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HomeMy WebLinkAboutMiscellaneous - 226 SALEM STREET 4/30/2018 (2) �.. 226 SALEM STREET 210/037.D-0001-0000.0 _.. / � I t � � r I '1 .a _ � V r Lot & Street �-� .. Map/Parcel <:3 7D J CONSTRUCTION APPROVAL Has plan review fee been paid: YES Permit# !2 .7,—:;P) Plan Approval: Date: p roved by: G'�U -31 Desi ner. WZ leIq S Plan Date: Conditions: Water Supply: Town Well Well Permit: Driller: Well Tests: ChemicalDate`Apprroved Bacteria I Date Appro`ved., Bacteria II Date Approved Plumbing Sign-Off: Wiring Sign-Off.- Comments: ign-Off:Comments: Form"U" Approval: Approval to Issue: S. NO Date Issued By: Conditions: Final Approval: All Permits Paid? YES NO Well Construction Approval? NO Septic System Construction Approval? - NO Certification? r`YENO Other "YES `--NO------ Any Variance Needed? YES NO FINAL BOARD OF/HE�LT' APPROVAL: DATE: /�'I APPROVED BY:/ r - SEPTIC SYSTEM INSTALLATION Is the installer licensed? NO Type of Construction: REPAIR New Construction- Certified Plot Plan Review YES_ NO Floor Plan Review YES_~ NO Conditions of Approval from Form U YES ,-,NO Issuance of DWC permit: NED NO DWC Permit Paid NO DWC Permit 9 W 1 Installer:... Begin Inspection: YES NO Excavation Inspec ion: 4 /�3; Needed: — - Passed: By: Gam/ Construction Inspection: Needled: ,z-, ��, ._��;��%�T ,�s -�,G�;1� /'I') c7 v"�-C�f.J ���.��°�1/ (..tl�__1/ -� �' /.3::✓'C wry` �5 r i m c L.n_�a ! C (� �.;�/� rAj GS MSatisfactory: d .1k9 1�1 Approval of Backfill: Date: By- Final Grading Approval: Date: By: �yk Final Construction Approval: Date: By: , Certificate of Compliance: Approval: /' Date: Gl { 226 Salem Street, North Andover, MA AS-BUILT CIIECKLIS"I' XX LOT NUMBER, STREET NAME xx , ASSESSORS MAP&PARCEL NUMBER , XX LOT LINES&LOCATION OF DWELLINGS XX LOCATION & DEMENSIONS OF SYSTEM. INCLUDING RESERVE XX TIES TO LOT LINES& DWELLING, WELLS -a. FROM SEPTIC TANK °-'b. FROM LEACH AREA ' XX LOCATIONS OF DEEP HOLES&PERC TESTS XX ELEVATIONS OF DISPOSAL SYSTEM XX TOP OF FDN ELEVATION t XX LOCATIONS OF WELLS,DRAINS,WATERCOURSES W/IN 150' OF SYSTEM XX LOCATION OF WATER,GAS, ELECTRIC LINES, CABLE •XX DISTANCES FROM CORNERS OF$HOUSE TO CENTER OF TANK&D-BOX XX STAMP&SIGNATURE N/A IMPERVIOUS AREAS -DRIVEWAYS, ETC. Driveway not paved at time of inspection XX NORTH ARROW XX FINAL CONTOURS XX LOCATION&ELEVATION OF BENCHMARK USED xx LOCUS PLAN 1 226 Salem Street, North Andover, MA AS-BUILT CHECKLIST XX LOT NUMBER, STREET NAME XX ASSESSORS MAP&PARCEL NUMBER , XX LOT LINES&LOCATION OF DWELLINGS XX LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE xx TIES TO LOT LINES& DWELLING, WELLS -a. FROM SEPTIC TANK -b. FROM LEACH AREA XX LOCATIONS OF DEEP HOLES& PERE TESTS x ELEVATIONS OF DISPOSAL SYSTEM X)( TOP OF FDN ELEVATION F XX LOCATIONS OF WELLS,DRAINS,WATERCOURSES WAN 150' OF SYSTEM XX LOCATION OF WATER,GA5,ELECTRIC LINES, CABLE •XX DISTANCES FROM CORNERS ORHOUSE TO CENTER OF TANK&D-BOX XX STAMP&SIGNATURE N/A IMPERVIOUS AREAS -DRIVEWAYS, ETC. Driveway not paved at time of inspection X)( NORTH ARROW XX FINAL CONTOURS XX LOCATION&ELEVATION OF BENCHMARK USED XX LOCUSPLAN TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE This is to certify that the individual subsurface disposal system constructed (x) or repaired ( ) by North An Installer Andover Licensed Inst er John Carr at 226 Salem Street, North Andover, MA has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations as described in the Design Approval Site System Permit# 973 dated November 12, 1998. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector 1 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# LOCATION: �� LICENSED INSTALLER: SIGNATURE: TELEPHONE# C ONE: REPAIR: NEW CONSTRUCTION:_. IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As-Built?. Yes VX No Floor Plans? Yes V No Approval Date: r T5r ' TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( constructed; ( )repaired; by located at o�02 1 was installed in conformance with the.North Andover Board of Health approved plan, System Design Permit# dated 1 f �a q.P with an approved design flow of gallons per day. The materiars used were in conformance with those specified on the approved plan;the system was installed irraccordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading'agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Installer: Lic. #: Date: O D Engineer: l -, Date: I i r10RT own of Andover dower, Mass., 19 �7 Q LAKE - '9�_COCHIC HEWICK v `G BOARD OF HEALTH Food/Kitchen Septic System �� ✓! f� C BUILDING INSPECTORPERM111 I[ D •7 THISCERTIFIES THAT..........................................................C.0.1...(IN..S.............................................................. Foundation p .................. buildings has permission to erect..................... on ......ZZ............... .: ..E.M......... ou to be occupied as................................................. ... .�1 .. .d�...�r....... !1. ../ .............................................. Chimney provided that the person accepting this permit shall in every respect conform to the terdis of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ocgh!� �Sf� Final PERMIT EXPIRES IN 6 MONTHS ELECTRIC S E ` UNLESS CONSTRUCTION ST TS Rou . ................................. ........ ..... .......... ...... ............................... BUILDING oe INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove ough Final No Lathing or Dry !Nall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT urner 2-Z Street No. OSmoke Det. I FORM O - LOT R.ELF..ASE FORM INSTRUCTIONS: This form approvals/permits from is used to Verify that all necessary landowner from compliance dis oth not Depart 11 havin relieve the 9 jurisdiction regulations or any applicable local and/or • requirements. or state law, _ ****************Applicant 1f ills out this section****** ' APPLICANT: LOCATIONPhone : -Q�Z� Assessor's Map Number Subdivision Parcel Street Lot(s) M � S t. Number ************************pffic ' 1 Use RECO DAT NS WN A • Conservation Administr Date -- or Approved Comments • Date Rejected Town Planner Date Approved ected - c/ Date Re ' Comm is • Food Inspector-Health Date Approved ed Date Rejected �n,,�i, l/Septic Inor-Heath DateAp roved DateRejected Re Commected omm is . i Public Works - Sewer/water Gonne ctions - driveway permit Fire Department partment Received by Building InspeCtor Date 1 Me o To: , Sandy Starr From: Dan Koravos Date: 10/15/97 Re: 226 Salem Street Enclosed, please find three(3)copies of the revised septic design for the above referenced project. As requested,the water service was extended to the proposed building. Should you require any further information, please contact me. I 25 Teloian Drive Hudson,NH 03051-3937 Phone: (603)886-0966 a-Mail: dkengr@earthlink.net �5s ,� r `� ' �y ,a aJ�' - - z D �� f. i..