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Miscellaneous - 170 Liberty Street
_ .� `� � . I � ' Q L �(..-� W� `1, v J \\ I` l sill II 1 1 1 I f '' I 21UR'D °F H&o J t - 7 t-�--r 1 4LI&2TY ST. ,- Citi 1 1�(C- jj Lp u- ,�P oyCD 1YJTC SY STEXI-- yE`t 6A _ . . OL-5) U. V DI,�PPR�V�p COn�p(1�G�JS , DA) k-)SlPt��6 1JvS TAU TinAJ CX4V4T(UJr- Q ii�SS T� F�4S �� H0o6 I-o TA r L1 PryS5 � PoJL 1P OT6 Ap)'-r4)JjA)G Auj-HDi?i / i NST U.C- 4D�iT(p�AC, DIS�J P1'I�OvED D,a rC I��✓J`.A NS" , FkA L /J PPFZVAL APplwIJ6 /6u iHog i �'/ i{re jl't!q!�@7r•'t}a�,I '�I 'r,r.'�i i '_1. r� . y ' i ~ 14 TOWN-OF NORTH ANDOVER ` SYSTEM PUMPING RECORD 3 �•34'r',���'Q�vtirf r,�at.�'�'t+t�`#tya: lrr r',; ' v� t � •t F �t , )PAM. ��yI Ny1�R..�1�, ae Yi:4�p(la r' n I I~6,•k�a���9 v � � r t, �,t S STEM OWNER&ADDRESS SYSTEM LOCATION (+example: left frout'of house) 04 I tt NNI �it '1t1 ��� F�R.if���k xhft i��in`��}�t.�'f�!'k���4� 'gyral"' •alit ,v4.: r..4r,gd.r7t",�!c.r� '"`' C�' ��:.` >< i ....,. .. .,.. . - N ' t,xti } QUANTITY PUMPED GALLONS t �3s1 It" Fit i�llu c'I41 il>� I r '''� ';!h ._ A"' ., t _ .';• � ;�. .. t ! , ESSP,OOL, NO ' SEPTIC TANK: NO YES_ NATURE OF'SERVICE•i ROUTINE EMERGENCY 4 f" "•ti+ .. s 6v v ' r rr 43�t AT -"GOOD HEAVY G NDI1'ION' FULL TO COVER GREASE C BAFFLES IN PLACE . , ROOTS .. LEACHFIELD RUNBACK t : S EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) a ittif� t j lir:��+ CtiftL'SIid �t i34 r t d���7�,,}CiV�1 i��1 ![ MIPEDt //�•� ' Y�4 'f i \71 Y!i y,{V� 14�JF�R7 I L N M' ��• FV '��� _ - 0�`i11lj�1 4�i'h.( :v`"P �°ti�k+' ��'("4t�"h•I'+rl�Y".P,'�t :-��p'�i its ,1 --7-777777 - ..d !h�'1>c lire af:- t Z• 1 Y ., .' _ OF sa ?.__a_ it tt� RIA 1 FT 1 elA C.Ji Rr 4 4t1i cuu, i r 0 , j����t],�,�•F�{�i,St�i7S��br����15�1�'I�t�i�'�(� i - 71{yf �.�4. k ' �'� �1�1')1'Y v r NIP`t '4 , I!. FORM U TOWN OF NORTH ANDOVER j, LOT RELEASE FORM "I SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) C '� STREET APPLICANT r-- r � � C � PHONE DATE OF. APPLICATION TOWN USE BELOW THIS LINE PLANNING BOA i DATE APPROVED tOWN1PLANNER I DATE REJECTED CONSERVATION COMMISS ON DATE APP VED �J CONSERVATION ADMIN. ATE R CTED I �I, BOARD OF HEALTH DATE APPROVED HEALT SANITARIAN DATE REJECTED s DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT �Q,Qa �at ( � ,�, ,� a113 u.> SEWER/WATER CONNECTION/S/ A'IrLAIFP/_IC oU J WC-a- 1! 22 2 Sz�7,9l TJ4) 6-2 F' C'Q��,�e'J // C U7J/��GaG (,�/ ��1 ��CC cr�1'� OG'r' �� �Q FIRE DEPT. i L 'Ac/11. elt /�q�%G��})% 1 uJ� Q,( �i�Jal�fr' )9-'n-,;i4' ZE 9 dF �c,S t /..1c te-�,fCC1 e4e47-uel�t RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. I Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH j 3� 5. .6 °� /1 19 IN "`G! ,r o w . APPLICATION FOR SITE TESTING/INSPECTION SSACHUS���� Applicant fJC 12,16 171 NAME ADDRESS TELEPHONE Site Location 1-71 i Engineer NAME ADDRESS TELEPHONE r ' Test Inspection Date and Time , CHAIRMAN,BOARD,OF HEALTH Fee r✓�y Test No. •���5 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. /` i Ill ALLS Wilmington Pump Supply, Inc. . PUMPS ARTESIAN Est. 1936 SALES&SERVICE EXPLORATORY Water Supply Contractors TURBINE REHABILITATION MUNICIPAL - INDUSTRIAL CENTRIFUGAL TEST WELLS 639 Woburn Street-P.O.Box 517-Wilmington,MA 01887-0717 SUBMERSIBLE GRAVEL DEVELOPER Tel.Area Code(508)658-9111 SEWAGE GRAVEL PACKED CHEMICAL i7 -i L, Z'e��y s �. rr s Trt #a4-E s' P7/�h4L K / p�pr0 X 'Y�71f l �,� a-1 4/I s c 4r-k JU S Si1 kt 42 �6 i� At r a/ e A* , v� r ' T r w 4it r-- Wcw s ,9Y -4'"Ie'e s C) 6S vc A s LS -rz t4es�C�t�` c�tLl, / 70� « �, ,� ll r S2 ,'- LZr � .s V1 J rUe,1c -� STEVENS ANALYTICAL LABORATORIES, INC. 38 Montvale Avenue, Stoneham, MA 02180, (617) 438-6114 FAX (617) 438-0173 RAFT 11 SAMPLE DATE: 4/02/91 DATE RECEIVED: 4/03/91 ON PUMP SUPPLY X 577 ON, MA 01887 (?� MP 17 �% 171 LIBERTY STREET, NO. ANDOVER, MA E'T'HQDS FOR THE EXAMINATION OF WATER X '6TER, 16T EDITION: 1225. R - REMICAL ANALYSIS OF - hTER Nla WASTES,_ 79-020 . REVISED MARCH 1983 . a......,-........., CONCENTRATION Total. Coliform 0 per 100 ml PH Chlorides mg/1 Hardness mg/1 Manganese. mg/1 Sodium mg/l Iron mcg/1 Nitrate mg/1 Nitrite Mg/1 COMMENT: Authorized by: S Alan P. Stevens, aboratory Director 1 2'd T -DLII `SBU-1 SkGA31S TS'-0T T6, OT ddH i M� STEVENS ANALYTICAL LABORATORIES, INC. ;r 38 Montvale Avenue, Stoneham, MA 02180, (617) 438-6114 FAX (617) 438-0173 b"AFT - LABORATORY NUMBER: 12441 SAMPLE DATE: 4/02/91 DATE RECEIVED: 4/03/91 SUBMITTED BY; 'WILMINGTON PUMP SUPPLY P. 0. BOX 577 WILMINGTON, MA 01887 SAMPLE SOURCE: WATER SAMPLE JAB RICH. 171 LIBERTY 6TRE4Tc NO. ANDOVER, MA REFERENCES: 1) STANDARD METHODS _ — FOR THE EXAMINATION OF WATER AND WASTEW6TER, 16T EDITION: 1295. 2) METHODS F9 FEMICAL ANALYSIS OF- WATER AND WASTES , EPA1600/4-79-020 . REVISED MARCH 1983 . PARAMETER CONCENTRATION Total Coliform 0 per 100 m1 PH Chlorides mg/l Hardness mg/1 Manganese. mg/l Sodium mg/1. Iron mg/1 Nitrate mg/1 Nitrite mg/1 COMMENT: i . Authorized by: Alan P. Stevens, aboratory Director i 2'd T "OHI `SHUN Sf•13A31S TS:GT TE., CST ddU i r p Tl-+t-r7�•x �x pffil i y t i F�y�yri �� 1,t� r}tix�h� '� zv`��d rt ry^'�Lxre'u n.+" �t ry��� 3��r'e�c e � tt ZC� 1r r •r i��Fj n�'i� 11l r 't a }Yow. �.�''{"'tiF`.>a+. "lf"S) v4 zr i- r� a: 1'•M• ` 4 1 4,ii �P . w t;rist t<+2 ii l £v� �T r k "j,$ ' �t4) a k N J1p Ja i,� t��Y-�Zr.�'a yt5. i0 N �,pC?;�F'y�es:� t e R 7 A <y,' ft 4 p r4Ilxtiarg4t4Jand� � �'°t' ut y fy'�#"ppyri�r)ti�x r��'.A'JAvj{rir AY~i"Pi"`�cr r p�y.r 2 e�r,��xi�r-Y'°��p�+ilt{�ferH3y�r�� ♦ �fsr tt�.r/ I ... Viq, r cf 7k t l�.rb�- 4�•l� rx �' `• x � •'� a + y'• i' Y t J` y, �4 1� !,I 1� vtF *�"P1 ' h Y rc A 1 tV+ 2-rri�''&t P #"1x i w� : a ti�xx< -'4 FEE NUMPFR �, t ,+y sRMrrs $25. 00 ' a"v. :f';��r� rS �Y—J"r y;, TOWN A'of NORTH ANDOVER ........% ', r �x ........... ��i. .. ..° .... Thie;,is,to Certify, that .�l-�er�_•-4pI£.•�.�. Cm % , NAME ov4e ...Street.....Georgetaw- 1i ,MA .......................................................... 253And �4-w-. ADDRESS t f • IS HEREBY GRANTED A LICENSE Eor Well Permit............. 2� .... .......... t ..-_._.-.._._-.- ,...'� .................................... { ...... ........................1 .�. ....................._.....__...._.._•_--......_._._.....--_.....-. - n .. ..._. ...... ........................................... license is granted inconformity With the Statutes and ordinances relating thereto, and Z t p }� t s ex free per-emher...31, .19.9.1...............unless sooner si nchd" evoked. �la �h 29 .19...91 Y...:-.