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HomeMy WebLinkAboutMiscellaneous - 169 BOXFORD STREET 4/30/2018 / 169 BOXFORD STREET 2101106.A-0086-0000.0 Board of Health Let North Andover, Mass ApplicantAiem�J11,11 10 "9, A9 Water Supply Town Welles Approved Date S.S. -� (i Septic System Design A 1P Approved DateApproving Authority IF CONDITIONS+ Disapproved Date Reasons= DWC ¢74 -1`� Septic System Installation Joe Excavation Inspection Date CP /( Jq PashA2 Fail Final Inspection Approved Date Approving Authority _ Additional Inspections (if any) Disapproved Date Reasons Final Approval D A e 14do Approving Authority s✓ North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/106.A-0086-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge 169 BOXFORD STREET Location: 169 BOXFORD STREET Owner Name: MURPHY,KEVIN W ELIZABETH A MURPHY Owner Address: 169 BOXFORD STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 - 5 Land Area: 2.02 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 2214 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 435,000 408,400 Building Value: 248,100 235,000 Land Value: 186,900 173,400 Market Land Value: 186,900 Chapter Land Value: LATESTSALE Sale Price: 100 Sale Date: 02/18/2003 Arms Length Sale Code: F-NO-CONVNIENT Grantor: KEVIN MURPHY Cert Doc: Book: 05279 Page: 0305 http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&LinkId=808628 11/2/2006 Residential Property Record Card PARCEL_ID:210/106.A-0086-0000.0 MAP:106.A BLOCK:0086 LOT:0000.0 PARCEL ADDRESS:169 BOXFORD STREET PARCEL INFORMATION Use-Code: 101 Sale Price: 100 Book: 05279 Road Type: T Inspect Date: 12/10/2002 Tax Class: T Sale Date: 02/18/2003 Page: 0305 Rd Condition: P Meas Date: 12/01/2002 Owner: Tot Fin Area: 2214 Sale Type: P Cert/Doc: Traffic: M Entrance: C MURPHY,KEVIN W Tot Land Area: 2.02 Sale Valid: F Water: Collect Id: RRC ELIZABETH A MURPHY Grantor: KEVIN MURPHY Sewer: Inspect Reas: C Address: 169 BOXFORD STREET Exempt-B/L°/a / Resid-B/L% 100/100 Comm-B/LOW Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 8 Main Fn Area: 1190 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: R1 Story Height: 2 Bedrooms: 4 Up Fn Area: 1024 Bsmt Area: 1024 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: L Full Baths: 3 Add Fn Area: Fn Bsmt Area: 0 1 P 101 S 43560 1 182,080 Ext Wall: FB Half Baths: 0 Unfin Area: Bsmt Grade: 2 R 101 A 1.02 4,794 Masonry Trim: Ext Bath Fix: Tot Fin Area: 2214 DETACHED STRUCTURE INFORMATION Foundation: CN Bath Qual: T RCNLD: 196442 Str Unit Msr-1 Msr-2 E-YR-131t Grade Cond%Good P/F/E/R Cost Class Kitch Qual: T Eff Yr Built: 1962 Mkt Adj: 1.1 G1 S 420 1980 A A ///86 10,400 Heat Type: HW Ext Kitch: Year Built: 1915 Sound Value: g1 S 2400 1988 A A 50///50 21,600 Fuel Type: G Grade: AG Cost Bldg: 216,100 Fireplace: 1 Bsmt Gar Cap: Condition: AG Att Str Val 1: VALUATION INFORMATION Central AC: Y Bsmt Gar SF: Pct Complete: Att Str Va12: Current Total: 435,000 Bldg: 248,100 Land: 186,900 MktLnd: 186,900 Att Gar SF: %Good P/F/E/R: //100/78 Prior Total: 408,400 Bldg: 235,000 Land: 173,400 MktLnd: 173,400 Porch Tvoe Porch Area Porch Grade Factor S 252 W 450 SKETCH PHOTO S 252 Sq.R. W 14 14 450 Sq. 30 jummis _ 10 10 FU O/B/FM 504 Sq.Ft. _ FM { 28 28 67,%Sq.Ft. 520 Sq.Ft. 20 20 169 BOXFORD STREET — Parcel ID:210/106.A-0086-0000.0 as of 11/2/06 Page 1 of 1 Commonwealth of Massachusetts City/Town of System Pumping-Record .� Form 4 DEP has provided this form for use by local Boards of Health. Other forms may be'used, but the information must be substantially the same as that provided here. Before using.this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility. Information 1. System Location: LeftRi ht front of ho , Left/Right rear of house, Left/right side of house, Left/ Right side of building, Le ront of building, Left/Right near of building, Under deck Address C4/Town State Zip Code 2. System Owner. Name Address(if differs M from location) P City/Town v state C ��q I e Ccl, 0 2014 . F Telephone Number HER' E ' B. Pumping Record 1. Date of Pumping Data 2. Quantity Pumped: Canons >. 