. OLD BUSINESS VI. NEW BUSINESS A. 155 Boston Street—Stewart Allen,owner of 155 Boston Street.Mr.Allen is in violation of Mass DEP Environmental Code regarding a failed subsurface disposal system that has exceeded the allowed time for replacement.Michele Grant,Public Health Inspector,gave the back ground history on the failed septic system at 155 Boston Street.Mr.Allen has an approved plan.With the permit extension act,this plan expires on September 30,2015.Mr.Allen approached the podium and addressed the Board.Mr. Allen explained that as of this week a permit was pulled,a contract was signed with an installation company,the plans are approved and he is ready to go ahead with the installation.Mr.Allen apologized to the Board for waiting so long to go ahead with the installation.Due to the previous engineer passing away,Mr.Allen needed to find an engineer to move forward on someone else's plans.JM Engineering will be taking on the job and Mr.Allen will send an email to the Health Department stating that.Mr.Allen stated that he was financially able to move on with the installation. Ms. Grant described the type of system that will be installed and the location of the system.The approved septic plan was shown to the Chairman and a discussion regarding the system ensued.Dr. Trowbridge asked Mr.Allen if his installer was aware of the time limit to get the new system into the ground.Due to freezing of the ground,there is a time limit in North Andover in which the septic season ends.Mr.Allen stated that his installer is well aware of the time limit.Mrs. Sawyer informed Mr.Allen that there is a state tax credit for installing a new septic system and for Mr.Allen to check with his tax accountant.Mr.Allen was not aware of the tax credit and thanked her for making him aware of it.Dr.Trowbridge stated that other than the confirmation of the engineer,there is no 2015 North Andover Board of Health Meeting Page 1 of 4 Board of Health Members: Thomas Trowbridge,DDS,MD,Chairman;Larry Fixler,Member/Clerk;Francis P.MacMillan,Jr., M.D.;Joseph McCarthy,Member; Edwin Pease,Member Health Department Staff:Susan Sawyer,Health Director; Debra Rillahan,Public Health Nurse;Michele Grant,Public Health Inspector;Lisa Blackburn,Health Department Assistant additional action needed by the Board at this time.Mr.Allen stated that he will have the information sent to the Health Department in the morning. VII. COMMUNICATIONS,ANNOUNCEMENTS,AND DISCUSSION A. Mr.Fixler reviewed the roles of the BOH members and the Health Department staff. Some of the reasons why a person would appear before the Board of Health is to ask for local approval upgrades for variances on septic,ask for modifications for rules or regulations where they can't comply due to a hardship,businesses that fail to follow the sanitation code or food code,landlords/renters who might fail to follow the human habitation,failure to follow trash truck routes,swimming pools that might need a for variance to not have lifeguards,food labeling issues or recreational camps for children that fail to follow rules,or proper CORI's and SORI's. Susan Sawyer,Health Director,stated that recreational camps and most other applications are permitted in house and only come before the board if there is an issue.The BOH members also write rules and regulations to protect the public health. Mass. General Law gives the Board the right to act. The board consists of five members and the Health Department consists of,Susan Sawyer,Health Director,Michele Grant,Health Inspector,Debbie Rillahan,Public Health Nurse and Lisa Blackburn, Health Department Assistant.The BOH members give their authority to the agents in the Health Department to initiate,inspect,and advise.The agents act on the Board's behalf.Besides once a month meetings,the BOH members also have the same rights and privileges given to agents to go out to do Title 5 reports and perform all legal and administrative functions and inspections.Board members occasionally inspect complaints on housing and restaurants to see and understand what's going on and to see what they can do to help. Mr.Fixler will periodically go out on inspections and the purpose is to help the owner/manager to come into compliance with whatever problems they might be having.He is there strictly to help take the pressure off them and to work with them.If not in compliance,a landlord/establishment may be brought before a BOH meeting where they have to sit in judgement and the Board may issue a vote with restrictions that could be embarrassing and hard on a business.Mr.Fixler will work with owners of establishments to see what he can do to help them come into compliance. BOH members have the authority go out on these inspections with the BOH agents,which in turn give them a better understanding of what is done in the field and report back to the other BOH members to come up with suggestions or improvements. B. Mr.Fixler would like to clarify the language and wording on the regulations on the hauling and disposal of solid waste.Few words need to be clarified.He would like to do this at the next BOH meeting.Dr.Trowbridge suggested that it be done before the upcoming permitting season for issuing of the permits and placards.If the Board agrees on the changes,no public hearing is needed.There would need to be a vote on the changes and a notification would need to be published in local papers stating that there was an amendment to the regulation.Mrs. Sawyer thanked Mr.Fixler for all his help reviewing the document and that it was appreciated. Dr.Trowbridge clarified,from.the previous discussion,that the authority rests with the Board and the Board assigns the staff at the Health Department as their agents.At times the Board members may need to go out and be the primary decision makers;however,the Health agents have the experience and knowledge of the regulations. The Board members are the public information officers and need to be included and up to speed on all issues. C. Permitting—With the food establishment permitting season coming up soon,notifications will soon be going out. The majority of permits run from January 1St through December 31St.There are a few categories of permits that run on a different schedule.Mrs. Sawyer stated that food establishment renewals will now run from March 1St through February 28th.With the holidays being a busy time of year for everyone,especially food establishments,it is best to get them off the January through December permitting cycle.Applicants will apply for their food permit thirty days in advanced of December 31St this year.A notice will go out with all new permits stating that their 2016 permits will run from January 1,2016 through February 28,2017.After that,the permits will then run from March 1St through February 28th.All other permit dates will remain the same.Only food establishments will change.Dr. Trowbridge asked if this is typical of other cities or towns running their permits come due on the calendar year.Mrs. Sawyer stated that it is typical but not the only way. Some cities and towns do it differently.North Andover have other permits such as tobacco permits,frozen dessert permits and swimming pool permits that come due in different months as well as funeral director permits.Mrs. I f { r North Andover Board of