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Miscellaneous - 2050 TURNPIKE STREET 4/30/2018
71 N � N d O O O W � n M 1 A 6 Z O m W m o cn O —1 0 :o O m v m 0 O x (D MAP # PARCEL # v , LOT STREET CONSTRUCT I_QN_APPROVA.L, HAS PLAN REVIEW FEE BEEN PAI S YES NO DATE APP. BY._ KLAN APPROVAL: � --�'� DESIGNER: PLAN DATE;_��`��_ CONDITIONSS��M �G //llST��J �c�/�,�Cy_.��011✓`�� _.___ WATER SUPPLY: WELL PERMIT WELL TESTS: COMMENTS: TOWN WE L nATI 1 17P CHEMICAL BACTERIA I BACTERIA II DA1 E APPROVED .__,�Zf/gL�. DA 1 E (IPPRUVED DATE APPROVED FORM U APPROVAL: APPROVAL 1'U ISSUE YES NUS DATE ISSUED ........ CONDITIONS: &)& C FINAL APPROVAL: ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED FINAL BOARD OF HEALTH APPROVAL: YES NO DATE: ..............._..._ .....IIY:.... _ Of _fir .. t �.. ( 1.I,.a} , •- -�L- -}11 )" l !� 1 � •• ' - .t' ISTHE INSTALLER LICENSED? NO ` TYPE OF -CONSTRUCTION: NE REPAIR _' CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW E5 NO t - CONDITIONS OF.. APPROVAL NO y t ♦ (FROM FORM U) :ISSUANCE OF DWC PERMIT ES NO ?l DWC PERMIT N0. ° k �C! �lC�• t INSTALLER: �7PJ -Zriylj% BEGIN INSPECTION NO: EXCAVATION, INSPECTION: :NEEDED: < °PASSED �..\._r>'1 Q1 HY : ^ `;.�v • �' _ =-•.:•CONSTRUCTION INSPECTIONS .: ;;= .. ; NEEDED: Aw- AS BUILT PLAN SATISFACTORY. tj v DBY APPROVAL. TO BACKFILL. DATE. :,,;,FINAL- GRADING APPROVAL: DATE /' !aBY 7-7 ::FINAL CONSTRUCTION APPROVAL: DATE: BY Try 1 4891 NOR + N p Town of North Andover HEALTH DEPARTMENT =,rmU CHECK #: �5 DATE: i�?1/p / 0 LOCATION: G� DS�� Gu✓2/✓�! H/O NAME: CONTRACTOR NAME: Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment$ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Sustems: ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 -Inspector $ itle 5 Report $ e• ❑ Other. (Indicate) $ r G�f Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer Owner information is required for every page. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. CbIMM ohwealth of Massachusetts Title 5=#�cia� n EcwEc Subsurface Sewage Disposal System Form o Not for Voluntary sass is 10 2010 v2 SO, iu. 'kt s� Property Address L.C1LJ_CLr^t'�'i�i� UGm n HEALTHDEPARTMEh wmers Name Ci frown tY 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. A. ueneral Information 1.. Inspectors: Name In Se Company Name Loompany Address cityfrown state / — r�'7� 3 7y ��C13 S�\ a 699 Zip Code 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 ❑ Needs Further Evaluation by the Local Approving Authority '7- Inspector's S'nature 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 DEO, 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 bow -the system will perform in -the future under the same or different conditions of use. t5ins • 09/08 Title 6 official h spedon Form Subsurface Sewage D*"W System - Paye 1 of 17 Owner information is required for every page. l . Commonwealth of Mass4chusetts Titlef,:5::�0#cal-�r�spe#gin Fr Subsurface Sewage Disposal System Form - Not for Voluntary Assessments x lu t n Property Address - a rj Owner's Name // Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check .A,B,C,D orf-1afways-eomplete all of Section 0 A) ,System Passes: 2rTl have not found any. inf.,ormatiooich 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: 61 -rn s' ee-&U - 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 exfiltratlon 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): t5ku • 09M THIS 6 Of6dal hspedion Form: Substrrace Sewage Disposal System •Pape 2 d 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 O 2�til n ke 5 -4 - Property Address, Owner's Name 0 Cityrrown State Zip Code B. Certification (cont.) B) System conditionally Passes'(cpnt.�): Date of Inspection ❑ 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 a0proval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 is X5.09/08 Title 6 Official l npectionfofm: Subsurface Sewage Disposal System • Pape 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments rY �?o so -wr) a)'ke 5* Property Address _ 11J1, Owner Owner's Name information is / % // required for Al f 7 1 /1 O every page. City/Town 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 supe 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 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: 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 ❑ 1 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-0verloaded or clogged SAS or cesspool ❑ 3/_*" ,Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day.flow -- - t51ns • 09M . Title 6 official Inspection Forth: Subsurface Sawage 040-81 System• age 0 T Owner information is required for every page. Commonwealth of Massachusetts Title 5' Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address X Owner's-Name ---- Alo t'4 yc i l A •7- / 5-- /o Cltyrrown 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: ❑ L� Any portion of the SAS, cesspool or privy is below high ground water elevation ❑ L� Any portion oT cesspool or privy is within 100 feet of a surface water supply or ❑ tributary to a surface water supply. L�' Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Ly' Any portion of a cesspool or privy is within 50 feet of a private water supply well ❑ lJ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal 'coliform bacteria -indicates -absent and the presence of ammonia nitrogen