� 6 ' PLAN .REVIEW CHECKLIST,': ?' l J - C �/ r 3 ADDRE 1 AK �_�L�1. ENGINEER : .f� O I I/� - . GENERAL 3: COPIES �1 ,,, STAMP Ld _LOCUS l/ NORTH ARROW i:w� SCALE � '_ .: ,D... r CONTOURS ��� R PROFILE' `2* /:. SECTION BENCHMARK �� ,-SOIL; & 11 I ' PERCS ELEVATIONS._ WETS DaISCLAIMER'.�---�� WELLS &, WETS; c! r: SNt 1 �, WATERSHED? 1 '.7. ( y`D�y ; r DRIVEWAY .(� Elev) WA ER LINE FDN DRAIN .`--, ; t } , yp.. f. .. . ,* SCH4I.0f� TESTS'CURRENT' SOIL:: EVAL � � -6/�' 1 .6- 1. ;.l I1.1 11 . } by - I ` er1. =�t;s P,TIC TANK a u N y y y; k ",-�' MIN 1`500G ] 7 `INVERT DROP : GARB GRINDER z r {2 comps . 00) S 1. t' : M. h F._�2 ,. "1.0 ' TO FDN MANHOLE ELEV GW # COMPS .`' GB<f: 1 . �' .�, M S ..: , r � Y' ., r r z , v ', * 't h n ' 'SIZE r g b i ,, k*� : " o "3� LINES FIRST 2 LEVEL STATEMEidT y r �a r � � �� .. i• f n, -^ ' � ¢ .y a� F� °'vi a. .x11. r H t � wit. Y`t `INLET ao� a OUTLET Ib Cid t 7 {2" OR 17 'FT) � TEE REQ`'D�� ' , r'"} LEACHING w + ; �" a k �. :.� y s ' � z a 9i. s . i- V y3'� „_ rM-IN X40 F GPD�f s e r , RESERVE AREA � 4 FROM `PRIMARY C� ��/ ° f 2 o SLOPE ' 'j 100 ' -TO;--.`WETLANDS �/ 100 ' TO WELLS 'pLk`' 4' TO S 'Fi GW4 . `"""� 4�: rz " � .�r X20 TO FND & INTRCPTR DRAINS 4fl0LL,' TO SURFACE H2-. SUPP `- -` w �; ^a r r, - ,.., 5 A _ 4' PEi2M SOIL":BELOW FACiL`ITY MIN 12" COVER � IFIL ,� 5:' ��_ fi 1. ,�}r _ { ) • j --_ r r c e } k ' 4xBREAK< UT M£'P'� k 7 t y< 1 a Y u w { w y L: ,moi u� 'I.° �•k i7 '�.. .� r.; .. `: 4 i .,:r e r:` {yF e._f ,t t; 4YH Y.�. r 1 �� x �, y a• - ,. -r,.w• ,. w> 1.iSPri\Ci3Ti� .i 9 F�: zt r - - k. m ys;+ a Yt } � k ' J - WK k a J f ♦ .! 3 1 '3 S 1 t i "t Y fi < MTN 440 gpd SLOPE (min 005 or 6"'/100 ' ) SIDEtn1ALI; DIST 3X. EFE_s h ', r. L�/� Y W w0F2 A4 (MIN 6 ' ) r RESERVE BETWEEN TRENCHES N.,.FILL?. MUSTa e i BE i0 MIN` 4" PEA,STO,NE� � VENTS- >3 '`:COVER, LINES ,>50'I r 1 L �' r'` 1. {' tr a gpT �j" ,'+ SIDE X LD'! T6T T 4�d LM s ` x (L x W I #) (.DxLx2x## /ft r . . 2 ` r r ��D Copyright ,fl 1996-Lby S L. Starr- �, i/1'` ` . - -- . � .r : a SEPTIC PLAN SUBMITTALS LOCATION: NEW PLANS: YES $60.00/Plan REVISED PLANS: $25.00/Plan DATE: 'o� DESIGN ENGINEER: 1 When the submission is all in place, route to the Health Secretary !/ ------ - - -_ --- - r � P1�5 G---�- �� Daniel • • ©(QF B t�1,301 ER/ Me = 7 o OCT To: Sandra Starr- North Andover Board of Health From: Dan Koravos Date: 10/06/97 Re: Collins Septic Design - Map#37D Lot 1 Subdivision Lot#1-1 The above referenced plan was previously submitted for your review. Recently, my client requested changes to the plan including the relocation of the house and septic system. I am submitting these changes for approval. I apologize for any inconvenience this may cause. If additional review fees are required, please contact me. Sincerely, 25 Teloian Drive Hudson, NH (603)886-0966 SEPTIC PLAN SUBMITTALS LOCATION: o� -P�-y-r- NEW PLANS: YES $60.00/Plan