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HomeMy WebLinkAboutMiscellaneous - 166 DUNCAN DRIVE 4/30/2018 166 DUNCAN DRIVE 210/104.B-0190-0000.0 ,� P/ T• �NN I 4 r � _ �.,.-- /Sia,r n r �c��"�,' t ,� ,� • { < t s / Soy CIS 19 i 2 U0 E. IS:12 47868:7847C. HEALTH RECEIVED) COMITIOn. wealth tof Massachusetts RI DEC 12 2006 City/Town of.NORTH ANDOVER MASSACH SETTS 4 Jr System PUMP!ng Record TOWN—_QF_MRTH ANDOVER .... .... FOrm 4 HEALTH DEPARTMENT j Dep has Provided this fOrrn for use by local Boards of Health. The System Pumping Record must be subMittpd to the 10cal Board of Health or other approving authorjty, A. Facility In mation important: Vtfien fiffing out 1. SYsttUrn Locatioll: forms on tne computer,use U 0MY thL,lab key 6, to move your ddr;ZA _— cursor--do lJot ule Ill e return Cltv/Towrl key, VC 2. SYS-tem Owner _�_6d­ris_s Wif different IT fetent T State, -7il—P1111101le NU-rboer Date of PuMr_jj)q Date 2. Quantity Pumped: 3. rype of system: c EJ Gallons esspool(s) Septic Tani Tight TanK ❑ Other(dC-S0ribe).- 4- Effluent Tee Filtel,present? ❑ Yes No 5, Condition of System. If yes, was it Cleaned? Yes El No 6. System .puill ed BY: roan; 'M- . 11 e ROOTER-MAN 12 EAST DRACUT ROAD -60 METHUEN,MA 01844 7. Location W11c-re contents we.,'a disposed: http:/l4wvw.rrtass.gu�ildeplwaterioarrovaisft5for - —^_ --- 1` t5forrr,4.Lloco c76103 '5yStem PumP;,Ig Record,Page, i of I TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD . s 1 STEM OWNER & ADDRESS SYSTEM LOCATION (example; left front of house) C� � /fie s U:\"I,E OF PUMPINC: gj/6j_ (QUANTITY PUMPEDG;ALL01> C. I:a.51'UUL. NO �_ YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE �K EMERGENCY cell.>FRV:\TIONS: COOD CONDITION. FULL TO COVER HEAVY CREASE BAFFLE'S IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER 01�HER (EXPLAIN) 1',)TL PUMPCD BY: c um.,yi F-NTS: � u�:1I:NrS � IzANsrcIZRLD ro: Address .. C 0 Title of FilePa e o 9 f Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes action Document/ document/ T Num. Action Department Board of Appeals - Board of Health - Planning Board - Conservation Commission- Building Department f NOpTH AN4it ApD OF HEA - a . 1 SUBSURFACE SEWAGE DISPOSAL SYS EM CTION P Address of property � �� Ouv-sc-vkv-) � owner's name Date of Inspection PART A CHECKLIST Check if the following have been done: v Pumping information was requested of the owner, occupant, and Board of /Health. y crone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the sxstem recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. L'/The facility or dwelling was inspected for signs of sewage back-up. l/ T e site was inspected for signs of breakout. G All system components, excluding the SAS, have been located on the �e. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of s udge, depth of scum. ' The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. �.