� u•�- ` 'Z •: --- Q .. ..........................------ z,• . �J I$ FORM 488 ' YHOBBS 8 WARREN. INC. 4 s u xi�y. I o }3,n+!yrnt 01![5�^gii..I..ppr�yt,r�,�yrn 4�TY.j1 c5"+•}t�4�,�!tJYsY;i1y rMi7 P�.f�ti.tj:.:;�;�;1°�'3'�!'^tYY„t'fb'^+7y,��!,,�,.N,h/l'A��4&J�!iwi,tr;t�"om,:,yfFx•5lfr 3R, k� 1A.iS44kw. 1, 311,ft 1SS s 14& vA- ,5 . c C5 yi,` �y.3,�,, kd�`' 'xlCy'. s#d..{,S�F , ''C'd'r uR J ^�•i. '1, }� : ! > ..f .t GyK; r'°..J ..y f.0 N S� d U � .N1 1Ej f41 i y+ ✓.eb'f ..ph� ,,n W f R r r h�� / krS fJ r If�'f �. .�. i < n . f yr s t3 ti 1r k cN5°` ,yF i .r rC rr / s '�'•a?Y, ttd 9"rkhe •'-x c`t `3�J-,;,Lxr'F C l a.,tl 4 S`�` - ? - 3 - }, `Cyd±�Y�ltf:.lpyflC �k'<st1��.J,�ItLR�/;I� 7 ';'�t _y.,lq �+ �14�j_..sJ"SkrY 'J.�+ l tk7agtfiA,4A''+j7'A 1i 4'i t ;�` F A" J;4t a i 5 r ! r 1 f s.yyUirt{etL 4j4[, h�,P 5 M. 1 1� a s�Y} - ('�I �NI'a '..x _ 5 , h , f o v ki of Y t 'at t f r:.Fkw 1 - ' V, t I+ ! ' ' a �t4 ry ' ;� '� rJkxwr � t4�{fiyu >e N�,p.'x� Yfi y�y ',�, tory'�5..�'�4 F . sxr 1. RdhFs.S k;tw (55.? Si "�..y �` ', 4 1 a! a ti 1 x� #. t' ' 3 y ¢:i +.7r FEE NUMi:Fl..'' �3z � '" .THE iCOMMONWEALTH OFuMASSACHUaETTS` $25. 00 ,oNORTH NDOVER ..TOWN ..... .... .. 9 `c•k15 u'4 -t °` J� 'a�' Vi 11(i r n. 4 :t KskSy+�n' v rtr"�z ° .' " x.... ;, .......................................................... 1R ? Th<s is to. Certify, that �G'Xs�...hie�.]...CII.......... ��xxF NAME X." t f r tiF ¢ I .' K r t 253 Andover. Street•,•-•-GeorgetQW-rL, ,.MA................................................. t { 1 n ADDRESS IS HEREBY GRANTED A LICENSE kWWf For; •� £r Well Permit....... �Iae . E� ............ ......................................................... ......... t{.g ................................._.............._.. ..... w a ,. ...................................... fir:Th►s license is granted in conformity witlh the Statutes and or ances relating thereto, anfl t 7 a g 0p ex iree D�eGelnher--.31 19.9.1...............unlesst sooner tit nits evoked. ,ry� r Y3 f�4< ;: (t f 6 '. r 19...91 : .� u.d . 't'`-.t.�Ll PP .............................. FORM 498 '�,YHOBBS a WARREN, INC. (v\ qtr. BOARD OF 11IrAL'1'1l Town of North Andover ,t•tass . .rmi C i#_ _ APPLICATION I. WLLL & I'UhIP PLRt1I"f ,plica tion .is hereby made for permit to drill a well (X ) . Application i-s de to install ( ) a pump system'. . . Lot . . . . . .. lation Lot ation : Address Address Tel - � �j�•dNC �"' s, `ll Contractor v/EI�4 60,6-&C6 Address Imp Contractor cV�w��;�, Add r c s s u • p _5'i vt i�v „ "I e 1 �' ���i _ at time of pump test ) ILL CONTRACTOR (To be completed I Well pe of Well used for - Size of C,as 'iameter of Well i.ng casing; into pth of Bed Rock Dept L'eci IZocic :s Seal Tested? Yes (_) No Date of Testing; pth Well Ended in What. tlaterial pth to Water- ., a ter_ . l'cr Hill . for It hours Delivers Gals 'aawdown feet after pumping hours at: Gl'M I.te of Completion Sig;nat:urc hell ( ontractur •X X�:c:Y is:. .. .r it.. .r'r:,sr�1c:r:'::;;;::'t.ii�k:c is sr sr:.:r:. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Imp INSTALLER (To be'- filled in before insCal. ].ati.on ) Type Used :ze & Name Pump -- - ------ - - -- i ,iter Pump Delivers GPM Size of Tal le-_ .pe Mate Cyst Iron l _) G;Ilvalfl ed tial Used in Well : ( _) 1'lr� stic ( _1 ::11 Pit (_) or Pitless /Adapter ( _) sleeve used Lo - protect pipe? Yes (_) 110( _) hype or I'lainc �cll Seal ►s slee , Ite �4t4��i4��4�r�4J��4�4ti4�4�'r�'r�'e►'rti'r�`r,'r���,�';�;��;'��+C','c�.'';:��L US .Cc� ��;��fiJr#r�t*'I — ',' ate •later analysis . repor-t 'submitted to o Board oL I(ea1 r}ate release given tD owner of record & 10-09 . 11e�� lth Inspector -- 7033 E JAMES F.VIRA D-B-A VIERA ARTESIAN WELL COMPANY 53 117 253 AND STREET,ROUTE 133 113 GEORGETOWN,MA 01833 19��/ (508)352_8586 , Sr PAY �— TO THE F �c7 1J �� r'/CSO DOLLARS ORDER O o Shcawmt �uu f e ywwmut Atunglon 'cam � 76►,65 ?u■ FORW . a■00703311' �:0LL30LL70�: 32 3 _ - p. _ y r - U 1 t _ e �,tom,,✓ 2 �d�� U ���-�s { � � �., � - a �'�i414K x"' z'e���yw�.aeSn�^w k.lr.,eti.4 6� ,�}',�, '��y-�1�t'�' �+��'�� �•f'b�V� g����`"a't�+k-��,�'�'�y.+k�� .t"E. � - .. '�:..:._........_ ��,-+,�o:.....e...,...ev.... ...:....«..� i.a.-rr�^"4�_,.�' yrs�r. #«�y+aaF^,�`y�i� x't .`Y, "„sf�n�J•';'�5� e>""' "� .�.T' _ _ - I 71, I _ NY -- -- �,_7 --- -- - G 'tel Q_ ;c 7]"TI j 1 omT -/ t Ic }1 1 M 1S Ilz —Al } ! h I ✓� 1. -77 it I Kt _ 2— 1 T* osa lot I I i t I I I I ! i j l Cy idl I I I I I I 'I � I I I I ! ! I I I I i i i �✓ I I I i 1 -.� � �� ��` ♦ tom. �'y R 'k y�� - '4, .wa Pk A - i I i ^ I ' �y�;_�i��rvU ���•�j1 �77�1 I 3 ���t♦r, ilti,Ky 7 1r pJ Y {j'190 mt : { r k i x' W,1-I )L �g� F Y i'4y4t 4ky �` ` k t•6, y '77 -. 1 ' ( L �, r' •;^ ry f ,J 4 . e.,.- S, S C •. .w i {, I i - .'i, $,r y 4^4 �{ � ��.• _'.Y x9"v "hv � rt i..<r*i' .� ✓4;�.e{ " ff 1 x r Ort r. i 1 t xiFi yµt3 x,� '� ;.. •v 3 - ""'ak •� s ,.'a !�}.'k 2irx?5`'ri. �4e. ` ,;�% i •.s fill �, e • , �,}'•�. _ "�'r..l>r .r"t:._..1.:.a�a.`:�V',. §'s�> 4a.-"; �aa+.�,-,� • f 4 I F,• i i � � I � i ! I I i _ � 1 Y. ----------------- �`'' "='moi �-�`•-- �4r✓!�� �'�Z� -_tom-C�.. -. -- -- ------ ! - --- - 19n/ t 1 j 9 C oma; b r v)-- vv,e'?e�� -t4 a-�N�l kJ-� `��`� .-"- -..__''`✓$. --f*�-'./?� _/.�I ---- pROPosEC Sue Sa a -Ace .SEwA y 6 ��s s4L SVS rE,4't .cam�.: '�_s� sy &' ALE 'N OT OWA14ER f bLt a � .=* t� v O1-�� " 1 �fcwr �G�i �- � � • --.-Lys_ .r�.E.a--�E-a----�-�=---- vti bog �5 la,��T M1n •�" 2114 ��, . �G � yr.✓r t vrwEAv co BA eaAe,. ,L o , lis. ;%6,%. n vim' y n. ,a/� 74 t c�cw�v-- E.. \rti / ? / WESTit/A/ed ClRCc.E � a CTi�-,� I E -- f No. �EAA/o/!w , MASS. `�.91 � G I k ?; _ � TEL. GGA-¢983 �o J; 9% A j �' �. G OATH TYPE of BL/!L D/vCs: $ e•R, T � ;'/',��/C, _ _ QAAAGE CEZ", C 0*LUM49/N4 jArAV41 rlES:IY,,q �^c>1/L YES5_ I1►� up ra i ' � `- - .., + /, `� eSEWAGE Jc4iOW E'ST/M.4F4: Gao G P �3 SEPTlG TgNfC : I S o a G 4.p 4 � ,� � iOQSGt4PT/ON .4,CCA 3 Sl4 A!/a u�' P 17-S c)�+�o� Ivy +c,va+'1C�� {�vv7 I �'C m ..,. � ._ `: ., tt _ / p CPFea4-4rloAj 7EST1wrg. t s' �• aim„ Y P)r� tZA T� 7 s/G1 0011- z ' B07'77�M EGEYA7,bat/ I f SlrutATiv�/ Mr�l. MSN ,r,/r��/ MIAI �tY �t1��'j ��� /� ..r- � \ � /I�1b 9" DROP M/N. .KEN. .•1.1�i�1� M�t/ _. ~G- oe4A RIN. (M/N. AlAA1' 0�4rMu riow! P•vM ,S ,V.-s,w Af,4 ; t E ® TEST P/TS - // Pu (Sp fA t1h ER. u s P. f i 66 QA TOP E4Z447/ 13 C • o !3 c 3 s- Q E I I V F N t E A d�k P e'i- =T �� I 6. / 1 3o f SO![ TYPES i f �� � S"6so,4- Su bsa'i L - n< '`o l �- , �� APJa /r'C"Graa�.