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HomeMy WebLinkAboutMiscellaneous - 193 FOSTER STREET 4/30/2018 (2) 193 FOSTER STREET
2.10/1-04-D-DD42�D00.0
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A
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t
Lot & Street 1 '1� A.,;L Map/Parcel MAjJ 16 Y 6
CONSTRUCTION APPROVAL P> �
Has plan review fee been paid: YES NO Permit
Plan Approval: Date: / Approved by:
Designer: C�,�/2J,5�ji9/11 Plan Date:
Conditions:
Water Supp : Town _ _.-___ - Well.
Well Permit: Driller:
Well Tests: Chemical Date Approved
Bacteria I Date-Approved
Bacteria II to Approved -
Plumbing.Sign-Off: - inn- Sign-Off:
Comments:
NO
Form"U" Approval: Approval to Issue: YES �
Date Issued Bv:
Conditions:
Final Approval:
All Permits Paid? YE.S . NO
-Weld-Construction Approval? S NO
Septic System Construction Approval? Y-ES:--�' NO
Certification? NO
Other YES NO I n
Any Variance Needed? S NO
FLNAL BOARD, OF A TH APPROVAL:
DATE: lILEz
APPROVED B'�:
* 1
f
SEPTIC SYSTEM INSTALLATION
Is the installer licensed? NO
Type of Construction: NEW REPAIR
New Construction: __._Certified Plot Plan Review YES NO
Floor Plan Review YES NO _
- - Conditions of Approval from Form U YES NO
_Issuance ofDWC permit: - NO
_DWC Permit Paid?
Per NO
-w !� - C�' - NO .
- Installer: Y�11(Cj4
-------- - --Begi_mInspection:_ -
- YES NO --
_Fxcavation Inspection:
-Needed:
—Passed: ---
By:
-Construction Inspection:
Needed`
As�uiltP Satisfactory:
Approval of Backfill: Date: ,2 By
-Final Grading Approval: Date: !•
Final Construction Approval: Date: By:
Certificate of Compliance: Approval: Date:
1-14.1 "` neoposof FIRST-CLASS MAIL
. Town of North Andover :;��=; ,w�-+�°•�Y"��
11/16/2015
•��••'" HEALTH DEPARTMENT .:q
COMMUNITY DEVELOPMENT AND SERVICES • o $00.482 O 5
1600 Osgood Street,Suite 2035 ' ''
ZIP 01845
North Andover,Massachusetts 01845 041L10235393
4
IMPORTANT DOCUMENT14
COC (CERTIFICATE OF + RETURN T O SENDER i�
MCOMPLIANCE)IS ENCLOSED ��;
NOT DELIVERABLE dss ADDRESSED I
UNABLE TO FORWARD I
8C.: 0:1845104899 A2021-0673-=3-;i6-46
S VT l D41 .
RATED ��,
PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF.
COMPLIANCE
As of- 11/16/15
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Repair of D-Box
By: Todd Bateson
At:
193 Foster Street
Map 104.D Lot 00.42.
North Andover, MA 01845
The'Issuance of this c ific.to shall no be construed as a guarantee that the system will function satisfactorily.
Ache le Grant
Public Health Agent
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
i
PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: 11/16/15
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Repair of D-Box
By: Todd Bateson
At:
193 Foster Street
Map 104.D Lot 0042
North Andover, MA 01845
The Issuance of this c�tificate shall nobe construed as a guarantee that the system will function satisfactorily.
Michele Grant
Public Health Agent -
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
.. • S�gTt°-EDj 4 .
x
1•
North Andover Health Department
(ommunity and Economic Development Division
ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 193 Foster St. MAP: 104.D LOT: 0042
INSTALLER: Todd Bateson
DESIGNER:
PLAN DATE:
BOH APPROVAL DATE ON PLAN:
INSPECTIONS
D-Box INSPECTION: 11/16/15
DATE OF BED BOTTOM INSPECTION:
DATE OF FINAL CONSTRUCTION INSPECTION:
DATE OF.FINAL GRADE INSPECTION:
SITE CONDITIONS
❑ Contractor reports any changes to design plan
❑ Existing septic tank properly abandoned]
❑ Internal plumbing all to one building sewer
❑ Topography not appreciably altered
Comments:
SEPTIC TANK
❑ Building sewer in continuous grade, on
compacted firm base
❑ Cleanouts per plan
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 gallon tank has been installed
H-10 loading
❑ Monolithic tank construction
❑ Water tightness of tank has been achieved by
visual testing
❑ Inlet tee installed, centered under access port
❑ Outlet tee installed, centered under access port
(gas baffle/effluent filter)
❑ inch cover to within 6" of finish grade
installed over one access port
❑ Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 gallon Pump Chamber installed
❑ H-10 loading
❑ Monolithic tank construction
❑ inlet tee installed, centered under access port
❑ Pump(s) installed on stable base
❑ Alarm float working
❑ Pump On/Off floats working .
❑ Separate on/off floats
❑ Drain hole in pressure line
❑ cover at final grade installed over pump
access port
❑ Water tightness of tank has been achieved by
testing
❑ Hydraulic cement around inlet & outlet
Comments:
CONTROL PANEL
❑ Alarm & Pump are on separate circuits
❑ Alarm sounds when float is tripped
❑ Location of control panel: basement
Alarm signal located inside: basement
Comments:
DISTRIBUTION-BOX
X Installed on stable stone base
X H-20 D-Box
❑ Inlet tee (if pumped or >0.08'/foot)
X Hydraulic cement around inlet & outlets
X Observed even distribution
X Speed levelers provided (not required)
X Schedule 40 PVC Pipe
p
Comments: replaced cover on tank
`a •
Application for S00 -, ©isposal Systerr�
TODAY'S DATE
Construction; Permit — TOWN OF
Full Re
$ 0'— pair
NORTH ANDOVER;:MA 01845 125:0a Component
Important:. Application is hereby made for permit to:
When-filling out ❑Construct a new on-site sewage disposal system'
forms on the
computer.use Repair or replacean existing onsite sewage disposal'system*
only:;the tab key �ir or replace an existing system component–What? X
to move your
cursor-do not
A. Facili Information
use the return ty 1 � .
key. 9-3 Fosf�/L
Address or
Nap
10
cityfrown ?015
2:*TYPE OF SEPTJC SYSTEM*: HEALTH DS HAM)oVE
PARr R
M
[3-Gravitychoose one F
—if pump syst m,attach copy of electrical permit to application"'
➢ [ 'Conventional System (pipe and stone system)
➢ ❑Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system.)
❑Pressure Distribution S.A.S.(No D-Box)
➢ ❑Pressure Dosed(D-Box Present)SAS.
➢ ❑ Does the system require an effluent filter? Yes No
!f yes, does plan specify make and model of filter? YES=(no further info.needed)
NO=(installer must specify brand of filter before DWC issuance)
Wlratis the Make? What is thcModcts
2. Owner Information
CIt"G.C.
Mame
Address(if different from above)
pl/D� v.R� ys
Cityrrown State Zip Code
X33- 4/
Telephone Number
3. Installer Information
BATESSON ENTERPRISES INC,
Name Name of Company 111 ARGILLA ROAD
/rte n rry /ANDOVER,MA 01810
Address
yr'J,4 DlOilt�
CitylTown State Zip Code
!?"7?
Telephone Number(Cell Phone#if posslb/e.please: )
4. Designer_Information
Name Name of Company
Address
State Zip Code
City/Town
Telephone Number(Best#to Reach)
Application for Disposal System Construction Permit•Page 1 of 2
:7 . e�AppliCa#ion..for Septic Disposal sy-tern
iZ
TODAY'S DATE
41 a construction Perrrtit - TOWN. OF ,
"►R�, �': $:250.00-Full Repair
�sy�,v. , ORTH 1�NDOV , MA 0145 $125.00.Component
dACMUs
PAGE 2 OF 2
A. Facility-Information continued.,..
S. Type*of Building: esldentialDwelling or❑Commercial
B. Agreement
The undersigned agrees to ensure the construction and maintenance of the afore-described
on slte sewage disposal system In accordance with the provisions of Thle 5 of the
Environmental Code,as well as the Local Subsun°ace Disposal Regulations for the Town of
North Andover, and not to place the system 6 operation until a Certificate of Compliance has
been lssu y this Board of Health.
Nam Date
A I ( Approv4yo4ar o e Ith Representative) _
Nme
Date
Application Disapprove . or the following reasons:
For Office.Use Only:.
1 Fee Attached? Yes No
2.- ProjectMartager Obligation Form Attached. Yes No '
3.; Puma System? gfso3 Attach copy aMAectrrcal Permit`; 'es No
4. Foundation As Built:?(hew construction•ronly). Yes No
I
(Same scale ss approrcdplaa) —'
S. Floor Plans?thew construction-only): des_ No
—
Appl�catidn'fior•p(spGsat 4ysti3M`0on*Uc80r permit:Rage 2 of 2
V
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
v5
193 Foster Street '
Property Address
George Finn l
Owner Owner's Name
information is North Andover MA 01845 9/29/2015
required for
every page. Cityrrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: A. General Information ' °"
When filling out
forms on the OCT G 7 2015 VA gR)J-1-
computer, use 1. Inspector:
only the tab key
to move yourTOWN OF NORTH ANDOVER
Neil J. Bateson ,,,r„Inc pT�ATZAiT
cursor-do not Name of Inspector °
use the return
key. Bateson Enterprises Inc.
Company Name
111 Argilla Road
Company Address
Andover MA 01810
Cityfrown State Zip Code
978-475-4786 S115
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on 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:
❑ Passes ® Conditionally Passes ❑ Fails
❑ Need urther Evaluation by the Local Approving Authority
9/29/2015
In toe Signat Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP.The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 1 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form .
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
,M 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
❑ I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria;not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
® One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health,will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ® N ❑ ND (Explain below):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
T
V Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityfrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
i
❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ® N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not.for Voluntary Assessments
M 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other:
Outlet cover on septic tank&d-box needs to be replaced.
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6'° below invert or available volume is less
than '/2 day flow
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
1 0,000g pd.
❑ ® 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 servea facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area— IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M z193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityfrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
1:1 ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. CitylTown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d Yes
9 ( Y 9 (gP ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: September 11,
2015
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3/13 Title 5 ficial Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: Pumped four years ago, owner
Was system pumped as part of the inspection? ® Yes ❑ No
If yes, volume pumped: 1500
gallons
How was quantity pumped determined?
Measured tank.
Reason for pumping: Inspect tank&tees
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityrrown State Zip Code Date of Inspection
D. System Information(cont.)
Approximate age of all components, date installed (if known) and source of information:
16 years old, 9/20/1999, as built plan
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
4" PVC through wall. 3" PVC in house, no leaks visible.