REVISED PLANS: YES $25.00/Plan "� DATE: DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary APR - 2 - 98 T H U 1 0 26 S E _ C u m m i " -3 s Assoc i a. t e s P _ 0 1 FAX E Date 0402198 Number o1 pages including cover shoot 2 TO: Town of North Andover FROM: Hugo Findeisen Board of Health P.O. Box 612 Ann.: Susan Ford Sandown, NH 03873-0612 Phone (978) 688-9540 Phone (603) 887-2756 Fax Phone 978 688-9542 Fax Phone 603 887-2756 f RE: 226 Salem Street REMARKS: ClUrgent ❑ For your review C1Reply ASAP ❑ Please Comment Dear Susan: Here is fax of a portion of a 20 scale plot for your review. Dan Koravos asked me to fax this to you. if you have any questions please call myself or Dan. 1 believe Dan will be in touch with you to get your mailing address so that we can mail you the entire lot at 20 scale. Sincerely Hugo Findeisen APR- 2-98 T H U 10 : 26 S . E . C u m m i � Assoc f a t e s P . 02 1 , P4,T, . -4p14P 09, zo fiUXjS _NG - 2-2.0' NSA T/pN 67 7, N /N /6 °03'46 W ,. � 43. 72' ,Ate/ rV o �b ti F,q. O c� o P Town of North.Andover, Massachusetts Form No.z i f NORT► BOARD OF HEALTH Alp&° •...o �a 1 p t �. DESIGN APPROVAL FOR �ss,C"SSE` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant "Adk aj:° � ���\� CA Ujft Test No. Site Location_ `/l2 Reference Plans and Specs. ✓s ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHXFRMAN,BOARD OF HEALTH Fee Site System Permit No. 7 k,1 I AW 3 9' r THE COMMN� .'r i vto x s' E µ, • WEALTH OF MASSACHUSETTS " n TOWN OF NORTHANDOVER BOARD OF HEALTH �r•Y�r,d�� ax � ;•�•,r - fi� r � K December 22,7997 Mias, Permit#: 119-8DW1 This is to certify that: JOHN E.CARR,DBA RAMEY CONTRACTORS-ENGINEERS,INC.,33 .. CJs . i ` u Oak Knoll Rd.,Methuen,MA 01844 HEREBY GRANTED A "DISPOSAL WORKS INSTALLER'S PERMIT" TO CONSTRUCT,ALTER, INSTALL OR REPAIR, INDIVIDUAL SEWAGE DISPOSAL SYSTEMS - This permit is granted in conformtty,with the State Environmental Code Title V,Regulation 2.2,and w` expired Ue�c82tinless �s`ooner suspended or revoked. r} }x aN 1' - yton d`'"rQ11rcia'��li�}l�}$:ya9.+'��ATrx"brte�w.7i�.T'�.t•,�i` 3s`14:..i,x4S 1,.:...,�atrx�w.�...,-.:.t:�•ar,�,�..1r�.i�.rdE..+es:.'�. r...�a... ...-.'—--. _ ... ..,.Osgood, sgo�od " Francis P. Ma M.. ,....�,..,,b�..e«r t , 71. ....ow^•.*x r see,a.� ...>�r wdr..u.'.nG.u::.a.w7'.t�ua.y.�a'2�., tra' � f � - �; i r +r :e. rear ireu c*, s...m^ psx,I1;IR 'II'I;11 it'v°1i1riE',?�.hifi+ttSSRa:.-. .+ .+wWts CERTIFIED A 0 T PLAN S.E. CUMMING'S & ASSOC/A TES P.O. BOX 1337 PLA/STOW, N.M. 03865 TELEPHONE (603)-382-5065 FAX (603)-382-52f6 D5k 61 N TAX MAP 37D kci LOT 17!--1 42,820 S.F. 0.98 ACRES FOU EXISTING FV017NG W (FW STAIRS) UI O ALSEe'`'.T T G� N C3 TPM)-7L z No.3nls3l; (J 1Q, j pFs /STE �o W �6 -76'03 2 i 441 00 M�rno. ccvi z NO CUT SCALE 1" = 50' DATE.