Health Meeting Minutes Thursday—September 24, 2015 7:00 p.m. 120 Main Street,2nd Floor Selectmen's Meeting Room North Andover,MA 01845 Sawyer stated that the food code is very specific stating you can do whatever you want as far as changing permitting dates. D. 2016 BOH Meeting Agenda—In 2016,the Selectman's Meeting Room will not be available to hold the BOH meetings.The dates for the BOH meetings for 2016 have been set.Mrs. Sawyer gave the Board members a list of meeting dates for 2016 and asked that they check to see if there are any dates that need to be changed.With the Fire Department building being completed soon,the Community Development offices will be moving within another year and there will be shuffling around of departments.The town will advertise properly where next year's meetings will be held as the Selectman's Meeting Room will not be available next year.The dates are already set for next year's BOH meetings.Mrs. Sawyer gave the Board members the dates and asked to check if there are any dates that need to be changed. The dates need to be submitted to the Town Manager so that a meeting room can be set up for 2016. Due to other departments having meetings on the same nights as the Board of Health,Mrs. Sawyer suggested that that best bet for the 2016 meetings be at the meeting room at the North Andover Police Department. If the Board has a meeting where there will be a larger audience or a public hearing,the meeting location could always be changed.The meetings are the 4`h Thursday of every month except for December where the third Thursday is recommended.Dr. Trowbridge stated he could not attend the first meeting in January 2016.The dates have been checked for the Massachusetts school vacation dates.The Board agreed to meet on December 15,2016 instead of the December 22,2016 date. E. Flu Clinics—Mrs. Sawyer stated that there was a small flu clinic today at the Senior Center as well as one held last week. Since the public health nurse has only received a small amount of doses,there haven't been many clinics set up.The family flu clinic,which is well attended,will be on Monday, October 19a'at the High School.The date will be advertised.A discussion ensued regarding flu and pneumonia shots.Quadrivalent is being offered this year.There is a sign-up sheet for pneumonia shots for people over 60.Although a date has not been set yet,Mrs. Sawyer stated that anyone interested can call the Health Dept.to be added to the list.A discussion ensued on pneumonia shots.Mrs. Sawyer also stated that the Health Dept. is pre-purchasing the shingles shot in small amounts since it is expensive at$185.00 a dose. Some insurance companies cover it but Medicare does not.For those whose insurance does not cover the shot,the Health Dept.can offer the shot at a discounted rate of $150.00 a dose and is also trying to look at a possible grant to the help out the ones who need the shot the most but cannot afford it. VIII. CORRESPONDENCE/NEWSLETTERS IX. ADJOURNMENT MOTION made by Mr.Pease to adjourn the meeting.Mr.Fixler seconded the motion and all were in favor.The meeting was adjourned at 7:50 pm. 2015 North Andover Board of Health Meeting Page 3 of 4 Board of Health Members: Thomas Trowbridge,DDS,MD,Chairman;Larry Fixler,Member/Clerk;Francis P.MacMillan,Jr., M.D.;Joseph McCarthy,Member; Edwin Pease,Member Health Department Staff:Susan Sawyer,Health Director; Debra Rillahan,Public Health Nurse;Michele Grant,Public Health Inspector;Lisa Blackburn,Health Department Assistant Prepared by: Lisa Blackburn, Health Dept.Assistant Reviewed by: All Board of Health Members&Susan Sawyer,Health Director Si ng ed by: Larry Fixer, Jerk of t e Bo rd Date Signed North Andover Health Department Community and Economic Development Division September 15, 2015 Stewart Allen 155 Boston Street North Andover, MA 01845 Dear Mr. Allen, Please be advised that you have been placed on the September 24, 2015 Board of Health agenda, for the purpose of consideration of action to be taken for continued violation of the MA DEP Environmental code. The subsurface disposal system at 155 Boston is in failure and has been since the property was purchased in December of 2003. The Health Department has been working with you for over a decade to have this system repaired. You have engaged an engineer,there has been soil testing and two separate septic designs completed and approved for installation at 155 Boston Road. This is a significant investment by you. As you are aware, the permit extension act allowed the septic plan approval for 155 Boston Street to be extended to September 2015. Unfortunately,the system has not been installed to date and the Board must determine if there is sufficient evidence to; - issue of a monetary fine - Require alteration of the onsite system to prohibit effluent from entering the leaching area; such as requiring the placement of a high water alarm in your tank and plugging the outlet of the tank itself, which would make it a"tight tank". - take legal action At the meeting on September 24th, you will be given the opportunity to provide evidence or explain such to the board to explain why you have not complied with the requirements of the state code. The meeting commences at 7:00 and will be held at the North Andover Town Hall at 120 Main Street; 2nd Floor selectmen's conference room. Sincerely, Xc: File 1600 Osgood Street,Unit 2035,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com I� Grant, Michele From: Benjamin Osgood <beno@ttienv.com> Sent: Tuesday, October 06, 2015 12:55 PM To: Grant, Michele; 'martin@avproworldwide.com' Cc: Hadge, Lisa Subject: RE: 155 Boston Street Michele, That is understood and is what I consider the as built will show. ben BENJAMIN C.OSGOOD,Jr. Director of Engineering TTI ENVIRONMENTAL, INC., Engineering Division 13 Branch Street,Suite 111 93 Stiles Road,Suite 201 Methuen, MA 01844 Salem, NH 03079 Office: 978-749-9929 x 75 Office: 603-226-1950 Direct:978-296-2575 Fax:603-226-3235 Mobile: 978-435-1324 Fax: 978-749-9920 www.ttienv.com I beno@ttienv.com Providing Dedicated Service to Our Clients Since 1985 A SERVICE DISABLED VETERAN OWNED SMALL BUSINESS(CVE Verified) Note:This message originates from TTI Environmental,Inc. It contains information that may be confidential or privileged and is intended for the individual or entity named above. It is prohibited for anyone else to disclose,copy,distribute,or use the contents of this message. If you received this message in error,please notify the sender at once at:benoR@ttienv.com or Benjamin Osgood @ 978-749-9929 ext.75. From:Grant, Michele [mailto:MGrant@townofnorthandover.com] Sent:Tuesday, October 06, 2015 12:54 PM To: Benjamin Osgood <beno@ttienv.com>; 'martin@avproworldwide.com'<martin@avproworldwide.com> Cc: Hadge, Lisa<Ihadge@townofnorthandover.com> Subject: RE: 155 Boston Street Hi Ben, You will also need to Shoot the elevations and confirm that it's to plan as well as consultation if any problems occur. In others words,the project needs complete oversight. Thank you Michele E.Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 1 Grant, Michele From: Dan Ottenheimer <dano@millriverconsulting.com> Sent: Monday, November 23, 2015 4:47 PM To: Grant, Michele Subject: Property lines Michele, • Section 220 of Title 5 specifies the contents of what must be on the design plan. o Subsection 4 D calls for the depiction of the legal boundaries of the lot. o Subsection 3 is the only part of Title 5 that I am aware of that speaks to needing a reference to a plan of land prepared by a surveyor, and that is limited only to instances where a property line setback is being requested. I hope the above helps. Also,for what it is worth,there was a situation about 6 or 8 years ago like this for which the Town did hire us and our surveyor to figure out the property boundaries. I am not sure there is a desire or the finances to make it happen again in this instance, but I did want to apprise you of that fact. Good luck. Dan 6 O > I U cons u It in g< Civil Jn8inerline, 4- �ei4'lrt�nrttc'ra�»I P'�art9a��rr.� r.5itnr�;a��tl Cntirr����ns�yt�t 1(rap�l� qtr+:},ut1�v�� Daniel Ottenheimer, President Mill River Consulting,Inc. 6 Sargent Street Gloucester, MA 01930-2719 978-282-0014 x 802 www.millriverconsulting.com dano@millriverconsulting.com Member: Massachusetts Association of Onsite Wastewater Professionals, Massachusetts Environmental Health Association, Cape Ann Chamber of Commerce, New England Water Environment Association i 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 15,216: continued (b) A Facility Aggregation Plan shall be deemed to be approved by the Department if, within 60 days from a determination of administrative completeness,the Department has not, in writing: 1. requested additional information from the applicant which may include,but is not limited to, additional measures the Department deems appropriate to protect public health,safety,welfare or the environment;or 2. granted a written approval,which may include any conditions the Department deems appropriate to protect public health,safety,welfare or the environment;or 3. denied approval., In the event the Department requests additional information from the applicant,a new 60 day constructive approval period shall commence upon receipt of the additional information. 15.217: Systems with Enhanced Nitrogen Removal (1) The nitrogen loading limitations established in 310 CMR 15.214 shall not apply to discharge of an effluent meeting the federal Safe Drinking Water Act nitrate standard of 10 ppm through either an approved alternative system or a treatment works with a groundwater discharge permit issued pursuant to 314 CMR 5.00 and 6.00(groundwater discharge program). (2) An increase in calculated allowable nutrient loading per acre may be allowed with the use of a technology approved for enhanced nutrient removal pursuant to either the piloting, provisional or general use certification provisions in 310 CMR 15.281 through 15.288 as illustrated by the following example: Recirculating Sand Filter 550 gpd/acre In the event that the Department determines that a system approved for enhanced nutrient removal using a technology approved by the Department on a piloting or provisional basis pursuant to 310 CMR 15.285 and 15.286•respectively is not performing in accordance with the Department's approval,the Department may require the system owner to instead use an enhanced nutrient removal technology that has been certified for general use by the Department. The increased design flow allowed reflects the nutrient removal performance of the approved technology compared to a standard system otherwise described in 310 CMR 15.100 through 15.293. A system receiving a design flow credit for enhanced nutrient removal pursuant to 310 CMR 15.217 must still comply with the requirements of 310 CMR 15.100 through 15.293 with respect to system siting and design; the credit does not affect any other siting or design requirement. 15.220: Preparation of Plans and Specifications The plans and specifications for every on-site system shall be prepared as follows: (1) Every system shall be designed by a Massachusetts Registered Professional Engineer or a Massachusetts Registered Sanitarian provided that such Sanitarian shall not design a system to discharge more than 2,000 gallons per day pursuant to 310 CMR 15.203. Any other agent of the owner may prepare plans for the repair of a system designed to discharge not more than 2,000 gallons per day pursuant to 310 CMR 15,203 provided they are reviewed by a Massachusetts Registered Sanitarian or Massachusetts Registered Professional Engineer and approved by the Approving Authority; (2) Every plan submitted for approval must be dated and bear the stamp and signature of the designer. At least one copy submitted shall bear the original stamp and signature of the designer. (3) Every plan for a new system or plan for the upgrade or expansion of an existing system which requires a variance to a property line setback distance,must also reference a plan which bears the stamp and signature of a Massachusetts Licensed Land Surveyor in accordance with M.G.L.c.112;§81D; 4/21/06 - 310 CMR-516 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 15.220: continued (4) Every plan for a system shall be of suitable scale(one inch=40 feet or fewer for plot plans and one inch=20 feet or fewer for details of system components)and shall include depiction of: (a) the legal boundaries of the facility to be served; (b) the holder and location of any easements appurtenant to or which could impact the system; (c) the location of all dweIling(s)and building(s)existing and proposed on the facility and identification of those to be served by the system; (d) the location of existing or proposed impervious areas,including driveways and parking areas; (e) location and dimensions of the system(including reserve area); (f) system design calculations,including design daily sewage flow, septic tank capacity (required and provided); soil absorption system capacity (required and provided); and whether system is designed for garbage grinder; (g) North arrow and existing and proposed contours; (h) location and log of deep observation hole tests including the date of test,existing grade elevations marked on each test, and the names of the representative of the Approving Authority and soil evaluator; (i) location and results of percolation tests including the date of test and the names of the representative of the Approving Authority and soil evaluator; 0) name and approval date-of the Soil Evaluator of record; (k) location of every water supply,public and private, 1. within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply wells, 2. within 250 feet of the proposed system location in the case of tubular public water supply wells,and 3. within 150 feet of the proposed system location in the case of private water supply wells; (1) any surface waters of the Commonwealth,Zone As,rivers,bordering vegetated wetlands, salt marshes, inland or coastal banks, regulatory floodway, velocity zone, surface water supplies,tributaries to surface water supplies,certified vernal pools,private water supplies or suction lines,gravel packed or tubular public water supply wells,and subsurface drains located up to 100 feet beyond the setback distances in 310 CMR 15.211,any leaching catch basins and dry wells located up to 25 feet beyond the setback distances in 310,CMR 15.211; and the location of any nitrogen sensitive area identified in 310 CMR 15.215 within which any portion of the facility or the proposed