�L It:t''ur)-av; L /gal- ! _ f � i,• f r COCA T/D/�/ .. /1/0 ,�/� — �Xr S f'/•VG G 6,S w BOTTOM 6CEt/AT t 3 • D i 3 •3 S Nv _ z TE5T5 CaViXICTEO By, t TOSEFN T 64RBA6A440 W/TNES 'a SY : Com-/? S P44AI t 460eAl CRI TER A L5,".=Cr I or Mi - — � 5$CMh10N ���SYIMYJVSV�98RlfdWlpIIDMfi�tWR6MYY.KY�[.Y '�AH�RYY'.'fi4T18:ANWYYMl+Y11NNWW.{'U1'�YG.1f@/NfAVintMt/p�MMMIZ1YMNiel�fa V4'6fNr'1s'16Fvhi V.{'wRWICSNRi�ln4NW7C'IbLftllblO�4iMANN'.1V.bOM.wK.1tI1TWMAY11:10iP.YM.N?Y/trJl[i+1.t:wSYNO1fiWMwMN»Mn»M%tirich\tk]IVMYA4M�•Q P,QECAST CONGk'ErC .SEERA66 P17- �B-x�3e" WASHED C�/•CS'�1� S7't�� v / - �L1cal�BLE H/ASXE� -gASN� SPK• T-i/�d� w1 rH .rE�� i !t"Af,44 Q O Gl O O O O Q C? 4> G' O O 0 .33" O o o fl fl PA D O O O O O O O o ii o o co o c7�p /¢' aC`_sz�o cSEE,pAGE /�!T - ECT/oA/ A-A UEaE?stGE P/T- cSEGTl/ S-,e ,44E j/8,. ��=0" AGE -�8"�-/•-,D„ ¢"56 C45"7"j7 c'Da, .5z.00-5 5�---c-PAG7E. RF_4 PIT. e�SD a 4V,4!. eOA1G.2 BrE SEPrtC rA AIA4. ¢'' ClJ IA Sq,,4LL®W SEEPAGE P/TBE � ' / 1 A-R-C- b SSV ry CHECK VALVE ' Li S IN MFIIIAe $o O Cr A L /yl I N� _�df /5tS//V�O a R/� t N• I C aNC R E 'f //U P 4d &,,4>0 `--a•—Q �.� L <S'E P SES ��u A'F R mod Geo% DdSE ~. E AGE 17 -- PLA,c/ f s cSEEPAGE /T,. LAAIr:, ND ,cSCC 77AD a �NEET y i \ Y2. E`< c TOP a y T `rvV � • �4&"-D , 4-7 CS - ��� ,. 2 � of Hari-1 t.ar f UBCRF" (A)A-r -sc�� y Q ��awnl C1 uiEu . ��� --�._ ��. - - _ o�cD arc- s S V& SCI Tic sY sE,,,t VES1 6A3 ? APRzOVIN6 Aurhoi;�lTy l CovPITiav5_ CJ� 5; re v;s -3 �-- i �l.S,�PPRp VED R�SoNs 'Y-f StPT'c c 5`fSTENt ��STA�-L.Q`Tio�..J L X4U/J cow l"S t�-.G►SON �2-fo� " -� l�i�SS E] F��L ,.4e 1,is�-,5 (t w i r1 / .. �✓BSc ��°► err wiTfr 7 �P�j�dvED /JTC IZ- Ili AWN00111G AUTHoR1 7y (IV TITuA DiSfi pPj�vv6V DTC R�✓j�NS , �'o,v� �v E. � �� e Mz4 3,30 -�� a: s p 2 ?� �Y THK5 ! TWA 6u Y5 4�M-4,Y 60111PLIE'T6 iA,A,-r�u.;5 RAL APP OVAL ,. �2_f8,�� AP�►�a�r�G Av iNO�;i �/� � 5 1-h(5 Z-OT A)57" �s � _..- �!!�-,�r^a.�,�'-..��. �-�-,r.,._ -._. __._-___._ ___ _. _ __ _ _ �@000s�® .�:u�su�e,cet.� .SEsu.�tF,� ��sf�s� v�s�,�.•a - P P,POva1,SEG 1cr $•t.vdl.vG &ALE f �'_ ��° 44TE OWAvER: s' 1OCAr1oAJf: < i y ' LCA/e.A/tcR T ell .44 44. 40A rA i v f .Z-1_k _'r,.2� "` t'"f� .fir '.r�• _ _.. _._. _ '� J '_' -�.-. r• ..�. �.. -r•.. ''/' ,�' {�~y T 7 IP46 of BUt 41O/A/4p: is•;+�• ti,,r�,�G«5�. ..�'f,r�hf:�r9. ` f f a RAGS 0 CEUA;C PL!/ME/A/ @ FAC/LrrES r _ # 1. 515W 4E FLOW ;4 i445GaePT/DN .t REA • 3 54,4 der/•�o ' � ;�- --,0-S PERraCAT/oN 7 5r3 a/ AV Z q C s..� � �--wry., -..•,�, �• y/r, ,/ Y' 1, ol. THIP SLE✓AT/O�AJ 'ct� 13dT73�M EtEY.1 TiCiA/ 4 qw a " °`' ....e. f . 1 `' ` /I�1'IIi 9• OR®P M/N. Afl tirfii� /�f Iry /W4rO"F.1OA/ RAM '} t FFST PITS r TOP E4Ei1ATI l 3 L c � 3� / lam-- ; ' _•� -°^ t ''~ .�C TYPES Z 44 4 A/V0 ( G'r^A v C a •* vet �` WAM4 TA®t EVI COCA T/O Al !' �` �- --- �X r S ;�-f M•� :�Y "� .� �,.• +�,< �• ,•--•r'�m r-- BOTTOM • ,,.. _ �;,. � '"';.� �_-�:_� - TESTS C.C.wLYJGTED 8Y TOSEFN J 84R8�164000 , �? S f �- ?ES73 Wi rNESSED QY PLAA! c' Dstew Gel rem.(•4 c.�NEET I �- s - �twllllgl994Nt�4 tlm]I]5t'1�+@TS7P [�K6i.`►7YlhYAtlt'ids.t9dA'�vc��e-1[,r+...•+±a«+r�my 'upeAArsmLif+GAnk1yANR•'7tlyKFt. -. - - - AW6E, AST COM—ZETE S66PACrE PIT- -• t Iz' i-IASMW C,eu..wEa .57a +E >' ` r�r `�:'G �!'A4► C ie . CG104184E WA--W./E-® wa:. 3=E A Er PI PC �r o oO G3 a o o Cy CI a t� G. .'mss lG�y',�x 3"-4-SH r ez:mi r.<4-R6/C V Q 3ro a Q Q' 7 o Q a 4=o C- � /qc• 6crio v A-A tS;.-Eaa,E Ar- Se rio•v 8-� c5LEPs�aE AR�5A 16 PE,e O tl- If f ` I T`��-•� tpF SEEPAGE PfT• 70 • -i,s �� -moo tea. --,- .f i w _ . _ - .-- — .- - -- - �_.�� •,- tar ! I q Ila Al cc-- 4077- P17- .P!A A! 4RfQ e�'ECTCd.+�ls �=�Ec; �- Cv- 22 s BOARD OF HEALU, No.Andover, Mass . c�� 50(, � SUBSURFACE' DISPOSAL DESIGN CHECK LIST C S )~ L r ; L/ APPROVED -, DATE f( DISAPPROVED DATEw Providdds Reasons: avv( Title V FAIL Reg 2.5 The submitted plan must show as a minimum: a) the lot to be served-area,dimensions lot #,abutters blocation and log deep observation hoes-distance o ties c location and results percolation tests-distance to ties a d design calculations & calculations shoving required leaching area (e) location and dimensions of system-including veserve area f) existing and proposed contours (g) location any wet -areas within 100' of sewage disposal system or disclaimer-check wetlands mapping (h) surface and subsurface drains within 100' of sewage disposal system or disclaimer (i) location any drainage easements within 100' of sewage disposal system or disclaimer-Planning Board files W known sources of water supply within 200' of sewage disposal system or disclaimer (k) location of a=yc proposed well to serve lot-100' from leaching facility (1) location of water lines on property-]A' from leaching facility (m) location of benchmark (n) driveways (o) garbage disposals (p) 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 Reg ( Septic Tanks - (a) c—spec t es-=507o of flow, .water table, tees, depth of tees, access, pumping (b) cleanout (c) 10' from cellar wall or in.ground s W uni ng pool (d) 25' from subsurface drains Reg 10.2 Distribution Boxes (a) pe.greater than 0.08 Reg 106 b) sum. w b ' f :b F ce Design Check List - Page 2 FAIL OR , L�hi-Pits Leaching pits are preferred where the installation is possible Reg 11.2 a) calculations of leaching area-mdnin n 500 -eq ft 11.4 b) spacing ' 11:,10 c) surface drainage 2% 7.1.11 d) cover material e) ��x2 Aft splash pad P) tee at elbow g) no bends in pipe from d-box to pipe L!!StLug Fields Reg 15.1 a no greater trian 20 .minutes/inch b area-minimum 900 sq ft -_. c construction-of field 15.8 d) surface drainage 2 % 3.7 e) 20t from cellar wen or inground and m dug pool Leachin Teenches Reg 14.1 a)c a its o eitching area-min 500 aq ft -._._---14.3 b spacing-4 ft min 6 ft with reserve between 14.4 c dimensions 14.6 dconstruction 14.7 a stone 14.10 f surface drainage 2% Downhill Slope a) ipe y x - N be shown b) y/x % 150 - (to be shown) DIMS Reg 9.1 a) approval 9.6 b) stand-by power. Department of Environmental Management/Division of Water Resources j �i WATER WELL COMPLETION REPORT ' `` WE/LL//LOCATION lb� ' Address -CA.