• JANUARY 1 1998 0, EASEMENT d REVISED: JULY 30, 1998 ��/(3,438 S.F.) / HEREBY CERTIFY TO TOWN OF NORTH ANDOVER �_ L=61.58' L=63.42' MASSACHUSETTS BUILD/NG DEPARTMENT THAT THE EXIST/NG FOUNDATION DRAWN — R=760.00' L=125.00' ON THIS PLAN /S L OCA TED AS SHOWN AND THAT/T DOES COMPL Y TO THESALEM STREET MIN/MUM BUILDING SETBACKS TO PROPERTY LINES. (COUNTY LAYOUT — 1962) 1. PROPERTY IS NOT IN THE 100 YR. FLOOD HAZARD AREA ❑ 2. PROPERTY IS IN A FLOOD HAZARD AREA ❑ 3. INFORMATION IS INSUFFICIENT TO DETERMINE FLOOD HAZARD. FLOOD HAZARD DETERMINATION FROM THE LATEST FEDERAL FLOOD \ INSURANCE RATE MAP PANEL# 250098 0006 C (JUNE 2, 199.3 794-CPP.OWG 3v Z f Vl ii16 -k:, SEWER-8ERVICE 00 f COMPLETE SEWER- DAA A SE CE RSERVICE INVOICE C CLISThMER NAME BILLING ADDRESS < (508) 683-5709 (508) 470-1400 Methuen, MA Andover, MA G1� CITY STATE ZIP PHONE: (508) 937-9889 (508) 851-8839 L41Lti l OUul b t l �� Dracut, MA Tewksbury, MA I (603) 898-9339 (508) 663-6633 JOB ADDRESS IF DIFFERENT THAN BILLING ADDRESS Salem, NH Billerica,MA ADDRESS STATE ZIP DESCRIPTION OF WORK VACUUM PUMP 11 SEPTIC TANK GALS. ❑ CESSPOOL ❑ OVERALL SYSTEM ❑ DRYWELL ❑ BASEMENT ❑ FAILED SYSTEM DRAIN LINES CLEANED ❑ MAIN LINE: FT. ❑ BATH TUB: FT. ❑ KITCHEN SINK: FT. ❑ TOILET BOWL: FL ❑ FLOOR DRAIN: FT. ❑ VANITY: FT. ❑ 0THER LINE: ::. 4 WORK ORDER AUTHORIZATION USE ONLY ON CHARGES GUARANTEES INVOI E AMOUNTS I hereby authorize you to perform the above described services and I agree to pay the amounts indicated to the right. I hereby certify PARTS $ that I am duly authorized to order and approve the work requested. Interest ® 15 per month 18%per annum on past due balances. LABOR SIGNATURE TITLE OTHER OTHER- _..__. TERMS OF PAYMENT TYPE PSERVICE TAX EXEMPT _ CASH ❑ RES/COMM nTAX INDUSTRIAL ❑" CHECK;--'<HARGE ❑ PLUMBING ❑ „TOTAL $_ i JOB COMPLETION Thi§ is to acknowledge ompI Lion of the above described work which has been don t my complete isfaction. DATE CUSTOMER SIG ATURE SERVICE AN' NAME l SEPTIC SYSTEM INSPECTION FORM i. ADDRESS 2 2 DATE INSPECTED PROPERLY FUNCTIONING? O N WEATHER CONDITIONS COMMENTS: WA'ER QuALI T Y TES t E'b ? JZESuLTS? DYE TEST PERFORMED? Y N i DATE? SKETCH: Please forward us as much of the following Infa.rrro,'tion that is po9s-i.hl.e 1. Type o.f system 2 . Ag.e d Oct. ►17, 1, 6 T 3. Il o c a t ion, GGG 1 � • Maintenance records and date of last pumping; out i 'Documentation of repairs and reconstruction b. Site conditions 4.2 c-i"X2,j` 7. Builder of system 8. Engineer who approved: — Site — System 1 I I� I 9 . Snstallation Procedure 10. Problems nb-7Lk_. �I I I i FORM 11 - SOIL EVALUATOR FORN1 Page I Date... �- - lq� No. ...................................... . .......................... Commonwealth of Massachusetts tNipe-rwc Aii Massachusetts Soil Suitability ,Assessment for On-site Sewage Disposal ............ ........... . . ..............Perfonned By: ........ . . . .. ..... ............................ Witnessed By: ...... .................................................................................................................................................................................................................................................................... L=ion Address or 6 GA LC-�i owner's Nam. L4x 0Address,wid P�kl*'10'ovde, Tetephone# i� 5 c9 -4 6 New Construction Repair ❑ Office Review Published Soil Survey Available: No ❑D Yes Year Published Publication Scale Soil Map Unit ....... (f�tATLL-TCK) DrainageClass Soil Limitations ............................................................................................................................. Surficial Geologic Report Available: No� Yes El Year Published ................... Publication