and nitrate nitrogen Is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered -a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area — IWPA) or a mapped Zone I I 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. t5ms • 09108 Title 5 Official Inspec0on Forth: Subsurface Sewage Disposal System •Page 5 0l 17 Commonwealth of Massachusetts Title A.Offidal.Inspection. -F(P�r n Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a0 4 urn O,`ke 54 Property Address /14 () k Ck i/G.l7]rr✓1 Owner owner's Name nformequine tion is AA i required for /Vl/(�h Q ✓� O VZa' every page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate" yes" or"now as'to each of the following: Yees/ No LTJ ❑ Pumping informa�on was provided by the owner, occupant, or Board of Health ❑ L�1 Were any of the system components pumped out in the previous two weeks? 03 ❑ Has the system received normal flows in the previous two week period? ❑ �/ Have large volumes of water been introduced to the system recently or as part o this inspection? L7 ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) L� ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of break out? [B ❑ Were all system components, excluding the SAS, located on site? T ❑ 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? P ❑ 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 ofdistanoe is -unacceptable) (310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Humber of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): t5ins • 09/06 Tide 5 Official hspecticn Form: Subsurface Sewage Disposal System •Pape 6 0l 17 i f D. System Information Residential Flow Conditions: Number of bedrooms (design): Humber of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): t5ins • 09/06 Tide 5 Official hspecticn Form: Subsurface Sewage Disposal System •Pape 6 0l 17 Commonwealth; of ma'ssachusetts Titld" 5,'.Qf#acial lnspetft'�Tw Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner owner's Name ?— information is / required for Alejdk- A4,,1 VGA every page. City/Town state Zip Code Date of Inspection D. System Information Description: w y Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes [R} o Is laundry on a separate sewage system? (if yes separate inspection required) ❑ Yes D—No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes E4 --No Water meter readings, if available (last 2 years usage (gpd)): ti/A Detail: D rn we lI Sump pump? ❑ Yes E—No Last date of occupancy: CCA < ((f n 4- - Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day (gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non -sanitary waste discharged to the Title 5 system? ❑ Yea ❑ No Water meter readings; if available: t5ins - 09M T* s ardor ku on Fomc subaufaoe sewage Disposal sy lam - Paps 7 d 17 Commonwealth of Massachusetts L` { Title ,5##�c�a Ir speed ;pari }'.'45F�,'^+� ,tb i rt!.;� sant C"W1 Subsurface Sewage,pi>:posal System Form -Not for VoluntaryAssessments Property Address Owner Owner's Name information is D required for d /�� A/O iV�Ads _.. every page. City/Town , State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Other (describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? If yes, volume pumped: How was quantity pumped determined? Reason for pumping: Date [B<es ❑ No r5oo gallons /na.lk-r 2A vumv-J-c�E/uS R !arts. of r4«k ,^A*- -boa 1"kY Type of System: a . . 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/Altemative 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): t&ns • 09M .... -TW@ 5 Of"Ynopection Fahr SWarfaoe Sewage Mpad System • Pape 6 of 17 Commonwealth of Massachusetts Title 5. ffic al -Inspection_ Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2056 -74-1 i2f`Yt s 4. Property Address Owner owner's Name information is lu r �)'1'h � ►/ required for A� r�'�U }/ t C 44,i_ every page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: !G t AS - 1344; 14 .'c.n Were sewage odors detected when,Wving at the site? ❑ Yes 21� Building Sewer (locate on site plan): A vc Depth below grade: y � feet Material of construction: f ✓ C ❑ cast iron 210 PVC ❑ other (explain): — Distance from private water supply well or suction line: 106 t feet Comments (on condition of joints, venting, evidence of leakage, etc.): <::& I i -J Septic Tank (locate on site plan): Depth below grade: 1 Material of construction: concrete v ❑ metal ❑ fiberglass feet ❑ 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: Sludge depth' t5ins • 09/08 Title 5 Offidal Inspection Forth: Subsurface Sewage Disposal System • Pepe 9 of 17 Owner information is required for every page. t5ins • osroa Commonwealth of Massachusetts Title 5 O fficlaa -Ins ection -Form Subsurface Sewage Disposal System or - Not for Voluntary Assessments Property Address uwners Name --T— City/Town D. System Information (cont.) Septic Tank (cont.) /1 "7- /S;- /6 State Zip Code Date of Inspection Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle t/5- n so 1 S_ r t How were dimensions determined? <,x' Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiber -glass 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: feet .❑.polyethylene ❑ other (explain): Date Me 6 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 Property Address 100 Owner Owners Name w ,t information s AlvC.�� 41 �yeC AA,` . required for !