HomeMy WebLinkAboutMiscellaneous - 155 CHRISTIAN WAY 4/30/2018 (2) 155 Christian Way Ext. —
Commonwealth of Massachusetts -
u Cit /Town of . _�l���i��
F
a System Pumping Record !1AY 251011
Form 4
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
DEP has provided this form for use by local Boards of Health. Other for a used, DUte
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Locat' n: Left front_ o_ f_ e;rl'ght front of house, left side of house, right side of house, Left
rear of house, rig rear of house, left side of building, right rear of building, under deck.
City/Town Stat Zip Code
2. System Owner:
Name
Address(if different from location)
City/Town Sta� �! ��ip ode
Telephone Number
B. Pumping Record
1. Date of Pumping Date Z. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition oT,System:� �Qxj'Q�
6. System Pumped By:
Neil J. Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc.
Company
7. Location where contents were disposed:
G.L.S. L ell Waste WatRr
Signatur of a er Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1
Commonwealth of Massachusetts
City/Town of
System Pumping Record
�' tJ Ja14
Form 4
DEP has provided this form for use,by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using.this form, check with your
local Board of Health to determine the form they use.The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility. Information
1. System Location e Righ ont of hous Left/Right rear of house, Left./right side of house, Left/
Right side of buil Id ng,'Left/Rig t front of building, Left/Right rear of building, Under deck
Address
City/Town State Zip Code
2. System Owner. I
Name
Address('d different from location)
Citylrown State _ZiCode
Telephone Number
r
B. Pumping Record
1. Date of Pumping Date 2• Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank El Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yep No If yes, was it cleaned? ❑ Yes ❑ No;
" 5. Condition of s ,m:�
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Location where contents were disposed:
S. Lowell Waste Water
Signitufe it HaulwU Date
t5form4.doc•06/03
. System Pumping Record•Page 1 of 1
Commonwealth of Massachusetts
City/Town of � ®
System Pumping Record
y Form 4 JUL 10 Z01Z
DEP has provided this form for use by local Boards of Health. Other
information must be substantially the same as that provided here. B with your
local Board of Health to determine the form they use.The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location L g e 'g of house, Left/right side of house, Left/
Right side i ding, Left/Right front of building, Left/Right re building, Under deck
(:ddreC� l(/�� U
y/Town State Zip Code
2. Owner.
Name
Address(if different from location)
Cityrrown State Lf_ Ce Code
Telephone Number
B. Pumping Record
1. Date of Pumping pe
Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes Er No If yes,was it cleaned? ❑ Yes ❑ No
5. Condition of System:
N 0�- t V\-
6.
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Lo here contents were disposed:
G.L S. Lowell Waste Water
jSig t e Haule Date
t5form4.doc•06/03
System Pumping Record•Page 1 of 1
Commonwealth.of Massachusetts
City/Town of I
System Pumping Record FEB o 8 20
Form 4
DEP has provided this form for use by local Boards of Health. The Sy4em--P-Umping Record must
be submitted to the local Board of Health or other approving authority. .
A. Facility Information
Important:
When filling out 1. System Location:
fomes the �� ✓� C.�"� l
computer.use
only the tab key Address n
to move your
cursor-do not �-
use the return Cityrrown State Zip Code
key.
2. System Owner:
Name
til Address(if different from.location)
-City.frown Stat Zip—'de'
Telephone Number
.B. Pumping. Record
1. Date.of Purnpng Hate 2. Quantity Pumped:
Gallons
3. Type of system: ❑ Cesspool(s) [ eptic Tank ❑ Tight:Tank
❑ Other(describe):
4: Effluent Tee Filter present? ❑ Yes ( 'No If yes, was it cleaned? ❑ Yes ElNo
5. Condition of System: Q
1(���/�� Qom. 1 1�. •
6.
Syster Pump d By
Name Vehicle License Number
Company
.7. Locatio where cont` isdisposed::
Signa re au r Date
http://www.mass.gov/dep/`Water/approvaIS/t5foans..htm#inspect
t5form4.doc-06!03 System Pumping Record•Page 1 of t
TOWN OF 1 C
SYSTEM PUMPING RECORD
I2
DATE: '[ "0-5 }
r
SYSTEM OWNER& ADDRESS SYSTEM LOCATION
(example:left front of house)
�ow�se�
�5 C�((
DATE OF PUMPING:_ QUANTITY PUMPED : GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER(EXPLAES)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: c
TRANSMISSION VERIFICATION REPORT
TIME 10119/2006 15:56
NAME HEALTH
FAX 9786888476
TEL 9786888476
SER.# 000B4J120960
DATEJIME 10/19 15:56
FAX N0./NAME 816175760581
DURATION 00:00: 42
PAGE{S} 06
RESULT OK
MODE STANDARD
ECM
Nor h_Andover Health Oepartment NORTH
1600 Osgood StreellLetter of Transmittal,
i° Q°�
Building 20, Suite 2-36
North Andover, MA 01845 � '*
978 688.4540 - Phone °+A
978.688.8476�- Fox Page of �' cwu 'sig
heap e t townof o dover.com-E-mail
www.townofa-oj-t.hq,ndover.com-Website
TO: DATE:
COMPANY: FROM: Pamela Del eChiaie,Health Deportment Assistant
Phone: XIS / , �G'U' RE:
/ � /7���•— / �
Fax; 1 � J
We are sending you; O Copy of letter O dans Q Other ffi//in below)
These are transmitted as checked below:
> 174ttM1WAbt9d > L7rnr4gprpW > Chjzb lbr
A Aagr al ➢ ,CJ Y wa dm vz& WVW
> ➢ L7rarraur& L7&*n# apk*ra t
REMARKS:
COPY TO:
North Andover Health Department NORTH q
1600 Osgood Street ?
Letter ®f Transmittal
Building 20, Suite 2-36 ° o
North Andover, MA 01845
e
978 688 9540 - Phone
Page ofSSgCHUs���y
978.688.8476 — Fax
healthdept(UD-townofnorthandover.com-E-mail
www.townofnorthandover.com-Website
T0: DATE:
COMPANY: FROM: Pamela Del eChiaie,Health Department Assistant
Phone: / �U �/ y RE:, 17
Fox:
We are sending you: O Copy of Letter O P/ons O Other(fill in below)
These are transmitted as checked below:
➢ a Mvled ➢ akr,�,gorwr� ➢ OIPi�e6r�rt a�sfa
➢ 41� � ➢ okrl7a*wadarnn w#
➢ 0Asfi'ap" ➢ Okrraruse ➢ L7&A 't cgaiesfEr4k
REMARKS:
COPY TO:
COPY TO:
COPY TO: SIGNED:
V,
/
/
X
/
01• / / - ® O
C�
OPS J1pp / OPO5�0 P PCO BUF 0
9�
2-CB 9' 1y TGF-184.83 O
TP-98-3-2 , 2
SEPTIC TANK gym.
`y �9
D. BOX
AS-BUILT FIELD
28' WIDE X 3S'LONG.
(�) SEPES 00' BETWEEN 22LIN '
SEPARATION BETWEEN r X8 -JiF���. D
UNES/EDGE FIELD - 4' 3-1 ��9
Z AS-BUILT LEACHING ��
G AREA 910 S.F.
L �
�O
(� BENCH MARK
"0" BOLT OF HYDRANT AT END
(n PW OF CHRISTIAN WAY EL.=176.28'
2� M1 s
SEPTIC AS-BUILT ATLANI7C ENG/NEER/NG
MARTI ,�'� IN SURVEY CONSUL TANTS
M.. 00LALL A" ��' N. ANDOVER, MASS. 97GSRGE>O�MA 01833 5
`\ DATE.' 4/21/2000 SCALE I" - 20 FT. JOB NO. 9906-17
LOCATION: OWNER:
LOT 3 CHRISTIAN WAY EXT. MITSU REALTY TRUST
DATE: 4/21/2000 N. ANDOVER, MASS. TEWKSBURY, MASS.
SI 3E CHRISTIAN WAY N�R� GRESNBE�T �s`�F+
4 EXTENSION' ESSEX t✓OV ``�y
1o5
7
6
127.35' \
DRAINAGE EASEMENT
\ LOT 3
\ MAP 104-D
\ PART PARCEL 1
a \
`lp. \
LOCATION AS-BUILT PROPOSED \
AT HOUSE 162.88 162.78 \
SEPTIC TANK IN 162.48 162.58
SEPTIC TANK OUT 162.32 162.33 \
D-BOX IN 162.23 162.23
D-BOX OUT 162.07 162.06 \ TIE DISTANCES io
BEGINNING FIELD 161.97 161.96 \
END FIELD 161.78 761.77
X TO TANK 51.0 c�
\ Y TO TANK = 27.2
X TO D.BOX =62.8
Y TO .BOX
X TO A 82.3
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE:
5/2/00
This is to certify that
the individual subsurface disposal system
constructed (X) or repaired ()
by
Arthur Hutton
at
Lot 3 Christian Way(Brook Farm)
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
Board of Health Inspector
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION,
r c her-,by Sewage Dispcsal System
Tne uncle:='? ,e r.... .,, certify tra: the a y��� �..�
by uf tor, bvcf
located at LOT 3 CJII?15rl,4AI WA-y EXT (,*,aik Ff,,.f '�
was installed ir:conf rr_ance xith ttie icrh A-i-?cver Board cf Hearth piam.
Svsiem Design Pemut dated ':111th ar, approved desig,t
flow cf 5�6 ra"ors per day T're materiais use^, were in conFo=nance V-r':_ these
specified on the aupi6ved plan; the system was installed r ac:ordance :A•:th the provisions
of:10 CvSR 15.000, Title 5 and local re?uiat:ens, and the *-nal aiding agrees
substantially with the acproved plan. Ali work is accu:ately represented on the a-5-built
which has been subs i:ed to the Beard of Hezitr.
Bed:r,spec;on dare:
uineer-Reoresemative
Finz1 inspect-an date: �� //�/
nC�n prezentanve
=ns:tiller: --AIC L:c.T: Date: J
DesiCn Engineer.
,+SPR 2 8
Atlantic Engineering
• Survey Consultants, Inc.
97 Tenney Street — Suite 5
Georgetown,MA 01833
(978)352-7870 — Fax(978)352-9940
SEWAGE DISPOSAL SYSTEM
CERTIFICATE OF COMPLIANCE ADDENDUM
DATE: y/ 2-11 a
SITE LOCATION:
Commonwealth of Massachusetts Form 1255, last revised May 1996, requires that the system
designer for this"Sewage Disposal System" certify that the above system has been installed in
accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans.
Atlantic Engineering& Survey Consultants, Inc. (Atlantic)was not been retained to provide any
construction supervision, inspections, soils analysis or layout relating to the sewage disposal system
and as such has no responsibility express or implied relating to said construction supervision.
Atlantic was hired to perform the following services during the construction phase of this project
and limits certifications to the scope of these services.
1. Stakeout the corners of the proposed system structures.
2. Provide a project bench mark.
3. Stakeout any lot lines less than 10 feet from the system.
4. Field locate the as-built septic components and prepare a system as-built showing
the horizontal and vertical locations of the as-built system structures.
5.
6.
Atlantic Engineering and Survey Consultants, Inc. and its officers, directors, employees and agents
assumes no professional or financial liability for any erroneous or unsuitable construction related to
the installation of this system for which Atlantic was not providing service.
The issuance of a certificate of compliance by the approving authority shall not be construed as a
warranty; gua tee that the system will function as designed.
artin M. era , P.E.
DARIes-WP\Septic Forms\SEPTCOMP.WPD
V
Lot & Street jp � ����'�'�-
�-a�'�' Map/Parcel
CONSTRUCTION APPROVAL
Has plan review fee been paid: YES NO Permit#
Plan Approval: Date: �; q4 Approved by: �����
Designer: ATL/34,�/ Plan Date:_
Conditions:
Water Supply: Town _ Well.
Well Permit: Driller: '
Well Tests: Chemic Date Approved
Bacteria Date-
Approved
Bacteria II Date Approved .
Plumbing.Sign-Off. Wiring Sign-Off.
