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Miscellaneous - 240 FARNUM STREET 4/30/2018
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LLco O N N ZN Q U)M J M G L -� M ; North Andover Board of Assnrs Public Access 0 Page 1 of 1 Parcel ID: 210/107.A-0100-0000.0 SKETCH Click on Sketch to Enlarge Community: North Andover PHOTO Nu toicture Available Location: 240 FARNUM STREET Owner Name: GULEZIAN, ROBERT P Owner Address: 240 FARNUM STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 - 5 Land Area: 1.05 acres Use Code: 101- SNGL-FAM-RES Total Finished Area: 2474 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 427,800 409,600 Building Value: 259,000 248,600 Land Value. 168,800 161,000 Market Land Value: 168,800 Chapter Land Value: LATESTSALE Sale Price: 0 Sale Date: 12/31/1969 Arms Length Sale Code: N -NO -OTHER Grantor: Cert Doc: Book: 01163 Page: 0410 http://csc-ma.us/NandoverPubAcc/jsp/Home jsp?Page=3&Linkld=468141 7/1/2005 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, July 10, 2009 10:59 AM To: 'Igallahue@hotmail.com' Subject: Septic Information - 240 Farnum Street - from Health Department Attachments: I. R. - Septic - 240 Farnum Street - COC; I. R. - Septic - 240 Farnum Street - Septic As Built Plan; image001.gif; image002.gif Here is the information that you requested for 240 Farnum Street, North Andover. Reference: 978.208.0793 Pamela DelleChiaie 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 - Website DelleChiaie, Pamela Subject: I.R. - Septic Information - 240 Farnum Street - from Health Department Start Date: Thursday, July 09, 2009 Due Date: Friday, July 10, 2009 Status: Completed Percent Complete: 100% Date Completed: Friday, July 10, 2009 Total Work: 0 hours Actual Work: 0 hours Owner: DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, July 10, 2009 10:59 AM To: 'Igallahue@hotmail.com' Subject: Septic Information - 240 Farnum Street - from Health Department Attachments: I.R. - Septic - 240 Farnum Street - COC; I.R. - Septic - 240 Farnum Street - Septic As Built Plan Here is the information that you requested for 240 Farnum Street, North Andover. Reference: 978.208.0793 Pamela DelleChiaie Pamela DelleChiaie 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 1 978.688.8476 - Fax pdellechiaie(aD-townofnorthandover.com - E-mail http://www.townofnorthandover.com - Website cid: image001.png(a)_01 C9A6EB.C8D13910 ieptic Information - 240 Farnu... 0 Town of North Andover 0 Office of the Health Department Community Development and Services Division 400 OSGOOD STREET North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/RS Public Health Director 978.688.9540 - Phone 978.688.8476 - Fax CWqWq7IGA2E OAF COJK�'GIANCE As o£ December 15, 2005 �Thiis is to cert that the individual subsurface disposal system was a Fully Repaired by James Kellett At: 240 Farnum Street North Andover, JKA 01845 Yfas been installeddin accordance with the provisions of Titre v of the State Sanitary Code and with the worth Andover (Board of ifealth regulations. 7lie Issuance of this certiftate shall not 6e construed as a guarantee that the system will function satisfactorily. (Public Ifealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER of MORTM Office of QMMUNITY DEVELOPMENT AND ERVICES HEALTH DEPARTMENT 400 OSGOOD STREET t NORTH ANDOVER, MASSACHUSETTS 01845 'SS�cNuget 978.688.9540 — Phone Susan Y. Sawyer, REHS/RS 978.688.8476 — FAX Public Health Director E-MAIL: healthdept@townofnorthandover.com WEBSITE: hqp://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (/constructed; j ) refWQPIVED by /l ffM/\ ff //e (Print Name) located at /' n tA, (Installation Address) J t— DEC 12 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT was installed in conformance with the North Andover Board of Health approved plan, originally dated X �n c 26 2"`'' and last Revised on -7 /t T165 , with a design flow of Lf q0 gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bed inspection date: 10 9 -7 1 0 5 Final inspection date: 1612-0 D Installer: And - Print Name And - Print Engineer Rffresentative (Signature) Gee �aILb And - Prihf Name Engineer resentative (Signature) G� �a And - Prig arae (Signature) Date: 12 .S OF, C►eyron A,'� r 30864 PO CIVIL Q Date: 2- UN C c A* E-4 w �+ �+ v1 j1 o Z Q Q= `` CE C:) CE NZ Z p Q o mo 00 N Lil E- o b Nptj II W J a 0 zY Q ^ U o o w o- IQI II II `� �� ao -t-, . 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Z/1 0 0 AS -BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS 1. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF F'DN ELEVATION Vim DEC 12 2005 TOWN OF NORTH .ANDOVER. HEA,I TH DFP1,RT'. n:NT LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D -BOX ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW LOCATION & ELEVATIONS OF BENCHMARK USED 240 Farnum Street 0 Page 1 of 2 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, November 23, 2005 10:17 AM To: 'info@millriverconsulting.com' Subject: RE: 240 Farnum Street Hi, Can you please send the Final Construction report on this? Thanks. -----Original Message ----- From: Dan Ottenheimer [mai Ito: info@ miIIriverconsulting.com] Sent: Thursday, October 20, 2005 2:52 PM To: DelleChiaie, Pamela; 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' \ Cc: Sawyer, Susan; Grant, Michele 1 Subject: RE: 240 Farnum Street All set for Friday at 8:30 Dan I Daniel Ottenheimer, President Mill River Consulting, Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www rnillriverconsulting.com dano@millriverconsulting.com From: DelleChiaie, Pamela [mai Ito: pdellechiaie@townofnorthandover.com] Sent: Thursday, October 20, 2005 8:57 AM To: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail); McBrearty Andrew (E-mail) Cc: Sawyer, Susan; Grant, Michele Subject: 240 Farnum Street Importance: High Hi, This one is all set for a final per Greg Saab and Jim Kellet. One note - the retaining wall is not in yet, as it needs to be put in after Jim backfills. Please call Jim at 781.953.7146 to schedule. Thanks! Susan & Michele - FYI 86sf Ragatds, P44y¢44 A9000040,01a1¢ Health Department Assistant 11/23/2005 E0 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, November 09, 2005 2:44 PM To: Sawyer, Susan; Grant, Michele Subject: Final Grade Inspection Requests x Jim Kellett called to state that the following are ready for Final Grade Inspections: 1240 Farnum (call to setup a time to get into see the pump -- could not get inside at Final Constr. Insp). 497 Foster Street 50 Sherwood Please let me know when I can schedule. Thanks. 1910slR1004rds, PuyyaBw BOAZOG001141.0 Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com Tracking: Recipient Read Sawyer, Susan Read: 11/10/2005 9:44 AM Grant, Michele Read: 11/9/2005 2:51 PM O O TOWN OF NORTH ANDOVER cE Na*H ti Office of COMMUNITY DEVELOPMENT AND SERVICES �r •` '`'• °°p HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss';CHU Susan Y. Sawyer, RENS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX ADDRESS: 240 Farnum St. INSTALLER: Kellett Excavating DESIGNER: Engineering & Surveying Services PLAN DATE: 6/20/05 (Rev 7/29/05) BOH APPROVAL DATE ON PLAN: 8/8/05 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS MAP: 107A 10/20/05 LOT: 100 0 Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Could not access basement to verify plumbing — to be done at final grade (10/20/05). SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged 0 1500 gallon combo tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) 0 Inlet tee installed, centered under access port 0 Outlet tee (gas baffle) installed, centered under access port 0 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present 0 Hydraulic cement around inlet & outlet Comments: Inlet tee to be relocated under access port per Mill River request. Talked to installer, and he said town requested straight line to tank (10/20/05). Page 1 of 3 0 0 TOWN OF NORTH ANDOVER a Office of COMMUNITY