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? [3Yes 2-Wo If yes, was it cleaned? ❑ Yes ❑ No: " 5. Condition of s m: 6. System Pumped By.- Nell y:Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc I Company 7. Location where contents were disposed: Lowell Waste Water SignHaul Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 i <Lx Commonwealth of Massachusetts City/Town of I RED IVSD System Pumping Record 006 Form 4 NOV - 3 2 DEP has provided this form for use by local Boards:of Healt .T 1tANDovER ecord must be submitted to the local Board of Health or other approving A. Facility Information Important: When filling out 1. System Location- forms the computer.use only the tab key Address to move your cursor-do not use the>retum City/Town State Zip Code key. 2, System Owner: Name Address(if different from location Cityfrown State Zip Cade: Telephone Number B. Pumping Record ` 1. Date of PumpingD t Quantity L � Date Q nttty Pumped: Gallons .3. Type of system: ❑ Cesspool(s) eptic Tank ❑ -right Tank. ❑ Other(describe) 4. Effluent Tee Filter present? ❑ Yes [-'No If yes, was it cleaned? ❑ Yes Q No 5. Condition of System, 6- Sy to Pump n Name Vehicle license Number Company 7. Locati wh ere conte s wer 'sP os ed: 10 S' nit e o auler Date http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect ' t5fonn4.doc•06103 System pumping Record•Page 1 of 1 Septic System Information 169 BOXFORD STREET y Printed On: Thursday,November 02, 2 System ID: BHS-2002-0196 General System Information Latest Permit Information Calcaluted Design Flow. Test Pits Septic Tank Disposal Trench Design Flow: One TWO Capacity: Number: Design Flow Provided: Minutes per inch: Width: Width: Total Flow. Depth: Length: Length: Seasonal: No No Depth to Water. Diameter. Leaching: Grinder. No No Soil Type: Depth: Laundry: No No Hauling/Pumping Listin Quantity Tvpe System Type Pumped Pumped By Transferred To Disposed At Date Pumped (gallons) Routine Septic Tank Todd Bateson 09/29/2004 1500 Inspections: Inspected: Expires: Inspector: Status: 10/13/2006 Neil J. Bateson Passes Comments: TITLE 5 TITLE 5 GeoTMS®2006 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 v 'i. Of NOPT.,h I Town of North Andover HEALTH DEPARTMENT ,SSACHUSt� J 'R CHECK#: of i- LOCATION: ,Bo /d s� ' F H/O NAME: /roc'✓/w ` CONTRACTOR NAME: P///4S1-)/-e— f 6 Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ I' ❑ Massage Practice $ r ❑ Offal(Septic)Hauler $ r ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: f ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $` Title 5 Report ]Q $ © ❑ Other. (Indicate) $ 1 1942 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Ile V COMMONWEALTH OF MASSACHUSETTS fD EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a d DEPARTMENT OF ENVIRONMENTAL PROTECTION a ', 8V TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_169 Boxford Street North Andover_ Owner's Name: Kevin Murphy Owner's Address:_169 Boxford Street RECEIVED —North Andover,MA 01845_ Date of Inspection: 10/13/2006_ NOV 0 12006 Name of Inspector: Neil J.Bateson_ Company Name: Bateson Enterprises Inc._ 70WN OF NORTH ANDOVER Mailing Address:_111 Argilla Road_ HEALTH DEPARTMENT _Andover,MA Win— Telephone 1810 Telephone Number:_(978)475-4786_ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ,X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fai Inspector's Signature: Date: _10/13/2006_ 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. Page 2 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:_169 Boxford Street _North Andover_ Owner:_Murphy_ Date of Inspection:—10/13/206_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain . The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: I Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_169 Boxford Street _North Andover — Owner: Murphy_ Date of Inspection:_10/13/2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require fiuther evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. T 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_169 Boxford