system is located as well as any nitrogen sensitive area up to 100 feet beyond any property line of the facility. (m) location of water lines and other subsurface utilities on the facility; (n) observed and adjusted ground-water elevation in the vicinity of the system; (o) a complete profile of the system; (p) a note on the plan listing all variances to the provisions of 310 CMR 15.000 sought in conjunction with the plan; (q) the location and elevation of one benchmark within 50 to 75 feet of the system components which is not subject to dislocation or loss during construction on the facility; (r) when pressure distribution or dosing is proposed,complete design and specifications of the distribution system proposed including but not limited to dosing chamber capacity (required and provided),pump curves and specifications,number of dosing cycles and depth per cycle; (s) when a Recirculating Sand Filter or equivalent alternative technology is required or proposed,a complete plan and specifications for the system,including a hydraulic profile; (t) a locus plan to show the location of the facility including the nearest existing street; (u) the street number and lot number,if any,and the tax map number and lot number,if any, of the facility;and (v) the materials of construction and the specifications of the system. 15.221: General Construction Requirements for All System Components (1) All tanks,including septic tanks,distribution boxes,pump chambers,dosing chambers and grease traps,shall be either: (a) watertight through manufacturer's specification and warranty;or (b) made watertight by the manufacturer,equipment supplier or installer using asphalt or synthetic polymer sealer specified by the concrete or synthetic material manufacturer. 4/21/06 310 CMR-517 Grant, Michele To: martin@avproworldwide.com Subject: 155 Boston Street Attachments: 201509151448.pdf; 201509151132.pdf FFF�---►►►"'n111 C�/� Dear Mr.Allen Attached, please find a letter indicating options for your septic System.The Board of Health Meeting takes on September 24th,2015 at the Town Hall on Main St. at 7:OOpm,on the second floor in the selectmen's room. Also attached is a list of the Licensed Town Installers as well as list of the licensed Engineers. Please, if you have any further questions, I can be reached at phone number below. Many Thanks Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com -----Original Message----- From: noreply@townofnorthandover.com [mailto:noreply@townofnorthandover.com] Sent:Tuesday,September 15,2015 2:40 PM To: Grant, Michele Subject: Message from "ComDev-Health-Ricoh" This E-mail was sent from "ComDev-Health-Ricoh" (Aficio MP C3002). Scan Date: 09.15.2015 14:40:17 (-0400) Queries to: noreply@townofnorthandover.com • ; TEED, . North Andover Health Department Community Development Division October 23, 2014 Stewart Allen 155 Boston Street North Andover, MA 01845 Dear Mr. Allen, The Health Department recently received complaints of odors within the vicinity of your property. As you are aware, the permit extension act allowed the septic plan approval for 155 Boston Street to be extended to September 2015. This extension would not apply if it is found that your system is causing any nuisance or hazard due to overflow of the system. Your file shows that your system was pumped in October of 2013, and that it was "over full". This information supports that you may be in active failure. Please have your tank pumped immediately. It appears that this system will need continual monitoring and pumping. Please submit an agreement between you and a septic pumper, noting that you will have it pumped monthly or as needed. It would be the preference of this office that you pursue the actual repair of the system rather than spend finances on tank pumping, however the pumping will alleviate the environmental hazard if one exists. If you have contracted with a licensed installer to get this system repaired, please submit proof of when this installer is planning on doing the installation. I appreciate your anticipated compliance; however, if voluntary pumping of your system does not occur, this matter will be placed on the agenda of the Board of Health for discussion. The BOH could consider requiring the placement of a high water alarm in your tank and plugging the outlet of the tank itself, which would make it a"tight tank". Sincerely, Susan Y. Sawyer, REHS/RS Public Health Director Xc: File 1600 Osgood Street,Bldg 20 Unit 2035,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com RECEIVE 0 SCP 10 2012 THEALTH N E TH ANI) DE T8 OVER 155 Boston St. North Andover, MA 01845 Sept 4th. 2012 To: Ms. Susan Sawyer. Ms. Saywer, Thank you for your most recent correspondence regarding the septic system at the above address. Your comments and instructions have been duly noted. Attached find copy of the most recent receipt for pumping the system, for your files. We have already spoken with the Soucy Company and are making arrangements to have it pumped again within the next few weeks. Thank you for your assistance with this matter. Cordially, Stewart J Allen Woo DATE OF SERVIqE CE COMPLETE SEWER-SEPTIC SERVICE CUSTOMER NAME — — BILLING ADDRESS Serving AVIA & NH CITYSTATE PHONE: 80'0-541 -8379 JOB ADDRESS IF DIFFERENT THAN BILLING ADDRESS ADDRESS STATE ZIP I I i I I DESCRIPTION OF WORK k 11's(CUUM Puo< SF.PT''IC TANK GALS. 0 CESS:SQQ6—___ D OVERALL SYSTEM 'b'DRYWELL D BASEMENT 0 FAILED SYSTEM COMMENTS TERMS OF PAYMENT TYPE OF SR�VICE TAX EXEMPT CASH ElRESiCOMM TA) INDUSTRIAL[I TOTAL $ CHECK CHARGE 0 PLUMBING Q JOB COMPLETION This is to acknowledge completion of the above des(ribed work which has been done to my complete satisfaction.We will assume no responsibility for any damage made to sprinkler,la,vn,bush,driveway,curb or walkway.The customer signing below assumes all responsibility for payment in full,al)ng with any collection or reasonable attorney fees on outstandin-:1 balances, All accounts will ac Prue interest at 1.5%per month,18%annually from due date. FA—TE CUSTOMER SIONATUkE SERVICE N'S NAME lvoG� 'e✓e 1 DATE OF ERVIGE COMPLETE SEWER-SEPTIC SERVICE INVOICE �� �� ✓L 78 N. Broadway(Rt. 28), Salem, NH 03079 CUSTOMER NAME Serving MA & NH BILLING ADDRESS _ff /�J-SAGr) S- ree 800-541 -9379 CI �1'161,omet STATE ZIP PHONE: ��f� �G 7q_yU� Come visit us at JOB ADDRESS IF DIFFERENT THAN BILLING ADDRESS ADDRESS STATE ZIP www.soucysewer■com DESCRIPTION OF WORK 07_1n_,j �✓C' ✓'�dfi ✓� VACUUM,PUMP ❑XEPTIC TANK GALS./ ❑ CESSPOOL-` ❑ OVERALL SYSTEM '❑ DRYWELL ❑ BASEMENT ❑ FAILED SYSTEM ; COMMENTS 0(,,'`� i TERMS OF PAYMENT TYPE 0-.