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Miscellaneous - 1615 OSGOOD STREET 4/30/2018
1 1615 OSGOOD STREET T 210/034.0-0028_0000.0 ✓ --- - - --- Residential Property Record Card PARCEL_ID:210/034.0-0028-0000.0 MAP:034.0 BLCK:0028 .0000.0 PARCEL ADDRESS:1615 OSGOOD STREET PARCEL INFORMATION Use-Code: Sale Price: 1 Book: 03119 Road Type: T Inspect Date: 03/15/2004 Tax Class: T Sale Date: 06/17/1990 Page: 0244 Rd Condition: P Meas Date: 03/15/2004 Owner: Tot Fin Area: 1816 Sale Type: P Cert/Doc: Traffic: M Entrance: X HANG'N TREE REALTY TRUST Tot Land Area: 0.51 Sale Valid: A Water: Collect Id: RRC GEORGE J FARKAS,TR Grantor: FARKAS AGNES Sewer: Inspect Reas: M Address: 1615 OSGOOD STREET Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LOBO Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: RN Tot Rooms: 7 Main Fn Area: 1816 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: IS Story Height: 1 Bedrooms: 4 Up Fn Area: Bsmt Area: 1816 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: H Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 22215 0.51 154,405 Ext Wall: BV Half Baths: Unfin Area: Bsmt Grade: VALUATION INFORMATION Masonry Trim: Ext Bath Fix: Tot Fin Area: 1816 Current Total: 340,800 Bldg: 186,400 Land: 154,400 MktLnd: 154,400 Foundation: CN Bath Qual: T RCNLD: 155358 Prior Total: 326,200 Bldg: 179,000 Land: 147,200 MktLnd: 147,200 Kitch Qual: T Eff Yr Built: 1965 Mkt Adj: 1.2 Heat Type: HW Ext Kitch: Year Built: 1960 Sound Value: Fuel Type: O Grade: A Cost Bldg: 186,400 Fireplace: Bsmt Gar Cap: Condition:- A Aft Str Val 1: Central AC: N Bsmt Gar SF: Pct Complete: Aft Str Va12: Aft Gar SF: %Good P/F/E/R: ///77 Porch Type Porch Area Porch Grade Factor E 228 SKETCH PHOTO E 12132SgktP No Picture 18!16Sq.R. 26 26 Available Parcel ID:210/034.0-0028-0000.0 as of 7/12/05 Page 1 of 1 North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/4. 0.0 Community: North Andover SK PHOTO Click on Sketch to Enlarge No i' ur AVailable Location: 1615 OSGOOD STREET Owner Name: HANG'N TREE REALTY TRUST GEORGE J FARKAS, TR Owner Address: 1615 OSGOOD STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 - 5 Land Area: 0.51 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 1816 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 340,800 326,200 Building Value: 186,400 179,000 Land Value: 154,400 147,200 Market Land Value: 154,400 Chapter Land Value: LATEST SALE Sale Price: 1 Sale Date: 06/17/1990 Arms Length Sale Code: A-NO-FAMILY Grantor: FARKAS AGNES Cert Doc: Book: 03119 Page: 0244 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=461722 7/12/2005 2� 5 SEE PLAT NO. 61 �9 9 \J 5, �9 �7 46i 6 4 5 sEE3.32 31 90�_ 48 1 2 20 7 2 41 "2 50 Y 22 4 ='z 9 31 tc t.95o .g" 'Ce !BJ o.r 2 P t. <y t.93 0 3.Y 3.a o 5.9t]a 16 c eso 12 a OSGOOD 20 e a !Oa a >•J.e6 '^ STREET p16 21 30 43 13 t.- c 142 6 53 a•c 49 17 15 sa o ,< 0 1ss.9s w 2c �S.S6 ac t t.80 ac 2O '23 \ 78 910 0 $ \ �� �o OG cu. st 'SG f �'P V z oz o= --1 P. x 40 21 9z o= FISCAL 2004 MAPS DRAWN BY FRANK S. GALES. P.L.S. MEASUREMENTS ARE SCALED ONLY NOT FOR SURVEY PURPOSE. SCALE-40 FEET=7 CR 27 SEE PLAT N0.79 EE PLAT N0.77 z,qq Z 4 1615 OSGOOD STREET JS-2004-0069 Proiect Detail Report Printed On:Mon Sep 27,2004 Project Name: System repair _ GIS#: 1620Project No: JS-2004-0069 Owner of Record,HANGN TREE REALTY TRUST& .4 V&ORT"4Map: 034.0 Date Submitted: Jul-15-2003 1615 OSGOOD STREET �` • } Block_-__ 0028 Status: Open -- — _ NORTH ANDOVER, MA 01845 Lot: Work Category: Septic System. Work Location: 1615 OSGOOD STREET Zoning: Proposed Use: _ _ — — -- District: ti•.... tsswc►�us�t� land Use: 101 — Proposed Use Detail Subdivision Description Septic system repair Comments: ' of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health YELLOW FLAG BHJ-2004-0006 9/24/04-Presented by Chris Distefano of Bergman&Associates. Ms.Sawyer states that this a long overdue fix. This site is located next to Jimmy's Pizza. To the left is the automotive shop and behind that shop is a house. This was a small parcel which was separated into Lot 28 and Lot 44,and both now have failed septic systems. The previous Health Director recommended not renewing licenses at the automotive location. Follow-up on this property came about after the Health Department received a complaint from a tenant at the property who complained about the landlord shutting off the water,and it came to her attention. Both of the septic systems must be in the rear lot,as in the front area,there is no soil. A septic easement was created on both properties. Bergman and Associates is asking for a setback for a drainline in lieu of having to excavate. The first proposal called for removing drainline,but no one is sure what the line is. Would prefer to not excavate. Really tight with space. Decided to put in a 400 inch EPM water barrier at the suggestion of Susan. This will prevent leakage into drainlin,so any effluent cannot leak in. Need variance to allow 13 feet instaad of 20 feet. This is Lot 28. For Lot 44, want to put in barrier as well,so it's water tight put EPDM barrier as well,so if any leakage, will not get in. JM do the owners understand builout restrictions due to offset. JM has no problem putting in barrier to protect drain. This will be a variance for 20 feet to 13 leaching, for Lot 28,and 10 to 2 for the septic tank for Lot 44 Groundwater offset from 5 ft.to 4ft CB made motion,and TT 2nd. All in favor. 7/6/04-Called GF in Texas and gave update.--SS 7/1/04-Called Bergman re:water line and review.-SS 6/9/04-Received 1 additional copy via priority mail. Forwarded to Consultant.--p.d. 6/5/04-Per S.Sawyer-pass on to Consultant. Only one copy of plan-requested that Bergman&Assoc.Send additional copies.--p.d. 6/4/04-Revised plans received from Bergman&Associates. Passed to Ms.Sawyer for GeoTMS&2004 Des Lauriers Municipal Solutions,Inc. Page I of 2 1615 OSGOOD STREET JS-2004-0069 Proiect Detail Report Printed On:Mon Sep 27,2004 review.--p.d. Note: Michael T.Stella Attn: George Stella P.O.Box 1528 Lawrence,MA 01.842 978.683.2132-Phone 978.683.5396-Fax 4/24/04-Tank pumped. 4/21/04-Setup meeting for 4/22/04 with all parties and Bob Nicetta,Building Commissioner, y to discuss the issues at hand. 4/16/04-Susan called engineer:Bergman&Assoc. Engineer,Marty DeForge has left the firm. Problems. Asked to re-submit Lot 28 with changes and Lot 44 will be sent to engineer today. Homeowner's Son: George Farkas 2110 White Lane Haslet,TX 76052 817.706.8301 4/16/04-Called George Stella-978.683.21.32-left message. 4/13/04-Issues with property brought up by tenant. See complaint module for notes. 12/4/03-Per Brian-send plan for review to Dan. Note: this plan review was never looked at by Sandy Starr. Had a preliminary review by Brian in April 2003. 12/3/03-Atty.Stella stopped by to check on status of septic plan. On Brian's desk. Sent e- mail asking what status is. 11/26/03-Atty.Stella stopped by to check on status of septic plan. Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: Design Approval-Plans BHP-2003-0238 DENIED JS-2004-0069 Plan Review BHP-2004-0650 NEEDS REVIEW JS-2004-0069 Rev.3 Plan Review BHP-2004-0417 SIGNED OFF JS-2004-0069 Rev. I Plan Review Repair Soil Tests BHP-2003-0187 Jul-15-2003 SIGNED OFF JS-2004-0069 Septic system repair Septic System_ BHP-2003-0188 Jul-15-2003 Open JS-2004-0069 GeoTMSS 2004 Des Lauriers Municipal Solutions,Inc. Page 2 of 2 U � S a✓-Z-ac-� GSrr;,�, 1615 OSGOOD STREET JS-2004-0069 Proiect Detail Report Printed On:Fri Sep 17,2004 Project Name: System repair __- GIS#: 1620 Project No: JS-2004-0069 Owner of Record HANG`N TREE REALTY TRUST& Map: 034.0 Date Submitted: Jul-15-2003 1615 OSGOOD STREET Block: 0028 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Septic System Work Location: 1615 OSGOOD STREET Zoning: Proposed Use: District: land Use: 101 Proposed Use Detail. Subdivision Description Septic system repair Comments: of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health YELLOW FLAG BHJ-2004-0006 7/6/04-Called GF in Texas and gave update.--SS 7/1/04-Called Bergman re:water line and review.-SS 6/9/04-Received 1 additional copy via priority mail. Forwarded to Consultant.--p.d. 6/5/04-Per S.Sawyer-pass on to Consultant. Only one copy of plan-requested that Bergman&Assoc.Send additional copies.--p.d. 6/4/04-Revised plans received from Bergman&Associates. Passed to Ms.Sawyer for review.--p.d. Note: Michael T. Stella Attn: George Stella P.O.Box 1528 Lawrence,MA 01842 978.683.2132-Phone 978.683.5396-Fax 4/24/04-Tank pumped. 4/21/04-Setup meeting for 4/22/04 with all parties and Bob Nicetta,Building Commissioner, to discuss the issues at hand. 4/16/04-Susan called engineer:Bergman&Assoc. Engineer,Marty DeForge has left the firm. Problems. Asked to re-submit Lot 28 with changes and Lot 44 will be sent to engineer today. Homeowner's Son: George Farkas 2110 White Lane GeoTMSm 2004 Des Lauriers Municipal Solutions,Inc. Page 1 oft 1615 OSGOOD STREET JS-2004-0069 Proiect Detail Report Printed On:Fri Sep 17,2004 Haslet,TX 76052 81.7.706.8301 4/16/04-Called George Stella-978.683.2132-left message. 4/13/04-Issues with property brought up by tenant. See complaint module for notes. 12/4/03-Per Brian-send plan for review to Dan. Note: this plan review was never looked at by Sandy Starr. Had a preliminary review by Brian in April 2003. 12/3/03-Ally.Stella stopped by to check on status of septic plan. On Brian's desk. Sent e- mail asking what status is. 11/26/03-Ally.Stella stopped by to check on status of septic plan. Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: Design Approval-Plans BHP-2003-0238 DENIED JS-2004-0069 Plan Review BHP-2004-0650 NEEDS REVIEW JS-2004-0069 Rev.3 Plan Review BHP-2004-0417 SIGNED OFF JS-2004-0069 Rev. 1 Plan Review Repair Soil Tests BHP-2003-0187 Jul-15-2003 SIGNED OFF JS-2004-0069 Septic system repair Septic System BHP-2003-0188 Jul-15-2003 Open JS-2004-0069 GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 2 of 2 1 1615 OSGOOD STREET JS-2004-0069 Proiect Detail Report Printed On: Wed Jun 09,2004 Project Name: System repair GIS#: 1620 Project No: JS-2004-0069 Owner of Record HANGN TREE REALTY TRUST& Map: 034.0 Date Submitted: Jul-15-2003 1615 OSGOOD STREET Block: 0028 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Septic System Work Location: 1615 OSGOOD STREET Zoning: Proposed Use: District: land Use: 101 Proposed Use Detail Subdivision Description Septic system repair Comments: of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health YELLOW FLAG BHJ-2004-0006 6/9/04-Received 1 additional copy via priority mail. Forwarded to Consultant.--p.d. 7/., r+ �z«� �Y" �+v '� �`''��' / A"',e 6/5/04-Per S.Sawyer- ass on to Consultant. Only one co of plan-requested that / -� rev/.�w �Y P Y PY P 9 Y Bergman&Assoc.Send additional copies.--p.d. / 6/4/04-Revised plans received from Bergman&Associates. Passed to Ms.Sawyer for review.--p.d. Note: Michael T.Stella Attn: George Stella P.O.Box 1528 Lawrence,MA 01842 a 7 S- _ 5 3 978.683.2132 4/24/04-Tank pumped. 4/21/04-Setup meeting for 4/22/04 with all parties and Bob Nicetta,Building Commissioner, to discuss the issues at hand. 4/16/04-Susan called engineer:Bergman&Assoc. Engineer,Marty DeForge has left the firm. Problems. Asked to re-submit Lot 28 with changes and Lot 44 will be sent to engineer today. Homeowner's Son: George Farkas 2110 White Lanes / Halet,TX 76052 ` 817.706.8301 4/16/04-Called George Stella-978.683.2132-left message. GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 1 of 2 1615 OSGOOD STREET JS-2004-0069 Proiect Detail Report Printed On: Wed Jun 09,2004 4/13/04-Issues with property brought up by tenant. See complaint module for notes. 12/4/03-Per Brian-send plan for review to Dan. Note: this plan review was never looked at by Sandy Starr. Had a preliminary review by Brian in April 2003. 12/3/03-Atty.Stella stopped by to check on status of septic plan. On Brian's desk. Sent e- mail asking what status is. 11/26/03-Atty.Stella stopped by to check on status of septic plan. Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: Design Approval-Plans BHP-2003-0238 DENIED JS-2004-0069 Plan Review BHP-2004-0417 NEEDS REVIEW JS-2004-0069 Rev. 1 Plan Review Repair Soil Tests BHP-2003-0187 Jul-15-2003 SIGNED OFF JS-2004-0069 Septic system repair Septic System BHP-2003-0188 Jul-15-2003 Open JS-2004-0069 GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page 2 of 2 Memo from . . . Paul Bergman RECEIVED 147SEP 15 2005 4 TOWN OF NORTH ANDOVER HEALTH DEPA,'R1 ivIENT Y171) 57 1.0 ) TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The dersigned hereby certify that the Sewage Disposal System ( )'constructed; ( repaired; by located at l 6 /ZD was installed in conform ale with the North Andover Board of Health approved plan, System Design Permit# pplan dated l V4-'? O 5 , with a design flow Of �t q gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000 Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative '� Installer: uc.#: y-I3SIDate: — E i Date: 5e--P)Q'J SEP - 7 2005 TOWN,a C H :;._DYER HEAL';r•f D��='RF??.�E;•!�• USETTS, NORTHERN PART 95 ,ton fine sandy loam, 0 to 3 Udipsamments own of Salisbury, in a wooded ards north of the radio station Udipsamments consist of deep, excessively drained soils with light gray, grayish brown, and gray medium sand. The soils formed in wind-deposited sand from the nch; undecomposed deciduous nearby coastal beaches. Udipsamments are on sand dunes subject to wind-controlled deflation and deposi- 3decomposed leaves and twigs. tion. Slopes range from 3 percent to more than 50 per- dark brown (10YR 2/2) fine cent. :fine granular structure; very fri- Udipsamments are similar to Windsor soils but are edium and coarse roots; medium stratified and grayer than the Windsor soils. arboundary. ery dark grayish brown (10YR 3/2) Udorthents ew fine faint strong b?bwn (7.5YR fine granular structure; very fri- Udorthents consist of areas from which soil material e=and medium roots; strongly acid; has been excavated and of nearby areas where the ndary. material has been deposited. This material ranges from a s olive (5Y 5/3) fine sandy loam; mixture of sand and gravel to silty loam. Slopes range ominent gray (5Y 6/1) and yellow- from 0 to 25 percent. 8 ;mottles; weak fine granular struc- Udorthents are associated with many different soils mon fine roots; strongly acid; clear_, and with Urban land but do not have the structures that are characteristic of Urban land. i3s; olive gray (5Y 4/2) fine sandy fine prominent gray (5Y 6/1) and Unadilla series YR 518) mottles; moderate thick The Unadilla series consists of coarse-silty, mixed, r`m; medium acid; clear wavy bound- mesic Typic Dystrochrepts. These deep, well drained hes; mottled olive (5Y 4/3) silty clay soils are on old lakebeds. The soils formed in glaciola- es;e distinct yellowish red (5YR 5/6) custrine deposits. Slopes range from 0 to 15 percent. Unadilla soils formed in the same kind of material as firm; thin clay films in some pores; moderately well drained Belgrade soils, very poorly clear wavy boundary. drained Birdsall soils, and poorly drained Raynham soils. light olive 4/3) silty clay; common They are similar to Agawam, Hadley, and Suffield soils. f, light grayy (5Y 6/i), yellowish red Unadilla soils have more very fine sand and less fine d''dark reddish brown (2.5YR 2/4) mot- sand than the Agawam soils; are more developed than ery thick platy structure controlled by the Hadley soils, which formed in recent alluvium; and ents; very firm; slightly acid. have more sand and less silt throughout the profile than fthe coarse-loamy mantle ranges from the Suffield soils. 'The solum is generally free of coarse Typical pedon of Unadilla very fine sandy loam, 3 to 8 tion in the solum ranges from strongly that was ercent soonce cultivated,, 800 fepes, in the town of et Rowley, wooded the ju ca cid and in the substratum from medium tion of Stackyard Road and Far Patmos Road: fhas hue of 7.5YR to 2.5Y, value of 2 or Ap-0 to 9 inches; very dark grayish brown (10YR 3/2) of 1 or 2. It is typically fine sandy loam very fine sandy loam; weak fine and very fine granu- m` sandy loam to very fine sandy loam. lar structure; very friable; many fine medium and n has hue of 2.5Y or 5Y, value of 3 to 5, coarse roots; very strongly acid; abrupt smooth and is distinctly or prominently mottled. boundary. ne sandy loam but ranges from sandy B21-9 to 17 inches; yellowish brown (10YR 5/4) very e sandy loam. fine sandy 16am; weak fine and very fine subangular s have a IIB horizon that has hue of 2.5Y blocky structure; very friable; many fine medium and �5 or 6, chroma of 2 or 3 and is mottled. coarse roots; strongly acid; clear wavy boundary. ges from silty clay loam to clay. B22-17 to 29 inches; light olive brown (2.5Y 5/4) very on has hue of 5Y, value of 4 or 5, and fine sandy loam; massive; very friable; common fine 0 3. It ranges from silty clay loam to clay and medium roots; strongly acid; clear wavy bound- in some pedons. ary. Town of North Andover Health Department Date: Location: (Indicate Address,if Residential,or Name of Business) Check#: Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TraslglSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER;Qndicate) Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Map-Block-Lot Block-Lot Commonwealth of Massachusetts 034.0-0028- at Board of Health PennitNo « • BHP-2005-0090 North Andover ---------------------_ P.I. FEE �SSxCaa iS2 F.I. $250.00 ---------------------- Disposal Works Construction Permit Permission is hereby granted Bill Hall ------------------------------------------------------------------------------------------------- to(Repair-LOT 28)an Individual Sewage Disposal System. at No 1-615 OSGOOD STREET ------------------------------------------------------------------------------------------------------------------------------------------------------ as shown on the application for Disposal Works Construction Permit No. BHP-2005-009 Dated April 27,2005 ---------------OB:!Wd ----------------------------- ---------------- --------------------------- ---------------- Issued On:A r-27-2005 P f Health 'coPT" Map-Block-Lot oti,Ym,� ,&��� Commonwealth of Massachusetts r- �� 034.0-0028- M Board of Health ----------------------- North Andover Certificate of Compliance THIS IS TO CERTIFY,That the Individual Sewage Disposal System (Repair-LOT 28) byBill Hall ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at No 1615 OSGOOD STREET - -------------------------------------------------------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. 13HP-20057009 Dated April 27,2005 ---------------------------------------------------------------- Printed On:Apr-27-2005 Board of Health -------------------------------------------------------------------------------- TOWN OF NORTH ANDOVER 'OORTM Office of COMMUNITY DEVELOPMENT AND SERVICES ,to,'•: HEALTH DEPARTMENT 400 OSGOOD STREET �b NORTH ANDOVER MASSACHUSETTS 01845 ' ss�CMU 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com-e-mail www.townofnorthandover.com-website APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: LOCATION: s 52-a", l ,7 a e LICENSED INSTALLER NAME:/ PLEASE PRINT SIGNATURE: TELEPHONE# 6cf 91"3711 4 CHECK ONE: FULL SYSTEM REPAIR: ($250) COMPONENT REPAIR(indicate what parts): ($125) * NEW CONSTRUCTION: * If NECONSTRUCTION, please attach the Foundation As-Built Plan. �r $250.00 or$125 Fee Attached? Yes No Project Manager Obligation From Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes No. Approval of Health Agent C_Zo� �'�- Date: OSS PP g Gc-�.v-� 'r 1 Town-of North Andover ' Health Department Date: 6 p Location: (Indicate Address,if Residential,or Name of Business) Check#: ; Type of Permit or License:(Circle) 3 ➢ Animal $ j ➢ Dumpster $ a ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ Al ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ 6" tic-Design Approval J� $ 157 � 4 ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ 9 ➢ Tobacco $ 8 ➢ TrasIVSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) AA Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer i k Bergman & Associates, Inc. Engineers 20 Washington Street Haverhill, MA USA 01832-5524 SSawyer, RS Tel. (978) 372-1125 Susan Y Sa �'Y Fax (978) 372-1130 Public Health Director Town of North Andover 400 Osgood Street North Andover, MA 01845 Reference: 1615 Osgood Street,Map 34, Lots 28 and 44 Dear Ms Sawyer: 1 July 05 Enclosed are revised plans for the referenced parcels. In response to the revised ESHWT, we have redesigned both systems. Please contact me or Chris DiStefano with questions. Sin re yours, Paul A Bergman, PE Enclosed plans and check for review fees cc Atty George Stella -r Dellechiaie, Pamela From: Sawyer, Susan Sent: Friday, November 05, 2004 1:14 PM To: Dellechiaie, Pamela Pam, PIs fax an installers list to George Farkas in Texas. No cover sheet needed. 871439-1311 fax# Susan Sawyer, REHS/RS Public Health Director North Andover Health Department 27 Charles Street North Andover, MA 01845 978 688-9540 office 978 688-9542 fax � oJ U/ r V V i 1 4F HP Fax K 1220xi . Log for NORTH ANDOVER 9786889542 Nov 05 2004 2:36pm Last Transaction Date Time 1,V& Identification Duration Pages Result Nov 5 2:35pm Fax Sent 818714391311 0:38 0 Error 388* * A communication error occurred during the fax transmission. If you're sending, try again and/or call to make sure the recipient's fax machine is ready to receive faxes. If you're receiving, contact the initiator and ask them to send the document again. HP Fax K1220xi Log for NORTH ANDOVER 9786889542 Nov 05 2004 2:38pm Last Transaction Date Time TV& Identification Orin Pam Result Nov 5 2:37pm Fax Sent 818714391311 0:38 0 Error 388* * A communication error occurred during the fax transmission. If you're sending, try again and/or call to make sure the recipient's fax machine is ready to receive faxes. If you're receiving, contact the initiator and ask them to send the document again. 4 Town of North Andover Licensed Septic System Installers (Disposal Works Installer's) Year 2004 List Last Updated: 5/6/04 (Please note that the septic installer is licensed only--not the company) Name Company Permit# Phone# 1 Amor, Robert* R.T. Amor BHP-2004-0022 978-887-5468 2 Bateson,Todd* Bateson Enterprises, Inc. BHP-2003-0396 978-475-1474 3 Breen, Peter* Peter Breen Excavating, Inc. BHP-2003-0400 978-687-7774 4 Busby, Philip A.Jr.* Busby Construction Co., Inc. BHP-2003-0405 603-362-4650 5 Carr, John* Ramey Construction BHP-2004-0031 978-633-6791 6 Colosi, Philip A.* Colosi Construction LLC BHP-2004-0165 978-777-5679 7 Coyle, Kevin- NEW LaPlume Excavation BHF-2004-0159 978-479.2818 8 Currier, James H.* James H. Currier Construction Co, Inc. BHP-2004-0008 978-774-6685 9 Daigle, Rob* Creative Builders BHP-2004-0308 978-682-4948 10 DeLucia, Rocci Jr.* Frank DeLucia& Son, Inc. BHP-2003-0393 978-686-8200 11 DiVincenzo,John L.* Andover Septic/J&S Dev. Corp. BHP-2003-0394 978-521-5251 12 Giard, Daniel* Daniel A. Giard Septic Service BHP-2003-Q402 978-686-7653 13 Hall, Bill, Inc.* Bill Hall, Inc. BHP-2003-0407 978-689-3711 14 Henderson, George* G. Henderson Co., Inc. BHP-2004-0101 978-686-5845 15 Hutton,Arthur* Hutton's General Construction, Inc. BHP-2003-0398 978-685-2627 16 Innis, Robert L.* R.L.I. Corp. BHP-2003-0397 978-663-6006 17 Kellett, James* Kellett Excavating BHP-2004-0291 781.953.7146 18 Linskey, William M.* Linskey Construction, Inc. BHP-2003-0408 978-744-2700 19 Maker, Ronald* T Ford Co., Inc. BHP-2203-0404 978-352-5606 20 Marsh, Steve* The Westchester Co. BHP-2003-0316 978-742-9778 21 Maynard, Dave* Maynard Construction BHP-2003-0399 603-228-4436 22 McKee, Brian* D.P. McKee & Son Excavators BHP-2004-0023 781-942-7608 23 Osgood, Ben* New England Engineering 4BHP-2004-0024 978-686-1768 24 Patenaude, Richard* Dracut Sewer Service, Inc. BHP-2004-0034 978-452-4851 25 Petrosino, Angelo* Angelo Petrosino BHP-2003-0391 978-664-2030 26 Quinlan,Timothy* Quinlan& Rand Builders BHP-2004-0025 978-682-1570 27 Reilly, Michael W.* F.P. Reilly&Son's, Inc. BHP-2003-0401 978-475-1237 28 Richard, Roger* R.J. Richard Corp. BHP-2004-0035 978-686-7445 29 Sawyer, William T.* Arco Excavators, Inc. BHP-2004-0028 978-685-5113 30 Shaw, John III Wildwood Excavation, Inc. BHP-2004-0265 978-474-8088 31 Simard, Ralph* Ralph Simard BHP-2004-0293 508-958-2002 32 Soucy,John J.* Soucy's Sewer Service BHP-2004-0026 978-470-1400 33 St. Hillaire, Paul* Andover Construction & Dev. BHP-2003-0403 978-749-0073 34 Surianello,Joseph* Ralph Surianello, Inc. BHP-2003-0406 617-799-3900 35 Todd, Charles R.* Charles R. Todd Contractor, Inc. BHP-2003-0392 978-667-7853 36 Zaher, Charles* Charles Zaher BHP-2004-0030 978-441-9429 Note: The Septic Installer Exam is held in January, March, May,July and September of each year. You must call the Health Department to sign up for the exam at 978.688.9540. The testing fee is $25. Last Updated: 5/6/2004 Town of North Andover 4 ° T►, Office of the Health Department � p Community Development and Services Division ��o 27 Charles Street -�- North Andover,Massachusetts 01845 9SSAcwus�< Susan Sawyer Telephone(978)688-9540 Public Health Director Fax(978)688-9542 NORTH ANDOVER BOARD OF HEALTH ORDER LETTER Issued under the provisions of the State Sanitary Code, Chapter II, Minimum Standards of Fitness for Human Habitation, 105 CMR 410.000. Date: April 21, 2004 To Owner of Record- George Farkas Trustee Hanging Tree Realty Trust 1615 Osgood Street, left side N. Andover, MA 01845 Re: 1615 Osgood Street, Right Side North Andover, MA 01845 An authorized inspection was made of your property at the above referenced address by North Andover Health Department personnel on April 20, 2004. This inspection revealed violations of certain regulations of the State Sanitary Code, Chapter II, as listed on the attached Violation Form. You are hereby ORDERED to correct these violations within the time allotted on the enclosed form. Failure to comply within the specified time period may result in further action by the North Andover Board of Health. You have the right to request a hearing before the Board of Health if you feel this order should be modified or withdrawn. A request for said hearing must be made in writing and received by the Health Department within seven (7) days from the receipt of this order. At said hearing you will be given an opportunity to be heard and to present witnesses and documentary evidence as to why this order should be modified or withdrawn. All affected parties will be informed of the date, time and place of the hearing and of their right to inspect and copy all records concerning the matter to be heard. You may be represented by an attorney. You have the right to inspect and obtain copies of all relevant records concerning the matter to be heard. -S san Sawyer, R REI-15,� Public Health Director BOARD OF APPE ALS 688-9541 BTADING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PL NTNTING 688-9535 y ORDER LETTER An authorized inspection of 101 Foster Street was performed by Board of Health staff on April 20, 2004at which violations of 105 CMR 410.000 Chapter II of the State Sanitary Code, Minimum Standards of Fitness for Human Habitation were found. Failure to respond within the allotted time period may result in a Board of Health finding that the dwelling is unfit for human habitation. All violations must be corrected within seven (7) days of receipt of this Order Letter or a plan for completion must be approved by this office if a professional contractor must be hired to do the work. Violation Regulatory reference Re-inspection 1)Septic in failure. No cover over open tank 410.300 or cesspool. Odors present. -Owner must maintain the property in a sanitary condition The owner is in the process to replace the existing septic system. Until completion,the following procedure must be followed. 1) A licensed septic hauler shall be contracted to pump the tank 2) The septic hauler shall remove the wishing well and place a temporary cover over the opening 3) The septic hauler is to check the septic tank every two weeks to determine if it needs pumping and will pump it as they feel necessary 4) The owner is prohibited to access the septic tank or to cause any effluent to be pumped from the tank. If the tank appears to be overflowing the owner shall immediately contact the septic pumper for service 2)The tub does not drain properly. 410.352 The drain handle must be propped open to work. - The owner shall maintain the plumbing in good working condition The owner shall not work on her own plumbing.A plumber shall be hired to fix the tub 3)The bathroom sink faucet continuously drips f` - The owner shall maintain the plumbing in good working condition The owner shall hire a plumber to repair the faucet 4)The kitchen sink drainpipe leaks. Temporary 410.352 / duct tape is not working. The owner shall maintain the plumbing in good working order The owner shall hire a plumber to repair the kitchen pipe leaks 5) Most of the kitchen-stove burners are not working. 410.100 O` The right rear burner has burned through f 1 - The owner is responsible for maintaining the stove in good working order All the burners should work properly. If they cannot be replaced due to age,the stove shall be replaced entirely 6)All the smoke detectors do not appear to be working. 410.482 The unit must have working smoke detectors. The condition of existing units are unknown The owner is responsible to maintain working smoke detectors I ' f Check all smoke detectors. If the detectors are damaged,they must be replaced immediately. If batteries are missing, place batteries 7)The front walk-in area has a loose rug placed 410.500 y4.� over uneven layers of plywood. The inspector tripped upon entry to the hall. - The owner must maintain all floors in good condition Repair or replace flooring in front hall as needed Very Important: Please be advised,that the owner shall give the tenants at least 24 hours notice prior to entering the premises to bring in repair personnel to effect repairs. Other than repairs or in the case of an emergency,the owner is not to enter the tenants apartment for any reason. It is the tenants responsibility to provide access to the owner and repairpersons. If at any time the tenant does not allow reasonable access, the owner may still not enter the apartment. She instead may contact the health office to mediate the issue. Cc: Matthew McAuliffe, Tenant ZL NORTH ANDOVER HEALTH DEPARTMENT 120 Main Street • North Andover, MA 01845 Telephone (508) 682-6483, Ext. 32 Complaint Investigation/Inspection Report OWNERK�'5 A... ADDRESS 'c imp bnl -• DATE / 2 ' 9:Z4 Of J&I fir,d/Z-- Met L 7�f_ 3C / i -k— �c w`-7� /f s 6 t � INSPECTOR Y �[� /-7 7 L - � o / NORTH ANDOVER HEALTH DEPARTMENT 120 Main Street s North Andover, MA 01845 Telephone (508) 682-6483, Ext. 32 Complaint Investigation/Inspection Report OWNER ; �r. s �i+-1<P-S /-r��►-, �- �tw c ADDRESS DATE z.