�.,_. � {:L f r ' � ,, � i 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of bedrooms number of current residents 1/0- garbage grinder, yes or no laundry connected to system, yes or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: N/ /� ov, Last date of occupancy GENERAL INFORMATION Pumping records and source of information: L4 System pumped as part of inspection, ' yes or no if yes, volume pumped t CIO Reason for pumping: c� Type�€ system t/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) Other (explain) Approximate age of all components. Date installed, if known. Source of information: PCS Sewage odors detected when arriving at the site, yes or no f ` 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) /! Ef depth below grade: C, material of construction: concrete - metal FRP _other(explain) dimensions: sludge depth aTn distance from top of sludge to bottom of outlet tee or baffle �- 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 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evydence f lea age, rec mmen�lations for repairs etc. ) a� DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidg�ce of leakage in o qr� o t of box, recommendation for pail , etc. ) 2J� .L (2 U bA- i G GSC C CZG�. U V' - C� , PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions -tel overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, co dition of vegetation, recommend tions for main _e anc or repa ` s,gtc. b G �v A 1 �r � I of V_ e ��CESSP LS (locate on site plan) : V)(`y\e number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) PRIVY: fl0j\(_ (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, recommendations for maintenance or repairs,etc. ) 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks loc te-' wells within 100 ' p � `�- 1101 aA,00- UJC Ft4� n�SP_ ko S` _ �� .ko s3 g a ' r b4U �a � C) DEPTH TO GROUNDWATER G//++ t depth to groundwater WOW -'rt2kC� 6:3qow. , method of determination or approximation-, _9 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the distribution box above outlet invert? NLiquid depth in cesspool <611 .below invert or available volume< 1/2 day flow? NRequired pumping 4 times or more in the last -year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? NIs any portion of the SAS, cesspool or privy: below the high groundwater elevation? Nwithin 50 feet of a surface water? Ar within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh . (cesspools and privies only, not the SAS) ? Nwithin 50 feet of a private water supply well? less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysi for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. 13 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector Ne`l �, 6cc� c�n Company Name t J�-'� '� � A--Q Company Address Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and manitenance of on-site sewage disposal systems. T�C eck ne: I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15. 