HomeMy WebLinkAboutMiscellaneous - 270 SOUTH BRADFORD STREET 4/30/2018 (2)tA
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CONSTRUCTION APPROVAL
Has plan review fee been paid: YES NO Permit#
Plan Approval: Date:- /I r� Approved by:
Designer: O.j�., &j)4,q Raw, a Plan Date:
Conditions:
Water Supply: own
Well Permit:
Well Test§��Chemical
Blar�ria I
Bacter'ia-I,L
Plumbing Sign -Off:
Comments:
Well
Driller:
Date Approved
Date Approved
Date Approved
Wiring Sign -off:
Form "U" Approval* Approval to Issuer YES"�,,) NO
Date Issued
Conditions:
Final Approval:
All Permits Paid? Cj_�D NO
Well Construction Approval? IV14 YES NO
Septic System Construction Approval? 6�:Y�� NO
Certification? - �Y�E NO
Other? YES NO
Any Variance Needed? YES
FINAL BOARD OF HEALTH APPROVAL:
DATE:
APPROVED BY:
SEPTIC SYSTEM INSTALLATION
Is the installer licensed? 1,4V
Type of Construction: NEW REPAIR
New Construction: Certified Plot Plan Review YES Q16
Floor Plan Review YES NO
Conditions of Approval from Form U YES NO
Issuance of DWC permit:
DWC Permit Paid?
DWC Permit#
Begin Inspection:
Excavation Inspection:
Needed:
YES NO
YES NO
Installer: '56,eW (0 Z5 60n
Passed:—///2 2- �p� By:
/ _
Construction Inspection:
Needed:
As Built Plan Satisfactory:
YES:
Approval of Backfill: Date: 12, Z, -),,21 By:_
6� � /
Final Grading Approval: Date: �2 Z-,, �� By:
Final Construction Approval: Date: By:
Certificate of Compliance: Approval: Date:
YES NO
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TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
7/12/01
This is to certify that
the individual subsurface disposal system
constructed (X ) or repaired ( )
by
Ben Osgood, Jr.
at
270 So. Bradford Street
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.
The Issuance of this certificate shall not be construed as a guarantee that the system will
fimction satisfactorily.
Board of Health Inspector
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 270 South Bradford Street—
North Andover—
Owner's Name: James Nyhan_
Owner's Address: 270 South Bradford Street-
- North Andover, MA 01845_
Date of Inspection: 6/6/2003
Name of Inspector: —Neil J. Bateson—
Company Name: —Batesbn Enterprises ]Inc.—
Mailing Address: —111 Argilla Road —
— Andover, Ma. 01810
Telephone Number: _( 978 ) 475-4786_
Towiv
,A. D
BOA- RD b
Q 9nm
L-- — - -
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Inspector's Signature: Date: 6/6/2003
-T U
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or
DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Page 2 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 270 South Bradford Street_
— North Andover—
Owner: Nyban
Date of Inspection: 6/6/2003
Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D
A. System Passes:
X I have not found any information which indicates that any of the failure criteria described in 3 10 CMR
T5—.�-03 or in 3 10 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the "Conditional Pass" section need to be replaced or
repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass.
Answer yes, no or not determined (YN,ND) in the for the following statements. If "not determined" please
explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s) are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if (with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
ND explain:
Page 3 of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 270 South Bradford Street-
- North Andover—
Owner: _Nyban
Date of lns�ecti;n: 6/6/2003
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require finther evaluation by the Board of Health in order to determine if the system
is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CNIR 15.303(l)(b) that the
system is not functioning in a manner which will protect public health, safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the
system is functioning in a manner that protects the public health, safety and environment:
— The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply.
The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
Page 4 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 270 South Bradford Street -
North Andover
Owner:.Yyhan -
Date of Inspection: 6/6/2003
D. System Failure Criteria applicable to all systems:
You must indicate "yes" or "no" to each of the following for all inspections:
Yes No
-No- Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
-No- Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
-No- Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
- No Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2day flow
-No�- Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
No Any portion of the SAS, cesspool or privy is below high ground water elevation.
-No-- Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
No Any portion of a cesspool or privy is within a Zone I of a public well.
-No- Any portion of a cesspool or privy is within 50 feet of a private water supply well.