[(. #�j ^^/ /Ia�f�tN .5�- City/Town A6, A aVP1-1 i G.S.Quadrangle Map Grid Location Owner fOlAbl1C A-UfInhMen C4- Address to 4e YC _ WELL USE CONSOLIDATED WELL Domestic R Public ❑ Industrial ❑ – Type of Water-bearing Rock Other Water-bearing Zones Method Drilled R aR AV 14 1) From— To �Lp1� 2) From �S4o To 34 4;, Date Drilled _I 3) From To 4) From To CASING n Depth to Bedrock '21' Length �,4' Diameter Type 17 ilk. -,fee I UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surfaced_ Sand: fine❑ medium❑ coarse❑ Date measured Gravel: fine❑ medium❑ coarse[] GRAVEL PACK WELL Screen: Yes No Slot# length from to ❑ Split Screen(or 2nd screen) WATER QUALITY TESTS MADE -Slot# length from to Chemical ❑ Biological ❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured Recovery feet after hours. i LOG of FORMATIONS COMMENTS: (On well or water) Materials From To I � O DRILLER Cb Firm M �Iy O Address e R \ City K 4 114{ p 1U1�• Registration No. o 7 -�, — (/ Operator'signature Please print rrm y BOARD OF HEALTH COPY 25M•10.85.801101 {, EABORA'T'URY ANALYSIS A A Stevens Water Analysi's 38 Montvale Avenue * Stoneham, MA 02180 • Mass. (617) 438-6114 • Salem, N.H. (603) 893-3106 LABORA'T'ORY NUMBER s 165668 SAMPLE DA'Z'E i 1/15/87 SUBMITTED BYt Wilmington Pump Supply Inc. 639 Woburn Street Wilmington, MA 01887 SAMPLE SOURCE s New Well/collected from pump Republic Development Lot #1 ANALYSIS: According to Standard Methods of Water and Wastewater Analysis, 15th Ed . Total Coliform . . . . . . . . . 0 per 100 ml Chlorides . . . . . . . . . . . . 5 mg/L I P11 . . . . . . . . . . . . . . . 8.0 Hardness . . . . . . . . . . . . 74 mg/L Manganese . . . . . . . . . . . . 0.05 mg/L Sodium . . . . . . . . . . . . . 16.7 mg/L Iron . . . . . . . . . . . . . . 0.05 mg/L I Nitrate . . . . . . . . . . . . • less than 0.10 mg/L Nitrite . . . . . . . . . . . . • less than 0.10 mg/L COMMENTt The results of these nnnjvses meet the federal. and state standards for drinklnp water. . Water quality cnn vnr.y st{;niHc-nntly from time to t1me due to various local conditions. Lt TG ndvisable to have your water tested in npproximntely six to twe.tve months to determine any change In waiter (111.111ty. chemist/Pltcrob IoIop,lst w it ;1 1 STEVENS, WATER ANALYSIS 38 MONTVALE AVENUE STONEHAM, MASS. 02180 Tel.(Stoneham)617.438-6114 Tel.(Salem, N.H.)603.893.3106 Interpretation of Test Results TOTAL COLIFORM The coliform test is used to determine the possible presence of septage pollution and pathogenic organisms in water. The U.S. Public Health Service has established that the coliform concentration should not exceed 0 per 100 milli- liters in public water supplies. An absence of coliform bacteria eliminates the possibility that septage pollution and pathogenic organisms are present in water. HARDNESS Hard waters are generally considered to be those waters that require considerable amounts of soap to produce a foam or lather and that also produce scale in hot water pipes, heaters and boilers. Specifically, hardness is a measure- ment of the calcium and magnesium concentration in water. These hardness minerals are responsible for ring and sediment buildup in bathtubs and sink bowls and many other domestic problems. From an economic standpoint, hard water can increase water heating costs due to the scale build up in boilers and also increase detergent con- sumption. Waters are commonly classified in terms of the degree of hardness as follows: 0-75 mg/1 Soft •75-100 mg/l Moderately hard 150-300 mg,,/1 Hard 300 up mg/1 Very hard PH Water with a pH of less than 7.0 is considered acidic. Water with a pH above 7.0 is considered alkaline or basic. A pH of 6.0 to 6.6 is moderately acid and may eventually corrode plumbing fixtures and water using appliances. A pH of 4.0 to 5.9 is considered very acidic and corrosion could be even more extensive. CHLORIDES Chlorides in reasonable concentration are not harmful to humans. However, they can give a salty taste to water which is objectionable to many people. For this reason the U.S. Public Health Service recommends that chlorides be limited to 250 mg,/l in supplies intended for public use. Salting of nearby highways is often the cause of high chloride concentrations in water supplies. IRON AND MANGANESE Iron and Manganese can cause problems with staining during laundering operations, impart objectionable stains to plumbing fixtures, and cause difficulties in distribution systems by supporting growth of iron bacteria. Such waters when exposed to the air become turbid and highly unacceptable from the aesthetic viewpoint. Iron imports a taste to water which is detectable at very low concentrations and can be very objectionable at higher concentrations. Iron can also change the taste and color of beverages and food. For these reasons the U.S. Public Health Service Standards recommend that public water supplies should not contain more than 0.3 mg/l of iron or 0.05 mg/l of manganese. SODIUM Sodium in high concentrations can promote hypertension or high blood pressure in humans. Some individuals are more susceptible to the effects of sodium than others. Thz U.S. Public Health Service recommends that sodium be limited to 20 milligrams per liter in public water supplies. Note: ml = milliliters NITRATE STANDARD : 10 mg/L mg/L = milligrams per liter ARSENIC STANDARD : 50 ppb LEAD STANDARD: 0.05 mg/L - AZA" sHDuiIivCS �AWP03E40',\ SUASMCA4" SEWAC.4 h/SR^�S�L c STEM _.-.�� 1'�.N_.6_�/_zf---✓``_!�4 �/�/� �/i/_..a..f La-t�1C�__ar-�-���-__�L�1.�I PRO P4.4Z0 Lor 6.t vd�.vG ` SCALE / = fo' 44rE OW AJER' ILS. PC rJVFk -S 1 ss LoGAr/oAj I /' Lof ' Zie E RTY Ste. �i; s { 2uE-cw cr. AA4a1 fL ✓''`� `T e5�t[ o, NQS• tWEsrwAjcA ClAzeew , Dm -e4t �J rilA000r AL 4DESIG AJ oA rA j `j / f � T YPE of $l!/[G✓N4a: 4 8 g, b ts-1..t ll,-,,V C.- GA.9•4GE If Ce.4"R PLUMB/N<. FAC/CIT/ES=Al, ,j - _ _ Wu446E cwW e�rwArLc,: - ;�t`�/�- i ."` . - _..._ � � -,.,, .,� ��_' �� �4aSd►EP.T'/ON AREA : 3 5!s�g l f G t..•�/ P�7'-S its . . low DA mr 00, i AbT7oM ez&wArAmv, s ..r— --- *_ ` i .SiITY/.tAT/ort/ AOJ. MSN M�iv ' G• DRaW JIV. OrAL41.1 MMI M/•v.. � / � - .� �,' \ F� ` �� � ��ICG�U row/ RAr� .S` ,.v. �a Q .N•. / .�1ir.w Mpg y/,,•', 3 L , 1 �, TEST PITS a3 "¢ AA TLS y • a �; rbP 64EVATMOV 13,c o t 3 c•3 s 3o';O.0,0 .0- % JWC. ryAF.S suQsoiL saGseiL AA/O l = — � WAree rAec 6 f, t,•r B-14. 126J [oCAT/OPV ' � ti 1 � P �► N,oKa o,Iv fat 3 __ Y Exp s-,.4- IV- G r • w ! ° BorroM 6[ta✓ter 3,c 3 •3 s f t TESTS C.t3r 4cx TED B 1I, m,5EPN J a weA6Ac 4o , R 3 PLAw E S,to" :ek.,re ,.A a a �`- f •- 4L71ilS{•C1MD`YifL!'lMMtlti1l�41K1�AlEpdS71+I+!1.K 'xslXwrtw.y RpYWeplyMll6Ya0lfdf%r. w9iwurwr[ttfxm�!