Scale .................. GeologicMaterial (Map Unit) ......................................................................................................................................................... Landform ................................................................................................................................................................................................................ Flood Insurance Rate Map: Above 500 year flood boundary No El Yes" Within 500 year flood boundary No CJ Yes ❑ Within 100 year flood boundary No-E Yes El Wetland Area: National Wetland Inventory Map (map unit) ................................................................................................................ Wetlands Conservancy Program Map (map unit)................................................................................................... Current Water Resource Conditions (USGS): Month .................. Range Above Normal El Normal El Below Normal El Other References Reviewed: FORM It - SOIL EVALUATOR FORM Page 2 On-site Review Deep Hole Number Of..-J. Date:._.Z1_1*7l' 'O. 75 Time:.................. Weather ...............,........... .............. .. Location (identify on site plan) ........Sec...... ................................................... .............................................................. Land Use .........SRX. t5.,........................... Slope (%) ....3.......... Surface Stones .....-......................................................................... Vegetation .......��t...1�...-..0L .......................... ............................................................................................ Landform ..... ` Tz—- ,.L.!..\1................................................................... Positionon landscape (sketch on the back) ......................................................................................................................................................... Distances from' Open Water Body'... Pd. feet Drainage way? feet Possible Wet Area>.....IP . feet Property Line .. 5.... feet Drinking Water Well?...\oa feet Other ......................................... DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) (Munsell) (Structure,Stones,Boulders, Consistency, %Gravel) 6 ' 17, r S,Z., (big Y3 V 36 IC9 49 5Aklb 5 6.avEL i Parent Material (geologic) 77�...�nL................. .... Depth to Bedrock: Death to Groundwater: Standing Water in the Hole: Nv.tjtc Weeping from Pit Face: d"o46 Estimated Seasonal High Ground Water: .. 3L FORM 1i - SOIL EVALUATOR FORM Page 2 On-site Review v�- z g-zZ- q� i ,as ;4 ?5 Deep Hole Number ................... Date:................... Time:................ Weather ............ ...:.........:......... ..... Location (identify on site plan) ............s..L�......F�-A!J ........................................................... ..................................................................... Land Use ......... ........................... Slope (%) .. .......... Surface Stones ............................................... ..................................... Vegetation .............. .................................................................:.. ....................... .. .......................... ........................................... ................................... Landform ........ 