Comments:
Form "L" Approval: Approval to-Issue: YES
Date Issued Bv:
- NO
Conditions: J
Final Approval:
All Permits Paid? YES NO
Well Construction Approval? YES NO
Septic System Construction Approval? YES NO
Certification? VES NO
Other YES NO
Any Variance Needed? YES NO
FINAL BOARD QF HEALTH APPROVAL:
DATE: r ,
APPROVED BY: '
SEPTIC SYSTEM INSTALLATION
t
Is the installer licensed? NO
Type of Construction: REPAIR
New Construction: ..._Certified Plot Plan Review YES NO
-Floor Plan Review YES NO
_— Conditions of Approval from Form U YES NO
_Issuance of DWC permit: - NO
DWC Permit Paid? — O
- -DWC Permit# Installer: ( 4L L �
Begin_Inspection:- YES NO
Excavation Inspection:
-Needed-
Passed:— 113 By:
Construction Inspection: o C y1Vv'
Needed:
AsJkdltAan Satisfactory:
Approval of Backfill: Date: By: -/� -
-Final Grading Approval: Date: S - ' By:
x
r
Final Construction Approval: Date: By: ,- '
Certificate of Compliance: Approval: Date:
• i
' Colonial
maneanoDraftingConstruction
®
f Sery ices
110 Main St., unit 0204 3(o Hillman Street - Unit 12
Tewksbury, MA 01816 Tewksbury, MA 0181(
5° (9l8) SSI-7330
rook Farm Estates t9�18 8�1- 311
Christian Extension
North Andover, Massachusetts
till-All -it, till,
It I
it I
ill, l"i Hit till. till
aq
IMI 0® ® i
2S x 40 Colonial
4 5edrooms - 2 1/2 5aths _
C280901—W240901-2LS Family Foom - 2 Car Garage - 2kI,5 sq, ft.
Classic House Plan : S-31
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Note e= [s e a O t S Minimum Uniformly D istrbuted
1. All notes and details contained within these drawings are to be used rive Loads (lbs./ sq.firs
as they would apply to the house being constructed. (oth ECi itfon r'ia55achusetts Build inn Code LIVE
2. When plans are used in conjunction with builder specifications and Notes and details apply as necessary to the house design. 115 LOAD(per)
( any discrepancy occurs,the specIfIcations will supercede the drawings. Balconies and decks bO
3. All substitutions are the responsb1ity of the Builder. Access to Crawl Space C 3603 .S .2 I
i Garages 18"x 24" (min.)
� arages(passenger care only) 50 i i?
4. All dimensions are to be field verified by the Contractor and any
adjustments made accordingly. Access to Attic C 3603 , 3 .2 3 - Attica (roof slope 3/12or less,no storage) b
i 5. All work shall be completed in compliance with all a llcab[e
p p p� ZZ" x 30" (min)For attics with a height greater than 36" � Attics(limited storage) ZO
Building,Plumbing,Electrical codes. Any other local,state and/or m Livings Areas(except sleeping rooms) 40
1 federal codes that may apply to this project shall be considered Csirder Ends C 3603 .22 . I m n9 p p 9
l as part of the construction documents. The ends of wood girders shall have a 1/2' at space on top,sides d end. 6 Sleeping Rooms 30
1 6. All waste materials and debris shall be removed and disposed Fire Separation I 3603 .5 .2 3 Li Stairs 40(2)
I of properly. Ther_garage shall be separated from the residence and its attic area by
5/8-inch(min.)type X sum board applied to the garage side.
Guardrails ails and Handrails 200
1. Numbers set within I I reference that section of the bth Edition of p gyp pp 9 9 (akgla carrcantratad toed at airy point along top)
J the Massachusetts State Building Code. Minimum Coiling Haight 13603 .6 .1 I Note=
f 8. These drawings were prepared per guldelines set forth in the Minimum telling height:Habitable rooms,except kitchens,shall have a (2)Stair treads shall be designed for a single concentrated
Mass.State Building Code Section C 36 1 For 14 2 family dwellings. ceiling height of not less than 1' 3" for at least 5O% of their required areas, load of 300 lbs.over an area of four square lnches.
Legend: S -Smoke Detector Floor Surface C 3603 .5 .3 I Design Dead Load=IO lbs.per square Foot
Q Garage floor surfaces shall slope to Facilitate drainage toward the [Tables 36052.3 ,]a,3605 .2 .3 .b t 3605 .2.3 .lc I
_ C4 main vehicle entry/exit doorway.
to o� Joist Under Bearing Partition C 3605 .2 .3 .2 I Minimum Glazing Area t 3603 ,b .4 .2 I
Joists under parallel load bearing partitions shall doubled or a Exterior glazing area of not less than 8%of the area 1/2 of the required
1 beam of adequate size to support the load. area of glazing shall be operable.
R `
I Bearing C 3605 .2 .4 1 Safety Glazing C 3603 .20 .4 .2 I
The ends of all joists,beams or girders shall have 11/2' (min.)of All doors and fixed side panels with 24" to either side of a door.
bearing on wood or metal and 3" (min.)on masonry. Exposed bottom edge less than IS" above floor.
Individual panels that are greater than S sq,ft.
)3ridging t 3605 .2 .5 , 13
Bridging shall be installed at Intervals of 8, (max.) Basement Ventilation C 3603 .6 .6 .2 , 13
Chimrlts clearances C 3610 .2 .5 3 Exception=Cantlevered joists shall be laterally braced Basements and cellars not used as habitable,occuplable space shall
at points of support be provided with a minimum of four sliding tope,or awning tope basement
Chlmneya shall extend at least 2' hfgher than any portion of the windows For every BOO sq.Ft.of floor area.
building within 10' but shall not be Tess than 3' above the
point w ere the chimney passes through the roof. MdXi up allowable Spans for header Sleeping Room Window O n 13603 .10 .4 . 13
supporting wood Frame walls p�9 p 9
Gar" / House Separate C 3603:5 .1 I 33 sq,ft,20" x 24' in either direction.
Openings from a private garage with either solid wood doors 13/4" .o Size Support'g Headers in
p g g B 6
thick (mina or 20-minute ire-rated doors,self ROOF i Story 2 Stone Walls not Ventilation R
closing devices and `" Header pnl Above Above supporting qui ed C 3603 2 1
'
fire resistive rated door frames are not req'd. Ali door openings y floors or roof Every room or space intended for human occupancy shall be provided
%Q Ibetween the garage and the dwelling shall be provided with a raised O2.2x4 4 with natural or mechanical ventilation...
61"11 with a 4" min.height. m Exception=Every bathroom and toilet room shall be equipped with a
Smoke Detectors E.3603 , 16 10 I � 2-2x6 b41 mechanical exhaust fan.
Smoke detector/heat detector locations 2-2x8 8 6' ip'
Exit Doors C 3603 . 11 . 1 I
1. in the immediate vicinity of bedrooms., •�� 2-2x10 10' 8' b' p' 1-36" wide x 6'6' high,others 2'8" wile min...
2. In all bedrooms. 12' 10' 8' I6'
3.In each story of a dwelling unit,including basements and cellars, Interior Doors C 3603 .11 .2 I
but not including crawl spaces and uninhabitable attics: 1. Nominal Four-inch thick single headers may be 30" wide x 6'6' high(min.)
4. 1 for every 1200 sq.ft,unit, substituted for double members. Exception
Roof and Attic Ventilation 13603 ,b .S . i .1 I 2. Spans are based on No.2 Grade Lumber with I. Bathrooms 28" (min)
Ventilating area shall be V15O of the space.This can be reduced IO tributary floor and roof loads.
2. Ex(ating Bathrooms 14" (mkt.)
1/300 when a vapor retarder Is Installed.
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• - 5'2" 31411
510" 52 4" .11334" l'0"
2'10" X 3'5�t' 210"X 3'514" #
YeM Yen
5"BV2"X 4'5V2"
6D Ln Bedroom 04
Fan
Walk-Ino CI. ° _ Jc
° Closet�� 2'0" rjjz�j :il
=Y
2,4„ 2,4° 2'E7n .5
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3,0 34" high (min.)n 2-2'6" _
12'4 r
Guardrail �n GPost Post Post -
o O r S Closet N
30' -38" high ,----,
26' O 2-26
handrail (typ.)�., a-oil
n
M Bedroom $1 24 ClosetFrnheaopes o Bedroom 03
to mahtatn headroon
3'6" For starnuag below x
Ln
Bedroom #2
' 2'10" X 4'5'2" 2'10" X 4'51'2" 2'10" X 4'S�2" 2'10" X 4'5"2"n
N
Post-
(3 # # 2'10 X 4'51/211 # #
2'2" X 4'51h" # 2'2" X 451'2"451'2"3'(211 1
4b" 6'6" 6'O" 610" 3'6" 6'6" 4'0
14 0" 120 14'0"
40'O"
���,.��`� 5-31= 5cscond door Flan
L`1G tet: -
1. All dimensions to be Meld verified and changes made accordingly.
2. Window rough opening sizes are For Merrimack Valley window units, r1
3. 0 - Indicates egress window unity. Living ar .Pia sq.
r -i r I r i
I o -
-- - - 3 -2x12
Center beam
3 -2 x 12 _ below
Center beam - - - - -
below
N
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N
Double Shear Lap Splice
Joist hanger 2 x 10 Q12" O.C.
Simpson LUS hanger ,
or equivalent
All members are 2 x 10 6 16" O.C.(UN.O.)
irsoor Fram Ina,
14'33/4" 5'4" 20T/2"
,,33/4„ TO" 2'6" 2'10° 4'0i/4" 10'5/4" 5.011, 3'23/4" 2'6" 5'O"
v0"X 3'511 3'4"X13'5
O
I a it F— F=—� I .
5'912" X 4'9'/2" O __; fir _r____ 6'O" SLIDING 2'10" x 4'9/2" 2110" X 4'912'
Fan SED.
3'4 2 "
o = Study Lav Qo Kitchen 5reakfast - - - - - - - - - - - - - - -
o 90 -
- v 2'4� - O -
X . 1 4 i
O O O O
Actual eabYri layout i ;b
C U "�lV� irn
i=am ii y
= O O
3141/4" 31g" ��� __ vaulted ceiling X n N
1. ----- ----- 26 ------ _
2I$" n ---- a�
PostCO
_ __--
Post
_ _t n :c �
{{' ON N
t O
t _ _ 6" 3'91/4" H
— - - - - - - - - - - - - - - - - -
`r Living 34" high(min.) p in Ing O
ix Guardrail 4
o " 30" -38" high " 2'10" X 4'9/2" 2'10" X 4'9/2"
r handrail ( )
gyp. °
Foyer
2
2'I0" X 4'91'2" 2'10"X 4'9/2" 2'10" X 4'9/2" 2'10" X 4'`312"
6' 3'0" 1'6
3'O" 3'O"
4'O" 6'6" 3'6" 3'O" 3'O" 3'6" 6'6" 4'O"
1410" 12'0" 14'0" 4'6" l'O" 4'6"
40'0" 16'0"
Ae
1. All dimensions to be field verified and changes made accordingly. �7�3 1 : irst l o o r Ian
2. Window rough opening sizes are for Merrimack Valley window units. 3/16" = 1'0" '
3. P,E.D.- Primary r egress doorway Living area sq. T t. � 2
S.E.D.-Secondary egress doorway
56,0„
I 34'0" 22'011
T3-/4
91611 1�12��;11 116" 51011
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1177771
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ii------------ ;
14 X I3 24 X 13 G-arade Finish
1 , ' Foundation '�'-4" Concrete Slab 5/8 ype X gypsum wallboard '0
O 10" Conc.Wall / 8'O" Pour(+/-) 6 x 6-6/6 welded wire Fabric shall be installed to the Garage
1 r 3,000 p.s.t,concrete placed at mid-depth of the slab. side of wail(s)and ceiling or
500 ; -
X 10" dp.x 20" w.contin.Ft'g.