/fC! -'_ " 5 /d every page. Cdyrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and _outlet tee or. baffle.condibon,. structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ..Vb 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 15ins . oeioe TWO 5 Official 4upectlon Form: Subsurface Sewage Disposal System •Pepe 11 of 17 Owner information is required for every page. l5im • oaroe Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner's Name City/Town 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 1 iy '° %e w / e� f Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of bgx,,,etc.): e na► 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Title 5 Difiaal Inspection Form: subsurface sewage Disposal system • page 12 of 17 Commonwealth. of Massachusetts Tithe 5 .fflcial -lns-pec#ion : For -r Subsurface Sewage Disposal System. Form - Not for Vgiuntary Assessments . 4;2 50 —11A (-n i21` lre S4 Property Address Owner Owner's Name information is / required for Ajei rlk 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: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and conflguratiQn Depth — top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater Inflow ..❑,.. Yes ❑ No t5ins • 09108 Title 5 official tracpectim Form: Subewfaee Sewage Disposal System • Pape 13 d 17 Owner. information is required for every page. Commonwealth of Massachusetts Title , 5 `O #a�� -I s�pecta� form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments C�o56 Wo pfk '� 54- Property Address /J /!/ia AG rn e -i Owner's Name A& rA AreJa�- is- io ritvrrown staA4—IS--10 te — Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs -of hydraulic failure, level of.ponding, condition Df vegetation, etc.): n rti�` lU(Ps tri r ,i ei t ti M 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 09/ofi Titiv 5 offidel knpecOon Form Subsurfaoe &ewsP OWPnd r7Yetem • Pepe 14 a» Z - Commonwealth of Massachusetts Title 5 Official Inspection -dorm o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address I ' Owner Owner's Name ' information is required for 1V6 CA An U V r 'Met every page. Cityfrown 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 t5ins - 09/08 Title 6 Official Inspection Form: Subsurface Sewage Disposal System - Page 15 of 17 ` Comm nwe, MTitle�•�5�} rYrrw ; Subsurface S' Property Address Owner information is required for every page, ,. 'j, A.44 ocf,Massachusetts Ins �ec#ion orr I'i$posal System Form Not for Voluntary Assessments Owner's Name _ � ���� ��� m•`n . 1 City/Town . /1/n� An Ql/� State Zip Code 11. Date of Inspection D. System Information (cont.) Site Exam: Check Slope l�o� ❑ Surface water No ERCheck cellar yeS ❑ Shallow wells /ve, Estimated depth to high ground water: I/ " feet Please in all methods used to determine the high ground water elevation: 09"000' Obtained from system design plans on record If checked, date of design plan reviewed: - �99y Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: s Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins - 09" -Tide 6 o"kW In-Pe000nfonn: SW -f— S -%P D*x*W SYatem - Pepe 16 d 17 Owner information is required for every page. t51ns • 09/08 t,ommonwealm of Massachusetts Title 5.0sops a mclal Ins-pect-ion -Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1;26,so %f rn I F: e S4 Property Address Owner's Name //// // i[/ri (A AtxdovCr Clty/Town E. A4_ 7—/S- /O State Zip Code Date of Inspection Rep Completeness Checklist Insp tion Summary: A, B, C, D, or E checked ns ection Summary D (System Failure Criteria Applicable to All Systems) completed System Information — Estimated depth to high groundwater ER Sketch of Sewage Disposal System either drawn on page 15 or attached In separate file Title 5 Official Inspection Form; Subsurface Sewage Disposal System • Pepe 17 of 17 .. L ` C15 Existing ^h Well , , Lot .6C A Ex is.t inn- D w-ell.i:ng- Top of Foundation Elev. = 103.88' : : Sept Tank (1500JqL B �o , D Boz o ` E, o ' F - P90 -8 e S17(A) Dr' . Lc 86, 7.! Leach. Trench Syst4 2 Trenches62' Lori 4,' Wide, 12"' Deep "•i i IA z P90-7 P9 6 ? 96-1 ® 18 16(A)H Ven t K_ QTE � OVERHEAD. E S aI e m Turn p 1 .k e 1� Commonwealth of Massachusetts� UWTown of NORTH ANDOVER. MASSACHUSETTS System Pumping Record foffn 4 R. Puntong Record I. Date of -Pumping %- %2`d-7 • 2. Quantfty Pumped: / nets P 3. -Type of system: [j Cesspool(s) Septic Tank ❑ Tight Tank -Q Other (dWribe); 4. Effluent Tee Filter present? ❑ YesgNo If Yes, was it cleaned? ❑ Yes CINo 5. Condition of System: cif 6 6. System Pumped BY: Now Wtricfe License Numbw n cit%��Gc 7. Location where contents won, d C�GU/�cfn.cL, ~/6-67 biw— Wwrnd.dw mm %stern pwnping q - Page i of i ©EP has provided this farm for use by local Boards of Iftatth. The System Pumping rd be subrntftd-tatho BootrdvUHeaith or other ap fn wi q � � � EIVE A. Facility Inform #aorl W*Qftm* OCT 12 2007 VIMMM".oma 1.. SYS&M lncalkn fbftm on the / � ti f GSC TOWN OF NORTH ANDOVER 0WVUW. Use I T PDA.R l,AF I only the tab icay Aftesss, YOUT 141+ trdw - rtes' use the retum CttylTom state Zp Code kq. 2. -Systern Queer. - -/%o P, qA c4g,11 Name Addma (if different from location) CyRown b'tate Zip Code Telephone Number R. Puntong Record I. Date of -Pumping %- %2`d-7 • 2. Quantfty Pumped: / nets P 3. -Type of system: [j Cesspool(s) Septic Tank ❑ Tight Tank -Q Other (dWribe); 4. Effluent Tee Filter present? ❑ YesgNo If