-SERVICE TAX EXEMPT CASH ❑ RES/COMM If TAX INDUSTRIAL❑ CHECK ❑ CHARGE �L PLUMBING ❑ TOTAL $ JOB COMPLETION This is to acknowledge completion of the above work which has been done to my satisfaction.We will assume no responsibility for any damage made to sprinkler, lawn, bush, driveway, curb or walkway.Any form of payment provided by the customer constitutes a binding signature of this invoice and assumes all responsibility for payment in full, along with any collection or reasonable attorney fees on outstanding balances. t DATE CUSTOMER SIGNATURE SERVICEMAN'S NAME A S4gTLED' . �• f f I North Andover Health Department Community Development Division September 30, 2011 Martin Allen 155 Boston Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 155 Boston Street,Man 107A,lot 226, North Andover,Massachusetts Dear Property Owner, The North Andover Board of Health has completed the review of the septic system design plans for the above referenced property, submitted on your behalf by Richard Tangard, P.E., dated July 25, 2011, last revised September 19,2011. The design has been approved for use in the construction of a replacement onsite septic system for a three -bedroom(seven room total) design at 330 gallons per day. Generally this plan would be good for three (3)years from the date of approval, however since this repair is the result of a Title V report failure,this system must be completed within one (1)year. Duringthis time a licensed septic stem installer must obtain p y a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring,the North Andover Board of Health may reduce the time period for which this plan is valid.Note that the 2011 septic season will close November 30, 2011. No permits will be given out after November 15 2011. This includes the approval of local upgrades 1) This plan includes a local upgrade approval allowing a single test pit within the system area rather than two test pits. Please retain the included form 9B for your records. 2) A reduction in offset distance between a foundation and a leach bed from 20 feet to 17 Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 155 Boston Street September 30, 2011 3) A reduction in offset distance between the bottom of the leach field and the water table from 4 feet as required to 3 feet. This approval is also subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincere , San Y. Sawy , REH S Public Health irector cc: Richard Tangard, P.E. file encl: DEP form 9b Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 r. Commonwealth of Massachusetts F City/Town of Local Upgrade Approval Form 913 �M Ssy`e DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. A. Facility Information Important:When filling out forms 1. Facility Name and Address on the computer, use only the tab Martin Allen key to move your Name cursor-do not 155 Boston Street use the return key. Street Address North Andover MA 01845 r� City/Town State Zip Code 2. Owner Name and Address (if different from above): Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 330 gpd 5. System Designer: Richard TangardName ® PE ❑ RS 33 Pillings Pond Road Lynnfield MA 01941 Address City/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for: ❑ Reduction in setback(s)—specify: ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction 155 Boston Street form 9b 9.28.11.doc•rev.7/06 Local Upgrade Approval* Page 1 of 2 • Commonwealth of Massachusetts City/Town of t F a Local Upgrade Approval Form 913 4M B. Approval (continued) ❑ Reduction in separation between the SAS and high groundwater: Separation reduction 1 ft. Percolation rate min./inch Depth to groundwater 3 ft. ❑ Relocation of water supply well (explain): ❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater ® Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test List local variances granted not requiring DEP approval per 310 CMR 15.412(4): To allow use of test pits over 2 years old. List variances granted requiring DEP approval: North Andover Health Dept Approving Authority Susan Sawyer, Health Dir. '� 9/30/11 Print or Type Name and Title Sj nature /r Date 155 Boston Street form 9b 9.28.11.doc•rev.7/06 Local Upgrade Approval*Page 2 of 2 p9 Pp 9 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, September 30, 2011 2:39 PM To: Sawyer, Susan Subject: RE: 155 Boston Hi Susan, Heidi told me today that she went to the 155 Boston Street site,and it was really moist in the area heading into the wetland but before the actual wetland. She did not smell any"effluent"so she said it could have been high groundwater,but not 100%sure. Just FYI as you were looking for her feedback. The file is in the septic drawer if you need it. W Ref a%4, Pamela DelleChiaie From: Sawyer, Susan Sent: Wednesday, September 28, 20114:03 PM To: DelleChiaie, Pamela Subject: 155 Boston Just another note to you,from me about 155 Boston in case I forget. have the draft approval letter ready and have the form 9b in progress. Hopefully Heidi will say that the owner does not have to apply to Conservation or does not have to hire someone to reflag the wetland. If she says yes,to either of those,this project will end up dead again. .... Thx S Stman Sawyn J aNk 3teafth Dkectox. 1600 06 good Skeet XUg 2U,unit 2-36 ✓VomdA andma,.MCL 01845 office 978 688-9540 fax 978 688-8476 All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the [ http://www.sec.state.ma.us/pre/preidx.htm ]Massachusetts Public Records Law. I Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 1 DelleChiaie, Pamela From: Sawyer, Susan Sent: Wednesday, September 28, 20112:22 PM To: Irctang100@hotmail.com' Cc: DelleChiaie, Pamela Subject: RE: Septic- 155 Boston Street, North Andover, MA 01845- Plan Review Disapproval Hello Dick, I received your revision. 1) 1 just spoke with Heidi,from Conservation,she had not spoken to you or gone to the property yet.She will drive by tomorrow. 2) 1 may have found an error that was missed. It is not a big one,just a number error. In the Design data box; septic tank required 200%daily flow(440 gal should be 330 gal and total 880 would be 660) Let's wait to see what conservation says before you bother changing and reprinting. I would hate to kill a tree for a single#change when I could just change it with a pen. Otherwise it all looks good. Thanks Susan From: DelleChiaie, Pamela Sent: Friday, September 02, 20113:55 PM To: 'rctang100@hotmail.com' Cc: Sawyer, Susan Subject: Septic - 155 Boston Street, North Andover, MA 01845 - Plan Review Disapproval Importance: High Hello Mr.Tangard, Attached is a letter from Susan Sawyer regarding the Plan Review submission for a Septic System at 155 Boston Street,North Andover, MA. The plan is disapproved at this time. Please address the outstanding items and resubmit a revised plan at your earliest convenience for re-review. There is no charge for the revised submission. Thank you. Vest Regaw&, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover,MA 01845 IR Office-978-688-9540 Fax-978-688-8476 ( Email-pdellechiaiena townofnorthandover.com '6 Website hnp://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. Anonymous Cc:Homeowner Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:hftp://www.sec.state.ma.us/pre/l)reidx.htm. Please consider the environment before printing this email. 1 DelleChiaie, Pamela From: Sawyer, Susan Sent: Wednesday, September 28, 2011 4:03 PM To: DelleChiaie, Pamela Subject: 155 Boston Just another note to you,from me about 155 Boston in case I forget. I have the draft approval letter ready and have the form 9b in progress. Hopefully Heidi will say that the owner does not have to apply to Conservation or does not have to hire someone to reflag the wetland. If she says yes,to either of those,this project will end up dead again. .... Thx S Swan Sawyu J ub&36at?tPc Dmd" 16CO Uayaad Stwet JIVdg 2U,unit 2-36 .North andm=,.MCL 01845 dice 978 688-9540 fax 978 688-8476 All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the [ http://www.sec.state.ma.us/pre/preidx.htm ]Massachusetts Public Records Law. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:hfti)://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 1 I �I Richard C. Tangard 33 Pillings Pond Road Lynnfield, MA 01940 781334-5049 FAX: 781334-0115 9/20/2011 North Andover Health Department 1600 Osgood Street North Andover, MA 01845 , Att: Susan Sawyer, Director Dear Ms Sawyer: Reference is made to your letter of September 2, 2011 relative to requested revisions to the proposed 155 Boston Street septic plan dated July 25, 2011. 5 copies of the revised plan dated 9/19/2011 are enclosed. All of the issues have been addressed and changes made with the exception of the possible Conservation Department concerns with the wetland line. Please advise status. I would appreciate your approval as soon as possible as the owner would like to get this project completed prior to the onset of inclement weather. Sincerely, Richard C. Tangard . �� • • e ,.. .. .. . ., . , . . �, ,r Commonwealth of Massachusetts City/Town of , a - - Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board.of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new-des- n-Mow above ve the existing approved capacity of an on-site system constructed in accordance wit elt e s CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: 'tOWN OF NORTHANOOVelt forms on the ,1�L y-/ -�- �l (�G /�i� WRAL'TH DEPART ENT computer,use iY ' /f only the tab key Name to move your cursor-do notuse Street Address key the return e&zal'zl-w �J DQ� >`^ M4_ ©/e7W5— City/Town State Zip Code 2. Owner Name and Address (if different from above): Name Street Address City(TUwn State Zip Code Telephone Number 3. Type of Facility (check all that apply): 2 Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: 3 IZ?&0E&7aiV't 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) (� Conventional ❑ Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): / L <759.t /,vim4;W. t5form9a.doc•rev.7/06 Application for Local Upgrade Approval, Page 1 of 4 � II / Commonwealth of Massachusetts 12 E SEEM City/Town of - - Form 9A — Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: 3 gpd Design flow of proposed upgraded system gpd Design flow of facility: gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): �] Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: dale of inspection 2. Describe the proposed upgrade to the system: 77V /opo 7727 3. Local Upgrade Approval is requested for(check all that apply): �] Reduction in setback(s)—describe reductions: �7�yC7jo.�� Inc/ � { T ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft — Percolation rate min./inch Depth to groundwater ft t5formga.doc•rev.7/06 Application for Local Upgrade Approval, Page 2 of 4 rn . Commonwealth of Massachusetts City/Town of Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a ty. member or agent of the local approving authori High groundwater evaluation determined by: Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 31^ r`\ID 4r,.000 is not feasible: 2. An alternative systema approved PP pursuant to 310 CMR 15.283 to 15.288 is not feasible: t5form9a.doc•rev.7/06 Application for Local Upgrade Approval, Page 3 of 4 J A/ Commonwealth of Massachusetts j _ City/~own of Form 9A - Application for Local Upgrade DEP has provided this form for use by local Boards of Heal � Approval forms may be used, but th information must be substantially the same as that provided here. Before using this form, checkewithY our local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible: 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): Application for Disposal System Construction Permit Complete plans and specifications ❑ Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or propertylines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of m knowledge and belief, are true, accurate, and complete. I am aware~ that the~ consequences for submittingfats a may Y e Inform Y be significant information, Imprisonment for deliberate violations." n Including, but not limited to, penalties or e and/or 7 Facility Owner's Signature M-ZI -r �iC� T � � Date Print Namer 9 Name of Pre a er Date Preparers add State/ZIP Code Telephone t5form9a.doc•rev.7/06 Application for Local Upgrade Approval- Page 4 of 4 � StiTTIED/� � FILE COPY North Andover Health Department Community Development Division September 2, 2011 Richard C. Tangard, P.E. 33 Pillings Pond Road Lynnfield, MA 01941 Re: 155 Boston Street,North Andover, MA 01845 - (May 107.A—Lot#226) Dear Mr. Tangard: The proposed wastewater system design plan for the above site dated July 25, 2011 and received on August 23, 2011 has been reviewed. Unfortunately,the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item where applicable. 1. Please provide a statement identifying whether the property is within or not within the Lake Cochichwick watershed(NA 3.2). 2. The following statement is required by the North Andover Board of Health: I certify the locations, elevations and ties shown on this plan result from an actual survey made on the ground. (NA 3.2) 3. An additional variance should be requested to perform only one deep hole per disposal area(3 10 CMR 15.405(k)). 4. A gas baffle should be installed on the outlet tee of the septic tank(3 10 CMR 15.227(4)). The distribution box should have H-20 loading(NA 3.2). 5. The wetland line is over 10 years old. A copy of the plan has been provided to the Conservation department and they will do some investigation. Considering that the existing tank is in the 100 feet and the line has not been recently flagged,there will be at minimum the need to contact Conservation for direction in this matter. (Heidi Gaffney, Conservation Associate 978 688-9530) Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 6. Groundwater is assumed to follow the contour of the land unless proved differently; the groundwater table was established at 48 inches in TP-1. As designed the southeasterly side of the leaching field does not have the required/requested 4 feet of separation; it appears to be about 2 feet. Please provide the required/requested groundwater separation for the entire soil absorption system or perform more soil testing and provide explanation to establish the groundwater table near Boston Street. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerely S san Y. Sawye ,/REHS/RS Public Health Director cc: Richard C. Tangard, Engineer—rctang100ghotmail.Com Homeowner—Martin T. Allen(Stewart Joseph Allen-Assessor's) Page 2 of 2 North Andover Health Department, 1600 Osgood Street,Building 20, Suite 2-36, North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Ms. Susan Sawyer Director North Andover Health Dept. C.C. Mr. Thomas Trowbridge Chairman Dear Ms. Sawyer, I have an application on file with North Andover Health Dept for the installation of a new septic system at my home at the above address. The application is due to expire in September 2012. I am the owner of the property, which was the house I grew up in, however it is presently occupied by my parents, Martin&Anne Allen. The septic system did not pass its last inspection and was classified as "failed". It was my full intention to replace the entire septic system this summer; however, due to my business being slow this was not financially possible. I am requesting a 12 month extension to the project. An Engineer(Richard Tangard) was hired and he drew up plans for the system which was duly accepted and approved by the Health Dept. I also interviewed and secured a contractor to do the project (Jim Kellett& Co. ). Although classified as failed,the system is working perfectly and has not shown any signs of breaking ground. I would be obliged if the Board would consider my request for an extension to this prof ect. Cordially, Stewart _ Owner 155 Boston St. North Andover, MA 01845 TOWN OF NORTH ANDOVER pOWT#t O'er o �ti0 Office of COMMUNITY DEVELOPMENT AND SERVICES 32.... 