Septic Tank(locate on site plan):
Depth below grade: 1
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 10'x 5'x 4'
3"
Sludge depth:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
UWTitle 5 Official Inspection Form
5 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
30"
Scum thickness
3"
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
12"
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. Outlet cover broken, needs to be replaced. Depth of
liquid at outlet invert. No evidence of leakage.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owners Name
information is North Andover MA 01845 9/29/2015
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle:condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
"Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D-box level &distribution equal. Evidence of carryover. No evidence of leakage. D-box badly
corroded, needs to be replaced.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins.3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
, 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length: 3 trenches 46'
long
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Soil Ok. Vegetation ok. No sign of ponding to surface.
I
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
i
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 13 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is
required for North Andover MA 01845 9/29/2015
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
a Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is North Andover MA 01845 9/29/2015
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
a
O �
� Mem
- aLt
Vill
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
s 193 Foster Street
Property Address
George Finn
Owner Owner's Name
information is North Andover MA 01845 9/29/2015
required for
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
I
® Check cellar
® Shallow wells
Estimated depth to high ground water: 4
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 10/2/1998Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
Design plan
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Test pit data on design plan
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
• Summary Record Card generated on 10/2/2015 10:44:49 AM by Karen Hanlon Page 1
• Town of North Andover
Tax Map # 210-104.D-0042-0000.0
Parcel Id 16729
193 FOSTER STREET
FINN, GEORGE
410 EAST MAIN STREET
WASHINGTON, NC
27889
Class 101 Single Family Property Type 1 Residential
Zoning2 1 Residential Zoning3 1 Residential
Size Total 2.03 Acres
FY 2016
UB Mailing Index
Name/Address Type Loan Number Active/Inact. From Until
FINN, GEORGE Payor
410 EAST MAIN STREET
WASHINGTON, NC
27889
UB Account Maint.
Account No Cycle Occupant Name Active/Inactive
Bldg Id. 17737.0-193 FOSTER STREET Last Billing Date 7/14/2015
3170403 03 Cycle 03 Active
UB Services Maint.
Account No. 3170403
Service Code Rate Charge Multiplier/Users
MISCFEE ADMIN FEE 0.635/8 7.82 1/
WTR WATER 01 ALL METER SIZE 49.40 /1
UB Meter Maintenance
Account No. 3170403
Serial No Status Location Brand Type Size YTD Cons
32945034 a Active ERT HH b Badger w Water 0.63 0.63 423
Date Reading Code Consumption Posted Date Variance
9/9/2015 580 a Actual 13 -1%
6/10/2015 567 a Actual 13 7/24/2015 -7%
3/12/2015 554 a Actual 14 4/28/2015 -16%
12/12/2014 540 aActual 17 1/15/2015 -13%
9/11/2014 523 a Actual 20 10/15/2014 1%
6/9/2014 503 a Actual 19 7/16/2014 12%
3/11/2014 484 a Actual 17 4/11/2014 -26%
12/11/2013 467 aActual 23 1/17/2014 -1%
9/12/2013 444 a Actual 24 10/15/2013 21%
6/11/2013 420 a Actual 19 7/24/2013 -11%
3/14/2013 401 a Actual 22 4/22/2013 142%
12/12/2012 379 aActual 9 1/9/2013 14%
9/12/2012 370 a Actual 8 10/15/2012 -1%
6/12/2012 362 a Actual 8 7/16/2012 -16%
3/13/2012 354 a Actual 10 4/14/2012 2%
12/9/2011 344 a Actual 9 1/17/2012 27%
9/13/2011 335 a Actual 8 10/13/2011 276%
6/7/2011 327 a Actual 2 7/20/2011 -36%
3/7/2011 325 a Actual 3 4/13/2011 -24%
12/8/2010 322 aActual 4 1/12/2011 -72%
9/9/2010 318 a Actual 15 10/15/2010 -31%
6/8/2010 303 a Actual 21 7/15/2010 73%
3/10/2010 282 a Actual 12 4/14/2010 15%
12/11/2009 270 aActual 11 1/12/2010 -59%
9/8/2009 259 a Actual 26 10/15/2009 -19%
6/9/2009 233 a Actual 30 7/20/2009 188%
3/16/2009 203 a Actual 12 4/29/2009 20%
12/8/2008 191 aActual 9 1/20/2009 -45%
9/11/2008 182 aActual 18 10/10/2008 -20%
: Commonwealth of Massachusetts
City/Town of .
ti 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: Left/Right front of house, Left/Right rear of house,/right of hous Left/
Right side of building, Left/Right front of building, Left/Right rear of building, Under deck
Address
City/Town State Zip Code
2. System Owner.
Name f( 0
Address(if different frpm location)
AV -7
City/Town _ •� State yz Zip Code ;
f �'.
Telephone Number
B. Pgmping,Record
1. Date of Pumping Date 2. Quantity Pumped:
Gallons
3. Type-of system: ❑ Cesspool(s) eptic Tank E] Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes 3__Ao If yes, was it cleaned? ❑ Yes ❑ No:
5. Condition of System:
6: System Pumped By:
Neil.Bateson F5821
Name Vehicle Lioense Number
Bateson Enterprises Inc-
Company
ncCompany
7. Location where contents were disposed:
S. Lowell Waste Water
Sign 9t Haul Date
0orm4.doc-06/03 System Pumping Record•Page 1 of 1
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE:
09/22/99
This is to certify that
the individual subsurface disposal system
constructed ( x) or repaired ()
by
F.P. Reilly & Sons
at
1.
193 Foster Street
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations as described in the Design
Approval Site System Permit# 1043 dated 4/19/99.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
Board of Health Inspector
r
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System ( ) constructed;
(�f) repaired; r�
by S RG-1 LLL-j 1- �GU
located at
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit 9/6)1/� dated�l A with an approved design
flow of D gallons per day. The materials used were in conformance with those
specified on the approved plan; the system was installed in accordance with the provisions
of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees
substantially with the approved plan. All work is accurately represented on the As-built.
which has been submitted to the Board of Health.
Bed inspection date:
Engineer Representative
Final inspection date:
Engineer Representative
Installer: X2 Lic.#: Date: e.o_g,
Design Enginee Date: Z L
I
r
AS-BUILT CHECKLIST �� 5
LOT NUMBER, STREET NAME
I
ASSESSORS MAP & PARCEL NUMBER
-`f LOT LINES & LOCATION OF DWELLINGS
LOCATION & DEMENSIONS OF SYSTEM,
INCLUDING RESERVE
TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
✓r ELEVATIONS OF DISPOSAL SYSTEM
�rLTOP
OF FDN ELEVATION
✓ LOCATIONS OF WELLS, DRAMS, WATERCOURSES
W/IN 1 50' OF SYSTEM
LOCATION OF WATER,"GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D-BOX
_ STAMP & SIGNATURE
EVIPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
i
FINAL CONTOURS
LOCATION & ELEVATION OF BENCHMARK USED
LOCUSPLAN /
�o hovSG
Nov-19-98 09_39A Paul D. Turbide, PE/PLS 508-465-0313 P.02
November 19, 1998
Sandra Starr
North Andover Board of Health Administrator
Office of Community Development and Services
30 School St.
North Andover,MAO 1845
3
ltE: Title V review of revisions to plans for Foster Street system upgrade
Dear Sandra,
Enclosed find the"Checklist for North.Andover Septic System Pians" for the above-
mentioned site. The following is a list of all the`Problem' areas and deficiencies Port
Engineering has found:
e Minor Problem: Thero sed septic tank needs a 24"riser/manhole.
P Po Pn
310CU R228(2)
I also have the following general comments:
o The leaching bed will be less than 100 feet from wetlands and therefore will need a
variance from the local regulations(which in my opinion is acceptable).
o As shown on the pian, a grading easement is needed from the Town ofNorth
Andover(which is acceptable in my opinion, if granted by the Town). A condition
of approval of this plan should be that the owner will receive a grading easement
from the town.
If you have any questions or comments please call me. Thank you.
Sincerely,
Port Enginecring Assoc.Inc.
Carlton A. Brown
PORT
ENGINEERING f
mem°-767A #of Pages ` p�
Civil Engineers 8t gr(litta D —
Land Surveyors WIA brand iax trap from rv- f/
One Harris Street Post- O aN Co t�
Newburyport,MA 101J
01950 gone#
C�
978 465-8594 Co.
j E } Fax#
Dept• �/ /�
Fax#
�a_ (rJC✓
i
i
i
Town of North Andoverr y°RTM ,
OFFICE OF 3�°
COMMUNITY DEVELOPMENT AND SERVICES A
27 Charles Street ^o
North Andover, Massachusetts 01845
WILLIAM J. SCOTT 9SSACmU51a
Director
(978)688-9531 Fax(978)688-9542
December 16, 1998
Christiansen& Sergi
160 Summer Street
Haverhill,MA 01830
RE: 193 Foster Street
Dear Mr. Christiansen:
This letter is to confirm that the North Andover Board of Health at their regularly schedlaled
meeting on December 14, 1998,voted to grant the following variance:
a) a reduction in the offset from the approved wetland line to the soil absorption,system from
100 feet to 50 feet
In addition this correspondence is to inform you that with this approved variance, the proposed plans ur
the site referenced above have been approved. It should be noted that, as a condition of this approval, a
grading easement must be obtained by the owner from the Town of North Andover and registered on the
deed.
If you have any questions, please do not hesitate to call the office at the number below.
Sincerely,
Sandra Starr,RS.
Health Administrator
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
TEMPORARY GRADING
EASEMENT AGREEMENT
The Town of North Andover, a municipal corporation duly organized under the laws of
the Commonwealth of Massachusetts, through its Conservation Commission, (hereinafter called
the "Grantor"), for consideration paid of less than One Hundred($100.00)Dollars, the receipt and
sufficiency of which is hereby acknowledged, hereby grants to the Fleet National Bank,-Trustee
Foster Trust u/d/t dated May 30 1985 recorded with the Essex North Di
of o strict Registry of
0
Y
g Y
Deeds at Book 1985, Page 207 of 75 State Street, Boston, Massachusetts 02109 (hereinafter called
the "Grantee"), its successors and/or assigns, the temporary right and easement to access and
� e
regrade a five-hundred and ninety square foot area of land (hereinafter called the "Easement
m >
y Area") shown as "Proposed Grading Easement from Town" on an unrecorded plan of land entitled
"Septic System Repair Design, Map 104D, Lot 42" dated December 9, 1998 and revised January
I
6, 1999 relating to 193 Foster Street, North Andover, Mass., and prepared for Owner/Applicant:
Foster Trust, 75 State Street, MABOF, 03U Boston, MA 02109, by Christiansen & Sergi,
Professional Engineers, Land Surveyors, 160 Summer Street, Haverhill, MA 01830, Tel. 978-
. __
373-0310," (hereinafter called the "Grading Plan").