� �`� L�C s� .���� �� �.��.-�. ��� �- vv�.1.._:�-...��..tom.i► 41, / i/ f) / J �eC�� /sem !/7 a..✓t �� Gfi►I JC !�J //y?T/�E g-CQ l �j c � y � � /�P ,4� 1�a r c '� ��LS � C..i_�L'7✓/�✓RL"`�w ./ l��C�I"C/ i!/i�9lS.S'/ e4-Lz^ /.,' -1-7 e-)Y'2 ..t--i _ j *-I Sd_ 06 I I I INSPECTOR kc, v e- 1955 1615 Osgood St. Bernice F. & Edward .J. Dudley Erection and maintainence of a gasoline filling station and service station Granted — April 11, 1955 (variance) 1615 Osgood. Street Operate premises as has been -- Gulf Station plus display of a few clean late models for sale as a side line. Frank A. Ronzio October 1959 •DJ R� I � t04 16.5 Osgood Street 19 2 George Farkas Sale of used carsas an accessory to the present Automobile service u P1 llin,- Station. Granted— Ai E—ust 25, 190"2 s.. N0�;h�� RFC`-IYI,r� o; 11ed � A►w��Yn�Sz� � 1 .���1' 4'.,lif�1� f\ �.� be the a teas �g� NORTH +�"7;'�1 ',,,,�:� �'�� y. '�1ce •;sqc„ug;;��` 47 Ii�'1 1 JD ny a; ,S No DEC 3 . 9 �� ;nn { the TOWN OF NORTH ANDOVER 01 ff�ce c MASSACHUSETTS .n G�eCK� BOARD OF APPEALS NOTICE OF DECISION Edward J. Cummings 23 Fernview Ave. #5 North Andover, MA 01845 Date . . .December 12, 1990 * 2 . . . . . . . . Petition0.. . 133-90 Date of Hearing. . December 11 r 1990 Petition of . Edward J. Cummings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . premises affected . . . 1615 .Osgood .Street. Special Permit Referring to the above petition for a mabWn from the requirements of AM .S e c t ion .4, • • . . . Paragraph 4.134 of the Zoning Bylaw . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . so as to Permit -auto. repairs. and -auto sales- at. .1615 .Osgood -St.. . . . . . • . . . . . . • • • • • . . • • . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . After a public hearing given on the above date, the Board of Appeals voted to GRANT the Special Permit . . . . . . . . . . . . . . . . . . .. . ��A � �� �kX� X . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . Sign Frank. Serio' .Jr,,. chairman. . . . . . . . . . . . . . William. S.ullivan,. .V.ice-chai.rman. . . . . W.alter. So.ule, .Clerk . . . . . . . . . . . . . . . . : Anna .O.'Connor . ... . . . . . . . . . . . . . . . . .. Louis. Ris.sin. . . . . . . . . . . . . . . . . . . . . . Board of Appeals J-- 3 51 5 6 2 31 ; 390 a� 3.32 ac 2.65 2.0 ac 7 1.95 ac 2 3 28 4 41 42 A 50 O —„ 29;. 1.32 ac g 10 ,)g 44 x Z yr 165, 1.93 aC 2.54 ac 3.4 ac W 5.913 ac zsv '71' 3 2 3.2 7 ac 0 aOSGOOD 70, Jaz a w w 17 156.96 ac �o s� f i �o SCALE- 400 FEET=I IN 1 SEF. PIAT T,rn ,Q l � � I I I Town of North Andover Thursday,November 2,2000 To whom it may concern, Please let it be known, that as of September of 2000, I have vacated the premises located at/!615 Osgood street.I have enclosed my occupancy permit as well as my classII used car licence. There were several health and safety issues involved with the property. I was x notified by the Town of North Andover at the beginning of this year, in regard to a test of the septic system. This request was forwarded by my attorney to the property owners. The property owners, George Farkas and Attorney George Stella have refused to comply with the request. Since the licence was issued subject to the test being completed,I felt this would hinder my getting the license renewed again this year. The septic system is backing up into the building, during heavy rain, or when the toilet is flushed repeatedly. Raw sewage fills the garage area,creating an unhealthy work environment. Additionally, the roof is leaking so badly, that it pours water directly into the electrical panel,causing an unsafe condition.The property owners have failed to act on this as well. Respectfully, rent EdwPresiMari .� ` , h GE. -;e FatasFec r ke,.5 16zy Osgood St. APPLICATION FOR SEWAGE DISPCSAL INSTALLATION HEA I;TH DEPA RTNE NT - NORTH ANDOVER, KSS. I hereby make application for a permit for a sewage disposal installation at 1615 Osgood St. . I will install this system in ac- cordance with all the laws of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 11 until 10 feet pre- ceding the septic tank, where the grade shall not exceed 2%. I will install a con- crete septic tants of inong� —in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 200 lineal ( g ) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 inches (dia. ) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/4" (dia. ) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of the will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree not to cover any portion of this installation until approved by the inspection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application. DATE 0 Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DA TE,`r d J 0 Signature of Health Agent I have inspected the uncovered system indicated above and find everything done a�s�fidescribed. DA 1t1V , 1 � 4 Signature o nspecting Officer Percolation Test 5 min, Soil-Sandy clay Garbage Grinder No BOARD OF HEALTH TOWN OF NORTH ANDOVER WS. / fop, � xv I ' Wk O r 50 1 ?N �;O :Y r � WNTER 1 N � a X � y M 1. MANE �^�,o. 4�. Fid�2�1�5 . . . . . . . . . . . DATE 26 ADDRESS y�� # oSoDa S:. . . . . . LOT NO. . . . . . . . TELo a. 3. N0, OF BEDROONS Fd UR. DEN YES .vP . . NO. . 4. GARBAGE GRINDER YES A" . . . N0. . 5. SHOW DIKENS IONS OF HOUSE 6 X %0 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIL-ENSIOIS OF LOT JSZ-3J'4 ' ion}-3fo�t 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL 9, NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM 10, SHOW LOCATION OF BROOKS, STREAKS, DITCHES, LEDGE OUTCROP, ETC. NO 11, SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE BEAD CAREFULLY. r c x a r OL 64,,, , • �� t s ti tr. af, � 9sG • f j C `1 APPLICATION FOR SESAGE DIS KSAL IM3TALLA''ION HEALTH DEPARTIv1ENT-s-N(1R1 H ANDOVER) IMASS., I hereby make application for a permit for a sewage disposal installation at �L_�� . X gill install this system in accordancewith ait laws of the Commonwealth of Massachusetts and regulations of the Hoard of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet preceding the septic tank, where the grade shall not exceed 2%. I will install A concrete septic tanksof o o �_ in size. A manhole (s) permitting easy clean- ing will' be pxWvided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with open jointed bell and spigot Ackron pipe at f J least 4 inches in diameter and laid in a series of trenches, the bottom of which will provide a minimum of Lineal ( w ( ttrre) feet of effective absorption area. 4epTp`es �.�i11 be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1 .1/2 inches (dia. ) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/4" (dna. ) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree_ not to cover any orgtionn of this installation until approve tie inks e�tion officer, as prov' de �e owanc��" to incorporate any a Ud t3—ional"requ r" reme is that may be attached to the permit. Plot Plans must be submitted with application. DATE ,190 S&U�" SignaturW of App t I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. 7 Signature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. Date ignature oF Inspecting Officer Percolation Test Garbage Grinder (-�y September 17,1955 Miss Mary Sheridan R.N. Health Agent Board of Health North AndoverpMassachusetts Dear Miss Sheridan: An examination has been made relative to the suitability of the soil for the sub-surface disposal of sewage on the proposed Osgood building site for a gasoline filling station consisting of two pumps. The property is owned by Mr. Edward Dudley. The soil in the area consists of sand. A one minute percolation test was conducted. It is recommended that two septic tanks be installed$ each 500 gallons. Two seperate drainage fields will be constructed, both consisting of 120 feet of drain pipe. 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July 30, 1956 Miss Mary Sheridan Town Hall No. Andover, Mass. Re: Gulf Service Station 1615 Osgood St. No. Andover, Mass. Dear Madam: After meeting with Mr. Romano, Saturday, July 28, 1956, it seemed the only solution to our leaching field problem was to bring it forward as shown in red on enclosed sketch. Will you take it under consideration and let this office know the results of your decision. Thanking you, we remain Yours truly, SINGLETON CONSTRUCTION CO. George R. Singleton GRS:bs Enclosure TRANSMISSION VERIFICATION REPORT TIME 07/12/2005 15:27 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 07/12 15:15 FAX N0./NAME 818174391311 DURATION 00:00:49 PAGE(S) 02 RESULT OK MODE STANDARD ECM TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES F y p HEALTH DEPARTMENT 27 CHARLES STREET � NORTH ANDOVER, MASSACHUSETTS 01845 ��Ss�CHuS Susan Y. Sawyer 978.688.9540—Phone Public Health Director 978.688.9542—FAX July 11,2005 Mason-Dixon Realty Trust George Stella,Trustee 160 Common Street Lawrence,MA 01842 RE: Subsurface Sewage Disposal System Plans for 1615 Osgood Street,Map 34,lot 44,North Andover, Massachusetts Dear Mr. Stella, Due to complications that were discovered during the construction phase of 1615 Osgood Street,the North Andover Board of Health required the engineer to redesign the septic systems for both sites, #44 and#28.In short, it was found that the water table was much higher than was first found in 2002.If this had not been identified,the proposed septic systems would have been built in the water table,and could have failed prematurely.Hence, although this change has caused a delay and hardship,in the long run,it is best for the property owners and the environment that this high water table condition was found. The response of the installer and engineer,who brought these conditions to light,was highly professional and ethical.The Health Department has completed the review of the septic system design plans,for the properties, submitted on your behalf by Bergman&Associates and last revised July 1,2005 and received on July 5,2005. All other conditions of approval are still in place as was listed in the September 29,2004 approval letter for both lots. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated The Health Department may be reached at 978-688-9540 with any questions you might have. Sincere , Y.Sawyer,REHS/RS � S r lic Health Director cc: Bergman and Associates v6rge Farkas,Hanging Tree Realty Trust file LETTER OF TRANSMITTAL North Andover Health Department ILE 00RT14 E 400 Osgood Street o <su`o North Andover, MA 01845 0 - 978.688.9540 - Phone # 978.688.8476 - Fax �4 toewtwwuw 1 healthdent&townofnorthandover com - E-mail 3' ' ,Too wwwatownofnorthandover.com -Website Page- of_ �SSwCNus�� TO: DATE: COMPANY: FROM:Pamela elleCh'aie,Health Dept.Assistant Phone: Fax: 113 We are sendinyou: o o Letter OPlans OOther ill in below) These are transmitted as checked beloL4,equired OApproved as Noted OAs Requested OResubmtt copies for.approval OFor approval OFor Review and comment OFor Your Use OSubmit copies for dist. REMARKS: I i COPY TO: COPY TO: COPY TO: SIGNED: i r TRANSMISSION VERIFICATION REPORT TIME 07/12/2005 09:42 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATEJIME 07/12 09:40 FAX NO./NAME 89783721130 DURATION 00:01:41 PAGE(S) 02 RESULT OK MODE STANDARD TOWN OF NORTH ANDOVER ce NaRTN Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET ""°+ • �' * NORTH ANDOVER, MASSACHUSETTS 01845 �SS�cnuSEi Susan Y. Sawyer 978.688.9540-Phone Public Health Director 978.688.9542-FAX July 11,2005 Mason-Dixon Realty Trust George Stella,Trustee 160 Common Street Lawrence,MA 01842 RE: Subsurface Sewage Disposal System Plans for 1615 Osgood Street,Map 34,lot 44,N rth Andover, Massachusetts �'Y Dear Mr. Stella, Due to complications that were discovered during the construction phase of 1615 Osgood Street,the North Andover Board of Health required the engineer to redesign the septic systems for both sites, #44 and#28. In short, it was found that the water table was much higher than was first found in 2002. If this had not been identified,the proposed septic systems would have been built in the water table,and could have failed prematurely.Hence, although this change has caused a delay and hardship,in the long run,it is best for the property owners and the environment that this high water table condition was found. The response of the installer and engineer,who brought these conditions to light,was highly professional and ethical.The Health Department has completed the review of the septic system design plans,for the properties, submitted on your behalf by Bergman 8t Associates and last revised July 1,2005 and received on July 5,2005. All other conditions of approval are still in place as was listed in the September 29,2004 approval letter for both lots. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated The Health Department may be reached at 978-688-9540 with any questions you might have. Sincere , Y. Sawyer,REHS/RS lic Health Director cc: ---,Bergman and Associates George Farkas,Hanging Tree Realty Trust file TOWN OF NORTH ANDOVERf NpRrH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES `,�.° ? 6!..4 F A HEALTH DEPARTMENT . F 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 �SS�cHuStt Susan Y. Sawyer 978.688.9540—Phone Public Health Director 978.688.9542—FAX Jury 11,2005 Mason-Dixon Realty Trust George Stella,Trustee 160 Common Street Lawrence,MA 01842 RE: Subsurface Sewage Disposal System Plans for 1615 Osgood Street,Map 34,lot 44,North Andover, Massachusetts Dear Mr. Stella, Due to complications that were discovered during the construction phase of 1615 Osgood Street,the North Andover Board of Health required the engineer to redesign the septic systems for both sites, #44 and#28.In short, it was found that the water table was much higher than was first found in 2002.If this had not been identified,the proposed septic systems would have been built in the water table,and could have failed prematurely.Hence, although this change has caused a delay and hardship,in the long run,it is best for the property owners and the environment that this high water table condition was found The response of the installer and engineer,who brought these conditions to light,was highly professional and ethical.The Health Department has completed the review of the septic system design plans,for the properties, submitted on your behalf by Bergman&Associates and last revised July 1,2005 and received on July 5,2005. All other conditions of approval are still in place as was listed in the September 29,2004 approval letter for both lots. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated The Health Department may be reached at 978-688-9540 with any questions you might have. Sincere , Y. Sawyer,REHS/RS lic Health Director cc: Bergman and Associates George Farkas,Hanging Tree Realty Trust �e TOWN OF NORTH ANDOVER of °RTN , Office of COMMUNITY DEVELOPMENT AND SERVICES W..t�•• °� HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 'SSwCHUst� 978.688.9540—Phone Susan Sawyer, REHS/RS 978.688.9542—FAX Public Health Director healthdeptt(.dtownofnorthandover.com www.townofnorthandover.com FAX T«(ls) From: Company Fax: Pages: Phone: ,-y� j ` � Date: IC12 �le�l ❑ Urgent ❑ For Review ❑Please Comment ❑ Please Reply ❑Please Recycle Please contact the Health Department at the above numbers for further assistance if required. TOWN OF NORTH ANDOVER NORrN t� Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ; 27 CHARLES STREET . ss-. ► • •�� NORTH ANDOVER, MASSACHUSETTS 01845 c ,�< Susan Y. Sawyer .978.688.9540—Phone Public Health Director 978.688.9542—FAX September 29,2004 George Farkas 2110 White Lane Haslet,TX 76052 RE: Subsurface Sewage Disposal System Plan for 1615 Osgood Street,Map 34,lot 28,North Andover, Massachusetts Dear Mr.Farkas, The North Andover Board of Health has completed the review of the septic system design plans,for the above referenced property,submitted on your behalf by Bergman&Associates and last revised September 13,2004. The design has been approved for use in the construction of a replacement onsite septic system.The time period for this approval has been reduced to two years from the date of time that the septic system inspection did not meet the acceptable criteria in the state regulations.However,as this was identified as a failed system and subsequently deemed an imminent hazard in April of 2004,the Health Department is requesting that this system be installed as soon as possible.Until such time,the apartment must remain unoccupied and consistent pumping must take place as needed. The following requests were approved at the Board of Health meeting held on September 23,2004. 1. To allow the construction of a leach field to a subsurface drain from 20 feet to 10 feet. 2. To allow the application for a Local Upgrade as requested,for a reduction in the separation between the soil absorption system and the high groundwater from the required five feet to four feet.With the granting of this reduction,a deed restriction must be placed on the property,which limits the maximum number of bedrooms of this dwelling to four bedrooms.The applicant must submit proof of recording,prior to the issuance of a Certificate of Compliance by the health department.(See attached example of a deed restriction)This restriction shall remain on the property until such time that the dwelling is connected to a municipal sanitary sewer system and the soil absorption system is properly abandoned. This approval is also subject to the following conditions: 1. The attached DEP Form 9b must be submitted to the appropriate Regional Office of the Department of Environmental Protection at One Winter Street,Boston MA by the property owner 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void,installation shall stop,and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(l)). 3. It is the responsibility of the applicant and/or the applicant's septic system designer,septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission,Zoning Board,Planning Board,Building Inspector,Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 4. As the field of the septic system of Lot#44 is being placed on this lot(#28)a copy of the recorded easement must be submitted prior to the Health Department issuing a Certificate of Compliance for this septic system. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely, S n Y. Sawyer,REHVS Public Health Director cc: Bergman and Associates file George Stella,Trustee Commonwealth of Massachusetts City/Town of F Local Upgrade Approval Form 913 DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information when fpftv out 1. Facility Name and Address for,, on the computer,use Hanging Tree Realty Trust, George Farkas, Trustee only the tab key Name to move your 1615 Osgood Street, lot 28 cursor-do not Street Address use the return key. North Andover MA 01845 City/Town State Zip Code r 2. Owner Name and Address(if different from above): Name Street Address City/Town state Zip Code Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional El Commercial El School 4. Design flow per 310 CMR 15.203: 440 gpd 5. System Designer. Paul Bergman ® PE ❑ RS Name 20 Washington Street Haverhill MA 01832 Address city/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for ❑ Reduction in setback(s)—specify: ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction 1615 Osgood lot 28 9b 9.04•rev.5/02 Local Upgrade Approval• Page 1 of 1 I Commonwealth of Massachusetts Cityrrown of Local Upgrade Approval Form 9B B. Approval (continued) ® Reduction in separation between the SAS and high groundwater. Separation reduction e / Percolation rate <2 min inch minfuxh Depth to groundwater 4 ft. ❑ Relocation of water supply well(explain): List local variances ranted not requiring DEP approval r 310 CMR 15.412(4): g t'eq 9 pPr'o per in setback from a of leaching facil' to a subsurface drain from 20 ft to 13 ft and to the Reduction edg ng ity tank from 10 ft to 2 feet List variances granted requiring DEP approval: North Andover Board of Health Approving Auffwft �/a,Y Print or Type Name and Tithe nature 7 Date 6�t+ C. 1615 Osgood lot 26 9b 9.04•rev.5102 local upgrade Approval- Page 2 of 2 4 Bergman & Associates, Inc. Engineers 20 Washington Street Haverhill, MA USA 01832-5524 Tel. (978) 372-1125 il Fax (978) 372-1130 13 September 2004 RECEIVED Susan Y. Sawyer, REHS/RS SEP 16 2004 TOWN OF NORTH ANi�OVER Town of North Andover HEALTH DEPARTMENT Community Development& Services 27 Charles Street North Andover, MA 01845 Reference: 1615 Osgood Street Ma #34 Lots #44 and#28 Dear Susan: Enclosed with this letter are the revised septic system design plans for the referenced lots at 1615 Osgood Street in North Andover. The revised plans reflect the decision to install a 0.040" EPDM barrier between the drain line and the septic system for both lots. We trust we have made the required modifications to our design, so as to be in full compliance for final approval by the North Andover Board of Health. Also enclosed are the applications for local upgrade approvals for both lots. In addition, we have contacted Tim Willett at the North Andover Department of Public Works in regards to the new water line connection for Lot#28. We are currently in the process of applying for a permit to access Route 125, and are putting together a Traffic Management Plan for that application. If you have any questions or concerns, please contact me at the number above. Sincerely, Christopher E. DiS ano Cc: Attorney George Stella Enclosed: Septic System Plans(8 Sets) Application for Local Upgrade Approval(2 Copies) Bergman & Associates, Inc. Engineers 20 Washington Street Haverhill, MA LISA 01832-5524 George Stella, Esq Tel. (978) 372-1125 Fax (978) 372-1130 Box 1528 Lawrence, MA 01842 Reference: Osgood Street, North Andover, MA Dear George: 19 August 04 Enclosed is a draft of the plan for the referenced property. Please call me back with and comments. I will then have my surveyor generate the final mylar plan. Sincer ly yours, !/ r Paul A Bergman, PE 'rit ccs S tsaL -Y-SW. er,ffS,-T_Qwn of Nort l.fin o r i� Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Tuesday, June 29, 2004 8:17 AM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie' Subject: 1615 Osgood Street plan review Sue and Pam, Attached please find the plan review for the property at 1615 Osgood Street. Unfortunately, the designer has chosen to modify the plan to address some of the easy stuff in our review letter but not the more critical information. I do believe the key environmental health issues here left unaddressed are: the use of a field instead of trenches, no indication if wetlands are present within 100', the request for a LUA when there appears no reason to reduce the groundwater separation, and the setback to the drain pipe which can easily become a route for pathogen or nutrient migration. There are other, less critical, but important, issues which should also be addressed. Let me know if you have any questions or need to meet with me and the designer on this one as I know it has a long history with your office. Dan Daniel Ottenheimer,President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 6/29/2004 Bergman & Associates, Inc. Engineers 20 Washington Street Haverhill, MA USA 01832-5524 SSawyer, RS Tel. (978) 372-1125 Susan Y Sa �'Y Fax (978) 372-1130 Public Health Director Town of North Andover T ORR OF Ai C 27 Charles Street r North Andover, MA 01845 I Reference: 1615 Osgood Street, Map 34,Lot 28 Dear Ms Sawyer: - -- �June-"04 Enclosed are revised plans for the referenced property. We have revised the plans in response to a letter from Brian LaGrasse, of your office, dated 7 January 04. Our responses below are in the same order as the comments in his letter: 1 Abutter names have been added to Sheets 1 and 2. 2 Note 7 regarding foundation drain added on Sheet 2. 3 See Note 9 on Sheet 1 regarding absence of wetlands. 4 Four(4) inch drain is believed to be abandoned. See note on Sheet 2. 5 In consideration of the relatively small lot area(0.65 Ac) and the need for said lot to also accommodate the leaching field for the adjacent lot(Lot 44), we have proposed a leaching bed because it utilizes less land area and is less disruptive to the existing site. 6 Schedule 40 PVC is now specified throughout the design(all Sheets). 7 The Town Assessor's Office recognizes Lots 28 and 44 as separate lots. County Land Survey has performed the requisite boundary survey and assembled a plan, for recording at the Registry, depicting the property lines of both lots 28 and 44,the shared property line, and the easements for both the Lot 44 leaching field, and the access/utility way to Lot 28. This plan will be submitted to the Town and recorded at the Registry. 8 A design for Lot 44 was submitted to your office on 17 December 02. 9 We requested a variance for depth to groundwater based upon the same concerns outlined in comment 5 above. 10 There are no A or B soil horizons within the area of the leaching field(See test pit logs 2 and 4). I/ s� Page 2 - Letter to Susan Y Sawyer, RS, Town of North Andover 11 Note regarding building sewer added to Sheet 1. 12 Note regarding air spaces added to Sheet 1. 13 The system profile on Sheet 3 indicates a riser to 6" below grade. 14 Note regarding tank added to Sheet 1. 15 Tank loading calcs are on Sheet 1. 16 Locus map is on Sheet 1. 17 Note regarding end connection added to Sheet 1. 18 Note regarding d-box added to Sheet 1. 19 The system profile on Sheet 3 indicates said material to be removed. Note also added to Sheet 1. 20 Note regarding testing dates added to Sheet 1. Aerely7k""" Paul A Bergman, PE cc Atty George Stella sa - Commonwealth of Massachusetts City/Town of q� Form 9A ® Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information must be substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd,where,full compliance,as defined in 310 CMR 5.404(1),is not feasible. 310 CMR 15.403(4)requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection,Bureau of Resource Protection,Title 5 Permitting Program,upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405,or in full compliance with the requirements of 310 CMR 15.000,require a variance pursuant to 310 CMR 15.410 through 15.417., NOTE:Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy,or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms computer,Use Hanging Tree Realty Trust — George Farkas, Trustee only the tab key Name to move your 1615 Osgood Street — Lot 28 cursor-do not use the return Street Address key. North Andover MA 01845 City/Town State Zip Code 2. Owner Name and Address(if different from above): "If c/o George Stella,, Attorney 160 Common Street yam:. «.'<<.<> Name Street Address Lawrence MA Cityrrown State 01842 (978) 683-2132 Zip Code Telephone Number 3. Type of Facility(check all that apply): Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Multi—Family Dwelling 5. Type of Existing System: El Privy ` Cesspool(s) ❑ Conventional ❑ Other(describe below): t5form9a•rev,5102 Application for Local Upgrade Approval*Page 1 of 4 commonwealth of Massachusetts City/Town of 1 A Form gA ® Application for Loyal Upgrade Approval pp DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system(trenches,chambers,leach field,pits,etc): No existing soil absorption system 7. Design Flow per 310 CMR 15.203: Design flow of existing system: N/A gp440 Design flow of proposed ro ose P9 Y d u raded system Op x+40 Design flow of facility: gpd B. Proposed Upgrade of System 1. Proposed upgrade is(check one): Voluntary ❑ Required by order,letter,etc.(attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: 13' x 47' Leaching bed with a 1500 gallon septic tank, gravity fed. 3. Local Upgrade Approval is requested for(check all that apply): tK Reduction in setback(s)—describe reductions: Asking for a reduction in setback between an existing drain and leaching bed, from 2o, 117.5' ❑ Reduction in SAS area of up to 25%: sAs size,s—ft. %reduction a Reduction in separation between the SAS and high groundwater: Separation p tion reduction 1 ft. Percolation rate K2 min./inch Depth to groundwater 4 ft. t5form9a•rev.5/02 Application for Local Upgrade Approval*Page 2 of 4 Commonwealth of Massachusetts City/Town of �1 Form 9A ® Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used,but the information must be substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well(explain): N/A ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: N/A If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation,an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 3 CMR 15.40 ):i)(1).The soil evaluator must be a member or agent of the local approving auth High groundwater evaluation de, r 9 Paul Bergman �22 Aorlig>�02 Evaluator's Name(type or print) S "nah r ... � Qate„pjgyaTuatlon ew� C. Explanation Explain why full compliance,as defined in 310 CMR 15.404(1),is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: A fully compliant design would make a large area of a relatively small lot unusable for the service station. There are also dimensonal constraints that limit the design and location of the leaching 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: bed (SAS) . There is no known alternative system feasible for this site that would be in full compliance. t5form9a•rev.5102 Application for Local Upgrade Approval*Page 3 of 4 Commonwealth of Massachusetts City/Town of 1 Form 9A ® Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health.Other forms may be used,but the -information must be substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: The adjoining lots are two (2) separate, legal lots, and the owner does not believe a shared system wnu1d be appropriate, 4. Connection to a public sewer is not feasible: There is no public sewer system for this area. 5. The Application for Local Upgrade Approval must be accompanied by all of the following(check the appropriate boxes): ❑ Application for Disposal System Construction Permit ❑ Complete plans and specifications ❑ Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15:405(2). ❑ Other(List): D. Certification "I,the facility owner,certify under penalty of law that this document and all attachments,to the best of my knowledge and belief,are true,accurate,and complete. I am aware that there may be significant consequences for submitting false information,including,but not limited to,penalties or fine and/or- imprisonment for deliberate violations." va Facility Own isSlgnature Date Gea,ge Far13s Trustee Print Name Bergman & Associates, Inc. September 8, 2004 Name of Preparer Date 20 Washington Street Haverhill. Preparer's address Cityfrown MA; 01832 (978) 372-1125 State/ZIP Code Telephone t5form9a•rev.5102 Application for Local Upgrade Approval,Page 4 of 4 1 Commonwealth of Massachusetts City/Town of Form 9A ® Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information must be substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form they use. Form!A is to be submitted to the Local!card of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd,where.full compliance,as defined in 310 CMR 5.404(1),is not feasible. 