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Miscellaneous - 21 APPLETON STREET 4/30/2018 (3)
4 Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street Sandra Starr North Andover, Massachusefts 01845 Telephone (978) 688-9540 Health Director Fax (978) 688-9542 January 17, 2001 Thomas W. Lyons, President Willow Enterprises 99 Cross Road PO box 8344 Bradford, MA 01835-0844 Dear Mr. Lyons, This correspondence is in regards to the proposed addition to the hom at 21 A Z Street, North Andover. As of January 17, 2001 the septic plans for this property een approved. In addition, a review of your request to allow the construction of the addition prior to the septic system installation has been made.. Firstly, this office's current policy prohibits the construction of the addition until completion of the septic system installation. Also, as you are aware, North Andover regulations state that septic installations are to occur between March 0 and November 30`h'of each calendar year, weather depending. We are not without understanding of the homeowners time constraints, as well as we are aware of how late in the year this project was finally put into action. Having only conducted the preliminary soil tests in November. So, the decision is to assist as best as we can, and still maintain our policy's integrity. Rather than waiting for the septic completion, the Health Department will sign off on the building "form U' simultaneously when the septic permit is issued. This can occur after March I". This will ensure that a locally licensed installer has been contracted with, an agreement has been made to install this system and will give you an earlier start date for the addition. Thank you for assisting in this long distance situation. As the authorized agent for Mrs. Dickson, I hope that you will pass on this information. If you need a list of licensed installers, feel free to contact this office at the phone number above. I hope that this decision is clear. As the new septic season quickly approaches, I will expect the septic application on or around the beginning of March. Sincere San Ford, R. S. Health Inspector Cc: file BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Site:/ f��'��T Final Date: Installer: 31 YM /��'3Uxt a— U Tel: Date Yes No Initials A. Bottom of Bed' - 1. Excavation to proper depth 2. With trenches, sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation, etc. Comments: (Use back of sheet for diagrams.) B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed ( Q 3. Wall minimum 10' to leaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 6z�6 �- 1. Pipe diameter minimum 4" 2. Schedule 40 pipe U CQ 9 3. Watertight joints 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8" per foot minimum 6. Pipe properly set on compact firm base. 7. Pipe laid on continuous grade in straight line C> K. A 8. Cleanouts precede all change in alignment and grade ./V 9. Manholes at any 90° change f V-4 10. 10' minimum offset to waterline Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas bale present on outlet 4. Manhole to w/in 6" of grade t/ 5. Manholes over center and each tee 6. 3-20" manholes 7l 7 --r ,tc"- � : �» ,��j invert 8. �(2�,r�P�+�-n�;r.„ td" d� ;t�►vert 9. Outlet line cemented 10. " 11. 2" – 3" drop from inlet to outlet Date Yes No 12. Pipe set 13. Compact base with 6" of 3/4" crushed stone under tank 14. Tank is watertight Comments: E. Pump Chamber 1. If separate from tank, compact base with 6" of V stone underneath 2. Minimum 2" pipe to d -box if gravity system 3. 20" access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d -box Comments: F. Distribution Box 1. D -box level 2. Minimum 0.17" (2") drop from inlet to outlet 3. Minimum 6" sump 4. Outlet pipes show equal distribution v 5. Compact base with 6" of stone beneath box �-- - 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double -washed — V —1 '/2" f - pea stone `f Bucket test done? 2. Minimum 2" of pea stone above distribution lines ti 3. Minimum 6" stone beneath pipe 4. Distribution lines capped or connected together 5. Toe of slope stops minimum 5' from edge of property; 5a. if not, then swale. Comments: Initials 0 Date H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agrees with plan. (Max. length 100') 3. Width of trenches agrees with plan — Minimum 2'; maximum — 4'. 4. Vent present if >50 feet or specified 5. Minimum distance between trenches 10' 6. Pipe slope minimum 0.005 or 6" per 100' 7. Depth of trenches below outlet invert minimum of 6". 8. . Pipes set on stable base. Comments: Yes No 1. Leach Field 1. Maximum length of field 100' f 2. Pipe slope minimum 0.005 or 6" per 100' 3. Separation between pipes 6' maximum 4. Pipes connected at end 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines ice' Comments: J. Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12" and 48" wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02. 2. All system components covered by at least 9" soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond 6. Grading meets 3:1 slope 7. Minimum of 9" of fill graded over system Initials I /1 Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director June 4, 2001 Robert Masys R.A.M. Engineering 160 Main Street Haverhill, MA 01830 Re: 21 Appleton Street Dear Robert: Telephone (978) 688-9540 Fax (978) 688-9542 This is to notify you that the revised plans dated 5/30/01 for 21 Appleton Street have been approved. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, a Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: McClellen File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 North Andover Health Department 27 Chades Street No. Andover, MA 01845 Phone (978) 688-9540 Fax (978) 6889542 To: Willow Enterprises, Inc. Tom Lyons, President Fax: (978) 372-1394 Phone: 374-7475 Re: 21 Appleton Street v/ From: Susan Ford, Health Inspect4101 ►� Pages: 1 (11 Date: CC: �P ❑ Urgent X For Review ❑ Please Comment 0 Please Reply ❑ Please Recycle This correspondence is in response to your letter regarding the proposed home addition at 21 Appleton Street. The Health Department received the septic repair plans submitted by RAM Engineering along with your letter. These plans have been processed and are presently being reviewed. Your request to move forward with the home addition can not be acted upon until there is an approved septic plan. This office will review your request at that time. Although I have no definitive answer to your request, I felt it was important to let you know of its status so that you remain informed. I will contact you as the process moves forward. Thank you, .^�,ru,� j�aLrsQ2G� TOWN OF NORTH ANDOVER INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Site:. gyp«mac Final Date: Installer: J-1 M /16u.xt a- Tel: Date / Yes No Initials A. Bottom of Bed 1. Excavation to proper depthy 2. With trenches, sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation, etc. t/ Comments: (Use back of sheet for diagrams.) B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed , r 3. Wall minimum 10' to leaching facility 1V 4. Wall meets specifications of plan Comments: C. Building Sewer z, 1. Pipe diameter minimum 4" 2. Schedule 40 pipe of - 3. r 3. Watertight joints 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8" per foot minimum 6. Pipe properly set on compact firm base, r/ 7. Pipe laid on continuous grade in straight line C> 8. Cleanouts precede all change in alignment and grade /V 9. Manholes at any 90° change f l%A 10. 10' minimum offset to waterline Alv+ Comments: D. Septic Tank _ 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet 4. Manhole to w/in 6" of grade 5. Manholes over center and each tee 6. 3-20" manholes 7.ej invert 8. .�� t anAmder4nvert 9. Outlet line cemented 10. " 11. 