O 2 p s.Lconcrete attic For fire separation I O
I `o' m
1
' 5asement Garage
" 22 11 n 1 22 1 22
516 510 51011 424 60 BO
1 p
1 �
—
�„ 4" Concrete Slab -
a----- a-- Slope for drainage Q, ;
1 �
3 -2 x 12 Center Beam
1 , �- - ' "� 3,500 p-91 concrete
O ' beam Pocket x 6-6/6 welded wire Fabric I ° 0
r ( '' b" W x 6" pp x 9" N 2 -3 I/2" Dle,Lally Columns = placed at mid-depth of the slab. l ;
' With 2'6" x 4'6" x 1'3" d
Shim beam with steel p"ft'g" �^ 4"(min)o
Step down into Garage
,x shms or hard brick
• v � F � uP 20 minute fire door(min)
qtr (I Req d) 11 -------------------------'� °
IN 3 1/2 Dia.Lally Columns r------- cII
1 -
' W/2'6" s x 1'3" d rooting
34" high (min? O q p 9 r - ------------ ----
Guardrail (8 req d) � � _
^ O
' '' !----------------------------- r----------------- --------J i L
i ir-----------------� � ,
7 i
. 11 - ---- ---------------------
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_ — ---------------------------� " r _—
O 1 ' L� •.• 1 � � 1 •.•
iv C1461011
1 1
14'O" 31011 61011 31022 141011
40'0 16'0"
631 = Poandation F Lan
1. .411 dimensions to be field verified and changes made accordingly. 3/16" ■ I'O"
2. Foundation drainage shall be provided around all concrete or masonry _
foundations enclosing habitable or usable spaces located below grade.
• C 3604 .5 . I and table 3604 .5 .1 ] l
3. Foundation walls enclosing habitable or storage space shall be Garage area Sq. ri 1., 552 '
dampproofed From the top of the Footing to finished grade. Basement area sq, ft. = 913
13604 .6 .11
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2 x 12 Ridge Board
All members are 2 x 10 lad I6" O.C.(U.N.0)
x 3/16" = l'O"
Cw w O�O � Continuous Baffled Ridge Vent
l8 _—_—_— 2x 12 Ridge Board
10, 10, S / 14-14 1 x 8 Collar Ties 9 4'0' O.C.
located in the upper third of the
height of the roof,measured from
the sill plate to the ridge.
12
9 —Rom
Composite Roofing
No.15 Building Paper
" 1/2' PI ood
14 0" 14 0 2 x 10's 16, OL.
i
I T _ Attic—_
Ln -----
C4 Fascia Board
f 2x8e16" O.C.
SP m R30 Insulation
i Va�or Barrier \--6offlt with venting
o n 1/2' Wallboard.
m N o o Floor
3/4" T 1 G Advantec
aSecond 2 X 10 9 16' G.C. �dll
-—-—- Cedar Clapboard Siding
I O Fire Blocking Air Barrier
M 1/2" Plyywu000d
{ 2x616" O.C.
` RIS Insulation
m o Va�or barrier
1/2' Wallboard
CO
Floor
C',
3/4" T t G Advantec
2 X 10 6 16" O.C.
First_—_ RIS Insulation Sill
Continuous Sill Gasket
-—- Fire Blocking 1/2' O.D.Anchor Bolts aQ b'O' O.C.
- Arox_ 3 -2 x 12 Center Beam
Finish
Grade Foundation
3 1/2" Dfa.Lally Columns 10" Concrete Wall/8'0" Pour
3,000 pat concrete
co 10' dp.x 20"u.contin.ft'g.
r Dampproof exterior surface
Basement 4" Concrete Slab Perimeter drain(tVp
-—-—- - r 4" perforated PVC pipe
Crushed stone
* Filter membrane cover
-31= Main S w i l l ind Section - I 3604.5 Foundation Drainage 1
1/4" =1'0' ftdC Table 3605 .5.1 I
14'b�/s"
Flush Framed Beam 5M-1
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r i r 9 r r r
1
r 9r -1
2x8Qlb" OL.
IEII III II II
Joiet hanger 2
Slmpwn LU5 hanger ,
or equivalent
All members are 2 x 10 aQ 16 O.C.(UN.OJ
-3 = Secana Floor Framing
w
14'33 " 11'6��4•
Flush Framed Beam- BM-2
1
1
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1
I L J L J L J L1 L J L J L J
t
1
Jo lot hanger
Simpson LUS hanger
or equivalent
12'O"
Flush Framed Beam: BM-3
All members are 2 x S aQ 16" O.C.(UN-0)
IG
3/16" ■1'O"
r �
4" Slab Stepdown Standard Soffit , Mass. B 1 d d. Cc d Sill _ 2x Bottom Plate
Qqdgr 610der t Column eibacW 2x Band Jo tat
vl ' Roof Rafter TRu66 TRUSS Insulation
Maintain 1" min.clear. - ` 2x Floor Joist
A a p a ( - 3o Peg
I-2xb P.T.
30 SP 1-2x6 K.D.Sill
l Fascia Board40 PW p_ w/Sill Sealer
4.. Ceiling Jois
min Soffit One $t0 Two 5t0 Three Story Anchor Bolt or
with venting Mudsill Anchor Straps
1 - COLUMN SPACiNGS UNDER GIRDERS Concrete Foundation
I 3/8" ■1'O" 3/8" 1'O" Cstder size I Table 3405-6 I 3/8' = 1'0"
W - 24 W - 26 W - 28 W - 32
i Step Footing Standard Soffit _
one story b'-3" 9'-10" 9'-6" B'-11"
Two sto 1'$" T'-4" �'-1" 6(.-all2x Fire Blocking
2x Bottom Plate
Roof Rafter
-----------� '�
' �� Thus story 6'-4" 6'4' 5'-II' S'-6"
Maintain 1 min.clear. Insulation
4O P8F 4 P°F
+ Q Column sizes-4" x 4" or 3 1/2' diameter steel 2x Floor Joist
C4 Hurrfcane clip Footing Size:Y-6" x 24 x V-3"d
Center Beam
Fascia Board SPRUCE-PINE-FIR No.2 Lally Column Cap Plate
' Soffit Modulus of Elasticity "E' -1,400,000 fasten to Center Beam
with venting Fb: 2 x 4 _ 1 ,510 2 x 10 _ 1 , 105
_ 2 x 6 1 ,310 2 x 12 1 ,005 Lally Column
r 2 x 8 - 1 ,210 I TABLE 3605 ,2.3 .Id I
3/4' = 1'0" 3/8" • 1'O" MAXIMUM ALLOWABLE SPANS FOR 3/8'
Mudsill Anchor Exterior Interm.Fir. JOISTS/RAFTERS Ridge Bean
.Spacing Plan Joist Continuous Baffled
Floor stze 2 x 6 2 x 8 2 x 10 2 x 12 (Zidge vent
2x Bottom Plate 12"OL. 10 -I V2 13-41/2 ri-11220-41/2 Ridge Beam
(max.) (max.) - 2x Sand Joist F irst V,'O.C. S-11/2 12-1 V2 15-I V2 ri-5 IR
2 x 8 �A I6" O.C.
r t1' 4e n 4 Q n`''1 '. n•a Floor Sheathing 12"O.C. 11-1 V2 14-9 1/2 8-10 1/2 22-4 1/1
i -Yip Q - Q -Y¢Q . M S e c o old 16.O.G. 10-I in 13-41/2 16-8 in IS-131/2 Roof Rafters
a- p Y 2x Floor Joist Attic. 12"0L. II-I V2 14-91/2 18-101/2 22-4 V2
Simpson Mudslll a� ° Future Rooms 16"OL. 10-1 V2 13-41/2 16-9 V2 19-3 In
Anchors 'MA6" ti -- 2-2x Top Plate
Attic iC 12' OL. 12-91n 16-101n 21-11n — - --'—'-- -
-.. _
See note 'Sill Anchorage" 136043.1a1 No future rms 16' O.C. 11-11/2 15-41/2 19-11/2 —
N.T.S. 3/8" ' l'O" Attic 12"O.C. 16-1 1/2 21-31/2 21-3 In — 3/8" =I'D°
--------------------------------------
G es 3/12( ib"O.G. 14-1 V2 19-4 In 24-8
Anchor Bolt Cantilever °p — Ridge Boar
SpacN Plan ROOF 12"O.C. 12-1 15-3 18-8 21-8
over attic 16"O.C. 10 -5 13-3 16-2 18-9 Continuous Baffled
Floor Sheathing ROOF Ridge Yent
12 OL. 11-0 13-11 TT-9 20-6
(max.) (max) Solid Blocking 2x Bottom Plate Cathedral ib"O C. 9-6 12-1 6-4 rl-9 Ridge Board
�, y Notes I x 8 Collar ties
t �T'a •p o-T'a'a .� - z 2x Floor Joist 2x Band Joist L All structural materials shall be void of any defects that may Qa 4'O' O.G.
.p °- •" �'- •`' D°� •4. o ' Insulation diminish their capacity to function in an adequate manner. - Roof Rafters -
Structural Engineering or any other professional servlces that ---
Anchors bolts or a 2-2x Top Plate Cantilever may be required shall be provided by others. ___ ___
N App'd Equivalent -' overhang 2. Use built-up 2 x 4 posts under all beams(4 minimum). _ _—-—_—_ _
See note Sill Anchorage' C3604.3.W 3. Built-Up Beams,Flush Framed Beams and/or Substituted Beams
N.T.S- 3/8' = 1'O" shall be sized by the contractor.
3/8" = I'O'
W240901
Continuous Baffled Ridge Vent
2 x 12 Ridge Board
I x S Collar Ties 9 4'0" O.C.
located in the upper third of the
j12 - - - height of the roof,measured from
5 - - -- the all[plate to the ridge.
Composite Roofing
No.15 Building Paper
r Cep 1/2" Plywood
1 2 x 8 9 I6' O C, 2 x 10 16" O.C.
i
-—-—
R30 Insulation Barrier
Fascia Board
1/2' Wallboard.
Soffit with venting
O Wall
Cedar clapboard siding
� Air Barrier
f 9! 1/2" Plywood-
(z p100r 2x64) 16" OC.
3/4 T t G Advantac
2 X 10 Qa 16" O.C. RiB Insulation
First -— R19 Insulation vapor barrier
IR' Wallboard
nAraoe Finish Fire Blocking
5/S" t X sum wallboard 3 -2 x 12 Center Beam 1 -2 x 6 P,T.,I-1 x 6
ype gyp Continuous Sill Gasket
shall be installed to the Garage 1/2" O.D.Anchor Bolts Q 6'O' O.C.
side of walls}and ceiling or
attic for fire separation
3 1/2' Dia.Lally Columns Foundation
10' Concrete Wall/8'0' Pour
3,000 psl concrete
10' dp.x 20"w.Contin,ft'g.
Basement 4' Concrsts Slab Dampproof exterior surface
- -—-— Perimeter drain(typ)
4' perforated PVC pipe
Crushed stone
Finer membrane cover
5-31' Section thru l=am ilu / araae — 2 13604 .5 Foundation Drainage I y
1/4" =1'0" v v
I Table 3605 .5 .1 I
f
Colonial 218 - Two L Stairs
Drafting
Services Framina Sention Detiall Stairwau Width
110 Main St., Unit #204 6th Edition Mase, B l dg. Code C 3603.13.1 I Width=stairways" no be lea than 36'In clear width..
Tewksbury, MA 01816
(9l8) 851-1330 Treads and Misers
C 3603.13.2 I Treads and risers;The max(rum neer he ht shall be 8 1/4"
and the minimum tread depth shell be 9'
Tolerance between adjacent risers:3/I6"
Total riser dkonsion tolerance:3/8"
Hosing Profile:
2x Header F2x Floor oist 2-2x Header C 3603.13.2.1 I Nosing profile,A roetng&hall not extend more than
E cU 2 x 4 Studs 1 iR"beyond the Face of the rear below.
E 9" m 1 n imum B I Q�eyond) ( Headroom:
j cc t read m m I R30 insulation R30 Insulation C 3603.13.3 I Weadroom-The minimum headroom h ail parte or the
I e in Insulation
stairway shall not be less than 6'-6 .
between platform
1 r -� r r Stringers
CP I _= 2 x 12 Stringers 1=irestopp ing:
m -
2 x 4 Fire Blockingq 13606.2.1 I Ftaatopptrg shall be provided to cut off all corcealed
Placed parallel wa%stringers Spaces between stat stringers at the top and bottom of the run.