� gfaI1YI1 , P"QECASI- CpMGQETE S' EPAC51E FAIT - • WASHED Ck-&'S�WEO _57M A(E /Z` ,f!!'AX✓/�ft1rN CO✓Ee !Z ' ,� ►"tJ�ir'�:M C ! '----1 :...'. . �Lb[/BGE WASh/E�-4ASfAI� SPK. r-e/,66) O O 0 d O O O O . U c.rf�'.4:sr/Y PALD O O O O O O O Jry j c5'EE�'AGE R r- 5EcrGA/ A-,4— ' cSEEPdGE P/r- �S'Ecrio�y B-8 ¢"#�r,45r- ZaAl, S-.003 E PAae AsMEtt s J� B �Q. f-T PIER- PIT �•vG2 ETE SEPT/G TA AIDC � �Q ¢-Stf S,'e lb R�/C. SE•4GEd ,T0iu rS, S - 3 SNdL�vW SEEPAGE P/r- 11 It It It r" 137 r ' 134 — a 133 �' '1 ►' '( r i 4 .- -132. 1 1 VU 3V v Wi �W fc� �t►► 1 It 11 A. !3 N v to { (p ( - ® - ria I X9 . - 1 ---- Fxisf/�� Gy • . All m 4 IV/ 74l4/"v 6 o C L2N I.S-4/.S-4 G R/9 m� c�EEaAGE �T PL.4 al IE /�©.e ���31. � YE�2T. ���' ¢� �ieQF/GE . _' c)EEPAGE P/T �G.411! R/a cSECTlON.Sf/EET 3- Cam Z R.E Departmen tof Environmental Management/Division of Water Resources i WkTERMELL COMPLETION REPORT, �WEL� LOCATION Address Liberty Lane Lot fel City/Town Andover; MA 01810 G.S.Quadrangle Map Grid Location Owner ' N. )``7iddlesex Construction Address eu-13 -j 1'4. Andover, ,,,A 01u10 _^---- WELL USE CONSOLIDATED WELL Domestic Q Public ❑ Industrial ❑ Type of Water-tearing Rock ..' Other _ Water-bearing Zones n Method Drilled 9/8/88 t) From 00 To 3 2) From To Date Drilled n-4-- __ 3) From To w vut 4)1From To CASING Depth to Bedrock Length_Diameter r n Type st-pip, UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface 7q t Sand: fioe❑ medium❑ coarse❑ f Date measured Q/Q/ Gravel: fine❑ medium❑ coarse❑ GRAVEL PACK WELL Screen: / Yes El No Slot At length from to Split Screen (or 2nd screen) WATER QUALITY TESTS MADE SIot'F length from to Chemical Q Biological ❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at 20 GPM. How measured 2 i v, nSmr,2;Ln Recoveryfeet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 Cb C' DRILLER y Firm Skillings and Sons. I'~ . Address 269 Proctor Hill uc ad City '011is , NH 03049 Registration No. 20 q ! r � vO oetator's inature� Please print irm y BOARD OF HEALTH COPY 2sie•10•85-807101 BOARD OF HEALTH L Town of North Andover,Mass • t Permit u 3 Date 196y APPLICATION FOR WELL & PUMP PERMIT Application is hereby made for permit to drill a well ( Application is made to install ( Ma pump system. Location: Address - '31 Lot # . �. . . Owner ressJ �.� 1 . �/ j Well Contractor Id�r�• s' el ./-bo3 8 Jy Pump Contractor Address Tel . WELL CONTRACTOR (To be completed at time of pump test ) Type of Well Well used for G� Size of. Casing Diameter of Well Depth of Bed Rock_ �, Depth casing into Bed Rock Was Seal Tested? Yes No ( ) Date. of Testing Depth of We-1-1 - - Well ,Ended in Wha-t. Material G Depth to Water_ J Delivers � � Ga1s . Per Min . for 4 hours Drawdown feet after pumping--S--hours, at Date" of Completion �—� - 0 gnature Vell Contra r n.0 X.0 iC. .•.J.J.:.iC is:.J.J.J..I.J.i•.J.J.:.J. • •..... n•. n .. •• .. .. .. •• •• •• .. .. •• •..• .0 I n .• •. .. .. n n n . • n n •• n n��F��T PUMP INSTALLER (To be-- filled in- before installation) � - �- /7- ( ) �' ' S'i z e & Name Pump Pump Type. Use �----.___--..--_._---- Water Pump Delivers l " GPM Size of ,Tank � - Pipe Material Used''"iWell : Cast Iron (_) On I. v:ini zcd (_) P as is � Well Pit (_) or Pitless ,Adapter ( 1_� lM .. Was sleeve used to protect pipe?. Yes ( ) NO( ) Type or Name Well Seal AR Date I`7 -�,.�-r t4 t4�1r�4�M�r�ir�4�'rt4t4t'ct4�'rtlr�4t'rt�rt'rtMti4t4t4�'rtkt4t4t4t4t4ti'rtYti4t'tt4t'rt4tiYtiYt'rt'rt'rt'rt'rt'r,':�S"rQi1 � Gttjt :c 7Ti� , Date Water analysi's repor--t submitted to Board of jfcal'th 1i] d Date,. release given tD owner of record & g Ins p Health Inspector Y , r North Andover Test Sodium Iron Manganese Coliform Ph Hardness ` ' ' The Water Works, abo` xmmoR" es / fMASSACHUSMS. INC. P.O.Box 687 * Leominster,Massachusetts 01453 * (508)534-1444 * 800-LAB-0094 (In Mass) Name : Skilling & Sons Inc Sample Location : Mark Conserver Address : 269 Proctor Hill Road Lot 1 Liberty Street N. Andover Ma City : Hollis Sampled By : Skillings & Sons W -52 State : Nh Zip Code : 03049 Invoice Number : 12121 Date : Sep 15, 1988 WATER QUALITY TEST RESULTS { P } Primary Standard { S } Secondary Standard TEST RESULTS LIMITS Coliform Bacteria IrP } 0/10 4/100 0 all. Fecal Bacteria { P } NT 0/100 ml Standard Plate Count NT 200/100 ml 0 0 05 /l Arsenic { P } NT - . mg Sodium { S } 7. 10 0-250 (ng/1 Copp0-r { S } ND 0-1 mg/l. Iron { S } 0.04 0-0.3 mg/1 Leaa { P } NT O-0.05 mg/l Manganese { 8 } 0.03 0-0.05 m /l Magnesium 8.20 0-200 mg/l Calcium 62.00 0-200 mg/l Alkalinity { S } 94.00 NO LIMIT Chlorine ND 0-0.05 mg/l Chloride { S } 5.00 0-250 mg/l Hardness 153.00 0-16O nig/l, Nitrate { P } ND 0-10 mg/l Corrosiveness { S } CORR NO LIMIT Sulfate { S } ND 0-250 mg/l. Total Solids { S } 123.00 0-500 mg/1 pH -'L6. 5-8.5 S } 7.20 Conductivity 246.00 0-550 Color { S } 1 ^00 0-15 cu Dissolved Oxygen 7. 10 0-15 mg/l. Odor { S } ND 0-3 TON Turbidity { P 0-5 NTU Comments : NT - Not tested ND - Below level of detection for this parameter For those items tested, this sample meets the following EPA criteria for drinknwr ig ate . { X } Primary { X } Secondary { } >Neither Date : Sep 19, 1988 Reported By : Eric J . Koslowski � 2C4RD of eek-cy 5,f Mol' *I-m Aupouel,, MA, �D9c::v,� 1JPiZoviN6 AuPloi�,Ty .G' PLA,J 51 �ti c l� �oS�J(1 Fl,�ti P14-TC- /LC 14TC Zo e D15,QPPRpVEp COnJ�(�(OrJs � �� 5v�� GJE� G�� R 45oNS = T-0 G 1,466 Dw� 42 St�-r c SYSTEM! t S iA ll,Q�'io�l J I�i�Ss [j F'Q1L. ►tiSPF-z�TlonJ PAPE F ^A t;tock Tv T/J5 `Q R;.L 4 Pn(�OvED Q/STCG /�PF'��UvrivGG'�/ 1)VP(T(o)JAj- CERTIFIED FOUNDAT/ON LOCATION PLAN LOCATED IN. .dt?��-+ . . . ►.�.�4v. . . . . SC,4LE P' = Gl v DOTE CHR/ST/ANSEN 4' SE /QG/, INC. -o 160 SUMMER ST. 114VERN/LL, A-64. 01830 C I _ f La i I CLIENT. .d `�.�:: P. h't = 3 o A`-+ TH/S CERTIF/CATION /S MADE .4ND LIMITED TO THE .4,60VE CLIENT. G I CERTIFY MAT THE STRUCTURE SHOWN CONFORMS TO 71-IE DIMENS/ONAL REOUIREMENTS OF THE ZONING BY-LAWS OF THE . . 