DEVELOPMENT AND SERVICES �r •'y� °°p HEALTH DEPARTMENT 400 OSGOOD STREET ► •, ._�;,:., s x NORTH ANDOVER, MASSACHUSETTS 01845 ��SSgC US Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged 0 1000 gallon tank installed H-10 Monolithic 0 Inlet tee installed, centered under access port 0 Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working O Drain hole in pressure line 0 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved (Visual testing 0 Hydraulic cement around inlet & outlet Comments: No power to pumps — could not verify float operation or drainback. To be done at final grade inspection (10/20/05). D -BOX 0 Installed on stable stone base 0 Inlet tee (if pumped or >0.08'/foot) 0 Hydraulic cement around inlet & outlets 0 Observed even distribution Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan 0 Size of SAS excavated as per plan 0 Title 5 sand installed, if specified on plan 0 laterals installed and ends connected to header (and vented if impervious material above) 0 Gravelless disposal systems: type, number and location as per plan 0 Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Final cover as per plan Comments: Page 2 of 3 0 0 TOWN OF NORTH ANDOVER OE MORTa , Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss' C U t� Susan Y. Sawyer, REHS/RS 978.688.9540 - Phone Public Health Director 978.688.9542 - FAX CONTROL PANEL 0/ Alarm &Pump are on separate circuits ® Alarm sounds when float is tripped Location of control panel: Basement ❑ Rated for exterior if placed outside Comments: Could not access Basement - Verifyfinal gr de inspection (10/20/05). t)a " C�e SETBACK DISTANCES Tank SAS Sewer ❑ Property line 10 10 -- 0 Cellar wall 10 20 -- SYSTEM ELEVATIONS Benchmark: 80.00 Rod at Benchmark: 8.14 Height of Instrument: 88.14 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 77.20 76.37 Septic Tank IN 77.00 76.24 Septic Tank OUT 76.75 75.90 Pump Chamber IN 76.70 75.88 Pump Chamber OUT 76.45 76.23 Distribution Box IN 85.77 85.77 Distribution Box OUT 85.60 85.63 Lateral 1 HIGH 86.00 85.97 Lateral 1 LOW 86.00 85.98 Lateral 2 HIGH 86.00 85.96 Lateral 2 LOW 86.00 85.97 Lateral 3 HIGH 86.00 85.96 Lateral 3 LOW 86.00 85.97 Lateral 4 HIGH 86.00 85.97 Lateral 4 LOW 86.00 85.97 Page 3 of 3 N DelleChiaie, Pamela From: amcbrearty@verizon.net Sent: Monday, October 24, 2005 9:44 AM To: Sawyer, Susan; DelleChiaie, Pamela Cc: Grant, Michele; lisal@millriverconsulting.com; info@millriverconsulting.com Subject: Construction inspections Hi All, Here are two inspection reports from last week. Gave OK to backfill both, but issues remain to check at final: Lot 3 Gray: Barrier to be installed, Check hydraulic cement at d -box and septic tank pipes, and verify riser on tank (within 6" of final grade) 240 Farnum: No power to pumps. Need to check floats, and wiring, and all flow to single sewer with basement access. thanks, -andy 1 PW1�3 240 Farnum St LoU Gray St Const Const Insp..doc Insp.doc Hi All, Here are two inspection reports from last week. Gave OK to backfill both, but issues remain to check at final: Lot 3 Gray: Barrier to be installed, Check hydraulic cement at d -box and septic tank pipes, and verify riser on tank (within 6" of final grade) 240 Farnum: No power to pumps. Need to check floats, and wiring, and all flow to single sewer with basement access. thanks, -andy 1 DelleChiaie, Pamela From: Grant, Michele Sent: Wednesday, November 09, 2005 3:43 PM To: DelleChiaie, Pamela Subject: RE: Final Grade Inspection Requests Hi Pam, I'm waiting to hear back from Jim Kellet rega -ding 240 Farnum treet. I've asked him to set something up for Monday with the homeowner so as I can view the Electric ox as well as the alarm. I'm going to try and make it out to 497 Foster Street and 50 Sherwood Street tomorrow. Thanks Michele -----Original Message ----- From: DelleChiaie, Pamela Sent: Wednesday, November 09, 2005 2:44 PM To: Sawyer, Susan; Grant, Michele Subject: Final Grade Inspection Requests Jim Kellett called to state that the following are ready for Final Grade Inspections: 240 Farnum (call to setup a time to get into see the pump -- could not get inside at Final Constr. Insp). 497 Foster Street 50 Sherwood Please let me know when I can schedule. Thanks. Aft/Ragaads, Payy¢Ba ZPAM001#1410 Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com EO DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, November 09, 2005 2:44 PM To: Sawyer, Susan; Grant, Michele Subject: Final Grade Inspection Requests Lel Jim Kellett called to state that the following are ready for Final Grade Inspections: 240 Farnum (call to setup a time to get into see the pump -- could not get inside at Final Constr. Insp). 497 Foster Street 50 Sherwood Please let me know when I can schedule. Thanks. Aosf Rapwads, Pwft.0010 D.044067,914 0 Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 240 Farnum Street O Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer [info@millriverconsulting.com] Sent: Thursday, October 20, 2005 2:52 PM To: DelleChiaie, Pamela; 'Lisa LeVasseur (E mail)'; 'McBrearty Andrew (E-mail)' Cc: Sawyer, Susan; Grant, Michele Subject: RE: 240 Farnum Street All set for Friday at 8:30 Dan F1 Daniel Ottenheimer, President Mill River Consulting, Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www. millriverconsulting.com dano@millriverconsulting.com From: DelleChiaie, Pamela[mailto:pdellechiaie@townofnorthandover.com] Sent: Thursday, October 20, 2005 8:57 AM To: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail); McBrearty Andrew (E-mail) Cc: Sawyer, Susan; Grant, Michele Subject: 240 Farnum Street Importance: High Hi, This one is all set for a final per Greg Saab and Jim Kellet. One note - the retaining wall is not in yet, as it needs to be put in after Jim backfills. Please call Jim at 781.953.7146 to schedule. Thanks! Susan & Michele - FYI 80sf R¢gAads, PwAy¢Bw Da10.010014ia/¢ Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 10/20/2005 It O TOWN OF NORTH ANDOVER Q , pORTh Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'SS Sty Susan Y. Sawyer, RENS/RS Public Health Director �cHu 978.688.9540 — Phone 978.688.9542 — FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS:Z r'l-4,1 MAPJ014OT: /V Z) INSTALLER: DESIGNER: PLAN DATE: / - ck>s BOH APPROVAL DA ON PLAN: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1Po I LOADING OF. SEPTIC TANK = GALLON PUMP CHAMBER = /tsc?ra LOADING OF PUMP CHAMBER = TYPE OF SAS = � I -r-- DIMENSIONS AND DETAILS OF SAS: SITE CONDITIONS Comments: ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Page 1 of 4 O TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 C U <� Susan Y. Sawyer. REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ /5917gallo kc has been installed (H-10 0 (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: Page 2 of 4 O TOWN OF NORTH ANDOVER Q NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845U5 C <� SACH4 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX D -BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to oil layer as Ga,.^..H,� e^ o j,V--1 A000Lw /provided on plan . X ize of SAS excavated as per plan iTitle 5 sand installed, if specified on plan 43-----3/4-1 Y2" double washed stone installed `8— :1/2" (peastone) double washed stone installed -0—ta�erals installed and ends connected to header (and vented if impervious material above) $--@rifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan . Zs y�tzf- le.,.y ❑ 40 Mit HDPE barrier installed ev / ❑ Retaining wall (boulder / concrete / timber/ block) El cover as per plan Comments: PRESSURE DISTRIBUTION Comments: inch manifold laterals installed with end sweeps size: material: Squirt test ft in height Equal distribution to all laterals orifice size inch as per plan Page 3 of 4 O TOWN OF NORTH ANDOVER O t NORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES 3?