Insulate wall
' 2x Head `•' ' 2x Header Guardrail Details:
C 3603.14.2.1 I Guardrail details Porches,balconis&,decks or
2x Floor Jo let raised floor surfaces located more than 30"above the Floor or grade
abelow shall have auardralle not less than 36"h haigrrL Open sides
rn, ( I s Center Beam
o of etch wRh a total res of more than 30 above the Floor or grads
below shalt have guardrali,which shall also serve as handrails,
Cc r not leve than 34"irrhaight measured vertloally from the rasing
4 I m � I of the treed&. ,
v
t n Guardrail Opening Limitations:
Lally column(beyond) 13603.14.2.2 E Exc.3: Required guardrails on open side of eta"*,
'• OC r I r balconies,porches,decks and raised floor areas,shall have htarnediate rape
—2 x 12 Stringers balusters or ornamental closure which prevent the passage of an object
r i r 5"or more In diameter.
1 _ Exception=Triangular spaces forced by the rear,tread and bottom rag of
a guard at the open side of a etatnwey may be of size to prevent
j I the passage or a sphere 6"In diameter.
Minimum tread=9" I.
Handrails:
E 3603 ,14 . I.1 I Handrails having 30' min,and 38" max,heights
respectively,measured vertically from the nosing of the treads,
shall be provided on at least one aide of stahuays of 3 or more risers.
Exception:
I. Handrails shall be permitted to be Interrupted by a newel
post at a turn.
2. The use of a volute,turnout or starting easing shall be allowed
/ over the lowest tread.
Handrail Grip Size:
r Stairway circular handrail cross section:11/4' min.and 2" max.
Other shapes,perimeter-4' min.and 6 1/4" max.
Croas-sectional dimension of 2 5/8" max.13603.14 .1.2 I
I . 12' I ` 18' DECK ILII �I�II TrII �III
180
r---+-------------------- --------------------�----
I I I 1
Oi I
t
I
1'O" Dia.Concrete Pier
! _ Number of doers and
O treads may vary due
`V O . to site conditions O
O 2x13Q16 OC, p
I
I
Joist manger(typa '
I
JLI
r 2 x 10 Ledger
Lagbolted 6 Ib° O.C. J�
OFICK FidAMIN FOUNDATION
1/4' 1'011 1/4' •11011
jFlashing
5' Clear(MaxJ Lag bolts 9 16" O.C.
Rail
Decking
WHOM
O Post --+-2x peck framing (P.7)
m --I
3-2x10
6 x 6 Post L Jobt Danger
Grade Post Anchors
O Concrete Foundation
O �
O E e ✓ FC1 \ / POusrm cO N1 `EV 1 IO1
O
_ a SII -IIOI
ti
1/4" 1'O' i
project Number & Title: 5'-�J" S ' °C�� `�al Project Number & Title: S ` 3 a-6 X AQ C<n i ,=N'+�t_
Prod
• Calculations for Floors Table
for Windows & Doors
Table of areas for Double Hung windows Table of aroPROXrIcaGainentMATE Nwlndowa
Floor Pian APPROXIMATE WIDTH
1'10' 2'2" 2'6" 2'8' 2'10" 3'0" 3'2" 3'4" 3'6" 1'5• 1'8" 2'0" 2'4" 210" 3'0" 3'S" 4'0" 4'9" 6'0"
!0 3'S- 6.26 7.41 8.54 9.11 9.78 10.25 10.92 11.38 11.96 2'0" 2.83 3.34 4.0 4.66 5.66 6.0 6.83
e -D 3'9. 6.87 g.13 9.38 10.0 1061 11 11.88 12.4913.13 2'4" 3.26 3.89 4.66 5.43 6.59 6.99 7.96 9.32 11.07 13.98
O q'I' 7.47 8.85 10.21 10.89 11.6712.25 12.93 13.60 14.29 3'0" 4.25 5.01 6.0 6.99 8.49 9.0 10.25 12.0 14.25 18.0
@ X q'S' 8.18 9.57 1 1.04 1 1.78 12.62 13.25 14.10 14.71 15.58 3!3'5" 6.83 7.96 9.67 10.25 11.68 13.67 16.23 20.5
m 4'g' g.80 10.29 11.88 12.67 13.57 14.25 15.16 15.82 16.75 m 4'0" 5.67 6.68 8.0 9.32 i 1.32 12.0 13.67 I6.0 19.0 24.0
1 _ m 5'1• 9.30 11.02 12.71 13.55 14.39 15.25 16.10 16.93 17.79 m 5'0" 7.08 8.35 10.0 11.65 14.15 15.0 17.09 20.0 23.75 30.0
4fLangth�l G1 5'S"10.03 11.74 13.54 14.45 15.46 16.25 17.28 18.04 19.09 =5'5' 7.67 9.05 10.87 12.62 15.33 16.25 18.51 21.67 25.73 32.5
+ L X W °Area �+6'1. 11.13 13.18 15.21 16.22 17.22 18.25 19.26 20.26 21.29 -4 6'0• 8.5 10.02 12.0 13.98 16.98 18.0 20.5 24.0 28.5 36.0
' Illork Area Calculation table for Casement windows
Calculation table for D N.W(Total Unit size Area of unit X quanity • Total
Unit size Arca of unit X quan8y Total
+ Area of floor over unconditioned (unheated)space (L X W)
12,('2 f `
2 12, 140
t Calculation table for other lazfn,.�w.yt
Calculation table for Glass DoorsCalculation
size Aree of unfl x quanity •gTotal Unit size Area of unit X quwlty Total
L�e
t!
Calculation table for Interior doom
Calculation table for exterior doom poor size Area of unit X quanny Total
Area of floor over outside air L X W) Door size Area of unit X quanfty Total
� t x6 1 �
Total area of Interior doors
Colonial Colonial Total area of exterior doors
5rarttng Grating 2'6" = 16.67 5'0" = 33.35
5e"IcaG Services
2'8" = 17.81 6'0" = 40.00
Ilo Maki St,Unit#204 170 tlah St.Unit 1204
Tevksouy.MA 01816 TewksMry,4A 01876 3'0" = 20.0 8'0" ='"5u.36
I
(918)851-1330 (978)851-7330 Area of various doors(68 height)
Project Number & Title: - 310 `2S K40 C�oL-O0'aqL
i )Project Number & Title: S- �l = 29 -, Cc,Lol t►AL
Calculations for Square Footage(s) of Ceiling(s) Calculations for Square Footage of Malls
Flag. "=u uaid or rAthe-dral Cell
A A
5 �2 H lat Floor Plan 5 D 2nd Floor Plan 5
_ roentlon -----------
Ll
1
H3
Width U)
LI+L2+L3)X W a Area e
Plan View Perimeter I(PI)= A +B +G + Perimeter 2(12)= A + B +G + D 2nd Floor
H2
L X W Area
D +F +F +G +H i
ILinrk Area Hl
PI X HI = Ist floor wall area (Al)
P2 X H2 = 2nd floor per(meter area (A2) lat Floor
P3 X H3 = 2nd floor wall area (A3)
AI + A2 + A3 = Total wall area
Work Area
s
isT �A t 3 -9,*�3 >.3t
; - a
)_�>2�i ( I`4 * -7j •r 3 -T � r 3•e- I�' f�� y-�G T�.��
-J 141
141
2W5 77
a7 1
Golonlel Colonial
Drafting sda L 9
Be-lads Servkes
110 Maki St.,Unit 0204 110 Main SL,Unit 0204
Tewksbury,MA 01816 Tewksbury,MA 01816
(918)851-1330 ('318)851-1330
1
I
TITLE: Classic House Plan # S-31
• MAScheck COMPLIANCE REPORT I MAScheck INSPECTION CHECKLIST
Massachusetts Energy code I Permit # I Massachusetts Energy Code
MAScheck Software Version 2.01 Release 3 I I MAScheck software version 2.01 Release 3
I I DATE: 6-2-1999
1 checked by/Date I Bldg. 1
TITLE: Classic House Plan # S-31 I I Dept. 1
Use I
CITY: North Andover
i STATE: Massachusetts [ ] ( CEILINGS:
HOD:HDD: 6322
I CONSTRUCTION TYPE: 1 or 2 Family, Detached I Comments/Location
HEATING SYSTEM TYPE: Other (Non-Electric Resistance) _
DATE: 6-2-1999 I WALLS:
I PROJECT INFORMATION: [ ] i 1. Wood Frame, 16" O.C. , R-19
Brook Farm Estates, Christian Extension comments/Location
North Andover, Massachusetts
28 x 40 Colonial , 4 Bedrooms - 2 1/2 Baths - Family Room I WINDOWS AND GLASS DOORS:
2 Car Garage under - 2,678 sq. ft. [ ] I 1. U-value: 0.49
I For windows without labeled U-values, describe features:
I 1
COMPANY INFORMATION: # Panes Frame Type Thermal Break? [ ] Yes [ ] No
I
Mangano Construction Comments/Location
36 Hillman street - unit 12 [ ] I 2. U-value: 0.5
Tewksbury, MA 01876 1 For windows without labeled u-values, describe features:
(978) 851-7311 i # Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
NOTES: [ ] I 3. U-value: 0.48
Merrimack valley "Northeaster" Primed wood series window units I For windows without labeled u-values, describe features:
• I # Panes Frame Type Thermal Break? [ ] Yes [ ] No
` I Comments/Location
COMPLIANCE: Passes [ ] j 4. U-value: 0.47
For windows without labeled U-values, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Maximum UA = 514 I
Your Home = 505 Comments/Location
I
Area or Cavity Cont. Glazing/Door
j Perimeter R-Value R-Value U-Value UA I DOORS:
------------------------------------------------------------------------------- [ ] I 1. U-value: 0.14
CEILINGS 1580 30.0 0.0 55 I Comments/Location
i WALLS: wood Frame, 16" D.C. 2710 19.0 0.0 163 [ ] I 2. u-value: 0.35
GLAZING: Windows or Doors 330 0.490 162 I comments/Location
GLAZING: Windows or Doors 40 0.500 20 I
GLAZING: Windows or Doors 36 0.480 17 1 FLOORS:
GLAZING: Windows or Doors 12 0.470 6 [ ] I 1. over Unconditioned Space, R-19
DOORS 20 0.140 3 I comments/Location
DOORS 17 0.350 6 [ ] I 2. over outside Air, R-19
FLOORS: Over Unconditioned Space 1525 19.0 0.0 72 I Comments/Location
FLOORS: Over Outside Air 15 19.0 0.0 1 I
HVAC EQUIPMENT: Furnace, 80.0 AFUE I HVAC EQUIPMENT:
------------------------------------------------------------------------------- [ ] I 1. Furnace, 80.0 AFUE or higher
COMPLIANCE STATEMENT: The proposed building design described here is I Make and Model Number
consistent with the building plans, specifications, and other calculations I
submitted with the permit application. The proposed building has been I AIR LEAKAGE:
designed to meet the requirements of the Massachusetts Energy Code. [ ] I Joints, penetrations, and all other such openings in the building
1 envelope that are sources of air leakage must be sealed. when
The heating load for this building, and the cooling load if appropriate, 1 installed in the building envelope, recessed lighting fixtures
has been determined using the applicable Standard Design Conditions found I shall meet one of the following requirements:
in the Code. The HVAC equipment selected to heat or cool the building I 1. Type Ic rated, manufactured with no penetrations between the
IL shall be no greater than 125% of the design load as specified in 1 inside of the recessed fixture and ceiling cavity and sealed or
Sections 780CMR 1310 and J4.4. I gasketed to prevent air leakage into the unconditioned space.