Yes, was it cleaned? ❑ Yes CINo 5. Condition of System: cif 6 6. System Pumped BY: Now Wtricfe License Numbw n cit%��Gc 7. Location where contents won, d C�GU/�cfn.cL, ~/6-67 biw— Wwrnd.dw mm %stern pwnping q - Page i of i O O r0, v1 II poi oi w O.O 4 L4w li L, r., Q o w o o a)Cb� O � �l, w DO � Q o0 � ,•C w bZ • b Q p o II o V II II ff II q) Q) 3 C 0 lb � q)C � ^O li II � QON QxN cw v V� O ~ LZ c II y gibra ° �� O � o •� o o h O o v v �N ►� o Q o0 p N O r; Cti If if If If �'''y O b Qm Qm , o G °' c O j o-ooco ai � O °orn ,o�o,ov its Ok qo �w0►Oh 3 � , Jf L ` Q O (j C Opp 00 a C �'r.,� O►�,00 41 4) Nr) C:) 'tj o�� j C � to I m� ca oqj)o a) _ W i 3 Nq tO C4 a�'� a� Q �G I QQ r4 cl- 64q W o LU Q W 0' ...... ,' , 00'P£l is D r m N 40'20'22" E fbGf 134.00' ° °F WE o, N 68. n 25.9' NEW CONC, J 59 4 N 1.0' FND. 4435 5 �. LOT 6B 86,825± SF CIT 110 g MAR 2 4 m �� OF t!v c, PARKER U'cr o tic -D -O ±'ELL No. 220 cn ,� �</� °-Essl -N 00 Lq m DATE PROFESSIONAL LAND SURVEYOR • 0 �• •O�• ll�s NOTE: may\{ �� f�?' U LOT 6B MAP 108—C PT. LOTS 18,21, & 24 o� CERTIFIED PLOT PLAN C, IN y NORTH ANDOVER MASS. o ��o° SCALE:11N.=60 FT. OCT 7, 1997 N S NOONAN & MC DOWELL, IN -C. SUITE 6, 25 BRIDGE ST. BILLERICA, MA. 01821 (508) 667-9736 DWG NO. 1503P THIS PLOT PLAN IS THE PROPERTY OF NOONAN do MC DOWELL•INC. AND MAY NOT BE ALTERED. JOB NO. 1503 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (Konstructed; ( ) repaired; by < A Lwe,1 located at was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # , dated F-, 3 - 916' , with an approved design flow of 41y'o 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: S�Zlo�9$' M Final inspection date: gzsl Installer: ;Vm Lic. #: Date: Design Engineer:,,, m Date: �$ 9$ Town of North Andover, Massachusetts Form N0.3 f NorrrH BOARD OF HEALTH C 19c 9SSACHUSEt� DISPOSAL WORKS CONSTRUCTION PERMIT Applicant NAM Site Location _- ADDRESS E Permission is hereby granted to Construct.' Sewage Disposal System as shown on the Design r Repair ( ) an Individual Soil Absorption g Approval S.S. No. CHAIR(vfAN, BOARD OF HEALTH n Fee D.W.C. No. 4L� APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# / a 7 LOCATION: Z TU Q Tl LICENSED INSTALLER: U0 LZ L, s SIGNATURE: TELEPHONE# 97F 3- oa 6 CHECK ONE: NEW CONSTRUCTION: f/ IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT-.- Administrative S-BUILT: $75.00 Fee Attached? Foundation As -Built? Administrative Use Only Yes C/ No Yes No Floor Plans? Yes No Approvalzj_/Date: /� 66 LITTLETON ROAD WESTFORD, MA 01886 (508) 692.8395 PAX (508) 692.0023 1.800.649•TEST Report Number: C-wps-25514 Client: Wilmington Pump Supply Inc. P.O. Box 517 Wilmington, MA 01887 Samples Taken By: WP$ utaff TEST PARAMETER: Total coliform (P) Calcium copper (S) Iron (S) Magnesium Manganese (S) sodium Potassium (S) Alkalinity (s) Ammonia chloride (s) chlorine (total) color (S) Conductivity Hardness Hitratee(as N)(e) Nitrites(as N) PH (6) odor (s) Sulphates (5) Turbidity Sediment Report Date: July 18, Sample Taken Att American Realty Trust 9,--q,Lot Q Rt 114 N. Andover MA On: July 15, 1997 CERTIFICATE OF ANALYSIS r- '6 i 1997 EPA Max RESULTS UNITS 0 0 her 100m] No Limit 28.6 mg/L 1.3 0.08 mg/1, 0.3 _ 4, `0.58 mg/1, No Limit 2.6 mg/L 0.05 0.05 mg/L " 28 5.6 111g/l, No Limit 0.5 mg/l, Not Spec. 66.5 mg/1, Not spec. x:0.03 mg/L 25.0 22.5 mg/L Not Spec. 0.81 mg/T, 15� 25 CPU No Limit 166 umhos/cm No Limit 82 mg/1, 10 0.11 mg/L 1 <0.01 mg/L 6.5-8.5 7.9 S[1 3 3 TON 250 18.8 mg/L 5 3.72 NTU pos/neg neg NT -Not Tested, #=value Exceeds EPA STD, TNTC -Too Numerous to Count *Background Bacteria Noted, "=EPA Advisory Limit -Exceeds EPA Advisory Limit (P) -Primary EPA standard, ($)-Secondary EPA Standard (may affect aesthetics of drinking water i.e. taste, color, etc.) This water sample, as submitted, is considered SAFE to drink according to EPA guidelines. However, one or more of the parameters exceeds EPA secondary standards as indicated by the ((I) sign. /i1 -rim Massachusetts State certified Michael P. Carlson, for Testing Laboratory #MA048 Thorstensen Laboratory Inc. Town of North AndoverNORTH Of. OFFICE OF 3? h° O o� COMMUNITY DEVELOPMENT AND SERVICES p 146 Main Street , 109 North Andover, Massachusetts 01845 �9 `°4,rEo �•° �t5 WILLIAM J. SCOTTSSACHUSE r Director August 27, 1996 Thomas E. Neve Associates, Inc. 447 Old Boston Road Topsfield, MA 01983 Re: Lot 6B Salem Turnpike Dear Tom: This letter is to confirm that at the regularly scheduled meeting of the North Andover Board of Health held on August 21, 1996, the Board voted unanimously to grant the following variances to the North Andover Regulations: • Design Flow: 110 Gal/Bedrm/Day vs. 165 GalBedrm/Day required • setback distance from foundation drain to leaching facility: 31 feet vs. 35 feet required If you have any questions, please do not hesitate to call the Health Office. Sincerely, Sandra Starr, R.S., Health Administrator SS/cjp BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 3 THOM, "AS LAEVE ASSOCIATES, INC. July 26, 1996 Ms. Sandy Starr Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 613 Turnpike Street - Riding Realty Trust Dear Sandy: - TOWN OE NCR` BOARD 0' i I JUL 2 9 1996 You are in receipt of copies of the sanitary disposal system design for the above - referenced lot, the site suitability forms and the $60 review fee. Please review this lot at your earliest convenience and place us on your agenda for the meeting of August 22, 1996 for the purpose of discussing our request for waivers as set forth in our June 5, 1996 letter to you. If you should have any questions regarding this please do not hesitate to contact our office. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. ---� D-� � � Thomas E. Neve, PE, PLS President, CEO /km Enclosure #962 CHANNUMPS • ENGINEERS • 447 Old Boston Road (508) 887.8586 • LAND SURVEYORS • • LAND USE PLANNERS • U.S. Route #1 Topsfield, MA 01983 FAX (508) 887-3480 THO July 19, 1996 Ms. Sandy Starr Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 6B Turnpike Street - Riding Realty Trust Dear Sandy: INC. =Y�, Find enclosed a check in the amount of $60 which is the required septic review fee. Also enclosed are the Soil Suitability Assessment forms. Please review this information at your earliest convenience and place this matter on the Boards July 25th agenda for the purpose of discussing our request for waivers as set forth in our June 5, 1996 letter to you. If you should have any questions regarding this please do not hesitate to contact our office. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. Thomas E. Neve, PE, PLS President, CEO I Enclosure #962 CHANNUMPS • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 FORM 11 - SOIL EVALUATOR FORM Page I of 3 Date: --019 yK Commonwealth of Massachusetts , Massachusetts oral —Sod Suitab for On pal : . too Dace: 519196. rmed By Pe,I ................ .... ... Witnessed By: . . .... Nmf S -4 gloll 1_=tjon AddrtSS CX AddJCSS. Z- y 71e Tcle.-nom I 7V,&1U10 Ile elWl-il-jel /,:�7 r111M%Af rr)nqvriicricn V1 Repair L7 Alecoer office Review Available: No Yes 91- Published Soil Survey ....... .-. Publication Scale Soilklap Unic -W .... .............. ytarr Published 11?I ... ............... .... Drainage Class ......... I ........ Soil Limitations ❑ Surficial Geoiogic Report Available: No F-1 Yes Publication Scale Year Published ..... ...... Geologic Material (Map Unit) ............................... ......................... I .......... '00, 7, ............................... .............................. ............ . ........ ...... .... Landfor-n ..... ................ �. ............. Flood Insurance Rate Map: No XYes Above 500 year flood boundary Within 500 year flood boundary No Yes ❑ Within 100 Year flood boundary No ;s Wetland Area: National Wetland Inventory Map (map unit) ............................... ............... ... .................. .................................................... .................... Map (map unit) Wetlands Conservancy ProgramN Current Water Resource Conditions (USGS): Month Range :Above Normal E]Normal 713elvvNormal 7 Other References Reviewed* DEP APPROVED FON" - 12107195 FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location .address or Lot No. Determination for Seasonal High Water Table Method Used: ��fF ❑ Depth observed standing in observation hole ......... inches �tlfi� ❑ Depth weeping from side of observation hole......... inches /.4'❑ Depth to soil mottles inches A%— ❑ Ground water adjustment .................. feet Index Well Number .............. Reading Date ......._. ... Index well level Adjustment factor ................ Adjusted ground water level Deoth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? C If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, Expo; tise ar1c; experience described in 310 CMR 15.017. Signature Date DEP APPROVED FORM - 12/07/95 03-21-1996 14:36 5i7 932 7615 GEP NCPTHEaST PEGiCNGL. P.02 FOR.N1 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS , Massachusetts Percolation Test' d Time: Date; %/ la `�47 Observation Hoie I ..... �7 (Depth of Perc Start Pre-soak End Pre-soak Time at 12" 1 I Time at 9" I i Time at S" Tire Rate Min./Inch • Minirnum of 1 percolation test must be performed in bath the primary area AND res^or ve aree. Site Passed 9 Site Failed ............... __.................... ....... . ........ _................ .............. Performed B y- �c �1Uws0 - p Witnessed By:'� Comments: :........ .... _._ June 5, 1996 Sandra Starr, R.S. Board of Health 146 Main Street North Andover, MA 01 THO Re: Lot 6B -Salem Turnpike Dear Sandy: Please find enclosed 3 prints of the Sanitary Disposal System design for the above - referenced lot. The following waivers are being requested from the Board of Health: Design Flow: 110 GalBedrm/Day vs. 165 GalBedrm/Day required Setback distance from foundation drain to leaching facility: 31' vs. 35' required. As you are aware, this lot had an approved septic design on file with the Board of Health which was revised to December 28, 1992. The permit has expired and a new design must be submitted and designed according to new "Title W criteria. The original system was based on a design flow of 150 gal/bedrm/day and the omission of the four foot separation between reserve and primary trenches as required by the North Andover Board of Health. The new design, being submitted, is based on 110 gal/bedrm/day in order to keep the system 100' from the edge of wetlands, as required by the North Andover Board of Health, and to stay within the testing areas performed on the site. Please note that, due to the new loading rates, the new system size is 240 s.f. larger than the original