2" - 3" drop from inlet to outlet M/ M ,J� TOWN OF NORTH ANDOVER NOTICE OF JOB POSTING October 16, 2000 RECEIVED JOYCE BRADSHAW TOWN CLERK NORTH ANDOVER Z000 OCT I b A 10: 00 A Vacancy exists in the Division of Public Works for one (1) Special Motor Equipment Operator on a full time basis: Summary of Duties: Operates any piece of motor driven equipment including trucks with a rated capacity of over 9 tons, tractors, simi-trailers, truck -trailer combinations, and special equipment such as road rollers, rotary snow plows, mobile highway graders, mobile highway graders, mobile bituminous spreaders, and tar distributors. Operation of equipment in this class usually requires a Class I license from the Registry of Motor Vehicles. Position in this class also operates hoisting equipment where a special license from the Massachusetts Department of Public Safety is required and when the operation of this equipment is not a primary duty. Greases, oils, cleans, and performs other minor preventive maintenance on equipment including some servicing on the job for certain special equipment. Will be responsible for operation of Catch Basin Cleaning truck. May occasionally operate motor equipment of a lower level of difficulty. Qualifications Required: Salary: CDL from the Registry of Motor Vehicles and a hoisting license from the Massachusetts Department of Public Safety. Experience in use of catch basin cleaning truck a must. As of this notice: W-5 $13.03 —14.31 Anyone wishing to apply must do so in writing, stating qualifications and date of permanent appointment in Labor Service as per Civil Service. Such applications shall be submitted no later than October 30, 2000 to: J. William Hmurciak, Director Division of Public Works 384 Osgood Street North Andover, MA 01845 The Town of North Andover is an Affirmative Action/Equal Opportunity Employer. POST: Town Hall, Annex, Senior Center, D.P.W. (2), Police Fire, Library, Veteran's Services, W.T.P. Date Yes No Initials 12. Pipe set 13. Compact base with 6" of 3/4" crushed stone under tank 14. Tank is watertight Comments: E. Pump Chamber 1. If separate from tank, compact base with 6" of V stone underneath 2. Minimum 2" pipe to d -box if gravity system 3. 20" access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d -box Comments: Comments: F. Distribution Box 1. D -box level 2. Minimum 0.17" (2") drop from inlet to outlet 3. Minimum 6" sump 4. Outlet pipes show equal distribution c,- 5. Compact base with 6" of stone beneath box _. 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe ✓ Comments: G. Soil Absorption system 1. All stone double -washed - 3/4" -1 '/2" - pea stone Bucket test done? 2. Minimum 2" of pea stone above distribution lines ri- 3. Minimum 6" stone beneath pipe L� 4. Distribution lines capped or connected together 5. Toe of slope stops minimum 5' from edge of property; 5a. if not, then swale. Comments: un vx H VH un vK d HH a ooS paouuqug ajonD uosuag :Sui;ug Date Yes No H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agrees with plan. (Max. length 100') 3. Width of trenches agrees with plan — Minimum 2'; maximum — 4'. 4. Vent present if >50 feet or specified 5. Minimum distance between trenches 10' 6. Pipe slope minimum 0.005 or 6" per 100' 7. Depth of trenches below outlet invert minimum of 6". 8. _ Pipes set on stable base. Comments: I. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6" per 100' 3. Separation between pipes 6' maximum 4. Pipes connected at end 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines V- Comments: J. Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12" and 48" wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02. 2. All system components covered by at least 9" soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond 6. Grading meets 3:1 slope 7. Minimum of 9" of fill graded over system Initials Ufl VN v `H ufl. dN d VH a ooS pootitqug 01311D uossag :LilaIuD :5ullird Town of North Andover � NORTI{ Office of the Health Department Community Development and Services Division . 27 Charles Street '� ?• North Andover, Massachusetts 01845 "SSA�HUS�` Sandra Starr Telephone (978) 688-9540 Health Director Fax (978)688-9542 June 4, 2001 Robert Masys R.A.M. Engineering 160 Main Street Haverhill, MA 01830 Re: 21 Appleton Street Dear Robert: This is to notify you that the revised plans dated 5/30/01 for 21 Appleton Street have been approved. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: McClellen File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 North Andover Health Department 27 Charles Street No. Andover, MA 01845 Phone (978) 688-9540 Fax(978)688-9542 Mw North Andover BOH To: Willow Enterprises, Inc. From: Susan Ford, Health lnspect +� Tom Lyons, President Fax (978) 372-1394 Pages: 1 Phone: 374-7475 Date: Q001 :rye: 21 Appleton Street CC: 0 Urgent X For Review ❑ Please Comment 13 Please Reply ❑ Please Recycle This correspondence is in response to your letter regarding the proposed home addition at 21 Appleton Street. The Health Department received the septic repair plans submitted by RAM Engineering along with your letter. These plans have been processed and are presently being reviewed. Your request to move forward with the home addition can not be aged upon until there is an approved septic plan. This office will review your request at that time. Although I have no definitive answer to your request, I felt it was important to let you know of its status so that you remain informed. I will contact you as the process moves forward. Thank you, North Andover Health Departmerd 27 Charles Street No. Andover, MA 01845 Phone (978) 688-9540 Fax (978) 688-9542 To: Willow Enterprises, Inc. From: Susan Ford, Health Inspect Tom Lyons, President Fax: (978) 372-1394 Pages: 1 Phone: 374-7475 Date: 001 Re: 21 Appleton Street CC: ❑ Urgent X For Review ❑ Please Comment © Please Reply 0 Please Recycle This correspondence is in response to your letter regarding the proposed home addition at 21 Appleton Street. The Health Department received the septic repair plans submitted by RAM Engineering along with your letter. These plans have been processed and are presently being reviewed. Your request to move forward with the home addition can not be acted upon until there is an approved septic plan. This office will review your request at that time. Although I have no definitive answer to your request, I felt it was important to let you know of its status so that you remain informed. I will contact you as the process moves forward. Thank you, Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director May 11, 2001 George McClellen 21 Appleton Street North Andover, MA 01845 Dear Mr. McClellen: Telephone (978) 688-9540 Fax (978) 688-9542 This letter comes to update you on the status of your septic system installation and explain why a stop work order was verbally given to your installer. On May 10, 20011 entered your property to perform a bottom -of -bed inspection at the request of your installer, James Howard. I determined the following: 1. Referring to the approved plan the excavation lacked the appropriate depth for approval. 2. The septic tank had been installed and covered without benefit of an inspection and approval from the Board of Health. 3. Mr. Howard claims that the soil is consistent with what can be seen in the excavation to a depth of ten feet. If this is so, then there was a problem with the original site evaluation and soils testing. My actions were as follows: 1. Mr. Howard was directed to cease all work on the site until a meeting could be held on site with the Health Department and the engineer who evaluated the site and designed the system. 2. The engineer, Robert Masys, was called immediately. He was, however, out of the office and engaged all day on May 12, 2001 so we are attempting to contact him for a meeting as soon as possible. 3. Since the installer appeared not to understand the technical reasons why the excavation needed to be deeper, his file was reviewed. There may be a problem with his license. Once all involved parties meet and determine where the problem lies, whether with the plan, the site evaluation or the interpretation by the installer, and solve it, then the installation may continue. Because the septic tank was installed without an inspection, it must be excavated and inspected before further work on the leach area can be done. Please be assured that the Health Department will make every effort to move this installation along as quickly as possible, but that all pertinent regulations and requirements must be met. If you have any questions, please call the office at 978-688-9540. Sincerely Sandra Starr, RS., C.H.O. Director of Public Health C� BOH T. Lyons J. Howard File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the ,l property at% relative to the application of ECJ '� atedU for laps by and dated 11 �i / with revisions dated 0S �! I understand the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection, and the system is not ready then item two shall be applicable. 2. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation 'of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Date: 4/0' Disposal Works .Construction Permit # "off 119 N. Shore Road • Derry, NH 03038-5801 (603) 898-1118 CFS May 13, 2001 Sandra Starr Health Director 27 Charles Street North Andover, MA 01845 Dear Ms Starr, �C;rtf�vOFkOFR�FIA�?v^�i/ BOARD OF HEALTH MAY 15 2001 ( This letter is in response to your communication dated May 8, 2001. In referring to the approved plan you specified an elevation of 32" below grade is what you claimed is needed to excavate to an acceptable class of soil for the receiving layer. When I asked you why the 32" you responded by referring to the test pit data. The test pit data is true and correct for the purpose it is required for under title 5. During the excavation for the septic tank the test pit data was questioned by the owner, at that time I showed the owner the elevations of the soils and the mottles. He would have wanted the tank lower if I could, and I informed him that all the data was correct. As far as the location of the leach field, 80% of the area to be excavated had no topsoil what so ever. Some areas of the bed might require more than 32" BGL and some less do to the changing topographic, and existing soils. When I explained to you that I was removing all the topsoil and sub -soils, this is with the designer's intent. (Again I say the test pit data is correct) But the conditions in the field are different. I was about to explain why we weren't completed excavating all the top and sub -soils, at this time you boldly stated that I was not a licensed installer, when in fact I am. There is no question more excavation is needed. By standing outside the soil absorption area and without physically touching the soil you determined that the proposed effluent liquid strength does not exceed that of a typical sanitary sewerage system. In referring to the installation of the septic tank. The day I applied for the permit to install the system I talked to Susan (from your office) and we reviewed the plans. One of the issues that were discussed was the placement of the septic tank before the bed bottom could be excavated because of its proximity, she said it was not a problem, we also discussed inspections. A hole was open for inspection, but it was the hole for the invert. Your literature contradicts itself. How can you have a septic tank inspection without a septic tank? If you wanted a septic tank excavation inspection you should say that on your literature. I did not say that the soil is consistent with what can be seen in the excavation to a depth of ten feet. What I said was a major portion of what I had already excavated was consistent throughout, and I said that I have done excavations over ten feet. It was not that I didn't understand the technical reasons why the excavation needed to be deeper; it was that you could not answer me as to why 32 inches. When in fact some areas needed more than 32" and some needed less. I wanted this information from you for future knowledge, but you refused to provide me with an explanation for the 32 inches, and proceeded to insult my professionalism, and question my intelligence. 'A " - mill�� tib 119 N. Shore Road • Derry, NH 03038-5801 (603) 898-1118 I felt it was unecessary for you to cease the operation, I should have continued in removing the sub soils to an acceptable class or you could have directed me to do what you wanted and rescheduled the inspection. I do apologize for not being completed at the time specified due to circumstances beyond my control we had a late start. At this time no fill has been brought on site with the exception of crushed gravel„ only excess fill was hauled off site. Regards Cr, BOH T. Lyons R. Masys File Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street Sandra Starr North Andover, Massachusetts 01845 Health Director January 17, 2001 Thomas W. Lyons, President Willow Enterprises 99 Cross Road PO box 8344 Bradford, MA 01835-0844 Dear Mr. Lyons, Telephone (978) 688-9540 Fax (978) 688-9542 This correspondence is in regards to the proposed addition to the home at 21 Appleton Street, North Andover. As of January 17, 2001 the septic plans for this property have been approved. In addition, a review of your request to allow the construction of the addition prior to the septic system installation has been made.. Firstly, this office's current policy prohibits the construction of the addition until completion of the septic system installation. Also, as you are aware, North Andover regulations state that septic installations are to occur between March I" and November 30`h of each calendar year, weather depending. We are not without understanding of the homeowners time constraints, as well as we are aware of how late in the year this project was finally put into action. Having only conducted the preliminary soil tests in November. So, the decision is to assist as best as we can, and still maintain our policy's integrity. Rather than waiting for the septic completion, the Health Department will sign off on the building "form U" simultaneously when the septic permit is issued. This can occur after March I". This will ensure that a locally licensed installer has been contracted with, an agreement has been made to install this system and will give you an earlier start date for the addition. Thank you for assisting in this long distance situation. As the authorized agent for Mrs. Dickson, I hope that you will pass on this information. If you need a list of licensed installers, feel free to contact this office at the phone number above. I hope that this decision is clear. As the new septic season quickly approaches, I will expect the septic application on or around the beginning of March. Sincere san Ford, R. S. Health Inspector Cc: file BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: y`/9 - y r . SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example:: left front of house) 74 .c//'�C%( S!d Y i/ �r T J A/' DATE OF PUMPING: `x-lS-o / QUANTITY PUMPED %S J GALLONS CESSPOOL: NO 'I FES. TANK: NO YES r NATURE OF SERVICE: ROUTINE XEMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS n LEACHFIELD RUNBACK _ EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) y' SYSTEM PUMPED BY: gORTH 1 O�,�t�ao a°�6ti00 : iL F 9 ,SSACHUs�t Town of North Andover, Massachusetts Form No. 3 BOARD OF HEALTH 9/ DISPOSAL WORKS CONSTRUCTION PERMIT Applicant NVAE ' Site Location - '7/PP-1 Permission is hereby granted to Construct ( ) or Repair (4an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. //"7/ Fee _HAIR, BOARD OF HEALTH D.W.C. No. 02` BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT ,9 DATE: °= LOCATION: LICENSED IN SIGNATURE - CHECK ONE: REPAIR: TALLER'S LICENSE# TELEPHONE# (Q()� ` �C �Z(�- C� > > ) NEW CONSTRUCTION: 1 IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only f $75.00 Fee Attached? Yes i-,� No Foundation As -Built? Yes No ss 1�14-L- Floor Plans? Yes ✓ No Approval,,,/— Dat /G of Town of North Andover . Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director January 17, 2001 R.A.M. Engineering 160 Main Street Haverhill, MA 01830 Re: 21 Appleton Street Dear Sir: Telephone (978) 688-9540 Fax (978)688-9542 This is to notify you that the revised plans dated 115101 for the repair of the septic system for 21 Appleton Street have been approved. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, /� 414-11� jv Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: McClellen File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director December 14, 2000 R.A.M. Engineering 160 Main Street Haverhill, MA 01830 Re: 21 Appleton Street Dear Sir: Telephone (978) 688-9540 Fax (978) 688-9542 This is to inform you that the proposed plans for the site referenced above have been disapproved and have technical deficiencies as followed: 4 Groundwater separation not adjusted to the highest existing grade as required by 310 CMR 15.240 (1). It appears that the leaching field needs to be raised by approximately 0.43 feet. • Name of soil evaluator is not provided as required by 310 CMR 15.220(4)0). • Septic tank inlet and outlets require "tees" per 310 CMR 15.227 (1). • Dimensions of the septic tank inlet and outlet tees not specified as required by 310 CMR 15.227 (6). • Gas baffle not specified on septic tank outlet as required by 310 CMR15.227 (4). • Six inches of 3/4" crushed stone not specified under septic tank as required by 310 CMR 15.221(2) and 15.228(1). • Minimum of 9" of cover over the septic tank not specified as required by 310 CMR 15.228(1). • Minimum of 0.02 ft/#1 final ;grade over leaching facility not specified as required by 310 CMR 15.240(10). BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 • Distribution lines not connected with solid pipe as required by NA 15.01. • First two feet of outletpipes from the D -box not set level as required by 310 CMR 15.232(3)(c). If you have any questions, please do not hesitate to call the Board of Health Office. Sincerely, Sandra Starr, R.S., C.H.O. Health Director cc: McClellen file Jan -17-01 10:53A Paul D. Turbide, PE/PLS 978-465-0313 PTOR ENGINEERING Civil Engineers & Land Surveyors One Harris Street Newburyport, MA 01950 (978)465-8594 January 17, 2001 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE: Title V Review for 21 Appleton Street Revision • •O Dear Sandra, I find that the design plan for a SDS upgrade at 21 Appleton Street with a revision date of January 5, 2001 adequately addresses the concerns outlined in my report dated December 11, 2000. If you have any questions or comments please feel free to contact us. For Port Engineering Associates, Inc i Paul D. Turbid- nnr8r c 1 .,. � ��� r D ✓ �- l [ 'trig i-- sem- ,1s 1� ��- \\server\p\nabh\2884\Bannan45rev.doc ST Jan -17-01 10:53A Paul D. Turbide, PE/PLS POIDT ENGINEERING Civil Engineers & Land Surveyors One Harris Street. Newburyport, MA 01950 (978)465-8594 January 17, 2001 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 978-465-0313 1 P.02 RE: Title V Review for 21 Appleton Street Revision Dear Sandra, I find that the design plan for a SDS upgrade at 21 Appleton Street with a revision date of January 5, 2001 adequately addresses the concerns outlined in my report dated December 11, 2000. If you have any questions or comments please feel free to contact us. For Port Engineering Associates, Inc Paul D. Turbide, PE/PLS \\server\pinabh\2884\Bannan45rev.doc Jan -17-01 10:53A Paul D. Turbide, PE/PLS 978-465-0313 P.01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Paul D. Turbide, P.EJP.L.S., President Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 465-0313 Date January 97, 2000 Pages Including This Cover Page: 2 Comments: Sandy, I have attached our review of the revised SDS upgrade at 21 Appleton Street. Thanks, Paul D. Turbide, P.EJP.L.S. PORT INGINEIRRING Civil Engineers & Land Surveyors One Harris Street Newburyport, MA 01950 (978)46S-8594 Dec -13-00 05:22P Paul D. Turbide, PE/PLS 978-465-0313 ORTp Iti MGINEERING( Civil Engineers & Land Surveyors One Harris Street Newburyport, MA 01950 (978)465-8594 December 11, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School Street I a M 0 0 z d z° 0 g C C k7 a GQ � c o tri a d z g• � �v b o� A � c r' W Cr Mr UQ °' M A� �CD A � � � �a o� b= �. o a. 1 C!S a M 0 0 z P.02 r t AR by ZR d z° 0 y r tri a d z con b P.02 r t AR by ZR z° 0 r a d P.02 r t AR by ZR Dec -13-00 05:21P Paul D. Turbide, PE/PLS 978-465-0313 P.01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Paul D. Turbide, P.E.IP.L.S., President Company: Port Engineering Associates, Inc. Phone: (978) 465-8694 Fax: (978) 465-0313 Date December 11, 2000 Pages including This Cover Page: 2 Comments: Sandy, I have attached our review of the SDS upgrade at 21 Appleton Street. Thanks, Paul D. Turbide, P.EJP.L.S. PORT ENGMERING Civil Engineers & Land Surveyors One Harris Street Newburyport, MA 01950 (978)465-8594 •T FORM - U - LOT RELEASE FORM ROW i INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having Jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. m.ssssssssssssrrrrrrssrsrrsrsrrrsssrssrsr■srN's rarsrrrsrrrrsrsssssrs■'.rssssssss APPLICANT �� �.wrrlct2pRISEs.. .uc PHONE of 78 - 3 7zl- % f 4_ ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER 12 ST. STREET NUMBER STREET- �rsrrrssrrrrrsrssrrrrsrrrrrrrrrsrssssrrsrrrrrrsrrrrrrsrrsrrrsrrrsrrrrrssssr■ TAY �rrrsrsssrssrssrsssssrssrrr O`1`I �TS RECOMMENDE ONLYrssrrsssssrssssrsrss.sssssrs• ATIONS OF TOWN ' DATE APPROVED CONSERVATIONADM N]STRATOR (� DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COIvIlvIEN rS DATE APPROVED FOOD INSPEC, R -'HEALTH DATE REJECTED DATE APPROVEDs S C SPE R - HEALTH DATE REJECTED D 9-; COIvIIviENTS ,5 PUBLIC WORKS — SEWER WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE UJ E � � E D nTA PR 12 2001 BUILDING DEPT. n � v o n 7 1 � L a fi 1 � P7' 1 fD 7 1 1 I " avv c� 3 0 (D 1 06 M 0 J �+ c iD � 3 mrt sto I 0 m a c flPc a o' l 1 a 1 1 1 99 em -ii Awad Y'19 -Wox 83,1-1 Muzq oza! c*'V 07835--0"V (978) 374-7475 1-877-374-7475 (978) 372-1394 fax November 13, 2000 Town of North Andover DEC 5 Board of Health 30 School Street North Andover, MA 01845 RE: 21 Appleton St. As the authorized agent for Mrs. Eleanor Dickson, I am writing to request special consideration of applications before you for a permit to build an addition and a permit to replace an active failed septic system. I would like you to consider allowing the construction of the addition to precede the installation of the new septic system. Here are the facts: ♦ The current septic system is under -sized by today's standards, and it has been declared an active failed system ♦ An application for a permit to build a 700-sf addition is pending ♦ The owner of the property is elderly, living out -of state, and for reasons of failing health needs to be near family as soon as possible ♦ The sequence of events has precluded the pursuit by regular channels of resolution of the problem of the failed septic system ♦ The new placement of the new septic system requires moving the water line so that it enters the house in the basement of the new addition Desirous of returning to North Andover to live out their twilight years, Eleanor and Bob Dickson have contracted with my company to provide first -floor living space for them at the home at 21 Appleton Street. Upon completion of the addition, the Dicksons will move here from Shreveport, Louisiana. At present, the two-bedroom two-story house is inhabited by Eleanor Dickson's son and granddaughter. The addition we propose to build provides Bob and Eleanor with a bedroom and 1-1/2 bathrooms on the first floor, and it provides a larger, more modem kitchen and dining room for the 4 of them. The goal is to make possible independent but increasingly assisted living for the Dicksons by virtue of their sharing a home with family members. It had been our plan to build the addition this fall so that the Dicksons could comfortably enjoy the holidays in their new home. Based on the information provided by the customer, we had no reason to believe the, septic system would pose a problem, but here we are. Since the discovery of the system's failure, we have done everything in our power to diligently pursue resolution of the problem, but timing has been against us. The deadline for submitting an approved septic design for installation in 2000 had , -4 lapsed before we even had a deep hole and perc test done. Even with a variance, installation could not be completed by November 30. However, with this letter and the accompanying septic design submitted for your approval, we continue to diligently pursue the repair of the system and are targeting an early spring installation date. We ask that you help us to set things in motion again by approving the building permit application with the caveat that an approved septic system be scheduled for installation at the earliest possible date in 2001. This would allow us to: ♦ move the water line into the new foundation prior to excavation for the new septic system and ♦ have the new living space completed and ready to tie into the new septic system by early spring. The Dicksons could move into their new home and use the existing septic system for a month or two until the repair could be completed. We appreciate your time in considering our request