The Easement Area as described above constitutes a portion of the 36.887 acre parcel as
IQZ
�i
owned by the Grantor, abutting said Lot 42 on the above-referenced plan, the Grantor's land
y
being commonly known as Foster Farm, North Andover, Massachusetts and being more
particularly described in a Deed dated September 24, 1998 as recorded at the Essex County North
District Registry of Deeds at Book 5186, Page 255 and shown as Lot B on Plan Number 13321
(hereinafter referred to as "Grantor's Parcel").
Said access of the Grantee onto or in the Easement Area shall be solely for the purpose
of regrading the Easement Area in connection with Grantee making repairs to the Grantee's Septic
System at the parcel shown as Lot 42 on the Grading Plan, said 2.028 acre parcel being
commonly known as 193 Foster Street, North Andover, Massachusetts and being more particularly-
shown
articularlyshown as Lot D on said Plan No. 13321 and being described in the Deed dated March 26, 1999
as recorded at the Essex County North District Registry of Deeds at Book 5380, Page 24
("Grantee's Parcel"). Said access to and regrading of the Easement Area shall be in compliance
with the terms and conditions of that certain Order of Conditions as issued by the Town of North
Andover, Conservation Commission with regard to DEP file number 242-944 as recorded at the
Essex County North District Registry of Deeds on April 24, 1999 at Book 5376, Page 272. Both
Grantor's parcel and Grantee's parcel are reflected as Lot B and D respectively on a plan entitled
"Plan of Land Located in North Andover, MA. Record Owner & Applicant The Foster Trust,
Scale: 1" = 100', Date: September 4, 1998, Christiansen & Sergi Professional Engineers,'Land
Surveyors, 160 Summer Street, Haverhill, MA 01830, TEL. 978-373-0310 being recorded at the
Essex County North District Registry of Deeds on September 24, 1998 as Plan Number 13321.
It is agreed and understood that Grantee shall have limited access to Easement Area for
purposes of repair, replacement, and maintenance, as well as other operating requirements, in
order to repair the Septic System on Grantee's Parcel in compliance with the Repair Design as
approved by the Conservation Commission; and Grantee shall be permitted to remove, compile
and/or alter the earth within the Easement Area in order to make the repairs to the Septic System
at the Grantee's Parcel (hereinafter collectively referred to as the "Temporary Grading
Easement"). Upon completion of the repair to the septic, Grantee shall make any and all
- 2-
reasonable efforts to return the Easement Area to its present condition as permissible without -
causing detriment to the Septic System as repaired.
Said Temporary Grading Easement shall be on a non-exclusive basis, for the benefit and
appurtenant to the Grantee's Parcel. All references to Grantor and Grantee and the foregoing grant -
of easements shall mean and include their respective successors and assigns, and any lessees,
licensees, invitees or guests of either the Grantor or the Grantee and their respective successors
and assigns, and the easements and rights as herein granted shall inure to the benefit of and be
binding upon Grantor and Grantee, and, in each case, their successors and assigns, it being the
intent of the parties that the benefit and burdens of the Temporary Grading Easement set forth
therein are to run with the land, constituting Grantor's Parcel and Grantee's Parcel, respectively,
during the life of this Easement until its termination in compliance with the terms and conditions
as established herein.
This Easement Agreement is subject to all easements, restrictions, conditions, reservations,
agreements and other encumbrances of record, and insofar.as the same may be in force and
applicable, as of the date hereof.
The Grantee hereto agrees that Grantee shall not suffer or permit any mechanics' or
materialman's liens claims to be filed against the lands of the Grantor in connection with any
work performed under this Easement Agreement. Grantee hereby agrees to indemnify, defend and
hold harmless Grantor, its successors and assigns, from and against any and all loss, claim, costs,
I
damage, liability, fine, penalty or expense resulting from, directly or indirectly, allegedly or
actually, the construction, installation, maintenance, use, repair, replacement or restoration of its
Temporary Grading Easement.
- 3 -
I
This Temporary Grading Easement shall automatically expire upon the receipt of a
Certificate of Compliance from the Town of North Andover Board of Health stating that the septic
system as repaired is in compliance with Title V and the regulations promulgated thereunder.
In witness whereof, the parties hereto have executed this Easement Agreement as a sealed -
instrument this day of May, 1999.
_
_—GRANTOR: GRANTEE:
Town of North Andover Foster Trust
Conservation Commission by Fleet National Ba
-- - TrusteZssi'stant
said-
Al
B B fj
r;
A ert P. nzi, Chairman Mc N' it
Vic ,President
Fleet National Bank, Trustee
COMMONWEALTH OF MASSACHUSETTS
ESSEX, SS May 1999
Then personally appeared the above named Albert P. Manzi, in his capacity as Chairman
of the North Andover Conservation Commission, and acknowledged the foregoing instrument to
be his free act and deed and the free act and deed of the North Andover Conservation Commission
before me,
G Z11i"A-1
Notary Public
My commission expires: /65
COMMONWEALTH OF MASSACHUSETTS
SS May 1999
Then personally appeared the above named G.-Bryan McNeil, in his capacity as Assistant
Vice President of Fleet National Bank, in Fleet's capacity as Trustee of the Foster Trust, and
acknowledged the foregoing instrument�to be his free act and deed, the free act and deed of Fleet
National Bank and the free act and deed of the Foster Trust, before me,
Notary Public
My commission expires: _Z � ) 3
G:I REAL-ES71 EASEMEN71 fostenrustcampare.doc ( .
$KEEN O'CONNOR BERNAlt
Notary Public
M Commission Ex ires December 4,1003
- 4- r. a
North Andover
�Department
Memo
To: North Andover Board of Health-
From: Michael D. Howard, Conservation Administrator
CC: file
Date: 12-14-98
�.3
RE: Septic Repair @ Foster Street.
Per the request of Sandy Starr, this Department inspected wetland
resource areas potentially impacted by proposed work associated with
the above referenced septic repair. I offer the following comments:
1. The applicant will have to file a Notice of Intent with the North
Andover Conservation Commission (NACC) prior to performing
any work within 100' of on-site wetlands. However, in order to
facilitate the Board of Health's review this evening I reviewed
the proposed wetland delineation. I have preliminarily
approved wetland flags NU through NL11 only as depicted on
the plan of record; the NACC will officially approve the
delineation when the applicant files accordingly.
2. The applicant proposes to grade on that portion of Foster Farm
owned by the Town but under the care and custody of the
NACC. Formal approval will have to be granted by the Board
of Selectmen, the NACC and Town Counsel prior to permitting
said work.
3. According to FEMA-FIRM Maps, the 100 year floodplain
associated with Mosquito Brook is elevation 125' (NGVD). It is
not clear what datum was utilized by Christiansen & Sergi, Inc.
but it does not appear as though work will occur within the
0 Page 1
3
jurisdictional floodplain. This matter should be discussed in
greater detail.
I trust that this correspondence will suffice. However, in the future it
would be greatly appreciated if the Board of Health would mandate that
all wetland delineation's be approved formally with the NACC prior to
deliberating and/or rendering a decision with an applicant. Sandy and I
have made it very clear to applicants that this is the correct procedure to
follow yet for reasons unbeknownst to us they file irregardless of our
recommendation. The wetland delineation must be approved during the
initial design stages otherwise the Board's review specific to wetland
setbacks is moot.
Thanking you in advance.
0 Page 2
CHRISTIANSEN AND SERGI, INC. MEMO
Professional Engineers & Land Surveyors
160 Summer St. Haverhill, MA 01830
(978)373-0310 FAX(978)372-3960
DATE: 7 1
T0: �J
sitSUBJECT:
V 2_
0
reo w J c�
U
SIGNED
Please reply. No reply necessary. TOWN OF NORTH ANDOVER/
BOARD OF HEALTH
`APR 16 IM
i
f'➢
3
t
n�b
Landscape Architecture and Environmental Planning
206 A Street,Boston,MA 02210 tel 617-437-G461 fax 617-269-4221
Christianson&Sergi
c/o Phil Christianson
160 Summer Street
Haverhill,MA 01830
September 3, 1998
Re: Wetland flagging-Foster St.,North Andover,MA
Dear Mr. Christianson:
On Friday August 21, 1998,Robert E. Marini, Landscape Architect, of Native Landscapes delineated the
wetlands relative to the above referenced lot in Haverhill, MA. Pink flags numbering NL 1 - NL 8 were
positioned in the field along the edge of BVW which borders a wet meadow / swale (See Wetland
Diagram). The relevant Data Forms are attached corresponding to orange flagged Obsevation Plots IA
(upland)and IB (wetland).
There are no Estimated Habitat Areas or Certified Vernal Pools within the limits of concern of this site,
according to the Atlas of Estimated Habitats of Rare Wetlands Wildlife, 1997 - 1998 Edition. This
document is updated annually by the Natural Heritage and Endangered Species Program, Massachusetts
Division of Fisheries and Wildlife.
Please contact us if you have any questions.
Ve#y truly yours,
Nde Landscapes Robert E. Marini,LA
Principal
Attachments: Wetland Diagram,DEP Data Forms,DEP Methodology
i
Prepared for:
FOSTER STREET
NORTH ANDOVER, MA
CHRISTIANSON&SERGI
PROFESSIONAL ENGINEERSAND LAND SURVEYORS
160 SUMMER STREET
HA VERHILL,MA 01830
Wetland Diagram
Native Landscapes
Landscape Architecture&Environmental Planners
205 A Street
Boston,MA 02210
tel:(617)437-6461
fax:(617)269-4221
NOT TO SCALE
N
Foster St.
House
Garage
Data point Fence
NLA
Wetland point
NL 8
Wetland point Wetland point
NL 1
Wetland Line
Data point
NLB
i
i
I
i
i
DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Form
Applicant: Christianson& Sergi Prepared by: Robert E. Marini Project location: Foster St., N. Andover DEP File#:
Check all that apply:
❑ Vegetation alone presumed adequate to delineate BVW boundary: fill out Sections I only
Vegetation and other indicators of hydrology used to delineate BVW boundary: fill out Section I and 11
❑ Method other than dominance test used (attach additional information)
Section I. Vegetation Observation Plot Number: Transect Number: 113 Cad NI-5 Date of Delineation: 8/21/98
A. Sample Layer and Plant Species B. Percent Cover C. Percent D. Dominant Plant E. Wetland
(by common/scientific name) (or basal area) Dominance (yes or no) Indicator
Category"
GROUND COVER
Mint/Mentha arvenis 11 14.5 yes FACW
Purple Loosestrife/Lythrum salivaris 20 28.5 yes FACW+
Soft Rush/Juncus effesus 20 28.5 yes FACW+
Upright Sedge/Carex stricta 20 28.5 yes 0131-
Use
BLUse an asterisk to mark wetland indicator plants: plant species listed in the Wetlands Protection Act(MGL c.131, s.40); plants in the genus Sphagnum; plants
listed as FAC, FAC+, FACW-, FACW, FACW+, or OBL;or plants with physiological or morphological adaptations. If any plants are identified as wetland indicator
plants due to physiological or morphological adaptations, describe the adaptation next to the asterisk.