design that was approved even though the design flow is less. Please find attached a red lined sketch showing the system size based on a design flow of 165 gal/bedrm/day or 660 gal/day. The trenches would be 30' longer and only 70' from the edge of wetlands. Also, the system would be much closer to the foundation and would require a waiver for setback distances from foundation drain to septic tank and leaching facility. • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 Sandra Starr June 5, 1996 Page 2 We feel that the proposed design based on 110 gal/bedrm/day protects the public health, since it is designed on the state criteria, along with the Town of North Andover since the system being proposed is much larger than the system that was once approved. Please put us on the agenda for the next available Board of Health meeting so that we may discuss these waiver requests with the Board of Health. If you should have any questions or concerns, please do not hesitate to call. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. 9jv.,. *U;'-, John Morin Civil Engineering Consultant JM/ec Enclosures cc: Bob Webster John\962.doc Town of North Andover, Massachusetts Form No. 2 �oR*� BOARD OF HEALTH 0 q6 . w 19 D DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant— Test No. Site Location_1 P A 11 k-) .1 Reference Plans and Specs (NEER SIGN i; Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. $, 0 Fee L CHATRMAN, BOARD OF HEALTH Site System Permit No._ FS 3 � � Y is— � � Y W� a t ��*"� w�+{ ��'���"`1 ,HP�i�e -fit^, T(iT rt�� y�lr, lt•.t t.i�} rt a _ - • ;Sbles i j, , � � I � � % AGI i �� ���� f, I�/✓G i i I � Si W� a t ��*"� w�+{ ��'���"`1 ,HP�i�e -fit^, T(iT rt�� y�lr, lt•.t t.i�} rt a _ - • FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section*********** =*1107, APPLICANT: 1 Kir `, Phone ` t LOCATION: Assessor's Map Number �� Parcel Subdivision Lots) b Street - �ci�,,.., �u ^�.�� 11 St. Number ************************Official Use Only************************ RECO ATIONS OF TOWN AGENTS: f PMA TIONS dministrator Comments !S Date Approved a Date Rejected _6. (7, Date Approved 2_JZ441q2 Town Planner Date Rejected Comments Date Approved Food Inspector -Health Date Rejected .L� ,u� Date Approved Septic Inspector -Health Date Rejected Comments JPublic Works - sewer/water connections I J f - driveway permit Fire Department Received by Building Inspector Date HOARD OF HEALT11 Town of North Andover Mass., q , .........-- Date 19 'ermiC # APPLICATION FOR WELL & PUHP PERMIT '.\cation.is hereby made for permit to drilla well _). Application i.s PP ;Wade to install (,^) a pump system'. �+� Lot :.'location: Address c.,x�' C�sv� U/�/7l /moi •�' 'T c 1 3 /d ,ca n e r l • .��: 4 7�7 7 p /1 u s Address 7A.r�✓rZ/�i� Lam.. / /!�— �1ell Contractor s <1dress� `I c1 .�Q ;Pump Contractor e. Address ''aELL CONTRACTOR (To be completed at time of pump test) I� ,Type of Well Well used for _06cdealk- Diameter of Well t� Size of C•asi.ng b - .Depth of Bed Rock Depth casing; into Bed Rock ,Was Seal Tested? Yes (_) No (_) Date. of 'resting ,Depo-f-'.�1ell - - Well 1:nded ill W}�.�t• Material th ~Dr-th to Water_ Delivers Gals.Per Min. for 4 hours Drawdown feet after pumping —_Hours at GPH Date of' Completion _ Signature We Contractor Contractor it ,,PUMP INSTALLER (To be'• f'i.11cd i.n' before instal.l.ation) .S'i_ze & Name Pump _ _._:__.______..---•—•-- Pump 'Type Used 14ater Pump Delivers GPM Sire of 1'ank — p Pi e Material Used in Well: Cast Iron (_) C,nl vrini zcd (_) Plastic (_) ldcll Pit (_) or Pitless•Adapter (_) Was sleeve used to -protect pipe? Yes (_) NO(_) 'Type or Name Well Seal Date r �C�'c�r�4�4�1ci4�4�'t►r�4ic�4�4�4�t�t�4t't�r�4i4�4�Y�4�4�4�'t�4�Yti4�'rti'r�4�'rti'rti`ti:S':�,';�ir�ti���5`tJ.iJcl��:�i;��;��. 1,—e I•later analysi's'. repor-t 'submitted to Board of Ileal'th Do -e .release given to owner of record & Bldg.. Insp llealth Inspector PLAN REVIEW CHECKLIST ADDRESS T�" �'.� /.��' ENGINEERy V �� ✓ GENERAL 3 COPIES STAMP LOCUS NORTH ARROW SCALE CONTOURS PROFILE SECTION (/� BENCHMARK SOIL & PERCS _Z/ ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED? �(� DRIVEWAY (Elev) WATER LIN- � FDN DRAIN SCH40 &,-' TESTS CURRENT? SOIL EVAL J . cb SEPTIC TANK / MIN 1500G .17 INVERT DROPy GARB. GRINDER /D (+200% EDF) 25' TO CELLAR U"" MANHOLE ELEV GW # COMPS. D -BOX i SIZE # LINESy' FIRST 2' LEVEL STATEMENT INLET(Fq,G d - OUTLET `7 � _ ' v ( 2" OR .17 FT) TEE REQ' D?A/0 LEACHING 4111x jo MIN 660 GPD.' /6 RESERVE AREA y 4' FROM PRIM?RY? " 2% SLOPE $� 100' TO WETLANDS'/ 100' TO WELLS 4' TO S.H.GW -I--- (5'>2M/IN) JPt�35' TO FND & INTRCPTR DRAIN 4—)k- 325' TO SURFACE H2O SUPP 4' L� PERM. SOIL BELOW FACILITY � MIN 12" COVER FILL? �( 5' if above natural elev; 101if below) BREAKOUT MET? TRENCHES MIN 660,gpd SLOPE (min .005 or 611/100') Z"� SIDEWALL DIST. 3X EFF. W OR D (MIN 61)1-,� RESERVE BETWEEN TRENCHES?? IN FILL? MUST BE 10' MIN. ./ 4" PEA STONE? L"� VENT? /— (>3' COVER; LINES >50') BOT 4TC' + SIDE R 1�6 X LDNG e 6 = TOT (L x W x #) (DxLx2x#) (G/ft2) CopyngKL O 1995 by S.L. Starr CHANNEL January 26, 1996 Ms. Sandy Starr Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 6B Turnpike Street - Riding Realty Trust Dear Sandy: This letter is to authorize excavation and any other field operations necessary to conduct deep hole tests on our property. Thank you for your assistance. Very truly yours, Robert E. Webster Riding Realty Trust Channel Building Company, Inc. • Real Estate & Construction 242 Neck Road • Haverhill, Massachusetts • 01835 508-373-3000 FAX 508-373-4900 THOMAS E. NEVE ASSOCIATES, INC. Engineers - Land Surveyors - Land Use Planners 447 Boston Street US Route #1 TOPSFIELD, MASSACHUSETTS 01983 (508) 887-8586 FAX (508) 887-3480 TO Sandy Starr North Andover Board of Health 146 Main Street North Andover, MA 01845 LFEUTEM (01' MUSEOTTIL DATE 1/22/96 '�B `x°62 -6c ATTER ndy Starr RE: Approval AIN OF NORTH ANDOVER/ BO A-kiij U- mm 73 L.