and look forward to your help in resolving the issues. Sincerely, 4'1X0141 Thomas W. Lyons President, Willow Enterprises It lapsed before we even had a deep hole and perc test done. Even with a variance, installation could not be completed by November 30. However, with this letter and the accompanying septic design submitted for your approval, we continue to diligently pursue the repair of the system and are targeting an early spring installation date. We ask that you help us to set things in motion again by approving the building permit application with the caveat that an approved septic system be scheduled for installation at the earliest possible date in 2001. This would allow us to: ♦ move the water line into the new foundation prior to excavation for the new septic system and ♦ have the new living space completed and ready to tie into the new septic system by early spring. The Dicksons could move into their new home and use the existing septic system for a month or two until the repair could be completed. We appreciate your time in considering our request and look forward to your help in resolving the issues. Sincerely, 41t" Thomas W. Lyons President, Willow Enterprises c� 4 d b d etc La. @ � 1 H 4 H tyrJ ... Ts �a r a� dA d O y x Q r:. rA _ � o � A• O o _ b ° o °+ � c t co Dec -13-00 05:22P Paul D. Turbide, PE/PLS December 11, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School Street North Andover, MA 01845 978-465-0313 P.02 RE: Title V review for SDS upgrade at 21 Appleton Street Dear Sandra, Enclosed find our review of the "Checklist for North Andover Septic System Plans" for the septic system upgrade at the above-mentioned site. The following is a list of technical deficiencies that Port Engineering has found. o Groundwater separation not adjusted to the highest existing grade as required by 310 CMR 15.240 (1). It appears that the leeching field needs to be raised by approximately 0.43 feet. o Name of soil evaluator is not provided as required by 310 CMR 15.220(4)0). v Septic tank inlet and outlets require "tees" per 310 CMR 15.227(1). o Dimensions of the septic tank inlet and outlet tees not specified as required by 310 CMR 15.227(6). o Gas baffle not specified on septic tank outlet as required by 310 CMR 15.227(4). a Six inches of V crushed stone not specified under septic tank as required by 310 CMR 15.221(2) and 15.228(1). o Minimum of 9" of cover over the septic tank not specified as required by 310 CMR 15.228(1). o Minimum of 0.02 ft/ft final grade over leeching facility not specified as required by 310 CMR 15.240(10). o Distribution lines not connected with solid pipe as required by NA 15.01. u First two feet of outlet pipes from the D -box not set level as required by 310 CMR 15.232(3)(c). If you have any questions or continents please feel free to contact me. PoWn�E�VA E . a It I Sincerely DA .- ti. ENGINEERING f' N.O. x8375 Pau D. Turbide, PE/PLS /Z 00 9EC �E Civil Engineers & F �� � Land Surveyors One Harris Street Newburyport, MA 01950 (978)465-8594 \\Server P\NAMP2884\Appleton St 21.130C 0 n H �o �M Cl d a CM mCD CD C � � y z 4 �, z C eD rD m A !� O C A C y � n• � O O .r `b o. 0 �a 0 n H �o 4A. NE.A.1,14f 14-i S-6.0-9540 TFI NC 1,*- 71 Fr.ic Lnd t) I ,e, aA t i g t j a u I I ut es A g, Fcf T`: Of' --r iot fi.r- ne'v This x,-v.n, rv.! two deep holes anu -%V lot i6r z ii 0 P';6 Mlo-,!) r: —ti :.,-e lislvlv�'I u V',F�*-:;:,:_ i: -,w.. 5xer; cay SO fill navin"!"T ;11 157 4 da% r, 1-2 be ti:i ( Tn �'tz r -j to !.,-I 9o., U -A U'A F ut Vr Bf %v T L itlt StMURFACE SEwAt3E ptSPOSAL SYSTM INSPEGfIM! FOM • PARY C SYSTEM MOUJAA it' N €ten*Wdl P,apWy Ads "$'. s;,(ETul OF SEi/fAGEOSPOSAR SYeTIN! krluds ties to st Isest two ppm reference IwWmstk• or banchmtrkt locate aU we" within 100' €Locate where pubic water supply cones Into house! DN tit e AR[o t�rl '95 per _ Wt3/w revised 9/2/98 _ prep t0 t 1S APPLETir N :33TREET i revised 9/2/98 _ prep t0 t 1S APPLETir N :33TREET ;R Common�nrealth of Massachusetts a City/Town of No Andover System Pumping Record Form 4 'M 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 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, I use only the tab '-2 ei key to move your Address cursor - do not use the return key. City/Town City/Town B. Pumping Record State State Tele^hone Number 1. Date of Pumping Date ` ✓% 2. Quantity Pumped: 3. Component: ❑ Cesspool(s) ❑ Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes P� No 5. Observed condition of component pumped: 6. System PZ!! Name Stewarts Septic 58 So Kimball St Bradford Ma Company 7. Location where contents were disposed: 20 so mill st bradford ma Signature of Hauler Signature of Receiving Facility (or attach facility receipt) t5form4.doc• 11/12 Zip Code Zip Code Gallons ❑ Grease Trap If yes, was it cleaned? ❑ Yes ❑ No S-7-7/5 -- Vehicle License Number Date Date System Pumping Record • Page 1 of 1 2. System Owner: � Name Address (if different from location) City/Town B. Pumping Record State State Tele^hone Number 1. Date of Pumping Date ` ✓% 2. Quantity Pumped: 3. Component: ❑ Cesspool(s) ❑ Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes P� No 5. Observed condition of component pumped: 6. System PZ!! Name Stewarts Septic 58 So Kimball St Bradford Ma Company 7. Location where contents were disposed: 20 so mill st bradford ma Signature of Hauler Signature of Receiving Facility (or attach facility receipt) t5form4.doc• 11/12 Zip Code Zip Code Gallons ❑ Grease Trap If yes, was it cleaned? ❑ Yes ❑ No S-7-7/5 -- Vehicle License Number Date Date System Pumping Record • Page 1 of 1 ^~� ����� /� � �� �- �� \� \\� \� \\\-\\\\ /d\\ d /.� %2� � � <� . � , . � a , � � \�\ \. .�\. �� � ^� �^�� � � � \� � � � � � � � � � » y©»§<� \� � }� � �«? \ \� » : � . � , : � -,.2. . \\ �~�-�v«,,. � . �� dw � � . . . � � �:. .� & �� � � � :� >� � � � � � �� � 2" � � � :� � ~ ©� � � � 2+�= tt� e� � � � � «,� <..�.. . .. y\w.. _ ^� ��« \ � ,� \. �\�� � � ; � \: � � � � \,� � � � � ;� ?� � \� � \\ _ \d§\�^ ! .©vw.w. ,z: 2 ®~ _:�� �� �� 9Sx :- _- w«� wc� �� � ,r: «, . - � �. .. :w - �::w�©» y :� aw �. � \.:«.. © »� � ~\�/�����/��'�\/�\��:\:e����<y�y�«: > � ..<,>/w y yr \. � � � � /�<« ..� �>: � 2«2 .�\yyy.. y�. � »swyyy� .w � a \ ~ :� »``�^° %°«?y © ©:� p y .. `w\� � � »s � \ ,m«x� � :y y� y� . .,�� 2�— m a� ,mom � , .. .. ... - � G ^� � ^°� ,� � � � \� � � >\� � �� � � y .. w a v a c �.. FORM 11 - SOEL EVALUATOR FORM Page 1 Da ; Commonwealth of Massachusetts Massachusetts l,acarion`Address or'] Owner's Name, �y Loi N C " Address. and (' G1 tic, J s . Ue iJ Telephone N New construction ❑ Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes ❑ Year Published .................. Publication Scale ................. Drainage Class ............... Soil Limitations .......................................... Surficial Geologic Report Available: No ❑ Yes ❑ Year Published ................... Publication Scale ............ Geologic Material (Map Unit) ................................................ Landform....... .......... .................................................................................. Flood Insurance Rate Map: Above 500 year flood boundary No ❑ Within 500 year flood boundary No ❑ Within 100 year flood boundary No ❑ Wetland Area: National Wetland Inventory Map (map unit) ............ Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range : Above Normal ❑ Normal ❑ Other References Reviewed: Soil Map Unit Yes ❑ Yes ❑ Yes ❑ Below Normal ❑ I FORM 11 - SOM EVALUATOR FORM Page 2 Oil -Site Review Deep Hole Number).:....... Date:....f Time: ../:,..(% Weather Location(identify on site plan) ............. ..... ..................................................................... ...... ..... ......:............ ............... Land Use ............ .................. Slope ( %) Surface Stones ... Y.V..v ............... Vegetation....... .. -j ............................................................................................................................................ Landform................................................................................................:...................................................................................... Position on landscape (sketch on the back)..................................................................................................... Distances from: E. Open Water Body i. ........ feet Drainage way ................... feet Possible Wet Area .. feet Property Line ................... feet Drinking Water Well ';fe... feet Other ........................................ ............................................. ............................................. DEEP OBSERVATION 1 LOG Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, JV...Q...... Consistency, % Gravel) i r � � S � � s1U N �• D i Z -`i Parent Material (geologic) .... ........................................................................... Depth to Bedrock: ................ Depth to Groundwater: Standing Water in the Hole: o`ii`.L�.......... Weeping from Pit Face: JV...Q...... Estimated Seasonal High Ground Water: e FORM 11 ~SOM EVALUATOR FORM Page 2 � --� / On-site Review .� � D�o Ho� Numb� D�e� 0 Tlmo /.e�.^ao Weather Location(identify site plan) ........... .................. ...................................................................................................................................................... LandUoa............ ^ ��J�� _' Slope �~'7 Surface Stones -- ..................................................... Vegetation --����������-----------------------------------------------_-'_-'--_----- Landform.............................. ....... ...... ...................................... ..................................................................................................................................................... Position onlandscape (sketch onthe back) -............................... Dista nomnfrom: - /0... ' Open Water Body -� feet Drainage vvoy-----' foot � Possible VVetArea 1.0 -0.,, -feet Property Line .................. fuat Drinking Water Well ^�/4.' /eat Other --...... � DEEP OBSERVATION HOLE LOG Depth from" Surface (inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, % Gravel) 4 it Parent Material (geo|ngio) --H�� �-v�-'---'-------............................. Depth toBedrock: ` De th to Groundwater: - . m � � StandingVVutor inthe Hole: --���^^l ' Weeping from Pit Faco: "���_�u__ Eodmu\od Sooyono| High Ground Water: ----.- FORM 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test Date: e> I a 0 Time: ........ Observation Hole # Depth of Perc Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" Time (9"-6") Rate Min./Inch Site Passed Site Failed ❑ ....................................................................................................................... Performed By: Witnessed By: Comments: ...... .... ... ... . I FORM 11 - SOIL EVALUATOR FORM Page 3 Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole ................... inches ❑ Depth weeping from side of observation hole ................... inches Depth to soil mottles .................. inches Se � f( �` �e-- ❑ Ground water adjustment ................. feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor .................. Adjusted ground water level ........................................................ Depth 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? If not, what is the depth of naturally occurring pervious material? Certification I certify that ony<� (date) I have passed the examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. ", (—'\ Sign Date 11 ,r t ARGEO PAUL CELLUCCI Govawr - 'ICUIVT,_iIFTTCF y .TAr. F� yFApu!mFAN /1EINNMOLwyENRAL R]jye() -y 7 SURSURFACM IF-WAOF F At, SY, 0 MFIE ;" il~+URK PMT A P10/M+fiy Ate: " i j� r!.' i ) • e$tptuR Oar fb*3infr 59:1° ( 4:asa`r 1 ` „4''r —A YI �,ue,.,, :�'�? , i� �!a! of +fit3°rnati; � .y � � ac._�w�1.. � .. f�:x r1. -A:�.t.:er Dab cr/ €+�prar#oo90 (M Know of %$Peetcr. E an°t a DEP ap "vtd rynam 6-!@ actw pwsws>m'w Seem 1 r. or, TWO .5199c5 CYR 1 SIM01 Udkq Adkk it: MUM CaAL ;a+ T94EN_T 1 cartify that 1 have personally €nspoctad the stwaga diapcval Ibis #RdAwu cs)4 ;iso.; Vot7 ?vlarnjztlon bQ*,,a =a �rs,e,.rui ,ut a end complete ss of the timq of Lv poctian. The !ralprs,.t'ira� "Wang Pf+r-rrxrr?vi btlsgc: ?n V- F Ircgar €ursmiml w-;® maintanar,ce of an -nits rew-agedispose€ vyaterres, 7'ha �r:u:crr: �, pairs:a conditlamelly Passel _ ifesds F;a:tlz .r Eve €�a t3k+ t+o LtRcat !t.7grirslrs Ru>dsamti, . Fails ms'stf�R1• The System tn92ractvr *hall si bw ,.. -:o,+y of thin i4pecllcrn rip-', tho Appre5.nrg A,ItioxKy '$vt.,Fd ar €W,51t1.1 isr ?.)Cp 064y (wGj days of completing this intpection, It t;se aysts•.v iz; e shAd zsy,'—.m OF " at a 4&4'.2n flow r 1,+vf"(' tT yr trrr v. . s'Iff + qN-z:or runts tha siyvz; m owner shalt strbsvti3t tars report ste the t,pprcz�-i=x� r��yiprlai ti�L1! �'��* th+e [}H�e`t=r2+S�t' �+t'f_=.`;u��9r=are�ltCx9 :•�`;�':F. !'G!i. �'�2PY 3pi�rrlai' tt��i€rt !,ste l6k1)w 4u ;Cit! system own## and tcples sect co arse Grayer, if wpligable, sari the Appr"rtg utharlty. NOTES AND COMMENTS revised 9/2;"Std D 1iit3 rl-' l'i`- 5U35E)nr-,ACF SEW -GE 04POSAL 9751714 (NSFECTON FORM RAWI A CEFrACAMMj'ean*A4dl ftpoft Ad*vm- 7, 1 A�r Ir DA" a 17,z 14;z WSKC� SUMMARY: Cbs* 0 0, C, of 0, A.. SYSTM PASSES; 6 pisvp rW found any Triter-notan wt -t, -.N ocidicates thea. any 0 Via fo6urp. IV, 310 ct?lrq 15,3C3 exist, Any' feilure aftmis no, &4u#.t*d aft Irdleatod bvl",. a. SY CONDITWHALLY PASSES: &Z Ono or mnrm SyMern Con.'Porm-as ;as da-led,134"i lljoff-r!--�" ('r Tt'# lq:klmm' l((ir" complif.tion of the rep,'acctment or vsp"4" as ftrpxp-.Wb"' 4- p F, card of HmjAlll, will -4pil Indcateyor put determne!" CY, D' or R, 01mOti be -'vi *I Prvj(�rl F- t-4 K -r-.ctt dclunined", expWirt why tact, yl The sept c tonk is rootni. onloos Oiou owrmi tv 6ilt V"V9 tilwaWof .t„ ads a r'QPV Of '% CordflCM& Q1 Compliance lattached) ladleating that the 011* Wn*0zla'4H(Pd W'rh!41 t'VOVV'Y m *m date of thA Insperm, ion; or the septic tank, whether or not mitlpl, to arcked, rm.-mrAv uw-i�.aund, ahvN+'j [nf"ilfatJor, j5r failure In immimi.01. The xystgm *41 pstis in%pa--fit:11 of th* *Aiq6r-.0 #.flppta�' taf-+ is mpr'"zorf -with m Com-plyinro septic, tank as approved by the $card of Health, ZSewage backup 0.brmmkouX or nigh 4tatic vip;m, o-jvI :'bf,0TV0 In Ftlf "VWlN;-??'3r. bo,( 4 1JR, to larolcan, of ZhOwltod p.ii nisi or due 10 a Wvkm, -,ietlled or vpoymv 1;slrlhiV' n :iw. Tt!* myriom 7rp44to Frr! if fw;th&,p,tree the ftmt of Hoelthl. broken pipeW m-9 replaced obstruic lion N mm wed distribution hoIt; N,-vellel 7f- irpileced Thw yvtorn required purrepingmwo than fcuySmAjn u Inspection f! (with approval of thry lgoistcl of Htv.Nh)" Woken pOp-i iat' arm rcpt :5-1 mUnAorl,' ib lrtttlgv?ti --evised 9/ u/98 PlAe 2 g4.' 11 s1j=-UW A % rVV? :,?:fit O"8POSAL V!S'TE1 PISPEZiBM FORM M PART A t;i-MISICATICA ttaf#rbr WWb Owner, r . Canjjtions a 9st iwhlch eequire'futhxrr tcv la ct I: tf by flea 13ogrd of Hagt£t in or6er to dat.amine if Life system Is falling t4 protect the public health, a+sfety and !i)e tt,7ylrunrnas;t. 9) SYSTM WILL PASS 4141 EFS BOARD Of W -:A .V. W ACCORDAMM WVTni 310 CMR 15,303 ,'flit+) THAT IM SYST m 13 Wei i1�WG'; )NWC INA MANffESYsi'iiillHIC 1 WILL �'t)TE T ME PUBLIC V�l.BFH Aifd� SAF�4Y AND iG15.�1f71RDtMIMk_4L1: -- lwbsiaiFaOpf U?;)tit"( iti lftli",c'�:i �v }tayti, ,•�€ �lifi�$$a Yiac.�:f Ga�>istnad ar ta�'ti`Y Ie �trii!ria� SC fcm ,.•f a b2rdbriva inn atod w*t1vnj -.r a alk mwsir. �) ST3 M WILL FAIL UMITSS 'T4* ti$t}f�RD OF ifw Ai "!! 1,AMIZ; PO UC 'f ATFA StpPPLA P, IF ANY) OFTEfif ES THAT THE SYSTEM M FMC:'flilPlNG W AI`!"Mt "iHAT ¢r$`vOM7,t?: THE PlJOUG 31L'las.'Pi MD SiAFM AND THE E'aalrtf3f?{iflYWIM, "he sy s,' om his a ,mptic tank ar-I al! vh9n:r,-A11*n tvstem ZAS+ and the _SAS It within ` Oo far4t of a vurfCaan water supply or tributory to a surfate Wotar afw! Oy. _ Ths t,ysteen ho:s a raptIc tanY ;Wid shit absorplion Aystfm and the SAS Is within it Zone I of a pubfle wour nupply well. The system has v a tO,4 rani, and so?I absw,,Jtl�ia ey+atern and the $AS Is MIMI, b0 taut of a privatA water suppiy )veli, Th* Fysln;,t Fas b s&wtir, tfrnk -if sm! 4suipitioil systsm and the SAS (a 441ts than 100 46aat but SC fee or more from a ._a ;yri'os.ta V"Wer g''.J1•14y wean?, unlots a wali'twsatti armysl.i for eanlifirny bacteda and volatile orgemIc comptrrtods indlicattas that the won Is trey (Torre ;tJ(Tutlan ftem :Ihan'!Acflity` and tho pjestmes of ammonia nitragen o0d nitrsto nitrogen is equal to or fess ih&n 5 ppm! N"etibc,'a used W i°x.'eaftniral listtiice W.,...,_____,a__,_ (aappruAnuifofe not vaild)..