-No- Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
No�__ (Yes/No) The system fails. I have determined that one or more of the above failure criteria exist as
described in 3 10 CMR 15.303, therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd-
You must indicate either "yes" or "no" to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
— — the system is within 400 feet of a surface drinking water supply
— the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - lVV`PA) or a mapped
Zone 11 of a public water supply well
If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered
"yes" in Section D above the large system has failed. The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 3 10 CMR
15.304. The system owner should contact the appropriate regional office of the Department.
Page 5 of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 270 South Bradford Street
— North Andover—
Owner: _Nyhan—
Date of Inspection: 6/6/2003
Check if the following have.been done. You must indicate "yes" or "no" as to each of the following:
Yes No
—Yes— — Pumping information was provided by the owner, occupant, or Board of Health
— —No— Were any of the system components pumped out in the previous two weeks ?
—Yes— — Has the system received normal flows in the previous two week period ?
— —No— Have large volumes of water been introduced to the system recently or as part of this inspection ?
—Yes— — Were as built plans of the system obtained and examined? (If they were not available note as N/A)
—Yes— — Was the facility or dwelling inspected for signs of sewage back up ?
—Yes— — Was the site inspected for signs of break out ?
—Yes— — Were all system components, excluding the SAS, located on site ?
—Yes Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the
condiiio� —of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of
scum ?
—Yes— — Was the facility owner (and occupants if different from owner) provided with information on the
proper maintenance of subsurface sewage disposal systems ?
The size and location of the Soil Absorption System (SAS) on the site has been determined based on:
Yes no
—Yes— — Existing information. For example, a plan at the Board of Health.
No Determined in the field (if any of the failure criteria related to Part C is at issue approximation of
disia�ce is—unacceptable) [3 10 CMR 15.302(3)(b)]
Page 6 of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 270 South Bradford Street-
- North Andover -
Owner: _j�iyhan-
Date of Inspection: 6/6/2003
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms (design): — 4 — Number of bedrooms (actual): - 4
DESIGN flow based on 3 10 CMR 15.203 (for example: I 10 gpd x # of �ed�ooms): 440
Number of current residents:
Does residence have a garbage grinder (yes or no): -Yes-
Is laundry on a separate sewage system (yes or no): -No- [if yes separate inspection required]
Laundry system inspected (yes or no):
Seasonal use: (yes or no): -No-
Water meter readings: -Yes-
Sump pump (yes or no): _NPm-
Last date of occupancy: -Current_
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow (based on 3 10 CMR 15.203): gp d -
Basis of design flow (seats/persons/sqft,etc.):
Grease trap present (yes or no): _
Industrial waste holding tank present (yes or no):
Non -sanitary waste discharged to the Title 5 system (yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER (describe):
GENERAL INFORMATION
Pumping Records
Source of information: -Never pumped, owner_
Was system pumped as part of the inspection (yes or no): -Yes_
If yes, volume pumped: - 1500_gallons -- How was quantity pumped determined? -Measured tank -
Reason for pumping: -Never pumped, inspect tank & tees -
TYPE OF SYSTEM
Septic tank, distribution box, soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be
�b—tained from system owner)
— Tight tank — Attach a copy of the DEP approval
— Other (describe):
Approximate age of all components, date installed (if known) and source of information: -2 years old, 5/18/2001,
As built plan -
Were sewage odors detected when arriving at the site (yes or no)- -No-
Page 7 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 270 South Bradford Street-
- North Andover—
Owner: _Yyhan—
Date of Inspection: 6/6/2003
BUILDING SEWER (locate on site plan) X
Depth below grade: —5'_
Materials of construction: —cast iron —X-40 PVC — other (explain):
Distance from private water supply well or suction line:
Comments (on condition ofjoints, venting, evidence of leakage, etc.): — —4" PVC thru wall to septic tank. 3"
PVC in house, no leaks visible._
SEPTIC TANK: —X —locate on site plan)
Depth below grade: —4 —
Material of construction: —concrete —metal _fiberglass ___polyethylene
__other(explain
If tank is metal list age: _ Is age confirmed by a Certificate of Compliance (yes or no): (attach a copy of
certificate)
Dimensions: 10' x 51 x 4'—
Sludge depth: — 4" —
Distance from top of sludge to bottom of outlet tee or baffle: 2311
Scum thickness: —5"—
Distance from top of scum to top of outlet tee or baffle: —8"—
Distance from bottom of scum to bottom of outlet tee or baffle: 1611
How were dimensions determined: — Measured scum & sludge depths to tee length_
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.): —Pumped septic tank. Inlet tee ok. Outlet tee ok. Depth of
liquid at outlet invert. No evidence of leakage. _
GREASE TRAP: _(locate on site plan)
Depth below grade: _
Material of construction: —concrete —metal _fiberglass ___polyethylene —other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
Page 8 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: – 270 South Bradford Street-
- North Andover–
Owner: _y4yhan–
Date of Inspection: 6/6/2003
TIGHT or HOLDING TANK: _ (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: _
Material of construction: —concrete metal fiberglass olyethylene other(explain):
Dimensions:
Capacity: _____gallons
Design Flow: ____gallons/day
Alarm present (yes or no):
Alarm level: Alarm in working order (yes or no):
Date of last pumping:
Comments (condition of alarm and float switches, etc.):
DISTRIBUTION BOX: _X_ (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: –0–
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of
leakage into or out of box, etc.): _ – D -box level & distribution equal. No evidence of leakage. Evidence of
carryover, pumped d -box to clean.