310 CMR 15.403(4)requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection,Bureau of Resource Protection,Tile 5 Permitting Program,upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405,or in full compliance with the requirements of 310 CMR 15.000,require a variance pursuant to 310 CMR 15.410 through 15.417.1 NOTE:Local upgrade approval shell not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy,or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer,use Hanging Tree Realty Trust — George Farkas, Trustee only the tab key Name to move your 1615 Osgood Street — Lot 28 cursor-do not Street Address use the return key. North Andover MA 01845 Cityfrown State Zip Code ISU 2. Owner Name and Address(if different from above): c/o George Stella Attorney 160 Common Street .,"s:,; Name ;;;w<, Street Ad .:";." ,. .;� dress Lawrence MA Cityrrown State 018%+2 (978) 68372132 Zip Code Telephone Number 3. Type of Facility(check all that apply): Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Multi—Family Dwelling 5. Type of Existing System: ❑ Privy ` Cesspool(s) ❑ Conventional ❑ Other(describe below): t5form9a•rev.5102 Application for Local Upgrade Approval•Page 1 of 4 i o � Commonwealth of Massachusetts Cityfrown of 1 Form 9A ® Application for Local Upgrade Approval i 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 withY our local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system(trenches,chambers,leach field,pits,etc): No existing soil absorption system 7. Design Flow per 310 CMR 15.203: Design flow of existing system: N/A gp440 Design flow of proposed upgraded system gp440 Design flow of facility: gpd 13. Proposed Upgrade of System 1. Proposed upgrade is(check one): Voluntary ❑ Required by order,letter,etc.(attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of Inspection 2. Describe the proposed upgrade to the system: 13' x 47' Leaching bed with a 1500 gallon septic tank, gravity fed. 3. Local Upgrade Approval is requested for(check all that apply): Reduction in setback(s)—describe reductions: Asking for a reduction in setback between an existing drain and leaching bed, from 20' 10.5' ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction Reduction in separation between the SAS and high groundwater: Separation reduction 1 ft4. Percolation rate min./inch Depth to groundwater ft.4 t5form9a•rev.5/02 Application for Local Upgrade Approval*Page 2 of 4 < 1 Commonwealth of Massachusetts City/Town of Form 9A ® Application for Local Upgrade Approval z DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information must be substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form they use. B. p9 Y Proposed Upgrade of stem (continued) p ❑ Relocation of water supply well(explain): N/A ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: N/A If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation,anApproved Soil Evaluator must determine the high groundwater elevationpursuant to 3 CMR 15.40 ( i)(1).The soil evaluator must be a member or agent of the local approving auth High groundwater evaluation de Paul Bergman , 22 Evaluator's Name(type or print) S net ..wData„sof @va uate 4 i�o_n C. Explanation Explain why full compliance,as defined in 310 CMR 15.404(1),is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: A fully P �compliant design would make a large area of a relativel small lot unusable for the service station. There are also dimensonal constraints that limit the design and location of the leaching 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: bed (SAS) . There is no known alternative system feasible for this site that would be in full compliance. t5form9a•rev.5102 Applicatlon for Local Upgrade Approval,Page 3 of 4 i Commonwealth of Massachusetts City/Town of Form 9A ® Application for local Upgrade Approval DEP has provided this form for use by local Boards of Health.Other forms may be used,but the information must be substantially the same as that provided here.Before using this form,check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: The adjoining lots are two (2) separate, legal lots, and the owner does not believe a shared system would be appropriate. 4. Connection to a public sewer is not feasible: There is no public sewer system for this area. 5. The Application for Local Upgrade Approval must be accompanied by all of the following(check the appropriate boxes): ❑ Application for Disposal System Construction Permit ❑ Complete plans and specifications ❑ Site evaluation forms I n r ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide roof that affected abutters have been notified pursuantto 310 CMR 15.405(2). P P ❑ Other(List): D. Certification I,the facility owner,certify under penalty of law that this document and all attachments,to the best of my knowledge and belief,are true,accurate,and complete.I am aware that there may be significant consequences for submitting false information,including,but not limited to,penalties or fine and/or_ imprispnment for deliberate violations." Facility Own i's Signature Date G�c� ge Farka.5 Trustee Print Name Bergman & Associates, Inc. September 8, 2004 . Name of Preparer Date 20 Washington Street Haverhill, Preparer's address City/rbwn MA% 01832 (978) 372-1125 State/ZIP Code Telephone t5form9a•rev.5102 Application for Local Upgrade Approval*Page 4 of 4 } TOWN OF NORTH ANDOVER 4 NORT► '1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845CHU CH ��sAs£t Susan Y.Sawyer,REHS/RS 978.6889540—Phone Public Health Director 978.688.9542—FAX healthdqM@townofnorthndover.com www,townofnorthandover.com May 18, 2004 George Farkas, Trustee 1615 Osgood Street, lot#28 North Andover,MA 01845 Re: 1615 Osgood Street sanitary code violations Dear Mr. Farkas, This correspondence is-in regards to the Board of Health Order letter, sent to you dated , April 21, 2004. A re-inspection was conducted on May 19,2004 by BOH personnel. The inspector observed the correction of all violations listed concerning the interior of the apartment, specifically, items#2-6. Item#,7,the floor in the front entryway, has not yet been completed. Item#l,the septic system has been pumped, and is being visually monitored by the owner. For the ease of monitoring, item.# J)- 2 has been removed from the order. The inspection found that the tank was filled to a proper working level, but is not currently in need of pumping. As a measure of good faith,the health department is granting you an extension of two weeks in regards to item 0. As for the septic system, continued monitoring and pumping will keep the system from being considered an imminent health hazard to the occupants of the dwelling. This office is and will continue maintaining close contact with the engineers who have been hired to address not only this property, but also the contiguous property that is in front of this home. Both properties are in septic failure and the Board of Health is in the process of plan approval to be followed by the installation of the two systems. This office recognizes the complications in these two septic system repairs;however, their continued use in failure should not extend into the fall of 2004. It is anticipated that all parties, including the health office, will continue to work diligently and cooperatively until this situation is finalized. Please be advised that if for any reason the apartment in this home becomes vacant,the owner is not to rent the unit until a final Certificate of Compliance is received regarding all the sanitary code violation and the septic repair. Thank you for your continued cooperation in this matter. Our office looks forward to continue to work with you in this very important matter of public health. Please contact this office if you have any questions regarding this notice. Since, Iy, .��— - Susan Sawyer,RS Public Health Director Cc: Atty. George Stella, Trustee of 1615 Osgood St lot#44 - 7171z>Y 'TOWN OF NORTH ANDOVER t%ORTN Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 27 CHARLES STREET p�gAtEO SPP y'(h NORTH ANDOVER,MASSACHUSETTS 01845 9SSACNUSES 978.688.9540—Phone Susan Sawyer,REHS/RS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com www.townofnorthandover.coni 1X Ta From: Fax: Pages: Phone: Date: 7/1. /b y Re: j qtr: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply. ❑ Please Recycle Please contact the Health Department at the above numbers for further assistance. TOWN OF NORTH ANDOVER of MORTH 9 Office of COMMUNITY DEVELOPMENT AND SERVICES E�,4ED tides HEALTH DEPARTMENT 27 CHARLES STREET '09 .......k. DAATEQ npP y'(QJ NORTH ANDOVER, MASSACHUSETTS 01845 RSSACHUSES 978.688.9540—Phone Susan Sawyer,REHS/RS 978.688.9.542—FAX Public Health Director healthdept@townofnorthandover.com www.townofnorthandover.coni FAX To: &e c ) f From: Fax: 77? 3 r b Pages: Phone: Date: 6 Re: CC: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle Please contact the Health Department at the above numbers for further assistance. PL) � S� Commonwealth oT Massachusetts City/Town of Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health.Other forms may be used, but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd,where full compliance, as defined in 310 CMR 5.404(1), is not feasible. 310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy,or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information krportant: When filling out 1. Facility Name and Address: forms on the computer,use only the tab key Name to nave your cursor-do not Street Address use the retum key. c4froum State Zip Code 2. Owner Name and Address(if different from above): Name Street Address Cityrrown State Zip Code Telephone Number 3. Type of Facility(check all that apply): ❑ Residential ❑ Institutional ❑ Commercial ❑ School t 4. Describe Facility: 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ❑ Conventional ❑ Other(describe below): t5formga-rev.5M2 Application for Local Upgrade Approval•Page 1 of 4 Commonwealth or nlassachusetts City/Town of Form 9A - Application for Local Upgrade Approval V DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): 7. Design Flow per 310 CMR 15.203: Design flow of existing system: gpd. Design flow of proposed upgraded system gpd Design flow of facility: gpd B. Proposed Upgrade of System 1. Proposed upgrade is(check one): ❑ Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: 3. Local Upgrade Approval is requested for(check all that apply): I ❑ Reduction in setback(s)—describe reductions: ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min./inch Depth to groundwater e t5form9a•rev.5102 Application for Local Upgrade Approvale Page 2 of 4 Commonwealth oT Massachusetts Cityfrown of EY Vd Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(1)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance,as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: P9 Y 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: t5form9a•rev.5102 Application for Local Upgrade Approval*Page 3 of 4 Commonwealth or nllassachusetts City/Town of Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form,check with your . local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible: 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit ❑ Complete plans and specifications ❑ Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification °l,the facility owner, certify under penalty of law that this document and all attachments,to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." Facility Owner's Signature Date Print Name Name of Preparer Date Preparers address Cityfrown State2lP Code Telephone t5form9a•rev.5102 Application for Local Upgrade Approval, Page 4 of 4 7/7/v 3ox TOWN OF NORTH ANDOVER O<NORT" Office of COMMUNITY DEVELOPMENT AND SERVICES f p HEALTH DEPARTMENTPlow 27 CHARLES STREET * s NORTH ANDOVER, MASSACHUSETTS 01845 �,SACH15 t� Susan Y. Sati mer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX July 6, 2004 Paul Bergman Bergman&Associates, Inc. 20 Washington Street Haverhill, MA 01832-5524 RE: 1615 Osgood Street, Map 34, Lot 28 Dear Mr. Bergman, The proposed septic system design plans for the above site dated December 12, 2002 with a revision date of June 3, 2004 have been reviewed. As we discussed on July 6, 2004 there are a couple of issues that remain outstanding. Assuming these issues are addressed, the plan will be able to be approved. 1. You have indicated the desire to abandon the drain pipe which is located proximate to the proposed soil absorption system. If this an actively used drain line, undertaking such action will have serious consequences for other property owners and should only be completed with the written approval of all owners who use or have rights to use this drain line. Moreover, should you continue to seek this approach to the setback encroachment, please specify the detailed construction mechanisms to be employed for abandonment so thei n p pe conduit does not act as a continual source of water transport. You are encouraged to consider seeking full compliance with setback standards or requesting a variance and/or Local Upgrade Approval for the setback to the drain i Pr's APP pipe depicted on the site plan. (NA 5.02 and 310 CMR 15.211) 2. Please clarify the existence of the property lines depicted on the site plan, and explain at what stage is the recording of such lines and easements. The plan indicates a division is proposed to create two parcels, with the onsite system for the current service station parcel being placed in an easement on the parcel containing the dwelling ands its onsite system. The septic plan references a survey document but does not indicate if this has been approved by the Planning Board and/or recorded at the Registry of Deeds. If approved or recorded, please provide a copy of documentation to that effect. Atty. George Stella,who is the trustee of lot#44 is still working on this issue. Should be all set prior to installation. 3. The design includes a Local Upgrade Approval request to reduce the separation from bottom of the soil absorption system to the estimated seasonal high ground water from the required 5' to 4'. Whenever a Local Upgrade Approval is requested, a completed application form must accompany such a request. Please submit form 9A Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Also, please submit the plan for lot#44 for this site as soon as possible. Thank you. Sincerel , san Y. Sawyer, REHS Public Health Director Cc: owner file LETTER OF TRANSMITTAL North Andover Health Department o� NORTf� 400 Osgood Street 3? e���~� Mb'`~�oL North Andover,MA 01845 978.688.9540 -Phone e� 978.688.8476 -Fax C«OU":« • A�'►wT ���.. healthdept(atownofnorthandover.com -E-mail VSs eo www.townofnorthandover.com -Website Page / of �CNu TO: DATE: 114 COMPANY: FROM:Pamela DelleChiaie,Health Dept.Assistant LFax : / ��/ �/ RE. X41 D�4' / D /� �J O"✓ �0 T We are sending you: 0 Copy of Letter OPlans OOther all in below) These are transmitted as checked below- OApproved as Noted OAs Requested LDAs Required OResubmit copies for approval OFor approval L7 For Review and comment OFor Your Use OSubmit copies for dist. REMARKS: .. "4141 COPY TO: r COPY TO: COPY TO: SIGNED: INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at /1,/6— DJ,0&o' S,'-- oT relative to the application dated or lby� �/� and dated fO2 �� with revisions datedgans I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work(other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction.steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer Date: Disposal Works Construction Permit# INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at /l/6— ®,2fa&07 J/'-- p� relative to theapplication of Zillllz� dated f" ��� or lans by % and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work(other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction.steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer Date: Disposal Works Construction Permit# APR-27-05 WED 07 :55 PM BILL HALL INC. 508 6870563 P. 01 04/27/7005 14:46 978688 ; HEAi-TH PAGE 02102 i I >NST81,LER FROJIECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at 16— 6�jee'019 c3l�r ?t,,,7 ttelative to the application of �J/ f/ dated or laps by and dated fd with revisions datedY I understand the following obligations for management of this project: i. As the installer I am obligated to obtain a))permits and Board of Health approved plans prior to performing any work on a site. I must have the,approvod plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowncr; contractor, project manger, or any other person not as5Qciated with my company schedules an inspection and the system is not ready then item three shall be applicable,3. As the itlsteiJer i am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without l Regulations completion of the treats to accordance with Tile 5 and he Board of Heltlth li �latimay result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection uni&w,y there is a retaintng wall which should be done first. Installer must request the inspection but does not have to be present b) Final inspection - En$incer must first do their inspection for elevations, iius, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system All electrical work must be ready and able to cause pump to work and Alarm to function. C) Final Gradc Installer must request inspootion when all grading is complete. Does not have to be nn site. 4. As the installer J Understand that only t may potform the work (other than simple excavation) required to complete the installation of the system identified in the attached application, for installation. J furiber understand that work by others tiBlicensed to install septic systems in North Andover can constitute reasons For denial of the system, and/or revocation or suspension of my license to operate in the Town. of North Andover, significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site dying the performance of the following construction.steps; a) Determination that the proper elevation of thQ excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consullanl. d) Installation of tank, D-box, riper, stone, vent, pump chamber, retaining wall and other Nnnponenta. f, As the installer I understand thm I am solely responsible for the installation of the system as per the apptoved plans. No instructions by the homeowner, general continctor, or any other persons shall absolve me of this obligation, Undersigned Licensed Septic installer i T Date: Disposal Works Construction Permit I Page 1 of 1 r DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Thursday,January 08,2004 8:34 AM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 1615 Osgood Street Heidi, Brian and Pam, Attached please find the plan review letter for 1615 Osgood Street. There appears to be significant differences in soil and ground water characteristics in test pits which are only +/- 100' apart. We assumed that the folks out in the field felt comfortable with everything and we completed our review based on the design which is located in the area of good soils. I would also point out that it appears that the septic system for the service station is in hydraulic and treatment failure (as described by a letter in the file and inspection report). In the review letter I asked them to explain the status of the septic system upgrade design for the service station. It seems that they are putting the cart before the horse in that they are proposing to divide the parcels and create a septic system easement area without even knowing if a septic system for the service station can go in that space. It would be prudent if hey submitted plans for the service station septic system upgrade at the same time we are reviewing these plans. Stay warm, Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 Mx: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 1/8/2004 Page 1 of 2 DelleChiaie, Pamela From: Brian Lagrasse[blagrass@townofnorthandover.com] Sent: Thursday, January 08, 2004 1:24 PM To: 'Heidi Griffin; info@millriverconsulting.com; 'Brian LaGrasse; 'Pamela Dellechiaie' Subject: RE: 1615 Osgood Street I spoke with the owners attorney and the engineers and they are willing to go through the regular plan approval process and do not wish to use the 45 day deadline regulation to circumvent the design approval process. They are more concerned about obtaining an approved septic design and a compliant system rather than a timeline default approval. Thanks, Brian -----Original Message----- From: Heidi Griffin [mailto:hgriffin@townofnorthandover.com] Sent: Thursday, January 08, 2004 12:14 PM To: info@miliriverconsulting.com; 'Brian LaGrasse'; 'Pamela Dellechiaie' Subject: RE: 1615 Osgood Street Hi Dan: Unless this is a new submittal, I believe they originally submitted septic plans over a year ago, thus entitling them to automatic approval. But....hopefully this is a new submittal. And if not, we could restructure the letter the way we did on a prior plan that was automatically approved. Thanks, Heidi -----Original Message----- From: Dan Ottenheimer [mailto:info@millriverconsulting.com] Sent: Thursday, January 08, 2004 9:17 AM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 1615 Osgood Street Heidi, Brian and Pam, Attached please find the plan review letter for 1615 Osgood Street. There appears to be significant differences in soil and ground water characteristics in test pits which are only +/- 100' apart. We assumed that the folks out in the field felt comfortable with everything and we completed our review based on the design which is located in the area of good soils. I would also point out that it appears that the septic system for the service station is in hydraulic and treatment failure (as described by a letter in the file and inspection report). In the review letter I asked them to explain the status of the septic system upgrade design for the service station. It seems that they are putting the cart before the horse in that they are proposing to divide the parcels and create a septic system easement area without even knowing if a septic system for the service station can go in that 3/30/2004 Page 2 of 2 space. It would be prudent if hey submitted plans for the service station septic system upgrade at the same time we are reviewing these plans. Stay warm, Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 3/30/2004 Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Tuesday, December 23, 2003 8:50 AM To: Brian LaGrasse; Pamela Dellechiaie Subject: 1615 Osgood Street Brian and Pam, We have completed review of the septic plan for 1615 Osgood Street. A few questions before we finalize a letter for you: 1 . Did they include any soil test reports? 2. Did they include an application for Local Upgrade Approval (form 9A)? 3. Did they include any other property plans with their submission? They are apparently going to be moving some property and easement lines. 4. Is there already a septic system plan for the service station which is located in front of the house? 5. Lastly, the septic plan is dated December 12, 2002. 1 assume it was only recently submitted to your office. Thanks in advance, Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 3/30/2004 TOWN OF NORTH ANDOVERp�pORTh ? 1 Office of COMMUNITY DEVELOPMENT AND SERVICES o �T�eD y}.p • e p HEALTH DEPARTMENT 27 CHARLES STREET s ' NORTH ANDOVER,MASSACHUSETTS 01845 'SSACH115£S Heidi Griffin 978.688.9540—Phone Acting Health Director 978.688.9542—FAX January 7, 2004 Martin DeForge Bergman&Associates,Inc. 20 Washington Street Haverhill,MA 01832-5524 RE: 1615 Osgood Street, Map 34, Lot 28 Dear Mr. DeForge, The proposed septic system design plans for the above site dated December 12, 2002 have been reviewed. Unfortunately,the plans cannot be approved as submitted. The following items are in need of attention prior to approval: 1. Please indicate the names of abutters from the most recent Assessor's map. (NA 8.02) 2. Please provide the location and elevation of the foundation drain. If there is no drain, please make a statement to that effect on the plan. (NA 8.02y) 3. Please indicate the presence or absence of wetlands within 100' of the onsite system. (NA 8.02) 4. Please maintain compliance with the design standards or request a variance and/or Local Upgrade Approval for the setback to the drain pipe depicted on the site plan. (NA 5.02 and 310 CMR 1.5.211) 5. Trenches are to be used as the soil absorption system mechanism whenever possible. Please use trenches in this instance or explain why they cannot be utilized. (3 10 CMR 15.240) 6. Please utilize schedule 40 piping in all components of the onsite system. (NA 10.01) 7. Please clarify the existence of the property lines depicted on the site plan, and explain at what stage is the recording of such lines and easements. The plan indicates a division is proposed to create two parcels, with the onsite system for the current service station parcel being placed in an easement on the parcel containing the dwelling ands its onsite system. The septic plan references a survey document but does not indicate if this has been approved by the Planning Board and/or recorded at the Registry' of Deeds. If approved or recorded lease provide a copy of documentation to that effect. 8. Please indicate the status of the septic system design for the service station site. It is unclear that a septic system design can be provided solely in the area depicted as a septic system easement. This should be factored in to the layout of the septic system design for the dwelling as well as the placement of property and easement lines. 9. The design includes a Local Upgrade Approval request to reduce the separation from bottom of the soil absorption system to the estimated seasonal high ground water from the required 5' to 4'. Several sections of Title 5 do not allow this request to be granted including 310 CMR 15.401 and 404(1)which indicates that whenever feasible a design should maintain full compliance with the standards in the regulations. Additionally,whenever a Local Upgrade Approval is requested, a completed application form must accompany such a request. 10. Please indicate that removal of soil horizons A&B shall extend at least 6" into the suitable soil of the C horizon. (NA 9.02) 11. Please indicate that the building sewer is to have watertight joints,be placed on a compacted base, and laid in a continuous grade. (3 10 CMR 15.222) 12. Please provide a 3" air space above septic tank tees and a 9"air space above the flow line. (3 10 CMR 15.227) 13. Please specify the placement of at least one septic tank access port to be at or within 6"of final grade, and indicate to what depth and which port(s) are to be so constructed. (3 10 CMR 15.228) 14. Please note the requirement for the septic tank to be watertight. (3 10 CMR 15.221) 15. Please specify the tank loading. (3 10 CMR 15.227) 16. Please provide a locus map. (3 10 CMR 15.220) 17. Please connect the ends of the distribution laterals with solid pipe. (NA 15.01) 18. The distribution box should be specified to have a 6" sump and to be watertight. (3 10 CMR 15.221) 19. Please provide more clear guidance to the licensed Disposal System Installer to remove soil horizon C4 as indicated in the soil logs. 20. Please clarify who performed soil and percolation testing on which date, and who witnessed said activity. The plan note is not clear in this regard. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerely, Brain LaGrasse Health Inspector cc: Homeowner CD&S Dir. File Page 1 of 2 DelieChiaie, Pamela From: Heidi Griffin [hgriffin@townofnorthandover.coml Sent: Thursday,January 08,2004 12:20 PM To: info@millriverconsulting.com;'Brian LaGrasse';'Pamela Dellechiaie' Subject: RE: 1615 Osgood Street Hi Dan: Unless this is a new submittal, I believe they originally submitted septic plans over a year ago,thus entitling them to automatic approval. But....hopefully this is a new submittal. And if not,we could restructure the letter the way we did on a prior plan that was automatically approved. Thanks, Heidi -----Original Message----- From: Dan Ottenheimer [mailto:info@millriverconsulting.com] Sent:Thursday,January 08, 2004 9:17 AM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 1615 Osgood Street Heidi, Brian and Pam, Attached please find the plan review letter for 1615 Osgood Street. There appears to be significant differences in soil and ground water characteristics in test pits which are only +/- 100' apart. We assumed that the folks out in the field felt comfortable with everything and we completed our review based on the design which is located in the area of good soils. I would also point out that it appears that the septic system for the service station is in hydraulic and treatment failure (as described by a letter in the file and inspection report). In the review letter I asked them to explain the status of the septic system upgrade design for the service station. It seems that they are putting the cart before the horse in that they are proposing to divide the parcels and create a septic system easement area without even knowing if a septic system for the service station can go in that space. It would be prudent if hey submitted plans for the service station septic system upgrade at the same time we are reviewing these plans. Stay warm, Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 1/8/2004 rage cal c " 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulfing.com info@millriverconsulting.com 1/8/2004 'TOWN OF NORTH ANDOVER f NORTH a Office of COMMUNITY DEVELOPMENT AND SERVICES 3� HEALTH DEPARTMENT ~ ` 27 CHARLES STREET =" NORTH ANDOVER, MASSACHUSETTS 01845SacH �qs ACH ��5 USE Heidi Griffin 978.688.9540—Phone Acting Health Director 978.688.9542—FAX January 7, 2004 Martin DeForge Bergman&Associates, Inc. 20 Washington Street ' Haverhill, MA 01832-5524 RE: 1615 Osgood Street, Map 34,Lot 28 Dear Mr. DeForge, The proposed septic system design plans for the above site dated December 12, 2002 have been reviewed. Unfortunately, the plans contain some items that do not meet Title 5 or local regulation standards and revised plans should be submitted at your earliest convenience. The following items are in need of attention prior to construction: 1. Please indicate the names of abutters from the most recent Assessor's map. (NA 8.02) 2. Please provide the location and elevation of the foundation drain. If there is no drain, please make a statement to that effect on the plan. (NA 8.02y) 3. Please indicate the presence or absence of wetlands within 100' of the onsite system. (NA 8.02) 4. Please maintain compliance with the design standards or request a variance and/or Local Upgrade Approval for the setback to the drain pipe depicted on the site plan. (NA 5.02 and 310 CMR 15.211) 5. Trenches are to be used as the soil absorption system mechanism whenever possible. Please use trenches in this instance or explain why they cannot be utilized. (3 10 CMR 15.240) 6. Please utilize schedule 40 piping in all components of the onsite system. (NA 10.01) 7. Please clarify the existence of the property lines depicted on the site plan, and explain at what stage is the recording of such lines and easements. The plan indicates a division is proposed to create two parcels, with the onsite system for the current service station parcel being placed in an easement on the parcel containing the dwelling ands its onsite system. The septic plan references a survey document but does not indicate if this has been approved by the Planning Board and/or recorded at the Registry of Deeds. If approved or recorded, please provide a copy of documentation to that effect. 