°'� ��� HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845°"�<� S^GNUS Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX CONTROLPANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: 11 Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV @ TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D -Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral.3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 f "0"'" , Commonwealth of Massachusetts Map -Block -Lot 107.A- 0100 - Board of Health "" Permit No BHP -2005-0295 North Andover --------------_------- b �� t .. z ., P.I. FEE ?$3 CHU F.I. $250.00 ----------------------- Disposal Works Construction Permit Permission is hereby granted JAMES KELLETT --------------------------------------------------------------------------------------------------- to (Repair) an Individual Sewage Disposal System. at No 240 FARNUM STREET ---------------------------------------------------------------------------------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP -2005-029D t Eer 11, 2005 ID -T -------------------- Issued On: Oct -11-2005 Board of Health .............................................................................................................................................................................. . 0.4 , o'".+ Commonwealth of Massachusetts Map -Block -Lot o p� • 107.A- 0100 - Board of Health North Andover sA IStt Certificate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System by JAMES KELLETT at No 240 FARNUM S�theprovisions ------------------------------------------------------------------------------------------------------------------------ has been installed in accorda of TITLE 5 of the State EnvironmentalCode as described in the application for Dispo orks Construction Permit No. BHP -20057029 Dated October 11 2005 ------------------------------------------------------------ Printed ov-23-2005 Board of Health --------------------------------------------------- �' Commonwealth of Massachusetts 07.--°c 0100 00 1 - y `• °0 107.A- - *� Board of Health Permit No North Andover BHP -2005-0295 ----------------------- ,° FEE SSS CMU stt $250.00 ----------------------- Disposal Works Construction Permit Permission is hereby granted JAMES KELLETT ----------------------------------------------------------------------------------------------------- to (Repair) an Individual Sewage Disposal System. at No - 240 - - -FA----- - RNUSTREET ----------------M -------------------------------------------------------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP -2005-029 Dated October 11, 2005 --------- 'E ------------- ------------------Bo - -lf - - - Issued On: Oct -11-2005 `! Insurance Adjustment Service, nc. 435 King Street Second Floor Littleton, MA 01460 (978) 952-6966 Fax (978) 952-2459 UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 38 Town of N. Andover TO: Building Inspector/Board of Health N: Andover; MA 01845 RE: Insured: Robert Gulezian Property Address: Date of Loss: Policy Number: Type of Loss: File or Claim Number: Date: 3/13/03 240 Farnum St. North Andover, MA 01845 2/7/03 HO00024619 ice backup - water damage 5387 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct that information to my attention and include a reference to the captioned insured, location; date of lass and claim or file number, Thank you for your cooperation. Very Scott O'Neil Adjuster Ext. 129 J J APPLICATION FOR SEWAGE DISPOSAL INSTALLATION �I HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot # 6 Barnum St I will install this system in ac- cordance with all the laws of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre- ceding the septic tank, where the grade shall not exceed 2%. i will install a con- crete septic tank of 1000 gal in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 200 lineal (square) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 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 trench, 2 inches of gravel or stone 1/8" to 1/4" (dia.) will 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 case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree not to cover any portion of this installation until approved by inspection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application. 2 feet gravel to be installed DATE 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 I have inspected the uncovered system indicated above and find everything done as described. �r DATE �/1 eq,'. Signature of I s cting Officer Percolation Test 5 Min Soil: Gravel & Clay Garbage Grinder V -i BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. IN h 1. NAME DATE 2. ADDRESS-;�,ei(, -" S�` LOT NO. L TEL. 3. NO. OF BEDROOMS " Y DEN YES F-' NO 4. GARBAGE GRINDER YES NO /-- 5. 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE 16 O G `�� NAME OF APPLICANTL , 1110 -fl LOCATION Address of lot no, BUILDING: Dwelling tv, Other SYSTEM: New DC Repair r GENERAL DESCRIPTION OF LAND SUBSOIL: Clay � ave1 Sand PERCOLATION TEST minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK- 1±2& gallon capacity. LEACH FIELD /D lineal feet of drain pipes c , P�, -'. - . jj illiam , Dris oll, Engineer Board of Healt QTOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT'AND SERVICES or •`4a HT.ALTH DEPARTMENT 400 OSGOOD STREET '' ° -y,-•fir' NORTH ANDOVER, MASSACHUSETTS 01845 'SswCHU Susan Y. Sawyer, RENS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX July 21, 2005 Clayton Morin, PE Engineering & Surveying Services 70 Bailey Court Haverhill, MA 01832 RE: 240 Farnum Street, North Andover, MA, Map 107A, Parcel 100 Dear Mr. Morin, The proposed septic system design plans for the above site dated June 20, 2005 and received on June 28, 2005 has been reviewed. Unfortunately, the plans cannot be approved as submitted. The following items are in need of attention prior to approval, with the section of Title 5 (3 10 CMR 15.000) noted: 1. Please provide the correct name of the approving authority on the plan. The witness was Andrew McBrearty, and not Daniel Ottenheimer — 220(4)(h). 2. Please provide a statement, if true, that there are no public wells within 400', and no private wells within 100' of the facility. — 220(4)(k) 3. Please provide the setback distances from the waterline to the tanks and soil absorptions system. — 211 & N.A 5.02 4. Please provide a statement on the plan that building sewer is to be laid on continuous grade in a straight line. — 222(7) 5. Please provide an explicit note on the plan stating the minimum (9") and maximum (36") cover over tanks and distribution box. 228(1) & 221(7) 6. Please provide the stone size for stone placed under tanks and d -box. 221(2) & 228(1) 7. The pump chamber detail states that a brick riser is to be used. Is this valid? 8. Please specify the loading. (H -l0 or.H-20) for the pump chamber. — 226(3) 9. Please provide the elevation for the percolation test. — NA8.02n 10. Field notes show a catch basin near the property. Please locate this on the plan, and demonstrate that proper offsets have been achieved. 11. The design includes a Local Upgrade Approval request to reduce the separation from the bottom of the soil absorption system to the estimated seasonal high ground water from the required 4' to 3'. Several sections of Title 5 do not allow this request to be granted including 310 CMR 15.401 and 404(1) which indicates that whenever feasible a design should maintain full compliance with the standards in the •� regulations. Vi—rfile the concern stated in the Local Upg�,,,,.e Approval application regarding cost and height of the soil absorption system has legitimacy, it cannot displace the regulatory requirement to maintain full compliance with the code whenever feasible. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Su an Y. Sawyer, REHS/RS Public Health Director cc: Homeowner File LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax healthdept a,townofnorthandover.com - E-mail www.townofnorthandover.com - Website I/ Page ,/ of ur' OR NTIy O� �t Bilift s s_ - IL 3 TO: DATE: COMPANY: V , FROM: Pamela Delle hiaie, Health Dept. Assistant Phone: Fax: SIGNED: We are sending you: 170py of Letter flans /7 Other (rill in below) Thes retransmitted as checked below: ' pproved as Noted OAs Requested OAs Required OResubmit copies for approval OFor approval OFor Review and comment OFor; Your Use OSubmit copies for dist. REMARKS: COPY TO: COPY TO: SIGNED: COPY TO: Q DATE TIME ACTIVITY REPORT DURATION PAGE(S) TIME 08/09/2005 12:03 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 NO. DATE TIME FAX NO./NAME DURATION PAGE(S) RESULT COMMENT 0020 07/25 15:21 89789753925 40 01 OK TX ECM #022 07/25 15:24 819786851099 52 03 OK TX ECM #023 07/26 12:35 819784096122 24 02 OK TX ECM 07/26 13:09 9786238359 16 01 OK RX ECM 07/26 15:18 9783276563 25 02 OK RX ECM #025 07/26 16:20 89786851099 42 02 OK TX ECM #024 07/26 16:25 89786861768 00 00 BUSY TX 07/27 12:43 15 01 OK RX ECM 07/27 14:12 57 02 OK RX ECM 07/27 15:13 9786850249 12 01 OK RX ECM 07/27 15:16 617 252 6899 02:17 05 OK RX #026 07/28 13:03 819789880038 08:07 21 OK TX ECM 07/29 09:48 9783276563 26 02 OK RX ECM #029 07/29 12:17 819784091269 48 03 OK TX 07/29 15:03 781 383 0108 35 01 OK RX ECM #030 07/29 16:35 89786851099 01:06 03 OK TX ECM 08/01 08:43 19 01 OK RX ECM #032 08101 10:37 816177901392 01:31 08 OK TX ECM #033 08/01 10:39 816177901392 45 04 OK TX ECM #034 08/01 10:47 819788873480 03:17 11 OK TX ECM #035 08/01 11:24 89785210386 02:43 05 OK 'TX 08/01 15:13 38 06 OK RX ECM 08/02 09:03 22 01 OK RX ECM 08/02 10:31 9786238359 13 01 OK RX ECM #036 08/02 16:31 89786851099 57 03 OK TX ECM 08/03 09:04 9786238359 17 02 OK RX ECM #037 08/03 11:02 89784759231 15 01 OK TX ECM #038 08/03 11:03 89784759231 24 02 OK TX ECM #039 08/03 11:27 816172364339 01:30 07 OK TX ECM #040 08/03 11:47 817815813594 53 02 OK TX ECM #042 08/03 11:49 816173109815 01:11 03 OK TX ECM 4043 08/03 11:52 816173109815 01:36 04 OK TX ECM #044 08/03 13:09 816173109815 01:49 04 OK TX ECM #045 08/03 13:12 816172364339 01:04 04 OK TX ECM #046 08/03 13:19 89786836595 22 01 OK TX ECM 08/03 15:07 9786889594 15 01 OK RX ECM #047 08/03 16:03 819784668817 01:13 04 OK TX ECM #048 08/04 10:26 819786825669 07:20 18 OK TX ECM 08/04 13:03 24 02 OK RX ECM 08/04 14:42 19787748715 01:34 05 OK RX ECM 08/04 15:02 19787748715 01:37 05 OK RX ECM #049 08/04 15:05 817817746700 20 01 OK TX ECM 08/04 15:24 19787748715 01:26 04 OK RX ECM 08/04 15:44 978 922 6922 01:25 04 OK RX ECM 08/05 18:19 877 546 0517 21 01 OK RX ECM 08/08 15:05 978 557 8633 01:08 03 OK RX ECM 08/09 09:02 9786238359 14 01 OK RX ECM #050 08/09 10:01 89786886644 04:03 07 OK TX ECM #051 08/09 10:44 814139679646 02:33 04 OK TX ECM #052 08/09 12:00 89785560284 ✓ 02:26 05 OK TX BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION•/ OUT OF MEMORY CV COVERPAGE POL POLLING RET RETRIEVAL PC PC -FAX OTOWN OF NORTH ANDOVER () c� NoerM Office of COMMUNITY DEVELOPMENT AND SERVICES o? •'A' `�6hO�. HEALTH DEPARTMENT 400 OSGOOD STREET " "� -`� NORTH ANDOVER, MASSACHUSETTS 01845 CS Susan Y. Swyer 978.6889540 — Phone Public Health Director 978.688.9542 — FAX August 8, 2005 Robert Gulezian 240 Farnum Street North Andover, MA 01845 Re: 240 Farnum Street Septic Repair Dear Homeowners, The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property, submitted on your behalf by Engineering & Surveying Services, Inc. dated June 29, 2005, last revision date July 21, 2005. The 4 -bedroom (9 -room maximum) design has been approved for use in the construction of a replacement onsite septic system The following upgrade was approved regarding the proposed septic system 1) A reduction of 25% in subsurface disposal area design requirement This approval generally is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. This approval is subject to the following conditions: 1. The attached DEP Form 9b must be submitted by the homeowner to the appropriate Regional Office of the Department of Environmental Protection; North East Division of DEP, One Winter Street, Boston MA by 02108. , 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Constriction Permit (3 10 CMR 15.020(1)). 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a propepy-functioning septic system for your dwelling is Qatly appreciated. The Health Department may be reached at 978.688-9540 with any questions you might have. S7Y.5 Sawyer,ltEHS/RS f` Public Health Director cc: Engineering & Surveying Services List of N. Andover licensed installers Form 9b 5 knportwit When MM out loin on the computer, use ordy the tab key to move your cursor - do not use the return key. Idl ISI Commonwealth Massachusetts Cityffown of Local Upgrade Approval Form 9B DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information 1. Facility Name and Address Robert Gulezian Name 240 Famum Street Street Address North Andover MA 01845 Citylrown State Zap Code 2. Owner Name and Address (if different from above): Name Cftylrown Zip Code 3. Type of Facility (check all that apply): Street Address Telephone Number X Residential ❑ institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 Wd 5. System Designer. N�yton Morin X PE ❑ RS 70 Bailey Ct Haverhill MA 01832 Address C4fTown State, ZIP B. Approval 1. Local Upgrade Approval is granted for: Reduction in setback(s) — specify: ❑ Reduction in SAS area of up to 25%: 240 Famum Street 96.doc • rev. 5102 590 25 SAS size, sq. ft. % reduction Local Upgrade Approval* Page 1 of 2 r Commonwealths Massachusetts Town of North Andover Local Upgrade Approval Form 9B B. Approval (continued) m ❑ Reduction in separation between the SAS and high groundwater: Separation reduction Percolation rate ft. minfinch Depth to groundwater ft ❑ Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: N. Andover Health Department Approving Authority Susan Sawyer, Health Director ugust 8, 2005 Print or Type Name and Title S' nature Date 240 Famum Street 98.doc • rev. 5102 Local Upgrade Approval* Page 2 of 2 C PAGE 1 OF 5 RECEIVED Commonwealth of Massachusetts North 'A''31501) '�llassachusetts JUN 2005 TOWN OF NORTH ANDOVER Application for Local Up agr de Appro HEALTH DEPARTMENT Title 5, 310 CMR 15.000 DEP Approved form required by 310 CMR 15.403(1) To be submitted to Local Approving Authority/Board of Health: For the upgrade of a failed or nonconforming system with a design flow of < 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. To be submitted to DEP: For the upgrade of a failed or nonconforming system with a design flow of 10,000 up to 15,000 gpd and/or for upgrade of a state or federal facility, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of new design flow to a cesspool or privy or the addition of new design flow above the existing approved capacity of a system constructed in accordance with either the 1978 Code or 310 CMR 15.000. 1) Facility/system owner 2) Name `�- (- _5- u 1 4?� Z I Address a L4 0 %.'- n Phone # C1-')' 6 (e 13 P-> I 1 Address of facility a Lf C> —:E A-2. /1,J Ll -,Ph Applicant (if different from above) Name Address Phone # 3) Type of facility y�residential _ commercial _ school _ institutional (Specify) DEP APPROVED FORM - 12/07/95 . Q Q PAGE 2 OF 5 4) Type of existing system / _privy cesspool(s) V Conventional system Other (describe) Type of soil uption system (trenches, chambers pits,etc.) —e F,-elcQ� 5) Design flow based on 310 CMR 15.203 a) Design flow of existing system 44q6 gpd Approved? yes approval date no why? b) Design flow of proposed upgraded systemq`fa gpd c) Design flow of facility -Y 6) Proposed upgade of existing system is Q a) r/ Voluntary Required by order, letter, etc. (attach cop Required following inspection required by 310 CMR 15.301 (provide date inspection form was submitted to the approving authority) (date) b) Describe the proposed upgrade to the system S d C7 & "$ c C.. 0 A-) S a R+ �c. -T—A - (om- A L M Q r2a IIJ a5' -T' t3 l; c) Which of the following are applicable to the proposed upgrade? Reduction of setback(s) (list setbacks to be reduced with proposed setback distances) Percolation rate of 30-60 minutes per. inch (state actual perc rate) DEP APPROVED FORM - 12/07/95 0 PAGE 3 OF 5 —J—//Up to 25% reduction in subsurface disposal area design requirements (state required & proposed size) Relocation of water supply well (identify well, describe relocation) J+ G -%.