303 . The basis for this determination is prow ded in the FAILURE CRITERIA section of this form. Inspector' s Signature Date r QC Original to system owner I`'7 Copies to: Buyer (if applicable) Approving authority t C oR Z3R A//vs PROPOSED SUBSUeFAGE SEbt/ACvE /SPCLSgL. s.SYSTEM Peo oo.SEb Lor aYR.4D1A.I* � cS'CALE - !/ v DATE 0CT OWA.16e : Rr=t/is a Loc.a rioAJ: • L o T Z WV C /q1&/ D R.1 1/E i 6 De-516A.1 ew �$ o CTOSEPH c.T BA,2 BAGAL L. O , /P•s• �,�a coM,{/�N� WESTGW/ARb CIRCLEit a DES/G Al D A rA = TYPE OF BU/GD/A/G: 443 III fvG jT SEcU.4G6 FLOW ESriMArE : Goo G • 0 SEPT/e-- 7-4"1< : J500 r � L • Q 'u ! l tF fl BSo eP T/ON A,eEA c .a C x t s, _. o a S • `'• L ' �3 W 2 /� °� � rf, rF �- 6 -}- �1 /.� � �PERCocAriov rEsrs �/ sFZ �3 •�¢ r' 4 3��3� 5•F a DArE ` , � � � ` r y :r TDP ELE!/AT/ON - --I a•t_-a_ • • � � ! � ,QpTTD,y EGE✓A Tito./ r f SA rl%eA riot/ t 1/A/ XIS �rtv A ro 9" DROP L /�'I/N. M/�/ Miti/ AMI A". 3 �ll�'t'G J 9.. no G" DROP R ;�,�/N M/n/. M/N. M/.�/. A-,eeoe-4r/oA1 RATE L1ini /v. Miv//v Mew.//N• Miv /u. TEST PITS / TDP ELEI/AT/D/l/ •o d SO/� TYPES Su.E sat4- zo :. E A•tJ0 s+��`G•R�vE '��GR AvEL. WATER TABLE ti LSA 7-16AI ,�-t-.gr JAI EQ TLARPO Bo rTOM F.1cvArlml TESTS C OAA Z UC TED BY JOSEP<I J. 84,�BAG4 L L n_ �. S. v� h; -5"0/,k,5 • o TESrs W/rNESSEL By • �' ~ f G PCG-rE'A PAX 6y s�/�.vx. )OZ-4 AJ e �•�� <SEfIcEb DINT, �Soclp P!/C- P/PE E6)4/IVA4.EA/7-) o. . a CAPOEZ> EaDS- U C) 4'�d/oeeA eA rEp P I C. P/PE (OR E4cl/vAcENr) h V PART/AL BED E/./D SECT/Dill ti sSCALE �2'_l�-D// (FOR SPEC/F/CAT/O/VS - VECTID/V AT LOWEe ,2/CaNT f a,g7,2/BU7-/OAl BOX : h N r /-- -ISOO QAZ. f'OA1C2ETE SEPT/C TANK ` ¢"41�<5CV-/D f?[/.C., SEALED TO/NTS / ¢'¢ Rd.e. , s>:oas �I BSO.e PT/ON ,5E-Z:) !SZ-A/l/ /UDT 7o cSSCALE i is o EA ED �SEZ.EG T I { Z oe-ioT 84C K F!L - i d o �� TO j�8„ WAS HED . _ �+"li.t `'1 S, neo . • �Z. .Q v e b CRUS NES STO�JEe. ••r bR • •�•G— ' .. C6 i ie • o P. [/.C. P/PE D.e o u o 0 0 4--0a v,44 ENT Q d C�;) /XZ" WASAIED tv /F(/SNEv STONE � O O \ Doc/BGE N/ASf/ED TO MEET A.A.S.N.O. 4650,eP T/o ti/ BEZ) SEC T/O AJ SCALE ��-BO .4GE 4A&)D f�B5�-2PT/O n/ 3--L) /ALAN A�lv SECT/OIVS 51-167,E 7- of Z WELL DATABASE ADDRESS: J .vi�.�c�,� AGE OF WELL: WELL DRILLER: WELL PERlNIIT m: WELL LOCATION: / hi _—WELL PERMIT DATE: � ' DEPTH OF WE TYPE OF WELL: a.. DRIL.I ED Kvi b. DUG UNOWN TYPE.OF WATER BEARING ROC WATER ANALYSIS DATE- HIGH MANGANESE: Y HIGH IRON: Y N OT=CONTAMINANTS: Y N TO: NORTH ANDOVER, MASS IVej I/ / 19 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at L c 7 9 AI -D W/V C A/\/ .y /� / VF North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated raCT / Sy 19z? Z o�ss3�obd ° r J\ Rre Proh .er/Re S Ir rian No TE Iq s ��►,L r nz/:►N _y Beard of Hec 1th , N1Wrth Auciov�.r,ri sa ' SUBS&TACE DISPOSAL DLSICN CHECK LIST LOT —,G.1L.. APPROVED DATE_ DISAPPROVED DATE`r____ Provideds Reasons: s�'1 Title FAIL OR 01 . Reg 2.5 The submitted plan must show as a m n{ umt A) the lot to be served-area,dimensions lot #'Iabutters �.s b location and log deep observation hole s-distance to ties ' location and results percolation tests-distance to ties design calculations & calculations showing required leaching area e) location and dimensions of system-including reserve area existing and proposed contours g) location any wet areas t�itl�.tn 100 of sewage disposal system or disclaimer-check wetlands mapping (h) -surface and subsurface drains within loot of sewage disposal .