- 3q t}THER revise(: 9/2/98 Page 3u4it M�Grw mese. 4. ? Aid cleflep— Dame of D. SYSTEM Fes: you 9 Wilms anther "yet" or 'No' to esc": of the %Jl wmg: I have determined thrt one or more of the iglu -, raraciiti,3Art east? or flrrsrribad zr, :? 1 n tr VIP l if., T?3, The t Mia ►t r t1.7:t alowminstion is Identified beiaw. 'file Based ct i4ai:ls rhould be contsoled t f®termiM1e t w4l bre rtca3varV to cdrrect ,,e- fiail:um, No Backup of sewage inti ^lecit%tr>aregrittm vrrrr:prsrrirrtr3a4-to an oarriarrd,rd *r-ckftq;md SAfd a1s°vert3speaub. Dischergs or ponding of ,af-muant to tho sorf�cn of thm growil ,rasaa,rtars.rr cresspao►, _ Static liquid h vsl in tt►a rtir3rl1bu*m bzx abo,nr oaz set inti r~r' sat get aco tr f^vrlc a.de r4 o c1ng2g6 GAS o", e:cx.sp,4r , �G. LiCl6 d depth5i G9S:{1c3. 'Is iRv; 6' t6'•np,{ i.w rt rr rjv%ftah[#P ,m slwio Ela ih3ffi 11r'ir7 Z'2 rn,,� flow, ReguirwzI pumping more thorr A tinears in ttiat (*r yrstar j flue to ls.-Oo nod a'.t Number of Imes pLmped yC` Any portlort of rt►e Soil Absorption System, Osjpool rr PAVY +a 8100V tNit �fA!r grcv,: nr2wsyt�:r *I�+r#firer. Any porttvr of a x:esr;-guol w ejyNif fie within 106 f,!a? of o ;ii.r`acn w ,O rr :est^{pry lrl. ley Arty portion of �h %Y privy is witNn �q 7^ov I of a puN`r(t wort. Any portion of a cnsspnut ror Privy lis within fget Ulf s, priv010 vaso A�.gio't„ vrael4. Arry portior fit a ;.esspaal w privi•, is letm-1 ra: 100 feet hof# grrtatwt than SR') feet frl)m u prA.Kow sbww sup(^i,,; vWa(A Witt, 110 OcceptaNs waror aJuMity rereelysrs. If flee �qsl# 4+ss keaM 4nrlyzed to iian rc�fypYr,�9a, ex:eh r,.�f, of pail W rr.+ a valytis far �oll9arrrt baaa:terltt, vvi;atilc arglaerrincoagapouta�*, st*amanla Rttragraa,.rrr:� �itraste-Jtruge�. E. LARGE STUM FAKS: You must indicatd ttthsr "Ywt' or "N.)- to Patch of the lcllow;..g; The following criterle apply to Isaga twsLla ra In oddliicri to tha (Atpu4 aboyv: . he system serves a faciiity vAth a design flow of 10:00gptl ar W;P.vsr i;,.sr 4 syftiaro61d't";A ;sy+"dt* is it three ,,j putr'ic health ons► oefaty end the e6t "for:merif because one of mct<P of Rhs tnitnwiax, rcnirs0eng, agirft; yes No tho system is withnn 410 t-,f#t u! a ru*teams �tr,:knv wra.ttqr suppry the system It twlthin 200 foot a' eta trilx iwy Tro 0 surfat;a drrixueg ww'jr 1wwPlt, � ... _... _ the symem is bated in a ittoi:&% aersltavat arsa Vntelkri yl,'49;t•cW 7rotarct.'�,o Aran iklf*A„ n; a rrrirpPttif r ate u of ae rubli: urates suptrly wen) The owner or operator a` any such system shall ug?t:rad,,T the alis#arts In nzvnrdanrtt titl.h 11DIS,?04;1 .), F ra.txe ror'34sit itit local 11"110ai trfnct of the Department for further Infarmstiarr. revised 9/2,1`98 Not dortt SUBS'tt?t -ACE SIFWAOF DFSPOSAL lf'!' TUA FORM PART 10 s ftapvty Ad*ow-; IA 10 P. meas; V 4 R. fte• Check If tho foliewing hevu b aer- dant Yc:a male in&ete aaitbor 'Yet" or "No' as te, eor•,t. of =al1rW1ra. 5f�No ✓,r Pumping infrsrrnstlan was Arnvidpd try tf•e ,:avy,t4s, ar aupa�-sx, ar 13aa4rd of its a None of the ay!F�em eoropunsnt4 hav*.Jt6edr �r at 1 st yw.c vraaka -W-ft gymmer -flow r9tes during that Lange vvium.ts of vraOr hvvs not beyn 3r; oducee, int:< tsa eyuvtr;a rf+CRr-j6y or as part o5' Or� irasoaection. As built plans have beer ahtalnad nand sxsm:riodc Nits if !h'Ay bra raft witl? M/A, The facility or dwrning wes ;nal"tad low r,igns »f s@w. Ra ,ftck-up, .m The system does not raceive ncin-#r*N4mry Cr induattl°ri `ara tto 1s7 w. _ The aft@ was lospected frnr some of bFO&1rOUt. Ail system comp inents, excluding the $off At#orption Systaam, hewn bgen locot" on tha Qitc The septic tank. manhole,e wore uno4_vnree!, openod, and the lmseirR sf the- ;Ajolr, tank •ass ir,s aak.tet3 for tae buf. ler. ce tris, material of twistruction.. 6rn4onsia9rs, depth; of lkliA . d.vipt` of alu?pe; dtpiva? OTga�,,. The site and lotati;?rt of t -Se "I Ai aturpth- ayrf;i4nn �4YYha asi'!' to?L )4,o ; t#f t'"+;! rb;E6Td ;Wd O'Y:' 1/ Existing iofar."atiet-, Fear "x4mole, 1*4r.. at 6-C. H. Detorminel in th# f4q1,d (if +ar,y of it-* failure crite ie r:t'.etad ti) P -rt C ie r:*. ETsu , 4ptresfma,�ar or dlsotsrtr is 17 &302(3}(b)l The facility owne.land aacupants,.if difforsiU treat's raArrtw)..:atarsgi P. ctiijf?et�i.'hlth' 1ts�Stx�3r;lwra r9 49' ittiea8wratetiarllGR i? SubSurfece Disposal $ysterns. h revised 9/1/98 Fa2r ,r r; SUBSURrAi E SEWAGE Di: POSi91. SYSTIN NNSs-relit FORM PART is SYST04 INPIXIM04TION. h►Addrasa� �,i �T-�1,�� �,ta 4�� Gwtter Dame of kwpov"v d 1� FLOW COWIMONS RESDEyI'd L. Design flow: g,p.d.!bedroora. Number of bedrooms (design); j_ Number of bedroomv (aetual): Total DESIGN flow Number of currant residents.—i- ©arbtiQe grinder (yes or na).,V Laundry (separate system)) {yes or not:AL; If YeE, sapeW,,s.4ssyoction raquirad _ Laundry system it pm#d (yes or no; Sewevnsl use (yes or no) --AO Water mater roadings, V ava(leta!e (last two ywnr'x wlsnge igPo": Sump pump (yea or no):Ati Last data of aoaupanoy.,_ALGAItj tl Cx.4�,.�^.A CQMlANE6tC1ALlifaDR9lfl; Type of eotablish"nt: assign flow, asd ( Based on 15.203? Basis of design flow Grease trap gesent: (vies or no)____ - industrial Waste Holding Tank present: (yes ar n*3_,_. Non sanitary was4o discharged to the TWe. $ systcm: ?y+ss or Water meter ,endings, if eval sbie: . Last date of oceupe ncy: OTHER. (£Describet Lest data of occupancy: ��If�AL �ftfYtl�?f�i prJtII1MG fi� d soyree of Informatlow System, pumpell on part a inn er ran: fYas sr rlw._ta g If yea, volume pumped: T ___ _.Ssllrrnz Reason for lumping ---- TYPE OF 81PST to Septic tankld;stribution bQaJsolZ etvso::gtian .aystarar sirsgla cesspool Overflow cs3ap00i Privy Shared &+ ntsm ;yes or nrj) (if yes. attach previous inopection rec;orda, tf iiny! llp Toclinalegy tote. Attach copy of up to date ope,"wtirr and mairneriarnce Tigtq flunk Copy of OEP approval Other AP'PROXMATE A13E of nil er mpunents, date lrwwY044,41 knsrwjr ' orld SeWTW o¢bre d+stseted when Arriving at t4 toga: ;Yes or not _� f 76 617 revised 9/2/53 i:, 01 3EA14d Page R of i SU t117ACE: SIFVAQE IlI;PO! AL STSTUAI ONSPVCMIN MIisM PAR r. C SYSTEM INFOIrZ11ArONE lrraml limmil Pmpwq,flddttrsa: 21 jld R� G IR Daft of kapecdon- BUILDING SEWER.* Iloehts on site plan) i Depth below grrade.—I— Material of consvitt;d 0 . — cast Iron 40 PVC cf.her ;explain° LNstance from private water supply well or suction lire Diameter _ Comments, (cmation of jal"t:a. 'venting, *Aden;:O of (eQl rv� r t'•ie. (locate nn s49 plarn c .A i Depth below $rprJe:�L Material of constructiow lColicrete ,_metal Ftbergiass �Rolefethylene �otherlaxplair t If tank is Ematal, list ape •_ la,ag®:cooaflrmect by Gar4 rc2te pi ;u~ tlalit�rrca __,_�--Tl"aslhic? _ _ . _.�...�_ �._. Dimensions: Sludge de' :....a.�..� �.� ... Distsnca from top of sludge to bottom 07 outlet 2*e or t:t ffte:___ - Seum thlcknesst _ Distance from too. of scum to toll of outlet tee or W re- pfatance from bottom of zcum to hosSorn of Cutlet Pet or baffle: Flow dimensions war* datermin*d: Corrtrrtorrts (reCommendation for pumping, canditlon of 3n1tt gist) a.aqet lianas or :isfflea, depth of IT'ctild l ,v r; in r t ;i,„r ;a u^'Slpr ir,40.7. ,s,„u,r:W,.ei iggacse-a„ aYialany:e Cf le:akega, !vr..1 - ilocata an site pie” Depth below grads: Material of corstrtruction: _concrete _meta- .__9berglas:t _PCIS stog1e1-1b —_pthlFftexgrela f Dimensions. Scum thlaiktsesa: �,�.......�------•.T Distance from top of scram to top of rr,r!l�l ler *7 beffta: Oistonce from bottom aE scum to buttorri n” ovVel. tea cw 7h --1a Fate of Inst pumping: Commynte: (reromrmndatlon for pumping, condWon of in.:at and ouVat tars rat harfflz:n, der,01 aE liai.!d "qjer Ira rra;Atlon •ar± cut It irrv++r% u:a�;^tural Integrity, vAdanos of loakage: atc.3 revised 9/2/S3 biege'.' o� 7.R SUMMACE SEWAGE DEPOSAL L SYS'F'EM MISPEMIM IF &M t PART C SYBTEM WOMUTICIN foorftwedl draper(, Ate: Daft of kvVetem,/ n d SOL AOOWMM $Y$TEM ISASD: Rlocats an silo pian, If posaibie; sxesvutior+, t:o:.r*gjlrod, location may bo sppeoMmirme b no d-s�r tri�,e riogiy lx,• If not located, plain; IowWng pts, mirnber, _ I*wAW%g ehambers, numhgv.