04 HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 C,,,,s 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdepigtownofnorthandover.com WEBSITE:httn://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM -- - Date of Submission: Site Location: Tp'WN OF NORTH ANDOVER �� HEL'j H C1�t'AR7MErNT Engineer: /=-1 Ilwlzle) New Plans? Yes ✓ $225/Plan Check# ( (includes 1St submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes Nom_ j� ilLS/ pl�lTl � Local Upgrade Form Included? Yes `/ No Telephone#: Fax#: 7or E-mail: �'�-'�c !%:�%00 Homeowner �J Name: T//�l OFFICE USE ONLY When the submis ion is complete(including check): ➢ E Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File;Forward to Consultant ➢ Enter on Log Sheet and Database d Q� .IY Commonwealth of Massachusetts City/Town of - Form 9A — Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd,where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy,or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer,use i'•/ �only the tab key Name to move your cursor-do not Street Address ,J use the return key. ���_._/ /J �l�� Z_ ✓�- Ql � City/Town State Zip Code 00 2. Owner Name and Address(if different from above):' Name ./ Street Address City/Town ��State i Zip Code Telephone Number 3. Type of Facility (check all that apply): tR Residential Institutional Commercial School 4. Describe Facility: 5. Type of Existing Syste' ❑ Privy ❑ Cesspool(s) [ Conventional ❑ Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): /06 Z ®rt /�l/�L77,'lit� G' lYl fa7� t5form9a.doc•rev.7/06 Application for Local Upgrade Approval*Page 1 of 4 7 + w Y VO 'aA t Commonwealth of Massachusetts City/Town of - Form 9A — Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: gpd Design flow of proposed upgraded system 9pdj)j� Design flow of facility: gpd B. Proposed Upgrade of System 1. Proposed upgrade is(check one): Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: 17-,V —770P IZO 3. Local Upgrade Approval is requested for(check all that apply): Reduction in setback(s)—describe reductions: _:—e jel n .yon 4 Al RZO 1'r--4M9V X f� ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. Bio reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min./inch Depth to groundwater ft t5form9a.doc•rev.7106 Application for Local Upgrade Approval, Page 2 of 4 Commonwealth of Massachusetts City/Town of -- v Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Z?-X 11Z-;C X/TA----�l—t77" 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: t5form9a.doc•rev.7/06 Application for Local Upgrade Approval*Page 3 of 4 s Commonwealth of Massachusetts City/Town of n Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible: 5. The Application for Local Upgrade Approval must be accompanied by all of the following(check the appropriate boxes): Application for Disposal System Construction Permit .4 Complete plans and specifications El Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I,the facility owner, certify under penalty of law that this document and all attachments,to the best of my knowledge and belief, are true, accurate,and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." r -72-or / Facility Owner's Signature Date Print Name C- ��� 0/r7/zel l Name ofre,�ajrer Tom, Date' /L_/NI�_5 /wit11,114/P/A6 P Preparers address City own/ ���✓� ,J /_ State/ZIP Code Telephone 7LL CJ t5form9a.doc-rev.7/06 Application for Local Upgrade Approval* Page 4 of 4 STEWART ALLEN-OWNER 155 BOSTON STREET Original investigation was based on Odor complaints at Boston Road December 2003 —Sale of home to The Allen's-no Titles done-Sale price included money to repair system. February 2006— Odor complaint - Title 5 inspection was ordered by HD— Failed — engineer hired, plan submitted for review July 2011 — New engineer - Septic Plans submitted September 2011- Septic System Plan is Approved w/ 3 LUA's. System was to be completed within 1 yr. August 2012 — Mr. Allen requested an extension for 1 year. October 2014— Received Odor complaints at Boston Road from anonymous — identified they system was still in failure. The MA Permit Extension Act automatically extended all permits until September 2015. It either expires or they will start at the beginning of the process again. ➢ Permit MUST be pulled by Sept.30, 2015 or plans are Void ➢ System MUST be in the ground by Nov. 30, 2015. ➢ Engineer on record has passed away— Mr. Allen must hire another Engineer to oversee the plans/installation asap ➢ Over the past 2 months; 2 installers have inquired about the site. ➢ There are wetland issues. They will have to file a SMALL PROJECT, with ConCom. The next meeting is on Oct. 21. They have until Wed. September 30 to file with ConCom. Staff Recommendation ➢ Have a financial commitment, with signed Contract from both Installer and Newly hired Engineer. ➢ Have system in the ground by the Septic close date of November 30tH C ➢ Convert the existing Septic Tank into a Tight Tank. Have a float alarm system put on the tank, to alert them when it's to full. OR Have automatic pumping done. ➢ 'Note that the owner sealed the cover of the tank with cement (see photo); this will need to be removed in all case scenarios to be able to pump) Owner should be reminded that no person shall work on a system who is not locally licensed by the Health Department" ➢ Fines only if deemed necessary by BOH 1 e 4 ^- , A . pW� r ' s fit'•)�1 +� �`,( r, � 'i NEW ENGLAND ENGINEERING SERVICES INC March 9, 2006 RECEIVED MAR 13 2006 Ms. Susan Sawyer TOWN OF NORTH ANDOVER North Andover Board of Health HEALTH DEpgRTr/ENT 400 Osgood Street North Andover, MA 01845 RE: TITLE V REPORT: 155 Boston Street No.Andover,MA Dear Ms. Sawyer: Enclosed is the Title 5 Report for the above referenced property. The system FAILED the inspection. If there are any questions please call me at my office, 686-1768. Sincerely, Benjamin C. Osgood r. Certified Title 5 Inspector 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845.(978)686-1768-(888)359-7645-FAX(978)685-1099 Tof11 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Pro Address: 155 Boston N �( Property onto Street o Andover,MAO ��U Owner's Name: Martin Allen r Owner's Address: 155 Boston Street No Andover,MA 01845 1 Date of Inspection: March 9,2006 Name of Inspector:(please print) Benjamin C.Osgood,Jr.Certified Title 5 Inspector Company P y Name: New England Engineering Services Inc. Mailing Address: 60 Beechwood Drive North Andover,MA 01845 Telephone Number. 