- "-- 7, W- ��u-f- 9'A-jas _ Reductio frequired separation betw bottom of SAS & hig roundwater s ecify propo d reduction & perc rate) 60 Other requirements of 310 CMR 15.000 that cannot be met (specify sections of the Code) System upgrades that cannot be performed in accordance with 310 CMR 15.404 & 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410-15.417. 7) If the proposed upgrade involves.a reduction in the required separation between the bottom of the soil absorption system and the.high groundwater elevation, an Approved Soil Evaluator must determine the high ground water elevation pursuant to 310 CMR 15.405(1)(i)(1). The evaluator must be a member or agent of the local approving authority: from soil absorption system to high groundwater 14 feet As determined by: Evaluator's name e- Evaluator's signature Date of evaluation Sig/� s S DEP APPROVED FORM - 12/07/95 8) Notice to Abutters PAGE 4 OF 5 No application for upgrade approval in which the setback from property lines or a private water supply well is reduced shall be complete until the applicant has notified all abutters whose property or well is affected by certified mail at least ten days before the Board of Health meeting at which the upgrade approval will be on the agenda. Such notice shall include the date, time and place where the upgrade approval will be discussed. If the Department is the approving authority, then such notice to abutters must be completed prior to the date of submission of the application to the Department. The notices to abutters shall include a copy of the completed application form and shall reference the standards set forth in 310 CMR 15.402 through 15.405. List of affected Abutters: Abutter Name Date notified Address Abutter Name Date notified Address Abutter Name Date notified Address Abutter Name Date notified Address 9) Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible (each section must be completed): a) an upgraded system in full compliance with 310 CMR 15.000 is not feasible: b) an alternative system approved pursuant to 310 CMR 15.283-15.288 is not feasible: Ccs5-t- ©-F a (f���,4fio e SbS-f DEP APPROVED FORM - 12/07/95 PAGE 5 OF 5 C) a shared system is not feasible: d) connection to a sewer is not feasible: 10) An application for a disposal system construction permit, including all required attachments (e.g. plans & specifications, site evaluation forms), must accompany this application. Is the DSCP application attached? s_no 11) Certification K "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for knowing violations." ty owner's signa `Oga�- & V LE- /. Al Print Name bre Name of SCL4 5 Date to 1 a 1 16,Y - Date 770-5.3",�e -a-?g y `7o CT, Telephone # & address of prepares NOTE: Title 5, 310 CMR 15.403(4), requires the system owner or operator to submit to the Department a copy of the local upgrade approval upon issuance by the Board of Health and prior to commencement of construction. DEP APPROVED FORM - 12/07/95 X DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, August 05, 2005 9:04 AM To: Sawyer, Susan Subject: 240 Farnum Street - Rev. 1 Received from Greg Saab, E&SS Hi Susan, This revision is in your box with the 25% reduction info. Here were my rough draft notes from the minutes: 240 Farnum Street - Proposal from Greg Saab of Engineering & Surveying Services to request the following: Local Upgrade Approval Required A reduction in separation distance between the ESHGW and the bottom of leach bed from 4 feet required by Title 5, Section 15.212(A) to 3 feet. This is for the groundwater table. Look at page 2 for cross section on lower part of the sheet. On a sloping site. Will see the 3 feet waiver is for the first 2.5 infiltrator units. System averages to over 4 feet to groundwater. This saves cost on wall and sandfill. It is a great improvement over what's there. Dan disagrees with offering this as an option, and recommended denying this request. Went with bed configuration. JM asked how high the walls would be. GS stated that they would be 3.5 to 4 feet with current design. Fits the site. Limited area to work with. The other side of lot there is a catch basin. Must maintain 50 feet to groundwater. (Remind Susan to bring her scale ruler.) If system was in front of house, there would be a mound. The system is failed, and coming up out of the ground. JM states that if GS asked for an LUA, could keep it on a downslope, and get. rid of two front rows. Could shorten wall up at front, and blend into slope, and save evergreen tree. The wall height on back side will remain the same, but out front, wall will taper into the ground in the street. No motion. Greg Saab will resubmit a new design. 8Bst Ao#a4s, Pw1y¢44 A10"04014410 Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 0 0 LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone I 978.688.8476 - Fax healthdentna townofnorthandover com - E-mail www.townofnorthandover.com - Website Page __L of TO: / _ DATE: go COMPANY: �? FROM: Pamela D Phone: %/ ��� . � � RE' Fax: ^o c ••« � •AM• � a«�w.wcw _ �• .eChiai , Health Dept. Assistant We are sending you:opy o Letterlans OOther in. below, These are transmitted as checked below: OApproved as Noted OAs Requested As Re uired OResubmi q t copies for approval OFor approval OFor Review and comment OFor Your Use OSubmit copies for dist. REMARKS: COPY TO: COPY O: COPY TO: \V. N SIGNED: C// ' V" 0 TRANSMISSION VERIFICATION REPORT TIME 07/25/2005 12:00 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 07125 11:58 FAX NO./NAME 89785560284 DURATION 00:01:32 PAGE(S) 03 RESULT OK MODE STANDARD o TRANSMISSION VERIFICATION REPORT TIME 07125/2005 12:21 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 07125 12:20 FAX NO./NAME 89784740478 DURATION 00:00:37 PAGE(S) 03 RESULT OK MODE STANDARD ECM GT0 OWN OF NORTH ANDOVER pf ,10RTN Office of COMMUNITY DEVELOPMENT AND SERVICES 3 <•`'° •' ti°L HEALTH DEPARTMENT 400 OSGOOD STREET• NORTH ANDOVER, MASSACHUSETTS 01845 3'SS4CHU Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX July 21, 2005 Clayton Morin, PE Engineering & Surveying Services 70 Bailey Court Haverhill, MA 01832 RE: 240 Farnum Street, North Andover, MA, Map 107A, Parcel 100 Dear Mr. Morin, The proposed septic system design plans for the above site dated June 20, 2005 and received on June 28, 2005 has been reviewed. Unfortunately, the plans cannot be approved as submitted. The following items are in need of attention prior to approval, with the section of Title 5 (3 10 CMR 15.000) noted: Please provide the correct name of the approving authority on the plan. The witness was Andrew McBrearty, and not Daniel Ottenheimer — 220(4)(h). ,,2. Please provide a statement, if true, that there are no public wells within 400', and no private wells within 100' of the facility. — 220(4)(k) Please provide the setback distances from the waterline to the tanks and soil absorptions system. — 211 & N.A. 5.02 ,,i,4. Please provide a statement on the plan that building sewer is to be laid on continuous grade in a straight line. — 222(7) �+ 5. Please provide an explicit note on the plan stating the minimum (9") and maximum (36") cover over tanks and distribution box. 228(1) & 221(7) Please provide the stone size for stone placed under tanks and d -box. 221(2) & 228(1) ,/7 The pump chamber detail states that a brick riser is to be used. Is this valid? VPlease specify the loading (H-10 or H-20) for the pump chamber. — 226(3) ,9. Please provide the elevation for the percolation test. — NA8.02n L.O. Field notes show a catch basin near the property. Please locate this on the plan, and ,: , demonstrate that proper offsets have been achieved. 