Vegetation conclusion:
Number of dominant wetland Indicator plants: 3 Number of dominant non-wetland indicator plants: 1
Is the number of dominant wetland plants equal to or greater than the number of dominant non-wetland plants? yes no
If vegetation alone is presumed adequate to delineate the BVW boundary,submit this form with the request for Determination of Applicability or Notice of Intent.
Plot 1A
Section II. Indicators of Hydrology 1A Other Indicators of Hydrology: (check all that apply and describe)
Hydric Soil Interpretation ❑ Site Inundated:
1. Soil Survey ❑ Depth to free water in observation hole:
Is there a published soil survey for this site? yes no
❑ Depth to soil saturation in observation hole:
title/date: Essex County, MA, Northern Part
map number: 36 ❑ Water marks:
soil type mapped: HfC ❑ Drift lines:
hydric soil inclusions: Wareham & Medisaprists, shallow
❑ Sediment deposits:
Are field observations consistent with soil survey? yes no ❑ Drainage patterns in BVW:
Remarks:
❑ Oxidized rhizospheres:
2. Soil Description ❑ Water-stained leaves:
Horizon Depth Matrix Color Mottles Color ❑ Recorded data (stream, lake, or tidal gauge; aerial photo; other):
O 0-6" 10YR 3/2 none
A 6-12" 10YR 3/3 none
B 12-20" 10YR 5/6 none
❑ Other:
Vegetation and Hydrology Conclusion
yes no
Number of wetland indicator plants ❑
Remarks: >_number of non-wetland indicator plants
Wetland hydrology present:
3. Other: hydric soil present ❑
other indicators of hydrology
present El N
Conclusion: Is soil hydric? yes no Sample location is in a BVW ❑
Submit this form with the Request for determination of Applicability or Notice on Intent
DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Form
Applicant: Christianson & Sergi Prepared by: Robert E. Marini Project location: Foster St. N. Andover DEP File#:
Check all that apply:
❑ Vegetation alone presumed adequate to delineate BVW boundary: fill out Sections I only
Vegetation and other indicators of hydrology used to delineate BVW boundary: fill out Section I and II
❑ Method other than dominance test used (attach additional information)
Section I. Vegetation Observation Plot Number: Transect Number: 1A 0, NI-5 Date of Delineation: 8/21/98
A. Sample Layer and Plant Species B. Percent Cover C. Percent D. Dominant Plant E. Wetland
(by common/scientific name) (or basal area) Dominance (yes or no) Indicator
Category*
GROUND COVER
Clover/Trifolium Sp. 20 25.0 yes FACU
Dandelion 20 25.0 yes FACU
Nodding Fescue/Festuca obtusa 40 50.0 yes FACU
SHRUBS
Japanese Barberry/ Berberis thunbergii 10 100.0 yes FACU
CANOPY
Apple tree/Pyrus sp 40 100.0 yes FACU
*Use an asterisk to mark wetland indicator plants: plant species listed in the Wetlands Protection Act(MGL c.131, s.40); plants in the genus Sphagnum; plants
listed as FAC, FAC+, FACW-, FACW, FACW+,or OBL;or plants with physiological or morphological adaptations. If any plants are identified as wetland indicator
plants due to physiological or morphological adaptations, describe the adaptation next to the asterisk.
Vegetation conclusion:
Number of dominant wetland Indicator plants: 0 Number of dominant non-wetland indicator plants: 5
Is the number of dominant wetland plants equal to or greater than the number of dominant non-wetland plants? yes no
If vegetation alone is presumed adequate to delineate the BVW boundary,submit this form with the request for Determination of Applicability,or Notice of Intent.
Plot 1 B
Section 11. Indicators of Hydrology 1 B Other Indicators of Hydrology: (check all that apply and describe)
Hydric Soil Interpretation ❑ Site inundated:
1. Soil Survey ❑ Depth to free water in observation hole:
Is there a published soil survey for this site? yes no
❑ Depth to soil saturation in observation hole:
title/date: Essex County, MA, Northern Part
map number: 36 ❑ Water marks:
soil type mapped: SrB ❑ Drift lines:
hydric soil inclusions: Sudbury fine sandy loam
❑ Sediment deposits:
Are field observations consistent with soil survey? yes no r ❑ Drainage patterns in BVW:
Remarks: Hydric soil is consistent with the Walpole description
❑ Oxidized rhizospheres:
2. Soil Description ❑ Water-stained leaves:
Horizon Depth Matrix Corior Mottles Color ❑ Recorded data (stream, lake, or tidal gauge; aerial photo; other):
O 0-15" 10YR 2/2 none
❑ Other:
Vegetation and Hydrology Conclusion
yes no
Number of wetland indicator plants ® ❑
>_number of non-wetland indicator plants
Remarks:
Wetland hydrology present: ® ❑
3. Other: hydric soil present
other indicators of hydrology ❑
present
Conclusion: Is soil hydric? yes no Sample location is in a BVW ® ❑
suhinf,'hi,fonn with the Request for determination of Applicability or Notice on Intent
DEP Field Data Form and Instructions
The Department of Environmental Protection's field data form should be used when delineating the boundary of a
Bordering Vegetated Wetland(BVW)under the Massachusetts Wetlands Protection Act(M.G.L. Chapter 13 1,
Section 40)and regulations(3 10 CMR 10.55). It should be used whether the boundary is delineated by vegetation
alone or by vegetation and other indicators of wetland hydrology. Note: if detailed vegetative assessment is not
necessary for the site, make a note on the data form and submitted it. The field data form should be submitted with
a Request for Determination of Applicability or a Notice of Intent. Details on the criteria for delineating a BVW
boundary and the terminology used in this field data form are described in the handbook,Delineating Bordering
i egetated Wetlands Under the Massachusetts Wetlands Protection.4ct(MA Department of Environmental
Protection,Division of Wetlands and Waterways, 1995).
INSTRUCTIONS
The data form includes a section on project identification,including the applicant's name,the name of the person
performing the delineation,project location,and the DEP file number,if available.
If vegetation alone is presumed adequate to delineate the BVW boundary,mark the first box, complete Section I of
the data form,and submit the document. If vegetation and other indicators of hydrology are used to delineate the
BVW boundary, mark the second box,complete Sections I and 11 of the form,and submit the document.
DEP has selected the dominance test as the preferred method of vegetation analysis at sample plot locations. The
information gathered for that method should be recorded on the form. If a method other than the dominance test is
used,mark the third box and explain the method and why it was used.
Section I: Vegetation
Section I should be used to record information about the vegetation within an observation plot and on a transect
used to delineate the BVW boundary. Note the date of the delineation. Submit a separate data form for each
observation plot. Attach supplemental sheets if more space is needed.
A. Sample Layer and Plant Species
Record each plant species using common and scientific names for the following layers:
Ground Cover: woody vegetation less than 3 feet in height(seedlings),non-climbing woody vines less than 3 feet
in height,and non-woody vegetation(including mosses)of any height within a 5-foot radius plot;
Shrubs: woody vegetation between 3 feet and 20 feet in height within a 15-foot radius plot;
Saplings: woody vegetation over 20 feet in height with a diameter at breast height(dbh)greater than or equal to
0.4 inches to less than 5 inches within a 15-foot radius plot;(note: dbh is measured 4.5 feet from the ground);
Climbing woody vines: woody vines that are attached,rooted,or climbing on trees,
saplings,or shrubs within a 30-foot radius plot;and
Trees: woody vegetation with a dbh of 5 inches or greater and over 20 feet in height within
a 30-foot radius plot.
If you do not recognize a plant species or do not know a plant's name,call it a generic name. Unknown plants
need to be identified only if they are determined to be dominant plants. In that case,a plant identification book or
key may be used to determine the species.
B.Percent Cover
Determine percent cover(or basal area for trees)for each plant species in each layer by visual analysis or
measurement. (See handbook for information about determining percent cover,page 12.)
C.Percent Dominance
Determine percent dominance for each plant species by dividing the percent cover or basal area for each plant
species by the total percent cover or basal area for the layer. (See handbook for information about the dominance
test,pages 15-19.)
D. Dominant Plants
1. Identify the dominant plants. Dominant plants are:
* plants with a percent dominance of 50 percent or greater,or plants whose percent dominance
add up to immediately exceed 50 percent;
* plants with a percent dominance of 20 percent or greater;
* plants with a percent dominance equal to a plant already listed as a dominant species.
2. Determine common and scientific names for any unknown plants identified as dominant
plants.
E. Wetland Indicator Category
1. Identify the Wetland Indicator Category for all dominant plant species using the
'National List of Plant Species That Occur in Wetlands:Massachusetts.
2. Use an asterisk to mark the wetland indicator plants. Wetland indicator plants are any of
the following:
* plant species fisted in the Wetlands Protection Act;
* plants in the genus Sphagnum;
* plants fisted as Facultative(FAC),Facultative+(FAC+),Facultative Wetland(FACW-),
Facultative Wetland(FACW),Facultative Wetiand+(FACW+)or Obligate(OBL);
* plants with morphological or physiological adaptations(such as buttressed or fluted trunks,
shallow roots,or adventitious roots).
If any plants are identified as wetland indicator plants due to physiological or morphological adaptations,describe
the adaptation next to the asterisk(e.g. White pine,Pinus strobus, FACU*/shallow roots,buttressed trunks).
Vegetation Conclusion
List the number of dominant wetland indicator plants and the number of dominant
non-wetland indicator plants. If the number of dominant wetland indicator plants is equal to or greater than the
number of non-wetland indicator plants, and vegetation alone is presumed adequate for the delineation,the plot is
located in a BVW.
jIf vegetation alone has been chosen for the delineation at this site,complete only Section I and submit the form
with a Request for Determination of Applicability or a Notice of Intent. Otherwise,continue the delineation
process and record information for Section H on the second page of the form.
Section H: Indicators of Hydrology
Section II should be used to record information on indicators of hydrology in those areas where vegetation alone is
not presumed adequate to delineate the BVW boundary,or to overcome the presumption that vegetation alone is
adequate.
Hydric Soil Interpretation
1. Soil Survey: Record information about the site from the Soil Survey Report prepared by the U.S. Natural
Resources Conservation Service(MRCS)-formerly called the Soil Conservation Service.
2. Soil Description: Record information based on observations at a soil test hole located within the vegetation
observation plot. Describe the soil profile of each soil horizon, noting the depth. Identify the matrix and mottles
colors by hue,value,and chroma(information from Munsell Soil Color Charts). For example,IOYR 5/2. Notes
on soil texture and other soil characteristics may be recorded in the Remarks section.
3. Other: note any additional information used to determine if hydric soil is present, such
as regional field indicator guides.
Conclusion: Indicate whether the soil is hydric based on information observed in the field.