777z?w t-1 OF ti V . - - - K/HEN CONSTRUCTED. OFFSETS SHOWN ARE FOR.ZONING DETERMINATION ONL Y AND ARE NOT TO BE 11SED TO ESTABL/SN PROPERTY L/NES OR TO DETERMINE LOCATIONS Z OF BUIL DING ADDITIONS. TO THE BEST OF MY KNOWLEDGE AND BEL/EF w - THE PRIMARY STRUCTURE SHOWN ON TN/S PLAN /S NOT LOCATED W MIN A FLOOD HAZARD ZONE AS -514OWN ON DEP,4RTMEJVT N.U.D. FEDERAL INSURANCE ADM/N/STRAT/ON MAPS. COMMUNI TY NUMBER: L DATE. \,~,H OF MiCHgEL J. SERG! y No. 91 C, • L GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:01 P.01 FAX TRANSMISSION LAW OFFICE OF GERALD L GOODSTEIN 20 CARLTON ROAD, MARBLEHEAD, MASS 01945 (781) 631-3072 (VOICE) (781) 639-1450 (FAX) TO: SUSAN SEER /Town of North Andover FAX NUMBER: 1-978-688-9542 FROM: Gerald Goodstein SUBJECT: Joseph Contrada OUR FILE GH: DATE: June 9, 2004 TOTALPAGESINCLUDING COVER SHEET: 12 ------------------------------- This facsimile transmission contains this cover sheet and: - l.Title 5 report . . , . , • , MESSAGE: - - - - (11 pages) F I I THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT 15 AQDRESSEb MAY CONTAIN INFORMATION T IS PRIVIEGECO LD FIDENT NO L AND EXEMPT FROM C OSURE UNDER APPLICABLE LAW, IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU NAVE RECEIVED THIS COMMUNICATION IN ERROR,PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA THE U.S.POSTAL SERVICE. THANK YOU. I GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:01 P.02 01 2401999 11:55 FROM EMS/IN510ER'S 6U1DE TO 17016391450 P.82 COMMONWF. TH OF MASSACHUSETTS FAECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS ftPARTXMT OF IRItVIRONNUNTAL PROTRCTI<ON T TLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Properly Addie; 171 ilhtmerty Street ^Norf6 Andover_ Owmes Names Joe Rich Owaer's Addrtat:_171 Ukrly Street- -North treet_North A adover,W01845 Date of inspection:_S/)(BGtApZ_ Name of InspectAr; Nal L saeeeoa Camplmy Name.�nte"a EWerprirte toe bulling Addren:_111 Arpw Road Alddeftr,Ma.01010 Telophooc Nowbe�r._(978)4754786_ 13 CERTIiFICATION STATEMENT 1 certify that 1 have persottalfy inspected the sewage disposal system at this adfcss and tbat the information reported below is true.aaccrrte and complete as of dw time of the inspeaiqu.The inspection was performed based on my training and overie nee in thrprope, function and maintwnce,of on site se rage disposal syste &t am s DEP - "PP god nsfta bispectorpursumt to Secdoa 1S30of 71dc S(310 CMR ISOW 'Glee system: _X PaW Caenditionally Passes Needs Ftxthar Evaluetico by the Local Approving Awhanty Fei c Inspector's Sigaetore; Date- 5/18iZM_ � The symew inspector shell submit a copy of this iA4pe6ti00 report to the AppfavigS Aeabority(Board of Health or DEP)within 30 days of compkiing dais inspection.If the system is a shared system at has a desiV paw of)0.000 gpd or grcatar,the inspector and the system owner shad submit the report to the appinptwe regional OWKw of dre DEP.The wiggW should be sort to the sysftn owner and copies sent to the buyer,if spplicsble�and the approving authority_ Notes and Comments ««««Tb'g RpoTt oub dsscrirbes coa'"ism at the time of insPurtim and ander Rhe conation of ace at teat time 1U tmpec4a does not address ho..fie o m will patiorm 6a the titare under the seem or Affereat coudiNoas of awn. GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:01 P.03 01/24x1999 11:56 FROM EMSf1NSIDER'S GUIDE TO 17816391450 P.03 Page 2 of 11 O CIA,L INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_171 Ubaq Street_ Nortb Andoeer_ Owner. Rico Date of Impectloa: Sd1V2M Iospecllot Samwary: Cbade LAC,D or E/ALWAYS a mple4e aB of Section D . A. System Passes: _X I have not 1bund any infwmadon which indicates that any of the faihae:criteria desaebed in 310 Cha 15.303 or ice 310 CMR 15.304 exist Any failure criteria not evaluated we indicated below. Comments: H. system Condomatty Passes; One or more system components as described in the"Conditional Pass"sa4aa need to be replaced or repaired.The system,Von completion of the replacemrat or repair,as approved by the Board of Haslth,will pass. Answer yes,no or cot determined(Y,N,NID)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 sot)is 9ftxturally unsound,exhibits substantial inf+lbstion a mliilnation or tank failure is imminent.System will pass inspection if the muting tank is replacod with a complying s9mic talar as approved by the Board of Hents. •A mama septic tmalc hM1t pass inspection if it is structurally sound`nae leaicmg and if a Corti6cate of Complihmae butiating than the tank is lees than 20 years old a avai able, ND explain: Observation of sewage backup or break out or high static ware level in the distribution box doe to brokers or obstructed pipe(s)or due to a brokers,seated or uneven distribution box.System will pass kspmtion if(wide approval of Board of Healthy broken pipo(S)are replaced obstruction is removed T distribution box is leveled or replaced NO explain. ' The systan r squired pumping more than 4 times a year due to broken or obdnicted pipe(s).The systema will pass inspection if(with approval of the Board of Health): broken pipe(s)we replaced Obstruction is removed ND explain.- GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:01 P.04 • 81i24i•1999 11:56 FROM EMS/INSIDER'S GUIDE 10 17816391450 P.e4 r f f Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CKR'TIFICATION(oontioand) property Addrwr_hl lAbe.ty Street_ _roA6 Audwer Uwaer: lilch- pate of I,upecrion: 511W20v C. Farther Evalaanoa id Repaired by the Board OFIRdtb: Conditions cttist wh idl require further evaluation by the Board of 14 in order to determine if the system is failit►g to protect pub]is health,safety of the anvironmtant. I. System WW PW mka Board of Beattb deteraai m is accer6we with 310 CMR 1S-VNI)(b)that Ik systelao b Reg flonctioolog in a mamter wbieb were prated public bealtk Safety and the envirunome Cesspool or privy is within 50 fact of a sutfaoe water .� Cesspool Cr privy is within 50 feet of a bordertnS vegetated wetland or a salt marsh 1. SyNhu wig fait aalem the Board 9(113]R■ltb(and r4W Wafer 8upplier,if any)detssrmbaes that tba system is famct eeft ins maxwr tW pi ote ce.the pablie betel*safety sad t'vlroamme*h 'Me system has a septic tank and soil absurytioo system(SAS)and the SAS is within 100 fete of a Surface water supply w triM sty to a w%ae water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. i ' The system.has a septic tank and SAS and the SAS is witlinx 50 fact of a private water supply wel4 � _ 7be syste i 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 disunce ••'This systm passes if she well water analysis,perfvrtned at a DEP certified laboratory,for coliform bscWja MW volatile organic wmpomd•indicates that the well is bee from polluli=Gam that facility and dke prerace of ammonia niitrageo and aibate ru roil is egud toter less thm 5 ppm,provided dist no other ed to this form. e