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HomeMy WebLinkAboutMiscellaneous - 21 CHERISE CIRCLE 4/30/2018 (3)i" trONSTRUCT iO _TQRj9PPR_ 'i�io ) HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE APP. BY_. DESIGNER: PLAN DA'I E:_(_�_/�`�_ CONDITIONS WATER SUPPLY: TOWN:, WELL WELI_`PERMIT DRILLER . .. . .. ......... .......... 1 1. WELL TESTS: COMMENTS: CHEMICAL DAIE APPROVED Skq�T E R I A I DAIE ()PPRUVED BACTERIA DAT'E APPROVED FORM U APPROVAL: / APPROVAL TO ISSUE NO 9/"/DATE ISSUED Y4 BY CONDITIONS: FINAL APPROVAL:. ALL PERMITS PAID NO WELL CONSTRUCTION APPROVALS � NO SEPTIC SYSTEM CONSTRUCTION APPROVAL S NO OTHER YES NO ANY VARIANCE NEEDED FINAL BOARD OF HEALTH APPROVAL: YES NO DATE BY: i `EpT aX •.,i i l .r•.i. , ,'J a :•r S-' `;J., +'n k..c 4,r p��Fr' f .. IS THE INSTALLER LICENSED? �rzti YE5 NO F TYPE.OF CONSTRUCTION: '-%NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW NO CONDITIONS OF:APPROVAL YES NO (FROM FORM U) r ''..,ISSUANCE OF DWC PERMIT A �' YE NO :DWC PERMIT N0.� .. INSTALLER:/iLl' 11,9_r/JJl� ti BEGINJNSPECTION (=Y=�'0a ,> .: . EXCAVATION JNSPECTION: ;NEEDED: PASSED l BY.' : --.:'CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: YES - APPROVAL. TO BACKFILL: DATE: HY " ;.•FINAL. GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE: BY MAP # LOT PARCEL # STREET - CONSTRUCT ION APPROVAL -1 HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE PP. BY DESIGNER: PLAN DATE: CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT I WELL TESTS: COMMENTS: DRILLER.. ------ -- ....... ICAL DAIE APPROVED BAc,rERI BACTERIA II DAIE (IPPRUVED I APPROVED FORM U APPROVAL: APPROVAL TO ISSUE NO DATE ISSUED -9/6/� CONDITIONS: FINAL APPROVAL:. ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES No SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NU ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DAI'E: ....... .. BY: 'THE .::r►�,r IS INSTALLER LICENSED? 7 L •. 3 • ` <' YES NO �; s 4j.. � '. tr '.•'r.i�`r "`fa••• :I.. 1:.1' _..3.11_ . ... '1 _ t. -TYPE . OF CONSTRUCTION :,� • • i. ' ' NEW . REPAIR' :• NEW CONSTRUCTION:.. CERTIFIED PLOT PLAN REVIEW 4 YES NO CONDITIONS OF:. APPROVAL YES NO {r f (FROM FORM U) R•OF ISSUANCE DWC PERMIT` YES NO , DWC PERMIT N0.' r . ' INSTALLER: BEGIN INSPECTION YES NO: :EXCAVATION INSPECTION:;NEEDED: - .i :,f �-' Vis•-,° _may-� •'` s; - - y. s•;'•' •1 . -;PASSEDpy S • ', ==.... CONSTRUCTION INSPECTIONS ` ; .:=;. NEEDED: = . f .AS BUILT PLAN SATISFACTORY: YESs -' APPROVAL TO BACKFILL: ' ` DATE: BY ;FINAL. GRADING APPROVAL: DATE BY .:,FINAL CONSTRUCTION APPROVAL: DATE: BY A/641 yqNt�6ver 1Jb4in N. ij Sf; A noav®e Li w l Lc 16/ -qp µ 4-/7 Lie ✓7 am" ADaRns � 019 14 ra�7 incy 47 RA ip.MD &rR= S CE ak4ATMP Mk 01835 978-372•-7471 man or j aocv • i �i o-Aps /ice. �Saa IQov loon 1,060 Sad 1600 )Oav 16d�' loot) )sad ml Id Ce /ail (K < f9v 4-/7 I" -A4 65 Gno 33 a-Pmp 79 �lA 4 qr) ✓ ��r9 /lao Sq/ems �.� v` 19n e ` 7 a3 f d /o t r 1' /ice. �Saa IQov loon 1,060 Sad 1600 )Oav 16d�' loot) )sad ml Important When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. 4 raven d Comrnon wealth of Massachus tts L'V6 City/Town of North Andover �� 104 System Pumping Record ` �rK IHMDOVER Form .4 >K>R 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 1. System Location: Address North Andover City/Town 2. System Owner: Name Ma 01886 State Zip Code Address (if different from location) State City/Town Telephone Number B. Pumping Record �) 2. Quantity Pumped: 1. Date of Pumping Date 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Condition of System: Zip Code 600:ls Gallons ❑ Grease Trap if.yes, was it cleaned? ❑ Yes ❑ No 6. System Pumpe By: Vehicle License Number Name Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signature of Hauler Date Signature of Receiving Facility Date t5form4.doc• 03/06 System Pumping Record • Page 1 0 LaMarche