8. Please indicate the status of the septic system design for the service station site. It is unclear that a septic system design can be provided solely in the area depicted as a septic system easement. This should be factored in to the layout of the septic system design for the dwelling as well as the placement of property and easement lines. 9. The design includes a Local Upgrade Approval request to reduce the separation from bottom of the soil absorption system to the estimated seasonal high ground water from the required 5' to 4'. Several sections of Title 5 do not allow this request to be granted including 310 CMR 15.401 and 404(1)which indicates that whenever feasible a design should maintain full compliance with the standards in the regulations. Additionally, whenever a Local Upgrade Approval is requested, a completed application form must accompany such a request. 10. Please indicate that removal of soil horizons A&B shall extend at least 6" into the suitable soil of the C horizon. (NA 9.02) 11. Please indicate that the building sewer is to have watertight joints, be placed on a compacted base, and laid in a continuous grade. (3 10 CMR 15.222) 12. Please provide a 3" air space above septic tank tees and a 9" air space above the flow line. (3 10 CMR 15.227) 13. Please specify the placement of at least one septic tank access port to be at or within 6" of final grade, and indicate to what depth and which port(s) are to be so constructed. (3 10 CMR 15.228) 14. Please note the requirement for the septic tank to be watertight. (3 10 CMR 15.221) 15. Please specify the tank loading. (3 10 CMR 15.227) 16. Please provide a locus map. (3 10 CMR 15.220) 17. Please connect the ends of the distribution laterals with solid pipe. (NA 15.01) 18. The distribution box should be specified to have a 6" sump and to be watertight. (3 10 CMR 15.221) 19. Please provide more clear guidance to the licensed Disposal System Installer to remove soil horizon C4 as indicated in the soil logs. 20. Please clarify who performed soil and percolation testing on which date, and who witnessed said activity. The plan note is not clear in this regard. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerely, r r � LaGrasse Health Inspector cc: Homeowner CD&S Dir. File Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulbng.com] Sent: Tuesday, December 23,2003 8:50 AM To: Brian LaGrasse; Pamela Dellechiaie Subject: 1615 Osgood Street Brian and Pam, We have completed review of the septic plan for 1615 Osgood Street. A few questions before we finalize a letter for you: 1. Did they include any soil test reports? 2. Did they include an application for Local Upgrade Approval (form 9A)? 3. Did they include any other property plans with their submission? They are apparently going to be moving some property and easement lines. 4. Is there already a septic system plan for the service station which is located in front of the house? 5. Lastly, the septic plan is dated December 12, 2002. 1 asf m it as only recently submitted to your office. �" Thanks in advance, CP Dan r Daniel Ottenheimer, President Mill River Consulting D Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 12/23/2003 r Town of No Andover, Massachusetts Form No.2 f MORTp BOARD OF HEALTH 4. 3: ._�. ... ., 0 19 O DESIGN APPROVAL FOR ss'C"USt` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant (��D�'�-° iTest No. Site Location Reference Plans and Specs. �� ENGINEER DESIGN D TE 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 Fee_ Site System Permit No. 1 SEPTIC PLAN SUBMITTAL FORM LOCATION: 1615 0S4DvD Sr2Et-7— LOT `644) NEW PLANS: YES $160.00/Plan 1� REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: NO 17 DATE: 9 DSL 0 2 DESIGN ENGINEER: BV,&,MAb3 ASSOG-,,ZNL. M Lk-jr t} DEFoR6,L/- PE DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. w CHECKLIST FOR NORTH ANDOVER SEPTIC SYSTEM PLANS Job The followingis a checklist that incorporates all Title 5 and local regulations for septic plans. � g P Name of Applicant:�rr„& Name of Designer: &L f+,a jD e T08 e t f rj Plan Date: IZ Z 0 Revision Date: Date of Review: Z g Property Address: i L S 0516' Sir Map: S� Lot: A'SIM Xv6 BOH Reviewer:_ Type of Plan(new or upgrade): Number q gpd) Garbage Disposal Allowed: u General Information: N.A. =North Andover Septic Regulations Other numbers refer to Title 5 OK Problem N/A Street number and map/lot-220(4)(u) Maximum scale of 1 "=40'for plot plan-220(4) Maximum scale of l "=20'for profile and component details-220(4) Legal boundaries of the facility being served-220(4)(a) prep buy-dr-� Names of abutters from recent tax map- NA 8.02j Number of bafh%-Upo,design calcs.,-NA 8.02i Name&address of record owner&applicant- NA 8.02k NVA 46e '� ° Name&address of designer N 8.021 Holder and location of all easements-220(4)(b) Date plan drawn&any revision date- NA 8.02m All dwellings and buildings,existing and proposed-220(4)(c) Location of all existing or proposed impervious areas-220(4)(d)No « All distances on site plan—NA8.03a-cS�' � �'� PIMP ��•�. W�11 �ovt�A'q Elevation of proposed driveway-NA 8.02t •J Location and elevation of foundation drain-NA 8.02y Location and dimensions ofthe system incl. reserve(new const.)-220(4)(e) Limits of excavation of leach area on site plan-NA 8.02z Locus plan-220(4)(t) (Not to scale) North arrow-220(4)(g) Existing and proposed contours-220(4)(g)proPOUA lei -31 Af'5�- Locations and logs of deep holes-220(4)(h) Locations and logs of percolation tests-220(4)(i) ✓ Date(s)of soil testing-220(4)(h)&(i) Existing grade elevation of each deep hole-220(4)(h) ti e\k.,J V Elevation of percolation tests—N.A. 8.02n ✓ Name of approving authority representative-220(4)(h)&(i) Name of soil evaluator-220(4)0) eovj-i ter Soil logs and perc test logs match BOH records^a--*A-1 Locations of waterlines,drains,and subsurface utilities-220(4)(m) Observed and adjusted g.w.elevation in the vicinity of the system-220(4)(n) Per-\Q Complete profile of the system to scale-220(4)(o),NA 8.02c Cross section of leaching facility-NA 8.02w (Not to scale) Location of benchmark(s)within 50-75 feet of facility-220(4)(q) Note listing all variance requests with proper citations-220(4)(p)10, k Local upgrade approval request form submitted-403(1) M 2 _— � Original R.S./P.E. stamp, signature&date-220(1)&(2) N64 r1/ P.E.,discipline specified within stamp. MGL C. 112 s. 8 1 M J y/ sfc. supplies(w/in 400'),pub.wells(w/in 250'),pvt.wells(w/in 150')-220(4)0 tNAt3 t� Locatidn of watercourses,wetlands,wells,etc.Win 150'of system—NA 8.02r a-,�* Wetland disclaimer—NA 8.02s Ak,,V-4e-cLaL�, T RLS plan reference&certification required(prop line setbacks)-220(3).Aj Ae Joey N aT Cdv vo, Plan contains designer's certification statement Net CdAi eJ i4 fe� Use approvals/standards checked for I/A system-DEP docs., Perc rate>30 MPI-not allowed for new,LUA for upgrade-245(1)&('3) Perc rate> 60 MPI-must use modified tight tank or UA technology-245(4) Proposed system qualifies as"shared"system-002(definitions) Flow is over 2,000 gpd-No R.S. allowed-220(1) Design flow was set in accordance with code-203 Existing system location and note on proper abandonment-354 Leaching facility at least 1' above Base Flood elevation—NA 9.05 All piping Sch 40 minimum—NA 10.01 Basement floor minimum 1' above groundwater elevation—NA 5.04 Foundation drain present with elevation—NA 8.02y On-site Soil and Groundwater Review OK Problem N/A Proper deep observation hole logs on plan-220(4)(h) 3 All deep holes and peres shown,including aborted tests—NA 8.02n c Soil evaluation forms submitted within 60 days of field work-018(2) Proper percolation test log-220(4)(i) Ample deep observation holes in primary disposal area(minimum 2)- 102(2) _ Ample deep observation holes in secondary disposal area(minimum 2)- 102(2) _✓— Ample perc testing(one in each disposal area,3 in prim.>2,000 gpd)- 104(4) Deep hole testing conducted within two years—NA 7.05 Hol dentification Numbers: ground elevation el. acceptable soil el. ns Leach facilitv invert el. ground water el. �do, refusal el. bottom of leach facility el. �b I t7 �`�� JD thickness of acceptable soil before&after soil R&R separation to groundwater T separation to refusal C ,Z soil class y r r v 3 perc rate rL nn►J loading rate 0-'+4 &Vo I to septic tank below g.w.table y Q 5 (yes or no) pump tank below g.w. table "I e5 (yes or no) 11 in fill -255(l) Setback Distances(Given in feet) 15.21 1 YES ZNO) Is the lot in the Lake Cochiewick Watershed? NA 6.00&5.02 OK Problem N/A Septic Tank Leach Facility ea r-P Property line 10 10 Cellar wall 10 20 Inground pool 10 20 J Slab foundation 10 10 JDeck,on footings,etc. 5 10 Waterline 10 10 J Private drinking well 75 100 J Irrigation well 75 100 Wetlands 75 100 lvote 6%N a,ror� d�)tNncc3 i t. 3"0—'&J' Public well 400 400 Wetlands bordering surface 150 150 water Supply or trib. (in Watershed) .� Trib.To Surface Water supply 325 325 Reservoirs 400 400 �t Tributaries to reservoirs 200 200 Drains(wat. supply/trib.) 50 100 ` Drains(intercept g.w.) 25 50 �r�- � Q� n,e^� ti'X Dr-,,J G JFoundation drains 10 20 Drains(Other) 5 10 r"^i N I`44 Drywells 20 25 Downhill slope 15'to 3:1 slope 3 r 4 w/o barrier Building Sewer OK Problem YA Grease trap required for certain uses(check 230 for details) 0'0 5 cPRr- - 6 J Pipe diameter listed(4"minimum)-222(1) Pipe schedule listed-222(3) Pipe cast iron or Sch 40 PVC—NA 11.02 r of Z Watertight joints specified-222(3)&(4) 11113 Q- _� Pipe laid on compact,fin base-222(5) t04r S(�e(A,',A Pipe laid on continuous grade in straight line-222(7)@ Cleanouts precede all changes in alignment and grade-222(8) Cleanout provided every 100 feet-222(8) ° Manhole at any 90 degree align�m�ent change-222(8) " Invert elevation at building:!1 Invert elevation at septic tank: °I%,!5' Length of run: 3 Si W c(cwc+, &4N'aa' Slope: •0 k (minimum of 0:01 -0.02 desired)-222(6) i 10'offset to private well or suction line-222(2) Septic Tank ** �' OIC, Problem N/A �/ Tank is accessible-228(3) No structures above tank—(228(3) Tank can accommodate both primary&reserve—NA 9.04 200%of flow(required&provided given. 1500 min.)-220(4)(f)&223)(1)(a) 2-3"drop from inlet to outlet-227(5) (S 4 a i- Al,q0 • J Minimum of 4'liquid depth-223(2) 3"air space above teesibaffles(minimum)-227(4) 7L 9"air space above flow line(minimum)-227(4) , J Tees are not to be replaced by baffles-227(1) Tees extend 6"above flow line j.227(1) Inlet tee extends 10"below flow line(minimum)-227(6) Outlet tee extends 14"below flow line(more for deeper tanks)-227(6) ✓ Gas baffle installed on outlet-227(4) Access d0thole cover above center of tank&each tee(except 2 compart) 0 5 0 228(2) N 3-20"manholes-228(2) I childproof;24"riser/manhole w/in 6"of final grade if<1000gpd-228(2) h-ilet and outlet tees on center line-227(l) Soil compaction below tank specified(if soil is non-native)-221(2) 6"of<=3/4"stone beneath tank specified-221(2)&22 8(I) If> 1,000 gpd AND not a single fam.dwell.must be 2 tks or 2 comp.-223(l)(b) If plan specifies disposal must be 2 tanks in series or 2 compart.tank-223(1)(c) Buoyancy calcs.required if tank at or below water table-221(8) / Tank is watertight-221 (1) 9"of cover over tank(minimum)-228(1) H- 10 loading(min.)-H-20 if traffic-226(3) Top of tank<=36"below grade-221(7) All pumping to tank(if applies)in accordance with-229 Tank is set to keep old system in service during install if possible 4 I 5 Tight Tank(Check here if not present: ) OK Problem N/A 500%of design flow or 2000 gallons provided—260(2)(a) 3-20"manholes—228(2) Soil compaction below tank specified(if soil non-native)—221(2) 6"of<=3/4"stone beneath tank specified—221(2)&228(1) Buoyancy talcs.Required if tank at or below water table—221(8) Tank is watertight—221(1) 9"of cover over tank specified(minimum)—228(1) H-10 loading(min.)—H-20 if traffic—226(3) Top of tank<=36"below grade—221(7) All pumping to tank(if applies)in accordance with—229 AN alarm set at 3/5 tank capacity—260(2)(c) Min. 1-24"frame w/cover at finished grade—228(2)(f) Year round access for pumping—228(2)(g) Distribution Bog(Check here if not present: rO>C \67, O' OK . Problem N/A 10 1. l &it Inlet elevation: I OA. Outlet elevation: 101.Tt- 0.17' 0.17'drop from inlet to outlet(minimum)-232(3)(b) 6"sump(minimum)-232(3)(e) All outlets at same elevation-232(3)(b) Outlet pipes laid level for first 2 ft. -232(3)(c) Pipe Sch 40-NA 10.01 Number of outlets: Z Number of laterals: 'L Size of outlets: Inlet baffieltee min. 1"over outlet invert for all d-boxes-232(3)(a), Soil compaction below distribution box specified(if soil is non-native)-221(2) 6"of stone beneath distribution box specified-221(2) oA\j SC I C; .6 r N„},,,Q 611 Box is watertight-221 (1) Nv T SCLZC,:�r) Top of box<-36 below grade-221(7) 51+awo�' 1 Pr��� �„t ac's. `sr`'te�+ '1'7 • Buoyancy calculations required if box is at or below water table-221(8) Pump Chamber(Check here if not present: ) PZ//4 OK Problem N/A !1 Volume specified: k C V 220(4)(r) ,, %..? Pump on elevation- J , 220(4)(r) i 2'� Pump off elevation: '® 220(4)(r) ,� ` Alarm on elevation: 220(4)(r)►c,.14 Number of cycles per day-220(4)(r)(also 254(1)(d)if gravity from d-box) Minimum 2"delivery line to d-box if gravity-254(1)(c) _( Pressure.dosed Lf. if flow>=2,000 gpd-254(1)(a)&254(2)(a) Cycles per day is consistent with chamber volume-23 1 Volume calculations include flowback volume-2') 1(2) ` 5 I 7oP ehom d eN, 6,1 be lout c r, e 24 hour storage capacity above pump on elevation-231(2) Number of pumps: 2 if system serves>2 dwelling units-231(6) Capacity of pump(s)- gpm @ 'TDH-220(4)(r) Pump can pass 1 1/4"solids(minimum)-231(7) Pump controls specified-220(4)(r) Alarm equipment specified-231(2) _ Alarm is in building and powered on separate circuit from pump-2') 1(9) Pump sequence correct(off-lead on-lag on-alan-n on)-231(8) Pump performance curves included-220(4)(r) �- Manual operating switch-NA 12.01 Check valve,bleeder hole-NA 12.016 R�k vhkv k. 1 childproof,24"riser/manhole to final grade-2'31(5),0^kIl S1i-veS " (OU, Soil compaction beneath pump chamber specified(if soil is non-native)-221(2) 6"of<=3/4"stone beneath chmbr. specified-221(2)&228(1), Buoyancy calculations if chamber is at or below water table-221(8)@ 9"of cover over chamber(minimum)-228(1) --�� H- 10 loading(min.)-H-20 if traffic-226(')), Chamber is watertight-221 (1) Top of chamber<=36"below grade-221(7) ''SHow.J �� lv,>fi S h.tcrf Leaching Facility(general-complete for all designs) OK Problem N/Ej 50%larger if garbage disposal-240(4) Trenches to be used whenever possible-240(6) No vehicle or imperv. area above l.f.unless unavoidable-240(7);NA 13.02 17 Vented if under impervious cover-241 (1) Vented through same pipes as distribution system-241 (1)(a) _ Vent protected from precipitation/animal entry-241 (1)(b) Vent is placed beyond traffic or impervious area-24 1 (1)(c) All lines connected to vent if bed or trenches-241(1)(d) 9"cover over peastone-240(9) Not Reserve area provided(new construction)-248(1) Reserve 4' from primary leach area-NA 9.04 'Jc+f%A-,e 4'(5'if perc rate<=2 MPI)separation to g.w. -212(a)&(b) 4'(down to T with variance or I/A-upgrades only)of natural soil under l.f. GW separation is adjusted to highest existinP grade if facility cuts into a hillside Pipe slope minimum of 0.005 -251(9} �► L S IG(e Require 5'removal and replacement if in fill-255_(5) J Top of leach facility<=36"below grade-221(7)'e7 row, N° J Final grade over 11 minimum 0.02 ft/ft-240(10) / Surface&subsurface drainage away from 11 -240(1 1)&245(5) J Minimum design flow 440 gpd without deed restriction-NA 13.01 J 3:1 slope where grading required-255(2) Toe of fill slope stops 5'from property line or swale installed-255(2) _1 Impermeable barrier if<3:1 slope or< 15 feet to-3:1 slope-255(2) / Impermeable barrier/retaining wall poured concrete-NA 9.02 Retaining wall stamped by P.E.-255(2)(6) Top of retaining wall>=top of peastone elevation-255(2)(0 7 ✓ 10'offset from edge of leach facility to edge of ret.wall-255(2)(g) Perc test(s)done in most restrictive layer- 104(2) Perc test 4' below leaching elevation-NA 7.06 Design flow listed and required/provided leach area given-220(440 Leach pipes SCH40 PVC-NA 10.01 �s c,M �rp e rC , Leach pipes minimum 4"diameter except for dosed system-NA 14.04 6 7 i 7 Leach lines capped,vented,or connected together-251(9) Pressure dosing guidance followed if ressure distribution-254(2)(c), Pressure dosing required over 2,000 dor with UA remedial use-231(l) Leaching Trenches(Check here if not present: ) OK Problem N/A Number of trenches: Minimum of 2 trenches-NA 9.01(2) Depth of trenches(max eff.2'): -247(l) Width of trenches(2'min.,4'max.): -251 (1)(b) Length of trenches(100'max.): -25 1 (1)(a) Trenches are vented(when>50')-251 (11) Trenches follow contour lines-251(2) Trench spacing 3 times effective width or depth minimum-251 (1)(d) In fill or reserve between trenches, 10'min. -NA 14.01& 14.03 Available leach area given(Min. 500 s.f.)-NA 9.01(2) Bottom=L x W X# _ _ s.f. Sidewall=L x x# x2= s. f. Effective leach area given Loading factor: Effective area=total area s.f.x LTAR = g/day Effective area is>=design flow of facility being served 2"of 1/8"- 1/2"2x washed peastone.-247(2) Trench depth of 3/4"to 1 1/2"double washed stone-247(1) Leaching Pits(Check here if not present: OK Problem N/A #ofpits/pit systems: (dosing chamber if>1,231 (1)) Dimensions of each pit or system:L W, D Depth of pits(max eff.2'): -253(l)( Available leach area given Bottom=L x W x#of systems= s.f. Sidewall=L+W x D x 2 x#of systems= s.f. Total area=bottom +sidewall = s.f. Effective leach area given Loading factor: Effective area=total area s.f.x LTAR = g/day Effective area is>=design flow of facility being served Minimum of 2 pits at least 13'X16'—NA 9.01(3) Distribution for galleries/chmbrs. in trench config.-pipe every 20'-253(6) Distribution for galleries/chmbrs. in bed config.-ea.pipe serves<=40 s.f.-253(6) Spacing-2 times the effective width or depth(the greater)-253(1)(c) 2"of 1/8"- 1 /2"2x washed peastone.-247(2) 3/4"to 1 1/2"double washed stone-247(1) Each pit has at least one 20"access cover.24"Cl to grade over 2,000 gpd -253(3) Surrounding aggregate thickness between 1'(min.)and 4'(max.)-253(1)(b) Vents, if necessary,extend under covers of pit(s)-241 (e) Leach Fields(Check here if not present: OK Problem N/A Number of fields: (need dosing chamber if> 1,231 (1)) 7 8 i Length(100'm�.): ��" -252(2)(b) Width: Total area:L 0 A QIX W ( _ = w I s. f Minimum 900 square feet-NA 9.01(1) JJ ✓ Distribution lines connected with solid pipe—NA 15.01 Effective leach area given Loading factor: e 7 Effective area=total area 1411 s.f x LTAR 17Y g/dav Effective area is>=design flow of facility being served Minimum of two distribution lines-252(2)(a) 6'line separation(max.)-252(2)(d) 4'maximum separation from edge of field to line-252(2)(e) 10'minimum separation between adjacent leach fields-252(2)(f Between 6"and 12"of 3/4- 1 1/2"stone beneath field-252(2)(g)&247(2) S�-owA) 1� -� 2"of 1/8"-1/2"2x washed peastone.-247(2) Final Grading OK Problem N/A Slope over leach area minimum of 0.02 feet/foot—240(10) Grading shall divert drainage away from leach area—240(l 1) Grading slopes away from dwelling M �w1D. 0 5/24/01 8 Bergman & Associates, Inc. Engineers 20 Washington Street Haverhill, MA USA 01832-5524 Tel. (978) 372-1125 Fax (978) 372-1130 10 October 2002 (•'�-x-.-.mac=__.-.._.,_ -'.' _._. Sandra Starr II Town of North Andover [F;' f>� 1202 Community Development & Services :_ _ f 27 Charles Street North Andover, MA 01845 - - Reference: 1615 Osgood Street (May #34, Lots #44 and #28) Dear Sandra: Attached for the above referenced lots is the soil testing information and a scale plan showing the location of the tests. Design plans for the proposed system(s) will be submitted upon completion. If you have any questions or concerns, please contact me at the number above. Sincerely, 7qo'-4'� k � Martin Deforge, PE FORM 11 - IL EVALUATOR FORM Palle 2 of 3 Location Address or Lot loo. JG/57-- aS a o a 0 - Ja� / 7 7 o%>7z On-site Review _ Deep Hole Number Date:3z 07-- Time: 3� Weather Location (identify on site plan) Land Use Slope (°.4:) — ____ Surface Stones N p�iy Vegetation- Aj0-o r tr Landform Dy 7'44✓ s Position on landscape (sketch on the back) Distances from: _ qty Open Water Body _ feet Drainage way feet Possible Wet Area feet Property Line 3P t feet Drinking Water Well feet Other DEEP OBSERVATION HALE LOGS i i Depth from Soil Horizon Sol Texture Sob Color Soli Other I Surface(inches) (USDA) !Munsell) Mottling (Structure.Stones,Soulders.Consistency. % Graven n P 1 7" 7, - 17 1=5 7.5YJ� 4,-C T ) 7 3L� 53 ,•7�v-p,ro . �, 5 75Y� rte r)w e r IV a- C.,,4Y� , N zs'tD 7 ,P T3 t= er � � Q�r7 ?SY� s e-�,o✓6 as /07 Pavan)Material(geoiogie) Depth to GroundwaterO�iJ Standing Water in the Hole: /V C% Weeping from Pit floe: ,N7/1.)L- Estimated Seasonal High Ground Water: / -3 ry WPrIja55e-D 3Y V,, Ln /1/0Off`73� 1=X t A VA 'TO rZ 0J1� DEP APPROVED FORA(-0107195 FORM 12 - PERCOLATION TEST Location Address or of No. Jc�a Nv. 7'20107 ZA COMMONWEALTH OF MASSACHUSETTS A* -n - 4-wvV$Vavi , Massachusetts Percolation Test* Date: ...:. ..2 Z ° 1 Time:....:.; Observation. Hole Depth of Perc Start,Pre-soak 10% 4Z 9 71-1 7rIr H-a. End Pre-soak Time at 12" G/1`l.�LoN c Time at 9" Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ Performed By: 17?ae nJ 17 E C Witnessed By: J, �. , N��N A ANJ Comments: ..::.::.::::::::::::::::::.:::::::.::::::::::::::..::. DEP APPROVED FORM-12/07/95 177-o f Q -7 Z FOR'1112- PERCOLATI01 TEST _ Location Address or Lot No. / COMMONWEALTH OF MASSACHUSETTS `7'* 1� , Massachusetts Percolation Test' Date: .. ... �-z5 Z_ Time% Observation Hole ,# i Depth of Perc l n Start Pre-soak End Pre-soak Time at 12- Time at 9" Time at 6- Time (9"-6-) Rate Min./Inch Minimum of ) percolation test must be performed in both the primary area AND reserve area. Site Passed ❑ Site Failed ❑ .............................. .._..._. -----------=............__...................... __ - - - Witnessed 6y: Comments: t DSP AMOVIM IrOBM-UWIVS FORM 11 - ;IL EVALUATOR FORM Page 2 of 3 17 7p7Z Location Address or Lot lqo. I / '� OSGOOA S� On-site Review _ f Deep.Hole Number ft Date: -..'�'�./ O L Time: % Q� Weather G L A -7Q C Location (identify on site plan) Land Use p/1'r>Z K/ti Ld 4.9T Slope M Surface Stones Vegetation Landform /J K ir457- Al 4 /-7)0-t'7 Position on landscape (sketch on the back) C Distances from; � r-p I Open Water Body 7>q9 feet Drainage way ,�4Q feet Possible Wet Area A 7/00 feetProperty Lined y iesi01 Drinking Water Well feet tither cvrrm i - i I DEEP OBSERVATION HOLE LOGS /5W<Ti.✓ I Depth from Soil Horizon Sol Texture Sol Color Soii pts Surface(Inches) {USDA) tMunseln Mottling (Structure,Stones,Boulders,Consistency, % Graven 0 I Pat� c 0 w 71 7v G rent Material(geologic) ^j/� I > Pa OepQitoBadrvdr: Death to Groundwater: Standing Water in the Hole: 0004 p ov,Z' Weeping from Pit Face: Ne Estimated Seasonal High &round Water: Z '0� DEP APPR O%'m FORM-1=7195 FO%M 11 - IL EVALUATOR ):ORM Page 2 or 3 Location Address or t i4o. /G15- Q.SG ao q 7� JOB IYO. 17701197z--4 /y, Aevg On-site Review _ jI Deep Hole Number z' Date: r Z vo,Z Time S G G� Weather Location (identify on site plan) Land Use P. Slope M ' Surface Stones _ -6f4? 4-a Vegetation NO'S 01 TefoNc Landform Position on landscape (sketch on the back) . .....'S �' Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line 5n feet Si� s- Drinking Water Well _ __ -- feet Other j DEEP OBSERVATION HOLE LOGS Depth from 5041 Horizon Sol Texture Sod Color Sod Other Surface(Inches) {USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Graven (� Z- T, ,-----�-- �/�13 L� .•oar�-- p� eo�GA=-s 7'0 y .� Z Tow Parent Material(aeoiopic) 6V 77aV A'- Death to Groundwater: Standing Water in the Hole: Q�NWeeping hom Pit face: O euy stim Eated Seasonal High ground Water 7- < DEP APPRONIM FORM-12W05 i FORD( 11 • IL EVALUATOR FORM Patio 2 or 3 i Location Address or Jot loo. 1615- Osz%7aop S 7--' 17 '70 a 724 /-L-, vt�O Q d i On-site Review _ i Deep Hole Number 3 Date: Time: Weather Location (identify on site plan) Land Use — 10L,-,o d"A 2 Slope (%) "Z Surface Stones _ N oOV-At r- - Vegetation WO n Landform 3 Position on landscape (sketch on the back) Distances from; Open Water Body feet Drainage way 3 feet Possible Wet Area ` feet Property Line feet 'Ce0>-c- Drinking Water Wel! #est Other 7a`+ i DEEP OBSERVATION HOLE LOGS i Depth cram Soil Horizon Soil Texture Sod Color Soil Other Surface(Inches) (USDA) !Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravel) 2,5r�/_ G/rte Parent Material(Qeologic) G 00 Se-_— j i i- L OapthwA ,r'cl: i-JL/DepthtoGroundwater: Standing Water in the Hole: 10,9 /A) Weeping from Pit Face: Estimated Seasonal High t3round Water. 17 JAJ �°VO O^JA-A/ DFP APPROMM FORM-12=35 1 Wind2 FMS-Noonan&McDowell,Inc. STI-a �.l. - X I File Edit TToffi Tools Data Maintain Process View Report Grid Windows Help ® D ( Lyl AP I BM I CM , CR I'EIS I GL I, PL J SM] '�pI ffilC ❑IX 3 Project: 1770 J Office of Health Department 27 Charles Street,No.Andover, Billing Group ID: F07277.11 I Billing Type: Fixed Fee Billing Fee: 200.00', Card ID: To NA _ J l M,�in Billing Info Contract Info Classfcatign GLAccognis @filling Messages Alerts Staffing Actiyities — -- - - - — s I --- 1 1 -- — -- Proposal Number: Assign To Department: Contract Number. Contract Date: 872272002 - Work Start Date: 1812212002 Expected Finish Date: 1912212002 r Use Government Invoice Style' Description: Engineering services required to observe soil testing. Engineer:Martin Deforge #978-372-1125 Assessors Map 34,Lot 44 Applicant:George Stella,Trustee 1615 Osgood Street I• z. I Close jyotes:an i l � OF 2 8 2092 FORM 11 SOIL EVALUATOR FORM Page I of 3 No. Date: 3MAY 2.002 Commonwealth of Massachusetts Massachusetts Soil Suitability Assessment wa,ge Disposal Performed By: .....M.W-W........De'7PM!� ..................... Date: M9 AP4,zoq Z 2. A06)Zo 0 Witnessed By: N ......... .............. J.P.0.......L .................................................................................. ..... . . Location Address orOwner's Nam, STELLA, -TR I.ot# Address,and M AP 0 3 A LDT jf2-V Telephone 1 (,,%0 CDM 14,01j 15 Irk et-Ir t40R:TR APJW"-,P-' M A L-A-Wke-m4z' t1h 01042- New Construction 0 Repair '978') 68 2 -L 2)32- Office )192- Office Review P Published Soil Survey Available: No Yes 111,5,64.p Soil Map Unit UD.................... Year Published Publication Scale Drainage Class ........... Soil Limitations .............................................................. ...M.b Surficial Geologic Report Available: No X Yes ❑ Year Published Publication Scale GeologicMaterial (Map Unit) ...............I.........I..................................................................I...............................................11.........------- Landform ....................I........................................................................................................................................................................... Flood Insurance Rate Map: r7A Above 500 year flood boundary No 0Yes W Within 500 year flood boundary No RYes D Within 100 year flood boundary No []Yes ❑ Wetland Area: f./A National Wetland Inventory Map (map unit.) ............ ...................................... ................... Wetlands Conservancy Program Map (map unit) .... ........*..........--*................. ............-7............. Current Water Resource Conditions (USGS): Month AROL Z()OZ- Range :Above Normal nNormal ElBelcw Normal Other References Reviewed: hJ01- 1 1T440 DEP APPROVED FORM-12/07195 FORM 11 - SOIL EVALUATOR FORA► Page 2 of 3 Location Address or Lot No. Sv�nc" On-site Review Deep Hole Number Date:1:-d5. k 2&b Time:.. Weather Location (identify on site plan) .:........::.:.::.::::::,.:.:::::.::::.:.. .. .,..::::::::..:....::::..:.:..::::::....:......::. ..::.:.:::.:....:..:::::::....... .. ... ....::..:..:::... Land Use .r1�. ::.:4.r3T..:... Slope (%) I Surface Stones :..:.... Vegetation :.:..:,0.90C.,-7.. .P-491 ' ._ _:..:.:.:.::...:..,:. Landform ::..:.:::...:.::.::.::.. ::.::..:..,:::.:..:. .. .. Position on landscape (sketch on the back) Distances from: Open Water Body . feet Drainage way :. .... feet Possible Wet Area ......:._.... feet Property Line feet Drinking Water Well ::::::.::..:... 