Street_ _North Andover— Owner; Murphy_ Date of Inspection:_10/1/2006_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or`no"to each of the following for all inspections: _ No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool No— Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool NoLiquid depth in cesspool is less than 6"below invert or available volume is''/z day flow. No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ No Any portion of the SAS,cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. No Any portion of a cesspool or privy is within a Zone 1 of a public well. _ No Any portion of a cesspool or privy is within 50 feet of a private water supply well. No Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 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 II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_169 Boxford Street_ _North Andover_ Owner: Murphy_ Date of Inspection:_10/13/2006_ Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _Yes _ Pumping information was provided by the owner,occupant,or Board of Health No Were any of the system components pumped out in the previous two weeks? _Yes_ — Has the system received normal flows in the previous two week period? _No Have large volumes of water been introduced to the system recently or as part of this inspection? _Yes_ _ Were as built plans of the system obtained and examined? Yes_ _ Was the facility or dwelling inspected for signs of sewage back up? Yes_ _ Was the site inspected for signs of break out? Yes_ _ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No _Yes_ _ Existing information. _Yes_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[3 10 CMR 15.302(3)(b)] Page 6 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_169 Boxford Street _North Andover Owner: Murphy_ Date of Inspection:–10/13/2006_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_R4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CM15.203_600_ Number of current residents:_4_ Does residence have a garbage grinder(yes or no): No_ Is laundry on a separate sewage system(yes or no): No_ Laundry system inspected(yes or no): Seasonal use:(yes or no): No_ Water meter reading: Yes_ Sump pump(yes or no):–Nom- Last No_Last date of occupancy:— Current-COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203):,gpd Basis of design flow(seats/persons/sgft,etc.):_ Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):— Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped last year,owner_ Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1500_gallons--How was quantity pumped determined?_Measured tank Reason for pumping: Inspect tank&tees_ TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool_Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe):_ Approximate age of all components,date installed(if known)and source of information:_16years old,7/11/1990, as built plan _ Were sewage odors detected when arriving at the site(yes or no):_No Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_169 Boxford Street_ _North Andover_ Owner: Murphy_ Date of Inspection:_10/13/2006_ BUILDING SEWER_X_ (locate on site plan) Depth below grade:_24" Materials of construction _X_cast iron _40 PVC_other Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.) _4"Cast iron thru wall,3"PVC in house, no leaks. SEPTIC TANKS:—X — Depth below grade:_12"_ Material of construction:_X concrete_metal_fiberglass_polyethylene --other(explain) of Com liance es or no : attach a co of If tank is metal list age:_ Is age confirmed by a Certificate p (y ) ( copy certificate) Dimensions: 10'x 5'x 4' Sludge depth3"_ Distance from top of sludge to bottom of outlet tee or baffle: 25"_ Scum thickness:_4" 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: 17" How were dimensions determined:_Tape Measure_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc Pumped septic tank.Inlet tee ok.Outlet tee ok. Depth of liquid at outlet invert.No evidence of septic tank leaking._ GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_169 Boxford Street _North Andover— Owner: Murphy_ Date of Inspection:_10/13/2006_ TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_X_ Depth Below grade 36"_ 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 leakage.Evidence of carryover,pumped d-box to clean.D-box cover broken,replaced it._ PUMP CHAMBER:_(locate on site plan) Pump in working order(yes or no):_ Alarm in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):_ Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_169 Boxford Street_ _ North Andover— Owner: Murphy_ Date of Inspection:_10/13/2006 SOIL ABSORPTION SYSTEM_(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: _ leaching chambers,number:— leaching galleries,number: _X leaching trenches,number,length: 2 trenches 60'long_ leaching field,number,dimensions:_ overflow cesspool,number: innovative/alternative system Typetname of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):_Soil ok.Vegetation oL No sign of ponding to surface. CESSPOOLS: Number and configuration:_ Depth—top of liquid to inlet invert: Depth of sludge layer: Depth of scum layer:_ Dimensions of cesspool:_ Materials of construction: Indication of groundwater inflow(yes or no):_ Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): I PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 169 Boxford Street_ _North Andover— Owner: Murphy_ Date of Inspection: Murphy_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building Garage House Driveway Water Meter- A B Septiclank D-Box A to Tank=32'3" A to Boa=3416" B to Tank=26'6" B to Box=5419" Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:_169 Boxford Street_ _North Andover_ Owner: Murphy_ Date of Inspection:_10/13/2006_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_5110"_ Please indicate(check)all methods used to determine the high ground water elevation: X_ Obtained from system design plans on record-If checked,date of design plan reviewed:_3/16/1990_ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: — You must describe how you established the high ground water elevation: As per design plan_ Summary Record Card generated on 10/20/2006 2:17:11 PM by Lisa Warren Page 1 Town of North Andover Tax Map # 210-106.A-0086-0000.0 169 BOXFORD STREET MURPHY, KEVIN 169 BOXFORD ST NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 2.02 Acres FY 2007 US Mailing Index Name/Address Type Loan Number Active/inact. From Until MURPHY, KEVIN Payor 169 BOXFORD ST NORTH ANDOVER, MA 01845 US Account Maint. Account No Cycle Occupant Name Active/inactive Bldg Id. 10014.0- 169 BOXFORD STREET Last Billing Date 10/16/2006 3170644 03 Cycle 03 Active US Services Maint. Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 96.48 /1 US Meter Maintenance Serial No Status Location Brand Type Size YTD Cons 19554415 a Active ERT HH METE METE w Water 0.63 0.63 0 Date Reading Code Consumption Posted Date Variance 9/12/2006 367 a Actual 27 10/20/2006 -14% 6/14/2006 340 a Actual 34 7/10/2006 5% 3/8/2006 306 a Actual 25 4/17/2006 _1% 12/22/2005 281 a Actual 31 1/17/2006 0% 9/20/2005 250 a Actual 33 10/14/2005 -4% 6/13/2005 217 a Actual 26 7/15/2005 4% 3/30/2005 191 a Actual 37 4/5/2005 -3% 12/9/2004 154 a Actual 25 1/14/2005 -9% 9/27/2004 129 a Actual 41 10/8/2004 _1% 6/10/2004 88 a Actual 22 7/30/2004 9% 4/13/2004 66 a Actual 41 5/17/2004 0% i Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 169 Boxford Street, North Andover Owner: Murphy Date of Inspection: 10/13/2006 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. Neiq1teson Bateson Enterprises, Inc. Town of North Andover, Massachusetts Form No. 1 r1ORTFI A BOARD OF HEALTH 0 1�SLED /6�'IrO � . 0 u t^ APPLICATION FOR SITE TESTING/INSPECTION QDQA TED �SSACHUS�S Applicant -- r NAME ADDRESS TELEPHONE Site Location ` Engineer ' NAME ADDRESS TELEPHONE Test/Inspection Date and Time ' CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit o,4/0/ D.W.C. No. 474 V C.C. Date P4ft-. Permit No. S f+ i f' tom. r r i 9GF k N LOT 2 f1 z VI_ F71881 sF '-1 EX►ST 71a10' ' 3 Typ Go D-Q®X 0� L. i OOH _ FORD -00 I , "THIS 1S TO CERTIFY THAT I HAVE INSPECTED TIIE CONSTRUCTION OF THE SAID DISPOSAL SYSTEM LOCATED AT LOT -.