--_ i > WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via thh folRl� r ng -items: ❑ Shop drawings ❑ Prints 0 Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 3 1/22/96 962-6 Lot 6c Salem Turnpike Spptic DpRign for Riding Realty THESE ARE TRANSMITTED as checked below: I& For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted > ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 REMARKS ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: PRDDUCT202 a mc, Dmmn, Mm Dian. If enclosures are not as noted, kindly notify us at once. THO January 22, 1996 Ms. Sandy Starr Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 6B Turnpike Street - Riding Realty Trust Dear Sandy: INC. Enclosed please find a check in the amount of $150 to cover the soil testing fee for the above -referenced lot. Please call me at your earliest convenience to schedule same. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. Nl� Kathy Molina Personal Assistant Enclosure #962 CHANNUMPS • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 Town of North Andover < NORTN OFFICE OF �? g�, 6 O L COMMUNITY DEVELOPMENT AND SERVICES A 146 Main Street KENNETH R. MAHONY North Andover, Massachusetts 01845 9SSACHUSE� Director (508) 688-9533 November 27, 1995 Neve Associates, Inc. 447 Old Boston Road Topsfield, MA 01983 RE: Lot 6B Turnpike Street Dear Tom: According to current North Andover regulations, approved proposed septic plans expire two years from the date of approval unless construction on the lot has begun. New plans must comply with any new regulations. Therefore, since the plans for Lot 6B Turnpike Street expired in February of 1995, new plans must be designed, and in order to comply with regulation changes, the lot must be re- tested with both soil tests and percolation tests. If you wish to be put on the list for spring 1996 testing, please have the owner submit the required $150 fee. (Current regulations still stipulate that soils tests be carried out March 1st to May 15th.) If you have any questions, please call the office. Sincerely, Sandra Starr, R.S. Health Administrator BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Parrino D. Robert Nicetta Michael Howard Sandra Sten Kathleen Bradley Colwell /U A /, D 6 --/:--,L 1-;,A)5 M05 October 10, 1995 Ms. Sandy Starr Health Agent 146 Main Street North Andover, MA 01845 Re: Lot 6B Turnpike Street - Riding Realty Trust Dear Sandy: We have been advised by our client, Riding Realty Trust, Robert Webster, that he never pulled a Disposal Works Construction Permit on Lot 6B shown on the attached plan. You will note that the plan was completed in December 1992 with test data that was performed in May and July 1990. Please let us know as to what extent you will require re -testing, resubmission or re- evaluation of this lot since our client wants us to update the previous permits we had obtained from your office and the Conservation Commission. Thank you for your cooperation in this matter. If you should have any questions please do not hesitate to contact me. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. Thomas E. Neve, PE, PLS President, CEO TEN/km cc: Greg Weich, Channel Building Company Attachment • ENGINEERS • 447 Old Boston Road (508) 887-8586 • LAND SURVEYORS • U.S. Route #1 #962 CHANNEL.WPS • LAND USE PLANNERS • Topsfield, MA 01983 FAX (508) 887-3480 THO ASS( January 26, 1993 Ms. Sandy Starr Board of Health -Town Hall 120 Main Street North Andover, MA 01845 Re: Lot 6B Riding Realty Trust Dear Sandy: INC. Find attached a revised plan changed as to Items #1,4,6,8 & 9 of your review. With respect to Items #2, 3, 5 & 7 no revisions were made. Please take note that the plan which created the lot was approved by the Planning Board on November 15, 1991. This plan is protected from any changes in the local Board of Health regulations until February 15, 1994 (see Chapter 111, Section 127P); therefore, we have not revised the plan according to any new regulations promulgated after February 15, 1991. With respect to the percolation test having expired, I can only suggest one of the following: 1. Request from the Board of Health a waiver to that requirement since the land has not been altered since the original tests and any additional tests may disturb the area where the system is to be installed creating a negative impact. 2. Conduct a percolation test, once the base excavation of the leaching area is constructed, in your presence and to your satisfaction. 3. Conduct additional percolation tests to your satisfaction at any time mutually acceptable to all of us. • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 Ms. Sandy Starr January 26, 1993 Page 2 Please review this entire package and get back to me with your comments or questions as soon as possible. Very truly yours, THOMAS E. ASSOCI TES, INC. Thomas E. Neve, PE, PLS President TEN/km cc: Jerry Diorio BAYFIELD DEVELOPMENT COMPANY, INC. 242 Neck Road HAVERHILL, MASSACHUSETTS 01835 Q Phone (508) 373-3000 Z� FAX (508) 373.4900 TO W IJ Q , T/J �.✓ Al ffit� �- �191� T �4�✓�er,�2 j4a i > WE ARE SENDING YOU ched ❑ Under separate cover via DATE /V —q i? DATE JOB NO. ATTENTION15 AN ! s RE: 60 w r � a i It D r ❑ Shop drawings ❑ Prints ❑aLap&— ❑ Samples ❑ Copy of letter ❑ Change order ❑ the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION 3 z sr/Q , THESE ARE TRANSMITTED as checked below: xFor approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment 0- 0 _❑ FOR BIDS DUE REMARKS COPY TO 19 ❑ PRINTS RETURNED AFTER LOAN TO US S'eafic 0It- 12.4t' au SIGNED: jig j p tea to PRODUCT 240-2 a I., Gmtm. Mass 01421. If enclosures are not as noted, kindly notify us at once. TO: BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 Tom Neve Associates 447 Old Boston Road Topsfield, MA 01983 FROM: Sandy Starr RE: Lot 6B Turnpike St. Dear Tom: TEL. 682.6483 Ext. 32 DATE: DecPmhPr 21;, 1992 This is to inform you that the proposed septic design plans for the above site dated 7/24/92 have been If you have any questions about the next step in the process, please call the Board of Health office. DISAPPROVED FOR THE FOLLOWING REASONS: See Attached sheet. PLAN REVIEW CHECKLIST ADDRESS Z. c, & ✓0-& 411K - ENGINEER 7e-lv7 GENERAL 3 COPIES t/ STAMP `� LOCUS &/ NORTH ARROW �'� SCALE CONTOURS SIDEWALL DIST. PROFILE z/ SECTION —" BENCHMARK L--' SOIL & PERC INFO c/ ELEVATIONS WETS. DISCLAIMER WELLS & WETLANDS ✓ WATERSHED?�✓ DRIVEWAY (Eley) WATER LINE L1 FDN DRAIN (DxLx2x#) SCH40� TESTS CURRENT? A � C%� SEPTIC TANK MIN 1500G. .17 INVERT DROP/ GARB. GRINDERJYD (+200% EDF) 25' TO CELLAR MANHOLE TO GRADE ELEV ✓` GW D -BOX SIZE # LINES L. FIRST 2' LEVEL STATEMENT INLET 160, Al, - OUTLET c1q,,%f _ , Z -O (2" OR .17 FT) TEE REQ'D? LEACHING RESERVE AREA L,-"4' FROM PRIMARY?/\ 100' TO WETLANDS 2% SLOPE 100' TO WELLS 35' TO FND & INTRCPTR DRAINSL.---- 4' TO S.H.GW L- 325' TO SURFACE H2O SUPP t,.-,--4!-PERM. SOIL BELOW FACILITY MIN 12" COVER L --"'FILL ?C/ (25' ifs bove natural elev; 101if below) BREAKOUT MET? TRENCHES MIN 660 gpdZ SLOPE (min .005 or 611/1001)L-"-' >3' COVER? - VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 61' IS RESERVE BETWEEN TRENCHES?,,--' IN FILL? C//- MUST BE 10' MIN. 4" PEA STONE? BOT 5� 1OX d LDNG k6+ SIDE 16-7- X LDNG TOT (L x W x #) (G/ft ) (DxLx2x#) DATE /2 / a Z Sheet z of z_ BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE � J PERMIT # v"r1,�', DATE RECEIVED 11/s�Z APPLICANT lfeleV D106-/6 ASSESSOR'S MAP /0,5-C ADDRESS PARCEL # LOT # ._--- STREET � U�i�P/�E ENGINEER / - Neve ADDRESS 4�7 �QG/) �/ 5? /OP�L"%EGD olgg i PLAN DATE %/�¢/ Z REVISION DATE CONDITIONS OF APPROVAL: APPROVED `�` bDISAPPROVED ✓ "ok /) 7//-)//V6 To �� s�/�4��. (jV. f�, /7.1%l a 4 /V aEb 41, -pew 5TG)N E 00C ,�/C TES �'A/'�� </�/ H. / TO 7) D 3) /11 1 V� mu ni D 15 T/ -)NC 7.P�/v cyC s � �� /� ` (/1/.,/-, /7. D3J NO 10ET-1/9/V65 b/SCL/�//iJG� (/V f� �• Za� ��//�/j/�/vCG NEEp�D �� vvor - �elml4lcr (N4 a. a3J N6;, A10 7-ev (A1,19: 6 , bA T) �) �LC�C ' /"'' UT //�/ C.(�D ss /�•4Tc/�iiyG Fp/� ,Li�y/T v— EXC/vV97i 16- /)/V D q/9� 9t'l 7v FORUM 11 - SOIL EVALUATOR FORM Paae ? of 3 Location Address or Lot ;qo. 4:06 On-site Review / Deep Hole Number Date:. Time: Weather Location (identify on site plan) Land Use Slope Surface Stones des., Vecetation �J,zGd Landform e-,7'wd Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* I Depth from Surface (Inches) I Soil Horizon Soil Texture (USDA) Soil Color (Munsell) I Soil Mottling I Other (Structure. Stones, Boulders. Consistency, 410 Gravel) Pe -4-r 49P y fey /G /Vl .... .......,., ... � v��.. ....vv,. ..... ... ... ..., .v. v.��u uwr v.n�nncr. Parent Material (geologic) DepthtoBedrock: �tp Deoth to Groundwater: Standing Water in the Hole: o Weeping from Pit Face: 46 Estimated Seasonal High Ground Water: fgV7t-_ 7/7 G� DEP APPROVED FO"I - 12/07195 F Q SYST�► p�G RECQ Com!tnonwealth of Massahuse rd 33 AIIJu 102010 TOWN OF NORTH ANDOM -- HEALTH DEPARTMEarr v �- • �mer�en�y ! �.outirn� G9� T}pe, ( Yes Yes4ptiC Tank. N0 Cesspcol: No ed; JS`�� _ gaiions Quarlt►ry Pump Date c : Pumping: 0RACZOW Permit „ S\-scei:. Pumped by (company) Conte .is transferred to: C �7r1ts ,its dispa�ed �t. .,..... Dalt G Pump4r Coneition or-Olem/other COMMencs: /�) i., or? MFROYM MMM , 0191+11 1+1 0 0 CL �V • �q), �p .lb C O lb a lb N ct C II o a� �d9e/ a I c 101 - Z�� V / a / --------------------------- � ----------------- 1001 00 *PlfI 0 9:0 Town of North Andover, Massachusetts BOARD OF HEALTH ED , o y. �z°Aon<,<E oPy APPLICATION FOR SITE TESTING/INSPECTION Form No. 1 19 Applicant ' NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time Fee CHAIRMAN, BOARD OF HEALTH S.S. Permit No. D.W.C. No. C.C. Date Test No, Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 NORTH d BOARD OF HEALTH 3�Oy SS `EO 6�00 D-3 ci 19 fl 7 ���Aoe° EwQa ^:'` APPLICATION FOR SITE TESTING/INSPECTION Applicant NAME ` ' - " ADDRESS ^ - TELEPHONE Site Location Engineers %1�•f NAME JJ ADDRESS // TELEPHONE Test/Inspection Date and Time a/ CHAIRMAN, BOARD OF HEALTH Fee '�� Test No. S.S. Permit No._.J, D.W.C. No. C.C. Date Plbg. Permit No.