PUW CHAMBER: (locate on site plan)
Pump in working order (yes or no):
Alarms in working order (yes or no):
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Page 9 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 270 South Bradford Street_
—North Andover—
Owner: _Nyhan_
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS): X— (locate on site plan, excavation not required)
If SAS not located explain why:
Type
leaching pits, number:
leaching chambers, number:
leaching galleries, number:
X— leaching trenches, number, length: —2 trenches 66' long
leaching fields, number, dimensions:
overflow cesspool, number:
innovative/altemative system Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,
etc.): _ —Soil ok. Vegetation ok. No sign of ponding to surface. —
CESSPOOLS: _ (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth — top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow (yes or no):
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
PRIVY: (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
Page 10 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 270 South Bradford Street-
-North Andover—
Owner: _Nyban_
Date of Inspection: 6/6/2003
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.
Driveway
• to Septic Tank = 26'9"
• to D -Box = 34'2"
B to Septic Tank = 20'
B to D -Box = 12'10"
House
W ter Meter
D -
Septic Tank Box
<S) P�
Page 11 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 270 South Bradford Street_
– North Andover–
Owner: _Yyhan –
Date of Inspection: 6/6/2003
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water –4– feet
Please indicate (check) all methods used to determine the high ground water elevation:
— X— Obtained from system design plans on record - If checked, date of design plan reviewed: 10/10/2000
Observed site (abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health -explain:
Checked with local excavators, installers- (attach documentation)
Accessed USGS database -explain: _ _
You must describe how you established the high ground water elevation: Design plan info_
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Tel: (978) 475-4786
Fax: (978) 475-5451
BATESON ENTE"FJSES, INC.
Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service
I 11 Argilla Road Andover, Mass. 0 18 10
Title 5 Inspection Report
Property Address: 270 South Bradford Street, North Andover
Owner: Nyhan
Date of Inspection: 6/6/2003
My report contained herein does not constitute a guarantee of future usage and the functionality of the existing
septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any ftu-ther
operation of your current septic system.
NA611 Ba beson
Bateson Enterprises, Inc.
7",77,
DISPOSAL S);qTj,:jNj
TOWN' OFNORTH ANDOVER SMVAGr
IN
\,STALLA-rioN CERTIFICATION
The undersitmed here:_,v cer-,Ifv that the Sewage Disposal System
recaired.-
by B rk, 0 5 6-0
j-70
located at
was installed in 6onfcrmance with the North A_nC'over Board of He-aith a`proved plan.
Svste,mDesii-,nPe.,-:r.l't.--�'/)_M dated. With an arr-roved desi-n
flow of gallonsperday The mater:a1s, usea; were in conformarct w-Ith those
specified oh the appio�7ed- plan; the sysiem was irwafled in' a-ccordarcevith the provisions
of 31 10 CNIR 15.000, Title 5 and local -m-ilaElons, and the final Qr-adipa agrees
su6stantlally,Nrith the approved
Ail workis accuraieiv reoresemed ��r the As -built
'Health.
M -Lich has been subm'tted to the Board c.
Bed inspection d atd-.
Engineer RI--m:stn-.aijVe
a
ion date
F'naJ inspect -
Engineer Represen1_11:-.-:e
Ver: Date:
Ensta.