11 % 4 The design includes a Local Upgrade Approval request to reduce the separation from the bottom of the soil absorption system to the estimated seasonal high ground water t from the required 4' to 3'. Several sections of Title 5 do not allow this request to be granted including 310 CMR 15.401 and 404(1) which indicates that whenever feasible a design should maintain full compliance with the standards in the regulations. While the concern stated in the Local Upgo Approval application regarding cost and height of the soil absorption system has legitimacy, it cannot displace the regulatory requirement to maintain full compliance with the code whenever feasible. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure -protection of public health and the environment of North Andover. Sin4YSgwyer, Su an REHS/RS 7 Public Health Director cc: Homeowner File W DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, July 19, 2005 3:54 PM To: 'Daniel Ottenheimer (E-mail)'; 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: Osgood Ben (E-mail) Subject: Septic Plan Follow-up Importance: High Hello all, Just want to be sure our records are up to date. My log book indicates that the following new plans were submitted for review, and I just wanted to have an estimated done date for each: 6/28/05 40 Farnum Stree E&S - 21 days 6/28/05 Paddock Lane NEES - 21 days 7/1/05 94 Boxford Street NEES - 18 days I know, I know, we have the 45 days:), but customers still get impatient..... also, our next Board meeting is on July 28th - next Thursday, and Ben was hoping to get feedback before then, as he is requesting an LUA and Local Bylaw Variance on 94 Boxford Street. Thank you for your assistance.:) 16100! Ragaodsl Paaie& A.0"Oe'4110io Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofilorthandover.com healthdept@townofnorthandover.com Town of North Andover Health Department Date: n; Location• �'�`� ���-iyI'G ~�✓ (Indicate Address, if Residential, or Name of Business) Check #: Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing -Sep Design Approval $ $��� o.. ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) �. f 829 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer Town of North Andover HEALTH DEPARTMENT. 27 Charles Street RECEIVED North Andover, NIA 01845 SEPTIC PLAN SUBMITTAL F 978.688.9540 healtladept(fownofnorthafrdovei:coni JUN 2 S 2 05 TOHEAOF NORTH LLTH DEPARTMENTER DATE OF SUBMISSION: SITE LOCATION: ;� `it> % a / n fL 'n' Jam, ENGWEER: C (a fb �'(� , ✓� NEW PLANS: YES V/ $225.00/Plan V Check #: (Includes 15'(""and one Re -Review Only) REVISED! PLANS: YES S 75.00/Plan Check #: SITE EVALUATION FORMS INCLUDED: YE.S NO LOCAL UPGRADE FORM INCLUDED: NO Telephone #: 97g " 55(? - O Zg-( Fax #: S•A /"I f - E -mail: HOMEOWNER NAME: Bc7 6 & q f e 210 P1 OFFICE USE ONLY When the submission is complete (including check): 1. Date stamp plans and tetter 2. Complete and attach Receipt 3. E/ Copy File, Forward to Consultant d. Enter on Log Sheet and Database 0 No. coCnmonwealth of RECEIVE JUN 2 8 2005 T&$Vql�04M!;SANDOVER I --1ADTfAPNT Date Certification Number: Performed By: . ........ ............................ v,ritnessed By: NEaw.craq sf%d T41- IT- Loczuon A el 0 rozz at Lot NO - -crt tcy o —vA Cl --) 8 - ec,;73-' ) 3 /-7 New Conztruction. rl Rap& aff F-utilis . hed sbil surl-cy No ED yet W5 -b 'Year Published A'�'5k Publication Sz-'lq 14 coil Map Unit Drainage Cl8Ss* Soil Limitations .. ............ ..... . .... . ........ ............... ❑ Surficial Geologic Report Available: No ii�yes Year Published Publication Scate Geologic Material (map Unit) Landform . .... ...... Flood Insurance Rate Map: Above 500 year flood boundary No❑Yes Within 500 year flood boundary No Yes ❑ Within 100 year flood boundary No U Yes ❑ Wetland Area: ........ - — ------------ . .... ........... .. ... . .. .. .... .......... . . .......... . . National Wetland Inventory Map (map unit) . .... Wetlands Conservancy Program Map map, unit) Current Water Resource Conditions (USGS): Monti Normal ❑ Normal Below Normal ❑ Range: Above Norm Other References Reviewed: . ...... . . . ..... ................. ... . ....... . ......... . ........... FORNIQ -SOIL EVALUATOR FORM Page 2 of 3 �,� . Location Address or Lot fJo. o PQ, n �, wn S rt - On -site Review Deep Hole Number ....... .. Date:. 511110,5-- / /1/a,5-- Time: U Weather -708 Location (identify on-site plan) Land Use �� ` " Slope (%o) —�O%Surface Stones ./U . Vegetation Landform Position on landscape (sketch on the back) Distances from: v feet Drainage way �� t- feet Open Water Body 1 _ Possible Wet Area rw feet Property Line feet Drinking Water Well 2-964-7 feet Other DEEP OBSERVATION HOLE LOG` Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, Gravel) -7,�Y G DepthtoBedrock: / — v Parent Material (geologic) 15&&), f �� Depth to Groundwater: Standing Water in the Hole: ! Weeping from Pit Face: Estimated Seasonal High Ground Water: killEP APPROVED FORM • 12/07/95 Location Address or Lot i4o. FORN10- SOIL EVALUATOR FORM Page 2 of 3 J-V(�> n..c M J— On-site ,review �g° J Weather �b Deep Hole Number Time: Date:...: Location (identify on site plan)- Land Use Q C 1�r� Slope (%1 %o � Surface Stones Vegetation Landform Position on landscape (sketch on the back) Distances from: �D-�- Open Water Body IbD� feet Drainage way feet t Property Line 2. feet Possible Wet Area ij ... feet P Y Drinking Water Well .664'- feet Other DEEP OBSERVATION HOLE LOG` Other Depth from Soil Horizon Soil Texture Soil Color Soil Surface (inches) (USDA) (Munsell) Mottling (Str ctur e, Stones, BoulGravders, Consistency. % f�IK_ c -7,Y�tt Parent Material (geologic) 54-V/J6 Depthto8edrock: Q f L7 Weeping from Pit Face: GJ Depth to Groundwater: Standing Water in the Hole: — Estimated Seasonal High Ground Water: DEP APPROVED FORM - 12107/95 a o - , FORM 11 - SOIL; LVALUATOR FORM Psgc 3 of 3 b rrt Location Address or Lot Na. Vete inadQU Ar Sake al h, Fater W is nye had used: ❑ Depth observed standing in observation hole inches ❑ D h weeping from side of observation hole inches epth to soil mottles inches ❑ Ground water adjustment ..... feet Index Well Number ........... _ Heading Date Index well level,., ...... . Adjuctment factor . .. ....... Adjusted ground water level .. .............. 9M A O ; �. • Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorptiop system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the soil evaluator examination approved by the a tment of Environmental Protection and that the above analysis was performed by md consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature _ Dote �• DU Arnorm FORM • 1,VGII s 4 DEP APYROYPM YOS W I_/G7M i PEPCOLATICW TESZ- Location Addrass or Lot No. ZLI b �'C-��� u ,-•-� C J COMMOMYEALTH OF MASSAC�-;USETTS J Percolation 'Test' Oate; ECbservaticrt Hole a . Cert; .e 07 ;'o...ma`------------------ Stzi-t Pre-soak p7e-sozk [End 3d Trr!e at 12' Time at °" _- , S w- /w- ktme at 6- 6 rnn k R Mirranurrr Cf--I-per=laiiori- test must be performed in both the primary ares AMID reserve area: - - - Site Passed Site Fared Ferflormed 8y: Witnessed 6y.