(See list of Hydric Soil Indicators in the handbook,page 29.)
Other Indicators of Hydrology
Record observations of other indicators of hydrology. Check and describe all that apply,Due to their seasonal or
temporal nature,these other indicators generally are used in conjunction with vegetation and soils to determine the
location of the BVW boundary.
Vegetation and Hydrology Conclusion
Determine if the observation plot is in a BVW. The observation plot is in a BVW if the number of dominant
wetland indicator plants is equal to or greater than the number of dominant non-wetland indicator plants,and if
hydric soil or other indicators of hydrology are present,
For an observation plot located in a disturbed area,any one of the three indicators is sufficient to determine that the
sample location is in a BVW. In that case, make a note on the form about that conclusion.
Submit the completed form with a Request for Determination of Applicability or a Notice of
Intent.
I
oe
Town of North Andover, Massachusetts Form No.3
a< NO RTM BOARD OF HEALTH
e t
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�'�'i�i�l�a-1.3 i 9 42101,
00 T
�9"°•,.��'� DISPOSAL WORKS CONSTRUCTION PERMIT
SSICMUSE
Applicant G I�i:El L.
NAME DD
n RE55 TELEPHONE
Site Location
Permission is hereby granted to Construct ( ) or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. /c
CHAIRMAN, BOARD OF HEALTH
Feed D.W.C. No.
Town of North Andover, Massachusetts Form No.2
f NORTq BOARD OF HEALTH
00
s
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DESIGN APPROVAL FOR
ssACHUSEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
i
ApplicantTest No.
k ALA
Site Location92 13
r Reference Plans and Specs— (�,
ENGINEER DESIGN' DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
t CHAIRMAN,BOARD OF HEALTH
c
FeeSite System Permit No.
CHRISTIANSEN & SERGI, INC.
PROFESSIONAL ENGINEERS AND LAND SURVEYORS
160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830-6318 (978)373-0310 FAX: (978)372-3960
HHEALTH
/
December 4, 1998 TO ANDQVEPi
Ms. Sandra Starrr_.
North Andover Board of Health Administrator
Office of Community Development Services
Charles St.
North Andover, MA. 01845
113
Re:-+39-Foster St. map 104D lot 42 septic system design
Dear Sandra,
Please find attached two copies of the revised design for the above referenced lot. Port
Engineering's comment was to add a 24" riser/manhole to the septic tank. We propose
to cut the existing grade so that the cover will be 6" from finished grade.
We also request that you schedule us for an appearance at the board's next meeting.
The purpose for this meeting is to request a variance from the Town of North
Andover's Minimum Requirements for the Subsurface Disposal of Sanitary Sewage for
the above lot. The variance requested is:
1. to allow the system to be built 50' from the wetlands per Title 5 as opposed
to North Andover regulation Section 5.02.
SincerelyPip .
ristiansen P.E.
PGC/epw
enclosures
I
I
Town of North Andover NGRT"
OFFICE OF0
COMMUNITY DEVELOPMENT AND SERVICES 60
30 School Street
WILLIAM J. SCOTT
North Andover, Massachusetts 01845 �,''�,, ; x
�SS�cHusEt<
Director
OUTSIDE CONSULTANT ESCROW AGREEMENT
NORTH ANDOVER BOARD OF HEALTH
Agreement is made between the
Town of North Andover and
of
for Soil Tests, -Pan Review
Cl r-3
5
KNOW ALL men by these present that the Applicant hereby
provides the Town of North Andover with a check in the sum
Of $ I , to be deposited in an escrow account for the
Town of North Andover and has deposited in an interest-
bearing account as designated by the Town Treasurer to be
expended by the North Andover Board of Health to insure
payment to any outside consultant (s) for Soil Tests, Plan
Review for the above referenced project .
This agreement shall remain in full force and effect
until the specified project has reached completion .
Board of Health Chairman Applicant
or Agent
1---i-A Date Date.
FAMILY MUTUAL'BANK
CHRI6TIANSEN :and SERGI, INC' HAVERHILL MA 19 4 Jc1,
160 SUMMER,STREET
HAVERHILL, MA 01830
53=7054/2113
CHECK NO 19451'
.:: -: ? ro
".
ONE HUNDRED TWENTY -..FIVE` DOLLARS .-DA
AMO
0
TE
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1030/98 *******$125 . 00
TO THE
ORDER TOWN OF. NORTHANDO:VER
OF
120 MAIN STREET
NO ANDOVER, MP 018'45 _
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Town of North Andover, Massachusetts
Form No. 1
BOARD OF HEALTH
NORTIy f� 19
320 SSLED 6 6'Y O
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0� ce<����<w�<. �> � APPLICATION FOR SITE TESTING/INSPECTION
SACHUS
Applicant `� 17Z TELEPHONE
NAME ADDRESS
Site Location f �®`�' `� 6,77- X
Engineer Ch'&6 7!1912 A,) ADDRESS TELEPHONE
NAME
Test/Inspection Date and Time
kZZ2
CHAIRMAN,BOARD OF HEALTH
Test No.
Fee
S.S. Permit No.
D.W.C. No. C.C. Date _Plbg. Permit No.
yy 11"774
BOARD OF HEALTH
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Cs4U5E�
30 SCHOOL STREET TEL. 688-9540
NORTH ANDOVER, MASS. 01845
APPLICATION FOR SOIL TESTS
DATE: July 8, 1998
LCCA ION OF SOIL TESTS: 193 Foster Street, North Andover, MA
Assessors map & parcel number: 104D - 42 & 43
OWNER: The Foster Trust TEL. NO.: 617-346-2352
ADDRESS. coo Fleet Bank, 75 State Street - MABOUF03U, Boston, MA 02109,
Attn: G. Bryan McNeil
ENGINEER: Christiansen & Sergi TEL NO.: 978-373-0310
CER71FiED SOIL EVALUATOR: Phillip Christiansen
Intended use of land: residential subdivisic=,milyhomcommercial
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM:
1. Proof of land ownership (Tax bill, deed, or letter from owner permitting
tests)
2. Plot plan
3. Fee of per ICt for new c:,nstruc:icn. This covers t.e minimum ;Ne deep holes
and t, r rCclaticn tests required fcr e-a& disp. csal area. Fee of ST-5.00 per lot fcr
I pairs Cr upgra e .
GENERAL INFORMATION
1. Cnly Cer:iried Scii Evaluators may pencrrn deep, hole Inscec:icns.
2. Only Mass. Registered Sanitarians and Prctessicnal E.^.CfnEerS Con CeSiCn ScCt(C
clans.
3. =.t lest ',Nc deep holes and t`NC percciatIcn +estS are revulred fcr _-Z&l Septic sySzem
dispcsai area.
4. Repairs require at least two deep holes and at le=st Cne cercclaticn -Lest. at the
discretion of the BOH representative.
5. Full payment ,Nill be required 'or all additional tests within i'No weeks of testing.
6. Within 45 days of testing, a scaied plan (no smaller than I%100') shall be submitted to
Lt-,e Board of Health showing the location of all tests (inc:udino aborted tests).
7. �Alithln '0 days of testing Scii evaluation forms shall be sucmitted.
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We. Earl L. Foster and Beatrice N. Foster. husband and wife. an joint tenants.
_ � I
of
North Andover. Essex
'
b gsoe n cried,for mnsideradon paid,and in fall C=fA=6=of less than One Hundred ($100.00)
Dollars
granr ro - Earl L. Foster and Beatrice N. Foster. Trustees of THE FOSTER 720ST. a
'
May 30. 1985 and duly recorded with Essex North
under Declaration of Trust dated
gjc District Registry of Deeds herewith of 135 Foster St.. NortbAnd v r, NA
with qugutat taQr�a 1 q
t.
x}siaatiac
VDewipcas and eacambana.it sfltl
A certain parcel of land situated in said North Andover. being Lot No. 1 on 1 '
a Plan entitled "Plan of Land in North Andover as subdivided for Adjutor Lavoie" E
by Ralph B. Brasseur. C.E. dated July. 1948 and recorded with North District of
Essex.Registry of Deeds as Plan No. 2111 and being more particularly bounded and.
described as follows:
r,eginning on the Nortnerly aide of Foster Street at a private vay; thence running
Easterly by said Foster StrSe 1s 5.00 ftet to Lot No. 2 on said plan; thence running
Northerly by said Lot No.21 2�ri. a ?Ser to land of Earl and Beatrice Foster as {{1
shown on said plan; thence running Southwesterly by said private way 359.9 feet
to the point of beginning.
1
Containing .76 acres more or less.
a '
Being the same premises conveyed to us by deed of James H. Dewhirst. Treasurer.
Custodian and Auctioneer of Tax Title Property of the Town of North Andover dated
October 4. 1978 and duly recorded with said Deeds at Book 1352. Page 765.
o Subject to all easements, restrictions, rights of way and encumbrances of record
to the extent that the same are in force and applicable. j
i i j i3
3IItiarasia our brads and sol a dzs 30th day of Nay .1981
_...............__....__....._.._...................._......_... ¢...� �
Earl L. Foster I
................._ _. I
• Bea rue N. Foster �
_..... .. ............_...._......._....................... ._......_.__..........-.........._...____....................
_
Essex, 1
n. Nay 30 1985
Then persnoallyapp=rdthe abovenamed Earl L. Foster and Beatrice N. Foster �I f
and acl9owledgcd the foregoing inattw=t to be their free aC and aid before me _
j!
I l
,
Richard A1ata<rP .11
i I
1 8 t1y a�i�iaa amimm 3/27/92
11 t: 'r;•:`,2�, l 'k
-corded June 9 5 at 2:58PU #12028 ?l� = yam.`
1
t
Vkry3; t
l:
KI985
i 2-1•- We, Earl L. Foster
and Beatrice E. Foster (a/k/a Beatrice N. Footer) husband and rife
of North Andover. .
i sez -
I� bear
` Dollarr Oan PO4 sad is fall c0oSUcC1ti0o of less than One Hundred
cr
f=r to Earl L. Foster and Beatrice N. Foster. Trustees of u
t u der Declaration of Trust dated �7 30. 1985 and dui THE TR � `'•
DI tract Registry of Deeds herewith y•recorded with Esse orth' },
135 Foster St.. North Andover. MA
gat2rlaim-saaM;M t
�j XhXJ2nda A certain parcel of land situated in North Andoverand bounded and described 5
1 as follows: . e
;r.
m
Beginning at a point on Winter Street at land)now or formerly of one Gaetano
Ferlico; thence running northerly by said Winter Street to land now or formerly "3
Of Calvin Rea; thence westerly by said Rea's land to a corner in the wall to land
now or formerly of Harry Foster; thence southeasterly as the wall stands, and by
o said Foster's land to a corner in the wall; thencesouthwesterly as the wall stands. _ ~~
'o still by said Foster's land to a corner in the wall; thence southeasterly as the
wall stands to a orner, still by said Foster's land thence southwesterly still ti
II by said Foster's and to n the
�fli to Foster Street v her tan%oF.e�r �$} • ���A�fi U-iu jtsrg)) r'%4ajje southerly
o Mort easterly as t e a stands co land o sa erlito; thf_nce
It Z northerly by said Ferlito's land to a corner in the wall; thence northeasterly
by said Ferlico's land to Winter Street and the point- of beginning.