� system or disclaimer LoOO(i) location any dralwge'easements vithin 1001 of serage disposal system or disclairzr-Planning Hoard files i (J) known sources of niter supply within 2001 of some disposal a system or disclaimer (k) location of any proposed loll to serve lot-I001 from leaching facility (1) location of water lines on property-101 from leaching facility (m) location of benchmark (n) driveways (o garbage disposals Cp; no PVC to be used in construction q) profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and other elevations (r) maximum ground water elevation in area sewage disposal system (s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans f Reg 6 S `tic Tanks (a) capacitio"s 150 of flow, grater table, toes, depth of tees, access, pining (b) cleanout (c) 101 from cellar wall or inground swimming pool - (d) 25+ from subsurface drains Reg 10.2 Distribution Boxes a) 'slope greater than 0.08 Reg 10.1 Subj*- face Design Chick List _Page 2 ' FAIL CK f. leaching Pits i Leaching pits are preferred where the installation is possible Reg 11.2 a) calculations of leaching area-ad.nimum 500 eq ft 11.4 1b) spacing 11.10 c surface drainage 2% 11.11 djcover material e) 2'x2'x4fl splash pad f) tee at elbow g) no bands in pipe from d-box to pipe L eachin Fields Reg 15.1 no greater than 20 minutes/inch v' b area-minimum 900 aq ft 15.4 - c construction of field 15.8 d) surface drainage 2 % 3-7 e) 20' from cellar wall or inground swimming pool Leaching irk®s' Reg 14.1 a) calcula4' =eaching area-min 500 sq ft 14.3 bspacingA ft min 6 ft with reserve between 14.4 c�' ons 14.6 d) ction 14.7 e) stone 1 14.10 i1f) sarface drainage 2% 'j Dounhill Slope '/,''a) s.fope y x = I be shom) V" b) y/x X 150 = (to be shown) s Reg 9.1 a) Wr—Oval 9.6 b)f`stand-by power c I i a 9oard of 'Health lorth Ani �LPTIC. SYSTEM-�.�r~.Masa. o INSrALLAtI(K CHWK LIST LOT �1�1CA� WID NOR DISAPPROVED XCAVATIOK PAIL P`ee i IL OK � -� Y, r 1. Distance Tot a. Wetlands b. Drains c. Well 2. Water Line Location �1 fix- `fir 's 3. No PPC Pipe � M 15 t E,z 4. Septic Tank---- a. Tees -_Length & To Clean Out Covers - b. Cement Pipe to Tank - On Both Sides of Tank 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Inds d. Clean Double Washed Stone 7. LeIch a. ns b. epth c. ads d. e. ipe to Pit - Both Sales f. ouble Washed Stone 8. No Garbage Disposal -� g. Final Grading Inspection 10. Barricading Covered System 11. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard-to Pere Test d. Elevations e. Water Table Board of Health . North Andover,Mass - SUBSURFACE DISPOSAL DESIGN CHECK LIST LOT # IPPROPED DATE DISAPPROVED DATE 'rovided: Reasons ��Nist=1 G�nC-S ��t� T KE1ET T'ITUE .5� Citle V FAIL OK teg 2.5 a submitted plan must show as a minimum: the lot to be served-area dimensions lot #,abutters location and log deep observation hoes-distance to ties location and results percolation tests-distance to ties d design calculations & calculations showing required leaching area e location and dimensions of system-including reserve area xisting and proposed contours g location any wet areas within 1001 of sewage disposal system or disclaimer-check wetlands mapping surface and subsurface drains within 1001 of sewage disposal system or disclaimer location any drainage easements within 1001 of sewage disposal system or disclaimer-Planning Board files 3) known sources of water supply within 2001 of sewage disposal a system or disclaimer ation of any proposed well to serve lot-1001 from leaching facility cation of water lines on property-101 from leaching facility cation of benchmark r iveways rbage disposals no PVC to be used in construction profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Other elevations maximground water elevation in area sewage disposal system plan mast be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks ka) capacities-150% of flow, water table, tees, depth of tees, access, pumping cleanout 101 from cellar wall or inground swimming pool 251 from subsurface drains Reg 10.2 Distribution Boxes a slope greater th 0.08 Reg 10.1 ) sump Subsurface Design Check List Page 2 FAIL OK Leaching Pits Leaching pits are preferred where the installation is possible Reg 11.2 a) calculations of leac g area-minimum 500 eq ft 11.4 b) spacing 11.10 c) surface 2% 11.11 d) cover mate e) I'x2 tx4n lash pad f) tee elbow g) no ends in pipe Brom d-box to pipe Leaching Fields Reg 15.1 $a) no greaer t an 20 minutes/inch -mini �m 900 aq ft 15.4 c struction of field 15.8 surface drainage 2 % 3.7 201 from cellar Wall or inground swimming pool Leaching Tamch Reg 14.1 a) calculatIone eaching area-min 500 sq ft 14.3 b) spacing-4 f min 6 ft with reserve between 14.4 c) dimensio 14.6 d) cons tion 14.7 e) sto 14.10 if) face drainage 2% DownhillSlo e a) slope y x�to be shown) b) y/x % 150 - (to be shown) Pupps Reg 9.1 a) approval 9.6 b) stand-by power j t .,r te��R�. � . t Rtrva R, • PLA til L5142 uWIAJ4 1• .�I_� !��Z AC-E_.LN.N.f-Chk __OR .DAA.1;Va- PROPOSED SaSSde. 4eE SEN/A46 blsPas4e- SYSTEN/ Lor CTRAAd/A/G SCALE DATE o - -r /S � Divwee• 1 / CArion/: t7 b DE-516 A/ER © cT,0-s F^1 cT BARSAGAG L o / it 6 / W6.57-WARb C/ L ROEly a 0 L1EsGAJ DA rA TYPE of BU/CD/A/G7: 4e.,c2. ,�t� c a4gAGE CELCAR PLUMB/N4 FAC/1-177/FS: d aEST/MArE : Goo G • !