%�I. (. %L t ✓ � � f0 i "—' /ate Comments: DEP APYROYPM YOS W I_/G7M i Mr. Greg Saab ESS 70 Bailey Court Haverhill, MA 01844 leffrev C. Orchard Envirenmental Consultant RECEIVED 2 S 2005 11111 NORTH ANDOVER Post Office Box 452 Windham, NH 03087 USA H DEPARTMENT Email JCOrchard@aol.com Certified Wetland Scientist - NH # 055 Cellular (603) 345-2530 April 5, 2005 Re: 240 Farnum St. No. Andover, MA Dear Mr. Saab, On April 1, 2005, 1 visited the above referenced property for the purpose of delineating wetlands at the rear of the lot. The wetland is dominated by Red Maple (Acer rubrum) in the overstory and is classified as a wooded swamp. I have enclosed a Massachusetts Bordering Vegetated Wetland (BVW) Field Delineation Data Form in support of my delineation, listing dominant species present. The wetland was delineated by placing pink survey tape bearing the words "Wetland Delineation" at the point where the plant community becomes dominant (greater than 50%) wetland species. I have included the bank as part of the resource area where appropriate. The flags are consecutively numbered from 1 to 9, starting near a stone wall at the rear of the property, extending up a swale to the south and back along the toe of slope directly behind the house to a fence adjoining with the property to the north. Please do not hesitate to contact me if you have questions or comments. Sincerely, 7 Jeffrey C. Orchard, CWS Environmental Consultant Understanding and interpreting our environment, a little bit at a time. M x 0 0 \ 113ornmonwealth or` ulassach rsetts D¢nart99!en of File a,led'lices ' BOARD OF FIRE PREVENTION REGULATIONS X 1'ernlit No. J Occupallcv and i'ec Checked [Rev. 111119911 leave blark) APPLICAT & FOR PERMIT TO PERFORM ELEC;TR.ICAL tAIO'RI �Ul %york to be r rformed in accordance with the Niassachuseits Eleciric21 (-',ode. ,,MEQ). 527, !f'I_EriSL P1211 T LVL'VK OR TYPE ALL 1WFOR 1,fAT ION) mate:j6 -13-0 5 City or Town of: �C�At'kjoye'r 7-0 the Inspector of bi%zres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number)�4o EA OZ;••,I 291Fifl Owner or Tenant a7� t_!a I" t„_!%2% J�11!! Telephone No. OI}ner's Address Is this permit in conjunction 'vith a building permit? gyres ❑ No (Checl. Appropriate hoz) Purpose of Building IC�//,mss Utility Authorization No. Existing Service Anips ( v'o3ts Overhead ❑ Undgrd U No. of ikleters New Service Amps f volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of'Proposed Electrical "Mork: (J� �� ��;✓4�%c. vrt. i nrnnlatinro nrtho (r.lim.rinv tnh%n mmv hn waivod hr the [nvnertnr nrfr"irzc No. of Recessed Fixtures a No. of Ceil.-Susp. (Paddle) Fans No. of Total I Transformers KVA No. of .Lighting Outlets _ No. of Hot Tubs Generators KVA No. of Lighting Fixtures g Above In_ Swimming Pool ' ❑ g grnd. grnd. _l3attery o. o mergenc}' Lighting Units of R-e-ce—ptacle Outlets `No. of Oil Burners FIRE ALARMS No. of Zones �NNoo. No. of P Switches No. of Gns Burners ^Io• of Detection and Initiating Devices htNo. of Ranges No. of Air Cond. ]Tonal No. of Alerting Devices No. of Waste Disposers Heat Punili Totals: Number "Fans KNA" No. of Self -Contained Detection/Alerting Devices �No. of Dishwashers Space/Arca IIeatim-, 3{W Municipal Local ❑ Connection ❑ Other Securitti- Systems: f No. of Devices or Equivalent i —f r, I Data Wiring: No. of Devices or Equivalent Date...... Telecommunications Wiring: ..'..`................ No. of Devices or Equivalent i ORTH °°;�.'"o TOWN OF NORTH ANDOVER -- ,tsrrd.o:esrrc:rireaitt'rielnsnectoro%Of elcctr]Cal LVc;1rk I77aV ISSUC un1��ti: tince % PERMIT FOR WIRING icrafie or its substantial eaui,''alent. itis the permit Issuing oftice- SSACMUSfct This certifies that ....... :':::9.�: t`.+::�........ � r t"' 1 .......................................................... has permission to perform ....~'. .. .'. t...-:......... +...... i::. wiring in the building of ... }..�t..�:'. ""'' at ...t.'.:g.....rr. :-'.£ `.:?`-'."..... ........................North Andover, Mass. Fee............ �....... L,ic. No.. .. ' ........ .'...:t^ :1 ;� ,.�{ . •......... ELECTRICAL INSPECTOR Check #I C 1 FxpiI•ation DitCl 81 posit:'.". C RUIC 111, anti pilon completion. ••7'fie 1117d �'— C 1181 ;1ity iiiSiiil?iiCC t o' CI -a -C nolm-'111% ow'nCr �_� ownc_i 'S PLI�,if1T I 1 : 6 YC), Commonwealth of Massach setts �r�-fit Board of Health,W r t,tta � North Andover 1 �4� 241-0295 Rte `'�x. • k _ , . r �r25© Qui r � Disposal Works ConstCUction Rerrri�f f Permission, is hereby granted - JAMES KELLETT -------- ------------------- ta (R.epair) an udividual Sewage Disposal System. , . at No 240 FARM M STREET asshown on t11e°appl`tction €or Disposal Works Construction PernutNo. BHP 2005-429 Dates F DtgWe 4 I, ZtO i -- f - Issued Qn `ibct 13 2005 == ct ; ---- ------ ----- .�.en.�n.n.fnnanent.riitq.nu��a....l4n.ununnua.............ni.un/....n.. nnu...ne..u.n¢..f rlMn1.►'' i11,.,.�1�`.w.tnn/.Y.Y��u..�.�Iq N. Commonwealth of Massachusetts: �' =1�0. -Lor 10�.A fl1 Board of Health - North Andover, Certificate of Compliance THIS IS TO CERTIFY,That the Individual Sewage Disposal System (Repair)' - by JAMES-KELLETT t a --------------------------------------------------- ----- er at No. 240 EARNUM STREET x --------------............----- M has,,been install ance with the provisions of TITLES of the,State Environmental. Code us -,des , applications Disposal Works Construction'Permit No. BHP -2005-429 Dated October x, _40AM A T ' ,' altr� Printed On Act �I 2005 - Board of 1t; Town, of North Andover Health Department Date: .%� d -� Location: .11 -//Q (Indicate Address, if Residential, or Name of Business) Check #: /7 - Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing $ ❑ Septi�Design Approval $ ❑LSeptic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrasWSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) C�1y g�� Health Agent Initials 592 White - Applicant Yellow - Health Pink - Treasurer Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. iertnn Application is hereby made for a permit to: ❑ Construct a new on-site sewage disposal system* ❑ Repair or replace an existing on-site sewage disposal system* ❑ Repair or replace an existing system component A. Facility Informa ion Address or Lot # 111A% a-5 TOD 'S DATE $ 250.00 — Full Repair $125.00 - Component /1, Cit /Town 2.- TYPE OF SEPTIC SYSTEM*: Pump ❑ Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ nventional System (pipe and stone system) Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. Owner Information 'e—) -r 61-o yA� Name iia F<r2Zy r7 7 ` Address (if di(�erent from above) (� ��7. /X ✓�� c�a'1✓lK. !r {9l City/Town State Zip Code Telephone Number 3. Installer Information Name 7 w Name of Company Add ess� 1 Cit own State Zip Code Telephone Number (Cell Phone # if possible please) 4. Designer Information 7 Irlf S 5�g C, , S..S . Name t Name of Company Addr s / G City/Town State Zip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 NORTH Application for Septic Disposal System 0�,�14eo ,e qb0 �.o.'_•, ,.ti', ,+a Op Construction Permit- TOVN OF ORTH ANDOVER MA 01845 4SSNCHUS�K PAGE 2OF2 A.Eacility Information ontinued.... 5. Type of Building: Residential Dwelling or ❑Commercial B. Agreement TODAY'S DATE $ 250.00 - Full Repair $125.00 - Component The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of NorA Andover, and not t place the system in operation until a Certificate of Compliance has be n "ssued by this Bo d Health. Na Date V Applic ion Approve By: (Board of Health Representative) e Application Disapproved for the following reasons: Date For Office Use Only: / L Fee Attached? Yes l/ No 2. Project Manager Obligation Form Attached? Yes No 3. Pump Ssy tem? If so, Attach copy ofElectrical Permit Yes_ No 4. Foundation As -Built? (new construction ronly): (Same scale as approved plan) 5. Floor Plans? (new construction only): Yes_ No Yes_ No Application for Disposal System Construction Permit • Page 2 of 2 .= _J O �INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at �l% r�rN relative to the application ofCJim `*l%1�i� dated for plans by 6�lnPv�!jt ?U"-j,,nd dated - 2-d with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must 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 three shall be applicable. 3. 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. 4. As the installer I understand that only I may perform the work (other than simple excavation) required 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 to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. 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 or consultant. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. 