— aW'0rPV 120, . N. AIYDOVGI? MA. THE GRADES ARE AS SPECIFIED IN TIIE PLANS AND SPECIFICATIONS "DATED HARCHIONDA & ASSOC., INC. GRADES ELEVATION TO TOP OF PIPE gPnut MARC jlo?t1A DWELLING: TANK IN: TANK OUT: 155100 D—BOX IN: 154. 6lo D—BOX OUT: A 5-4.47 P' DA E I3 IT-4.46r C >m, END OF DISTRIBUTION AS BUILT SEWAGE DISPOSAL LDM- A �s4,r� SYSTEM PLAN H 154.13 IN N. Al1l000, Mrd ( LOT - — X90-XFD/r'0 PP.) D AS PREPARED FOR ffi,1, SCALE 1"=40' DATE HARCITIONDA & ASSOC., INC. ENGINEERING AND PLANNING CONSULTANTS 80 1(APLF. STREFT R F.D. 18 STONEHAU, MASS. 0?180 VANCHESTER 1111 03103 (617) 438-6121 (803) 43-1-8725 •.. {py:-v.,Y -•,•...,..c cc..VtT.W�:t:lfdllYla••_•.�•.�.n:'.:{cthl".:L'.c--.•.•,:- .--• --.:.-:.;:N3:tiuti,l.::,;: ue'<eHnc..: I Address 2 Q Fob P '9?- Title of File Page of Date File Open: Date fele closed: Doc Document/Action Title Date of Refer to other Purpose of Documeant/Action and note action Document/ document/ Num. Action De artment Board of Appeals - Board of Health - Planning Board _ Conservation Commission - Building Department � , CHECKLIST FOR PLAN REQUIREMENTS FOR SUBSURFACE SEWAGE DISPOSAL SYSTENS TOWN OF NO. ANDOVER BOARD OF HEALlN MARCH, 1990 1. (Suggested Scale: 1" = 20001 ) A. Locus identified. c, B. Streets and names within 1/2 mile. C. North arrow and scale 2. (Suggested Scale: 1 " = 20,A. > Lot to be served» its dimensions and area. B. Fronting street. _�- . North arrow and scale. ^- D. Assessor' s designation. ~ E. Abutters names and lot numbers. - F. Easements. - G. Property lines. ....................... Footprint of proposed housn to be served showing ~� garage (attached or detached) . %. Where applicable setbacks to house. ~ _J. Number of proposed bedrooms. ....... '...........K. Location and type of material ( if known) of driveway. - . Water service well. well. Location of -- ~ ...........---N. Location of deep observation holes arid percolation tests. __..... _O. Existing and proposed contours. _p. Bench marks (2) and ties to prop,-)!-,cd systn./ leaching facility from bench marks or otl`er permanent physical features (stonewalls, etc. ) _... Location and dimensions of s�stpm (�nptic t�nhv pipes and leaching facility) including the reserve '/ area. // ' Profile and seotion arrows. Location of any streams, water bodies, surface and subsurface drains, known sources of water supply within 2(}0-feetv and wetlands within 100-feet ( locate wetlands» specify type of' resource and show \ 100-foot buffer zone line if: applicable) . Erosion control devices as VE-CII-tired by Con. Comm. , Board of Health or Planning Board witti detail arid description of device proposed. ' i 3. '^� ` ~ . PeYcm2ation rete used for design. B. Soil log results - designate various strata depths and descriptionv depth to ledge and/or groundwater if encountered. ^ . Date of percolation and deep hole tests. - . Number of bedrooms. __�__E. Calculations for leaching area requirements. 4. Pr file of Svstem (Suggested� �ggested Scale: 1 " = 41 ) . Finished floor of house. Invert elevations at ^house, septic tank ( inlet 8 outlet ) v and distribution box. If applicable for pump systemsv inlet and outlet of pump chamber and pump bloat switch settings with supporting calculations. Length, type and grade of pipe and 1pngth or leaching facility. +~ Elevation of ledge and/or groundwater. ~ Elevation of bottom of leaching facility. ~ Existing and proposed grades. _____ Slope (breakout ) requirement and calculations. _RZj-1H. Scale. 5^ (Suggested Scale: 1 '' = 41 ) Elevations of various components. _-M-,B. Existing and proposed grades. __ *^_C. Typev dimensions and stone and system components specifications. . D. Elevation of ledge and/or groundwater. �7 ^ E. Elevation of bottom leaching facility. �� F. Dimensions. ----��� . Slope (breakout ) requirements and calculations. 