� D • ' SEPT/C TA"K : i S o a G A L 0 / • Q ! o / f �4Bso;eoT/oN AREA of A ZPERCocATiory 76s7S / Z jW3 .uF¢ r Ir TOP 6-46114r-10N / . .7• �, � ,„ .. � t � � ,6iOTTOM EGE✓A T/o.V /�o • y . /Z"10 9" OROPL�t tiJ/N- M/N. A16V MIA-1. rso <v"' ORoP 7 y� ,q/^/ M/rv. MJN. AL-RC0,(4r1ON RATE ��' M/A/./IA . ' M/N�/� �fl.N /ry All-11.1 t TEST PITSDA rE Q TDP ELEV T/ON S/.;1 4f.0 i 3A'r rap f c,,r6 n + \ SD/[ TYPES SKb sora. SKb-vo t'L WATER R- 7 TABLE "C,,RAv,.L 7rGRAv L \ � N LDCA 7-/o A/ No 1,�IA7 /� A/6 Borro/W &EVAr/oN pM A(-2 1-<, TESTS 6G11/&1G TED BY �TOSE�H T 84reBAGAL C O , R. S. .4 +,i �s' f » L SP 1 A-e .//V 7`/k c E 1 ;) TESTs w/0•p( �.+,�, .� �;,• rNESSE,6 BY : oPoG/2Al�hy 6y GE/s"As eNGf>YEERr`ruG E LAA! e Gee/rE FIA t5'4VEE7T / of a ' /SLC .S t,c.K H.�..E. .�^I t-z o/e, ,ARS/iYS AROPO.S,'D SUBSIIR FAGS SEWA4 E b/SPaS* SyS 7'E'M � iIND AeORO-4 o LOT 4TR.4D1Av::j (�i 11/A n� RoC ,y,�- Rt<�.l�s�- U i LOCATION: R ZoT Z"/VC qM „DR/ VE DES/C.A/ER �c� P CQM,MO tro.5EPq c r BARBAGALL O / 1 / WE.S-rWAR,6 CIRCLE NO . REA 0 �/A/ rte- ; ..� TEL. �2:ly r4 ;�0 '# AES/G AJ DA TA = T YPE aF Bu/e-a/m/G: 4 43,R. .7�f,��/i�/v& GARAGE e CEUAR PLUMB/NU cAC11-/7-/ES 'i a° ; / v ` ` SEK/A(r7E Fe-oW E5r144A rE Z j „ SEP T/C TA,VK : l 5a L a F 4654f)RP7-/0N AREA .tea oc G.�[ . � ! ,c S /r - 9Ca G S • k"• !� \3 2 /t 6 '+ A ZPERCOCAT/OA.1 TE5TS �/ �`Z '�3 '*4 g 3��3�! - •F D D.or� .—. -- g- �-� Z RA i`r` f f.;OTTO�J EGE✓A T/ON / Cs S SATL/.QAr/OA/ Yf��/. M!N iNliV MSN. /Z"ro 9" DROP_ L� c � NI/N. M!A/. M!n/. N. _ Mliv. Ml�v. M/.�/. rb G,. DROP M! l v 1QL-eCO1-r4 TION R,47-E ,� ;Ll�ni.//v. M.��/v Ml,,71Au Mi v /u. 1 ` TEST PITS / DA rE -- --- s-- a ° - -.2 9 -& + E ` � TDP ELEYAT/ON I� �•t•o ,t o 3p'' rop � 3o'r6p + 1 SO/L TYPES Sktb Sar e,. SK b 5a t L c 14 AID S'lc"G R q V,- 1 L WArER TABLE ? GQ qv� \AE1_R ---- \ LOCAT/DN 1V[a f+/R?' fi NO i�/A*Ea r -n mr o.3r$g Y ,. V'' 4LAR1 14 o ante ^ BOTTOM ELEI/AT/ON /ei •O f K P!A. 5- ✓,^o �" t ao ,oG TESTS CSIDUCTED BY : �TOSEv.�•/ J 54PBAGALCo TESTS W1 TNES.SED BY • �' S h� !!v IV- 1,y G,�5//.v,4 s PLA AJ LEES/G--lam •C'/ rE�e/A cS'f-/E E T / OF I ' -- -- g••� SEALED c-7ol yr COR E4U/NALEA17-J • oma. v r a •• - Y• r • . � CAPPED �AlDS U O S S`-O" Z"-�" � �PE2Fa2A�'ED PI/C. P/PE COR EQU/vA4EA/r-� t PAR R-1AL BED Eti/D SECT/OA-1 h ti to 4g.--A = (FOR SPEC/F/CA7-/Oit/S - SEE SECT!DA/ AT LDwEe )2/�AvT) L1,e-s7-e1avr1ov ti - ¢,",9�CA57-I,PO,V, S = ( 1 614Z. e.OAICAEET� SEPT/C TQNlC .-rO/NT5 s=:ons .5EZ:) IDGAAJ /A DT• TO c5'CALE7 f cSELEG7- - �� � t�•Q, 1. �, � � � s.7�o0/OT �CKFlLL - -. _ - ., lv , < v.c. Ila ti o 1. C,eUSHE� s7O�/E • • . 0• o C. �:�. � ,� j�. �, _e a o e •�, e_ o. ,, meq, 8. 1 0 • o o P. {/.C. P/PE O� 0 0 0 0 0 EQc//dAL En/T To /1Z WfisHED 1V GFUSNE[7 STONE O \ wOUBCE lt/ASf.�E� TO MEET A.A•S.N.O. D ,4,BSOPPT/OA.1 5E-,o cSECT/p A/ Pie�F�L E I/ Ai /V i /? BEp PLAti! AAji) SEC T/ONS JUA 11 TOWN OF NORTH AN'DOVEP, JAN Q 2065 / 4// Y3TEM PUMPING R.ECOR.L, SYSTEM 0WNEJ(-j nDRESS SYSTEM LOCATTON ` J . DATE 4F PUMPTNQ:_._.. _ ,�� _._._.QUANTITY PUMPED:...15.x._...._............... .. . . . . . L.bSSPOOL: NO__..C/YE3 Sn 'c .. .. pu Tank: NO. YES v NA PURE OF SERVICE: RUU'rINF..