Associates P.O. Box 179 Natick, MA 01760 508-650-9777 Fax: 508-650-9870 March 25, 2010 Building Commissioner/Inspector of Buildings North Andover, MA 01845 Board of Health/Board of Selectmen North Andover, MA 01845 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss, cause of loss and LA file number. Insured: William & Mary Burt Loss Location: 29 Cherise Circle North Andover, MA 01845 Policy Number: HP233748 Date of Loss: 3/13/2010 Cause of Loss: Water LA File Number: MA -2-17529 On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Charles Kiablick Adjuster LaMarche Associates, Inc. - 800-349-1525 Page 1 of 1 7-4 V4-1 ro in 1� I FORM U - LOT RELEASE FORM _ .. FUC i 1 N3, This form is Used to verity that all Boards and nec,:sz-- rtments hiving jurisdiction have been obtained T rOVcls/Permits r-ror the aPPlicant and/or landowner from cam I'� p iance with any a his does not rel1evc- PPllczble or requirer;;ents. AF1✓LICANT FILLS AUT TH1S SBC T 1� APPLICA SVT I LU .(< -Bu ►�-} LocATror`I: P`'ct —7 v 8a - q o AssesSo�s I�1ap Number k F,4FC`_ SUEDfVIS10N STRF� a LCT (SJ �.rR cls ---_ ST. Nu�tiIEE�� OFr=1CIAL USc C N L RFC MMENDATION F TOWN AC" �o�,�C It (q ofy30 _Dtc I/ A CCN,,c; VATION ADMINISTRA T OR X' Ye DATI=APP ^ ��^ • � � Ud � DATE REJECTED�b coMMENTs C ., I TOWN PLANNER DATE AFPRCVED COMMENTSDATE REJECTED s �1 FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SE?T-IiC 1NSPECTCR-HF-AL7N DATE APPROVED DATE R1=JECTE0 OK COMMENTS ���•� � �ac.ai��i S c 74< .0 -SIC PUELIC'NGRI{S - SE-yVEpjWATER CONNECTIONS G' 11-r Pow DRIVEWAY PERMIT FIRE DEcAR7MEN7 RECEIVED EY EU1LGiNG iiNISPEC-r CR.. Revized R9 im DATA %r _`moo •�^ O/� A O'P9 '��+ sow` �osti .��s• \ 4 � G � �` •per � FORM U -LOT RELEASE FORM INSTF�UCT1 N Tnis form is used to verity that all necessary approvals/per .its from Boards and rtments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner, from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS IUN. .nn`..` `.... aPPuca,�T� �I LU I�� -6U �+ LOCATION: Assessor's Wap Numcer SID SUECIVISICN aCi IS URS OFFICIAL USE ONLY REC�MMENDAT,I( F�-CNE 9-78 - q8-70 FARCE:Oqq_ // LCT (S) ST. NUMEE: c Rem 0%2ti Gyts�'Ns 0'0EnN 7 Ec. F TOWN AGENTS: E:iVAT1ON ADMINISTRATOR DATE APPROVED W COMMENTS ( �+ , DATE(REJECTED_ TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE.APPROVED GATE REJECTED TH COMMENTS (,�j.rdr•� DATE APPROVED DATE REJECTED_ PUELIC WORKS -SEyVERIWATER CONNECTIONS DRIVE -NAY PERMIT FIRE DEPARTMENT /111 o c_1�1 rRECEiVED EY EUILDINC- ii ISPE,TCR '" DATA Revised 9127 im Z O W W Q Vj W :_4 N� M M M F -.W 2� pj M N N N N N N Q3 1:-7! `W` Mo Q L4 W Z h h O O M O O O w2 ` Og C C7 ^ N O a0 to h O O O of ci ai of vi W M M M N O N N N coCJ p 0: W b Z Z ow- Z rx� s y Q Q 2 j o 0 o Q Q '� U Q a � `/ Z) � W O O C) v v k m m m °o vwi v�"i o 0 0p 0 z II Z oQQQQ000 �o� ct c r� cl� C4 J 00000QQQ iz �c� z z� z z z z� z� � CZ`■ i JJ QW1 Z nR 0 Z6co I0 RISE N S7 ri W r; S`. 9 Im "a- C C • 'G� C •�O ts C C N O C„ C R R O C t O as c m � N `o CD cj c0 o ts cm o-` ccc co E N H cm m N � M-0 C C N R O m + Vc .3 s cm =Ci 47 �� N CoQ acz o mL C m C.) g= o coo c Ca) C- ~ m co, .o cn LU C L c m� 'C' .� � •N R R C O N CL_ — Z •E_ c3 'O cm., •N O C7 C7 p'00 = C/) n m O O = w= ` N •cc o O �- L w0., CL, Co CD O D O O G.7 Z CL °0 O CO) D � COm C C).— co co 0 y O O �E m m ow = O.0 O i co co cc 0 d �Q yCcC C CD .y Z V V y CC C C cc Q. 0 Na o U ° W N W ,.,� U 0 W U x z z w w C w w o a a ° -a �I cc a X w �1 �o ° m v v v w° V) q ° ° w" o a c� Vi o w cn w w w� c� cn "a- C C • 'G� C •�O ts C C N O C„ C R R O C t O as c m � N `o CD cj c0 o ts cm o-` ccc co E N H cm m N � M-0 C C N R O m + Vc .3 s cm =Ci 47 �� N CoQ acz o mL C m C.) g= o coo c Ca) C- ~ m co, .o cn LU C L c m� 'C' .� � •N R R C O N CL_ — Z •E_ c3 'O cm., •N O C7 C7 p'00 = C/) n m O O = w= ` N •cc o O �- L w0., CL, Co CD O D O O G.7 Z CL °0 O CO) D � COm C C).— co co 0 y O O �E m m ow = O.0 O i co co cc 0 d �Q yCcC C CD .y Z V V y CC C C cc Q. 0 L4 r -•q 4-3 uml O z T, m c y -z ooN oZ 1" �= o O Of- -4 J z E )� 1 all ,d o Z � CD jimcu-M o O D o `" xw z COD w = i o EQaCD CDW ui CE CC y �� O•C m m U) z w 0 O oo. y+ A' •+ N .00 O � O i O O L Cc O O. o cmQ i cm c E ca C .O o. »r a O (� a z co U ��3 = A ca Cf m N / G m G "•W' S : � R � N C N W O v R N Co u ° v v ° z Q 0 A 7 G co W G > in m H `/: v G� y O L w° U) ° U x u. G cn w P4 w w� cn cn 4-3 uml O z T, m c y -z ooN oZ 1" �= o O Of- -4 W Lil C Q o J z E )� 1 all ,d o Z � CD jimcu-M =�uj O D y C `" CD c COD w = i o EQaCD CDW ui CE CC y �� O•C m m U) z w 0 O oo. y+ A' •+ N .00 O � O i O O L Cc O O. o cmQ i cm c E ca C .O o. »r a O Cc Cc a co G� Z CD ��3 = C ca Cf m N / •� m G "•W' S : � R � N C N W O v R N Co Q1 o C1 a.v a� CO) C cm/� z Al c C Q •o o ac= .: as H `/: G� y O L c F- Q CD 5 rQ coa C003 o ' c, co O d W O .24— •o` C NO_L y...��y=. C WE Z O u �Oc3c oma COD a a, :2 o :o 2 R y O CO W Lil C Q o J z E )� L ,d o Z � CD O D y C `" CD c z o i o CDW y �� O•C m m U) z w 0 O O y+ .00 O � O i O O L Cc O O. cmQ ca C .O O Cc Cc co G� Z CD Z C (�' O � Q.�• C U- R Q1 CO) C C3 z z z J M W C Z O 2= Q E CL L `o W LL w 0 J r6 N Q W � = O U. O Z ' > > o U 1Q 3 E 1 m o c o 4 W b Z a � i :3 Z Q ro= O L O U rd J CL y Qw = N d L L W I- N Q O Q >= O Q C bO O Q Q N U U Q Q Y s z c m O o c 3 v o O ° 3 3 0 O ~ CL Ln 1 c r� ro t -- °a E W3 Q L Ln Z Q) — .c Vf � N Oa * O . ODER c O Q 0, ��� y Q � •� � _ N hMO.L * * w Q (n d N LL FOUNDATION LOCATION PLAN CLIENT: JPD DEVELOPMENT THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION: NORTH ANDOVER,MA. LOT 7 CHERISE CIRCLE I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMENTS OF THE LOCAL APPLICABLE ZONING BY—LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS, WETLANDSEASEMENTS ORDERS OF CONDITIONS,ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOYE,EXC£PT W17H THE WRITTEN PERMISSION OF CHRISTIANSEN d; SERGI INC. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR— MATION CONTAINED HEREON. BASED ON SCALED DATA ONLY THE PRIMARY STRUCTURE SHOWN IS NOT LOCATED IN A FLOOD HAZARD ZONE AS SHOWN ON FEMA FLOOD INSURANCE RATE MAP. COMMUNITY NO.: 25009B 0005C&&AA"XE:61219J SCALE. I" = 40' DATE: OCTOBER 19,1995 c� �.r.AEL • GI y No o� TELE F' 0 ENGI CHRISTIANSEN & SERGI PR LANDOFESSIONAL SURVEYORS ERS 160 SUMMER ST. HAVERHILL,MA. 01830 TEL 508-373-0510 © 1995 BY CHRISTIANSEN & SERGI INC. DRAWING No. 93067016 .1� FORM U - IAT RELEASE 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***************** APPLICANT: _ Sc U -V CON- � -.�ll� Phone 22y, 8 0zy LOCATION: Assessor's Map Number Parcel Subdivision (A.IA))--c 2:7 -- Lots) -#2 Street C,) �C/ e, Cj�c�z St. Number ************************Official Use only******************x***** RECOMMENDATIONS ?& TOWN AGENTS: a I 1&v �Ow' Conservation Admin' trator Comments Town Planner Comments Food Inspector- .ealth Sep is Inspector -Health Comments Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected I Public Works - sewer/water connections - driveway permit:2:: Fire Department Received by Building Inspector Date Town of North Andover, Massachusetts Form No. 2 NoRT►/ BOARD OF HEALTH 19 a _ o � , w A DESIGN APPROVAL FOR bAr.. US SOIL SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant 6 GZnn �1 ��, Test No. Site Location_ Reference Plans and Specs. L E Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN, BOARD OF HEALTH Is Fee 6 I Site System Permit No. r7 3 �i PLAN REVIEW CHECKLIST ADDRESS L ` Imo{ � ENGINEER GENERAL 3 COPIES STAMP LOCUS t/ NORTH ARROW SCALE CONTOURS PROFILE SECTIONS BENCHMARK X SOIL & PERCS / ELEVATIONS WETS. DISCLAIMER WELLS & WETS v WATERSHED? N)0 DRIVEWAY ! (Elev) WATER LINE 4 FDN DRAIN 4,1 SCH40TESTS CURRENT? t" SOIL EVAL SEPTIC TANK MIN 1500G_Z .17 INVERT DROP O' GARB. GRINDER NO(+200% EDF) 25' TO CELLAR / MANHOLE ELEV GW # COMPS. D -BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET OUTLET I R 1. 65 = • i ( 2" OR .17 FT) TEE REQ' D? Nd LEACHING MIN 660 GPD?_L.-,/ RESERVE AREA V 4' FROM PRIMARY? / 2% SLOPE 100' TO WETLANDS 100' TO WELLS 4' TO S.H.GW 35' TO FND & INTRCPTR DRAINS � 325' TO SURFACE H2O SUPP� 4' PERM. SOIL BELOW FACILITY 1-/ MIN 12" COVER // FILL?Y(25' if above natural elev; 101if below) BREAKOUT MET? !' TRENCHES MIN 660 gpd SLOPE (min .005 or 611/1001) SIDEWALL DIST. 3X EFF. W OR D (MIN 61) RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? VENT? (>3' COVER; LINES >501) BOT + SIDE X LDNG = TOT (L x W x #) (DxLx2x#) (G/ft2) Copyright © 1995 by S.L. Stan (LxWx#) (DxLx2x#) (G/ft2) PITS MIN 660 LEACHING MIN 1 (131x16') PIT MANHOLE/PIT GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x #) (2x(L+W)xD x #) (G/ft2) CHAMBERS MIN 660 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60' X 601) MIN 13' X 16' PIT BOT + SIDE X LOAD = TOTAL (L x W x #) (2 x (L+W)xD x #) (G/ft2) FIELDS 5 MIN 660 GPD 900 ft2 BED GW MIN 4' BELOW BOTTOM OF FIELD V/ PIPE ENDS JOINED? --Z— 4" PEA STONE?V/ DIST LINE SLOPE .005?__,rZ >31COVER-VENT SCH 40MIN 12" COVER RATE LDG X 660 = bO Y JX X„ 7 ¢.= TOTAL 6 (, G/ft2 REQ'D (ft2) LXW DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY Spm L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME gpm MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1' below inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL OP. SWITCH Copyright© 1995 by S.L. Staff THE COMMONWEALTH mFwAgsAc*u E30ARD OF. HEAL EQkJN —OF NOR AN601 Appliration for Di~ aK lVa~b Tono MAY 101995 Application is hereby ouydc for a Permit to Construct ()y\ or Repair ( ) an Individual Sewage byn�cnat: Disposal ----- ----^~ ��c�J Location - Address or Lot No. Owner Address --'---------------------`---`------------- ------'--`--------`----`----`--`-`----`----`-`----- Installer Address I�e� �'. Building"��� Size��L4�1�� 'L_ -.So. f�� Dw�Ung--yJo. of 8edr000�o-_---���.-.---'--.Expansion Attic ( ) Garbage Q�odcr'( ) Udec--Ivoe of Building ............................ No. cfpersons ............................ S6owerx {���cr� Other ' ) Other Distribution box ()r-) Dosing tank ( ) Percolation Test Results Performed by ...... QIKIMAN46H ... L.19.9hJ41AK.- Date..12/.7/*�­`S,.4l/�*0*�/`�*.I-,,`*`/�`(/�.r P. ° --' '- No. '---''--'~~~~~r~~~~' Depth"of ^="`^^ Depth mmground water ns -z» ______ Description ofSoil -' ____'----__-__-_------_._---__------ _-___ ~---'----'--~--~~---'~~^~--'----'~'-`------'^^^'-~--'~---^--'--'-~---'---~~-'---'----'~~-'-~-`~---'~~---- --`-----'---------`--`----`---------------~^`-------`--~------^--`---`~--`-~`--------`--~-`-`~~~--' Nub/nc of Repairs or Alterations --Answer when applicable ............................................................................................... --'-----'---''—'----'---'--'-------'----'------'----'---'---'--'----'--'---'------ A8rermeuc: The undersigned agrees to install theufore6escribed Individual S*wuge' - �a�n�u�c�� the provisions cf�I��E 5 /f the State � Son��y Cu�� The undersigned further to place the uyoUeo in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... ___________ Aooicudno Approved By .--'-.--'-_-.--_'__-___-__''___-._________ .................... Date Application Disapproved for the following reasons: .................................................................................. _____--_. - Date Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ -'OF ........ ...................................... THIS lSTO CERTIFY, That the Individual Sewage Disposal System constructed / ) nr by ( ) --_--,-----'---'----------------'-------------------------'--'--'------`-------'^-----^--- I"w,m" --------'---- has been installed inaccordance with the provisions ofTITLE 5 o The State Sanitary Code msdescribed in the application for Disposal Works Construction Permit No......................................... dated ........ ............. _----�----_ THE ISSUANCE OF THUS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. '------- Inspector - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF D�� �������� Workii Tomitrurtion Permit Pcnnboiomis 6ece6v granted ........................................................................................................................................ ___ to Construct( \ or Repair ( ) an Individual Sewage Disposal System at NoStreet -------'--'--'-'-------'-------------'-- FORM 1255 A. M. SULKIN, INC.. 130STON CHRISTIANSEN & SERGI, INC. PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830 July 26, 1995 Ms. Sandra Starr North Andover Board of Health 120 Main Street North Andover, MA 01845 Re: Lot 7, White Birch II Dear Ms. Starr: (508)373-0310 FAX: (508) 372-3960 In response to your letter of disapproval dated July 17, 1995, please find the enclosed revised plans for your review. A list of our responses to your reasons for disapproval are as follows: 1) No benchmark within 50 feet to 75 feet of the system. An appropriate benchmark has been added to the plan. 2) Leaching area not 35 feet from foundation drain. The invert elevation of the foundation drain has been raised to 130.5'. Since this is higher than the top of the proposed leaching facility (130.3 at the high end), the setback distance may be reduced to 25' according to Town of North Andover Board of Health Regulation 4.18.7. 3) Vent for lines over 50 feet. Although the vent was specified on the plan view of the design, it was not shown on the profile. The vent has been added to the profile on the enclosed revised plan. I trust that this information sufficiently addresses the issues raised in your letter of disapproval. Please call me if you have any questions. A Truly Yo is l J. O'Connell Encl. c.c. Dan Betty DESIGN REVIEW SHEET LOT 7 CHERISE CIRCLE PERMIT # 736 REC'VD 6/8/95 APPLICANT: DAN BETTY ENG: CHRISTIANSEN 160 SUMMER ST., HAVERHILL PLAN DATE: 4/27/95 DISAPPROVED nll&NO BENCHMARK WITHIN 50' TO 75' OF SYSTEM bqj�2. LEACHING AREA NOT 35 FEET FROM FOUNDATION DRAIN. 014: VENT FOR LINES OVER 50 FEET. �r10R7F� O't,�ao ,e,tiO e _ L BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 EXt23 July 17, 1995 Christiansen & Sergi 160 Summer Street Haverhill, MA 01830 Re: Lot #7 Cherise Circle Dear Phil: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1) No benchmark within 50 feet to 75 feet of system. 2) Leaching area not 35 feet from foundation drain. 3) Vent for lines over 50 feet. If you have any questions, please do not hesitate to call the Board of Health Office at 688-9540. Sincerely, Sandra +Star,.S. Health Administrator SS/cjp Town of North Andover, Massachusetts Form No. 2 NOR.h BOARD OF HEALTH i. r DESIGN APPROVAL FOR ?° ss,C"°st` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM i.. Applicants (�i�v1 n t,�k 1 P.E—.i >n., Test No. Site Location &A 01, —17 Reference Plans and Specs.(1),A- CJ�rc1 M � 1- A (�,� Z/2 - E1 ¢ ENGINEER ---r DESIGN a DATE 4' *: . Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN, BOARD OF HEALTH 41. Fee Vr ; ;.: Site System Permit No. ZrM.." .nwei ri ..w• , L .re.._ '�. .++-�+.- w..`�.�+••wa-•...-�......:-� yP.... a PLAN � REVIEW CHECKLIST ADDRESS,L 7- 7 ��E/�J�E C.//2 ENGINEER GENERAL 3 COPIES t/ STAMP LOCUST- NORTH ARROW SCALE CONTOURS 4,--- PROFILEy� SECTIONc—, BENCHMARK SOIL & PERC INFO / ELEVATIONS WETLANDS WATERSHED? FDN DRAIN_.Z' SCH40 SEPTIC TANK a WETS. DISCLAIMERS WELLS & DRIVEWAY-.-- (Eley) WATER LINE 4--' TESTS CURRENT? MIN 150OG !/ .17 INVERT DROP 41- GARB. GRINDER(+200% EDF) 25' TO CELLAR t/ MANHOLE TO GRADE. ELEV �� GW_Q_% D -BOX SIZE # LINES INLET - OUTLET /,19.35 = ./7 LEACHING FIRST 2' LEVEL STATEMENT (211 OR .17 FT) TEE REQ°D?-26- MIN 660 GPD? L RESERVE AREA C/ 4' FROM PRIMARY? 2% SLOPEL,----- 100' TO WETLANDS L---�100' TO WELLS Ll---- 4' TO S.H.GW 35' TO FND & INTRCPTR DRAINS �NC257' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY_4,,:j� MIN 1211 COVER if above natural elev; 10' if below) BREAKOUT MET? ,L ---- TRENCHES MIN 660 gpdIz/ SLOPE (min .005 or 611/1001) c-� >3'COVER?-VENTS SIDEWALL DIST. 2X .EFF. W OR D (MIN 61)±/ IS RESERVE BETWEEN TRENCHES? &,-----IN FILL? � MUST BE 10' MIN. L-�-1 PEA STONE? BOT X LDNG )-JZ + SIDEOIL X LDNG lY = TOT (L x W x #) (G/ft2) (DxLx2x#) (G/ft2) Copyright Q 1993 by S.L. Staff BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext23 May 11, 1994 Christiansen & Sergi 160 Summer Street Haverhill, MA Re: Lots #3-9 White Birch II Dear Phil: I have briefly looked at these plans and find that most of them do not have sufficient test holes in the system. In addition, there will be changes in light of the testing done today. Would you please review these plans keeping in mind the criteria I recently sent you, add the new tests and re -submit the designs. Sincerely, Sandra Starr, R.S. Health Administrator cc: Karen Nelson, Director, Planning & Comm. Dev. Jim Grifoni File No......................... Fxs ............... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN........................oF....................NORTH,...AN,DOVE.R........................... . ,� lirtt#ian far Diapaattl WvrI6 TmArixr#'tori ramit Application is hereby made for a Permit to Construct ( x ) or Repair ( ) an Individual Sewage Disposal System at: .,7 CHERISE...CIRCLE................................................................................................................ ................_. ............................ - Location . Address or Lot No. SCOTT...G.0.1`I ��UC�I.QN..._I.U.0......................... 12 ROGERS RD.,....HAVERHILL.�.--MA----.........._.. .................. Owner � Address ...............•---................................................................................................•--.......................................................................... Installer Address Z� Lj'31 Type of Building Size Lot..........�.................Sq. feet Dwelling — No. of Bedrooms ............. 4 ............................. Expansion Attic ( ) Garbage Grinder ( ) Other — Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures..---•-•.............................................................................................................................................. Design Flow.............8 5....................gallons per person per day. Total daily flow ............. 6 6 0.........._......... ---gallons. Septic Tank —Liquid* capacity)AQ0 O..gallons Length 1 '_- 6..' WidthA `. 8'... Diameter ................ Depth....'.......'... Disposal Trench — No. -. 2 ............... Width ..... 2............ Total Length......15A....... Total leaching area..... ft. Seepage Pit No ..................... Diameter.................... Depth below inlet.................... Total leaching area .................. sq. ft. Other Distribution box ( x ) Dosing tank ( ) Percolation Test Results Performed by..... C.. R I S T I A N S E N &--_ S E R G..x... I N Gbate...... /!�iifi.`i ... V12-3 ......... Test Pit No. 1..... Z....... minutes per inch Depth of Test Pit..../� ..`.�..... Depth to ground water .....t7�.G...`........... Test Pit No. 2..... 2 -......minutes per inch Depth of Test Pit .................... Depth to ground water........................ Description of soil ...... Q --L4. 7bpSoiC...4....�S�f!¢50i�............................................................................................... �t ..... S�'lf�................................................................................................................................ ...................................................................................................................................................................................................... Nature of Repairs or Alterations — Answer when applicable............................................................................................... ..--•-•-••-•••----•---••................•-•-•••-•--.....•••-•••--•--•....•-•-----•...............................-••--•••••--.....••••--................-•-•.....................•--.................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIL� 5 of the State Sanitary Code — The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... ................................ Date Application Approved By..............................•---.................--•--••--..........................................................Da.t-e.............. Date Application Disapproved for the following reasons:_ ........................................................... ---------....................................... ------------------------------------------------------------------•------•---•-----•••--•--•-------•----•....----------------- ------------------......-••--•••••---••--•-••---•-•-•-•-•-•-••--•••.•••--- Date PermitNo ......................................................... Issued......................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................................... OF ............................................................................ ........ Trdifiratr of Tampliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by............................................•-••----•-•.............•---.............................................-•-•••---•-•••-•--......•--•--••----•••.....•-•---..........-•-••-•--•-------•- Installer at---------------------------------------------------------------------------------------•----....----..........-....-----•---•-----........................----............-------........ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No ......................................... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................•... Inspector.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................... OF.............................................................. ................. No................ FEE........................ Rapaaal Worho Tanatrudian "rrndt Permissionis hereby granted......................•-•--.........----.............................-----.........---......---............................................... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo.......................•-----•-•-•...........................-•-----•-•--....................................-•----••----...................................................................... Street as shown on the application for Disposal Works Construction Permit No ..................... Dated .......................................... Iv • Ce y i S - ,p. �� s h� aer*•t p 1�rh� y' �,�4'd ►a . r` ef~ °: • t tai�dr#? ,r ¢ t r� � ' a t r°' '�' �s ! a i.s� Y +�j r � •'. . •}r'✓ 3 " �`a+ �wf' } y.F r F _ � ',._�� .� , fit•,,; ��. �� {�. �*�!.°n,� �•yl�'1 ;_�h y" '�'�t�;�: �t��.R y_ r>�' ��+�r,'�,� yj y • ;w 1 ^/ I w76 nod jrru(s: 7: 9 / syl ow s t< i♦? '^t. • Ore^ �. f1� F' ' . � .• .� iG � ��:�.�,, i ''•', \�\ ' -y, `r 't: �'t�'tti."ii`•I •', ( \• •�• •`� �,. ��'j'� t.�,1'�`t3: `i:•'�` n11a�`,�•r::'i,�;t:ti i(�'+ t� ', ��' t�?„ �ti,'!:• �,. �.� +'••\::` ,�<`\i',`�,L>d•'�,�' v y. `.\��}`'.v�z.l:.:C�:''1t.�11i �"�,�,•�; Fel :�..,' \; ,�• c ;l >, s.i�,:jl: ,1.'i�t`�',� � to v� • .,` �;�i .t t4�,�� rt , tt ��•�.,.. , i. y �K.�, y�,,� ;`..t t '`35.c , 5 :l�I:`...� • �, i. � ,. .. T \. �� ♦ 1`'" � �� • �'• i.'• � t � t t� ' ' \ Yip �D� „ K\� � ,,� jai �i ` 1- � 1 � ��/�,�[+� �}p {(�� �, 4, ii �,'(.,,` }�Ay\�,wYp s t ♦lJ. J{�` F t �� , tt• � � , . 'r. � t, r �• t �e'.t�"e`'�_W��\�-�l''+Y,�4:��4Mli��+l��gy�'�[L�•����������0.�`�,iC�i, f�, t ti.`�� i 1. t,}t � T11..1 ti �`t+ �.�,: �'1 r L Y '1. ♦ l �bt\ .l",. '+.\, 1 �... tc � 1 #a �:l �`ti-�.�\ •�V� �\L_�/. �,� \ � ` . ,_ �, ..: 1��.. Zi,.: l�, j• - � \ �.� td 4 t -{ � t c'4 t� \i� \- t f Il tyb q�+�� Stn` \•T � 1.: '•,•.\\ Applican Town of North Andover, Massachusetts BOARD OF HEALTH APPLICATION FOR SITE TESTING/INSPECTION Site Location? Engineer Test/Inspection Date and Time 75 t) Fee Form No. 1 19 94� CHAIRMAN, BOARD OF HEALTH Test No. (-01 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts IRTH BOARD OF HEALTH APPLICATION FOR SITE TESTING/INSPECTION \RATED PpP �'�y Form No. 1 19 Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time Fee CHAIRMAN, BOARD OF HEALTH Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. QUITCLAIM DEED Alfred F. Contarino and Jeanne A.M. Contarino of 35 Bonney Lane, North Andover, Essex County, Massachusetts for consideration paid and in full consideration of Four Hundred Thousand ($400,000.00) Dollars grant to JDP Development Co., Inc., a Massachusetts Corporation of 12 Rogers Road, Haverhill, Massachusetts with quitclaim covenants A certain parcel of land situated in North Andover, Essex County, Massachusetts, shown as Lots 1 through 10 together with the fee in Cherise Circle shown on a plan of land entitled, "Definitive P.R.D. Subdivision Plan 'White Birch II' located in North Andover, MA,.11 which plan is recorded with the Essex North District Registry of Deeds as Plan # X374, , Reference is hereby made to said plan for a more particular description of Cherise Circle and Lots 1 through 10. . w Premises are hereby conveyed subject to all easements shown on said plan. Reserving herein the right to connect into the water pipes as more specifically described on said plan. Being a portion of the premises conveyed to us by deed recorded in said Registry in Book 2401, Page 155. Witness our hands and seals this 30th day of M 1994. Essex, ss. Aifrgm F. Contarino eanne A.M. Contarino c COMMONWEALTH OF MASSACHUSETTS March 30, 1994 Then personally appeared the above -nam Alfred F. Contarino and Jeanne A.M. Contarino and acknowledged he foregoing instrument to be their free act and deed, before I , w m w 0 x e rn rn cu as Z as Xw .Nass W o ca x o -� ca a •1? JQ.n A. games, Jr. Notary Public My commission expires: February 21, 1997 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. t!f Commonwealth of Massachusetts City/Town of NORTH ANDOVER, MASSACH System Pumping Record Form 4 JUN - 5 2006 T DEP has provided this form for use by local Boards of Health. The S °�'T N�RTHANb,,,,�p be submitted to the local Board of Health or other approving authority. A. Facility Information 1. 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Ct./y/a�e c Q'rd ' tt:1, 4,, „llyj��!111,( l.i�'.1. . y •�({�� ;c,i:l!nn' TOWNIOF�NO ANl1`�i�"E� ' '1' •;4!(.nllh��,t J%/�"v„1y�'td%%1 j �� ylrrYl�r�'.',,..1�!{(,P;�.1;11:�ti•'.1'ilr;!: i7H'DEPA. '�iEN EP,•has ro06d vr•� , P, , Ii.(orm for use by local Boards of Health, The System Pumpin8 R oft be :ubml ed to the.local'Scard of Health or other approving author) .a :%•? :•i,.e,, '.'i:y•• ':',jai`;•i''';i:.li�S: v::.. _ tyr - A; Facility .Info rr a lon 4 J' C ar,'(�IN outva 1, ,''System lrocatlon; � U keyr Addrou to move your /� l `uis•the'rotum:yt ;;,: Cityllown i•,;• • ,;;...<. .,. ,•:�•. 4'IMli`:�I'�i/•`.,('•: i!:Ll:�•,}.1'1:•i�, ,Y ',• V,i'J ,,.:,'�:�: .. Stele , =•.Y ,•'key', ; 1 a' .. '.,'il.. s. �:�.• ,; , '�. , . .., Up Code. yl'�r• ,; Jji, 2i ,..�.SYstem n�er,-:, .G4!y'i��•�,�.:YN�;��,r.t,. "t;,�;�:,.�+,/•�.�•��I.Y ' � '��':. is 1. � :� r. 1 ” •.::• � � �,.� pi •h'; ' ,4}`•'•i" : i,.�.i� r'. � �. .. flulps ..r•ip: ':''�'���: ;r'"'�y'''�''I'�r•'•'i'r'.r7.' 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