'Aa_H. Scale. _P. Owner' s namev address and phone number. �-_B. Applicant' s name, address and phone number. __C. Engineer' s name, address and phone number. The designer should indicate any notes or special conditions peculiar to the site of interest to the Boardv Installer or Owner. Plans should be dated. Any revised plans after the initial submission should show a revision date and abbreviated explanation of the revision. _[Y_^4F. If a pump system, type, make, modelv operation head and pump rates should be provided. All required alarmv power and float switch data should be � provided for review and approval' � i i I C System components (septic tani�, D-bo)c, etc . ) details should be provided if other th<-1n s,t,indard as required from IOCAl st►ppl ir► ' Componevtt spec should be indicated somewhere on the plans for standard items. Reviewed and r•econ►mended by: _.._.........._ ..............................._.........._...... .... ................_...................... ..........._............ . ............... .__.. Dat REVIEW FORM FOR SUBSURFACE SEWAGE Dic,3poc--)nL SYSTEM PL(11\19 TOWN OF NORTH ANDOVER BOARD OF HUILIH OWNER NAME: 0. ..... ........... kl.t�........ .. . ... ...................... ADDRESS: PHONE: APPLICANT NAME: .......... ........................................ ............. ......- ADDRESS: PHONE: NAME: ADDRESS: ...................... ........ .................... .......... PHONE: 7 3 z PROPERT .. PLAN DATA ............................................ ASSESSOR? S MAP­­­­­.............................LOI......... STREETLON DATE E ..... ..... .. . ... ..........r .R..EV-I-.E-.W--C-O.,M.M..E.NT-S. CHECKLIST DEFICIENCIES... ............................................ ................................... ........... .. .................... .............. .............. ..................... ....... ................................................ ........... OTHER ............................................................................... ............... ........................... ................ .. .........-............ ...................... ................................ RECOMMENDATIONS RECOMMENDED DENIAL——— —. ..... .................. .. ...... I REASONS (CONT. ) RECOMMENDED APPROVAL CONDITIONS/COMMENTS i I i I . / . / � � , / ` NORTH ANDOVER BOARD OF HEALTH � LOT: SEPTIC SYSTEM PARCEL: INSTALLATION CHECK LIST MAP: ------ ' ' O.K. , / 1. DISTANCE TO: ' a. Wetlands b. Drains r�. Well -~~ F�// /�� �^- ��-~ �� ' . . ^. ° _- ^�;=J^~^ , 2. WATER LINE LOCATION � ' . ZS. NO PVC PIPE ` 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 Ends d. Clean Double Washed Stone ' 7. LEACH PITS � an. Dimensions b. Stone Depth c. Splash Pads d. Tees ' e. Cement Pipe To Pit f. Clean Double Washed Stone ` ` SNO GARBAGE DISPOSAL � 9. FINAL GRADING INSPECTION � 10. BARRICADING COVERED SYSlEM ` 21. AS BUILT SUBMITTED a. Lot Location ~ b. Dimensions of System c. Location With Regard To Perc Test d. Elevations ' e. Water Table ` . ^� f TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: 04 2 s 2001 SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) (, Jk6va ' . �S�- per- �Q�s-2 DATE OF PUMPING: C 1 ^t QUANTITY PUMPED �� `� GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: `� TOWN OF SYSTEM P PING RECORD RECEIVED DATE: '� �� OCT 19 2004 TOHEAOLTHD PART'ME NTaR SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of house) V vk ouS� 4�� DATE OF PUMPING: QUANTITY PUMPED : i; 5 nC� GALLONS CESSPOOL: NO YES EPTIC TANK: NO YES V//— NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACIOULD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.L.S.D Lowell Waste OF HEALT- TOWN OF U"` s NOV 1 4 2002 SYSTEM PUMPING RECORD DATE: _ -0 a SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example:left front of house) DATE OF PUMPING: ( ---C� QUANTITY PUMPED : GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES C 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: Septic System Information 169 BOXFORD STREET Printed On:Friday, November 03, 2006 System ID: BHS-2002-0196 General System Information Latest Permit Information Calcaluted Design Flow: Test Pits Septic Tank Disposal Trench Design Flow: One Two Capacity: Number: Design Flow Provided: Minutes