triggered- of the is moat tie attach failure�itab ter to A analysis I III GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:02 P.05 01,24r1999 11:57 FROM EMS/INSIDER'S GUIDE TO 17816391450 P.03 Page 4 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_1711 Ubery Street_ North Andover— Owner: Rich Daft of ingmcdon:- SAS/2m-P. System Failu re Criteria applicable to ad sraemu: You mart indicate*W or'VW'to each of the following for all iavw6ons. Yes No No Backup of sewage into facility or system component due to overloaded or dogged SAS or cesspool _No Disdtatge or ponding of effluent to the surface of the ground ar sumacs w2tt'1rs due to an overloaded or clogged SAS or Cesspool ^NuL Static liquid level in the distribution box above outlet mvat due to an ovedoaded or clogged SAS or ompool _NaL Liquid depth in cesspool is less that 6"below invert or available volume is less than%day Dow _No Required pumping more than 4 timer is tlue 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 Broe►d water elevation. NaAny portion of cesspool or privy is within 100 foci of a suffice water supply or tributary to a surface water supply. No, Any portion of a cesspool or privy is withal a Zwe 1 of a public well_ _Nlo Any portion of a crospool or privy is widtiu 50 feet of a private water supply well. _lvoAny portion of a Cesspool or privy is less than 100 feet but gt+esVa fbao 59 few from a private water supply well with no aomtable water Quality analysis,Fills sysees panty d do well.rater analysis, perforloaed at a DEP Cardlied laboratory,for calgform bacterin and volat&orp oic coagwunde indicates that the well is free from pollution than that facil4y sad the prtsea t of ammonia eitbgeu sad nibste uitrnges is egwal to ew leas than S pow,provided that aro outer fallurr criteria Bre trigg mad.A copy of the w yeis eanst be attached to 06 form.) _Ne (YeetJNo)'lbs 11ys�tatli I have detenalned that one or More of the abave Wlure ateria exist as described 11310 CMR 15.303,therefore the sysrtent fails.The system owner should contact the Baud of Health to determine valent will be necessary to correct the failure. E. large Sysieoa: To he eoesidered a Isrge systeem the system mast carve a 6eaidp with a dawn Bows of AO„M6 !o IS,Oti6 gp"d- You must indicate eitha'yeV,or'be to eaeb of the fdlowing: (',le following Criteria apply to large systems it addition to the criteria above) I Yes fro the system is within 400 feel of a surface drinic"t water supply the system is within 200 feet of a tributary to a surface drinlcutE water supply the system is located in a nitrogen sensitive v®(lntaita Wellhead Protection Arca-IWPA)or a mapped Zone Il of a public water supply well If you have answered•'yes"to any question in Section E the system is crosidered a sigafficaut dk rcK or sruwered ,yrs"in Section D above the large system has bailed The Oww- of operator of any large System considered a aigpific=tl 94=4w Scanlon E or hulled utift Sutlaim D*41 upgrade The qjftn is scoot dj=wilb 310 CM 15.304.The system owner abould eontad the appropriate regional ofltee.of the Depa tmeot, i - GERALD GOODSTEIN Fax:1-781-63971450 Jun 9 2004 13:02 P.06 01/24AI919 11:56 FROM EMS/INSIDER'S GUIDE TO 17616591456 P.06 Page 5 of I I OFFICIAL INSPECTJON FORM—HOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM R4SPEMON FORM PART B CHECKLIST Property Addreea:_17t Uberty Street_ North Aadorer t3wur. Rlik - Daar df Inpecdoe: 5/1tllJM Check if the following have beam done.You emmt mdicae'yea"ar'bo"as to mcb of the fdt!!!% r I yes No _Ye+_ — Pkmpmg intbrmstion—s provided by the own".oonupsuk err So"of Health _ _No Were any of the system coamponans pUMped out in the previous tvro Web? _X0- _ Has the Wmm semi-ed na=al flows ion the previous two week period? No Have large vokones of water boon iwoda ed to the syutmt cwmdy at as poet of this inspection? _Yes Warn as built plans of the system obtained and examined?(If they war,not available note as N/A) _Yes_ Was the facility err dwel ft inspected for sign of sewage bade up? _Yea- Was the sitc inspeued far signs of break out 7 Yes_ were ail sy*=cgmponants,excluding the SAS,batted as site 7 Yd _ W arc the septic took manholes m:o wacd,opened,and the mu iw of d10 tank inspected for the condition of the baffles or toes,mater of cmArmhon,dimensions,depth of lid depth of sludge mW depth of scum? _Yes_ was the&&Airy o"er(ond occupants if diBe+mt from ow=)provided-iith infotmation on the proper maintenance of subswrfaoc sewage disposal systems? 71tc shm mad tocafim of the Soil Absorption System(SAS)an the site has been determorod based on: Yes no -Yes _ Existing information.For comple,a pias at the Board of Health. No Determined in the Meld(if any of the failure aiteria related to Pat Cis ser issue approximation of distance is maeceptable)[3 10 CMR 15.302(3)(b)) GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:02 P.O? ® 01/241999 11:58 FROM EMS„ INSIDER'S GUIDE TO 17816391450 P.07 Page 6 of i l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION properly wddnw:171 liberty Street_ North Andover_ Oaoer. Rich Date of Impeed":-S/lAl=- FLOW CONOMNS RESIDF"AL Number of bodrmns(design,): -5'� Number of bedtvam5(acwA): ^S DESIGN flow based on 310 CMR 15.203(for example:110 gpd x 0 of bedrooms):,_750 Number of current reatdeats:_d— Does r=Wawc Mvc a rwbege ginda(Yes OF 8* lrla_ is tauttdry on a sepatste sewage system(yes of ao):-yea- (if yes a ionspoction required) aster z la isrcrt . . "wee tW>• Wet l . es users n Cs larutad<y systeta inked(yes a o) Y � d*3'p' �+ Seasonal use or no):* Watrr m rte.nerd' Weu Wsts'>100•m SAS_ Smp pmp(Va or no):-No- Last date of occupancy Cwrrent- CO Type of emmblishment swig flow(based on 310 CMR 15.203): ppd 9m of desip flow(seatslpctsons/sgft,ctc-): Grease tap pro”(yes or ao),_ indadirial waste holding tamk persalt(yes or no):_ Noo-sanhary waste dWdw&W to the Title S sysMn(yes or no): Water meter readings,d available: W date ofoccupaMIuse:, tTIMR(describe)- GEPOrWtI[.R0ORMAT/ON Yampbg Records Source of information. Pmmpsd every years owser— Was syskm pumped as part of the igoctm(yes or nor Pro r If yes,volume pumped: :pilau-Haw was gtaw*p+tmpad detavcined? Ream for pumping: TYPE OF SYSTEM X-Septic tack dimrib tion box,sail absoty6on sys _Single ce"Pool _Overflow cesspool _Shared systam(yes or no)(if yes,attach prewom mspation records,if any) Mlov&6vr/Altanative twmiogy.Attach a copy of