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. Undersigned VASensed Septic Inst e Date: �" x DelleChiaie, Pamela From: Sawyer, Susan Sent: Tuesday, May 31, 2005 10:09 AM To: DelleChiaie, Pamela Subject: FW: soils 240 Farnum Street Just in case you didn't get this I am forwarding it to you. Delete if you have it Page 1 of 1 -----Original Message ----- From: Lisa LeVasseur[mailto:lisal@millriverconsulting.com] Sent: Friday, May 20, 2005 1:38 PM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie'; dano@millriverconsulting.com Subject: soils 240 Farnum Street Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 5/31/2005 0 0 � pORTN 7 TOWN OF NORTH ANDOVER Community Development & Services Division . HEALTH DEPARTMENT 400 OSGOOD STREET S�cNus NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 - Fax FAX Daniel Ottenheimer From: Pamela To: Mill River Consulting 978.282.0012 Pages: Fax: 1.800.377.3044 or Date: Phone: 978.282.0014 Request for Soil Testing or CC: Re: Septic Plan Review � ❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle • Comments: Septic Plan Review Soil Test OTHER Address: Please call 978-688-9540 for assistance with any questions. Thank you. Cc: File � ��sr Pis 0 0 ACTIVITY REPORT TIME 04/13/2005 12:24 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 NO. DATE TIME FAX N0./NAME DURATION PAGE(S) RESULT COMMENT #243 04/08 15:32 817812709406 46 05 OK TX ECM #244 04/08 15:36 89786836595 01:50 05 OK TX ECM 04/11 09:39 0000000000000000000 02:04 04 OK RX ECM #245 04/11 09:49 819782688448 41 01 OK TX ECM 04/11 10:31 01:46 06 OK RX ECM 04/11 10:33 01:45 06 OK RX ECM #246 04/11 11:26 89786889556 01:04 06 OK TX ECM #247 04/11 12:48 89786888476 00 00 BUSY TX #248 04/11 12:50 89786888476 00 00 BUSY TX #249 04/12 13:01 89786826473 57 02 OK TX #250 04/12 13:33 89786826473 56 02 OK TX #251 04/12 13:37 89786826473 56 02 OK TX #252 04/12 15:02 89787948265 40 04 OK TX ECM #253 04/13 08:37 818608263769 00 u BUSY TX #254 04/13 08:43 818608263769 00 00 BUSY TX 04/13 10:29 8009608012 41 03 OK RX ECM #255 04/13 10:49 818608263769 00 00 BUSY TX #256 04/13 11:04 817812709406 55 06 OK TX ECM #258 04/13 11:09 89786835396 55 06 OK TX ECM #257 04/13 11:13 89786836595 02:12 06 OK TX ECM #259 04/13 11:16 89786836595 02:11 06 OK TX ECM .1260 04/13 12:21 819782820012 01:05 05 OK TX ECM BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION / OUT OF MEMORY CV COVERPAGE POL POLLING RET RETRIEVAL PC PC -FAX a o TOWN OF.,NORTH ANDOVER . , ,. K�*� Office of COMMUNITY DEVELOPMENT AND SERVICES',%~� HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS, RS Public Health Director 978.688.9540 — Phone 978.688.9542 — FAX healthdeptna,townofnorthandover.com www.townofnorthandover.com APPLICATION FOR SOIL TESTS DATE: :5 13 I L 5- MAP & PARCEL: T I P7A -- /bp LOCATION OF SOIL TESTS: qD r4 / 4 u -I e >'- OWNER: f�db`e /4- 6 ( 2 Z ic, � Contact #: ' 178 — 4eZ $ 1311 APPLICANT: Contact #: ADDRESS: i �q /h km 5 7-,ee-�— ENGINEER: Contact #: CERTIFIED SOIL EVALUATOR: 6 r 2!A --�5.6 Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: V/deUndeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No V THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x ]]"Plot plan & Location of Testing (please indicate test nit sites on the Dian ➢ 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): RECEIVED APR 13 2005 TOWN u, "Il,-� t,i P.+;uOVER HEALTH DEPARTMENT 0 M. MAP 107A LOT 100 0 „u, r sr. V APR 1 3 2005 TOW,, vu[ H pi' )OVER HEALTH DEPARTMENT F-ARNUM STREET 1 11.7 3d, FLAG 1 FLAGGED BY JEFF ORCHARD 7�2 II EDGE OF W WANDS FLAG 6 l FLAG 7 � � / // —' �,. FLAG 5 / FLOG FLAG 8 G4-74 .G 9 All / Z/2 3/s ca 100' BUFFER ZONE a f OAS $� —R�S0.00 / �• _ _a4— F-ARNUM STREET 1 11.7 3d, 6 r= :? x �' fes/✓ 6 4Town of North Andover � � � Health Department Date: Z) Location: _ �%� "!l/ T l �Cf,%' %%� J7, (Indicate Address, if Residential, or Name of Business). Check #: 3-1 Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: Soil Testing $Gt/• ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER (Indicate) — n jl%/qk - Health Agent Initials 760 White - Applicant Yellow - Health Pink - Treasurer � 0 0 of poerti � TOWN OF NORTH ANDOVER �r ,•';`'" "Oo� Community Development & Services Division . HEALTH DEPARTMENT ; s�a ��,�. �,,•',' 400 OSGOOD STREET S�cHus NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 - Phone Public Health Director 978.688.9542 - Fax FAX Daniel Ottenheimer To: Mill River Consulting 978.282.0012 Fax: 1.800.377.3044 or Phone: 978.282.0014 Request for Soil Testing or Re: Septic Plan Review From: Pamela Pages: Date: CC: ❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle • Comments: Septic Plan Review. Soil Test "V OTHER Address: rz �d Please call 978-688-9540 for assistance with any questions. Thank you. Cc: File i APPLICATION FOR SOIL TESTS DATE: MAP & PARCEL: I D7 A l bb LOCATION OF SOIL TESTS:f7ct OWNER: f & J3 -e "+ (2 Z I �,'� Contact #: "J770 CQ d S " f 31 `j APPLICANT: Contact #: ADDRESS: a9e) CJ 7ree-',4— ENGINEER: Contact #: Cc -7 CERTIFIED SOIL EVALUATOR: 6 r e, �4 Intended Use of Land: Residential Subdivision k ingle Family Homq Commercial Is This: Repair Testing: ,/ Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No t/ THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x ]]"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): RECEIVED APR 13 2005 TOWIN v, iv.::-E(H i,riuOVER HEALTH DEPARTMENT_ O ► TOWN OF.NORTH ANDOVER.,_,, � Mott f Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, RENS, RS 978.688.9540 - Phone Public Health Director 978.688.9542 - FAX healthdept(&townofnorthandover.com www.townofnorthandover.com APPLICATION FOR SOIL TESTS DATE: MAP & PARCEL: I D7 A l bb LOCATION OF SOIL TESTS:f7ct OWNER: f & J3 -e "+ (2 Z I �,'� Contact #: "J770 CQ d S " f 31 `j APPLICANT: Contact #: ADDRESS: a9e) CJ 7ree-',4— ENGINEER: Contact #: Cc -7 CERTIFIED SOIL EVALUATOR: 6 r e, �4 Intended Use of Land: Residential Subdivision k ingle Family Homq Commercial Is This: Repair Testing: ,/ Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No t/ THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x ]]"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): RECEIVED APR 13 2005 TOWIN v, iv.::-E(H i,riuOVER HEALTH DEPARTMENT_ 0 0 aoo` REr V E APR 1 3 2005 TOW,. ut.vu . H ANuOVER MAP 107A LOT 100 HEALTH DEPARTMENT FARNUM STREET `f!_ --:so, FLAG 1 FLAGGED BY JEFF ORCHARD 7F EDGE OF WETLANDS I FLAG 6 l FLAG 7 � / — ^ �. FLAG 5 / FZAG FLAG 8 — \3 G 4 / --74 .G 9 / C aD /Also\ ' o/59) / W /k 1 / m 100' BUFFER ZONE ku0. Q -g4— -R�'550,00 _ FARNUM STREET `f!_ --:so, Common"alth of Massochusetss I Massachusetts /, Location it -I �iw Type: Emergency Routine Cesspool: No Yes Date of Pumping: 13 /0 Y System Pumped By: Wind River Environmental, UC Contents transferred to: Contents Disposed at-. Date: �//p Condition of System/Other Comments Pumper Signature: Dep Approved Form - 12/07/95 Had 4 System Pumping Record F -RECEIVED TOWN OF NORTH ANDO\JER HEALTH DEPARTNiP.N-f Septic tank: w F]Y.S EEJ Quantity Pumped: /000 Gallons Permit #: TOWN OF`NOgTH ANDOVER SYSTEM PUMPING RECORD SYSTEM OWNER &ADDRESS /-2 SYSTEM LOCATION DATE OF PUMPING} QUANTITY PUMPED /000 CESSPOOL NOYIESSEPTIC TANK NO YES Z�L NATURE OF SERVICE,;;ROT;TINEEMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN LACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY COMMENTS: I TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: %oJ1/ CVC` rnw. ,''t,31 E1V1 v WINER & ADDRESS ,) z/o ll a 0 SYSTEM LOCATION (example: left front of house) DATE OF PUMPING-/ QUANTITY PUMPED U vL9 GALLONS CESSPOOL: NO YES SEPTIC TANK: NO __ YES NATURE OF SERVICE: ROUTINE _� EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE -- ROOTS ---- EXCESSIVE SOLIDS �— SOLIDS CARRYOVER — SYSTEM PUMPED BY: -'OMMENTS: ONTENTS TRANSFERRED TO: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPT AI -s') i v [JAN RD -' HEALTH 7 2002