per inch: Width: Width: Total Flow: Depth: Length: Length: Seasonal: No No Depth to Water: Diameter: Leaching: Grinder: No No Soil Type: Depth: Laundry: No No Hauling/Pumping Listing Quantity Tvpe System Type Pumped Pumped By Transferred To Disposed At Date Pumped allons Routine Septic Tank Todd Bateson 09/29/2004 1500 Inspections: Inspected: Expires: Inspector: Status: 10/13/2006 Neil J. Bateson Passes Comments: TITLE 5 TITLE 5 GeoTMS®2006 Des Lauriers Municipal Solutions, Inc. Page 1 of 1 Commonwealth of Massachusetts City/Town of System Pumping Recor .:7T`EIVED Form 4 DEP has provided this form for use by local Boards of Ht alth �Other f rms may be used, but the information must be substantially the sam .that proy A*@V re using this form,check with your local Board of Health to determine the fo th Pu ping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: forms on the computer,use only the tab key Address to move yourig �J. - cursor-do not Cityfrown State Zip Code use the return key. 2 System Owner: Name ISI Address(if different from location) City/Town Staten ��. 7��e Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes Ej-Wo If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. Systern Pumped By: t Name Vehicle License Number Company" 7. Location a contentversposed: Signature(of u Date t5form4.doc•06/03 System Pumping Record^Page 1 of 1 I-LCommonwealth of Massachusetts RECEIVED w City/Town of NOV 2 5 2008 a W� System Pumping Record Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: Left front, left rear, left side of hous . Right fron right rear, right sid of h us forms on the computer,use only the tab key Address to move your cursor-do not use the return City/Town State Zip Code key. 2 System Owner: H op Name Address(if different from location) City/Town State ip de Telephone Number B. Pumping Record 1. Date of Pumping Dade, 2. Quantity Pumped: Gallons 3. Type of system: El Cesspool(s) Septic Tank LD Tight Tank p Other(describe): 4. Effluent Tee Filter present? F1 Yes 0- 0If yes, was it cleaned? 0 Yes L! No 5. Condition of System: t'01AJA �nciv- 6. System Pumped By: Neil Bateson F 5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Loc * ntents were disposed: Q.L.S.D Lowell Waste Water a igna ure of H u r Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts City/Town of REC I a System Pumping Record Form 4 OCT 19 ZU11 �M DEP has provided this form for use by local Boards of Health. Other form mqy�g1p@p91���1LvTER information must be substantially the same as that provided here. Before our local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left front of house, right front of house, left side of house, right side of house, Left rear of house, right rear of house, left side of building, right rear of building, under deck. P S—f— �) C"r-r7'4-cA - Cityrrown State Zip Code 2. System Owner: ILI Name Address(if different from location) City/Town State t Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) ['Sept ank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes Ej No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of Sy tem: / ✓✓L,'�� 6. System Pumped By: Neil J. Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc. Company 7. Location whey contents were disposed: G L.S D - ow,ell Waste ater Signatur o au! r Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts FRCi3 City/Town of System Pumping Record Form 4r : atvi� , DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Le fight front of houP,, eft/Right rear of house, Left/right side of house, LeftRight side of building, Le Ight ron o ing, Left/Right rear of building, Under deck Address Cityrrown State Zip Code 2. System Owner. Name Address(if different from location) I City/Town Telephone Number B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes 0-No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition aof System: ►�J o l�-�C_J 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. 7G. io contents were disposed: L S. Lowell Waste Water Sign a Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1