2. Type Ic rated, in accordance with Standard ASTM E 283, with no
Builder/Designer Date I more than 2.0 cfm (0.944 L/s) air movement from the the
I conditioned space to the ceiling cavity. The lighting fixture I 170-180 0.5 I 1.0 1.5 2.0
I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I 140-160 0.5 I 0.5 1.0 1.5
difference and shall be labeled. I 100-130 0.5 I 0.5 0.5 1.0
I �
VAPOR RETARDER:
[ ] I Required on the warm-in-winter side of all non-vented framed ----NOTES TO FIELD (Building Department Use only)-------------------------
I ceilings, walls, and floors.
I
MATERIALS IDENTIFICATION:
[ ] I Materials and equipment must be identified so that compliance can
I be determined. Manufacturer manuals for all installed heating
and cooling equipment and service water heating equipment must be
I provided. Insulation R-values, glazing U-values, and heating
! I equipment efficiency must be clearly marked on the building plans -
I or specifications.
I
I DUCT INSULATION:
[ ] I Ducts shall be insulated per Table ]4.4.7.1.
� I
DUCT CONSTRUCTION:
[ ] I All accessible joints, seams-, and connections of supply and return
ductwork located outside conditioned space, including stud bays or
I joist cavities/spaces used to transport air, shall be sealed
using mastic and fibrous backing tape installed according to the
I manufacturer's installation instructions. Mesh tape may be
I omitted where gaps are less than 1/8 inch. Duct tape is not
I permitted. The HVAC system must provide a means for balancing
air and water systems. '
' I .
I
TEMPERATURE CONTROLS:
[ ] iThermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
I and/or cooling input to each zone or floor shall be provided.
i
i I HVAC EQUIPMENT SIZING:
[ ] I Rated output capacity of the heating/cooling system is
not greater than 125% of the design load as specified
in Sections 780CMR 1310 and 14.4.
I
SWIMMING POOLS:
[ ] I All heated swimming pools must have an on/off heater switch and
I require a cover unless over 20% of the heating energy is from
non-depletable sources. Pool pumps require a time clock.
HVAC PIPING INSULATION:
[ ] I HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F must be insulated to the following levels (in.):
PIPE SIZES (in.)
HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4"
LOW pressure/temp. 201-2S0 1.0 1.5 1.5 2.0
Low temperature 120-200 0.5 1.0 1.0 1.S
Steam condensate any 1.0 1.0 1.5 2.0
COOLING SYSTEMS:
chilled water or 40-55 0.5 0.5 0.75 1.0
I refrigerant below 40 1.0 1.0 1.S 1.5
CIRCULATING HOT WATER SYSTEMS:
[ ] i Insulate circulating hot water pipes to the following levels (in.) :
PIPE SIZES (in.) `-
NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS
HEATED WATER TEMP (F): RUNOUTS 0-1" 0-1.2S" 1.5-2.0" 2.0+"
Add e) s C—HlSTi
Title of Rie
Page of
Date File Open:
Date fide closed
Doc Document/Action Title Date of
action Refer to Other Purpose of Document/Action and notes:
Num. Document/ document/ --
Action De artment
Board of Appeals - Board of Heal h
Plan mg Board ; Con
seruatiion COm11lfSSlon - Building Departm, en�t 1—
IAORTIyTown ` � ,
F
® AxidovA
LA F
COCHICHE WICK V
ADRArED PFS`
BQA RD OF HEALTH
Food'/Kitchen
Septic System
PERI�A� IT
Q'LG� 111
BUILDING INSPECTOR
THIS CERTIFIES THAT.......AA.04Y.A*0........ .. .).14 .0'.....�.. .. . ..... ..................... .................... Foundation
has permission to erect.............I......................... buildings on ..�.* ., .. ../. .... .� .1 t4
!�.... 4
to be occupied as_1 ��®tom � J � �..... .... $ /1....�. . I.�U° no a�61 Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-taws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSP TORO
VIOLATION of the Zoning or Building Regulations Voids this Permit. ou �'"� UD
�C.,
M I04 1) PERmrF EXPIRES IN 6 MONTHS �;�.E ICAI, INSPECTOR
3 UNLESS CONSTRUCTION S T P
BLf,Paw F66z � g _
oto6P S o ........ ... .. ............................................. ..........:............................
115,10
DUE FRAME PERMIT'$.L.4.8$ 9 - .BUILDING INSPECTOR rine
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Behove Pin
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner 0i(
Street No. aJ`
SEE REVERSE SIDE Smoke Det. 0--
xk �!�
2-
1:AZ
r,c_
AS-BUILT CHECKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES &LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
INCLUDING RESERVE
vex TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
VO00000r
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
✓` DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK&D-BOX
ORIGINAL STAMP & SIGNATURE
IMPERVIOUS AREAS -DRIVEWAYS, ETC.
NORTH ARROW
_� R LOCATION& ELEVATIONS OF BENCHMARK USED
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
Yes NO Initials
A. Bottom of Bed
1. Excavation to proper depth
2. With trenches,sides of excavation are beneath B horizon
3. Edge of excavation specified distance from foundation,etc.
Comments:
B. Retaining Wall
1. Wall height and width as specified
2. Waterproofed
3. Wall minimum 10'to leaching facility
4. Wall meets specifications of plan
Comments:
C. Building Sewer
1. Pipe diameter minimum 4"
2. Schedule 40 pipe t-
3. Watertight joints
4. Inlet to tank cemented
5. Slope minimum 0.01 or 1/8"per foot minimum
6. Pipe properly set on compact firm base
7. Pipe laid on continuous grade in straight line
8. Cleanouts precede all change in alignment and grade
9. Manholes at any 90°change
10. 10' minimum offset to water line ci
Comments:
D. Septic Tank
1. Level °'"
2. 1,500 gal minimum
3. Gas baffle present on outlet
4. Manhole to grade
5. Manholes over center and each tee
6. 3-20"manholes ✓ �� s
7. Inlet tee minimum 12"under invert
8. Outlet tee minimum 14"under invert ✓ �l�
9. Outlet line cemented \�
10. Air space 3"above tees 1
11. 2"-3"drop from inlet to outlet
12. Pipe set
13. Compact base with 6"of/<"crushed stone under tank
14. Tank is watertight
Comments:
y.
Yes NO
E. Pump Chamber
1. If separate from tank,compact base with 6"of'/4"stone underneath
2. Minimum 2"pipe to d-box if gravity system
3. 20"access manhole
4. Tank level
5. Watertight
6. Tank size agrees with plan specification
7. Manhole to grade
8. Check valve and bleeder hole present
9. Alarm in building on separate circuit
10. Alann functions
11. Manual operating switch
12. Pump delivers liquid to d-box
Comments:
F. Distribution Box
I. D-box level
2. Minimum 0.1T'(2")drop from inlet to outlet
3. Minimum 6"sump
4. Outlet pipes show equal distribution
5. Compact base with 6"of stone beneath box
6. Box is watertight
7. All lines cemented with hydraulic cement
8. Schedule 40 pipe ✓
Comments:
G. Soil Absorption system
1. All stone double-washed-'/4"- 1 %z"
-pea stone
Bucket test done?
2. Minimum 2"of pea stone above distribution lines
3. Minimum 6"stone beneath pipe '
4. Distribution lines capped or connected together ✓ t�13/off,
5. Grading meets 3:1 slope �- ( r
6. Minimum of 9"of fill graded over system
7. Toe of slope stops minimum 5' from edge of property; if not,then Swale. ✓
Comments:
H. Leach Trenches
1. Minimum 2 trenches
2. Length of trenches agree with plan. (Max. length 100')
3. Width of trenches agree with plan-Minimum 2';maximum-4'.
4. Vent present if<50 feet or specified
5. Distance between trenches minimum 4' and maximum of 6'
6. Minimum distance between trenches 10'
7. Pipe slope minimum 0.005 or 6"per 100'
8. Depth of trenches below outlet invert minimum of 6".
a
Yes NO
9. Pipes set on stable base.
Comments:
1. Leach Field
1. Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6"per 100'
3. Separation between pipe 6'maximum
4. Pipes connected at end
5. Separation between adjacent fields 10'minimum
6. Pipes set on stable base
7. Maximum 4'separation from edge of field to first line
8. Minimum two distribution lines
9. Maximum perc rate 20 mpi
Comments:
J. Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between 12"and 48"wide
4. Access manholes on each pit
5. Pipes cemented with hydraulic cement
Comments:
K. Final Grade
1. Slope over soil absorption system minimum 0.02 l
2. All system components covered by at least 9"soil
3. Cover soil free of stones larger than 6"
4. Grading slopes away from dwelling
5. No areas over system that may pond
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERTIMT
DATE: 3-- -Z, m`° CURRENT INSTALLER'S LICENSE,
LOCATION: k O T 3 &40' a V r4vz w(
LICENSED INSTALLER: V2,Tha rL
SIGNATURE: TELEPHONE, �� 7
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
575.00 Fee Attached? Yes �� INC
Foundation As-Built? Yes No
Floor Plans? Yes No
Approval Date:
r
INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction of the septic system for the property
at a JAKP41ative to the application of STSG S
dated for plans by AlR*U-4c. and dated /D —02—4'g- with
revisions dated
I understand and agree to the following obligations for management of this project:
1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor,
project manger, or any other person not associated with my company schedules an inspection
and the system is not ready then item two shall be applicable .
2. As the installer I am required to have the necessary work completed prior to the applicable
inspections as indicated below. I understand that requesting an inspection, without completion
of the items in accordance with Title 5 and the Board of Health Regulations may result in a
$50.00 fine being levied against my company.
a) Bottom of Bed—generally first inspection unless there is a retaining wall which should be done first. Installer
must request the inspection but does not have to be present.
b) Final Inspection—Engineer must first do their inspection for elevations,ties,etc. As-built or verbal OK from
engineer must be submitted to BOH,after which installer calls for inspection time. Installer must be present
for this inspection. With pump system all electrical work must be ready and able to cause pump to work and
alarm to function.
c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site.
3. As the installer I understand that persons or companies not associated with my company may
not perform the work required by my company to complete the installation of the system
identified in the attached application for installation. I further understand that work by others
unlicensed to install septic systems in North Andover can constitute reasons for denial of the
system, and/or revocation or suspension of my license in the Town of North Andover plus
significant fines to all persons involved.
4. As the Installer I understand that I must be on site during the performance of the following
construction steps:
a) Determination that the proper elevation of the excavation has been reached
b) Inspection of the sand and stone to be used.
c) Final inspection by Board of Health staff.
d) Installation of tank,D-box,pipes,stone,vent,pump chamber,retaining wall and other components.
5. As the installer I understand that I am solely responsible for the installation of the system as per
the approved plans. No instructions by the homeowner, general contractor, or any other persons
shall absolve me of this obligation.
Undersign Licensed Septi taller
Date:
8
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT �yl ✓ '� I'1C�G�1 _ PHONE ' 79-7!;rg 3Cj
LOCATION: Assessor's Map Number PARCEL --
SUBDIVISION 640Ok- FaV'M CS Ic(10 S LOT (S) 3
STREET( V6VrlS7ctcq "V—EX-7-e-YIJ"Dy ST. NUMBER �5
* * *** * ********************OFFICIAL USE ONLY*** ******** ** ********
RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED '
DATE REJECTED
COMMENTS
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS /W/1' OM 4 S M S - A)O -lz::11-2161Y,�Q ,9rriC-9
PUBLIC WORKS -SEWERIWATER CONNECTIONS "v — j Z l 9
DRIVEWAY PERMIT S w << i Z— 79
+
FIRE DEPARTMENT x/l 2j hdR�cl. Cl) J�c� Lr l� 2�,v►,7 O c L QI//L�/
YEir« r flC,, 4 J 1 2dTOI
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9\97 jm
Town of North Andover, Massachusetts Form No.2
c� NooTM� BOARD OF HEALTH
o �/ 19 Q
•<• ••"o
o
W.
a
` °• -=-=- �r` DESIGN APPROVAL FOR
Arov
SSACMUSE� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant l�)rn ►ZJn ej—U Test No.
Site Location �D 3 17 Y'oo V .
• Reference Plans and Specs. C' �
ENGINEER DESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
CHAIRMAN,BOARD OF HEALTH
ke e Site System Permit No.