Date�
Cesism, Enrineer: R
C_
a
416
1DTIC
CIV V op� S'E
CTIO
3,hor;aOn
of 13ed er depill are beneath i - , etc -
P rf 00p C Vatjon �Oujjda&n
id ca`.Jll�_ fr
Bottom tioll to a, ,;�jce
s f e�( cefrom
des Of e)
Cava 1h s sp a , istOA
ches, 51 ecifid d'
With tren, ca, otion e
"I
-ca. 4atioll SP
3. 'Edge of
Comments'
� 7— �Wllld_ ecified
Retai!130�ulgr Wa VR ?Adth 35 SP
13. Wall tieight . facility
I. roofed 01 leaching
waterp I
'2. wall nj;jli�m spec,fi ons of P130
3. meets
4. 'N .
Comments*
S—ewer , . X,
C. BUitau1% a-imeter minimum
I. pipe 40 pipe
2 Schedule . oints
. gatertigh' 3 cemented 119" per foot minimum
3. Inlet to ta[4L 001 or fjrM base .
4. . . um * , 0, line
Slope rk compa stral
5. erlY set 01 and
rnmull Ct
pipe PrOP grade in ygnme,11
tinuous gr
'Alftge
6. laid on con .11 Chan
1 - p1pe 90 1 Ch
Cle3nouts precede !. . nge
9. lesAan'y ettO Water line
9. Manho Offs
0, minimum
comments--
Septle
I - Level Fa I juilivaorn n outlet
1500 g esent 0
2. 1 Sjjje Pr ,,h tee
3. Manho e to 3nd
4. Ma�holes Over invert
5. " marlho der
6. 3 -20 IT' Un , invert
Urn g under
Inlet imulu
tee rnir�.
6�ilet tee minim
et * e c ent
9. ®r, ace I above t to outlet
from stone under tank
T f 3/," CrUShed
p1pe set wi& 6 0
,act base
13. Comp. Xgtertight
14. T33�k is
Comments' 7,—�
Initials
'so
r7: -
Yes NO
E. Pump Chamber
1. If separate from tank, compact base with 6" of3/4" stone underneath
2. Minimum 2" pipe to d -box if gravity system
3. 20" access manhole
4. Tank level
5. Watertight
6. Tank size agrees with plan specification
7. Manhole to grade
8. Check valve and bleeder hole present
9. Alarm in building on separate circuit
10. Alarm functions
11. Manual operating switch
12. Pump delivers liquid to d -box
Comments:
F. Distribution Box
1.
D-boxievel
2.
Minimum 0.17(2") drop from inlet to outlet
3.
Minimum 6" sump
4.
Outlet pipes show equal distribution
5.
Compact base with 6" of stone beneath box
6.
Box is watertight
7.
All lines cemented with hydraulic cement
8.
Schedule 40 pipe
Comments:
G. Soil Absorption system
1.
All stone double -washed - 1/4" - 1 1/2"
- pea stone
Bucket test done?
2.
Minimum 2", of pea stone above distribution lines
3.
Minimum 6" stone beneath pipe
4.
Distribution lines capped or connected together
5.
Grading meets 11 slope
6.
Minimum of 9" of fill graded over system
7.
Toe of slope stops minimum 5' from edge of property-, if not, then swale.
Comments:
H. Leach Trenches
1.
Minimum 2 trenches
2.
Length of trenches agree with plan. (Max. length 100')
3.
Width of trenches agree with plan - Minimum 2'; maximum - 4'.
4.
Vent present if <50 feet or specified
.5.
Distance between trenches minimum 4' and maximum of 6'
6.
Minimum distance between trenches 10'
7.
Pipe slope minimum 0.005 or 6" per 100'
8.
Depth of trenches below outlet invert minimum of 6".