�P y .g
t, Meaning and intending hereby to convey those parcels of land described 1n _
plan of Archie 0. Foster Estate, recorded in the North District of
of Deeds and numbered Essex Re isa
is m
0 1512, and described on that plan as the "Sheep Pasture" ory
li�• °' "Orchard." "The Cow Pasture," and "Few Field," and the "North Pasture," reserving.
'however, the right of way as the same now exists over what is known as Bruin Hill ;
m lane for the benefit of Harry Foster, his heirs and assigns."
j,
II , Reserving, however. William
e Sheep Pasture" and to cutdownsuceright on the
h trees ashemay desire, until May d1. 1948.
Being the same premises conveyed to
grantors by I nd
Charlotte N. Foster by deed dated June 13. 1945 and drecordedeed of lwith saidttle A. Deedsster r
Book 674, Page 367. -''
Z � z
Excepting from the above described property so much of the above described property 4
-c as was conveyed in deeds duly recorded with said Essex -North District Registry
of Deeds, namely a
(1) Deed to R. W. Baird recorded at Book 820, Page 396 on 9/23/55; and
I e (2) Deed to G. Ferlito recorded at Book 687, Page 391 on 7/22/46.
I , Subject to all easements, restrictions, rights of way and encumbrances of record
i to the extent that the same are in force and applicable. "p
l `
I ( $Ttitcrsa our hands and =xb ;
�� °ttL-dar ef_ Maw '
85
EarI"L:'roster.:....��' *,.._.
II� I _ _ •._.. _».....•...._...._..._ ..........._.._... ..•...... -' E
li � _..... _......»..••....... .............•..................._...._..........•.......•....._...._.., i P
alp, rulik cf 2Saaaarhmartis
I.• Essex
I�7 ti
j
May 30 1985 •'r. k
JThen P=X=ll7appeared the above as Earl L. Foster and Beatrice E. Foster
and Acknowledged the
focegoin 8+a3tr2mcnt to be their free ad and dead lief=
Richard &.Cz
an Aioary public—
my
-
f;I�
Recorded 11 1 E mymmminime p4cz May 27
t( orded June , 9 5 at 2:5P.PL' "12029
K
Ili � V••'.• /l',•- f -
f +
i
B 9 1985
f�.
;i We. Earl L. Foster and Beatrice N. Foster. husband_and wifeg as point tenants 213
%r of North Andover, Essex Cou=tT�I`�+ +uwess
b�rf�rarenitd,for cros+drntion paid,sad m full eoatider+tioa of less than one Hundred (i100,00) –
Dollars _ ff
��� CO Earl L. Foster and Beatrice N. Foster. Trustee of THE FOSTER TRUST, e C
under Declaration of•Trust dated Hay 30. 1985 and duiy recorded with Esse; Kurth ti
strict Registry of Deeds herewith with qudrlatm.tatrtaacrla `I
135 Foster St., North Andover. 1SA
1:.._..
dais"ic Two parcels of land, situated in said North Andover. j.
Wa—P—sad---I esti
1. A parcel of property situated on 'the South side of Foster Street commonly called i t
"Ryefield". the. triangular piece of property 1n front thereof upon which stands t
theold Nathan Foster House, and the piece of land situated to the rear thereat,
all of,which said parcels together are commonly known as the "Charles S. Poater
House Lots or Home Fields".. and contain about 14 3/4 acres.
2. A parcel of. land containing about 16 -acres* commonly known as the "Town* Lend"
which was once conveyed by Jacob Towne to Charles S. Foster by deed dated April
27. 1878, recorded with North Essex Registry of Deeds, Book 50, Page 467.
Being the same premises conveyed to the grantors by deed of Laura C. Yard dated May
14. 1936 and recorded with said Deeds at Book 598. Page 276. 1
property P operty
� Excepting from the above describedso much of the above described r
> as was conveyed'in deeds duly recorded with said Essex North District Registry of
` c Deeds. namely
1
(1) Deed to Fickenworth recorded at Book 656. Page 162 on 2/24/43
s �
w (2) Deed to Carter recorded at Book 757, Page 552 on 11/28/51 �.
0 (3) Deed to Delia De Paris recorded at Book 930. Page 74 on 1/10/61
z
(4) Deed to A. R.Verville recorded at Book 959. Page 42 on 5/25/62
(5) Deed to R. C. Cable recorded at Book 964, Page 189 on 8/16/62
ti (6) Deed to Y. J. Chaput recorded at Book 1263. Page 462 on 7/17/75
a. rights of way and encumbrances of record
Subject to all.essemeats, restriction
o to the extent that the same are in force and applicable. '
� 1
z
t
s � f
33ttmem our hands and aceta rhe 30th day of -� y,� !9111
...........».....»..«..»... T��'Fos ...Lr `"'�.._-.-............
.... .
_.»......__................_.».«.».......»._»«...._....«... Be r ce osier ............ k
Essex W U+saa+Y �M"M"'N SL May
30 1985
_
7L=personally appeuvdthe aboreaarced Earl L. Foster and Beatrice N. Poster
and scbwsrI dged the�c$oiDB iaatznmmt m their Ecce act me
Xicha
U1®y. March 27
Recorded June 11,1985 at 2:58FU #12030 _._..— ; d'•,�,,r,,,•;; � i
-- BK1985
121-4 Z. Earl Poster (also known as Earl L. Foster)
of !forth Andover. Ee� _
coact,,;Ddsao _
1'
"S fm—fid,for tnodduation Feld,and is 64 aon"watiom of lass than one
ihmdred"($100.00)
�n,rr to Earl L. Poster and Beatrice A. Poster Trustees of TEE FOSTER TRUST.
!; ilnder Declaration of Trust dated May 30. 1983 and duly recorded vith Essex North
1: District Registry of Deeds herewith
! of 135Poster St.. North Andover. MA w�
• r{alSrlataisamtaasrSs
1 tbeland Nc with the buildings thereon. being a barn. situated on the Southerly i
i 1
side of Foster Street, in North Andover. Essex County. bounded and described as
0>�vwL..Ld .0-71
follows: Beginning at a point on the Southerly line 'Of said Foster Street at a .
stone wall separating land of the grantor from the land of the grantee; thence_
running Easterly by said Foster Street, in two courses of twenty-two (22) feet.
more or less. and fifty-six and 2/10.(56.2) feet to a stake set in the Southerly _
line of said Foster Street. said stake being the center point of a certain right
of way running Southerly from said Foster Street; thence turning and running Southerly,
sixty-four and 32/100 (64.32) feet to an iron pipe set in the ground; thence turn
ing•
and running Southea3terly twenty-two and 9/10 (22.9) feet to the end of a culvert;
thence turning and running in a Southerly ind Southeasterly direction along the
Westerly side of a ditch, two hundred nine (209) feet, more or less, to the inter-
section of another ditch; thence turning and running Southwesterly and Southerly
by the second ditch, thirty-four (34) feet, more or less, to a stone wall, one
f hundred (100) feet to the intersection of another stone wall; thence turning and
I? running Northerly by the said second stone wall.- three hundred fifteen (315) feet.
more or less, to Foster Street, and the point of-beginning. Said parcel contains,
twenty-four thousand three-hundred twenty (24320) square feet. more or less. and
0 is shown on "Plan of Rand in North Andover, Mass., as surveyed for F.H. Porter.--
Aug.. 1946, Ralph B. Brass2ur. C.E."
_h
I !! Being the same premises conveyed to me by deed of F. Howard Porter dated August
00 26. 1946 and recorded with said Deeds at Book 694. Page 174.
f
Subject to all easements, restrictions, rights'of way and encumbrances of record
to the extent that the same are in force and applicable.
e
- m -
0
w -
t
z
o
N
U
O
our hand s and td d.= 30th daof May
o y 7 19�_
'I 4 ..._.—.._..__�.�_�.__.._.._.._.._.—....... ..
Earl Foster a/k/aPoscer.»._... I.�.
Earl L.
--- �._ _�.. ... �_ ........ ...._.__................... ..._..»»
r
Iter I
Essex t
LL May 30 1985
Tbmpenownysppearedthe above named Earl Poster
tt I
a:
and ackaowiedgcd the forcgomg mstrvmcot to be his five ad and deed b �
• $!char ��pa6Gc� tl�
my ocunhdoo qty March 27 .........,j9 92
• - .fafl.dd�Cft 4F��p��•}•*�}•��J
' •-,b l&9tu•Lot de irtm>}-
1 andel ai;srt tLe-deed:• v} `Z
Recorded June 11,1985 at 2:58PU #12031 `
•i^:
.y
lr
� .BK19f35
_ --•
rwaa�►cawasrrs sUrrC .�.Dasa p�mum p Dao►owrl w
N
215 I ,i�.
st:
�.4 -1, Earl L. Foster qty,Mz=cbusetts ;
Ease%
• Horth Andover, `'•`
'rJ of
less than One Hundred ($100.00)
+ _ bai7rg:f 1�rmerried,for mnsidrntioa paid.and in full coosideratioa of - 1
Dollars trustees of TAE FOSTER TRUST' • ;.i; i ,
-t fiat Earl L. Foster and Beatrice N. Foster,
y under Declaration of Trust dated May 30. 1985 and duly recorded with Essex North
'
'1 Registry of Deeds herewith with pdrlalm raazas� {
District Reg i !+
of 135 Foster St., Horth Andover. MA .{,f
iDecipt;oe d=71 11.
shown as "Big Field 21.69
Two parcels of land situated in said North Andover, being i
-', more or less" and "B .12 acres" on Plan Brasseur Part of
CFE., Haverhill, Massporter. [
Acres, bounded
Korth Andover, Mass., March 16, 1948. Ralph parcels are more particularly
s
which plan is to be recorded herewith. Said p !
and described as follows: line of Foster Street
"Big Field". Beginning at au iron pipe is the Southerly i
t at land of Charlotte M. Foster as shown on said plan; thegrantor,
running in an Easterly I([
said Foster Street and other land of the grantor, fifteen hundred
direction by said
'* ten (1510) feet, more or less, to an an in the stone wall; thence running y ;1 f
said stone wall in a Southeasterly direction two hundred fifty (250) feet by `
�y other land of the grantor to another angle in said stone wall; thence the grantor
t said scone wall and other land of the g _ {
S running in a Southerly direction by
'-�- Westerly by said stone wall and land of Earle
and crossing Mosquito Brook, two hundred eighty-five (285) feet to land of Farle
r L. Foster; thence turning and running five hundred forty-
I.0 L. FosteL _-•uses of eleven hundred seventy (1170) feet, tan thence
a five (545) feet, and sixty-five (65) feet to a brook as shorn on said plan; thence
a
turning and running by the center line of said brook as showfeet,
on fourteen (14) feet,
7Cortheasterly direction in courses of thirty-four (}4) feet.