Town of North Andover, Massachusetts Form No.3
f No RTH BOARD OF HEALTH
do
9
' ...... `'h DISPOSAL WORKS CONSTRUCTION PERMIT
4CHUS�t
Applicant 1 U-le LL A)
NAME ADDRESS TELEPHONE
Site Location LI) r ,3 �3/a z-,gp—irq
Permission is hereby granted to Construct (0/or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
CHAIRMAN,BOARD OF HEALTH
Fee �� D.W.C. No.
_ _ ,i•_
•���.. FORM U - LOT RELEASE FORM _- -• --�----- v, �
,r..
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve ;7
the applicant and/or landowner from compliance with any applicable or requirements.
APPLICANT FILLS OUT THIS SECTION********* �
APPLICANT 17,714754170 PHONE
LOCATION: Assessors Map Number PARC:
SUBDIVISION LOT (S) 3
STREET C�idZrSflAi'! V�lA7 f ST. NUMBER 1,�_Y
OFFICIAL USE ONLY
QMME DA'IONS OF TOWN AGENTS: t L6 oPLN C-
CONSERVATION ADMINISTRATOR DATE APPROVED
1n l /py DATE REJECTED I Z R
COMMENTS_
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPEC OR-HEALTH DATE APPROVED
/ DATE REJECTED
F I PECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS -SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED EY BUILDING INSPECTOR r DATE
Revised 9197 im
127.35.
\
\
LOT 3
71 ,763 S.F.f
OD
\
\ N
\
N
r
f
s�
LA
ti �``
sxp
ti
ATLANTIC ENGINEERING do Boa No.
p A ISI QF LAND SURVEY CONSUL TANTS INC.
SEPTIC PLAN SUBMITTAL FORM
-,CATION:
NEW PLANS: YES $125.00/Plan
REVISED PLANS: $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: YES
DATE: % %f( f f
DESIGN ENGINEER: GL
DATE TO CONSULTANT:
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
When the submission is all in place, route to the Health Secretary.
SEPTIC PLAN SUBMITTAL FORM
LOCATION: �� 3
NEW PLANS: YES $125.00/Plan
REVISED PLANS: $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: YES NO
DATE: lalpq Lqg
DESIGN ENGINEER:
DATE TO CONSULTANT:
— 117 A41
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
When the submission is all in place, route to the Health Secretary.
Town of North Andover a NORTN
OFFICE OF 3?o�`" 4,100
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street : �9 •' ;
WILLIAM J. SCOTT North Andover, Massachusetts 01845 "SSACHUs���y
Director
(978)688-9531 Fax(978)688-9542
November 16,1998
Atlantic Engineering&Survey
97 Tenney Street Suite 5
Georgetown,MA 01833
RE: Christian Way Extension/Brook Farm subdivision
Dear Mr.Halloran:
This is to notify you that the proposed septic plan for Lot 3 Christian Way
Extension/Brook Farm has been disapproved for the following reasons:
1. Septic tank manhole to within 6" of finish grade missing. (310 CMR 15.228(2))
2. Both septic tank and D-box missing 6"stone bases. (310 CMR 15.221(2))
3. In"General Notes" section there needs to be a statement that"No garbage grinder is
alIowed."
4. Missing elevation of the garage floor and driveway grading. (NA 8.02t)
5. Please change note in leaching area to define proposed leaching field.
6. Please justify use of field. Trenches are to be used whenever possible. (310 CMR 15.240(6))
If you have any questions,feel free to call the office.
Sincerely,
Sandra Starr,R.S.
Health Administrator
Cc: File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
SEPTIC PLAN SUBMITTAL FORM
LOCATION:
NEW PLANS: $125.00/Plan
REVISED PLANS: YES $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: YES NO.
DATE: /aha I lqe
DESIGN ENGINEER:
DATE TO CONSULTANT:
When the submission is all in place, route to the Health Secretary.
Nov-09-98 12:49P Paul D. Turbide, PE/PLS 508-465-0313 P.05
November 9, 1998
Sandra Starr
North Andover Board of Health Administrator
Office of Community Development and Services
120 Main Street
North Andover,MA 01845
RE: Title V review for Christian Way Extension,Lot 3
Dear Sandra,
Enclosed find the"Checklist for North Andover Septic System Plans"for the above-
mentioned site. The following is a list of all the `Problem' areas and deficiencies Port
Engineering has found.
• One of the three access covers of the septic tank must be raised to within 6"of
finish grade by riser sections of 24"minimum diameter(3 10 CMR 15. 228(2))
• D-box must have 6" stone base. 310 CMR 15.221(2)
• Septic tank must have 6"stone base 310 CMR 15.221(2)
• In the"General Notes" section of the plan should be added the requirement that:
"No garbage grinder shall be installed". (It is stated in the"Calculations"section in
the calculation of flow that the system was designed for no garbage grinder,but 1
feel it should be stressed elsewhere on the plan in an area that the future owner of
the property can plainly see that no garbage grinder can ever be installed.)
• The proposed elevation of the garage floor,as well as grading on the driveway is
required. (This is especially important here because the proposed garage is on a slab
that is separate from the proposed building foundation).NA 8.02T
Minor comment: On sheet one,within the leaching bed shown on the plan, is the
statement: "PROP. SEPTIC". To be more accurate and descriptive, this should be
changed to"PROP.LEACHING FIELD".
PD rV If you have any questions or comments please feel free to contact us.
OR I
fNGlNEEGlNG Sincerely
Civil Engineers&
1And Surveyors Carlton A. Brown,PEJPLS
One Harris Street
Newburyport,MA
01950
(978)465.8594
rORM zz SOIL EVALUATOR FORM
Page 1 of
Date: 8/6L98
No.
Commonwealth of Massachusetts
AAOOV,.2 , Massachusetts
Soil Suitability 4ssessinent for On-sr'te Sewa e Disposal
Date:
Performed By: MAt�c�N 1�1ALt��aN a
tv-nc ,. RI9P�
Witnessed By: E
Q R ppK FARM — LvT-3 owner,N.x. MA R�es�" AN•1UN c ULA
LacAuon Addrtss a Addreu,and
Lo`I NO RTIA AN qbv ER 7dcpb= 111'1 C�ATF_W OOD D
A..EXA�1 DR1A VA 22 0']'
New Construction ❑ Repair ❑ '
Ofricc Review
Published Soil Survey Available: No ❑ Yes �.
Publication Scale � -IL Soil Map Unit, '�---
Year Published ..��-- `��S 13 N•1=C • (V`10��1���-�--k��^�^�
Drainage Class Soil Limitations
Surficial.Gcologic Report Available: No yes., ❑
year Published — Publication Scale --�••�--
Geologic Material (Map Unit) .
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes U
Within 500 year flood boundary No UYcs ❑
Within 100 year flood boundary No Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current'Watcr Resource Co ditions (USGS): Month - ----'
Range :Above Normal Normal ❑Bckw Normal ❑
Other References Reviewed:
DEP APPROVED FORM• 11/07/95
FOR11 - SOIL EVALUATOR I+O1tM
M
Pagc 2 of 3
Location Address or Lot No. 61?0014- FA RIM ' GOT
On-site Review
Deep Hole Number 12-3'9 Date:..5.1.3.19,45 Time::. -12t-4 Weather
Location (identify on site plan)
Land Use .`N00t:le 0 Slope (%) $ Surface Stones .
Vegetation .. �OZREST
Landform , OLr A SH PLA'tN
Position on landscape (sketch on the back) . .
Distances from:
Open Water Body L too feet Drainage'way e-wo feet
Possible Wet Area < ton feet Property Line L to feet
Drinking Water Well t 100 feet Other
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency,
Gravel)
IoYR
12 /gyp S,L. 312
Io YR
30
ID Y R S'/� ywtvEL.
Io Y R
1 b S.L. 7/(,MINIMUM 01- 2
i- S
Parent Material (geologic) ?1ZC)C4LA IAI. c->QTWAtN DopthtoOodrock:
Depth to Groundwater: Standing Water in the Hole: I os Weeping from Pit Face:
Estimated Seasonal High Ground Water:
DL•'P AI'IROVED F0101-12/07/95
4
FOItM II - SOII, EVALUATOIt FORM
Page 3 of 3 I;
U
I'
Location Address or Lot No. bROOV, FARM 1,Or✓1
Determination for Seasonal , i h Water Fable
Method Used:
D uepth observed standing in observation hole../-�.... inches
❑ Depth weeping from side of observation hole .......... .... inches
Depth to soil mottles inches
❑ Ground water adjustment ................... feet,
Index Well Number .................. Reading Date ................... Index well level ...................
Adjustment factor ................... Adjusted ground water level ..................................................
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system? t'�s
If not, what is the depth of naturally: occurring pervious material?
Certification
I certify that on
G� (date) I have passed the soil evaluator examination
approved by the Dep tment of Envir nmental Protection and that the above analysis
was performed by m consist nt wi ; the required training, expertise and experience
described in 310 CMR 15.0 7 r
i'
Signature Date
,1� 16 �Qo
DEP APPKOVLD Fo1LN1-12/07/95
Town of North Andover t MORTN
OFFICE OF 3� "' ��a
COMMUNITY DEVELOPMENT AND SERVICES
0 -
30 School Street
WILLIAM I. SCOTT North Andover, Massachusetts 01845 Ss:,.. V,
Director
FILE
OUTSIDE CONSULTANT ESCROW AGREE`�ENT
NORTH ANDOVER BOARD OF HEALTH
Agreement is made this n(,+- a dA lqq between the
Town of North Andover and PAA
of -1 1 A A--4 I) Mt �-LIA
for Soil Test
KNOW ALL men by these present that the Applicant hereby
provide the Town of North Andover with a check in the sum
of $ � , to be deposited in an escrow account for the
Town of North Andover and has deposited in an interest-
bearing account as designated by the Town Treasurer to be
expended by the North Andover Board of Health to insure
payment to any outside consultant (s) for Soil Tests, Plan
Review for the above referenced project .
This agreement shall remain in full force and effect
until the specified project has reached completion ,
JA AI�IL A'If
_56and of Health Chairman Applicant
or Agent
Date Date.
WILLIAM ANTONELLI 3-96 ss-log
sso 392
JANET M. ANI �2239 916
5431 FLINT TAVERNERN PL.PL.
BURKE, VA 22015 19
Pay to the
order of
Dollars
Crestar Bank
Alexandria,Virginia
1 L z 688-9535
nm
1:0 S E 0 0 10 7 9 t: 8 2 2 3 9 0 9�1i' 039 2 146 :MAIN STREET
1 0 )T— I — 1.-::; rrnr)V-��: --
Atlantic Engineering & LETTER OF TRANSMITTAL
Survey Consultants, Inc.
Land Surveyors - Civil Engineers - Planners
97 Tenney Street — Suite 5
Georgetown, MA 01833
(978)352-7870 — Fax(978)352-9940
Transmittal To: North Andover Board of Health Date: 10/22/98
Job No: 9701-02
Ref: Lot 3 -Brook Farm
Attention:
WE ARE SENDING YOU X Attached Under Separate Cover
Reports Letter Original Plans X Forms
X Prints Specifications Shop Drawings
COPIES DATE DESCRIPTION
3 10/2/98 Plan of Proposed Sewage System
1 10/2/98 Application for Disposal System Construction Permit
o? /S/9Fl So.✓ Sv i s s — 12-
THESE ARE TRANSMITTED as checked below:
For your use Approved as submitted Resubmit copies for approval
X For Approval Approved as noted Submit
As Requested Returned for corrections Return corrected prints
For Review and comment Other
* Remarks:
CAWINDOWSOESKTOMoleeds BhefcaseUransmittalsTrook Fane Lot 3 Septic-BOH.wpd
No. FEE
COMMONWEALTH OF MASSACITUSETTS
Board of Health, N• A"VANC l , MA.
APPLICATION L®I, DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct) Repair( ) Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components
Location jyV01ff FVAI 6641$76fV WAY AF)('C, Owner's Name At 4Nt0 11,Ft t 1
Map/Parcel# If It - 0 PAXT GF Address 1117 g#r6 k,,pop f. At rXRN R/A 4 pl/j
Lot# 3 Telephone# 7-07- — 7O fp _ f3 q2-
Installer's
ZInstaller's Name Designer's Name ATt.40-tc Oy-F
Address Address Gj6V" N Al Al A
Telephone# Telephone# 170 J1,5-7- 79le,4
Type of Building Lot Size 71 763 sq.ft.