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) 4 FILL MeL A ?e F1 LL MEb. �z1„ 2g _`�� C SQL' 2,55�3 fay /$ a Y&A. µ MINIMUM OF 2 HOLES REQUIRE15 AT EVERY PROP09ED DISPOSAL ARLA Parent Material(geologic) DepthtoBedrock:_ A Depth to Groundwater: Standing Water in the Hole: Nc1 r')E Weeping from Pit Face: V'We Estimated Seasonal High Ground Water: 28`' DEP APPROVED FO"t-12/07/95 FORM 12 - PERCOLATION TEST // , Location Address or Lot No. (O i° 0 S 00D STP cls T' COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test' Date: A.Pk ?00? Time: e � Observation Hole # Depth of Perc" Start Pre-soak 4-1 End Pre-soak I I Time at 12" 2 . 0 0 Time at 9" 1 f ID Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ............................................................................................................................................................... Performed By: I`'1hk-rlt3 `)•t ®P.&rte, Witnessed By: P,i A L A-6nR 2S 14LArt V1 lPr:C-'r* - Comments: e.... . DPP APPROVED FORM-121/7/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of:3; Location Address or Lot No. On-site Review Deep Hole Number : Date:2Z.hU67 '2- Time: 1 ,41) Weather PAkTq CLOODk Location (identify on site plan) Land Use 'WX\06, !w-OT' Slope (%) &-Ic7f, Surface Stones Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body t1p, feet Drainage way feet Possible Wet Area tjlA _ feet Property Line feet Drinking Water Well P/161 feet Other �JAt 2..a..tt• ��� DEEP OBSERVATION HOLE .OG` Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Gravel) 2- - 2 LL_ 5AOVY L ,©IP-g/4 Y C1 it J / 6 � C 1.1t� v. 49P-101-6 7L, MD MINIMUM OF 2 HOLES REQUIRE15 AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) 00TW ASid // DepthtoBedrock: p" Depth to Groundwater: Standing Water in the Hole: CJI}- Weeping from Pit Face: _ Estimated Seasonal High Ground Water: DEP APPROVED rottnt•12/07/95 FORM 11 - SOIL _EVALUATOR FORM Page 2 of'. Location Address or Lot No. On-site Review Deep Hole Number .:::::::: Date:..22:Pdbi Time:... Weather Location (identify on site plan) __. ... ......::.:: .: ... Land Use :.YANP' . ..:.... . .._ ..... Slope (%) . . Surface Stones Vegetation/ Landform ...:.:....:..::.:..::.. .... Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way. : . feet Possible Wet Area feet Property Line ._.>� .:.. feet Drinking Water Well ::.:: ':::. feet Other .:....:,.:...:::...:::::.:::::.:::::... DEEP OBSERVATION HOLE IF OG` Depth from Soil Horizon Soil Texture Soil Color Soil -Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) 17 FILL stwo 2. 17 . f,e11 2 � 5AIJ MINIMUM OF 2 HOLES REQUIRED AT EVERY PROP09ED DISPOSAL AREA Parent Material (geologic) (S) "A- DepthtoBedrock: 01A Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water:_ DEP APPROVED FORM-12107!95 T.ORNI 11 - SOIL EVALUATOR FORNI ' Page 2 of 3 Location Address or Lot No. (0i.5 OsC: dO �Vzfz-r On-site Review Deep Hole Number .. Date:.22-AY 07, Time:... ..:..:.:. :. Weather Location (identify on site plan) ..:.........:...:::.:::::.::.::.:::..:::........ .:..:..,::,,...::..::.,...:.::.:::::::...:.....:,:.:,:.:::....::.:......::::::::..:..... .. ..... ......:...: ..::.. Land Use :.:.:......:..::::... Slope M Surface Stones .. ...:.:.::.:.:.... :. Landform Position on landscape (sketch on the back) Distances from: Open Water Body . feet Drainage way. ,. .... feet Possible Wet Area ..... ... feet Property Line ... ........:.. feet Drinking Water Well .:::.:::,:..:.... feet Other DEEP OBSERVATION HOLE SLOG" Depth from Soil Horizon 'Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Gravel) 0 _ PA-QIEMCNT C s Ft Sowb -S� �4 f t1 3 -53 G 3 MD-caAO-sc 2 s Y17 073 C Ca+ t D�', `� (a 0 7,SYR��' -9A MINIMUM OF 2 NULLZI, REQUIRED AT EVERY-PRM Parent Material(geologic) DepthtoBedrock: 4-A Depth to Groundwater: Standing Water in the Hole: NI O tic Weeping'from Pit Face: Qbmm� Estimated Seasonal High Ground Water: 73 t! DEP APPROWTD FORA(-12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. bD� S -7— COMMONWEALTH 7COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation 'fest* Date: ::.:...��. ....:. uUST ® 'Z Time: ...:.I.D..r..?a. ?: ,...,.. Observation Hole # Depth of Perc Start Pre-soak 10: q2. End Pre-soak Time at 12" _z Time at 9" Time at 6" � Time (9"-.6") Rate Min./Inch * Minimum of 1 percolation test must be,.performed in both the Prim ry area AND reserve area. - ---- • Site Passed JK Site Failed.. ❑ ............................ Performed By: _ AP-T-dtQ Witnessed By: a ( JJOOPJ M Comments: .......::,.: .:>` . .. :.....:....... , �G - .... ...:�.: ;......:: :. i .........................,.:.,............. ...... .................... . ......... DEP APPROVED FORM.-12/07/95 v ~ FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. OSFOOD Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole.................. inches ❑ Depth weeping from side.of observation hole ................... inches Depth to soil mottles ...� .:::.:: inches ❑ Ground water adjustment ................... feet 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? ZS If not, what is the depth of naturally occurring pervious material? Certification I certify that on SPRiot,, M6 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature ?&L bf milml Date 314AY 7-067- DEP oa7DEP APPROVED FORM-12/07/95 'u - v, � 0 A \ Pin C avv3v. S. P 9D TIP vs r s �S3.po RhP�Pi Project Request Record Town of North Andover Date: 0 Z Client Id:ToNA Card Id:ToNA Client/Company NarL Board of Health Card Tyne-Client Contact Name:. Ms.Sandra Starr Phone: 978-688-9540 Title:Director Fax:. 978-688-9542 Address: 27 Charles Street Email: sstarr@townofnorthandover:com Notes:. - Town: North Andover State: MA Zip Code: 01845 Other contacts if applicable ie Engineer/Installer _ Name: Phone: / ,7 :a � "- Title: Fax: Address: Email: Notes: Town: State: Zip Code: Prot ct: 1,2 2" Project Id: 1770 f.'-' Project Title: Town of North Andover,Board of Health (JOB NO) (PROJECT NAME&STREET ADDRESS) Manager:NOW Billing Group: Billing Cod :Fixed Fee ?-� Contract Info.Project Description for each billing group BG/ Applicant G Assessors Man - Lot - } Street Type of service ' - Office/forms/jbrqutona IlEW REE [Elle Pd't Tools Qata Maintain Process View Report I Vvindows tieiP Project: 1770 I iLJ e of Health Department 27 Charles Street,No.Andover, OfficI Billing Group ID: ? Billing Type: Fixed Fee f-I Billing Fee: 200.00 Card ID: ToNA J It Moin [7 Billinglnfo Contractlnfo Classification GLAccoiints]LQillingMessages Ajerts l�Stafring,. `Actiyities i sign To Proposal Number: Department: Contract Number: Contract Date: 4119102 Work Start Date: 4119102 Expected Finish Date: 4130102 QUse Government Invoice Style, Description: Engineering services required to observe soil testing. Engineer:Martin Deforge #978-372-1125 ! . Assessors Map 34,Lot 44 Applicant:George Stella,Trustee 1615 Osgood Street $ave Close ._Notes... Project Request Record Town of North Andover Date: O Z Client Id: ToNA Card Id:ToNA Client/Company Name:Board of Health Card�Tvne-Client �,,'ContactName: Ms.Sandii Starr. Phone: 978-688-,954W Title:Director978 Fax: "Address 27 Charles Street Email: sstarr@townofnorthandover.com,..:: Notes: "'ifr„l11%ll'! 0Town: North Andover, State MA Zip Code:., 01845 7,7y t., Y1-: ' .•i• f lr it l��� Il7 r/ �iOthercontacts `apPhcable.."i E” in`eer �i,Name, i'arSi2 Ti ey J�. G E Phone: ly'rr`t' ,r n• .!�!r/��h(� j4Tide: Fax: Address: Email: Notes: hi.-,i-l! Town: f�`�T��/f/ G :glib .State:: ^1 Zip Code: Project: Project Id: 1770 Project Title: Town of North Andover.Board of Health (JOB NO) (PROJECT NAME&STREET ADDRESS) Manager:NOOJ Billing Group: Billing Cod :Fixed Fee Z v r �7 �.Cbntract Info.Project:Description for each.billing-group BGL Applicant' Ge�2t Assessors Man 3 f Lot 4- Street15' G'S G d d O % /;it l r / Type of service 5 Tn O /7 S J 7 PHONE CALL R DATE TIME! P.M. H0NEO RETURNED ONE YOUR CALL AREA COOE NUMBER EXTENSION CQLL :SSAGE WILL CALL AGAIN CAME TO _SEE YOU WANTS TO SEE YOU 3NEO �AIVetSal- 48003 Officelform§/jbrqutona Adwk Town of North Andover, Massachusetts Form No.s of MORTh 1 BOARD OF HEALTH O F P DESIGN APPROVAL FOR Ss�CHU9E` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant G7�� Test No. �0 Site Location /e/' �� Reference Plans and Specs. ENGINEER VDESIGN 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 Fee Q Site System Permit No. rt SEPTIC PLAN SUBMITTAL FORM LOCATION: Oso,60 D 571Z-FZ;7--r (LOT- WZB) NEW PLANS: YES $160.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: Q�D NO DATE: 17 D tG o 2 DESIGN ENGINEER: BEP46MAM 02 2r- ,rNX 114RTY-1 l e���, Pz�- DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. CHECKLIST FOR NORTH ANDOVER SEPTIC SYSTEM PLANS Job The following is a checklist that incorporates all Title 5 and local regulations for septic plans. Name of Applicant: Name of Designer: Plan Date: Revision Date: Date of Review: Property Address: ��✓UTGU�� Map: Lot: BOH Reviewer: Type of Plan(new or upgrade): ' Number of Bedrooms: IIY6gpd) Garbage Disposal Allowed: General Information: N.A.=North Andover Septic Regulations Other numbers refer to Title 5 OK Problem N/A Street number and map/lot-220(4)(u) Maximum scale of 1 "=40'for plot plan-220(4) Maximum scale of 1 "=20'for profile and component details-220(4) Legal boundaries of the facility being served-220(4)(a) Names of abutters from recent tax map- NA 8.02j Number of bedrooms,design calcs.,-NA 8.02i Name&address of record owner&applicant- NA 8.02k Name&address of designer-NA 8.021 Holder and location of all easements-220(4)(b) Datean lan drawn& revision date- NA 8.02m P Y ✓ All dwellings and buildings,existing and proposed-220(4)(c) Location of all existing or proposed impervious areas-220(4)(d) All distances on site plan—NA 8.03a-c Elevation of proposed driveway-NA 8.02t Location and elevation of foundation drain-NA 8.02y Location and dimensions of the system incl.reserve(new const.)-220(4)(e) Limits of excavation of leach area on site plan-NA 8.02z Locus plan-220(4)(t) (Not to scale) North arrow-220(4)(g) Existing and proposed contours-220(4)(g) Locations and logs of deep holes-220(4)(h) Locations and logs of percolation tests-220(4)(1) Date(s)of soil testing-220(4)(h)&(i) Existing grade elevation of each deep hole-220(4)(h) Elevation of percolation tests—N.A. 8.02n Name of approving authority representative-220(4)(h)&(i) Name of soil evaluator-220(4)0) Soil logs and perc test logs match BOH records Locations of waterlines,drains,and subsurface utilities-220(4)(m) Observed and adjusted g.w.elevation in the vicinity of the system-220(4)(n) Complete profile of the system to scale-220(4)(o),NA 8.02c Cross section of leaching facility-NA 8.02w (Not to scale) Location of benchmark(s)within 50-75 feet of facility-220(4)(q) V Note listing all variance requests with proper citations-220(4)(p) Local upgrade approval request form submitted-403(1) 2 v Original R.S./P.E. stamp,signature&OgD 220(1)&(2) P.E.,discipline specified within stamp. MGL C. 1.12 s. 8 1 M sfc. supplies(w/in 400'),pub. wells(w/in 250'),pvt. wells(w/in 1.50')-220(4)( Location of watercourses,wetlands, wells,etc.Win 150'of system—NA 8.02r Wetland disclaimer—NA 8.02s RLS plan reference&certification required(prop line setbacks)-220(3) Plan contains designer's certification statement Use approvals/standards checked for I/A system-DEP docs., ✓' Pere rate>30 MPI-not allowed for new,LUA for upgrade-245(1)&('3) Perc rate > 60 MPI-must use modified tight tank or 1/A technology-245(4) ✓ Proposed system qualifies as"shared" system-002(definitions) Flow is over 2,000 gpd-No R.S.allowed-220(1) Design flow was set in accordance with code-203 Existing system location and note on proper abandonment-354 Leaching facility at least 1' above Base Flood elevation—NA 9.05 All piping Sch 40 minimum—NA 10.01 Basement floor minimum 1' above groundwater elevation—NA 5.04 Foundation drain present with elevation—NA 8.02y On-site Soil and Groundwater Review 07 Problem N/A Proper deep observation hole logs on plan-220(4)(h) All deep holes and peres shown,including aborted tests—NA 8.02n Soil evaluation forms submitted within 60 days of field work-018(2) Proper percolation test log-220(4)(i) Ample deep observation holes in primary disposal area(minimum 2)- 102(2) Ll Ample deep observation holes in secondary disposal area(minimum 2)- 102(2) l� Ample perc testing(one in each disposal area,3 in prim.>2,000 gpd)- 104(4) Deep hole testing conducted within two years—NA 7.05 Hole Identification Numbers: 1 ground elevation el. 143- acceptable soil el. j�3 Leach facility invert el. IL01,6-, ground water el. 97 refusal el. bottom of leach facility el. f Q�• thickness of acceptable soil .9,3 before&after soil R&R separation to groundwater 'Y separation to refusal soil class 2 ` 3 perc rate a3 rnf°� loading rate Y septic tank below g.w.table (yes or no) pump tank below g.w.table (yes or no) l.f in fill -255(l) Setback Distances(Given in feet) 15.21 1 YES (NO� Is the lot in the Lake Cochiewick Watershed? NA 6.00&5.02 OK Problem N/A Septic Tank Leach Facility Property line 10 10 Cellar wall 1.0 20 Inground pool 10 20 Slab foundation 10 10 Deck,on footings,etc. 5 10 Waterline 10 10 Private drinking well 75 100 Irrigation well 75 100 Wetlands 75 100 Public well 400 400 Wetlands bordering surface 150 150 water Supply or trib. (in Watershed) Trib.To Surface Water supply 325 325 Reservoirs 400 400 Tributaries to reservoirs 200 200 Drains(wat. supply/trib.) 50 100 Drains(intercept g.w.) 25 50 Foundation drains 10 20 Drains(Other) 5 10 Drywells 20 25 Downhill slope 15'to 3:1 slope 3 I 4 w/o barrier Building Sewer OK Problem N/A Grease trap required for certain uses(check 230 for details) Pipe diameter listed(4"minimum)-222(1) Pipe schedule listed-222(3) Pipe cast iron or Sch 40 PVC—NA 11.02 Watertight joints specified-222(3)&(4) Pipe laid on compact,fin base-222(5) Pipe laid on continuous grade in straight line-222(7)@ Cleanouts precede all changes in alignment and grade-222(8) Cleanout provided every 1.00 feet-222(8) Manhole at any 90 degree alignment change-222(8) Invert elevation at building: Invert elevation at septic tank: Length of run: Slope: (minimum of 0.01 -0.02 desired)-222(6) 1.0'offset to private well or suction line-222(2) Septic Tank OK Problem N/A Tank is accessible-228(3) No structures above tank—(228(3) Tank can accommodate both primary&reserve—NA 9.04 200%of flow(required&provided given. 1500 min.)-220(4)(f)&223)(1)(a) 2-3" drop from inlet to outlet-227(5) Minimum of 4'liquid depth-223(2) 3"air space above teesibaffles(minimum)-227(4) 9"air space above flow line(minimum)-227(4) Tees are not to be replaced by baffles-227(1) Tees extend 6" above flow line-227(1) Inlet tee extends 10" below flow line(minimum).-227(6) Outlet tee extends 14"below flow line(more for deeper tanks)-227(6) Gas baffle installed on outlet-227(4) Access manhole cover above center of tank&each tee(except 2 compart) 228(2) 3-20"manholes-228(2) 1 childproof,24"riser/manhole Win 6"of final grade if<1000gpd-228.(2) Inlet and outlet tees on center line-227(1) Soil compaction below tank specified(if soil is non-native)-221(2) 6" of<=3/4"stone beneath tank specified-22](2)&22 8(1) If> 1,000 gpd AND not a single fam.dwell.must be 2 tks,or 2 comp. -223(1)(b) If plan specifies disposal must be 2 tanks in series or 2 compart.tank 223(1)(c) Buoyancy calcs.required if tank at or below water table-22](8) Tank is watertight-221 (1) 9" of cover over tank(minimum)-228(1) H- 10 loading(min.)-H-20 if traffic-226(3) Top of tank<=36" below grade-221(7) All pumping to tank(if applies)in accordance with-229 Tank is set to keep old system in service during install if possible 4 5 Tight Tank(Check here if not present: v ) OK Problem N/A 500%of design flow or 2000 gallons provided—260(2)(a) 3-20"manholes—228(2) Soil compaction below tank specified(if soil non-native)—221(2) 6"of<=3/4"stone beneath tank specified—221(2)&228(1) Buoyancy calcs.Required if tank at or below water table—221(8) Tank is watertight—221(1) 9"of cover over tank specified(minimum)—228(1) H-10 loading(min.)—H-20 if traffic—226(3) Top of tank<=36"below grade—221(7) All pumping to tank(if applies)in accordance with—229 AN alarm set at 3/5 tank capacity—260(2)(c) Min. 1-24"frame w/cover at finished grade—228(2)(f) Year round access for pumping—228(2)(g) Distribution Box(Check here if not present: ) OK Problem N/A Inlet elevation: Outlet elevation: 0.17'drop from inlet to outlet(minimum)-232(3)(b) 6" sump(minimum)-232(3)(e). All outlets at same elevation-232(3)(b) Outlet pipes laid level for first 2 ft.-232(3)(c) Pipe Sch 40-NA 10.01 Number of outlets: Number of laterals: Size of outlets: Inlet baffle/tee min. 1" over outlet invert for all d-boxes-232(3)(a), Soil compaction below distribution box specified(if soil is non-native)-221(2) 6" of stone beneath distribution box specified-221(2) Box is watertight-221 (1) Top of box<=36"below grade-221(7) Buoyancy calculations required if box is at or below water.table-221(8) Pump Chamber(Check here if not present: ) OK Problem N/A Volume specified: 220(4)(r) Pump on elevation- 220(4)(r) Pump off elevation: 220(4)(r) Alarm on elevation: 220(4)(r) Number of cycles per day-220(4)(r)(also 254(1)(d)if gravity from d-box) Minimum 2" delivery line to d-box if gravity-254(1)(c) Pressure dosed Lf.if flow>=2,000 gpd-254(1)(a)&254(2)(a) Cycles per day is consistent with chamber volume-.23 1 Volume calculations include flowback volume-2') 1(2) 5 6 24 hour storage capacity above pump on elevation-231(2) Number of pumps: 2 if system serves>2 dwelling units-231(6) Capacity of pump(s)- gpm @ 'TDH-220(4)(r) Pump can pass 1 1/4 "solids(minimum)-231(7) Pump controls specified-220(4)(r) Alarm equipment specified-231(2) Alarm is in building and powered on separate circuit from pump-2') 1(9) Pump sequence correct(off-lead on-lag on-alan-n on)-231(8) Pump performance curves included-220(4)(r) Manual operating switch-NA 12.01 Check valve,bleeder hole-NA 12.01 1 childproof,24"riser/manhole to final grade-2'31(5), Soil compaction beneath pump chamber specified(if soil is non-native)-221(2) 6"of<=3/4"stone beneath chmbr.specified-221(2)&228(1), Buoyancy calculations if chamber is at or below water table-221(8)@ 9" of cover over chamber(minimum)-228(1) H- 10 loading(min.)-H-20 if traffic-226(')), Chamber is watertight-221 (1) Top of chamber<=36" below grade-221(7) Leaching Facility(general-complete for all designs) OK Problem N/Ay P/ 50%larger if garbage disposal-240(4) ✓ Trenches to be used whenever possible-240(6) No vehicle or imperv.area above l.f.unless unavoidable-240(7);NA 13.02 Vented if under impervious cover-241 (1) Vented through same pipes as distribution system-241 (1)(a) Vent protected from precipitation/animal entry-241 (1)(b) Vent is placed beyond traffic or impervious area-24 1 (1)(c) All lines connected to vent if bed or trenches-241(1)(d) 9" cover over peastone-240(9) Reserve area provided(new construction)-248(1) Reserve 4' from primary leach area—NA 9.04 J/ 4'(5'if perc rate<=2 MPI)separation to g.w.-212(a)&(b) 4'(down to 2'with variance or I/A-upgrades only)of natural soil under l.f. GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005-251(9) Require 5'removal and replacement if in fill-255(5) Top of leach facility<=36" below grade-22](7) Final grade over l.f.minimum 0.02 ft/ft-240(10) Surface&subsurface drainage away from l.f.-240(1 1)&245(5) ✓ Minimum design flow 440 gpd without deed restriction—NA 13.01 3:1 slope where grading required-255(2) Toe of fill slope stops 5'from property line or swale installed-255(2) Impermeable barrier if<3:1 slope or< 15 feet to—3:1slope-255(2) Impermeable barrier/retaining wall poured concrete—NA 9.02 Retaining wall stamped by P.E. -255(2)(b) Top of retaining wall>=top of peastone elevation-255(2)(f) 10'offset from edge of leach facility to edge of ret. wall-255(2)(g) ✓ Pere test(s)done in most restrictive layer- 104(2) Pere test 4' below leaching elevation—NA 7.06 Design flow listed and required/provided leach area given-220(4)(f) !�— Leach pipes SCH40 PVC—NA 10.01 (� Leach pipes minimum 4" diameter except for dosed system—NA 14.04 6 r 7 Leach lines capped,vented,or connected together-251(9) Pressure dosing guidance followed if pressure distribution-254(2)(c), Pressure dosing required over 2,000 gpd or with I/A remedial use-231(1) Leaching Trenches(Check here if not present: OK Problem N/A Number of trenches: Minimum of 2 trenches-NA 9.01(2) Depth of trenches(max eff.2'): -247(l) Width of trenches(2'min.,4'max.): -251 (1)(b) Length of trenches(100'max.): -25 1 (1)(a) Trenches are vented(when>50')-251 (11) Trenches follow contour lines-251(2) Trench spacing 3 times effective width or depth minimum-251 (1)(d) In fill or reserve between trenches, 10' min.-NA 14.01& 14.03 Available leach area given(Min.500 s.f.)-NA 9.01(2) Bottom=L x W x# — s.f. Sidewall=L x D x# x 2= s.f. Effective leach area given Loading factor: Effective area=total area s.f.x LTAR = g/day Effective area is>=design flow of facility being served 2"of 1/8"- 1/2" 2x washed peastone.-247(2) Trench depth of 3/4"to 11 1/2" double washed stone-247(1) Leaching Pits(Check here if not present: 1/ ) OK Problem N/A #of pits/pit systems: (dosing chamber if>1,231 (1)) Dimensions of each pit or system:L W D Depth of pits(max eff.2'): -253(1)(a) Available leach area given Bottom=L x W x#of systems= s.f. Sidewall=L+W x D x 2 x#of systems= s.f. Total area=bottom +sidewall — s.f. Effective leach area given Loading factor: Effective area=total area s.f.x LTAR =—g/day Effective area is>=design flow of facility being served Minimum of 2 pits at least 13'X16'—NA 9.01(3) Distribution for galleries/chmbrs. in trench config. -pipe every 20'-253(6) Distribution for galleries/chmbrs.in bed config.-ea.pipe serves<=40 s.f.-253(6) Spacing-2 times the effective width or depth(the greater)-253(1)(c) 2"of 1/8"- 1/2" 2x washed peastone.-247(2) 3/4" to 1 1/2" double washed stone-247(1) Each pit has at least one 20" access cover.24" Cl to grade over 2,000 gpd -253(3) Surrounding aggregate thickness between 1'(min.)and 4'(max.)-253(1)(b) Vents,if necessary,extend under covers of pit(s)-241 (e) Leach Fields(Check here if not present: ) OK Problem N/A Number of fields: (need dosing chamber if> 1,231 (1)) 7 T • 8 e O • Length(100'max.): -252(2)(b) Width: Total area:L x W = s.f. Minimum 900 square feet-NA 9.01(1) Distribution lines connected with solid pipe—NA 15.01 Effective leach area given Loading factor: Effective area=total area s.f x LTAR = g/dav Effective area is>=design flow of facility being served Minimum of two distribution lines-252(2)(a) 6'line separation(max.)-252(2)(d) 4'maximum separation from edge of field to line-252(2)(e) 10'minimum separation between adjacent leach fields-252(2)(f) Between 6" and 12" of 3/4- 1 1/2" stone beneath field-252(2)(g)&247(2) 2"of 1/8"-1/2" 2x washed peastone.-247(2) Final Grading OK Problem N/A Slope over leach area minimum of 0.02 feet/foot—240(10) Grading shall divert drainage away from leach area—240(l 1) Grading slopes away from dwelling 5/24/01 8 ff i 534 )T< Georgl Farkas, 2j 9 5 PAG) I+forth Andover, Essex County, Massachusetts, =car", for co sideration paid, grant to Agneas Farkas, my wife, I ' _ I f., North Andove ssex Co ty 1 ssa'chusetts with quttristm ravel ants All mY ri hhtt, 1 e gd �int��es� it the Land in sid N�Or �n over, ount� o, Essex, State of Massachusetts, . lna�ac�aca5xs,ecacer.�a�,ai�4x I bounded and described as follows : - t : i WESTERLY1, one hundred f6x`ty-three (143) feet .by other land of George Fark*.is ; ,.. one hundred nine , two and 39/100 (192x39) feet NURTHERIjY, ty- more or less, :,by property now or formerly of Edward J. and Bernice F. Dudley ; , ninety (90) feet by jand now or formerly of EASTDRL�,' Coppola ; and . SOUTHERLY, two hundred acid three and .77/100 (203,77) feet by land now or formerly of Olenio. j� 7c 7C�cX3C9t c c C�Cx'X` 9cXlcX 9tfic rxx *KXXXXXXXXXXXXXXXXX pari: of Being/the same premises conveyed to me by the Gulf Oil Corporation by deed dated March 271 :1961, recorded with Essex North District Registry of Deeds, Book 9359 Page 91. There is no monetary:=consideration for this conveyance . all Subjectto/the encumbrances of record, together with a right of way fifteen (15) feet in' width along the southerly property line of the demised premises for ingressiand egree3from Grantor ' s remaining prol�erty, to Osgood Street. , : �xadxseic�cga�c, I rdeasex t�c�al�cgt�t�d� txoCE °e `�` 4� x�x>�x�txarte�ta��. '! jVttttrS5NY........hand and seal this.......,1.6th. .............:day of...........Mar ............196.. . ...... ...... ....... .................. ....................................... ...... ........................................................................ . ..................................... ............................................................................... T�llr fQnmttcattiurslill of :l�ta�srllu>�rii>� Essex, ! ss. March 16, 19 62 Then personally appeared the above named George Farkas and acknowledged the foregoing instrument to be hi ree act and deed, before me i ..1.... . .............�.. Notary Pubi — y My commission expires February 91 19 68 Essex,ss. Recorded Mar. 16, 1962 at 15m past !}P.M. #363 Individual—Joint,Tenants—Tenants in Common—Tenants by the Entirety.) ! r BB1934 ; A I, George )?ark6qr; of 1615 Osgood Street, of North Andover, Essex` bmrdsttftarid,foraoodderatioo pddiltiiy {grant to Agnes Parkas, ,my wire :t -j of forth Andover, Essex County, Massachusetts "U66 t soft ' All my right, title, and interest in irk i{d' d d thelsndin said North Andover, County of Essex, State of Massachusetts ; m I � �t,tpelm.ed�cmbr.ecy Y tlrJ •�` Ise` N bounded and described as followst a YESTBRL?, one hundred fifty-three and 59/100 (153.59) feet by ' e other land of George Parkasl °m p '-. a� NORTHERLY, two hundred twenty-seven and 26/100 (227:26) feet more or lees, by property now or formerly of Edward J. w and Bernice P. Dudley; EASTERLY, ninety (90) feet by land now or formerly of Coppola= 1 and undyed fourt -four and 77 100 244.77 feet by ,: c ;; .`•SOUTHERLY, two h Y / ( ) z land now or formerly of Olenio= y; Containing about 28,257 square feet, more or less. .. . „� y Beingart of the same remises conveyed to ms b the Gulf 011 P P y Corporation by Deed dated March 27, 1961. recorded with Essex, North District Registry of Deeds, Book 935, Page 91. o There is no monetary consideration for this conveyance. in 1. ..4 Subject to a right of way fifteen (15) feet in width along the southerly property line of the demises promisee for ingress and y agrees from Grantor's remaining property, to Osgood Street. 'e o This Confirmatory Deed, shall supersede other agreement between w the parties covering a Quitclaim Deed dated March 169 1962 and F recorded in Essex County North District Registry of deeds, Book Z w 954, Page 339. a This Amendment mads to correct surveyors errors maked in 1962. ; Ultatsm ....sty...hand and seal thL.....31r,tLh.........day of... sz►uery................19.81. ? ? f to' ��.,. j .......................................................................... .................... ......... I ..................... R .......................................................................... ................................ ..................................... 'ti 1+. .... JI Qflft auuttnattuudtq tlt uat'ft1 � .. � �! Essex, as Januar 31, Theo perroaally appeared the above named George Parkas V. and admawledged the foregoing kshument to be his free ad and aeod t sv *' o_ rtowr►�i�..i'1u�no.rtYp�rtl�: t. •{:; Recorded Nat.1,1985 at 1 t'3PM #3870 W amawm able. 11f. •�uWww�te laa9 ;.i 1. ..jf. til.. Ii I .�_i3F ii. v MAs6AG)1L'8FTT@ QUITCLAIM DEED SNORT FORM (INDIVIDUAL) 001 4 1, Agnes Farkas of North Andover Essex County,Massachusetts, being unmarried, for consideration paid, and in full consideration of ONE DOLLAR ($1 .00) and other valuable consideration grant to George J. Farkas, Trustee, Hang'n Tree Realty Trust, u/d/t dated June 73, • 1990, recorded prior hereto, of 2110 White Lane, Haslet, Texas 76052 ev with quarla lm rmtrana m The -land in said North Andover, County of Essex, State of Massachusetts bounded and described as follows: (Description and tnlcumbranco, if anll WESTERLY, one hundred fifty-three and 59/100 (153.59) feet by land of of George Farkas; NORTHERLY, two hundred twenty-seven and 26/100 (227 .26) feet more or less, by property now or formerly of Edward J. and Bernice F. Dudley; EASTERLY, ninety (90) feet by land now or formerly of Coppola; and SOUTHERLY, two hundred forty-four and 77/100 (244.77) feet by land now Ln or formerly of Olenio; Containing about 28,257 square feet, more or less. Being part of the same premises conveyed to George Farkas by the Gulf Oil Corporation by Deed dated March 27, 1961, recorded with Essex North District 0 Registry of Deeds, Book 935, Page 91. There is no monetary consideration for this conveyance. 0Together with a right of way fifteen (15) feet in width along the southerly property line of the demises premises for ingress and egress to Osgood Street. Being the same premises conveyed: to me by deed of George Farkas dated 4j January 31, 1985 and recorded-in the North Essex Registry of Deeds at Book 1934, Page 328. b 0 a°o See also deed to Agnes Farkas dated March 16, 1962 and recorded in Essex o County North District Registry of Deeds, Book 954, Page 339. See also, Plans PQ 11340 and 11291, recorded at the North Essex County Registry of Deeds. Ln Deed at Book 1934, Page 328 and Plan 11340 were recorded to correct surveyors error made in Plan 11291. rn v �ftntltie ....iy.....hand and seal this..seventh........... day of..........June............... ..19..9.Q.. )a .......................................................................... A n'�s Farkas................................................ g .......................................................................... ........................................................................... P4 0 P .......................................................................... ........................................................................... P4 (90 dlummmfwro at 1280=4UNAb Essex SS. June 7, 19 90 Then personally appeared the above named Agnes Farkas and acknowledged the foregoing instrument to be her free act and d fore me ................. .............. ..... c y2 -� George A. Stella� bK 'flK Publlc— U N0lr�r My commission expires December 17, 1993 C EXPIRES (alndivid�) Joint Tenants—Tenants in Common.) S ER11,0- 3 SEC. 6 AS AMENDED BY CHAPTER 497 OF 1969 Every deed presented for record shall contain or have endorsed upon it the full name. residence and post office address of the grantee and a recital of the amount of the full consideration thereof in dollars or the nature of the other consideration therefor, if not delivered for a specific monetary sum.The full consideration shall mean the totalprice for the conveyance without deductinn for any liens or encumbrances assumed by the grantee or remaining thereon. All such endorsements and recitals shall be tecord,d as part of the deed. Failure to comply with this section shall not affect the validity of any deed. No register of deeds shalt accept a deed for recording unless it is in compliance with the requirements of this section. ' Form 20 Clerk of Courts 1 WK Clerk Of lthe',-,Court ofuarter Sessions Q n in and for the County of Allegheny, in the jCommonwealth of Pennsylvania, the samee emg a Court of Law and 9 Record, do by these presents Certify that. . � �/..C�(,•,., ,�t:!6.O•, �' is a .....................MQWX PUBLIC,......... ..................................... ! ....:..........:................................................................................ ...............................I........ .........:.......,,:.:............................in and for said County of Allegheny, duly commissioned and sw�rn, and authorized by law of the Commonwealth of Pennsylvania to take affidavits and acknowledgments of deeds for lands and real estate in said Commonwealth of Pennsylvania, and Ito all whose acts as such due faith and credit are, and of right ought to be, given throughout t United States and elsewhere. Commission is dateil! .16.&k'. R ..... . ...•.......................... .................. ...... and will expire—,4, /,!�'.rla.6Z ...,, S ..... .........•........19�'.� A D. 25�12 ;y.... IN TESTIMONY WHEREOF, I have hereunto set my,4and and affixed the seal of the Court, at Pittsburgh,+ this......... ..........�..day of.. .................................A. D. , .... Clerk Essexss. Recorded Apr261 19615 past as 12P.�21n at ti 6. � 44 i _ i GULF OIL CCRPORATION a corporation duly' established under the law, of the CCMMOnwealth of Pennsylvania and having its usual place of business amt is Boston Suffolk County, Massachusetts for consideration paid, grants to GEClRGE FARM.# being married of Lawrence. County of Essex State of Massachusetts with the lewd with the buildings and ' > t�irlrl<im tntt>ertalntr� ng improvements thereon situated in J1 North Andover, County of gsaex, State of Massachusetts, bounded and described as follows: [Descriptioai and encumbrances, if any] WESTERLY one Street; tundred eighty-t-40 and 81/loo (182.81) feet by Osgood NCRTHII3LY three hundred forty-too and 39/100 (342.39) feetjo more or less, by Property nos or formerly of Edward J. and Bernice F. DzUey; EASTEEtI,y ninety`.( Cf)(116et-by land now or formerly of Coppola; and SOUTH IX three hundred 1 fiP �r-six and 77/100 (356.77) feet by land now or formerly of 'Olenio Containing about 1+7,625 square feet, more or less. Being the sameperty conveyed to the Grantor herein by deed of Tremnrco Corporation dated Pro M�.ch 27. 1g61 , and, recorded in Essex County No.Diatrict Regi.atry of Deeds IPPR 279961 , i HWIM-69 ut4r d, the said I GW OIL C(RPCEtATION has caused its corporate seal to .be hereto, afTxJd and these presents to be signed, acknowledged and delivered in its name and behalf by U. B, KIELLEY � its Visit President hereto duly authorized, this Z 7 V"— j L.. BK1492 I, ARTHUR S. DRINKWATER, TRUSItEE, DAMON STREET REALTY;TRUST under q I, e' ,,,,51 a Decl4ration oP Trust! dated Peptember 10, 1964 and recorded with Middle$ex SouthDistri6t Deeds at Book 10638, Page 97 ' 1 7-VI at u e4- 12,000.00 Osgood St., Count {[ for consideration paid,rcic4x to 'GEORGE PARKAS of.North Andoveij / QF -Si4- Essex County, Massachusetts the land In said North Andover, namely P Y i I WESTERLY One hpndred eighty-two and 81/100 (182.81) feet by j ! Osgood Stioet, North Andoverl o NORTHERLY Three hun4red forty-two and 39/100 (342.39) feet, �- more or 14ss, by property now or formerly of Edward J, ;and Bernice F. Dudleyt ! . ' o EASTERLY Ninety (9!)) feet by land now or formerly of Coppolatf. r, and ii SOUTHERLY Three hundred fifty-six and 77/100 (356.77) feet u: by land now or formerly of Olenio. ' a oo "Containing about 47,6 5 square feet, more or less. The property to be 4 N sold may be described as set forth in 935/91 and by adding a paragraph, 'Excepting therefrom, that portion conveyed by Deed in,Book 954, Page 339'. 1 This seizure relates only to the above-described property set I ? forth in book 935, page 91 exempting, therefrom, that portion conveyed w by deed dated March 16th, 1962, and recorded in book 954, page 339 in the Essex County Registry of Deeds for the Northern District." „ 14 Hereby releasing to George Farkas all the right, title andNN p ' P, interest acquired by the grantor under a Deed of Deputy Sheriff, Joseph 1•�' a, Axelrod dated January 28, 1972 and recorded with Essex North District + n, beads at Book 1189, Page 173. ,R o. �i f+ttsbaed te t.7 hh�nfrfrty Ise ooms �. �" UoiliYf gaGd.tl^maitYa� �! l !� 111ttteaa my hand and scat this ay of rch 1981. .......................................»................».......,...........................:..... »............... .—ANNVA...AA...lP#iJ{tiN&AT>aRA....TRU U!, jI DAMON STREETREALTY TRUST»........... . .......».........,. ...,..................... ...».»........... » ; » ,» Mile (Qatatuanwealtq of fliaaaariluaetts ' Middlesex, a ' March.4 ig 81 f; Thin phrsonally appeared the above named Arthur S. Drinkwator, Trustee k and acknowlcdgpd the foregoing Instrument to be his free act and deed Mnawitchusetts Dgt Deed Excise . before me, ` »... in m of $--4.46 nm>� nu . ti affixed and caucvIled on wia ! Noury Publi 1 tusl rurnimt. Recorded Mar.18,1981 aft 121l#M 02506 r eanm,w'. -ptro S i The land with the buildings and improvements thereon, situated in North Andovera described asCounty of sfollowste of Massachusetts , bounded. an WESTERLY one hundred righty-two and 81/100 (182 .81) feet by Osgood St NORTHERLY three hundred forty-two and 39/1O0 (342 . 39)rmerly feet more or less, by property Edward J. and Bernice F. Dudley; EASTERLY ninety (90) feet by land now or formerly of Coppola; and SOUTHERLY three hundred fifty-six and Olenio0 (356 .77) feet formeof by land now or Y There is excluded herefrom that portion of the premises previously conveyed by George Farkas. i i rn hate and to hold the same to -_.the said_____ Raymond J. Letourneau and--_his— __heirs and assigns,to their own use and behoof forever; subject,however,to be redeemed agreeably to the law in such case made and provided. '30d I hereby COMM with the said grantee that in making the said sale and in everything concerning the same, I have complied with and observed the rules and requisitions of the law in relation thereto,but I do not covenant that the said_ George J. Farkas-,•_Administrator of the Estate of George Farkas _ ____-had any right, title or interest in the said lands at the time aforesaid. �n lUltne�� Whet E01, I hereunto set my hand and seal this day of_...April A.D,� _ __�__.in the year one thousand nine hundred an 92 Signed and sealed in presence of PCar cr. b X . .. it 16.4 CK Cab H lu c;•rf✓. w Lu(r R'il`es ',i .:1.%� i • �, l F • 4. 47 �{• l4V I • 7a-. A.!'YJ ;p �I�►r tllantmouttin ith at 124008r4uOrtts Essex April 21st 92 19— James E. Marks Then personally appeared the above named_ and acknowledged the foregoing instrument to be. his -free act ed, before me Robert E. Curran Oil public– 4ifttffl5f#M&_ �,.. ,. . 1/30798 My commission expires_.__ _19.— L• at_.-- ...W. o'clock and... -minutes_____M. Received and entered with_--------- -__ Deeds, Book —Pages Attest: - Register. CHAPTER 183 SEC. 6 AS AMENDED BY CHAPTER 381 OF 1967 Every deed presented for record shall contain or have endorsed upon it the full name, residence and post office address of the grantee. Failure to comply with this section shall not affect the validity of any deed.No register of deeds shall accept a deed for recording unless it is In compliance with the requirements of this section. I MASSACHUSETTS SHERIFFS DEED FORM 637 • 17v Cxt all mm hu t4ne preants e `{ that tvhereaB I James E. Marks -- a Deputy Sheriff for the County of....._.._...._ Essex in the Commonwealth of Massachusetts, 2ndday of_. March A.D. , having on the._—_...__..._ _ __._ -- 92 in the year one thousand nine hundred and____._.__- __._.._. __..—...by virtue of a writ of execution, District Court which was issued on a judgment recovered at the. --•----------- Lawrencewo Essex "":''::;If holden at.. _____..-.-- .••-• ..within and for the County of on the �' 14th February A92 ? and rin'the year one thousand nine hundred o f_ ' -.-----day --- Y b Raymond J. Letourneau y - George J. Farkas, Administrator of the Estate of George Farkas against --- seized and taken all the right,title,and interest which the saidGeorge J. Farkas, Administrator of the Estate of George Farkas had on the 2nd March A.D. , 92 day of._._..._._._...._..___.._. in the year one thousand nine hundred and_.-_.._� seized and taken on execution being the time when the same was jkVWWxMAW=xRWtW in and to the lands hereinafter described, and having given the notices of the time and place of sale, and caused to be published the advertisements thereof which are required by law,did on the 21st —day of_..—April A.D. , in the year one thousand nine hundred and 92 *Hake sale of the aforesaid right,title J. Letourneau Eight and interest, at public auction, to Raymond •- Ei ht Thousand, One Hundred Sixty Dollars and Thirty-Nine Cents h for the sum o f._ . _g...— w --- --- - -- Ix which amount was bid by the said_ Raymond Letourneau and was the highest bid made therefor at said auction. ,� re, Eight Thousand, One Hundred Sixty OWt therefo in consideration of said sum of Dollars and Thirty-Nine Cents Raymond Letourneau to me paid by the sai the receipt of which sum I hereby acknowledge, .I do hereby grant, bargain, sell and convey to the Raymond J. Letourneau said . rfit all the right,title,and interest which the addGeba~ste J. Fark,as Administrator o the•Estate of Geor a Farkas --- - seized had at the time when the same was texas aforesaid, in and to the following described parcel of (OVER)land,natnely: _ 1,76 I, RAYMOND J. LETOURNEAU, of North Andover, Essex County, Massachusetts FOR CONSIDERATION of NINE THOUSAND ONE HUNDRED FIFTY and 00/100 ($9, 150.00) Dollars ' p hereby RELEASE to GEORGE A. STELLA, TRUSTEE OF MASON-DIXON REALTY TRUST, under Declaration of Trust dated April 15, 1993 and recorded with the Essex County (Northern District) Registry of Deeds as Instrument No. 110� 1 -- all my right, title and interest acquired under a Sheriff' s Deed 3 dated April 21, 1992 in the following property: The land with the buildings and improvements thereon, situated in North Andover, County of Essex, State of Massachusetts, bounded and described as follows: WESTERLY one hundred eighty-two and 81/100 ( 182.81) feet by Osgood x Street; "`� NORTHERLY three hundred forty-two and 39/100 (342.39) feet more or less, by property now or formerly of Edward J. and --c Bernice F. Dudley; C EASTERLY ninety (90) feet by land now or formerly of Coppola; and c SOUTHERLY three hundred fifty-six and 77/100 (356.77 ) feet by land 41 -; now or formerly of Olenio; ti a There is excluded herefrom that portion of the premises previously conveyed by George Farkas. M �n For my title see deed recorded at Book 3464, Page 34. cu z N Witness my hand and seal this 201Q day of April, 1993.x- Ra ®rnd J.�� a urneau -« COMMONWEALTH OF MASSACHUSETTS uQt Essex, ss. April ,26) , 1993 Then personally appeared the above named Raymond J. Letourneau and acknowledged the foregoing instrument to be his free act and deed, before me .ry u ,... Jo66ph 2 +' NgtarY f' Commx¢. fi '�`e� l 1/8/96 �.t 4J ,-� '`� :i '`• ti4 a�,� E Lie C5 C•Lij . .i 4: C I:..I �t�.3 4. •r,y �. i• `�'1 drY f Pit '` •.e {7'.,ti:.S j IRON PIPE U- a`j (FND)0.40' BENT - MAP 34 LOT 3 / ; CWA LOCAL,-1365 REALTY TRUST K Z 1-0 DANIEL A. BEAUREGARD, ET AL, TRUSTEES • m v 0 17'.f 1627 OSGOOD - STREET, N. ANDOVER, MA 01845 Lctis E.S.D.R.D. BOOK 1999 PAGE 137 O v ` DETAIL A Y IRON NOT TO SCALE `Q PIN` 342.39' DEED) o m " (FND) - 342.30 22'. r 1 IRON PIPE , , N *371 01 (FN4) - ELN?' �� .34.00 11f PROPOSED SEPTIC ,__, -. D --y- 1 SEE DETAIL A114.98' D _ ' SYSTEMS (BY OTHERS gpPROXIMA.TE LOCATION ' NhSEE PLAN REF. # pBIT CONC EXIST. WATER SERVICE TO BE ABANDONED • � ON � EDt,E OF C AlAs 31 .9, ~ CAU rp0 8UY vc 'A o'uj Ep / - } tts 31 1IN i 0:� Co Lo i 1 U fn0, LQ MAP 34 LOT 44 'n \ k o N/F MASON-DIXON REALTY TRUST w o 34.00 - . , ti N o GEORGE A. STELLA, TRUSTEE `y ) O �. -r4'37'54" W' ' w 3 160 COMMON STREET, LAWRENCE, MA 01842 �� 5 r E.S.D.R.D. BOOK 3707 PAGE 176 4 * 'S.EPTI•"C SYSTEM ►n EASEMENT . . ° 'NG F- ,n FOR BENEFIT OF LOT A `f' LOT ,44 ' p RAISED uo CONCRETE EXfSTING AREA 2,526 S.F.. REr`wALL a L.P ISLAND V 18,910 S.F. V ill ,TMH 0.434 ACRES v 9ENCHMAPK. PROPOSED RELOCATED PK' NAIL FOUND J 3 n a � WATER SERVICE � ' PROPOSED AREA EL_. 5.;1,. (1" TYPE K Cu) � U 45 N Z 16,438 S.F. �_- X56. 0.377 ACRES r-Lj �, ' co \,I ON 18,910 S.F. .-- 0.434 ACRES r � Q ' Od ubELL I ON co 8 N PIN Lo '� �9 2 /.� o n d� (FN N/F �w a g1• ON✓� CHRISTO 0c R==25.00 �� �, , �� i CL =44.96 /' �� /- r a9 35 WEB5TER^: � c) 6) PLAN OF LAND IN NORTH ANDOVER, MASS. AS SURVEYED FOR GULF OIL CORPORATION, SCALE: 1"=50', SEPT. 1955,, BY CLINTON F. GOODWIN, E.N.D.R.D. PLAN 3151 7) COMMONWEALTH OF MASSACHUSETTS 1955 ALTERATION OF OSGOOD STREET LAYOUT No. 5324, E.N.D.R.D. PLAN 3066 8) PLAN OF LAND IN NORTH ANDOVER, MASS., FOR EDWARD DUDLEY, SCALE: 1"=50', MAY 10, 1955 BY RALPH BRASSEAU. GRAPHIC SCALE w 10 20 00 ; so ( IN FEET } T' inch = 20 fL PLAN OF LAND IN NORTH ANDOVER, MASSACHUSETTS AS PREPARED FOR MASON tDIXON REALTY TRUST GEORGE A. STELLA, TRUSTEE HANG'N TREE REALTY TRUST GEORGE* J. FARKAS, TRUSTEE PEMBROKE LAND SURVEY CO. PO BOX 205 SALEM, NEW HAMPSHIRE 03079 PO BOX 491 NEWBURYPORT, . MASSACHUSETTS 01950 y CALF DATERA'alNG NO, S_ 1 IN. = 20 77 FT. AUGUST 20, 2004 REVISIONS JOB No. 04-33 F.B. 69/17 SHEET No., I OF 1 ... .....,.. e..,.•+4,.a, vo mr%—jjrit-f C4°Ji.. 1 3 17;;,J r1L,.I L!\/1 It V19 \!I- %.,#J\.7V VL` JIt\L.L,1 LAYOUT No. 5324, EN.D.R.D. PLAN 3066 6) PLAN OF LANG IN NORTH ANDOVER, MASS., FOR EDWARD DUDLEY, SCALE: 1 —50', MAY 10, 1955 BY RALPH BRASSEAU. GRAPHIC SCALE' 201 r, 7 G 2( a 8G ( IN FEET } I inch 20 ft. 0S5A C H U E:-rTS :lEALS PLAN � LAND ,. OF IN NORTH ANDOVER, MASSACHUSETTS AS PRE�PAREC FGR HANG'N *TREE REALTY !rR► S T GEORGE J. FARKAS, TRUSTEE DATE FEMBROKE LANG SURVEY CC). Ptd BOX 205 SALEM, NEW HAMPSHIRE 03079 ,.��-.SACI�U.�ETTS F0 BOX 491 NE"WBURYPC)RT, MASSACHUSETTS 01950 I CERTIFY THAT i HAVE CONFOR14ED 1AITH THE RULES & REGULA"DONS OF ,�... .�..� ....,��....._.,.^. �... .�..� .....r.,..._, THE: REGISTE=RS OF DEEDS INS(;AI.._E DATE C�RAV�'INC� No PREPARING THIS PLAN. ;.«--�.. _. �_---____-- N. = 20 FT. DECEMBER 22, 2004 M--1433---L - -- - f REV'SIONS _—_—_-------___--___-- -- __—_-- J013 No. 04 -3 F.B. 69/17' DATE SHEET N©. 1 OF 1 Pi A 0 F'T A,,I D VEI �7 D4' r! �_ � . .,N`_� ���.� �/I1� r i( , -] T IN F FIE T �`L ;N A`---l' PF;E'P AR EC FOR ( F'ORGE A. S iE_.E.A., 'RUSTEA BOX 205 'ISA EM ; NEOf HAMPSHIRE 030I9 1 � E:� E3 ��' '{�C�>�T� MA `aA�; �1'�E _r-S Ol950 I CERTIFY THil,7 I HAVE. CONFORIAE:C) 1�__ .o _..,._. _�_ �_�.� _ VVID THE R�_f t_EE & RI _1 t_A-- ON of THE. F}k ( lSTk:RS (Y" DEEDS IN C DA Wl PRET'=;R NG THIS I='I_ANr _ (3 � C). 20- r._7 DECEMBER 22, 2004 M—.. 143(13--1- R EV S 10 JOB No. 04—J 3 i�.B. 69/17 i SHE[sT No. 1 OF 1 .......<.........e.............��..�...,........®...._.�,....®.,..,...,...........,...........»..s.._,....d.«..�.�..�....�...��..�,...�.,»,_«.,�.�........._.�.........,��.�,.,....r..�...,.,.�«�.�JL,�...�..R......�,., .,...n..�.........._.....w..s. ..a...,.......�...�...�.A......,,........_..d....«...._.............®..�.,�«m....o..«.,«..�.,.,..,�,..o.�,.......»w.,.....o....�..�.......,,.....,_.................e ......_.�,,...�,....,...�.. -- N O.N. (PND) IN BOULDER 00� 01 O T B $ ►�Z?4.8 S•R A HAV ERHII.L D 90XFOR0 1.9 (FNO) A Q /rp•+ ��@�\ a� NORTH ANCOVER - N - 4ti! I � L O C U_ S 5 C A L E t 1 5 0 0 EASEMENT PLAN O F L A N G L O C A T E D { N N O R T H AN D O V E PRE P ARE D F O R .z?nyk {= s E O R G E F A R K A S E1..ti E R 14 t9 8e . S C A L E t Z O OATS � v, o 20 40 80 A S S O C i A T E S , 1 N C O R P O A A T E O 1 4 03 M A R S 'T 0 N S 'T., L A W R E N C E , M A. O { 6 4 l A� 4AtAA amt''` �? /tfr N ion yam:�o i ��v s D F- A IA-1 bo Fvzzafabl� .RTF-� Gni 1Y -F}14'T' -T}-1 lb ��-'�L-�' I •ZO �lx ll 77 .yC�� �`�1L�• 018 .1 ' 1 - I1111!j!ill:I F1,11111 li�iijffim yap ESSEX COUNTY, MASSACHUSETTS, NORTHERN PAR A f pas , SHEET NUMBER 23 "AWnB d0 �sG� CmB G WrB - - _ UD ' " WrB P .loins sheet 18 PbD I 125 C r �WrG 6 F -9 PbD aB SrB y�IC Pb8 W .: Coe ' � nC m PaC 'l' Sub \ f c \ �CO 6� f'aC PcE PaB y7y RIB HWE " Su COB `�C� o y CmB l/ ro PaC PbD y HfD m CHAPTilC, '�` - WsB c Se/ N y: ur3 .r � m �e PaB AIDEN �y E - Nls bB i7 eq _:. -Se ILL. me ') WaA PON. C WrB MC Pe PcE.. Pbe WrB Nn8 ? Q' e6 WnC '�• oe :A WP... WnC WnC�N nB Se CmC SFO mm B .!, ;(, o - 3 Sub r //' PbD De �� �j SuB Cl1lB PbD F WsB:; 1 1'x /� e WnD WnA (; c' D h We W5C - �CC Pb$ Ha �`�. Wig QQQ :� pe pew. 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MC m RdA Ur Ir( .o W$ Qp0 \M r WrA MmA Mrt1G ',RCE '. Pas i Ur d9 WrB PaB WrB A•..•. Pb SLeA Wh Pb0 -o Pa6 WrB RdB HWE _ac A o p� RdA W( m PaC Cm6 F <" 71 Se WsB i O WrB MmA MmB Mmc p wi WrB as m PbC PbD U $ �.. ox' o• C C:`: CmC q• D StB d De; PaC C 7�T 7� o. 1V iL ,Se Llr Pd6 'r` L De �f PaD PaC 7 „ PaD ! y WrB PaD PbC Roveys ?� MC HfD - RoD. ato f. Ur CmC LI PbD LeA LeA FOTq;E{ s MC �� oc MC.nx W LY PaB '- WrB ;:` WPB WrC 8 PeD �rs ' MinIE:.. RoGY 3tHDe _ 'i Ws6 PbD PbC I ti'ICIPALAIRPORTSt6 m W. WrB Crc r� i� PaB Wr8 n ' % B W� 5�yG RoC s RoG O H God m F¢ Rod a0 �W, s pa .CaB ^ Cr8 Cb8 3t�B SYe aD § SB sG� v Ret+ m ;.' R Jr UZ HMS , r Sr WSB SrA Cay Pa8 x, / .. 0 Mf1 lMC (LMW WsD ,� SL .: FQ7 / H feD Roll eB ,-, WrB CoC StB L- -:� Suc MC "" '6D,.. * uD m-n Paa wrC LAKF, so am ° e Roc Roc y►aQ \ Fff4` po f SUB tC m ao B RIB R4+,Cr ( vCOCHICHEWICK St ! RoD 193 n126 Coe r, PbD CoC PaD, l SYB _ WrB cF f. ."t: LeB ;.-� Coo $ H C; -• � Wr6Wr$ _ PaD * - �...� Sf BOXf0� PaC ,,.", r..:. �C a [ .., HfA HfA CoB Coy �' - f C c� at t8 Cmb G — C ' R v_. op fE1M 71 (Joins sheet 30) v r4 F � LOT #44 OTOP OF WALL ELEV = 106.5± F- SSDS FOR LOT #44 SEPTIC EASEMENT - X15' GL-j HANGING TREE REALTY TRUST ASSESSORS' MAP #34 LOT #28 (0.65 ACRES±) EXISTING DWELLING - D-BOX T -- PROPERTY LINE 6 n," P \A. 1500 GALLON SEPTIC TANK F A 20 0 10 20 40 SITE PLA 1" = 20' NOTE: THIS PLAN IS NOT A WARRANTY OF THE EQUIPMENT OR INSTALLATION SHOWN ABOVE; IT IS ONLY A VERIFICATION OF THE LOCATION OF THE EXISTING STRUCTURES. ELEVATIONS: DESIGN AS BUILT HOUSE OUT (INV. 4") EXISTING EXISTING (109t> SEPTIC SYSTEM AS- BUILT (109±) SEPTIC TANK IN (INV. 4" INLET) 108.44 107.97 PREPARED FOR: HANGING TREE REALTY TRUST SEPTIC TANK OUT (INV. 4" OUTLET) 108.19 107.75 LOCATION: 1615 OSGOOD ST.(LOT #28) N. ANDOVER, MA D-BOX IN (INV. 4" INLET) 105.59 105.60 SCALE: 1 20' DATE: 24 AUG 2004 LINE 1 START (4" PVC PIPE INVERT) 105.40 105.42 ' = LINE 2 START (4" PVC PIPE INVERT) 105.40 105.42 LINE 1 END (4" PVC PIPE INVERT) 105.20 1 105.16 PREPARED BY: - -�--- LINE 2 END (4" PVC PIPE INVERT) 105.20 i 105.15 Bergman & Associates, Inc. -- ---- -�---------- 20 WASHINGTON STREET HAVERHILL, MA 01832-5524 RECE►QED 978 372-1125 TEL 978 372-1130 FAX ' JOB #1027 SEP ` 7 2005 SHEET 1 OF 1 vvN -J .�., t :L20VER I HEALTH DLPARTt TENT a : . M LOT 44 # .. TOP OF WALL ELEV = 106.5± SSDS FOR LOT #44 PAVED UTILITY POLE PARKING - - #4776 CONSTRUCTION LDI PERC #2 r.P #2„I (MECO) 1y BENCHMARK (MAG. NAIL SET) ELEV = 103.58 WATER LINE Yl TP`#4 1615 OSGOOD STREET, LOT 28 I HANGING TREE REALTY TRUST ASSESSORS' MAP #34 LOT #28 �6 o' SEPTIC (0.65 ACRES±) I EASEMENT A � EXISTING DWELLING F.F. ELEV = 112.5± I Quo D-BOX eco \� y% DRAIN LINE °5' 40•g PROPERTY LINE 1500 GALLON 6 �P�NOfMgss9� SEPTIC TANK 49. PAUL o A. ,n 0 BERGMAN ^ o Na 34699 ~ TP #3 �O/STE N 20 0 10 20 40 SITE PLAN 1" = 20' 1 NOTE: THIS PLAN IS NOT A WARRANTY OF THE EQUIPMENT OR INSTALLATION SHOWN ABOVE; IT IS ONLY A VERIFICATION OF THE LOCATION OF THE EXISTING STRUCTURES. ELEVATIONS: DESIGN AS BUILT HOUSE OUT (INV. 4") EXISTING EXISTING SEPTIC SYSTEM AS- BUILT 1 1 SEPTIC TANK IN (INV. 4" INLET) 108.08.4)44 107.07.9) 97 PREPARED FOR: HANGING TREE REALTY TRUST SEPTIC TANK OUT (INV. 4" OUTLET) 108.19 107.75 LOCATION: 1615 OSGOOD ST.(LOT #28) N. ANDOVER, MA D-BOX IN (INV. 4" INLET) 105.59 105.60 SCALE: 1" = 20' DATE: 12 SEPTEMBER 2004 LINE 1 START (4" PVC PIPE INVERT) 105.40 105.42 UNE 2 START (4" PVC PIPE INVERT) 105.40 105.42 LINE 1 END (4" PVC PIPE INVERT) 105.20 105.16 PREPARED BY: UNE 2 END (4" PVC PIPE INVERT) 105.20 105.15 Bergman & Associates, I,nc. 20 WASHINGTON STREET HAVERHILL, MA 01832-5524 RECt"--',VED �978 372-1125 TEL 978� 372-1130 FAX $E P 15 2005 JOB #1027 , SHEET 1 OF 1 9 1 VVVIv V'i- Ivvi\oe r+r.v.. Alb HEALTH DEPARTW. w Town�bf No __ Andover,=Massachusetts Wrm No. a NORrM BOARD OF HEALTH 4 °°° w,°• " APPLICATION FOR SITE TESTING/INSPECTION �9SS.acHu5E�4y Applicant- Ea/ZG� JrTc�GC�, T-e, NAME ADDRESS TELEPHONE Site Location__Ao /�3— OS Gno� S r Engineer AI/M/U -D��-O,e6e NAME ADDRESS TELEPHONE Test/Inspection Date and Time 0 CHAIRMAN,BOARD OF HEALTH Fee Test No. /to/W S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH O� ',LED Aa APPLICATION FOR SITE TESTING/INSPECTION 7 ADRATED 9SSACHU`'�� t i C Applicant ��- NAME ADDRESS TELEPHONE { Site Location 4 Engineer-A'A/V A) i. NAME ADDRESS TELEPHONE Test/Inspection Date and Time z s CHAIRMAN,BOARD OF HEALTH i FeeTest No. l _ s y i f j 3 t S.S. Permit No. D.W.C. No.-C.C. DatePIbg Permit No Bergman & Associates, Inc. Engineers Martin L. Deforge, P.E. Senior Civil Engineer 20 Washington Street Haverhill, MA USA 01832-5524 Tel. (978) 372-1125 mdeforge@bergmanassociates.com Fax (978) 372-1130 TO ATE TIME AM C.� Ii o� I a °U PM FROM ^ HONE V� -arH� ELL O k I N AX( ) ,C.0 o Sf / 1-5 E m E dA M s a - EA des o Qr �er-f is MG Vl ece-S garam d �o Q E-MAILADDRE V;V-f�et SIGNED C LL ETURNED❑ SEE YOU ❑ AGAIN ALLO WASIN URGENT❑ B CK CALL u b d/F C0 NIN1U CATIONS, W3 re 5`_ . • � C39yOCA t.t? �SE-r ON tNE) 1�Z39 �L%GHT O� I POLE r m AREA = ZB,Z '74.8 ONLN %� mi EXISYING CATCH Q �� (11 I�➢ \ ST G �Y BASIN�O I F R P " L O T A �� v owE� SING AREA = 18,93 Z.Z. S.F. I o n '. 0 t -{ CO r ISLANrJ I Q m 1►' ° v ' I I y Y D CAPS @I I). " ti P >-` I CERTIFY THAT THE PROPERTY ,.t Lt NES SHOWN ON THIS Pt_AN ARE THE LINES D 1 V t U I N G EXISTING OWN ' T u m LINES O F T H E � c � � � --� �� �� ��� � �� � � ��/�a � ; �� �M, �,4,b To G�cc ��,r�,ec-� BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 'L S 5 UL v 02 MAP &PARCEL: MAP # 31 LOT 4'4ff2 S LOCATION OF SOIL TESTS: 6IJr 0S§70DD S rR&-o-r OWNER: C)MDR 1: 1S1-t44..A , TRVSMgTEL. NO.: 1, 975 3 z� 3 Z ADDRESS: _140 CoMMoN 57- , , LAS cc- ,MA 01 $¢2 ENGINEER:N RT/&) D��Fo P 67 C-, EUX 6MA,�11 cr L. NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: :Undeveloped lot testing: g In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$225.00 per lot for repairs_or_. e,, u ades. (If time is not critical, fee for repairs is$' 5.00) des""1V OF NORTH W160 `"�l BOARD OF HEALTH GENERAL INFORMATION JUL2 4 2002 1. Only Certified Soil Evaluators may perform deep hole inspections. _ 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. _.__ 3. At least two deep holes and two percolation tests are required for each septic system dis`osal area:�� p 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of test' - y mg, a scaled plan(no smaller than 1 100 ) shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted.. Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: COMPARISON MUM THIS. ISSUE .ITEMS UNDESIREDPROPOSED PLAN PLAN D MEETS TOWN REQUIREMENTS - YES YES (WITH SETBACK VARIANCE `-•------'— AS PROPOSED) N.ANO0 R % uIDDLeEDN - s'R! WHAT IS SEEN FROM STREET (ENTRANCE TO TOWN) PAVEMENT & PARKING IN FRONT OF UGLY BUILDING LUSH LANDSCAPING IN FRONTty� Po•� OF COLONIAL-BUILDING - �, PROPOSED GREEN SPACE/LANDSCAPING. MINIMAL - SUBSTANTIALLY INCREASED PROPOSED IMPERVIOUS/PAVEMENT EXTENSIVE MOP 101A PARCEL,[ REDUCED LOCATION ea N�F:.IgYID-YMULr - 4 ELIMINATE ROUTE 11{ OURB'Ct1T YES YES � i RNPt m.ruf ` BUILDING ARCHtTECTURE/SHAPE. AESTHETICALLY'UNPLEASINC APPROPRIATE COLONIAL • - ARCHITECTURE BUILDING LAYOUT TO 'CHILD REN.S AREA -w SPLIT/MULTIP..ULE LEVELS SINGLE:LEVEL (EFFICIENfi& SAFE) ,r PEDES RW,-SAFETY/TRAFFIC ROUTINGSAFE & EFFICIENT UNSAFE k COMPLICATED MmPOrt Alm OMr[I�CLRY ' PaLr-7LDDR ° torr t 0011E o ark CRAPHIO SCALL WP tank PARCEL N/r Won TRW ' ND RDA PARCEL` NOT FOR CO'NSTR•U"CYTON NJ' LPATAD Y,LNpriLTON k ' • fir' PATflICY NINA6UH ' (FOR COMPARISON'' • �. PURPOSES ONLY' p p � ALnumAza"grr1G pL."- U I (NOT'DESIRED OR';PROPOSED) ® aokaa or ePra/rs-arrcnt.rraarr AxaYAarx7ays . 2124'SKLN'SfML[i'{RR' �. - N kNDayplr�NA7kCNY9pi1 . N0'0a. I,ifllo'IfnT[Wiliign61iFr1m: ~ � Chliden'KGenhrr.' MUM MMU (RTE 114) N/r w�elco°OCin PRR"c��ir i°usr - r uvaows flLx1v tau � :pi tw LMA.L.PO:'fNle E M..71' w L.Nm INr MEmIVA 4JW1 _ M••-�I CDn. Pnb a'41LINiLN ruwN[EL.;lpLmofls ,-.. • BOARD OF HEALTH RECEIVED NORTH ANDOVER,MA 01845 978-688-9540 JUL 2 5 2002 APPLICATION FOR SOIL TESTS CONSERVATION COMMISSION DATE: 25 J UL`( 0"2. MAP&PARCEL: 14A P '131 LOT ! IF2 LOCATION OF SOIL TESTS: 6 IJP" O S 6�``DoD S ?-R G-0-'r OWNER: !�Qk&e- SrE-4 ..A ,, TRVSMaEL. NO.: _l 978 b 83 ?Q 32 ADDRESS: 1jO LoMMoN 57- , , LAWALmc,L- ,MA DI $f 2 ENGINEER:JA RTW DSO 26-,�� $ yM,y�, rEL. NO.:��713) 37Z —112.9 CERTIFIED SOIL EVALUATOR: t l Akm t�j Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: / Repair Testing: y Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$225.00 per lot foli__es or �,. .., , u ades. (If time is not critical, fee for repairs is$75.00) SOt.V° iT BOARD OF HEALTH ' GENERAL INFORMATION ' JL 2 4 2002 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design sepic plans. 3. At least two deep holes and two percolation tests are required for each septic' 'ts 4. Repairs require at least two deep'holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: l'�y T -A/IY ° sa 'to V ' f N 067 d-- 00eo + I' ° oc 4 N �hSflhEBil � � Wl J rva 1 ` 'wqtj 5 9j. 77 wo ,r.- -tee ., ,: _ •ori - -^ 2 �x � �a v..R `�'��'Krk�'`„At�.•."' �+,�a^LF� -,�A„-.`�"y.�.�. ac -.-�`3-'���.r u^5'�r' a 4i C �" h* �_� �Q n 3 a. • y i� FORM 11 - SOIL EVALUATOR FORN/f Page I of 3 No. Date: 3t4A?2,66 Commonwealth of Massachusetts Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed B 1. : `f�.l ........ r. .... �.. ' .... Date: ?5'24 AFr . By: �z2 AAzo0�.N 0f-6Mppr �.� ..... .k1-6.0........L.-A. . . A95.C.............................................................................. Witnessed By: .... ........................ . Location Address or 1615 / l �r Owner's Nam, ^�^ • 'Lot# �1 Address,and � sSr dT�To 8t� d /11 A 4® p `Z$ TegMne► 1(� COMMpl4J 57-kCtT New Construction ❑ Repair q70) 6 � � 2M�2- Office Review Published Soil Survey Available: No ❑ Yes Year Published .....11-91.... Publication Scale 1�11,94P Soil Map Unit lib................ Drainage Class ............. Soil Limitations .....U.I�BA0.....4. �..�..1��������'���......................._................_._...... Surficial Geologic Report Available: No N Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) .........................................................-........................................................................................... ._._... Landform .............................. ................................................................................................................................................_.._. A Flood Insurance Rate Map: Above 500 year flood boundary No []Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: f�]A National Wetland Inventory Map (map unit) ............... a r#........................................................................................ ._._. Wetlands Conservancy Program Map (map unit) +` ................................................................... .........._.___.. Current Water Resource Conditions (USGS): Month A ' ..... - Range :Above Normal ❑Normal ❑Bel:-�v Normal Other References Reviewed: 1- G 1TNw-3E-?SyS�� ) 1 I i' a` I `I`,A!I(=,----- DEF APPROVED FORM-12107/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. CZ On-site Review Deep Hole Number Date:'2:5APIZ 20 - Time:.:. 12.W Weather Location (identify on site plan) :....,...:. . Land Use Mvi..0G3 :...a,+t?T. ... Slope (%) I Surface Stones Vegetation ,.:.:t at :,. :.. . 'h I Landform Position on landscape (sketch on the back) .... Distances from: Open Water Body . feet Drainage way. :. .... feet Possible Wet Area ....... feet Property Line .:: ........:. feet Drinking Water Well :::::::::...:.. feet Other . .:..:: DEEP OBSERVATION HOLE SLOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) 0— 2 — t-A 14tMT A 2e ��1r Wk 2.5 ! Parent Material (geologic) DepthtoBedrock: ij LA- Depth to Groundwater: Standing Water in the Hole: N6rjE Weeping from Pit Face: 1001,36 _ Estimated Seasonal High Ground Water: 20/1 DEP APPROVED FORRt-12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. J(0 D S DOD S ` — COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test` Date: Time: a Observation Hole # Depth of Perc 5 + Start-Pre-soak End Pre-soak , Time at 12" 2 D O Time at 9" f D Time at 6" Time (9"-6") 3 Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ Performed By: Witnessed By: R)A-f,J L Astra ° ,SCR A/LZAVC7N 1 ) _'.,.';ro Comments: 1` .:}.