the currmt opra■tm and maintma me contract(to be obtained from system,owner) q di a of the J)EP s l t rank tta _�� _.,__ Dopy pPr'ava ,. Other(describe): Approximate age of aU components.date installed(if lumen)and aowm of infcoaratien: 11 years d&W511"I. , - As bmf pias- Were XW Me odors datcaod when aniviog at the site(yes or no): No GERALD GOODSTEIN Fax:l-781-639-1450 Jun 9 2004 13:03 P.08 Gle24e1999 11:59 FROM EMS-INSIDER'S GVIDE 17816391458 P.88 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSM1914TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(ccntinuod) )Property Addr■m, 171 Uberty Street ^Nott!Andover Owmers )Bleb Date of lmapftdm:_5/11sa E SUII.DING SEWER(locate on site plan)X Nth below glade: 3' Materials ofcoosltuction:�csst iron X 40 PVC odd(explavnj DI%vaoe boat private*uw supply w+d!or Amion Bait; Catmmaus(an condition of joints,venting,evidence of leakage,dc.):_4"WC tbra wraalf.3'►1PVC L boom No lemkL SEMC TANK-. X locate On site plan) Depth below grade:_T'_ Material of construction:_X concrete mewl_Bbeirzim_pvlydhyllme _.vther(e:xPlaul) If rank is meal list age._ 13 age confirmed by a C mdficate of cmpliaooe(yea or no):_(=Kb a copy of oatiRcate) Dimcrtisioos:_10'x 5'x 4'_ Sledge&V*: 0 Distance fft top Of sludge to bottom of outlet ter Or battle_`2r Scum dlidmess:_1`•' Durance from top Of SMER to top Of outlet tee Or batik:_r Dimanoe from bottom of saws to bottom Of outld tee Or bad Mr How waL dimensions dete mated: Subtract sca a slake deptlb to b egtb.^ Cavtmenb((n Pim W ng raoommendatiom,m1ft and oaflet tm or baffle omtd&M strnaUW integrity,liquid levels clonal as relrttd to cal invent.cvidepa of teakagn;,etc):_Inlet tae enc Outlet tee ale Depth of limed at oetkt i yam No evidence Of leahsg& GR>vASE TRAP: (late on site plan) l Depth below grade: Material of conmuaion: `concrete metal�6betrem_polyethylene ether (CrphkinDimenacns --� Scum thidmess: Distoma from top of acres to tOp of outlet tee of baffle, Distance*om bottom of sewn to ba toro of adlet toe abefut Date of lax paining; Cgmmettts(on pumping reeemmendmians,inlet and Outlet tee or baMe candidal,sorvc4&Q" teg as slated to outlet invert,evidemct:of leakage,eta): !:liquid levels 't h GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:03 P.09 '01/24,11999 12:00 room EMS,1INSIDER'S 6VIDE TO 17016391050 P.69 Page a of 11 OFFICLAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPKCTION FORM PART C SYSTEM XNIFORMATION(aandiav* Propet^d Address: 171 'b"Street NartL,Aodowtr I . Owtler: )Erich S Ds1se of fst peti600:-X1111004- MGM ew MXDM'LANK:,(tank must be pumped at time of iaspedion)(1, a an sitt plan) Depth below grade: iNateria)of eonso„cxim::oonceu_meta!`6barglaw--plye f►Ylew_o&er("W1a<0y. I Dioaonsiaas• Capecity cellons Design Flaw: aalk>,tslday Alarm pr'c3dlt(yes or no): Alam lewd: Alam in,waking order(yes or no): '1 Date of hot pumping: j Coommeatt(condition of sbrm and float_switches,de.r DLS7MImON BOX; X(if prexot mast be opened)(locatc on site plan) Depth of liquid kvd above outlet invest:—0 Convnpns(nae if box is level wW disa-ibudon to outlets equal,any evidence of solids ctnover,any evidence of teaksge imp or out of box,etc r boa lewd&diotribttoea tel,No evidence of Ekalorgr.Eridesoe of adld ' caayww,pmoped d-box to class_ PUMP CNA1rIBER_ _ (locate on site plan) i ptnnps in working order(yes or no):_ Alarms be working order(yes or no): Comments(vote condition of pump chamber,condition of pumps and appummancM e*c): �1 • I i i GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:03 P. 10 e1i24s1999 12:88 FROM ENS/INSlOER'S WOE TO 1 78 1 6 391150 P,18 Page 9 of I i OFFICIAL INSPECTION FORINT-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM[INSPECTION FORM PART C SYSTEM INFORMATION(eontitmued) Prop wty Addrew.- 171 Lb"Sfty* �Mortb Andow Oww: tt k Daae of Insp.co": 54812M Son,A3WRrn0r4 SYMIK(SASr >x (locate on aite plsisy etommboo ad rngared) If SAS not located explain wby: TYPE ka4ing pits_number:_ leafing dwsbem numbar: leading galleries.amber. X_leac apt trenches,number.lcng*: 3 treacles 39'long` ieacbiAg fields,number,dimarsioas: overflow cesspool,number: 9 _�innovatiwJalt�rtetive System Type/name of technology: Coomsents(ode aonditian of soil,sips of by uiic[ailue,lewd of P �P s4 + Sail ek.Ye¢ast m o1L.No sign d pow9ft to rariece. I-. CFASPOOLS: (cesspool must_be pumped as part of bapectionj(loatre on site plan) Nmaber end ooaGgtastion: Depth—top of liquid to inlet invert: Depth of solids layer: _ Depth of scum layrs' I Diroaemions of cesspool: 3 Materiels of oonstructice: 1 kk&Gldon of groAw"Ier inflow(yes of no), Comments(note eaWkian of soil,sips of bydrsWic f Aare,kvd of ponding,condition of vogehtioq etcy MW: (locate on site plan) Maerials ol'construction- Dimensions: i Depth of solids: Cemma+ts(am condition of soil,signs of hydraulic hWUM levwl of ponding,condition of vegeMlien,ere.): GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:03 P. 11 of"24111999 12:01 FROM EMS�INStDER15 GUIDE 10 17B16391a59 p. 11 Page 10 of l 1 OFFICIAL INSPECTION FORM-,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION'(0mbu od) ]Property AAdr+eas: 1771.0 h"St" _NaN6 Aat kwr Owser: Rids_ Date of bnmdkm: marim SKETCH OF WwAm owsr<pm SYk`IEAI Provide a Sketch of&e sewage disposal system including ties to u least two pwMancot refelmce landmwks or bmc6mwkg-Locate all wells widtin 100 fed.Locate where public watt Sarpply eaters the building. . Gatt>gc 8oa>te Tv vivv A $ A to Tads-6r Septlic A to Maas c 173'4" ; TAM& ® B to Tsmk=W411' Ig to Dan C 1dr4r D, GERALD GOODSTEIN Fax:1-781-639-1450 Jun 9 2004 13:03 P.12 " 81/24%1999 12.'91 FROM EMSIIN51DER'S GUIDE TO 17816391450 P. 12 Page 11 of 11 T. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(cornava� hVper'ty AddMr._171 LjWrty SRnet,- Nortb Aadwer Owmer: Rlcl_ - Deete of loepectio v_SnW2002_ S1'['E EXAM Slope Surface wets Check seller Shallow wells Estimated deo to ground water�l0'_feet Please indicate(Check).all methods uk d to determine the high Wamd*"or elevation: X Obtaitled frau q-Am des lens on d- � rraor If clue of dtei _ gtt pbat re�riewed: 6►lO✓198= —Obeerred site(ate propc rty/obsammon hole within 150 font of SAS) - Che*M with local Board of Health-explain: Chockd wi*local c=vawm iandws.(snob docame azom) Accessed USGS data6ase-exp1in: YOU meet describe how you ettablidwd the b*b Voattd water elevation:_Wager 10%Aa per detdlgla pbee _ 1