� Is*@" Oslwee, number"-- leaching trsnchts, number�laa�r„fr, _ ,.R leecMng fields, number, dirtrer4sions: ''� ovorf4aw cesspool, number:_ Altsrnative system: Mame of Tsa hnaal4ayl Comments: fnata condition of sold, signs of hydrUft ftaura, levei of pand;r%, demp Rail, cor ei for of vsryetetlnra, atc,l CUSIOCIM R: , Ilocate on alts I+Wrnbsr and ceMlguretlon; Dspth top of liquid to Inlet Invert._ Depth of solids lsysr:� depth of scum layar, Nmensloas of cesspool; Materials of construction:. Indication of growWwamr; Inflow (cesspool must bs ournoadi as part of Conimer+ts: (nota condition of atoll, signs of hydroulir, fsfivre, lsviA of ponding. co n&tlon of.Ynetafian. f2r..) pl11ai1t: 4n, pocate on Metarlels of constrvcOPn._ ____ Depth of MOWS' Comm4w”: fnots condition of soil, signs of hydraulic Wl ure, iaysf of pcnding, candkor, of vegr+t0ir -3, gts.b revised 9/2/98 SUBSUPFACF 31FINAGIF DISPOSAL SYSTEM POPF-roWA FORM PART C It aparty Ad s,- W,4wvle O*mw,A- 6 *,- -,-q e, /�, e f-- It Do* of Womftm SKETCH OF SEWACE DISIRMAL SYSTINI: Include epos to at least two permanent refamnep PancL-narks or benchmarks totato all wells wifti 100' (Locato whv* public wr.w vmp& com.% Into hNgst) "y revised 9/2/98 APPLETON 'STREFY 4r eA SUBSURFACE SEWAGE MISMIAL ItITMU wlsncrow FYAW PART C HYMN MMMATM 11,ae�ae Ile" chww: Geor e- Al- Dan at I= MRCS Repar'. name Sill ,typ*_ Typical dooth Uses Data wobble visited Obsorveflon Wells checked Iroundwstor depth; CITE M. Slope Surface water Chock Collor Shallow web Estimated Depth to GravNwaulr _(Vrest Please Indicate W1 tho rnetho4 used to 49rsrrNn* High Gf*Vw,',.V0o!r fjovotim'; Oblminvd from Nsign Planta on record V-11c"baorwed-She (Abuftrtg ptopotty, aha* vatiar a, basomeol sawp #ta.j V*t@rrWn*d from local acncOtlont Chocked with local Baud of h*aKh ---Chocked FEMA Maps Chocked pwping records Chocked local excmvatars, Imtellers Used VSQS Data Ducsibe how you established Im High Oroun4wt�iw EIvyatiori, iNIL Z �# revised 9/2/98 11 of ti �C! T r � • f I e4` —POSAt..D 931CM l 4'V'f'EC'Y1O Y KMM PART 8 f.'HF CXLIST of Ow w'J` "�.- .. Dela of kwpvl1&3n: Chafit 91 t e sli,2+�ei'rt9 'tare tas•sn dom" t ra a r:?�rr; 1Mdf:1K# Wilt ' b"�r' or "No* eye to each e! the toasuvuin� V7 No 1d)§ Board of HAe t'h, rfr - lr,E91p4ng Infa (mvth:n gabs ;lyd7wido'e' oy tlYaSi$Y ti:;apant,'jr f_ None vi "hip SX'1"'rjn s:�)?'l�Fl�"f'.4Td'f11 u1`trF�Nt1 $rA �tdoPFP9i��1"04�5%�:s9'l,1wn uarry6�c•@ aTi��G4tQ6"?ratNlsl f1B��d?Wllr!'�fCaivinQ�rwn l-lloW g1rt#v 6uon;! 11ul %wy a rf'jL!m'.g@ of wpt(st, lvavo "t been irwuducad Ir1fo t4a system recently or os part of th's itsap�t%ri;,A� • ._._ Aa boil; tl;dr!s 11''a'rd beevi 1+61�d.,e a ajscf 0 thoy are not aveilnbl-i viii, &A, Th* 4l611ty of *fts `nty*r,%vJ U4 alpni of teb*ags back-up. Tho Ovatan? doev 1 K rw,CW've n011 -SP t?4aty -or i"duss'ai -Wbate flow. f 'The bate vias 3nst,+v,-vas f+,t Ogns ttf loaskoul. . All ty tttrrl tos rl`t ii% •.;{tar $44 Abrd,�rt,$,.n Svvwn, have beton located on the alto. Tht ilepVlank" men'al+ts 91e•om'.InerweW, Openv'-, $vd tho inttEew Df +he so1p!ir, tank was inspected tr:r conditlon of bj�fges �._ oP t&,st, mgtr ial I tir iwiruttlwo, tWti*nsior'tlr, depth of liquid, dapth a# Oludg", depth U.' mcurn. T'hv sizes and iacstsun of'Ittr 5,is' AbsorV-Vun System on tho she has bofm detertrinsd basad on: fx'40ttp Irift:rrvistioo. For vxampla, !Tran at 8.0,H, t pt<{;trrrc'r za;; In th* iieid ; ¢ wly gut V.1% failure vf"Or'M t0vim) t•:, Pari C is at ittu*, approjtlmation c" dimanctt is unbeceptablel y -• 'Fhb 9erilky B wast ixrt ,r ru ye2rat5:.a# 601'em4i frwu ,ws+usrl.wme pxnvio,,ci with infntsnatIvo a s 4�e,QJtt�ef.malntanatraa.of Cub efface L1110posal s ym$binki MOxam@Im/Iv moxalactam disodlum M&a)Emteqrises, I= 0. Dav,4344 - See last pages for prescribing information. .y It.A.M. ENGINEERING ROBERT A. MASYS, P.E. 160 MAIN STREET HAVERHILL, MA 01830 TEL: 508-372-0449 FAX: 508-372-7183 August 28, 2000 Willow Enterprises PO Box 8344 Ward Hill, MA 01835 RE: 21 Appleton Street, North Andover, MA. Dear Sirs: As requested, I have inspected the existing septic system at the above address. According to the owner, the system is approximately 42 years old, and consists of a 750 gallon septic system, and leaching area. The owners have stated that they have had the system pumped twice a year from when it was installed. The system appears to be working, although there were signs that the system had overflowed the septic tank in the past. I was also informed that the Town is looking to install a sanitary sewer in the street within the next couple years. I believe that the life of this system could be extended to service this house until that sanitary sewer is installed. I would recommend that the system be inspected monthly, and the tank be pumped every four months. I would caution the residents not to overuse the system, and to limit the amount of flow into the system. I would highly suggest that all laundry be done off site. There is no guarantee that this system will continue to operate, but with care and maintenance, it should continue to work until the new sewer main has been installed..I would recommend that the building be tied into the sanitary sewer as soon as it is made available. If you should have any questions, pleas 1A iAPPLICATION FOR ,SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTBUT—NORTH ANDOM9 MASS* r 11ereb ke application for a permit for a sewage disposal installation at I will install, this system in accordance,ldth all the laws of the Commonwealth of Massachusetts and regulations .�of the Boira of Health of the Town of North Andover. Prtherp I'vdn* construct the house sewer of bell and spigot pipe# the minium diameter being./+ inches#.and will maintain a minimum grade of 1% until 10 feet preceding the septic tank where tjoe grade shall not exceed 2%. 1 will install a concrete septic tank of 7%� 204', in site. A manhole (9) -permitting easy"' cleaning will be provided wit li removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with open . .Jointed bell and spigot Aokron pipe at least 4 inches in diameter ar� :�aid in a series oftrencheop the bottom of which will provide a minimum of & 0 lineal (eqwwe)Meet of effective absorption area. The pipes will be laid on a 9 inch layer of,'washed gravel or crushed stone ranging in size from 3A to l-1/2 inches (dia.) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trencho 2 inches of gravel or stone 1/811 to 1/41, (dia.) wM-be placed over the course gravel or stone. The disposal field will be Installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any casep two lines of the wi3l be installed. A minimum of 6 feet will be maintained between the center Limes of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the in- . staLlAtion-will be less than 100 feet from any private water supplyq 25 feet from any stream 20 feet from any dwelling or 10 feet from any property line* I if.... . ... ap-r -j2g -a of thig ist&=gM until -wr d bry-tba- jnsR2oti2n_ as agt to 2= apyna , &Aq off seri as provided belowt and to incorporate any additional requirements that may be attached to the permit* Plot Plans must be submitted Frith application, DXM Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover# Massachusetts. DATE Signature of Health Agent 1. have inspected the uncovered system indicated above and find everything done as descrlb94 DATE Signature of Inspecting Officer Fereolation T00% ( I Garbage Grinder I -A � > -n 0 F m m �m �--------------I I I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I I I I 1 I --,I c) D------------- > G) om W �QO m m G -1 c. 0 .� 0 7 m 0 *-0 K m m N �. a Q (0Vi z '"G) U) > D 63 = a) X 00 " 00 0 3 o CD Q. a " Co W 0 C? CD 3 6 K) X 1 -"% 0 3 c4 JC -1 W 0mN O O N (�/� O '_ 3 53 ?oPLN �l �33 3 ._� 0 X mm "" D x bws 0 7 8' msW I y x� ID Wa La a p &C pp� C° o�_g m I .Z Aui = CF) CD L N.Z1 7 CL A4i mo S m(�9)N tb N ZZ O O dam m W � P � w mom? i ,0) w a'm m 2 0 � D w m Oi v WO m o97 " Ufa no ° o0)a m 0xz O -4 T57 73 J oi gwy a FTZE _ a 3 rL of I� �� 19'9I I 0 m m 0 U Z D m 0 D DI r 1� A GX G 1-2- -4- Fir- LL .,6 a -J- Yom. 7/ l S A1,6(4h AAlb6ve-r J2.a 4 Qb 'Mioln JV6 -Ihn A W-=ul Lie- t5/-Q6j4 ) f) r4rA / I Lt c- # /,-v -0 STEWART I S SEPTIC TANK SlTIa 47 RmLROAD STREET BWFORD, MA 01835 978-372-7471 MODM-1 OF MMMY REPORT FOR TCWN OF DATE ADDRESS GALWNS ----------- olhes-6&--t- L ibe+ CJ �5�+L 10460 56 11-1711n . -j/ 7Y cle. - 006 X, 60 w r t f"— -