978-686-1768 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the function and maintenance of the on sewage disposal proper g spo systems. I am a DEP approved system inspector pursuant to Section 15340 of Title 5(3 10 CMR 15.000).The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority --A—Fails Inspector's Signature: Date: 3 !0 c,k, The system inspection shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 of completing this 'on. ff the stem is a shared or has a design fl f 1 days mp g uLspech system system ow o 0000 or ,the inspector and !Pl Z� the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. I I Z of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: /AM 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: &L or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. if"not determined"please explain The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): Broken pipe(s)are replaced Obstruction is removed Distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will.pass inspection if (with approval of the Board of Health): Broken pipe(s)are replaced Obstruction is removed ND explain_ i 30f 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 C. Further Evaluation is Required by the Board of Health: AfO 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 is within 50 feet of a surface water � or privy�'Y 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 (SAS)Soil Absorption System and the(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 the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organize compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 4'of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 D. System 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 overload or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overload or clogged SAS or cesspool Li in l 1 6" 1 � quid depth cesspool is less than below invert or available volume�s less /z day flow A Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times Pumped Any Portion of the SAS,cesspool or privy is below high ground water elevation. _ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greaterthan 50 feet from a private water supply well with no acceptable water quality analysis. (this system passes if the well water analysis,performed at a DEP certified laboratory for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrogen is equal to or less than 5ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form) L l (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must' dicate either"yes"or"no"to each of the following- (The ollowing(The folio •teria apply to large systems in addition to the criteria above) Yes No The system is within eet of a surface drinking water The system is within 200 feet of a tary to ce drinking water supply The system is located in a ni n sensitive erim Wellhead Protection Area—IWPA)or a mapped Zone R of a public water well If you answered' o any question in Section E the system is considered a si threat,or answered"yes"in Section D above the large in has failed The owner or operator of any large system considered a si t threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner sho contact the appropriate regional office of the Department 5of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 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? f Have large volumes of water been introduced to the system recently or as part of an 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 sign of break out? Were all system components,excluding the SAS,located on site? f Were all 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 difference from owner)provided with information on the proper maintenance of the subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] 6-of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design) Number of bedrooms(actual): 3 DESIGN flow based in 310 CMR 15.203(for example: 110 gpd x #of bedroomsl: Number of current residents: � Does residence have a garbage grinder(yes or no): t,1' R_-�= Is laundry on a separate sewage system(yes or no):AI Q_[if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): 0 0 Water meter readings,if available past 2 years usage(gpd): Sump Pump (yes or no): V o. Last date of occupancy C T e�T COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no) Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: 19, DID A a Was system pumped as part of the inspection(yes or no): n!o 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 Attached a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected wen arriving at the site(yes or no): 70f 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: ✓cast iron 40 PVC_other(explain Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): •P I Pe t-ov►cs D IAC )nV el4sc�i SEPTIC TANK: (locate on site plan) Y Depth below grade: /a Material of construction: x concrete metal fiberglass_ uolyethylene Other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: /oo o 6!;; c.Lc)a 2c')v.v.� Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Dc -( o — c ; ,v .v C Scum thickness: Distance from top P baffle: of scum to to of outlet tee or bae: Distance from bottom of scum to bottom of outlet tive or baffle How were dimensions determined:_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): T/9�K ®I GREASE TRAP: (locate on site plan) Depth below grade: Materials 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 sludge to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc. Sof 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 TIGHT OR HOLDING TANK: All 4 _(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Materials of construction: concrete metal fiberglass polyethylene other (explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no):_. Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Z Comments(note if box is level and distribution to outlets equal,any evidnence of solids carryover,any evidence of leakage into or out of box,etc.): POA od-Q �,T)( mut C-- O K-4V(N C— S Fl�p �y2�L�i21,4n/ r'���5c v i c itf� t'�pN PUMP CHAMBER: A/ l4- (locate on sire plan) Pumps in working order(yes or no) Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 9,0f 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 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 in length 77' leaching fields,number,dimensions: yi;�E v,• I C . J,.�N s i2c overflow cesspool,number: innovative/alternative system'lope/name of technology: Comments(note condition of soil,signs of hydraulic failure.Level of ponding,damp soil,condition of vegetation,etc) CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of Construction Indication of groundwater inflow(yes or no) Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIW:_Zjff (locate on site plan) Material of construction: Dimensions: Depth of solids Comments(note condition of soil signs of hydraulic failure,level of ponding,condition of vegetation,etc. 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 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. O 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORINT PART C SYSTEM INFORMATION(continued) Property Address: 155 Boston Street No Andover,MA 01845 Owner's Name: Martin Allen Date of Inspection: March 9,2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water N'17 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record—If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checkedwith local Board of Health—explain: Checked with local excavator,installers—(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: