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HomeMy WebLinkAboutMiscellaneous - 164 BRIDGES LANE 4/30/2018 (3) / ( 164 BRIDGES LANEJ- C210/104.D-0082-0000.0 C Commonwealth of Massachusetts Tithe 5 Official Inspection Form 'i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane v Property Address `r Ma Ann Hill �� Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: RECEIVED When filling out A. General Information forme on the AUG 242015 computer,use 1. Inspector: l� only the tab key to move your Neil J. Bateson TOWN OF NORTH ANDOVER cursor-do not Name of Inspector use the return key. Bateson Enterprises Inc. Company Name 111 Argilla Road Company Address Andover MA 01810 Cityrrown State Zip Code 978-475-4786 SI 15 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8/20/2015 Inspectors ignature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving.authority. , ****This report only describes conditions at the time of inspection-and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection B: Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: Y ❑ 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. Check the box for"yes", "no"or"not determined" (Y,N, ND)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 indicatingthat the tank is less than 20 ears old is available. Y ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 . Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine,if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments " 164 Bridges Lane Property Address Mary Ann Hill Owner owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of.the analysis must be attached to this form. i 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or El ® 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 '/z day flow t5ins•3113 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown - State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. El ® . Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well R 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. t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? Z ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner) provided with ® El information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedroomsdesi 4 4 bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 600 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments <•' 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Yes 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 7 or 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped two years ago, owner Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Measured tank. Reason forum in : Inspect tank, baffles&tees P P 9 Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 164 Bridges Lane Property Address Mary Ann Hill Owner Owners Name. information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 31 years old, 8-4-1984, as built plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 4 feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting, evidence of leakage, etc.): 4" Cast Iron through floor to septic tank, 3"PVC in house, no leaks visible. Septic Tank(locate on site plan): Depth below grade: 3 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'x 5'.x 4' Sludge depth: 3" t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner owner's Name information is North Andover MA 01845 8/20/2015 required for , every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27" 4" Scum thickness Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? Tape Measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumped septic tank. Inlet tee& baffle ok. Outlet tee&baffle ok. Depth of liquid at outlet invert. No evidence of leakage. Inlet cover has riser 3"deep. I i Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3113 Title 5 Official Inspection Farts:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owners Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown state Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of lastum in : p p g Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No I I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 I �- Commonwealth of Massachusetts 111.4 r.I-,n U Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owners Name information is required for North Andover MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box,etc.): D-box level&distribution equal. No evidence of leakage. Evidence of carryover, pumped d-box to clean. i Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address. Mary Ann Hill Owner Owner's Name information fo is North Andover required for MA 01845 8/20/2015 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number,.dimensions: 1 bed 25'x 40' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comment n Comments(note condition of soil, signs of hydraulic failure, level ofondin , damP soil condition of P 9 vegetation, etc.): Soil Ok. Vegetation ok. No sign of ponding to surface. i I Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer j Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owners Name information is required for North Andover MA 01845 8/20/2015 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 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.): I t5ins•3/13 7"dle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is required for North Andover MA 01845 .8/20/2015 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below 0 drawing attached separately G i Cola 11 � �v r Q-3 � �t3rt t5ins•3113 Title 5 Official inspection Fonn:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts U Ir Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is North Andover MA 01845 8/20/2015 required for every page. Cityrrown state Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 4 feet Please indicate ail methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 10-22-1983 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Design plan ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: As per design plan test pit data j I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 164 Bridges Lane Property Address Mary Ann Hill Owner Owner's Name information is North Andover required wired fo for MA 01845 8/20/2015 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 - s•• 'f M r•: } ' _ •• .f. +? �i.r � �' 'r .fir �'�. �. - '� `' •• - i '� -+ a t• .,' �• - ,i rh i ' f y • - w+ow+o�.+w..r..+rMs.'.:.»r.., .�..+.. �w.„w.e.w..gL�.` ._ • s LANE 4 266019 i t3O4 1 IDt s i lY� LC9 13 5D,939 s�i ' ELE�ATION5 TOP ND , 480• ,. �E LET 1'?(3•.26 � ti ST INLET 172.35 e +� ' ST CUTLET 17240 ' D E}3�CXINLET, t�LET 1 7 1-42 jD X 170.04 END FW j s • .Y� . LAN [may j(��'''-'��,SU ij JJ{/'''�jam''•'-'' �.. }��''' ' "� - t v „ � �f" q.. + "•.�;. �.4.�.I '�lv�� l M's�vF'.✓�'aJ:�i '*Sw�L� •.1r» - C i` Y TI T HE s l w , � u D 3 _ ' E. -Y, EM- T SHE�t+�'N-THt��RANIS�tC7#;.INTE A�14 �#�Y L� --n 4 — THE s�EMHT � a ► E f .er.-.. .r• i •�wfi kr. •.e - �r r4F �'!i�`k-t+ i �' _r,.r•. � 'h � _ � av � r'`' 4 s — ���� a�` f"' f. rs C•, �. � 3 �� 4 * '�r, �F� '+ �� �'� .s. ` 11i� � �ei �, STO.o ' - f y`. ,d , - - 3 ` .S" .,. 'ter.%' � !L I F- + •,j' f- � ; .. ,_ q,y_.nPi 0 Y by 4 � �, s ' ♦, a;d• ` :tet .� ,++'•.+,.x.e 4 y, 'i'�'. 3'.* -- .� ; �i { 1 I �_ - --=vim`- r -�---�--- - - -' - , I I � I I J� I .Town of North Andover Tax Map # 210-104.D-0082-0000.0 Parcel Id 16770 164 BRIDGES LANE HILL, WILLIAM &MARYANN 164 BRIDGES LANE NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1.1 Acres FY 2016 UB.Mailing Index Name/AddPess Type Loan Number Activellnact. From Until HILL,WILLIAM&MARYANN Payor 164 BRIDGES LANE NORTH ANDOVER,MA 01845 UB Account:Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 17842.0-164 BRIDGES LANE Last Billing Date 7/14/2015 3170507 03 Cycle 03 Active UB Services Maint. Account No.3170507 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.63 5/8 7.82 1/ WTR WATER 01 ALL METER SIZE 30.40 /1 UB Meter Maintenance Account No.3170507 Serial No Status Location Brand Type Size YTD Cons 16939920 a Active ERT HH NEPTUNE NEPTUNE w Water 0,63 0.63 1055 Date Reading Code Consumption Posted Date Variance 6/10/2015 2226 a Actual 8 7/24/2015 9% 3/10/2015 2218 a Actual 7 4/28/2015 -33% 12/12/2014 2211 aActual 11 1/15/2015 -35% 9/10/2014 2200 a Actual 17 10/15/2014 -13% 6/9/2014 2183 a Actual 19 7/16/2014 45% 3/11/2014 2164 aActual 13 4/11/2014 48% 12/12/2013 2151 aActual 9 1/17/2014 -91% 9/12/2013 2142 a Actual 100 10/15/2013 194% 6/13/2013 2042 a Actual 34 7/24/2013 212% 3/14/2013 2008 a Actual 11 4/22/2013 -11% 12/12/2012 1997 aActual 11 1/9/2013 -72% 9/12/2012 1986 a Actual 40 10/15/2012 147% 6/12/2012 1946 a Actual 16 7/16/2012 16% 3/13/2012 1930 a Actual 14 4/14/2012 14% 12/12/2011 1916 aActual 12 1/17/2012 -85% 9/13/2011 1904 a Actual 89 10/13/2011 457% 6/7/2011 1815 a Actual 15 7/20/2011 -15% 3/7/2011 1800 a Actual 17 4/13/2011 1% 12/8/2010 1783 aActual 17 1/12/2011 .83% 9/9/2010 1766 a Actual 102 10/15/2010 240% 6/8/2010 1664 a Actual 29 7/15/2010 10% 3/10/2010 1635 a Actual 26 4/14/2010 -17% 12/11/2009 1609 aActual 33 1/12/2010 -65% 9/8/2009 1576 a Actual 91 10/15/2009 42% 6/9/2009 1485 a Actual 60 7/20/2009 156% 3/16/2009 1425 a Actual 27 4/29/2009 -3% 12/8/2008 1398 aActual 25 1/20/2009 _79% 9/11/2008 1373 a Actual 130 10/10/2008 64% 6/6/2008 1243 aActual 72 7/16/2008 191% I SOIL PROFILE & PERCOLATION TEST DATA North Andover, Mass. Street No Lot No Loc/Subdiv. Pland Owner � Gv Investigator S $oo _ Observer 4!L SOIL PROFILE DATES 1.'Elev _ 2.Elev 3.Elev 4.Elev h 'L 1Z' Z- 0 0 0 0 1 1 1 1 Ties plot Test 2 2 2 2 �S 3 3 3 3 4 4 'r'� 4 Ro -c, 4 5 Ck" 5 a� 5 5 �' '� 6 6 6 6 01 7 7 7 7 8 8 8 9 9 9 10- 10 10 10 Benchmark =11- 6 Location Elevation Datum PERCOLATION TESTS CTR- DATES Co(Zi I W3, Co I Z183 Pit Number 13- 1 '3�h. 13 2 3`�z +'Z 1 1'L 49 Z Start Saturation q: 32 'N 4C q :4Z 5".43 Soak-Minutes Start e 8 q:SD 10:00 10:� < W: oZ. 15 t Drop of Y"-Time (O; i$ 10 .0-1 to 1'L to;1S Dro of 6"-Time 1 b to a ?— Z1 v:34 M6ms.lst 3" drop t4 vj M IS Mins.2nd " Drop (p ZS tS Percolation (G, �( s t `�,ucwc..�'S �s �Z k�.-��� 4�.-L ,� 3o Z [� - 1 �% BOARD OF HEALTH DESIGN APPROVAL Lot # STREET ejex7(,te S Septic Tank Permit # Proposed Construction B eo dt-A Approx Building Size Garage Under Attached None Min elevation of top of slab '�V A Min elevation of top of foundation l� Height of foundation wall �,`2 Footing in fill yes ✓ no Further Comments