�L .::,..w:: :Z.. : 1 ( IQ.C<... DFP APMOVED FORM-1 WAS FORM 11 - SOIL !:VALUATOR FOlni Page ? of Location Address or Lot No. ��F� 67COD On-site Review Deep Hole Number Date: .? " �'7 b Time: r Weather j kTq C lbOO.f Y Location (identify on site plan) Land Use . ? kEt ,: -€>.'P Slope (%) 0--11/,o Surface Stones Vegetation ....: ..:... .. Landform Position on landscape (sketch on the back) . Distances from: Open Water Body 01p., feet Drainage way feet Possible Wet Area jjjA .. feet Property Line .. '-. . :. feet Drinking Water Well 4A 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) 2- r Aow Lqvt /4 Pr aa C yj 9e k, 7L 00 MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED 151SPOSAL AREA Parent Material(geologic) C)gYT-LJ A,-Sw DepthtoBedrock: _ Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: �t Estimated Seasonal High Ground Water: -76 DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of>3 Location Address or Lot No. On-site Review Deep Hole Number Date:.,22: � e'�- Time:.. ,o.. Weather Location (identify on site plan) Land Use ...YAfk;T' Slope (°lo) ' Surface Stones :... Vegetation ...... . .: Landform Position on landscape (sketch on the back) ....:... . Distances from: Open Water Body . feet Drainage way. : . feet Possible W A �' Wet Area .. .. . f �� eet Property Line ... ... ...:. feet Drinking Water Well .::::v ._.. feet Other . .;.:.:. DEEP OBSERVATION HOLE LOG' r Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) Y4- 1-7- Z311J 7, -- -C LIAIII MINIMUM OF 2 HULtb KtUUIHLu AT EVERY PROPOSED DISPOSTI AREA Parent Material (geologic) DepthtoBedrock: o ft Depth to Groundwater: Standing Water in the Hole: 19f Weeping from Pit Face: Estimated Seasonal High Ground Water: R- r� („P G�FAY C � �� t `u'/ p kit)r— DEP APPROVED FORM-12107/95 FUltl\� 11 - S011, I?VALUATOR F ORN1 Page 2 of 3 Location Address or Lot No. 0scl oD �lPgx On-site Review Deep Hole Number .:::.:.�" ..:. Date:.2Z: �}�...�(;q Time:.. Weather Location (identify on site plan) . .... ......::.:: ...::. Land Use :::..:....:.:.::.:: Slope M Surface Stones .. ..:..:.::..,.:.... ., Vegetation ::,:.:.::.::.. .:.. _ :......::....::.. Landform :..::.::...::.:::...::.. .::.:.:.::.:.::::. ...... Position on landscape (sketch on the back) Distances from: Open Water Body . feet Drainage way. :. .... feet Possible Wet Area .......:...... feet Property Line .:. feet Drinking Water Well ::.:::.:..::,.. 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) C ( Firj; Swb 5-9 IY pkjA? ►tic 1 ' C'2. V, 2.5'Y 16/3 pyd 7 54' ,x2. Parent Material(geologic) DopthtoE3edrock: r Depth to Groundwater: Standing Water in the Hole: t.)G K�c Weeping from Pit Face: 8tt.1• Estimated Seasonal High Ground Water: a1 DEP arraoVED FORM.12r07/95 1 • FORM 12 - PERCOLATION 'T'EST Location Address or Lot No. 08 COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation 'fest* Date: .::.: Time: .::..:�:p...:3. . .:.:,.: Observation Hole # epth of Perc Start Pre-soak ID: g2 End Pre-soak Time at 12" Time at 9" Time at 6 Time (9"-.6") Rate Min./Inch Z �e� INL * Minimum of 1 percolation test must be performed in loath the primary area A reserve area. AND Site Passed ] Site Failed.. ❑ ............................... ................................................ .................................. _.._.erformed By: Witnessed By: Comments: .::..::..,..:. ....::..::. DEP APPROVED FORM.-12/07/95 SII FORM 11 - SOIL, EVAI.,UATOR FORM Page 3 of 3 Location Address or Lot No. os oaf) Tke-w Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole .................. inches Depth to soil mottles ..:: :.:.: inches ❑ Ground water adjustment ................... feet 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? y"5 If not, what is the depth of naturally occurring pervious material? Certification I certify that on Srkior,,. Ob (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. P Signature p 2 9 � � Date 3MA� ab DEP APPROVED FORM-12/07/95 t Town of North Andover, Mass.'usetts Form No. 1 NORTH BOARD OF HEALTh 320 ,,,ED ggtiOL 16 S rO 0 R °° <<w°•�'' '` APPLICATION FOR SITE TESTING/INSPECTION ��SSACHUS���� Applicant (� �� -1� �T�� 4 NAME ADDRESS TELEPHONE Site Location Engineer c�����i�.� /f�7�� � ���✓� ������ NAME ADDRESS TELEPHONE Test/Inspection Date and Time AIRMAN,BOARD OF HEAL Fee Test No. /0—� S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. a Town of North Andover, Masssetts Form No. 1 ' NORTH A BOARD OF HEALTH O* LED /6qy� �? 5� 19 ° m APPLICATION FOR SITE TEST ING%INSPECTION 0 0A �i9SSACEHuS�� Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. f -c-f- -� acs - 3 nJ t�7G1}l e- C6 Y) XBOARD OF HEALTH TH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 1°� Ft:13 2ooL MAP &PARCEL: IIAP # 3q- .4 t-T �f LOCATION OF SOIL TESTS: 1615 06600b STRCT7 OWNER: C)EY.()ES I CIA-A , TKV5i`FC TEL. NO.: (178) �e 3 - 2 13 2- ADDRESS: - ADDRESS: 1 b0 C vMmvt0 LJ1 WkkrNtC , M,A 011242 ENGINEER: M AR` W b oR�-„E - RE b,MI# �i A Y. TEL. NO.: C9710) -7-2 — 112- CERTIFIED SOIL EVALUATOR: M W T)13 p e7- Intended Intended Use of Land: Residential Subdivision Single Family HomeCommerce Is This: Repair Testing: Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$200.00 per lot for repairs or up r; ades. (If time is not critical, fee for repairs is $75.00) GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic sstem disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted--WjV— d of Health showing the location of all tests(including aborted tests). '�" +eOARD of��AL'� 7. Within 60 days of testing soil evaluation forms shall be submitted. z �g 2 02002 Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: BOARD OF HEALTH RTH ANDOVER, MA 01845 978-688-9540 'l Id APPLICATION FOR SOIL TESTS �A- DATE: FtJ3 'Zoe)-zl MAP &PARCEL: 11AP # S�- A Lo 1 41 LOCATION OF SOIL TESTS: A015 0'-�16 006 ;TR— T" OWNER: 3-3i UCLA , TkU5i EC TEL. NO.: (17 1.3 2.. f ADDRESS: )L-d &OMtv►i11`1) L I ;{� N� jWl1 011212 ENGINEER: M A2 i!n: DEFv46)6 W- i�, TEL. NO.: CERTIFIED SOIL EVALUATOR: MART l>,3 1�)�f= -7 E-, �. F. Intended Use of Land: Residential Subdivision Single Family Home Commercial , Is This: Repair Testing: V/ Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$425.00 per lot for new construction. This comp-- two percolation tests required for each disposal areal, f0 upgrades. (If time is not critical, fee for repairs is$7. 74�e-c-' � h GENERAL INFORMATLd/ I. Only Certified Soil Eva �a2. Only Mass. Registered 3. At least two deep holes4. Repairs require at least %,� bS BOH representative. C- 5. Full payment will be required for ail"a=ricrr,.r--,jt 6. Within 45 days of testing, a scaled plan(no smaller than z' of Health showing the location of al.tests (including abc7,6 '� / G 7. Within 60 days of testing soil evaluation forms shall be s /fUj { L1) �• V GWL i Please Do Not Write Belo% �,,,s Line �� N.A. Conservation Commission Approval: `_ A '11m7101,41111 X13-Af Date Received: Check Amount: Check Date: J F, Town of North Andover NORTH 9 O t�{,!O 6 N _ Office of the Health Department �_ �`° * '°° O WO A Community Development and Services Division t 27 Charles Street �9SRIrep North Andover, Ma%.ticllusetts 01845 S"C""5 Sandra Starr Telephone (978)688-9540 Health Director Fax(978)688-9542 DATE: LOCATION: _ S 0 Sfi ENGINEER: ` �,� FU1 _ 1- ASsJ L BOH WITNESS: (cam- ��SLQ— PERCOLATION TEST# t BOTTOM DEPTH OF PERC TEST: TIME OF SOAK: (At least 15 minutes long) TIME AT 12" TIME AT 9" TIME AT 6" OVERNIGHT SOAK TIME STARTED '&1 .7-+' NEXT DAY SOAK (1: �k I (At least 15 minutes) TIME AT 12" Z-'a TIME AT 9" Q TIME AT 6" BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANINI TG 688-9535 _ pORT1� TOWN OF NORTH ANDOVER HEALTH DEPARTMENT % 27 CHARLES STREET f ' NORTH ANDOVER,MASSACHUSETTS 01845 SAC14 Sandra Starr Telephone(978)688-9540 Public Health Director FAX(978)688-9542 MEMORANDUM TO: Licensing Commissioners FROM: Sandra Starr, Public Health Director DATE: December 14, 2001 RE: Recommendation on 1615 Osgood Street This memo refers specifically to 1615 Osgood Street and the existing failed septic system. Mr. Mark Valentino is the owner of North Andover Auto Computer that operates at this location. He states he has been involved with Title 5 inspectors and engineers since the spring of 2001, having the septic system inspected and trying to get some plans designed for the system's repair. I believe that he has done everything in his power to ameliorate the problems on the site. The firms he has worked with, however, have neglected to communicate with the Health Department as required. I intend to fully investigate all activities related to the site's septic system until I have all the information that is available. At that point,working with the tenant and the property owners,the repair of the septic system will be addressed appropriately. Based on the Health Department's full involvement with this site, I highly recommend that my previous recommendation to not license North Andover Auto Computer be disregarded and another temporary license be issued until the septic system can be properly repaired. I apologize for any inconvenience caused by my previous memo, and hope that the Commissioners will see fit to issue the temporary license for this business. 19/1J/LUU1 10:.10 tiles U16 boo U00b 'IUWN Ur NUK11 ANDUV R 10001 1 TOWN OF NORTH ANDOVER OFFICE OF TOWN MANAGER 120 MAIN STREET . • NORTH ANDOVER,MASSACHUSETTS 01845 /gyp KORTt, `.4iVf0♦ �6 Mark H.Rees �+•;: . °p Telephone(978)688-9510 Town Manager FAX(978)688-9556 s y March 15,2001 Ms.Joyce Bradshaw Town Clerk 120 Main Street North Andover,MA 01845 Re:CLASS Il LICENSE Noah Andover Auto Computer Dear Joyce: At the Board of Selectmen Meeting of March 12,2001,the Board voted to grant a temporary license to North Andover Auto Computer on 1615 Osgood Street,North Andover, Massachusetts through May 31,2001,for 18 cars and let the applicant come back before the end of May with the results of his Title V inspection to extend his license. If you have any questions or need further assistance,please don't hesitate to contact this.office. Si ly, Mark H.Rees Town Manager Cc: William Scott,Director of Community Development Robert Nicetta,Building Commissioner Richard Stanley,Police Chief William Dolan,Fire Chief Sandra Starr,Health Administrator /kon - TOWN OF NORTH ANDOVER OFFICE OF • TOWN MANAGER 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 NORTH 9. Mark H.Rees o? 6: '° O� Telephone(978) 688-9510 Town Manager p FAX(978)688-9556 'ls4SSHCHUStii,`h March 15,2001 Ms. Joyce Bradshaw Town Clerk 120 Main Street North Andover, MA 01845 Re: CLASS I1 LICENSE North Andover Auto Computer Dear Joyce: At the Board of Selectmen Meeting of March 12,20_01,the Board voted to grant a temporary license to North Andover Auto Computer on,,1X615 Osgod-Street,-North Andover, Massachusetts through May 31, 2001, for 18 cars and let the applicant come back before the end of May with the results of his Title V inspection to extend his license. If you have any questions or need further assistance,please don't hesitate to contact this office. Sin ely, .�ht i,c Q� Mark H. Rees Town Manager Cc: William Scott,Director of Community Development Robert Nicetta, Building Commissioner Richard Stanley, Police Chief William Dolan,Fire Chief Sandra Starr, Health Administrator /kon i MAR 1 6 2001 02/05/01 'fiction King Enterprises, Inc. Disposal Report January 2001 Date Source Name Qty DISNOANDOVER DISNAND/LOW 01/08/2001 SUTTON POND CONDO'S LIFT STATION 500.00 ' 01/09/2001 1615 OSGOOD ST;MARILYN MOTORS 500.00 01/12/2001 350 HOLT RD CRUSADER PAPER 3,500.00 Total DISNAND/LOW Total DISNOANDOVER t Page 17 of 23 x own of North Andover oa Office of the Health Department �� °`�, �- 70 Community Development and Services Division I. i y n s O,pq<x.ww y ,Y William J.Scott,Division DirectorDA4rfD 27 Charles Street SSAu+us� North Andover,Massachusetts 01845 Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 MEMORANDUM DATE: January 30,2001 TO: Janet Eaton,Assistant Town Clerkff�j�//�� FROM: Sandra Starr,Health DirectoAr lz RE: 1615 Osgood Street—North Andover Auto Computer I had previously made a recommendation concerning this site that stated the Health Department had no concerns about the property because Marilyn Motors was no longer in business at the site. I was unaware that another business,NA Auto Computer,also leases space at the same location. I have received a proposal signed by Mark Valentino who occupies space at 1615 Osgood Street for the inspection of the septic system on the property. Because of this contract between Mr.Valentino and Mr.Benjamin Osgood,Jr.my recommendation is that NA Auto Computer be given a temporary permit to operate until such time as the septic system is inspected,according to the contract,before May 1,2001. Once the condition of the system is determined,I will make another recommendation for this site. BOARD OF APPEALS 688-9541 'BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLAININING 688-9535 1 /1.)/4vvi Lo.it rAA vto 000 vaao W"IN UY IVUKin AINVUVLK WjUU.S Town of North Andover Office of the Health.Department Community Development and Services Division William J.Scott,Division Director ate,+.��• • 27 Charles Street North Andover,Massachusetts 01845 Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 MEMORANDUM DATE: January 30,2001 TO: Janet Eaton,Assistant Town Clerk FROM: Sandra Starr,Hearth Director Zab RE: 1615 Osgood Street—North Andover Auto Computer I had previously made a recommendation concerning this site that stated the Health Department had no concerns about the property because Marilyn Motors was no longer in business at the site. I was unaware that another business,NA Auto Computer,also leases space at the same location'. I have received a proposal signed by Mark Valentino who occupies space at 1615 Osgood Street for the inspection of the septic system as the property. Because of this contract between Mr.Valentino and Mr.Benjamin Osgood,Jr.my recommendation is that NA Auto Computer be given a temporary,permit to operate until such time w the septic system is inspected,according to the c outmM before May 1,2001. Once the condition of the system is de=lh,ed„I will make another reCOmmendation for this Site. i f I BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-953,0 NURSE 688.9543 PLANNING 688-9535 NEW ENGLAND ENGINEERING S:ERVI.GES INC CONTRACT COPY PROPOSAL FOR F, JAN 2 6 z7N SEPTIC SYSTEM PF61ftN [-c"7 SNS P � o� January 26, 2001 Mark Valentino, DBA North Andover Auto Computer 1615 Osgood Street North Andover, MA 01845 Dear Mr. Valentino: The following is a proposal to complete a septic system inspection that complies with the procedures outlined in Title 5. The inspection will be performed on the septic system at 1615 Osgood Street,North Andover, MA. PRICE: The cost to perform the inspection is three hundred fifty dollars($350.00). PAYMENT TERMS: Payment for services is due upon completion of inspection. SCHEDULE: The inspection will be completed no later than May 1, 2001. Kindly advise if further information or clarification is required. Thank you for the opportunity to present this proposal to you. If acceptable, please indicate by signing below and returning a copy of this letter in the envelope provided. Sincerely, n U Benja Li C. Osgo;� r., E.I.T. President This proposal is acceptable as written: Mark Valentino: ?F-,/ . ate: /,- 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 12/09/00 Action King Enterprises,Inc. Disposal Report November 2000 Date Source Name Qty DISNOANDOVER DISNAND/LOW 11/03/2000 1504 SALEM DESIMONE 1,500.00 11/09/2000 350 HOLT RD CRUSADER PAPER 3,000.00 11/15/2000 �1615 OSCOOD ST;MARILYN MOTORS 1,000.00 11/20/2000 DALE STREE --1 500.00 11/29/2000 350 HOLT RD CRUSADER PAPER 4,000.00 Total DISNAND/LOW Total DISNOANDOVER Page 18 of 29 Town of North Andover Thursday,November 2,2000 To whom it may concern, _ Please let it be known, that as of September of 2000, I have vacated the premises located at,,4615 Osgood streef"I have enclosed my occupancy permit as well as my classIl used car licence. There were several health and safety issues involved with the property. I was notified by the Town of North Andover at the beginning of this year, in regard to a test of the septic system. This request was forwarded by my attorney to the property owners. The property owners, George Farkas and Attorney George Stella have refused to comply with the request. Since the licence was issued subject to the test being completed,I felt this would hinder my getting the license renewed again this year. The septic system is backing up into the building, during heavy rain, or when the toilet is flushed repeatedly.Raw sewage fills the garage area,creating an unhealthy work environment. Additionally, the roof is leaking so badly, that it pours water directly into the electrical panel,causing an unsafe condition.The property owners have failed to act on this as well. Respectfully, Edwd mings Presi ent Marilyn Motors Inc. ACTION KING ENTERPRISES, INC. SERVICE DATES DISPOSAL REPORT- NORTH ANDOVER 3-1-00 - 3-31-00 DATE CUSTOMER DESTINATION EST GALLONS ---------------- --------- ---------------------------- - -- _ 3_/_1_4/00 _MARILYN MOTORS LOWELL 1000 1615 OSGOOD ST 3/30/00 CRUSADER PAPER LOWELL 2500 -- -– ------------- 350 HOLT RD —--- 6 This is PROPRIETARY and CONFIDENTIAL information which may be used only by the Board of Health for regulatory purposes. ACTION KING ENTERPRISES, INC. SERVICE DATES DISPOSAL REPORT- NORTH ANDOVER 3-1-00 -3-31-00 DATE CUSTOMER DESTINATION EST GALLONS 3/14/00 MARILYN MOTORS LOWELL 1000 1615 OSGOOD ST 3/30/00 CRUSADER PAPER LOWELL 2500 350 HOLT RD This is PROPRIETARY,and CONFIDENTIAL information which may be used only b,),she Board of Health for regulatory purposes. TOWN OF NORTH ANDOVER OFFICE OF LICENSING COMMISSION 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 tkolf Donald B. Stewart,Chairman William B.Duffy,Jr. "„ Telephone(978)688-9500 John R.Leeman,Jr: FAX(978)688-9556 Keith A.Mitchell James M.Xenakis 9Ss%cHus��t� December 16, 1999 Mr. Edward L. Cummings Marilyn Motors, Inc. 1615 Osgood Street North Andover, Massachusetts 01845 -Via certified mail: Z 302 501 906 Dear Mr. Cummings: This letter is to notify you that the Licensing Commission voted on Monday, December 13, 1999, to renew the Class 2 License for Marilyn Motors, Inc. contingent on meeting the following requirement. The Board of Health recommends that the septic system of Marilyn Motors be inspected and passed by a licensed inspector. You have sixty (60) days from the receipt of this letter to have the inspection completed. Upon completion of the inspection, please forward a copy of the Title V inspectional report to the Town Manager's Office, 120 Main Street. If you have any questions, please contact Janet Eaton at 688-9500. Very truly yours, Donald B. Stewart, Chairman Licensing Commission Cc: Sandra Starr, Health Administrator Janet Eaton, Assistant Town.Clerk /amk PAGE II STEWART'S SEPTIC TANK SERVICE (CONT'D) 04-22-96 A 31 STONE CLEAVE ROAD 1,800 201 BRADFORD STREET 11000 04-23-96 585 BOXFORD STREET 1,500 HEAVY A 175 GREAT POND ROAD 2,000 04-24-96 -1615 OS000D STREET 500 FLOODED A 122 OLYMPIC LANE 1,500 A 1116 SALEM STREET 750 04-25-96 A 75 FORREST STREET 11000 04-26-96 550 BOSTON STREET 2,000 2-1,000 TANKS 04-27-96 A 1015 JOHNSON STREET 11000 175 FOREST STREET 11000 350 SHARPNER'S POND. ROAD 1,500 04-29-96 A 18 STEVENS STREET 1,250 A 100 FOREST STREET 1,500 A 82 PADDOCK LANE 1,500 04-30-96 A 133 SUN MER. STREET 11000 A 347 HILLSIDE ROAD 11000 7 a Inertia/ ort ..t-"-0rze...d —9azW,. Cott��o�e��i��, S. RUSSELL SYLVA 5 �7oaminai�ct�ealf� cae�ure Commissioner 935-2160 47���� ,cz aadwdell, 01X01 January 6, 19300 John Clement NEET 310 Main St. ��� t .t� Groveland, MA 01334 Re• ,< }i1 Andover Town. Line Auto Re! ap r 167.5 Osgood St Property Investigation Report Submittal DFOE Case No. 3-1062 Dear Sir/Madam: The Department of Environmenta Quality Engineering (De-par.t:nen�) has received a written report from you concerning environmental conditions at the above referenced property. If you are a potentially respons nie party as described in Sec,�ion 5(a) of MGL ch. 21E, the Massachusetts Oi.l and Hazardous Material Release Prevention and Response Act, you are also for ensuring appropriate assessment and remedial action,, if necessary, occurs at t:-'� s property. These and other responsibilities/li�,:);liti.es are descr:i';-----dL in irG ch. 21E. Based on a preliminary reviow, than `)eoartment believes that conditions as described in the report do not r_onstituze an imminent ^are, to the public health, safety, welfare, or the environzt:ent. .requi.rint immediate action by the Department. Consequently, further review ;f report and./or investigation of the property cannot be, given top >,pr"i.ol:ity because of the need to attend to cases which alp;pear to --pose the 1110St S&I-1011S threat to public health, safety, welfare, or the environment. Your c.-:s, will be reviewed in the order i.n which it was received as staff c. diverted from top priority cases. Iriorder that the Department �s review of yot,r report 1s as r:X?p.'i:.': t:ouF. as possible, you are urged to determine whether the report confor-..s `o the enclosed guidelines. Unfortunately, -many 'reports fail to ,")r';'i';: (]i .: ... . 'dent information to fully assess the proble;-: or to allow sound decisions concerning further assessment or remec`:ial act-.on. Di:;ficiencl s ofl cerl -2- include a lack of validated data, expert professional interpretation of data or recommendations for further action. Ve suggest that you examine your report in light of the general guidelines and policies enclosed to determine whether there are additional steps you should undertake to expand upon your r&nort . Please note that this letter does not constitute= a statement that the referenced property is or is not subject to the provisions of MGL ch. 21E. In addition, be advised that present statutory requirements coatpel. the ?-nartm; nt to maintain and publish a list of locations "to be investigated as possible disposal sites" of oil. or hazardous mats=,rials (MGL ch. 21E, section Accordingly, based upon information contained in the submitte6 repo`"` , the subject property may !De so listed by the Department, . :nd you .-lay i) contacted at a future date and be requested to complete a "Preliminary Assessrcnt" and/or "Site Investigation" form. If you ha„i: any question about your responsibilities or liabilities under Chapter 21E, you should obta; , "I"?,--Tal counsel to advise you. Please direct all further communications on this :Matter to t; e, Otter 1E'ad address, and reference the designated DEQ) . case number. Very truly yours, John J. Fitzgerald, P.E. Chief, Site Assessment iCi ,niiip Section JJF/dt ccc: Site Assessment Branch Chief, DEQE, 1 4'inter St. , Boston, TSA 0- � Board of Health, CHO Town Bldg, North Andover M 0 45 A 18 Enclosures: 1. Genera'. Guidelines for Property Investigations 2. Guidelines for the Preparation of Phase I Property ?nves--'cr.ations .3 . Miiniina]_ Standards for the Subm iss i.on of Laboratory Data C ZF) Aoaley-os4 �, c� . 1 11 OT-20-2004 05.01PM FR0M-MICHAEL T. STELLA SR,P-C. +0766635396, ,..;: T-281 P.005/006 F-338 YX& Q� �yr��t��i��Lrre�el�xL���rcrlJ���u�xin� G i .�a kolz- - ��l S.RUSSELL. SYLVA S 7vo�rurro��umeQ�.;�C�Gee�uce comm(cAnu► 935-2160 ry 6, 1988 John Clement MEET 310 Main St. Groveland, MA 01834 Re: orth Andover 1 Town Line Auto Repair 1615 Osgood St p Property Investigation Report Submittal DEQE Case No. 31062 Dear Sir/Madam: The Department of Environmental Quality Engineering (Department) has received a written report from you concerning environmental conditions at ' the above referenced property_ If you are a potentially responsible party as described in Section 5(a) of MGL ch. 21E, the Massachusetts Oil and Hazardous Material Release Prevention and Response Act, you are also responsible for ensuring that appropriate assessment and remedial action, if necessary, occurs at this property. These and other responsibilities/liabilities are described in MGL ch. 21E. Based on a preliminary review, the Department believes that the conditions as described in the report do not constitute an imminent hazard to the public health, safety, welfare, or the environment requiring immediate action by the Department. Consequently, further reviev of the report and/or investigation of the property cannot be given top priority because of the need to attend to cases which appear to pose the most serious threat to public health, safety, welfare, or the environment. Your case will be reviewed in the order in which it was received as staff can be diverted from top priority cases. In order that the Department 's review of your report is as expeditious as possible, you are urged to determine whether the report conforms to the enclosed guidelines. Unfortunately, many ,reports fail to provide sufficient information to fully assess the problem or to allow sound decisions concerning further asst:ssment or remedial action. Deficiencies often OT-20-2004 05:01PM FROM-MICHAEL T. STELLA SR,P.C. +8186835386 T-281 P-006/008 F-330 l -2- include 't-include a lack of validated data, expert professional interpretation of data or recommendations for futthes-actioA. we suggest that you examine your report in light of the -general guidelines and policies enclosed to determine whether there are additional steps you should undertake to expand upon your report. Please note that this letter does not constitute a statement that the referenced property is or is not subject to the provisions of NGL ch. 21E. In addition, be advised that present statutory requirements compel the Department to maintain and publish a list of locations "to be investigated as possible disposal sites" of oil or hazardous materials (MGL ch. 21E, section M . Accordingly, based upon information contained in the submitted report, the subject property may be so listed by the Department, and you may he contacted at a future date and be requested to complete a "Preliminary Assessment" and/or "Site Investigation" form. If you have any question about your -responsibilities or liabilities under Chapter 21E, you should obtain legal counsel to advise you. Please direct all further communications on this matter to the letterhead address, and reference the designated DEQE case number. Very truly yours, John J. Fitzgerald, P.E. Chief, Site Assessment/Cleanup Section JJF/dt ecc: Site Assessment Branch Chief, DEQE, I winter St., Boston, MA 02108 Board of Health, CHO, Town Bldg, North Andover, MA 01845 Enclosures: 1. General Guidelines for Property Investigations 2. _ Guidelines for the Preparation of Phase I Property Investigations 3. Minimal Standards for the Submission of Laboratory Data OT-20-ZOOa 05:03PM FROM-MICHAEL T. STELLA SR,P.C. +8786835386 T-282 P-001/001 F-340 FIGURE 2 Sl'1'B DRAWING 1615 Osgood Street North Andover, MA 01845 O to v- � 1 S7-0 o q y 0 0 0 BLOCK ao � G A RA � G E OW-3 O 0 o C.) p M' OW-4 4 PUMPS Gam' .0 W-I (NOT TO SCALE) OSGOOD ST. RTE 125 OT-20-2004 05:01P14 FROM-MICHAEL T. STELLA SR,P.C. +8786835386 T-261 P.00T/008 F-338 z PEASE,SNOW&ASSOCIATES,INC. ENVIRONMENTAL ENGINEERS AND LICENSED SITE PROFESSIONALS 23 Kirchinpon Road, Chelmsford MA 01824 Phone.(978)244-5625: Fax.-(978)250.4674 June 4,2004 Mr.George Stella Trustee Mason Dixon Realty Trust 160 Common St.,Curown Lawrence,Massachusetts 01842 Re: Commercial Property 1615 Osgood Street North Andover, Massachusetts 01845 Dear Mr.Stella: This letter represents a proposal from Pease,Snow&Associates,Inc. ("PSA")to prepare documents for the regulatory closure of a reported gasoline release at the above-referenced property, The work will consist of the preparation of a Response Action Outcome("RAO") Statement pursuant to the requirements of the Massachusetts Contingency Plan("MCP"). Submission of an RAO Statement to the Massachusetts Department of Environmental Protection ("DEP")signifies regulatory closure of the release condition,subject to possible audit by the Massachusetts Department of Environmental Protection. This work follows up an investigation of the property April and May 2004,the results of which indicated that an RAO Statement is warranted. The results of the investigation will be described in a report,along with other documentation required by the MCP for an RAO Statement. The work will also include file reviews at the Town of North Andover Fire Department,for information regarding former fuel storage tanks on the property,and the Health Department,for listings of potable water wells in the town,among other appropriate agencies for background information relative to the property and surrounding properties. The work will be conducted on a time and materials basis in accordance with the attached Terms and Conditions. The estimated cost of the work is as follows: 1. Local agency file reviews and reviews of on-line information sources Geologist,6 hrs ® $85.00: $ 510.00 Copying and mileage: $ 25.00 I OT-20-2004 05:00PM FROM-MICHAEL T. STELLA SR,P.C. +9796935396 T-291 P.001 F-339 PEASE,SNOW& ASSOCIATES,INC. E07ROMMENTAL ENGINEERS AND.LICENSED SITE PROFESSIONALS 23 Hitchinposr Road, Chelmsford,MA 01824 Phone: (978)244-5625: Tax: (978)250-4674 April 2,2004 Mr.George Farkas 1615 Osgood Strect North Andover,Massachusetts 01845 Re: Commercial Property 1615 Osgood street North Andover,Massachusetts 01845 Dear Mr.Farkas: As you are aware,the property at 1615 Osgood Street has been identified by the Massachusetts Department of Environmental Protection("DEP")as the location of a release of oil or hazardous materials. A copy of the listing of this property from the DEP website is enclosed for your information. As you can see from the listing,the DEP was notified that a release hied occurred on the property in 1989. It is our understanding that you are not aware of the reasons why the property was listed and that you have not received communications from the DEP in its regard. This letter represents a proposal from Pease,Snow&Associates,Inc. ("PSA)to conduct services in response to the above-referenced listing of the property by the DEP. The work will be conducted in accordance with the regulations that govern properties where releases of oil and hazardous materials have been identified,known as the Massachusetts Contingency Plan("MCP"or 310 CMR 40,0000). PSA's work will be conducted in accordance with the tasks described below. These tasks are designed to achieve a definition of property conditions,but do not cover regulatory closure of the release. Instead,once property conditions are defined,PSA will prepare a follow-on proposal for regulatory closure, if warranted. 