- ' ';MER0EN(')' UbSBRVA'nom: / GOOD CONDITION FULL.'r'U COVER HEAVY oi.twE BAFFLES IN PLACE. RCTs _. LEA,CHPIELD RUNBACK .�. 8XC6381VE SOLIDS FLOODED SOLrD CARRYOVER, _,0T{gR EXPLAIN Sy.urm Pumpcd by ... ...... ;.... i VUMMENTS. �-'UN I'!m'S rKA1 3yhRRBD 1.0 J � �'. '�r!�',4 �•' ��''�t'*� "^ttv'`�ru��a L1'a a.�r� r�..e 3» �.^-�?.�,�� - -�.. � --, A.1 tO , J '. t -,. �-?p`.'.. �� xia` e ti"s'•�•qf 1'r �1.�.' .r'+:rk�' :>.s:..7yt»t -��• .r` t+.. 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DArF l a iC�T7Q�1 E[E✓A T,i w / rl TL/�CA�7oy .N/�/ !/•� a/lv. titin/ a £Ariz i S 5 sK�iv. �1f1A.1 *Vp ,tr/in/. st+ti,v M/Av. M/N. — '� AWA'ro4I4T/OA/ R-47* M'A/ ,/4/ Jfi-A 46-11m. TEST PITS --J&/ z X34 t DA TL ,� TOP L�'GEYAT/Call/ !�cf•a 1 lC. r y''PES Sk b so 1 l- Sw b,3a i L A AID 6 c GR+gvE R�4vEt. � UlATmti'. TA84E . A.►E L t- •` 4DC4 T/0A1 1Vo WR '�R ./�►0 W-4 f-dEA • 7�M�oR�;t�Y r N . kAR14AR 0# ND 807-MM &CoAr //L .,o d W C N MARK 'TESTS CGr ajr-TED $Y : X. A6 4R2BAGAC L 0 , R.S. ta�C AN tV'F- .SP1-�.E.lnf FREE �. ��� TLS W/rA.IESSEd sy : e As /Nrr * oS % a.P a Gr'2 A PiY r6>r_G E/i ivlq _ /uG/NEER00 PLA/V OF�s�f,ti1 �.e�rE/eiA c�iyEE r / of 2 i I I �. 1, �r�� ,-�'�° �' u I TOWN O ' N TH ANDOVER DA SYSTEM PU PINQ RECOKL, SYSTEM (7WNF,R do ADDRESS SYSTEM LOCATION DATE OF PUMPINQ:_ /�-/v? ..�,z�_.__...._QLIANTiTY PUMPED:... CLSSPOOL: NU YES.. SOPuc Tank: NV_ YES NA rURE OF SERVICE: KOU'rINk �EMERUI;NC'1' ObSL'RVATIONS: DEC 017 2004 GOOD CONDITION PULL TO COVER y, HEAVY ORF-ASE BAFFLES IN PLACE. ROOTS LEACKFIELD RUNBACK rF- BXCBSSIVE SOLIDS_..' _ FLOODED -- — SOLID CARRYOVER._._ OTHER EXPLAIN Jy,tsm Pwnpcd by Itf c- r'vic� �-'UMMENTS. f KAN3FERKBL) I-t) TOWN OF NOR1' AN'DOVEP, SYSTEM PUMP Q RECOfZb UA l'F. SYSTEM OWNER.dt ADDRESS SYSTEM LOGAT1oN r�-s fJo- Aya()up- r DATE OF PUMPTNQ: ZZ/p c` �QIJANTITY PUMPED:_._:_/Sa ..._ ....... tsSPOUL: NO�- gS.. S00c Tank: NO YES N^ rURE OF SERVICE: WvrI.NH. �EMERUENC'Y • DEC 0 7 2004 U�sSERVA'flUN9: � � (K*D cONDrrwN 4k . w COVER ✓ �, HEAVY ORP.ASE BAFFLES IN PLACL -- - _ ROOT'S LEACHFIELD RUNBACK 6XC&S8iVE SOL1D3., ,__ FLOODED SOLID CARRYOVER,_.._.OTgEE EXPLAIN sy.tom Pum d b /'vices VUMMENTS. WN PEN'I'S rKANSnKm) ro i i FORM - SYSTEM PLIIPM REC ER/ SOWN of EAD1H Commonwealth of Massachusetts , Massachusetts System Pumping Record vstem wneryste�cation �� Ca C-0 L,) Date of Pumping: Quantity Pumped: tS^ce-)gallons Cesspool: No Yes ❑ Septic Tank: No ❑ Yes System Pumped by: _ License 4: Contents transferred to: Date Inspector Location�6 Nb. �/� % Date NORTp TOWN OF NORTH ANDOVER O?O�tt`•o I•,�OO� fie. � A Certificate of Occupancy $ # Building/Frame Permit Fee $ ^"°" c�' . Foundation Permit Fee $ s�cHus , ,.,Oth-er Permit Fee $ S U Sewer Connection Fee $ ,60 Water Connection Fee $ TOTAL996 Building'Inspector 1' 5 Div. Public Works PER-urr NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. !J PAGE 1 MAP KJO. LOT NO. 12 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONE I SUB DIV. LOT NO. F OCATION 6 In �C ij PNUOR.,PQOoFSES�TOFRIgElSu)�n1N� Romp )solfxx ER'S NAME" !"Iif kK 1. " SIZE WNER'S ADDRESS// BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD ILDER'S NAME /'T ] SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS I DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES ST. BLDG. COST a 0 0.