Zo fifty (50) feet. ninety (90) feet, sixty-five (65) feet. and ninety-one and 6/10
? e at land of Charlotte M. Foster as shown on said p
fty (150) feet
(91.6) feet to an iron pip
.; thence turning and running in an Easterly direction
pi eOethencehundred
turning and runn50) f et
{ s by said Charlotte M. Foster land to another iron pipe; f
v Sorthwesterlyistill by FosterdStarlottereet and the Fpoint ofoster nbeglnningd, one ndred fifty (150) t
i to the iron pipe
t by Foster Street; .
Parcel "B1': Northwesterly ninety-s lx and 18/lOarcel•lA, on said plan Easterly
y o Northeasterly seventeen and 73/100 `ee" b Baia parcel "A"; Southwesterly twenty-
:a Dae hundred three anu � C (1C..6)
two and 9/10 (22.9) feet by other land of Ear
le L. saldeland ofEarle L. roster
=. and Westerly sixty-four and 221an01apdu12)recordefeet d with Esses North District Registry
j Said p T
as shown on said plan.
of Deeds as Plan 11878.
d se by deed of P. Howard Porter dated April
Being the same premises conveyed to
15. 1948 and recorded with said Deeds at Book 709. Page 368. 1
s- is of way and encumbrances of record
Subject to all easements. restrictions.
rights
ars in force and applicable. 1
to the extent that the same
! r
• • j:i1
?•• C
��•((( A, `
�I.. „.A
_ ..
-BH1985
I;,. - -
", 21R 39mw ,t hmd =.d=1 this ds7 of
1 L. Foster
iii!'. �» ........_...».. `........•......
Essex ts. Ho 30 19 8S
1;.(i::
` F Thm peace sppmred the sho"asmed Earl L. Poster `
' sad admowledged the foregoing mstr�mt to be his five tads me
..
y., :,; J/
.4G 11j E Rlch4II >i
-
i March 27 I9 92
Recorded June 11,1985 at 2:58PD! 1f12032
r
I '
i
i 4
BH1985
2_.S I. Earl L. Poscar '.
North Andover. Ego" -. .. .
of
i•'�;.. less than one HUndred ($100.00)
` heir am..,ied,for 000siderstioa paid.and in full considlut
of
Dolrars •
i' to Earl L. Poster and Beatrice N. Poster. Trustees of THE FOSTER TRUST. _
ugn er Declaration of Trust dated
May 30, 19R5 and duly recorded with Essex North
:'• IIistrict Registry of Deeds herewith � �ria{in �pr=ds
n• D
135 Foster St., North Andover. HA
i•
theLwdia North Andover, ]mown as the Pry me
land. and now or forrly known as part
of the John Long Farm. bounded and described as follows: Beginning at the extreme
�oa•;prion,ad mcvmbama'a.if m71
northerly corner thereof at a stake and stones by land formerly of Nathan Foster
II and the heirs of Avijah Fuller, thence southeasterly seven (7) rods and twenty .
two (22) links to a stake and stones. thence in about the same course twelve (12) ;r
rods to a stake and stones. thence four (4) rods and twelve (12) Unica to a stake
^ and stones, thence more southerly four (4) rods to a stake and stones, thence three -
(3) rods and sixteen (16) links to a stake and stones, thence twelve rods to a
stake and stones, thence seven (7) rods and eight (8) links to a stake and scones,'
thence six (6) rods to a stake and stones, thence si7:teen (16) rods to a stake
and stouts, thence nix (6) rods and eight (8) links co a stake and scones, thence
nine (9) rods to a stake and stones, thenco six (6) rods to a stake and stones
to the road, thence crossing said road and running westerly by land formerly of
sixteen (16) links to a stake and stones, thence
Hannah Foster eight (8) rods and
thirteen (13) links to a stake and stones
southwesterly four (4) rods and i thence
rods y southerly five (5) rods to a stake and stones. thence auc� '=ester <<
� and five (5) links to a stake and stones, thence eleven (11) rods and twelve links
o ,<
to a stake and stones, thence three rods and fifteen (15) links to a stake and
! stones. thence Fourteen (14) rods to a stake and stones, thence four (4) rods to r,
a stake and stones, thence northwesterly eleven (11) rods and twenty (20) links.
t`.c-.c three (3) rods to a stake and stones. thence six (6) rods to a stake and
stones, thence four (4) rods to a stake and scones, [hence three (3) rods and seven
i (7) links to a stake and stones, thence two (2) rods to a stake and stones, thence
y three (3) rods and fifteen (15) links to a stake and stones, thence more westerly
., eight (8) rods to a stake and stones, thence eight (8) rods to a stake and stones. - 4
thence four (4) rods and ten (10) links to a stake and stones, the more northerly -
t9 s to a stake and stones, to the road above mentioned.
six (b) rods and eleven (11) link
thence crossing said road tvency three (23) rods northeasterly, thence northerly
twelve (12) rods to a stake and atones, thence nine (9) rode to a stake and scones.
a northeasterly by land formerly of Nathan Foster eleven (11) rods to a stake
,t..,r•:. anent
!'•�+• + and stones, thence eight (8) rods to a stake and scones, thence five (5) rods an
15•:� i. z
o fifteen (15) links to a stake and stones, thence twenty (20) rads to a stake and -
E, stones, thence ten (10) rods and twelve links to a stake and scones, thence fourteen
(14) rods and ten (10) links to the corner, the bound first above named.
?' : Subject to takings of record.
a
w Being the same premises conveyed to me by deed of Edna W. Marshall, Chester C. -
O Ward and-Mabel W. Foster dated August 22. 1942 and recorded with said Deeds at
°i Book 653, Page 485.
'7 -fr
Excepting from the above described property so much of the above described property _
as was conveyed in deeds duly recorded with said Essex North District Registry
of Deeds, namely =_
(1) Deed to A. Szelest recorded at Book 658, Page 313 on 6/2/43
(2) Deed to B. F. Robinson recorded at Book 934, Page 15 on 4/7/61
..+:
(3) Deed to N. C. Tardie recorded as Book 981, Page 373 on 3/20/63
(4) Deed to J. T. Sevigny recurdec' 1065, Page 23 on 7/22/66
(S) Deed to D. L. Carlson recorded at Book 1264, Page 96 on 7/25/75 .„
i' Subject to all easements, restrictions, rights of way and encumbrances of record
to the extent chat the same are in force and applicable. :a
i.
w B K1985 ---. ..
85219
b� aad adt
30th •,,,_ ,.,,._. y C� I
I R
I
ter
ur-*.
' may30 1988
Essex SL
named Earl L. Foster
Thea pm.-UTappeared the above -
I �;!►_
rl:�it
and ad=w the to be his before me
fotegoin$is
Richard i i lI.
iir ..
M,c�.i.�. ,. „ — tsss
_ A.
' 111» MIIMIII I I .i�.
Recorded June 11,1985 at 2:58PU #1203
FORM 11 - SOIL EVALUATOR FORA
Page 1 of 3
No. Date:
Commonwealth of Massachusetts
NOe--P-4 AADoVEk , Massachusetts
Soil Suitability Assessment,for On-site Sewage Disposal
Performed B Date:
� : Dame l &C-0 . ne . _. .
Witnessed By: S"a/r/612
- �-
L=a,on Address ds acv owrc-1 Namc, 7NE F70-sT12 U 6T
�- �G A)AT 64$J _
Lot�l �1 Adarw,ani
/vt,p /0q -)l l"GWC Lk I3/'i Gcm A C 7`5 �?u�
New Construction � Repair E3bSfa-n , Alt& Oa /0 1
Office Review
Published Soil Survey Available: No ! Yes
Year Published �`/�f'................ Publication Scale / % /S,..sC7 Soil Map Unit
Drainage Class ................. Soil Limitations ......................... ....... .. ..... .. _.......
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published Publication Scale
GeologicMaterial (Map Unit) ................. ............................................................. .............
Landform ................................................................................................................................................................... . .. ..........
Flood Insurance Rate Map:
.Above 500 vear flood boundary No 71Yes � i
Within 500 year flood boundary No es ❑ �0V
4
Within 100 vear flood boundary No es 17
Wetland Area:
National Wetland Inventory Map (map unit) - - -
Wetlands Conservancy Program Map (map unit) F l (�meL ....._......................_...._ _..__
Current Water Resource Conditions (USGS): Month
Ranee :Above Normal ❑Normal ❑Bele,•- Normal ❑
Other References Reviewed:
DEP APPROVED FORM- 12/07/95
q
f �
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot Ido. ��Sv
On-site Review
� G � n n 1
Deep Hole Number q�.'5 - Date:
d014l Time:. Weather sU
Location (identify on site plan)
Land Use Slope (%) �'�� Surface Stones
Vegetation . .:.
LandformMt. .. �
Position on landscape (sketch on the back) /U1 lboe-c- & PE - -
Distances from:
Open Water Body feet Drainage way feet
i
Possible Wet Area -5V-t" feet Property Line . . feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE '-OGr
Depth from Soil Horizon Soil Texture Soil Color Soil
Other
Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, %
Grav�P 3l3 goofs to fa Mve�
r
oel 17 to 15-YP FOSS;Ire,
6F s ,t oam Co rn m 0-4 F ©©
"5-Y&
C. S+onq a,5�1 Garain�a�' �oa�e
Z s C4Af Few r-00
CommO''`
e-
Loom s,Darn ss " lVjctss,ll�, V . oc>�/
49 % P� -
_
0
e thtoBed
rock:
Parent Material (geologic) ��L1— p
h o Groundwater: Standing Water in the Hole:
Weeping from Pit Face:
Dept t �
Estimated Seasonal High Ground Water:
DEP APPROVED FORM• 12107/95
�1
FORM 11 SOIL EVALUATOR FORM
Page 21 of 3
Location Address or Lot Ivo. 1el FQ S 1
On-site Review
Q / c
f Deep Hole Number l��b Date: 1012-IG e Time: Weather SU/'I dl
Location (identify on site plan) _ J
Land Use /vlfado Slope Surface Stones
Vegetation Gro-ss
Landform k,a� T'Cwna t. ' I_
Position on landscape (sketch on the back) M ddl S1��"e-�
Distances from:
Open Water Body feet Drainage way t feet
Possible Wet Area -5D feet Property Line 'ZJ0 feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE _OG'
Depth from Soil Horizon Sod Texture Soil Color Soil Other
Surface (Inches) I I (USDA) I (Munsell) Mottling (Structure, Stones. Boulders. Consistency, %
Gravel)
313
vii
l q 45 1 �� a,�� Y �.s ye ✓�I ass; - ry
L. SaInd
5 .La m 41 &13MINIMUM OF 2
H ) (�
Parent Material (geologic) -"7LL tr DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: l T Weeping from Pit Face:
r!