1..Conduct DEP File Review,Stemple Existing Wells,and Conduct Dig-Safe Markout PSA will review the file for the property at the DEP's file office in Salem,Massachusetts. The purpose of the file review is to determine the reason for the property's listing with the DEP and to obtain copies of prior technical reports or technical infommation that might have been generated from previous property assessments. PSA will also review records at the Town of North Andover Fire Department concerning the former storage of gasoline on the property. As you are aware,two monitoring wells are present on the property and these wells will be evaluated for potential use. On the same day as the file review.groundwater samples will be collected from the wells using a low-flow pump and flow-4hrough analyzer to determine if constant test parameter values(such as conductivity,dissolved oxygen,and temperature among others)are achieved during sample collection. (This will address a concern of PSA's that there may be insufficient water in the wells for a sample representative of bulk formation water.) Upon 1 07-20-2004 05:00PM FRO*MICHAEL T. STELLA SR,P.C. +8786835386 T-261 P-002/006 F-338 collectioq the samples will be discharged back into the well and PSA will determine whether the wells can be used for the current investigation or whether one or both will need replacement. PSA will conduct a Dig-Safe markout of the property at the same time as sampling of the two existing wells. As described above,all Task 1 activities will be conducted on one day in a single trip. 2. Project Planning and DEP Communications This proposal describes a property investigation which will be refined based on the results of Tasks 1 and 2. PSA will conduct site-specific planning for the property investigation based on the results of the Task lfrle review. The planning will include the number and locations of soil borings and monitoring wells that will be installed on-site,as well as the number and types of samples that will be collected and their chemical analysis. We will communicate this information to you,including the estimated cost of the investigation prior to the start of the work. Once closure documents are submitted to the DEP,it is likely that the DEP will require past due annual compliance fees. In order to be proactive,PSA will prepare and submit a letter to the DEP which describes the circumstances why MCP activities have not taken place prior to this time and which requests a waiver of past annual compliance fees. The letter will be sent to you in draft form for review and will be finalized and submitted based on your comments. I Install Borings and Monitoring Wells Several borings will be installed on the property in field-selected locations to determine the extent of residual soil contamination. Soil samples will be collected continuously from the ground surface to below the water table and headspace volatile organic compounds("VOCs")in the soil will be measured in the field using a photoionization detector('PID'). Samples will be selected for laboratory analysis based an the results of PID analysis. This proposal assumes that six soil samples,four from around the former location of underground gasoline storage tanks and two from the locations of newly-installed monitoring wells,will be collected for laboratory analysis. The proposal also assumes that the property condition that caused its DEP listing was a release of gasoline and not diesel fuel,lubricating oil,or other contaminants. Based on this assumption,the soil samples will be submitted to a state-certified laboratory for analysis for volatile petroleum hydrocarbons("VPH')which is appropriate for gasoline release sites. Selected samples will also be submitted for lead and ethylene dibromide ("EDB')analysis,which are former gasoline additives. If petroleum other than gasoline is suspected,the samples will also be submitted for extractable petroleum hydrocarbon("EPW)analysis,which is appropriate for petroleum compounds other than gasoline,however the cost of this analysis is not included in the estimate provided later in this proposal. Under the assumption that the existing two monitoring wells are usable,an additional two monitoring wells will be installed on the property in locations deterrnined in Task 2. Groundwater was measured by PSA in one of the wells to be at a depth of 17.5 feet. Based on this,we are 2 OT-20-2004 05:OOPM FROM-MICHAEL T. STELLA SR,P.C. +8186635386 T-281 P.003/008 F-338 assuming that the new wells will be installed to a depth of 25 feet below ground surface. The wells will be covered with a flush-mounted roadbox. The relative elevations of all four site wells will be surveyed at the time of installation to an arbitrary datum. 4. Collect Groundwater Samples,Gauge Wells,Prepare Groundwater Flow Map,and Prepare Proposal for FoOow-On Work Depth to groundwater measurements will be collected using an electronic interface probe and groundwater samples wiH be collected using a low-flow sampler. The samples will be submitted to a state-certified laboratory for VPH,lead,and EDB analysis. A groundwater flow map will be prepared and the results of analysis will be conducted. Based on can be achieved or din f anon PSA,will determine whetherulatory closurere the findings the investigation,g g whether additional investigations are required. PSA will transmit the results of the investigation to you,including a groundwater flow map,data table,laboratory reports,and a proposal for follow- on work. The work will be conducted on a tune and materials basis in accordance with the attached Terms and Conditions. The estimated cost of the work is as follows: 1. DEP File Review,Sampling,and Dig-Sak Markout Geologist, 8 hrs @$85.00: $ 680.00 File copying: $ 15.00 Sampling equipment: $ 75.00 Disposables and miscellaneous: $ 40.00 2. Project Planning and DEP Communications Licensed Site Professional, 2 hrs @$105.00: $ 210.00 Geologist,2 hrs @$85.00: $ 170.00 3. Borings and Monitoring Wells Drill rig,including well materials for 2 wells @ 25': $2024.00 Qeologist, 8 hrs @$85.00: 1 850.00 PID: $ 100.00 Survey equipment: $ 75.00 Six soil samples(VPH @$125 ea.): $ 750.00 Two soil samples(EDB @$45 ea.and lead @$20 ea.): $ 130.00 Disposables and miscellaneous; $ 60.00 3 07-20-2004 05:00PM FRO"ICHAEL T. STELLA SR.P.C. +9766635366 T-261 P.004i006 F—nae 4. Groundwater Samples,Well Ganging$Flow Map, and Proposal Geologist, 10 hrs @$85.00: S 850.00 Sampling and gauging equipment: S 165.00 Four groundwater samples(VPH @ S125 ea.): S 500.00 Two groundwater samples(EDB @ S45 ea.and lead @$20 ea.): $ 130.00 _ Disposables and miscellaneous: S 40.00 Licensed Site Professional: No charge Total Estimated Cost: 56864.00 . PSA can be authorized to conduct the scope of work by signing the signature block below. A down payment of$2000.00 will be required prior to initiation of the project. Please contact me if you have any questions in regard to this proposal or if you require additional information. We appreciate being able to assist you in these matters and we look forward to their successful conclusion. V truly yaws, 8t ASSOCIATES,INC. Robert W.Pease,Jr. Principal This proposal is acceptable and Pease, Snow&Associates,Inc. is authorized to conduct the work, in accordance with the attached Standard Terms and Conditions. 4 I07-20-2004 05:01 Pit FROM-MICHAEL T. STELLA SR,P-C. +8786835386 T-181 P.008/008 F-338 2. Preparation of RAO Report Contaminant transport groundwater modeling to to potential receptor locations,4 hrs @$85.00: $ 340.00 Report preparation,36 hours @ $85.00: $3060.00 Drafting,report assembly and copying,DEP form preparation, signature attaiument,report submission and distribution, 10 hrs @ $65.00: $ 650.00 Project management and ISP review and certification of RAO, $1050.00 10 hrs @ $105.00: Report production and miscellaneous expenses: $ 125.00 Total Estimated Cost: $5760.00 PSA can be authorized to conduct the scope of work by signing the signature block below. Please contact me if you have any questions in regard to this proposal or if you require additional information. We appreciate being able to assist you is these matters and we look forward to their successful conclusion. V ly yon, P S ASSOCIATES,INC. Y Robert W.Pease,Jr. Principal This proposal is acceptable and Pease, Snow&Associates,Inc. is authorized to conduct the work, in accordance with the attached Standard Terms and Conditions_ COMMONWEALTH OF MASSACHUSETTS TOWN OF: NORTH ANDOVER SYSTEM PUMPING REPORT ACTION KING ENTERPRISES, INC REPORT FOR THE MONTH OF: OCTOBER 2004 CONTENTS TRANSFERRED CONDITION OF DATE NAME ADDRESS GAL TYPE TO SYSTEM 10/4/2004 NORTH ANDOVER AUTOCOMP. 1615 OSGOOD STREET 1000 SEPTIC LOWELL WWTP 35 10/28/2004 GREENBRIAR ESTATES 5 GREENBRIAR DRIVE 500 SEPTIC LOWELL WWTP Npv 4 2004 T4\f1 n. TH A'fi'�l�T l TOWN OF 2 --- SYSTEM PUMPING RECORD DATE: SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of house) C) t� r DATE OF PUMPING: 4_c=)_q___0L(0UANTITYPUMPED : �� GALLONS CESSPOOL: NO L, 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: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED To: G.L.S.D Lowell Waste o ;, a 7a � II be served: s: i fess at least seven (7) days before the Ifee and a copy of your Food Service out of. lesitate to call the Board of Health 1 t Q COMMOW-EALTH OF NLkSSACHUSETTS EXECL"TIN"E OFFICE OF ENA1RON'MENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: Owner's Name: Owner's Address: IVZ) TC'vVN OF NOR9'H Ar'-,V Date of Inspection: 7—% — 01 BOARD OF HEALi; Name of Inspector: (please pript) /�� � Pl�D�� JUL , Company Name: f_'OLIre-4-- kAwiJ C:0.X)NC . Mailing Address: ®/30)( C#40 DIV .. Telephone Number: & 3ee2— �W - — CERTIFICATION STATEMENT 1 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 m,.- training y training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authorityy /Fails Inspector's Signature. &* 2 Date: 0-7/071,01 The system inspector shall submit a coPy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/152000 page I Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: 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 witb 310 CMR 15.303(l)(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 anv)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: 3 Page 2 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERJTIFICATION (continued) Property Address: ave. Owner: Date of Inspection: '?— 7 —(?/ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passa: 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 beloA. 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 exp tin: 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,scnlcd or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipes)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 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1,1Q 6 0060 L+10_p� No.&&jQvfx., ILIA- Owner: �'a•�Or — / }.S Date of lospectiW.. D. System Failure Criteria applicable to all systems: You must indicate yes"or"no"to each of the following for all inspections: Y?/ No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or / cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped . _ y portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface / water supply. / )-portion of a cesspool or privy is within a Zone I of a public well. _ ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or pr-i,.-%-is less than 100 feet butgreater 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 fret 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 forma (Yes o)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 Ch1R 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must 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 Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. j Page 5 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:—,l(o/.E �-O�� � e /Vo AVd V r-f _ Owner Qc,;:� ti /L Date of Inspect{ n: 2-7-6I Check if the following have been done. You must indicate'wes"or"no"as to each of the following: Yes No Xwere Pumping information was provided by the owner,occupant,or Board of Health : any of the system components pumped out in the previous two weeks Y--, is the system received normal flows in the previous two week period? ave large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) V Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? 1/ Were all system components,excluding the SAS, located on site? y _ 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? V — Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _ /Existing information. For example,a plan at the Board of Health. _ J 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)) 5 • Page 6 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:,/Z b � - Owner._j D � A Date of Inspcctio FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x a of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no):_ Is laundry on a separate sewage system(yes or no): _ (if yes separate inspection required] Laundry system inspected(yes or no): _ Seasonal use: (yes or no): Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no):_ Last date of occupancy: COMM ERCIAUINDUSTRIA L Type of establishment: J2A& Design flow(based on 310 CMR 15.203 : _;_ T4:> gpd Basis of design flow(seats' n Aft,etc.): /' ��T bq-s B fjta�/r15 Grease trap present(yes oro �+// Industrial waste holding •present(yes org: y Non-sanitary waste discharged to the Title 5 system()es or&:V Water meter readings, if available: Last date of occupancy/use:7-7-0 l OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:. Was system pumped as part of the inspection(yes no : If yes, volume pumped: _gallons-- How was quantity pumped determined? Reason for pumping: TYP OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative.'Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all co ponents,date installed(if known)and source of information: U I gdnL-Lr- Were sewage odors detected when arriving at the sit yc or no): 6 Page 7 of 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM�—IfNFORMATION (continued) Property Address: MA- Owner: A-Owner: 6e' Date of inspects— 7---a/ BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on siteP lan) Depth below grade: Material of construction:_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) J Dimensions: !O �� ,R,0UA/d Sludge depth: (o/' Distance from top of sludge to bottom of outlet tee or baffle: c7 Scum thickness: O Distance from top of scum to top of outlet tee or baffle: g:�) Distance from bottom of scum to bottom of outlet tee or baffle: eD How were dimensions determined: /�IN "'%g 'UyC' Comments(on pumping recommendations,tnlet and outlet tee or baftle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): > 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.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: D� w� M0 1171C&V MA Owner: Date of Inspectio . —�—D/ TIGHT or HOLDING TANK: (tank must be pumped at time of inspectionX locate on site plan) Depth below grade: Material of construction: concrete_metal fiberglass_polyethvlene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be openedxlocate on site plan) Depth of liquid level above outlet invert: 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.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): R Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORR'ViATION (continued) n }} 7 Property Address Owner: Date of Inspeci on• 2— 41 SOIL ABSORPTION SYSTEM(SAS): _(locate on site plan,excavation not required) If SAS not located explain why: I-A,wv.y -7 R&1ES rx. A ao — 3W Wencw Type leaching pits,number._ leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: _ _ innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS: (cesspool must be pumped as pan of inspection xlocate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids laver: 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.): 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: /✓D,fin/ vy� �— r Owner: 4r"k- Dattofin.spectio1V " 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. N a � Z>57�. c50v 6r-I- �. ADi�s' MEVS i i i ®J�Dq-7d o� �RA-1 N i 1 � 1 t] Page 11 of 11 OFFICIAL INSPECTION FOPUM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 164 Oc5 oz>DC2 "e -�' mp, "—,Z- Owner: ,2tak_ 45 Date of Inspection: 2-7-61 SITE EXAM VA-0-1 ° Slope • �/�1 i Surface water o^✓4-7� 5&P7`7 r"7 Wki Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: -Abtained from system design plans on record - If checked,date of design plan reviewed: t site(abutting property/observation hole within 150 feet of SAS) Necked 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 wale elevation: 11 E\ECt '-E OFFICE OF E\-\1RO\-1E\7AI-1ATFAIRS DEPARTMENT OF EN`VIRONMEtiTAL P.,JTECTION TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR �'OLL'NTARS' ASSESSMENTS SUBSURFACE SE«'AGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: I(y/S OS60lVo. AN;;n✓�'�2, MP Owner's Name: Owner's Address: Date of Inspection: — O Name of Inspector: (please pript) P/C Company Name: �OVN't-rce ,L�tw.J tLP.��'S. Com. Mailing Address: O X — _ 114,3 onl Telephone Number: CO CERTIFICATION STATEMENT 1 certify that 1 have personally inspected the sewage disposal s-stem 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 s:tc sewage disposal s\stems 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _ Passes _ Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: The system inspector shall submit a coPy of this inspection report to the Approvine Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10.000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable.and the approving authority. Notes and Comments ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system Aill perform in the future under the same or different conditions of use. Title 5 inspection Form 6!152000 page 1 OFFICIAL INSPECTIO OR.N1 - ?SOT FOR VOLt'\TARN' A;,_-5S;N1E\TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner• Date of Inspection: 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 CiiR 15.303(1 Xb)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 (2nd 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 r - i surface water su pp1, 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: 3 OFFICIAL INSPEC . iON FORM — NOT FOR `OLUNTA_ ASSESSMENTS SUBSURFACE SE«'AGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: U Date of Insp"tlon: ;— 7 —41 . Inspection Summary:- Chak A,B,C,D or E/ALWAYS complete all of Section D`" -^A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 C%1R 15.344 exist. Any failure criteria not evaluated arc indicatedbrlo«. Comments: B. System Conditionally Passes: One.or more system components as described in the"Conditional Pass"section need to be,replaced or repaired. The s}stem, upon completion of the replacement or repair;.as appro�cd.b) the.Board of Health,will pass. . . _ _ '. ` .. - . . w statements. f"not determined" leas( _ statemen 1 Answer for the following the Ans er scs, no or not determined(1',h,ND) in g P explain. The septic tank is metal and over 20)cars 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 b} the Board of Health. 'A metal septic tarik will pass inspection if it is struciurally sound, not lcakirtc and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. :.. NDexp atn: 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 uncycn distribution box. System will pass inspection if(with appro%al of Board of Health): broken pipes)are.replaced " obstruction is removed distribution box is'lcvcicd 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 4 of I I OFFICIAL INSPECTION FORM — ,NOT FOR VOLUNTARY ASSESSME^TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART .4 CERTIFICATION (continued) Property Address: Owner Date of Inspectioti: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Ye/ No /// _ Back-up of sc Aage into facility•or systcm component due to overloaded or clogged SAS or cesspool _ Discharge or ponding of effluent to the surface of the ground or surfdce waters due to an overloaded or clogged SAS or cesspool _✓ _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or j cesspool _j _✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than ''A day flow Required pumping more than 4 times in the last scar NOT due to clogged or obstructed pipe(s). Number % of times pumped An% portion of the SAS. cesspool or pns� is below high ground water elevation. Arts portion of cesspool or pnv� is within 100 feet of a surface eater supple or tributary to a surface j water supply. _/Any portion of a cesspool or privy is within a Zone I of a public well. �/ Am portion of a cesspool or prise is within 50 feet of a private Aaicr supply cell __ _✓ Ans portion of a cesspool or privy is less than 100 feet but greater than 50 fent from a private water supply µell with no acceptable water quality analysis IThis 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 ded that no other failure criteria are triggered. A copy of the analysis must be attached to this form.j Cs.No)The system fails. Ihave determined that one or more of the above failure criteria exist as described in 310 CNIR 15.303. therefore the sss.em fails. The system o%%ner 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 sen-e a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes•' or"no"to each of the following (Thc following critena apply to large systems in addition to the criteria above) scs no the ssstem 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 arca(Interim Wellhead Protection Area- 1 WPA) or a mapped Zone Il of a public waier supply µell If\ou !;ase answered"scs" to arts question in Section E the system is considered a significant threat. or answered "scs" in Section D above the large systcm has failed. The owner or operator of any large system considered a sit:, itica-: under Section E or failed under Section D shall upgrade the s\stern in accordance with 310 CMR 1 t-: The s\stem owner should contact the appropriate regional oft-ice of the Department .i Page 5 of I I OFFICIAL INSPECTION FORA — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECK//LIST Property Address: 6/,5' /✓o /4,Va�c�_ Date of Inspect n: Check if the following have been done. You must indicate'Yes"or"no"as to each of the followine: Yes No ". : _.. .:: ,: _.. : . -. - /Pumping information was provided by the owner.occupant.or Board of Health V. Were any of the system components pumped,out in the previous two weeks the system received normal flows in the previous two week period? ave large volumes of water been introduced to the system recently.or as part of this inspection? Were as_built plans of the system obtained and examined'. (If they were not available note as N:A). V Was the facility or dwelling inspected for signs of seµage back up Was the site inspected for signs of break out V/_. .Were all system components,excluding the SAS, located on site'. Were the septic tank manholes uncovered.opened. and the interior of the tank inspected for the condition of the baffles or tees.material of construction.dimensions.depth of liquid.depth of sludge and depth of scum? Was the facilitx owner(and occupants if diffe_rcnt from oµ•ner)provided µith information on the proper maintenance of subsurface sewage disposal s,'stems The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no� Existing information. For example,a plan at the Board of Health. J 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(3xb)) 5 Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspectio FLOW CONDITIONS RESIDENTUL . Number of bedrooms(design): Numbs of bedrooms(actual):---. DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x A of bedrooms): Number of current residents: `„• Does residence have a garbage grinder(yes or no):_ Is laundry on a separate sewage system(yes or no): _ (if yes separate inspection required) Laundry system inspected(yes or no).- Seasonal o):Seasonal use: (yes or no): Water meter readings. if available(last 2 years usage(gpd)): Sump pump(yes or no):_ Last date of occupancy: C O hi M E R C lA L/I ND U STRIA L Type of establishment: s 1<-&,-C l� 'f Design flow(based on 310 CMR 15.203 ;U'-D Rpd Basis of design flow(seatsns. ft,etc.): j - JET f�. hro�r�s Grease trap prescnt ():s or,, o), ✓ / Industrial waste holding tanZ.' present(yes or'}. Non sanitary waste discharged to the Title 5 s)stcm Ocs orco):V_ Water meter readings, if available: Last date of occupancy use: 7-7—D/ OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: ,+/C Was system pumped as part of the inspection(yesriot If acs. �olumc pumped: _gallons -- How was quantity pumped determined" Reason for pumping: TYP OF SYSTEM Septic tank,distribution box, soil absorption system _Single cesspool Overflow cesspool —Privy _ Shared system(yes or no)(if yes,attach previous inspection records. if any) _ Innovativr-Alternative technology. Attach a copy of the current operatiori and maintenance contract(to be obtained from system owner) Tight tank _Atiach a copy of the DEP approval _Other(describe): Approximate age of all co ponents•date installed(if known)and source of information: � I.Vere scAage odors detected when arriving at the sit &c or no) 6 Pape 7 of 1 1. OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ✓P�_ "A Owner: eta Date of Inspect 7 r 7-0/ BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC_other(explain). Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage, etc.): SEPTIC TANK:Zlocate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_pol}ethylene —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: Sludge depth: (� Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: D Distance from top of scum to top of outlet tee or baffle: C- Distance from bottom of scum to bottom of outlet tee or baffle: _ D How were dimensions determined: �i y 1-154vd - Tf+OG /yPctSi�r� Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): _ GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal _fiberglass _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.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORINT - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION tcontinuedi Property Address:, /(o 0�rPe Ow'ner:` Date of Inspectio TIGHT or HOLDING TANK:. . (tank must be pumped at time of inspectionxlocate on site plan) Depth below grade: :._ Material'of construction:_concrete._metal_fiberglass''_polyethj•lene- other(explain): Dimensions: Capaclt • gallons Design Flow: gallons/da) Alarm present(yes or no): Alarm level: Alarm.in working order(yes or no) Date of last pumping: Comments(condition of alarm and float switches,etc.): .. DISTRIBUTION BOX: _(if present must be openedylocate on site plan) Depth of liquid lc%cl above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of lcakaec into or out of box,etc.): PUMP CHAMBER:_.(locate on site plan) Pumps in.working order(yes or no): Alarms in working order(yes or no):_ Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Q Page 9 of 11 OFFICIAL INSPECTION' FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTpEM)INFOR,NIATION (continued) Property Address: 161 — 6po']. 7rcP� �(/�? ,fid o✓c../L,M� Owner: 6n,0r Date of Inspection: •�—7— 0/ SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: zyv Tree - 0 0";01V1'✓ ec 0 Type _leaching pits,number. leaching chambers,number: _leaching galleries.number: - _leaching trenches,number,length: - leaching fields,number,dimensions: _overflow cesspool,number: _ _innovative'altemative system Tvpe'name of technology_;, Comments(note condition of soil,signs flf hydraulic failure, lcvel%of ponding,damp soil, condition of vegetation, etc.): CESSPOOLS: (cesspool must be pumped as pan of inspection xlocate on site plan) Number and configuration: _ Depth–top of liquid to inlet inve : ` Depth of solids laver: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): — Comments(note condition of soil,sins of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan), Materials . Materials of c_o_nstcuction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure. Icvehaf ponding. condition of vegetation.etc'.)- - a Page 10 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORtiI PART C SYSTEM INFORMATION(continued) Property Address: ,N� �r�/ v✓G2. /moi 4- Owner Date of InspectioV 7- -7—,q1 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 Aithin 100 feet. Locate where public water supple enters the building. 1 1 i J l� V C7 J o L/Nl�--: I' J 1 \ C✓- J 1 10 Page I 1 of 11 OFFICIAL INSPECTION FORAI — 'OT FOR VOLUNTARV`A�S� §' N1ENIT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddress: Owoer. Date of l,ospeitioa; 7-7'26/ SITE EXAM. v Slope Surface water ✓; %��- `� Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water cle'vation: d btatned from system esigtti plans on record.- if checked.date of design plan reviewed:. �bserved site(abutting propertylobsmation hole within 150 feet of SAS)_ hecked with local Board of Health-explain: Checked with local excavators.installers-(attach documentation) Accessed USGS database-explain: You must describe how you/e/stablished the high ground watef elevation: 1 , S/70✓P Il lV j W J tool CLQ. � e w 0 L z 4z` =D v ro I m e OM (D U.S.U.S. r10 TACE W IMAILHRVERNILL.MA Y Ln L ay STATES "VM, . JUAMosk,f" '^ M UNITED 57ATES V, CD N cc rosTAi sE p 00021202-06 N O W - - --- - - } 9267 01845 W United States Posta Oi Service® J a DELIVERY CONFIRMATION'm I Q - -- -- - - --- - - a a 0302 1790 0003 9669 1323 � - �y. 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EXISTING FIRE FfYDRANf NN MS 04 a II J LOCJATION OF EXISTING 1 SEPnc SYSTEM LLI roUP ---4D l HANGING TREE REALTY TRUST C9 ----- --� �� ASSESSORS' MAP #34 LOT X128 -moi qrs �� �� (x.x ACRES*) 04 JC � \ 1Jr� / I1 1 1 I I C \ 1 / TRAILER \ 1 I I /A I / EXISTING t-STORY / BUILDING (OFFICE AND I 11 I I gNTl9 / c � / I / 2-BAY GARAGE) ' / 0 �V SAR TP N I I 1 1 `x`�/ii/ / -'ice PIT \ _ \ •0 EXISTING TWO-FAMILY v •1 1 �I 1 \-- • ` . / DWELLING (1-STORY EXISTING CB v+ �A 1\ \\ 1\ % WOOD FRAME) taro m IV a" oui 9306 \ I I 1 \\ \\ Q TP/2 i' I PERO n PAVED \ \ \ \0d / V �� ❑ I PARKING LAT \ p O 00 STAIRS / LOCATION OF DOSTM SEPTIC MASON-DIXON REALTY TRUST ,� / \\ SYSTEM Z ASSESSORS' MAP #34 LOT #44 � i O / (x.x ACRES*) n0 O /�� ' / i PAVED DRNEIYAY O W Oi/ O .'�/ • / �'� LEGEND PERAV — ,1 TP #1 / RELOCATE WATER SERVICE / 98----------98 EXISTING 2'CONTOUR / I X102.9 EXISTING SPOT ELEVATION RECORD LOCATION OF FUEL /' m _ PROPOSED OONTOUR FILL CAP. TYP (SEE NOTE 1) ® PROPOSED SPOT ELEVATION PERO TEST TEST PIT --� - . —w—. . WATER UNE W PROPOSED WATER UNE OF FIRE FIYDRANT DRAWN 6/:PROPERTY UNE EDGE OF PAVEMENT M. DEFVRGE 0A ❑ ❑ STOCKADE FENCE ® COWCH BASIN 111M 080010D ST. / \o2,* �`' �2 — ——D —— DRAIN UNE NOM AWOVM / —--—S—--— EXISTING SEWER UNE SITE PLAN NOTES ————5--——— PROPOSED SEWER UNE SITE PLAN 1" = 20' e�ER(i9 36s A°0°rm waONwF;UEL98� ROMNED N ® TELEPHONE VAULT LTInmr POLE 2. OWSAFE CONTACTED 9 APRIL 2002.DMAFE NUMBER #1505324. Y�Y LAMP POLE 3. SITE NOT WITHIN WATERSHED PROTECTION DISTRICT(NORTH ^�^ SI011 ANDOVER ZONING MAP 19 JAN 1999) 4. PROPERTY LOCATED WITHIN INDUSTRIAL S DISTRICT. �O FUEL FILL CAP (SEE NOTE 1)