1��.,.v►"..C.t..A. ...................................................................................................I.............................................. Position on landscape (sketch on the back) ............................:............................................................................................................................ Distances from: Open Water Body>!......�9 feet Drainage way.7...... feet Possible Wet Area,7.......(aa feet Property Line 7......Z-!�7 feet Drinking Water Well 7.......1P-9 feet Other ......................................... DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) (Munsell) (Structure,Stones,Boulders, Consistency, %Gravel) 62T Q v 7S t V. 31 LES YAJ 5AA GZaPeu Parent Material (geologic) ..............+..�...�-1--........................................................................... Depth to Bedrock: ........... Denth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: Lc Estimated Seasonal High Ground Water: ..3. '.. FORM 11 - SOEL EVALUATOR FORM Page 3 Determination for Seasonal Fligh Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from id of observation hole................... inches • See qq T . Z- Depth Depth to soil mottles 2..'`... inches ❑ 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? S If not, what is the depth of naturally occurring pervious material? Certification I certify that on 5 (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. Signature -. Date FORh1 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS Nc wr}L A4AVoV47 , Massachusetts Percolation Test Date: ...2; Z 17 Time: .....k..�..�.ae........ Observation Hole # ` 2— Depth of Perc I . .A% Start Pre-soak End Pre-soak 30 Time at 12" . Z I � Time at 9" Time at 6" Time (9„-6") Rate Min./Inch Site Passed Site Failed ❑ ............................................................................................................................................................... Performed :B �� �L Y Witnessed By: W �, Comments: ...................................................... ................................................... ................................................................................................ ........... DATE: a � � ; LOCATION: �- ENGINEER: / t/l BOH WITNESS: PERCOLATION EST# f TIME "SOK: / �r - (At least 15 minutes long) TIME AT 12" r` l 1,3 0 TIME AT 9" l t 3 -Is TIME AT 6" i OVERNIGHT SOAK TIME STARTED NEXT DAY SOAK: (At least 15 minutes) TIME AT 12" w TIME AT 9" TIME AT 6" .,I DATE: LOCATION: ENGINEER: BOH WITNESS: t� � t PERCOLATION TEST # TIME OF SOAK: % Q (At least 15 minutes long) TIME AT 12" TIME AT 9" t. TIME AT 6" OVERNIGHT SOAK TIME STARTED NEXT DAY SOAK: (At least 15 minutes) TIME AT 12" TIME AT 9" TIME AT 6" I Town of North Andover a NORTH OFFICE OFor°�'"`� °•e�°o� COMMUNITY DEVELOPMENT AND SERVICES A 30 School Street North Andover,Massachusetts 01845 "°••.�°.