Estimated Seasonal High Ground Water: `tom i/£�
DEP APPROVED FORM- 12/07/95
'03=21-1996 14:36 617 932. 7615 DEP'. NORTHEAST PEGI'ONAL. : P 02' r
FORtii 1' PERCOLATION 'PEST`
Location Address orlot No. _
COMMONWEALTH OF MASSACHUSETTS =
Massachusetts
Percolation Test'
Date:. Time:_ - .
Observation Hole # -
Depth of Perc
Start Pre-soak
Erid Pre-soak
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rate Min./inch
• Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed ❑ Site Failed ❑
Performed By:
Witnessed BY:\
Comments: _..
i
DIP AMOY=TORM-12wil!
s
FORM 11 - SUIL L� ALL:'>TU1� �'U1�j11
Pa-e ; of
Location Address or Lot No. i3q �GSf�v 5
Dote rmination for Seasonal Fl i�h Water 7'able
Method Used:
_ Depth observed standing in observation hole inches
_
Dept~ weeping from side of observatl0r, hale inches
Dept. to soil monies Inches
ground wale; adjustment Tei.
index Wel! NLim Der __ . . . Readinc Dote _.. ... Index well level
r;01l:St Tient f ac:Or .._ Adiusted ground water level
Occurring M21eria'
Does at least Tour feet 0i naturally occurring pervious material exist In all areas
observed throughout the area proposed for the soil absorption system?
IT not, what is the death of naturally occurring pervious material?
;ertiTV that On G r (Gate) I have Dassed the Soil evaluator examination
a.^.Drcved Dv the Department of Environme.�tal 'rotection and that the aDOve anaivs:S
was performed by me consistent with the reculrec training, expertise and ex,peNe11ca-
nesc a V1 �.
Signature PD,0,4uL �arvwd Date
I)v-P APPROVED F0R.%1- :210'7/95
14:,3b air (01= U=F, NUK1 nCHb 1 KCUlUNNL
n ' N
FORM 12 - PERCOLATION TEST
Location Address or Lot No. 13 FD SkV FaA,-
COMMONWEALTH OF MASSACHUSETTS
,i
M04, Ado YP-� , Massachusetts
Percolation Test'
Date: 10 2-I�,Y Time:
Observation Hole # "
Depth of Perc
Start Pre-soak
End Pre-soak
Time at 12" U
Time at 9" 2
Time at 6" C
Time (9"-6") Z F /m ;rl
Rate Min./inch l n
" Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed El' Site Failed ❑
................ .... ...................................... .
Ct-A Mal
Performed By: _ Dapa i O'
.\
Witnessed By:
� s
Comments: �r_
__.... ...... . . . . .. _.
)I?AF oy=FORK-uro7n!
DATE:
LOCATION: l 6
1
ENGINEER:
BOF-, Wl i NcSS.
PERCOL\TION TEST --,,'
BO OM DEPTH Or PERC TEST.
TIME OF SOAK: (At legis inures Icrc)
TIME AT 1`'"
4
TIME AT 9" c I
TIME AT t l 1
CVEr.NIG'r,T SOAK
TlN1E STAR T=D
NEXT DA" SOAK: (At ieEs;
T M E AT 112"
TIME T
TIMEL' ATS"
DATE;
LOCATION:
F � I
BOH WITNESS.
-te r "y
OL^ITION TEST #
I .. _
50 77 i OM DEAFTH Or Pr TEST.
I .
TIME OF -5OAK;
c rt leas �Iirutes Icrc
I i rvl E A 1 _
_
TIME TIMEAT �"
ZLTIME AT
Y l CA,
cvE .Nlc,-4 T SOr.K
^ RTE`D
TiiviE STS.;,
NAV T D,-"y SOAK: (. eZ-s Tiru-es
c )
l\
TuIE , , I %„
I 'iME I
TIME AT
r ..
DATE: 7 16
LOCATION. 3
ENGINE_ ::
` "7
BOH, VVI i NESS:
PEP.COL"\TION TEST :;
EOTT OM DEP H, OF PL:-::.IRC TEST.
_ 3 ° -
T WE OF SOAK.:
IiMEAt 1%"
TIME AT 2
T IME AT
VE NIGI✓T 50=.K
TiiviE
T=D
er
N`;\ I CJ
E A. I
T i T
TIME: AT 5"
Commonwealth of Massachusetts RECEIVED
City/Town of No Andover ��� `12013
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System Pumping Record
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TOWN OF NORTH ANDOVER
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Form 4 HEALTH DEPARTMENT
DEP has provided this form for use b local Boards of Health. Other forms may be used, but the
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information must be substantial) the same as that provided here. Before using this form, check with our
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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 within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
Important:When
filling out forms 1. System Location:
on the computer,
use only the tab
key to move your Address
cursor-do not No Andover Ma
use the return City/Town State Zip Code
key.
2. System Owner:
Name
ienen
Address(if different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
-311. Date of Pumping Dae 2. Quantity Pumped: J Ions
3. Type of system: ❑ Cesspool(s) ❑/Septic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other(describe): /
4. Effluent Tee Filter present? ❑ Yes/p,
es No If yes,was it cleaned? ❑ Yes ❑ No
5. Condition of System: �-
6. System Pump
f I*) �-
Name Vehicle License Number
Stewart's Septic Service
Company
7. Location where contents were disposed:
Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835
Signature of Hauler Date
Signature of Receiving Facility Date
t5form4.doc•03/06 System Pumping Record•Page 1 of 1
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V/ � RECEIVED,.,.
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f'UtiVN OF NUK1'M Y�NC1�.)� :.: .
SEP — 7 2005
u� ,'e SYST-N-1 PUMPINQ RTCOKI
TOWN OF NORTH ANDOVER
�Y 1' M OWT�KR �npi�ss . _ HEALTHQEPAR'CMcNT
i h t TSY�TQM lilN�
on t
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�4LCC�CARRYpY>rR;� OTHER, EXPLAIN
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6VN OF NORTH OVER
SYSTEM PHfPiNG RECORiS
JUJU ^ 3 2003
l"s'TEM (lVYM&R A ADDRESS SYSTEM LOCATION—-
(example:
(example: left front of house)193
/vic�ove r, 'AP%
VATE OF PUMPINC: o QUANTITY 0UMPED /L"Ud
{iALLU1�
F.SSI100L: NO YL? SEPTIC TANK: NO YES
NATURE OF SERVICE; ROUTINE , EMERGENCY ,
mis RVATIONSr
GOOD CONDITIOX FULL TO COY fit
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACNFIELD RU,I BACK-
EXCESSWE SO MDS FLOODED
SOLIDS CARRYOVER ,D.WHRR (EXPLAJN)
PUMPED BY: • '' ��-` ' �fi
ua'I I E.NTS:
u�"I•I:n•I•s
TRA NsrEItRE0 TO:
d 11 4.f
rA4+ i r r i
TOWN'OF'NORTH ANDOVER
SYSTEM PUMPING RECORD
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SYSTEM OWNER&ADDRESS SYSTEM LOCATION
(example: left front of house)
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t A 'tlrt Sri, •�e, J.ZZ �
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9
ell
PUMPING:
QUANTITY PUMPED 6GALLONS
�.�1sT'�•�tt? ^ n��Iv�r' �� t i �1t,� >✓! t + "' - f !
CESSPOOL: NO_ YES SEPTIC TANK: NO YES
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NATURE.OF-.SERVICE: ROUTINE• EMERGENCY - - -
3
pa �fipxOpst } },,Ptd r {.i i rlb. _
d a as r t
�SERVATIONS.
GOOD,CONDITION' FULL TO COVER
HEAVY --
GREASE BAFFLES IN PLACE _
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
' SOL IDS.CARRYOVER OTHER EXPLAIN
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tr' Ft�<ti1viF�Y 4'!'ti; °SYSTEM BUMPED BY: �bv
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RTH.'ANDOVER° MASSACHUSETTS
r,SV xe Pumping Rocord
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DEP..has provided thts form for use by local Boards of Health. The System Pumping Record must
be submitted to the.local'Board of Health or other approving author( ,
:A:.,Facility Inforrifiation .
R:DT7
(ITIRprtant:: ,
SE
;j;•Y."n,NMO out 1 System Location
.on the n AL1 I TOWNCCnlputel,use,;- 190 . �/ i� OF
HEALTonly the tab key Address
to move your;; ., / 07,
.cursor•do Ito(
`use therotum Cltyrrown ,: . State
�y p Code
-`Y 2 System Ownar.
1Yr�J•- x;J :J. �' Ja, ' t, �r.t 'f k.• :r„'7, ...�j��j��/� -
i �..�.,• ;+< ;, ; ��.•Name ,. r,.
Address(if different from location
CltylTowrt State'
Telephone Number
umping:Re`,,cord
.,.� �. �• • 1.;. Date'
P
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t
Q ntl
. Pumped:
to ry
' Gallons
.Typ9 9f.system- ❑ Cesspool(s) 0Stptic Tank C3 Tight Tank
❑'/Other(describe),
. ' Effluent Tee Filter present? ❑ Yes•( o If yes, was it gleaned? ❑ Y
No
ConditJon ofS stm,
n ` ( :.'/ Ir�l 4,.fi+liruil!��• t,J.tJ ,,'{,+•l:a�V�')JI +' � C•
i
rFC ,' 5; .fb ,« Vehicle Ucen4e Number
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... •� '!`��1..�•fit 7. 1��✓tr,�A� 'w„
ocatlon where contents yvere'di;3posed:
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'r. ,at.:a+ .t:,'.v'�r'i"F!•` '� '•'•5���•"�•� fd'";.t 1,•% ,}5• ///1/X��- .
,;`; :':: ;;�.:. «.°a.K:•4'.�.':'�.°;Signature of Date
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Commonwealth of Massachusetts
City/Town of - ~' IS
-
w
System Pumping Record
Form 4 OCT
I NO
�M
DEP has provided this form for use by local Boards of Hitj� e� sed, but the
information must be substantially the same as that provid e0t orm, 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: Left front of house, right front of house, left side of house, right side of house, Left
rear of house, right rear of hous<left side o buiIn right rear of building, under deck.
City/Town State Zip Code
2. System Owner:
Name
Address(if different from location)
Citylrown State � � � ^ Z�ip�C de
Telephone Number 7�
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 D-No If yes, was it cleaned? ❑ Yes ❑ No
5. Conditp n Pf System.
(IV cg�-AaA ky� \ '-"
6. System Pumped By:
Neil J. Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc.
Company
7. Locati ere contents were disposed:
L.S. w aste ter
Signature Wull Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1