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min.re ired) gpd Calculated design flow Design flow provided 01C gpd
Plan: Date q Number of sheets Z Revision Date
Title 1"/r 3 — R" Oak F"Al
Description of Soil(s) Wf 6 M G
Soil Evaluator Form No. Name of Soil Evaluator/M# OU 6-A?A-W Date of Evaluation $131474
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed Date
Inspections
No. COMMONWEALTH EALTH OF MASSACHUSETTS FEE
Board of Health, , MA.
CERTIFICATE Of COMPLIANCE
Description of Work: ❑Individual Component(s) ❑Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( )
by:
at
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application No. dated Approved Design Flow (gpd)
Installer
Designer: Inspector: Date:
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No. FEE
COMMONWEALT14 OF MASSACHUSETTS
Board of Health, , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system
at as described in the application for
Disposal System Construction Permit No. dated
Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health
.jai{7v.,.J,m....." .. .. i • . ..
FORM 1I -:SOIL EVALUATOR FORM,
Page 1 of 3
Date: MM 6
No.
Commonwealth of Massachusetts
N . ��oovErL , Massachusetts
Soil Suitabr'lity Assessment or On-site Sewa e ,Dis - Qsal
Date: L1-!Iga
Performed By:
Witnessed By: E T
ppK FARM LaT 3 0„•n<ra N&M. NEAP GAR'ET' ANIX)N E 1_1.1
L aeon Addrua a Q R Addrul.and
111'1 (�AT'EVv oDD D R
No Ryµ ANUovER T`lcph f1°I 22 0
ALEXAnIDRiA a yf1 3 7
New Construction ❑ Repair ❑ '
office Iicvic.v
Published Soil Survey Available: No ❑.' Yes
Publication Scale �. � Soil Map Unit
. Year Published 19� -
Drainage Class Soil Limitations
Surficial.Gcologic Report Available: No ED' Yes ❑
Year Published Publication_Scale .�-- -
Geologic Material (Map Unit)
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes
Er
Within 500 year flood boundary No UYcs ❑
Within 100 year flood boundary No zYes ❑
Wetland Arca:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map.(map unit)
Current'Water Resource Co ditions (USGS): Month w---'
Range
:Above Normal Normal ❑Bc1cw Normal ❑
Other References Reviewed:
DEP APPROVED FORM•12/07195
DORM 11 - SOIL EVALUATOR I,ORM
Page 2 of 3
Location Address or Lot No. BRooK FARM
On-site Review
Deep Hole NumberTP-3-1-g8 Date:...813)9R - Time:.: -a;.DopM Weather
Location (identify on site plan)
Land Use W ORNER Slope M — Surface'Stones .
Vegetation -
Landform .. bk TWAst-1 PLAIN
Position on landscape (sketch on the back) . .
Distances from:
Open Water Body L loo' feet Drainage way G Ion feet
Possible Wet Area -e- loo feet Property Line Lin feet
Drinking Water Well e I oo feet Other
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon, Soil Texture Soil Color Soil Other
Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, %
Gravel)
bYR
12 A L
• �2
10 YR
.25
. eta
0 YR 5'/n (gRAVEL
10 YR
120 C .S YR RoUrs r 46"
A.
ALARLA
Parent Material (geologic) PRb! LA GIA L OU-r WA5V1 DopthtoDedrock:
,Depth to Groundwater: Standing Water in the Hole: Og Weeping from Pit Face:
Estimated Seasonal High Ground Water: 2,91( QY MOTTLES —
DEP AI'PItOVLD FORM-11/07/95
FOIZM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. 5:Rcnic FA E A
Deterjnination dor Seasonal Hi h Water Fable
Method Used:
[Depth observed standing in observation hole....4015..... inches
❑ Depth weeping from side of observation hole .......... .... inches
U—Depth to soil mottles 4.5.::. inches
❑ Ground water adjustment ................... feet,
Index Well Number .................. Reading Date ................... Index well level ..................
Adjustment factor ................... Adjusted ground water level ..................................................
Depth of Naturally occurring Pervious Material
Does at least four feetof naturally Ilopervious� n�s areas
observed throughout the area proposed for theoilabsorption sy tem?
If not, what is the depth of naturally occurring pervious material?
Certification
1 certify that on `z (date) I have passed the soil evaluator examination
approved by the Depar ment of Enviro ental Protection and that the above analysis
was performed by me consistent with he required training, expertise and experience
described in 310 CMR 15.0 7.
0
Signature Date
DU APPRO'vl l)FOR,N1-12/07/95
roRAI. 1.2 - PER.COLATION .rC,S`1'
COMMONWEALTH OF MASSACHUSETTS
/j/ Massachusetts
Percolation. Test
Date: .... ./. ..�.4.&.......... Time: ....................................
Observatiori Hole {/
3 -1
Dcpth of Perc G „
Start Pre-soak
End Pre-soak 9 Z '• .30 '• 3C
�'...... Time at 12" 2 ; 30 : 3c)
Time at 9" 2, • 3'7 -
►5-
Time at G" 12 •' 44 20
Time (9"-6") D . "l • 6-
Rate Min./Inch
p
Site Passed Site Failed ❑
..........................................................................................................
Pcrformed.By:
Witnessed By: �� �6srnQ�''�-lS i iy.� o�/ X�/��
Comments. ................................................... ...................................... .......................................................................................................:...........:.......
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ATLANTIC ENGINEERING AND SURVEY CONSULTANTS, INC. $70 2 —0S
33 WEST. MAIN STREET, GEORGETOWN] MASSACHUSETTS, 01833
(617) 352-7870 (617) 593-3395
SOIL LQG'S
Locat ions Gl!/?lsI/Al/ J✓�y L Xr f✓C%�/� A//!�%���
L"ot nos 21
Dates I/`t
• Tests performed by: L///Cf'
observed bys P. GRAF
Pit # Pit #
Elev. Elev.
J 17IV J
Water Depth 2 Water Depth
Water Elev. Water Elev.
Perculation data/# Perculation data/#
Dates Date:
Elevations Elevations
Top of Pit Top of Pit
Depth to test Depth to test
Depth of test Depth of test
Time Time
Soak start Soak start
end end
Average ,min/inches Average min/inches
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DATE (/
Sheet of
BOARD OF HEALTH
TOWN OF NORTH ANDOVER
SUBSURFACE DISPOSAL DESIGN REVIEW
FEE (IJ� • PERMIT # 3 3 DATE RECEIVED 1Z 8'
APPLICANT A7-6,V&661 ASSESSOR'S MAP
ADDRESS PARCEL # 1
LOT # 3
STREET L',�1.eWllw /a A Y CXT
ENGINEER _�}TG,�/VT/G.
ADDRESS 97 2214/A�--y 57- D,eG&7-ocy c�
PLAN DATE _ /I1�/g3 REVISION DATE
CONDITIONS OF APPROVAL:
APPROVED
DISAPPROVED �–
—/ GCA5E 6b 4au0 1--7X/6 7 /V6 1A 6 o e,9, ez V.9T-16 V5 oA.)
3 . A10-r& `�}AT AGC SToitJG i»U5T Z3d �ouBCE -WASf/EL1 .
!�• �N�'v�6/C;/ANT L�'AGH A,�EA _ ��•�,I�ti
oAv
E�o,e� i4/°i°eovoz /1/.
w
PLAN REVIEW CHECKLIST
ADDRESS Z--
e"t5ll,1241 ENGINEER grZ,9 >j/U
GENERAL
3 COPIES l/ STAMP t/' LOCUS L-- ' NORTH ARROW '-�� SCALE ``-''
CONTOURS Z---�- PROFILE r/ SECTION BENCHMARK_ SOIL &
PERC INFO ELEVATIONS WETS. DISCLAIMER C/� WELLS &
WETLANDS WATERSHED?,4,�2 DRIVEWAY )<�(Elev) WATER LINE
FDN DRAIN C/ SCH40 ✓ TESTS CURRENT?
SEPTIC TANK
MIN 1500G C/ . 17 INVERT DROP L-� GARB. GRINDER(+200% EDF)
25 ' TO CELLAR &--- MANHOLE TO GRADE ELEVGW
D-BOX
SIZE # LINES �5' FIRST 2 ' LEVEL STATEMENT
INLET /55 2 z- OUTLET /,s9U,5-= 17 (2" OR . 17 FT) TEE REQ'D? /Vo
LEACHING / /
MIN 660 GPD?� RESERVE AREAL-- 41 FROM PRIMARY? ✓ 2% SLOPE �-
100 ' TO WETLANDS [,/' 100 ' TO WELLS C/ 4 ' TO S.H.GW L1-
351 TO FND & INTRCPTR DRAINS X325 ' TO SURFACE H2O SUPP �-
4 ' PERM. SOIL BELOW FACILITY lr/ MIN 12" COVER--'� FILL? 25 '
if above natural elev; 101if below) BREAKOUT MET? 04
TRENCHES
MIN 660 gpd SLOPE (min . 005 or 611/1001 ) >31COVER?-VENT
SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) IS RESERVE BETWEEN
TRENCHES? IN FILL? MUST BE 10 ' MIN. 4" PEA STONE?
BOT X LDNG + SIDE X LDNG = TOT
(L x W x #) (G/ft2) (DxLx2x#) (G/ft2)
Copyright 0 1993 by S.L.Stan i�NE M UST b AG-- 6t_), -5 14v L
4
PITS
MIN 660 LEACHING MIN 1 (131x16 ' ) PIT MANHOLE/PIT
GW MIN 4 ' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE
BOT + SIDE x LOAD = TOTAL
(L x W x #) (2x(L+W)xD x #) (G/ft2)
CHAMBERS
MIN 660 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT
MANHOLES 12"-48" STONE SPLASH PADS SLOPE . 005
BED/TRENCH (Bed max. 60 ' X 601 ) MIN 13 ' X 16 ' PIT
BOT + SIDE X LOAD = TOTAL
(L x W x #) (2 x (L+W)xD x #) (G/ft2)
FIELDS
MIN 660 GPD 900 ft2 BED t/ PERC RATE FASTER THAN 20M/IN
GW MIN 4 ' BELOW BOTTOM OF FIELD PIPE ENDS JOINED? ��
4" PEA STONE?()K- DIST LINE SLOPE . 005? V/ >31COVER-VENT Or_
SCH 40 MIN 12" COVER
RATE /`13-11, //iJ LDG X 660 = TOTAL
ft2/G REQ'D (ft2) LXW
DOSING TANKS AND PUMPS
DIMENSIONS X X = PUMP CAPACITY gpm
L W D Vol.
DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME
gpm
MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1 ' below
inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL
OP. SWITCH
Copyright®1993 by S.L.Stan
1/8/99
Memo to File RE: Lot 3 Brook Farm
Met with Tom Manetta on 1/7/99. After discussion agreed that Lotj should be designed with a
field because a costly retaining wall would have to be constructed if trenches were installed.
Town of North AndoverNORTF�
t tc A
OFFICE OF 3�°�` �°
COMMUNITY DEVELOPMENT AND SERVICES ° : p
27 Charles Street : 9
North Andover, Massachusetts 01845 �ySsgctM�s�t<y
WILLIAM J.SCOTT
Director
(978)688-9531 Fax(978)688-9542
November 16,1998
Atlantic Engineering&Survey
97 Tenney Street Suite 5
Georgetown,MA 01833
RE: Christian Way Extension/Brook Farm subdivision
Dear Mr.Halloran:
This is to notify you that the proposed septic plan for Lot 3 Christian Way
Extension/Brook Farm has been disapproved for the following reasons:
1. Septic tank manhole to within 6" of finish grade missing. (310 CMR 15.228(2))
2. Both septic tank and D-box missing 6"stone bases. (310 CMR 15.221(2))
3. In"General Notes" section there needs to be a statement that"No garbage grinder is
allowed."