��1 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS t - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BOARD OF HEALTH SIGNATU`Rt OF OWNER OR AU ORIZED AG FEE v � C/ PLANNING BOARD PERMIT GRANTED OWNER TEL. 0055pS YC ,S > fCONTR.TEL.# 19 CONTR. UC.# BOARD OF SELECTMEN BUILDING INSPECTOR `A BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE _ BRICK OR STONE HARDw D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/1 3/. FIN. ATTIC AREA _ N_O B MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS-7-7I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDNIJ'D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 6 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR 1= ADEQUATE NONE 5 ROOF 11 10 PLUMBING GABLE I HIP BATH 13 FIX.) _ GAMBRELMANSARD TOILET RM. 12 FIX.) FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING i l HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC Ist 13rd11 NO HEATING F OFFICES OF: Town-Of 'Y'..> :" - 120 Main Street North Andover. APPEALS ;1 .,N; NORTH ANDOVER 1 Massachusetts o 1845 1 BUILDING (617)685 4775 CONSERVATION DIVISION�OF ., > HEALTH PL,NNNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: (Location of.Facility) Signature of Pe it Applica Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ` N0RT►� / Town of cAndover � V% No. 434 k, v< ` _ Ct��3 D 19v . � o �A E ori. dower, Mass., COCHIC MEWICH V ORATED PPS\ Cl BOARD OF HEALTH Food/Kitchen Septic System . ., , P. ERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT .�ow" A..&.9...r1dr.6• ••••••••••••••••••••••••••y••••••••• Foundation has permission to e*eti Al?0iy1..A........ buildings on .....I.S.4.....AVN.•e*440:A0–.A—.. Rough to be occupied as..../ AF).• 4w./.C....41PAr r....,&0.. .1...:......................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office,, and to the provisions of the' Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough ........ ............ .... ......................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR gh Display in a Conspicuous Place on the Premises Do Not Remove F nal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT 04/06/1997 15:02 5083736611 STEWART/ANDOVER _ PAGE 61 Nar �Ntbver t3.o.H�,. Mr4 rA' naa/a- 17 IMAMMO K 01835 w,wv t c ,ns'�1 L►� ,� ,�q-p � 578..372�-771 mmm or �42?40d REPM FM ww CP s S Svc �eod �j BQnnan fir. ►.sod o?3-7 tri fnn Jane g� )Soo W nd k, vm 16 5;7 t e al 5'F- ldeo g! loZS J3acic �rdQ)C u m • ,d Ign�, f 5`7 O-a 16,*)[q Ovn rOn Jar )a �a- I�--el ghTailor) lgn fsQc� `, 15 Lan re ;mss pec h 744 LGrti A n� �