�''`qh WILLIAM J. SCOTT �SSAcNuSk� Director October 28 , 1997 Daniel Koraovs, P.E. 25 Teloian Dr. Hudson, NH 03051 Re: 226 Salem St. Dear Mr. Koraovs : This is to inform you that the proposed plans for the site referenced above have been approved. .If you have any questions, please do not hesi- tate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S . , Health Administratfor SS/cJP CONSERVATION-(978)688 9530 • HEALTH-(978)688-9540 • PLANNING-(978)688-9535 *BUILDINGOFFICE-(978)688-9545 *ZONING BOARD OF APPEALS-(978)688-9541 • *146 MAIN STREET } { •6 a M1 �s 1 �: 111111 1 1 11 11 111111111 _ - , ', Ills111 11 11 11 11 1 11111/11 11111 111111 111 1 11 1 1111 111 11111 111111 1111 1 11 i 1111 111 { 1111 11 I - 1111111111111111 1111 1 � . 1111 11 111 11 1111 IIIin 1 11 1 � � 11111111111 11 11 111 _ n1111 1 1 _ 1111 n 1111 1 11 111 111 � � A ' a 1111 11 1111 1 111 { 111111 4 �- 111111111111111 111 11 ni 111111 � s A �,� = IIIIn111111111 1 111 In11111 1 � � � , t � 1111 It 111111111 11111 . - 1 11 111 1111111 111 111 � ? - t w � 1111111 11 1 1 1 1 111111 :. ,, 11111 1 11 1 Im111 _ n 11 111 1111 11 1 1111 - 11 1111111111 1 111 A ! 11 11111 1111 1 III 111 i 1 _ . = � 11 1111 111 11 1 1 1 1 i 1111 � t 11 111 1 1 ,� E _ F a SE PLAT � d � / / to 41 � 4 '•i{ t4 DTZ 7 �, 'S)i y' IBJ.{L K• Q \��� ee Z i L C7 F— .t.," i a W � W � N ?a i u e CO \ 4 4 \ b f � ' SCALE- 100 ET I INCH f EE E Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH ,,ED l ////�/�)�'/j 0 �//J�Z7 �•rOL 19_ P • S 7 Qt fr j Ali ZD 0y APPLICATION FOR SITE TESTING/INSPECTION ��SSACHUSE��y Applicant AX—)G6 ✓/+1/A�/J6U NAME ADDRESS TELEPHONE ' Site Location Engineer NAME ADDRESS TELEPHONE Test/I nspection Date and Time q z i l CHAIRMAN,BOARD OF HEALTH- Fee EAL -Fee �76 Test No. C60 � S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form N0. 1 NORTH I' BOARD OF HEALTH �O��TLED ib�•y 01✓V • 19 T 1� L APPLICATION FOR SITE TESTING/INSPECTION ADAA TED P? �h ' ��SSACHUSE� i Applicant -4x6 NAME -ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time ..� CHAIRMAN,BOARD OF HEALTH Fee 's Test No. c' c-5 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. pO1T1r pt , w •,y0 BOARD OF HEALTH L # s # i a .....• 146 MAIN STREET TEL. 688-9 540 •" t5 ,SS,CNUSE� NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: 9 LOCATION OF SOIL TESTS: 'zZ6, 5'Qf-_ 4 .5T Assessor's map & parcel number: 37 D 1 OWNER: 10MY W7' TEL. NO.: (9Z 9Q12� ADDRESS: ENGINEER:Aw &'e-0 ✓oS TEL. NO.: t1eQ9 CERTIFIED SOIL EVALUATOR: Intended use of land: residential subdivision, single family home, commercial JA.16 zOL 1116114 THE FOLLOWING MUST BE INCLUDED WITH THIS FORM. 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of$175.00 per lot for new construction. This covers the two deep holes and two percolation tests required for each lot. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. 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). 7. Within 60 days of testing soil evaluation forms shall be submitted. ...__....._..._.�.---------•------------ __.�._...._ ..._..... . . pit _—_.___—.------- —r 7V rl7 G� U f �1 .� �1C1c7-'I ,lir Y ---- �- . a 1504 Date.... .. ....ff�............ t �10RT1� Obtt�w�a,ti0 p TOWN of NORTH ANDOVER �1SSACIIU NO.OF ' j 7 7/- �� , /� COPIES AMOUNT �x _�Com''CL /`✓'r_S.Q t/ Zoning By-Laws $ Zoning Maps $ Subdivision Rules and Regulations $ Copy Machine $ v .TOTAL $ By: PLANNING BOARD s