4. Missing elevation of the garage floor and driveway grading. (NA 8.02t)
5. Please change note in leaching area to define proposed leaching field.
6. Please justify use of field. Trenches are to be used whenever possible. (310 CMR 15.240(6))
If you have any questions,feel free to call the office.
Sincerely,
Sandra Starr,R.S.
Health Administrator
Cc: File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
i
260_07
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Town of North Andover t NORTH ,
OFFICE OF 3�o ".o °•b�°
COMMUNITY DEVELOPMENT AND SERVICES A
27 Charles Street
North Andover,Massachusetts 01845 sgc,Hus���y
WILLIAM J. SCOTT
Director
(978)688-9531 Fax(978)688-9542
February 2, 1999
Atlantic Engineering &Survey
97 Tenney Street
Georgetown,MA 01833
RE: Brook Faun/Christian Way Extension, Lots 1-7
Dear Mr. Manetta:
This letter is to inform you that the proposed septic plans for Lots 1-7
Brook Farm/Christian Way Extension have been approved.
Please do not hesitate to call the office at the number below if you have any
questions.
Sincerely,
Sandra Starr,R.S.
Health Administrator
Cc: M. Antonelli
W. Scott
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Jan-13-99 11 :38A Paul D. Turbide, PE/PLS 508-465-0313 P.03
January 13, 1999
Sandra Stan:
North Andover Board of Health Administrator
Office of Community Development and Services
120 Main Street
North Andover, MA 01845
RE: Title V second review for Christian Way Extension,Lot 3
Dear Sandra,
I have reviewed the revised design plan for the above project with revision date of 11
December 1998. I find all my original concerns have been addressed except for the
following. As per 310 CMR 15.221(2)there must be a 6"stone base beneath the d-box
and the septic tank. The plans correctly have added"310 CMR 15.221(2)" and have
added a six inch base beneath the d-box and septic tank on the plans, but they stilt call
for"gravel" instead of"stone". The word"gravel" should be deleted and the word
"stone"put in its place. (if this minor change is made, I do not need to review this plan
again.)
If you have any questions or comments please feel free to contact us.
Sincerely
L
Carlton A. Brown,PEIPLS
P011Tit I
ENGINEERING,
Civil Engineers&
Land Surveyors
One Harris Street
Newburyport,MA
01950
(978)465-8594
: Town of North Andover, Massachusetts Form No.2
fNORTq BOARD OF HEALTH
O O'i��.a .�•�,�•O ./L//�/U-fel/I fl
p
�,b,�,o,..••�, DESIGN APPROVAL FOR
• JSAcmuSEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
• Applicant �]� l Test No.
�/ r
Site Location Co n3 ��lJl.c ,S Qiyt L� 1
Reference Plans ana
d Specs. A--t
• ENGINEER DE GN DATE
: Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
: CHAIRMAN,BOARD OF HEALTH
N
: Fee Site System Permit No. 635
COMMONWEALTH OF MASSACHUSETTS
ID EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
> DEPARTMENT OF ENVIRONMENTAL PROTECTION
t
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address:_155 Christian Way_
North Andover
Owner's Name: Mike Thompson
Owner's Address:_155 Christian Way_ ,
—North Andover,Ma 01845_ NOV 10 �(
Date of Inspection: 11/5/2004_ I;
TOWN OF NC) ri r
Name of inspector: Neil J.Bateson_ HEALTH DIC
Company Name: Bateson Enterprises Inc._
Mailing Address:_111 Argilla Road_
_Andover,Ma.01810_
Telephone Number:_(978)475-4786_
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 proper function and maintenance of on site sewage disposal systems.I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
X Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
F '
Inspector's Signature: Date: _11/5/2004_
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving
authority.
Notes and Comments:
""This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address bow the system will perform in the future under the same or different
conditions of use.
Page 2 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:_155 Christian Way_
_North Andover_
Owner: Thompson_
Date of Inspection:_ _11/5/2004_
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
X I have not found any information which indicates that any of the failure criteria described in 310
CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to be replaced
or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will
pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please
explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to
broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if
(with approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The
system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
Page 3 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:_155 Christian Way_
—North Andover—
Owner: Thompson_
Date of Inspection:_11/5/2004
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
_ Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
_ The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
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 organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other:
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 155 Christian Way_
_North Andover—
Owner:—Thompson—
Date
hompson_Date of Inspection:_11/5/2004
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no?'to each of the following for all inspections:
_ _No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
—No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
No Liquid depth in cesspool is less than 6"below invert or available volume is'h day flow.
_No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
_ —No Any portion of the SAS,cesspool or privy is below high ground water elevation.
_No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
No Any portion of a cesspool or privy is within a Zone 1 of a public well.
T No Any portion of a cesspool or privy is within 50 feet of a private water supply well.
No Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.]
No (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
You must indicate either"yes"or"no?'to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
— _ the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
_ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
T Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system has failed.The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
r n n. .rn . . n rr r.• n
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:_155 Christian Way_
_North Andover—
Owner: Thompson_
Date of Inspection:_11/5/2004_
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Yes No
_Yes_ _ Pumping information was provided by the owner,occupant,or Board of Health
No Were any of the system components pumped out in the previous two weeks?
Yes_ _ Has the system received normal flows in the previous two week period?
No Have large volumes of water been introduced to the system recently or as part of this inspection?
Yes_ _ Were as built plans of the system obtained and examined?
Yes_ _ Was the facility or dwelling inspected for signs of sewage back up?
Yes _ Was the site inspected for signs of break out?
Yes _ Were all system components,excluding the SAS,located on site?
_Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the
condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of
scum?
_Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the
proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
_Yes_ Existing information.
_Yes_ — 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)]
Page 6 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address:_155 Christian Way_
_North Andover–
Owner:_Thompson_
Date of Inspection:_11/5/2004
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):_4_ Number of bedrooms(actual):_4
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_440_
Number of current residents:_4
Does residence have a garbage grinder(yes or no): No
Is laundry on a separate sewage system(yes or no):_No
Laundry system inspected(yes or no): _
Seasonal use:(yes or no): No
Water meter readings: Yes,612MFt3_
Sump pump(yes or no):_No_
Last date of occupancy:—
Current-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: Pumped last year,owner_
Was system pumped as part of the inspection(yes or no): Yes_
If yes,volume pumped:_1500_gallons--How was quantity pumped determined? Measured tank_
Reason for pumping: Inspect tank&tee_
TYPE OF SYSTEM
_X Septic tank,distribution box,soil absorption system
_Single cesspool_Overflow cesspool
_Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any)
Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank _Attach a copy of the DEP approval
Other(describe):_
Approximate age of all components,date installed(if known)and source of information: 4 years old,4/21/2000,
As built plan_
Were sewage odors detected when arriving at the site(yes or no):_No
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:_155 Christian Way_
_North Andover_
Owner: Thompson—
Date of Inspection:_11/5/2004_
BUILDING SEWER_X_ (locate on site plan)
Depth below grade:_22"_
Materials of construction: _cast iron _X_40 PVC_other
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.): 4"PVC thru wall to tank 3"PVC in
house,no leaks_
SEPTIC TANKS: X
Depth below grade:_10"_
Material of construction:_X concrete_.__metal fiberglass polyethylene
_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: 10'x 5'x 4'
Sludge depth3"_
Distance from top of sludge to bottom of outlet tee or baffle: 24"_
Scum thickness:_3"_
Distance from top of scum to top of outlet tee or baffle:_8"_
Distance from bottom of scum to bottom of outlet tee or baffle:_18"_
How were dimensions determined:_Tape measure_
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.)_Pumped septic tank.Inlet tee ok.Outlet tee ok.Depth of
liquid at outlet invert.No evidence of leakage_
GREASE TRAP:_(locate on site plan)
Depth below grade:_
Material of construction:_concrete_metal_fiberglass_polyethylene_other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to 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.):
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:_155 Christian Way_
North Andover—
Owner:—Thompson—
Date
hompsonDate of Inspection:_11/5/2004_
TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: concrete metal fiberglass_polyethylene other(explain):
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-
Depth of liquid level above outlet invert: _0_
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):—D-box level&distribution equal.No evidence of leakage.Evidence of
carryover,pumped d-boa to clean._
PUMP CHAMBER:_(locate on site plan)
Pump in working order(yes or no):_
Alarm in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): _
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:_155 Christian Way_
_North Andover_
Owner:_Thompson_
Date of Inspection:_11/5/2004_
SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:_
leaching chambers,number:
leaching galleries,number:
_ leaching trenches,number,length:
X leaching fields,number,dimensions:_1 field 26'x 35'
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):_Soil ok.Vegetation ok.No sign of ponding to surface._
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 sludge layer:_
Depth of scum layer:_
Dimensions of cesspool:
Materials of construction: .
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):_
PRIVY: (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
Page 10 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:_155 Christian Way_
_North Andover—
Owner: Thompson_
Date of Inspection:_11/5/2004_
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.
Garage House
Water Meter
A B
Driveway
Septic dankD-
(:3) 14 Boz
A to Tank=31'
A to D-box=4114"
B to Tank=2715"
B to D-box=2215"
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:_155 Christian Way-
—North Andover—
Owner: Thompson_
Date of Inspection:_11/5/2004_
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water _72"_
Please indicate(check)all methods used to determine the high ground water elevation:
X Obtained from system design plans on record-If checked,date of design plan reviewed:_6/14/1993_
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:_
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain: __
You must describe how you established the high ground water elevation:_As per design plan_
Summary Record Card generated on 11/16/2004 2:13:04 PPI by Lisa Warren Page 1
• Town of North Andover
Tax Map # 210-104.D-0187-0000.0
155 CHRISTIAN WAY EXT
THOMPSON, MICHAEL S Since Jan 2003
ANNA THOMPSON
155 CHRISTIAN WAY
NORTH ANDOVER, MA
01845
Class 101 Single Family Property Type 1 Residential
Size Total 1.65 Acres
FY 2005
UB Mailing Index
Name/Address Type Loan Number Activellnact. From Until
THOMPSON, MICHAEL&ANNA Payor
155 CHRISTIAN WAY
NORTH ANDOVER, MA
01845
UB Account Maint.
Account No Cycle Occupant Name Active/Inactive
Bldg Id. 2889.0- 155 CHRISTIAN WAY Last Billing Date 10/8/2004
3170539 03 Cycle 03 Active
UB Services Maint.
Service Code Rate Charge Multiplier/Users
MISCFEE ADMIN FEE 1 1 9.18 1/
WTR WATER 01 ALL METER SIZE 514.93 /1
UB Meter Maintenance
Serial No Status Location Brand Type Size YTD Cons
48029702 a Active EN FR.L NEPTUNE NEPTUNE w Water 1 1 0
Date Reading Code Consumption Posted Date Variance
9/27/2004 1 102 a Actual 124 10/8/2004 144%
6/23/2004 978 a Actual 36 7/30/2004 100%
Trouble Code:03
4/16/2004 942 a Actual 32 5/17/2004 0%
Trouble Code:03
12/17/2003 910 n New Meter 0 12/17/2003 0%
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Tel: (978) 475-4786
Fax: (978) 475-5451
BATESON ENTERPRISES, INC.
Excavating-Water.& Sewer Lines-Septic Systems & Pumping Service
111 Argilla Road Andover, Mass. 01810
Title 5 Inspection Report
Property Address: 155 Christian Way, North Andover
Owner: Thompson
Date of Inspection: 11/5/2004
My report contained herein does not constitute a guarantee of future usage and the functionality of the existing
septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further
operation of your current septic system.
Neil"J. Bateson
Bateson Enterprises, Inc.
TOWN NORTH ANDOVER
SYSTE PUMPING RECORD--
L�,,,.-:
DATE: V 19 2004
I l -
SYSTEM OWNER &ADDRESS SYSTEM LOCATION
(example: left front of house)
DATE OF PUMPING: C(—S
QUANTITY PUMPED GALLONS
CESSPOOL: NO -----YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER (EXPLAIN)
SYSTEM PUMPED BY:
COMMENTS:
CONTENTS TRANSFERRED TO: