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HomeMy WebLinkAboutMiscellaneous - 219 BERRY STREET 4/30/2018N � O �+ W vm North Andover Board of Assessors Public Access if a; �yKar+ry �ry h a Z R M ,� �snCfYu ¢�a Return to the Home page click on logo New Search Sales Summary Residence Detached Structure Condo Commercial Comparable Sales Tobvvn of Worth A zmdk) kv'er Uckard of Assessors Parcel ID: 210/106.D-0052-0000.0 SKETCH No Sketch Available l� Page 1 of 1 Property Record Card Community: North Andover PHOTO lac Picture Available Location: BERRY STREET Owner Name: ROSS, NATALIE C/O RUSSELL R ROSS JR. Owner Address: 28 HOLLYWOOD AVE City: RAYMOND State: NH ZIP: 03077 Neighborhood: 5 - 5 Land Area: 0.46 acres Use Code: 130 - RES -DEV -LAND Total Finished Area: 0 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 165,800 174,600 Building Value: 0 0 Land Value: 165,800 174,600 Market Land Value: 165,800 Chapter Land Value: II http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=1181675 5/7/2008 f NORTM fl a t4aS"' V/ CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER 0 Building Permit Number 53 7/20/09) Date: December 18, 2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 219 Berry Street . MAY BE OCCUPIED AS Single -Family Dwelline IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Nathan Brooks 219 Berry Street North Andover, MA 01845 Building Inspector 1 R TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTI-I ANDOVER, MASSACHUSETTS 0 184 Susan V. Sawyer, R.EHS/RS Public Health Director 25 �- RECEIVED v 9 xi 1 3 2009 S TO t, NORTH ANDOVER HEALTH DEPARTMENT 978.688.9540 - Phone 978.688.8476 -- FAX hea Ithdeptntownofiiorthandover.com www. townofnorthandovcr. coin Well and/or Pump Application (Please print) DATE: �y �-3 LOCATION to Drill Well or install a pump:ir1��/.� cam` Licensed Well Contractor Name and Company Name: l ///�' � E' �ZS f �� L� !/�` `/ tl C Contact Phone Numbers: Homeowner:, Address: — Contact Phone Numbers: "11-7-100 / WELLS (to be completed at time of pump test) Type of well Diameterofwell: r� Size ofCasing: / Depth of bedrock: Z2 Depth ofcasing into bedrock: Seal Seal been tested? Yes (-X No( ) Date of test: S d Depth of well: y� r Water-besriug rock:�J` 7 Depth of water: lJr Delivers:GPM for: (how long) Drawdown: feet after pumping:` hours at: GPM Date of Completion: Mgnst1k&ofWel1 Contractor PUMPS (To be filled in before installation) Name & size of Pump: Size of Tank: �� G Pipe used in well: �r o}/ Cast Iron_ Sleeve used to protect pipe? Yes Date: Date water analysis report submitted to Health Plumbing Type �rr.%r'�sS Pump delivers:_ % GPM: Galvanized Plastic , No Type of well -- Wiring Inspector Signature C:\DOCUME-I\bcurran\LOCALS-t\Temp\Well Application.doc Installer 7 G Health Department Representative dc r Massachusetts Department of Conservation and Recreation ,yasesoh+sarrs Office of Water Resources 2/2 dC r Massachusetts Department of Conservation and Recreation Mossucla,uefts Office of Water Resources Well Completion Report 10-NOV-09 14:49:03 WELL LOCATION 266882 (GPS North: 42° 38.03' GPS West: -710 4.028' Address: 214-5, Berry Street Property Owner/Client: Nate Brooks Subdivision Name: Mailing Address: 19.5 Borque Street City/Town:North Andover City/Town, State:Lawrence MA Assessors Map: Assessors Lot #: Permit Number:BHP-2009- Board of Health permit obtained:Y Date Issued: 05/22/2009 0531 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Domestic Air Hammer Air Hammer CASING From (ft) To (ft) Type Thickness Diameter .00 -30.00 Steel 17# 6.00 SCREEN From (ft) To (ft) Type Slot Size Diameter WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL From (ft) To (ft) Material Description Purpose 00 -30 Native Material WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) Date Method Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) 05/21/2009 Air Blow with Drill Stem 6.0000 004:00 425.0000 002:00 20 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) Date Depth Below Ground Pump Description: 1/2 7gpm Measured Surface (ft) Type:3 wire Constant Speed Submersible Intake Depth: 300.0000 05/21/2009 20 Nominal Pump Capacity: 7.0000 Horsepower: .5000 WELL DRILLER'S STATEMENT ADDITIONAL WELL INFORMATION Driller: Joseph Haynes Developed: No Fracture Enhancement:No Supervisor: Joseph Haynes Rig #:762 Disinfected:Yes Well Seal Type:None Firm: Northeast Water Wells, Inc. Total Well Depth: 425.000 Depth to Bedrock: 12.000 Registration #:762 Date Complete:05/21/2009 Comments: OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 3.00 Till Brown No N/A No Normal 3.00 12.00 Till Yellowish Brown Yes Add No Fast 1/2 Parcel ID: 210/106.D-0052-0000.0 as of 12/19/07 Page 1 of 1 LAND INFORMATION NBHD CODE: 5 NBHD CLASS: 5 ZONE. VR Seg Type Code Method Sq -Ft Acres Influ-Y/N Value Class 1 P 130 S 20000 0.46 174,553 VALUATION INFORMATION Property Record Card 7 PARCEL_ID:210/106.D-0052-0000.0; MAP: 106.D BLOCK:0052 SKETCH L'OT:0000.0 PARCEL ADDRESS: BERRY STREET - "4-� No Picture PARCEL INFORMATION Availeaftble Use -Code: 130 Sale Price: 0 Book: 01212 Road Type: T Inspect Date: 05/08/2006 Tax Class: T Sale Date:- 12/31/1972 Page: 0342 Rd Condition: P Meas Date: Owner: Tot Fin Area: 0 Sale Type: Cert/Doc: Traffic: M Entrance: ROSS, NATALIE Tot Land Area: 0.46 Sale Valid: N Water: Collect Id: SGC C/O RUSSELL R ROSS JR. Grantor: Sewer: Inspect Reas: Address: 28 HOLLYWOOD AVE RAYMOND NH 03077 Exempt -B/L% 0/0 Resid-B/L% 100/100 Comm-B/LORI Indust -B/L% 0/0 Open Sp -B/L% 0/0 Parcel ID: 210/106.D-0052-0000.0 as of 12/19/07 Page 1 of 1 LAND INFORMATION NBHD CODE: 5 NBHD CLASS: 5 ZONE. VR Seg Type Code Method Sq -Ft Acres Influ-Y/N Value Class 1 P 130 S 20000 0.46 174,553 VALUATION INFORMATION Current Total: 174,600 Bldg: 0 Land: 174,600 MktLnd: 174,600 Prior Total: 149,400 Bldg: 0 Land: 149,400 MktLnd: 149,400 SKETCH PHOTO No Picture Availeaftble Parcel ID: 210/106.D-0052-0000.0 as of 12/19/07 Page 1 of 1 North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/106.D-0052-0000.0 Community: Na No 'i *1 Ci Ava'161a Location: BERRY STREET Owner Name: ROSS, NATALIE C/O RUSSELL R ROSS JR. Owner Address: 28 HOLLYWOOD AVE City: RAYMOND State: NH ZIP: 03077 Neighborhood: 5 - 5 Land Area: 0.46 acres Use Code: 130 - RES -DEV -LAND Total Finished Area: 0 ASSESSMENTS A. noffITITM Total Value: 174,600 149,4 Building Value: 0 0 Land Value: 174,600 149,4 Market Land Value: 174,600 Chapter Land Value: Sale Price: 0 Sale Date: 12/31 Arms Length Sale Code: N -NO -OTHER Grantor: Cert Doc: Book: 01212 Page: 0342 http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3 &Linkld=991405 12/19/2007 A 14 k73 13 19 �28 0 31 12 SCALE 1 " 200 j SEE PLAT '.06 B / V XI / Z 21 2 8 6 23 } p0^� z 35 62 60 Sc 61 a 2^ / 20 25 Y 21 21 29 a , ass llb a;_ . i 51 50 39 / o Y ..• �o55P5 49 40J 30 zro °s. e 6> 5\\., 41 29 e7, saF e JI 31 GL g�c ]0 GG�i zNp69 r� 4. /.,� Z�f 41 37 46 v� !SCAL 2001 �BeR N BY FRANK S. GILES, P.O r SEE PLAT 10 D EASOREMENTS ARE ED ONLY NOT FOR SURVEY PURPO .V Page 1 of 1 DelleChiaie, Pamela From: Randy Burley [rburley@millriverconsulting.com] Sent: Friday, December 28, 2007 10:21 AM To: 'Daniel Ottenheimer; dobrzut@millriverconsulting.com; Grant, Michele; 'Marianne Peters'; DelleChiaie, Pamela; Sawyer, Susan Subject: Lot 5 Berry Street I'm back! Please find attached the soils information for lot 5 Berry St. The site was too wet to perc and there are probably some wetland issues. You won't see more activity until next summer, most likely. Best regards, again --,Mill River consulting Randy Burley, Project Manager Mill River Consulting, Inc. On -Site Wastewater Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverponsulting.com rburley@millriverconsulting.com 5/7/2008 TRANSMISSION VERIFICATION REPORT TIME 05/25/2010 15:27 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 0004J120960 DATE,TIME 05125 15:26 FAX NO./NAME 16035779947 DURATION 00:01:04 PAGE{S} 02 RESULT OK MODE STANDARD ECM Hp C91cojet Pro L7700 All -in -One series Fax Log for TOWN OF NORTH ANDOVER COMMONWEALTH OF MASSACHUSETTS North Andover Board of Health BROOKS, NATHAN -------------------------------------- 14A1ME BERRY STREET -------------------------------------------------- ----- ADDRESS IS HEREBY GRANTED A PERMIT , Artesian Well - Constructed by: Northeast water Wells, Inc. NUMBER BHP -2009-0531 FEE $135.00 This permit is granted In conformity with the Statutes and ordinances relating thereto, and expires . ------August 22, 2009 unless sooner suspended or revoked. ---------------- ----------------- Board of May 22, 2009 ----='��'� .o,m..'.,-- ---�•--------- Health - ------------- I... .................................. .-------------- Board of Health Chairman HP O ficejet Pro L7700 All -in -One series Fax Log for TOWN OF NORTH ANDOVER COMMONWEALTH OF MASSACHUSETTS NUMBER Kosf►a BHP -2009-0531 North Andover p FEE s $135.00 - a Board of Health 3 BROOKS, NATHAN �S�cNuS�t ----------------- NAME BERRY STREET --------------------------------------------------------------- ADDRESS IS HEREBY GRANTED A PERMIT Artesian Well - Constructed by: Northeast Water Wells, Inc. This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires .............. August -22, 2009__-- unless sooner suspended or revoked. May 22, 2009 --- ----- -------------------------- Board of --- ----- - Health Board of Health Chairman --------------------------------------------------------------- /-Ls L 1 s T COMMONWEALTH OF MASSACHUSETTS North Andover Board of Health SSACW BROOKS, NATHAN ------------------------------------------------------------------------------------------------- NAME BERRY STREET ------------------------------------------------------------------------------------------------- ADDRESS IS HEREBY GRANTED A PERMIT Artesian Well - Constructed by: Northeast Water Wells, Inc. NUMBER BHP -2009-0531 FEE $135.'00 ---------- This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires .............. Augu-st-22,20-09 -------------- unless sooner suspended or revoked. May 22, 2009 ---- t -------- I --------------- ------------------ Board of -------- - ---------- --- ------ --------- Health ---------- ------------------------------ ---- --n ----------------------------------------------------------------- Board of Health Chairman a TOWN OF NORTH ANDOVER -0. -. Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director j 978.688.8476 — FAX �� (O healthdeptp_townofnorthandover.com www.townofnorthandover.com Well and/or Pump Application/ (Please print) DATE- � Iy o LOCATION to Drill Well or install a pump: Z�/✓�� Licensed Well Contractor Name and Company Name: Contact Phone Numbers: �/J ,�� Ngl as �jQ // �� '�i�� ��� 413 S - Homeowner: Address:— Contact Phone Numbers: /I( -- -41%-%o0 WELLS (to be completed at time of pump test) Type of well:/i/ /��SI Gt H Use: Diameter of well: Size of Casing:. ---5----/f Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water -bearing rock: Depth of water: Delivers: GPM for: (how long) Drawdown: feet after pumping: hours at: GPM Date of Completion: Signature of Well Contractor PUMPS (To be filled in before installation) Name & size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron— Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis report submitted to Health Department: Plumbing Wiring Inspector C:\DOCUME—I\bcurran\LOCALS—I\Temp\Well Applicatiion.doc Health Department Representative DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, October 27, 2009 3:14 PM To: 'clifford@wellguy.com' Cc: Sawyer, Susan Subject: FW: Well Application and Follow -Up - LOT 5 BERRY STREET, NORTH ANDOVER, MA Attachments: SKMBT_60009102715000.pdf Importance: High Hi Cliff, Our fax machine has been down, so I thank you for your e-mail address. Please review the attached, fill in the information, and scan and e-mail back to me, or complete and mail a hard copy back to me as soon as possible. Thank you for your assistance. Health Department Assistant TOWN OF NORTH ANDOVER Health Department 1600 Osgood Street Building 20; Suite 2-36 North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax pdellechiaie@townofnorthandover.com - E-mail http://www.townofnorthandover.com/Pages/index - Website Nntec If copied to BOH Members - Reference Copy Only - no response requested at this time From: noreply@townofnorthandover.com [mailto:noreply@townofnorthandover.com] Sent: Tuesday, October 27, 2009 4:00 PM To: DelleChiaie, Pamela Subject: Well Application and Follow -Up - LOT 5 BERRY STREET, NORTH ANDOVER, MA Tracking: Recipient Delivery 'clifford@wellg uy.com' Sawyer, Susan Delivered: 10/27/2009 3:14 PM HP Officejet Pro L7700 All -in -One series Fax Log for TOWN OF NORTH ANDOVER ,..k COMMONWEALTH OF MASSACHUSETTS NUMBER BHP -2009-0531 North Andover FEE r Board of Health $135.00 BROOKS, NATHAN ----------- -------------------------------- ...---------------------------------------------------------.--- NAIVIE BERRY STREET ---------------------------------------------------------------------------------------------- ADDRESS IS HEREBY GRANTED A PERMIT Artesian Well - Constructed by: Northeast Water Wells, Inc. This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires -------------August -2,2009 ........ unless sooner suspended or revoked. :-:-_------- � `:i ---------------------------- Board of May 22, 2009 :.. -----=k�°eu�,�- --- ----- ----------� Health --------------------------------- ------------------- Board of Health Chairman ----------------------------------------------------------------- TOWN OF NORTH ANDOVER �°�, ;• Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH[ DEPARTMENT 1.600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, RENS/RS 978.688.9540 — Phone Public Health Director j 71 978.688.8476 — FAX ��t0 •lam healthdept(@townofnorthandover.com www.townofnoithandover.com Well and/or Pump Application (Please print) DATE: LOCATION to Drill Well or install a pump:%✓�� Licensed Well Contractor Name and Company Name: Contact Phone Numbers: e Homeowner: 1AJ tar� Address: Contact Phone Numbers: 7 WELLS (to be completed at time of pump test) Type of well: /��-Si tC . f Use: Diameter of well: � Size of Casing: Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water -bearing rock: Depth of water. Delivers: GPM fon (how long) Drawdown: feet after pumping: hours at: GPM Date of Completion: Signature of WeU Contractor PUMPS (To be filed in before installation) Name & size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis report submitted to health Department: Plumbing Wiring Inspector Health Department Representative C:\DOCUME—I\bcurran\LOCALS—I\Temp\Well Application.doc 4 I NUMBER COMMONWEALTH OF MASSACHUSETTS BHP -2009-0531 North Andover FEE .jj0&W2jgL % $135.00 Board of Health --------------------------- BROO-KS,--NATHAN ---------------- NAME BERRY STREET ------------------------------------------------------------------------------ ADDRESS IS HEREBY GRANTED A PERMIT Artesian Well - Constructed by: Northeast Water Wells, Inc. This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires -------------- Augu-st-22,-2-0-09 -------------- unless sooner suspended or revoked. May 22, 2009 ----------------------------------------------------------------- Board of ----------------- ---------- Health --- --------- - - __y ---------- ----------------------------------------------------------------- Board of Health Chairman --------- ------ DelleChiaie, Pamela From: Sawyer, Susan Sent: Tuesday, May 19, 2009 11:01 AM To: DelleChiaie, Pamela Cc: Hughes, Jennifer Subject: well Lot 5 Berry St. The well permit is approved. You may issue it and fax it to Fax 603 577-9947 att. Cliff Phone 800 562-9355 I spoke with Cliff this AM and told them they are all set. Jennifer H. is aware as well. They will be starting either this afternoon or tomorrow morning. Thx Susan 41 59 RT 0i, 0 Town of North Andover HEALTH DEPARTMENT C'�H �EICK DATE: L fW 9 N: H/O NAME: -4-� �a4 z4x�14^1 CONTRACTOR Type of Permit or License: (Check box) 0 Animal 0 Body Art Establishment 0 Body Art Practitioner 0 Dumpster 0 Food Service - Type: ----- 0 Funeral Directors 0 Massage Establishment 0 Massage Practice • Offal (Septic) Hauler • Recreational Camp 0 Sun tanning 0 Swimming Pool 0 Tobacco �11 Tr Solid Waste Hauler r ;Well 'Construction SEPT[C Systems 0 Septic - Soil Testing 0 Septic - Design Approval 0 Septic Disposal Works Construction (DWQ 0 Septic Disposal Works Installers (DW[) 0 Title 5 Inspector 0 Title 5 Report I - 0 Other. Undicate)60&4��-..l $ Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer 124.79 x IPF 125.11 1 124.7A :X t ` AUGUST, �s )00,3 : 48 JjEW 46 12 I CONTRA'' BARRIER 108 123. i5 , 123.12 �EW 3B AND l..iN,I i 124 , (SEE DETAIL) PROPOSED .Y PROP. u.J STONE WA ,.. / WELL p SOF WORK 'r N00 N 124.45 J 125.78 :MPO ARY SWALE ,J.�� gip_ STAKEI iP TO COLLECT o - EL DRILLING �,�.� ! PROP. LOAM DETAIL f x 126.07 . STOCKPILE Al � 18 1 54 X124.12 1 1 1 x �► N x 1iE�EP DECK .�- •� /� !_ 7.37 rRR i (PRIVATE -VARIABLES WIDTH) \ PROP. SANITARY ---' 1 _- ------ ER -pump -ST" . _ 12872 (FORCE MAIN LAYOUT, ?VC FORCE--jDESIGN & APPROVAL 3Y OTHERS)BY OTHERS) i PLAN CA4E: 20p Ke 1 � 4 fi PROP. ROOF RAIN INFILT ATOR ( E ETAIL) A 00 190 MH X 123.53 � O r CO O N x 123. 8 T B 124A`i 124 "-x 124.0< 124.79 x IPF 125.11 1 124.7A :X t ` AUGUST, �s )00,3 : 48 JjEW 46 12 I CONTRA'' BARRIER 108 123. i5 , 123.12 �EW 3B AND l..iN,I i 124 , (SEE DETAIL) PROPOSED .Y PROP. u.J STONE WA ,.. / WELL p SOF WORK 'r N00 N 124.45 J 125.78 :MPO ARY SWALE ,J.�� gip_ STAKEI iP TO COLLECT o - EL DRILLING �,�.� ! PROP. LOAM DETAIL f x 126.07 . STOCKPILE Al � 18 1 54 X124.12 1 1 1 x �► N x 1iE�EP DECK .�- •� /� !_ 7.37 rRR i (PRIVATE -VARIABLES WIDTH) \ PROP. SANITARY ---' 1 _- ------ ER -pump -ST" . _ 12872 (FORCE MAIN LAYOUT, ?VC FORCE--jDESIGN & APPROVAL 3Y OTHERS)BY OTHERS) i PLAN CA4E: 20p Ke 1 � 4 fi PROP. ROOF RAIN INFILT ATOR ( E ETAIL) A APPPDX- �� 146 L• , - 1 r ,394 38 10.25 r ,� �K 128.79 . BENCHMARK NAIL IN UP#3860 EL.=130.05 dns-p-fry 00 190 MH APPPDX- �� 146 L• , - 1 r ,394 38 10.25 r ,� �K 128.79 . BENCHMARK NAIL IN UP#3860 EL.=130.05 dns-p-fry v I 16 C-17/11/2013 09:34 6@37721966 f Frorn: SEALS ASSOCIATES PAGE 01/09 PLL C, Suite 309, Building B On.c.1jampton Read Exeter New Hamp5hire 0383-1 - 603 — 772 - 7853. Fax: 772 - 1966 FAX COVER SWEET Date: Project: NH- LocationW_,& / /-r _V 75mc: Z Y;;,6 Recipient Fax Nurnber: ,Tota I Page5 Sent (includilig cover shect.) pages -Vovd�L 6J C-6 o c� BE,,,1LsA.ssocIAT'ES,,J'LLC.TEI-L-,PHONF-NiLim..BE,R: (603)772-7851 BF.ALS.Assoct,%TES. PLI-C. FAX NuMBF-R: (603) 772-1.966 07/11/2013 09:34 6037721966 BEALS ASSf7CIA-TES PAGE 02109 Commonwealth of Massachusetts City/Town of Concord a Percolation 'Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must tie substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important: A. Site Information When filling out forms on the computer, use Natalie Ross co: Russell Ross only the tab Prey Owner Name to move your do Lot 5 Berry Street (Tax MAp 106D, Lot 520 cursor - not use the return Street Address or Lot 4 trey. _North Andover, MA 41845 MA 01742 Clty/Town State Zip Code roe Beals Associates, Inc. 603 772-7851 Contact Person (if different from Owner) Telephone Number B. Test Results 7-10-08 10:15 am 7-10-08 11:30 Date Time Date Time Observation Hole # perc. 4,1 per. #2 Depth of Perc 601, 72" — -- Start Pre-Soak 11.21 am 11:37 am End Pre-Soak 11:36 11:52 am Time at 12" 11:36 am 11:52_amam Time at 9" 12:55 pm 12:07 pm Time at 6" 2:12 pm 12:22 pm --- Time (9"-6") 77 min. 15 min. Rate (Min./Inch) 26 min/inch 5 min/inch Test Passed: Test Passed: Test Failed: ❑ Test Failed: ❑ Christian O. Smith, P',E'. Test Performed By: Randy Burley BIT __ Wltnessed By: Comments: C layer encountered with Deep Hole #1 encountered @ 30" +/-. C layer encountered with Deep Hole #2 found at 54", Weather 75-de gees & sunnsunny. t5form12.dcv 06/03 Pero Test - Page 1 of 1 11l?61*3 69:34 b6'??2196b 7 0 Q. c� c Cd> N .ate+ trJ "Z" U) � � P p � � E U u P.L. —1111 Ir lyj �? c � m 7 0 Q. c� c Cd> N .ate+ trJ "Z" U) � � P p � � E U u P.L. EEALE ASSOCIATES PAGE 63169 c 'AI 0 E f Ow cJ LJ N U - LL W N —1111 Ir �? Glu m S � EEALE ASSOCIATES PAGE 63169 c 'AI 0 E f Ow cJ LJ N U - LL W N rte» 0 p.. uj 0 0 �? Glu m C) (� CL U wCCD z pp M T7 D 9, TJ p N••. LO N � � N u� q> C O UUU C Q �i. rte» 0 p.. uj 0 0 �? Glu m C) (� CL U wCCD z pp M T7 D 9, TJ p N••. 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O Q T tf O _ O 6 j O C 0) E U O > O O U L Q o coa � � m D l' > o o0 C s E -o vOi-Oo 'S � � OI0) cn > L p o U CT mO caF- z Z 1 O a� 01 0 a N C C Q) E V) a) V7 Q 0 O U- CL a LU 0 M N O CL N co t� W io O E 2 T— T— E O UL Page 1 of 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, May 14, 2008 4:14 PM To: 'russellross4@comcast.net' Subject: FW: Lot 5 Berry Street -----Original Message ----- From: DelleChiaie, Pamela Sent: Wednesday, May 14, 2008 4:14 PM To: Osgood Ben (E-mail); Kimberly I Brown (E-mail) Subject: FW: Lot 5 Berry Street Hello, I am looking for the Form 1 I with the soil test information from you. The owners state that they have been in touch with you about this. Can you please bring us a copy asap? Thanks. Pamela 5/14/2008 ,AORT" V Town of North Andover HEALTH DEPARTMENT U CHECK DATE: LOCATION: H/O NAME: CONTRACTOR NAME: '4fzzc�jl Type of Permit or License: (Check box) $- 0 Animal $ 0 Body Art Establishment $ 0 Body Art Practitioner $ 0 Dumpster $ 0 Food Service - Type: $ 0 Funeral Directors $- 0 Massage Establishment $ 0 Massage Practice $ • Offal (Septic) Hauler $ • Recreational Camp $ 0 Sun tanning $ • Swimming Pool $ • Tobacco $ • TrashlSolid Waste Hauler $- • Well Construction $ SEPTIC Sustems: G ---Septic - Soil Testing $ 10PO 0 Septic - Design Approval $- 0 Septic Disposal Works Construction (DWC) $ 0 Septic Disposal Works Installers (DW[) $- 0 Title 5 Inspector $ 0 Title 5 Report $ 0 Other (Indicate) $ Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer 61 ,. DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, December 19, 2007 2:29 PM To: Dan Obrzut (E-mail); Daniel Ottenheimer (E-mail); Marianne Peters (E-mail); Randy Burley (E- mail) Cc: McKay, Alison Subject: Soil Test Application - Lot 5 Berry Street Importance: High Here is an application for the above. This is an undeveloped site. Please schedule with the engineer, Ben Osgood. Alison, if you have any issues with this site, please notify me, and I will let our septic consultant know. Thanks. -----Original Message ----- From: noreply@yourcopier.com [mailto:noreply@yourcopier.com] Sent: Wednesday, December 19, 2007 3:21 PM To: DelleChiaie, Pamela Subject: Message from KMBT_600 lrAd�kl SKMBT 600071219 15200.pdf w TOWN OF NORTH ANDOVER t NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS, RS Public Health Director 978.688.9540 — Phone 978.688.8476 — FAX healthdept@townofnorthandover.com www.townofnorthandover.com APPLICATION FOR SOIL TESTS DATE: bee I2�ZCQJ MAP &PARCEL: LOCATION OF SOIL TESTS: to 5" Beau .1 Vee A In . Andn va,- OWNER: i /` ` aa—' 11 '34$S Contact #: &0,5 —a yq-a G 43 APPLICANT: SQAtp- 6S obo Contact#: ADDRESS: 9 ENGINEER: f w 1 am' w' iNoo 1 tl f • PS. Contact #: `7 �d ' lY(L� � �" / �2 p CERTIFIED SOIL EVALUATOR: RECEIVED Intended Use of Land: Residential Subdivision ,�FamilyCommercial� DEC 13 2007 Is This: Repair Testing: Undeveloped Lot Testing:--1-Upgrade for Addition: In the Lake Cochichewick Watershed? Yes THE FOLLOWING MUST BE INCLUDED WITH THIS FORM No LfN OF NO2TH ANDOVER ALTH DEPARTMENT ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x 11 "Plot Plan & Location of Testing (please indicate test nit sites on the Plan ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. At least two deep holes and two percolation tests are required for each septic system disposal area. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent. Date back to Health Department: (stamp in): 96 APR 12, '915 PO' 20 Up 18/199 11,26 r4VRRj?4ACJ<ENGX 6S'Et 6ZIL-M raG 03 ; X 54� Awr�� IAI 1 1IW4-"1AWre d -, yd, 10('r-'f'W'6 TOWN OF NORTH ANDOVER Office of COMMUNITY DI'1VI LfbP.ME3'° T AND SERVICE"S HEALTH DEPARTMENT 1600 OSG'OOD STI$1G'E'r; BUILD] 1('20; SUITE 2-36 $ .4 � n NORTH A1VDt_t Y !.!!y MASSA' �.3-.U;4; ; [ TJ V 1845 air27�..•.. Susan Y. Savqer, RENS, IIS 978.688.9540 Phone Public Health Director 978.688.9476 FAX healthde L(chtown.oh.iorT}tari.dover.con7. w,�vw,insvizo li io�'tliaiidover. com APPLICATION FOR SOIL 'PESTS DATE: 'e 12, Lcc� MAP & PARCEL: I D -P 1' 1 UGC. 6-2– LOCATION -ZLOCATION OF SOIL TEST'S: �0 � 5- �P,d1�U 7 ?d A 1) • l��j(�� Vf% OWNER: / IAC Q$� Contact #: &,0,5 —a APPLICANT JQQx�L (is kboContact #: ADDRESS: d / )-, Q ,1677 '�°c _ ENGINEER: oojJ. P. �' Contact #: _ CERTIFIED SOIL EVALUATOR: JY� -F-7PF-CEIVED Intended Use of Land: Residential Subdivision�aniilyCommercial DEC 13 2007 Is This: Repair Testing: Undeveloped Lot Testing: i/ upgrade for Addition: i`vDO "E In the Lake Cochichewick Watershed? Yes No HE-ALTti 0i"JP, THE FOLLOWING MUST BE INCLUDED WITH THIS FORM. ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5" x 11 "Plot plan & Location of Testing (ylease indicate test nit sites on the elan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation. tests required for each disposal area. Fee of.$360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil. Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. Z At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at Least two deep holes and at least one percolation test, at the discretion of the BOH representative. Full payment will be required for all. additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the hoard of Health showing the location of all tests (including aborted tests). > Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line We.A-`a-3s nct wvv e-ve-1 cir afpro ve-A'R/ fl�.S-�er.P� 0.S Se�a� w� SeSNrf Ga,r�'SnoW �vG✓y 404 "e � eS � 1 endiea �.Q}la N.A. Conservation CommissionApprova Bate: Signature of Conservation Agent: Date back to Health Department: (stamp in): i'�J avcQ APR I- 26 Up I 99 31:2h 568a4�1aa f f4ER .%t4ACl Fair -i ,�.""..�..--""�.-•" dads �-,�+o+sM ��� ,es�✓`e� �'A�'a.I�'�` AVID �0, /.V 6s' -CL 6Z -LL -Li 0