Yes NO
9. Pipes set on stable base.
Comments:
1. Leach Field
I . Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6" per 100'
3. SeparationbaWee pipe6'maximurn
�p
4. Pipes connected at en
5. Separation between adjace , fields 10' minimum
6. Pipes set on stable base �*
7. Maximum 4' separation from edg field to first line
rl
8. Minimum two distribution lines
9. Maximum perc rate 20 mpi
Comments:
J. Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between 12" and 41 ide
4. Access manholes on each pit
5. Pipes cemented with hydraulic cement
Comments:
K. Final Grade
I . Slope over soil absorption system minimum 0.02
2. All system components covered by at least 9" soil
3. Cover soil free of stones larger than 6"
4. Grading slopes away from dwelling
5. No areas over system that may pond
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WHITE: Applicant 5- CACRY: Building Dept. PINK: Treasurer GOLD: File
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Propane Gas T-r.c. Chreck c4 -w-: certiricale
Address 131 Water Street
G--&'Wration
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INSURANCE COVEFLAIGE:
I havc a curl C nt_jt�-�� "Y insJrz nce PC4icY Of Ls subeanlia! e-q0v.-!cn', vehich rneets V.e requi.tments of MIGL Ch. 142.
Yes D NO 0
1'. you have checkc-,ySs, p;erse lr�dicate the tyPe coverage by clNecking the ap;xopr'--te t>ox.
A 4abliey iasu,-arice policy CLJ"-'� Other type of indemnily 0 sond n -
OWNER'S INSURANCE WAWER: I am aware that the licensee does not have the Insurance coverage required by
Chapter 142 of, the Mass. Genera! Lzws. and that MY sig.-Iz'ure On this permit app;ica!ion waives this (equirement.
Check one.,
$d9n.a'xre o! D.Ttr of Csv�*!'s 4ent OwnerO Agent 0
I he-ebyoetify Vz! 0 of the detAl(s and info.mation I h1vt sVb�nilttd (or enie!edl in &bave zppijzation &:c tnie ar�d &=,rale to the best of my
ar�d thal� V P;VMbjnl;; And "ta?lZti0n-S PerlcKrr*:l unde- %ne '0 th(s 111ricatio, I I in iance with all
pertinen�provisi�s of vie V2ssad-.&:set!s State Gas Code " 01.apter 142ortZ I Llsowts
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APP OFFI�;E USF 01%' -Yl
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SEP 2 6 1990
BUILDING DEFARTAAENT
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Propane Gas T-r.c. Chreck c4 -w-: certiricale
Address 131 Water Street
G--&'Wration
npT-�Vprc mzc-c- olq?l 0 ParinersNp
5us';r---ssTe:ep.1tone 508-774-1930 0 Fivrn/Co.
Nzme of Ucenst�d Plumt>---r C>r Gas Fit er A- -
INSURANCE COVEFLAIGE:
I havc a curl C nt_jt�-�� "Y insJrz nce PC4icY Of Ls subeanlia! e-q0v.-!cn', vehich rneets V.e requi.tments of MIGL Ch. 142.
Yes D NO 0
1'. you have checkc-,ySs, p;erse lr�dicate the tyPe coverage by clNecking the ap;xopr'--te t>ox.
A 4abliey iasu,-arice policy CLJ"-'� Other type of indemnily 0 sond n -
OWNER'S INSURANCE WAWER: I am aware that the licensee does not have the Insurance coverage required by
Chapter 142 of, the Mass. Genera! Lzws. and that MY sig.-Iz'ure On this permit app;ica!ion waives this (equirement.
Check one.,
$d9n.a'xre o! D.Ttr of Csv�*!'s 4ent OwnerO Agent 0
I he-ebyoetify Vz! 0 of the detAl(s and info.mation I h1vt sVb�nilttd (or enie!edl in &bave zppijzation &:c tnie ar�d &=,rale to the best of my
ar�d thal� V P;VMbjnl;; And "ta?lZti0n-S PerlcKrr*:l unde- %ne '0 th(s 111ricatio, I I in iance with all
pertinen�provisi�s of vie V2ssad-.&:set!s State Gas Code " 01.apter 142ortZ I Llsowts
E)� fv'�' * I ��
T I ucense:
vt*.- v Gas F-j5F-
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APP OFFI�;E USF 01%' -Yl
ID
SEP 2 6 1990
BUILDING DEFARTAAENT
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Town of North Andover �T
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
WMLIAM J. SCOIT A 1H U
Director NOTICE OF DECISION
(978) 688-9531 Fax (978) 688-9542
Any appeal shall be filled
within (20) days after the
date of filling this Notice
in the Office of the Town
ClerL
Date: September 8, 2000
Date of Hearing: August 1, 2000
Petition of- John Zahoruiko
Premises affected: ' 262 South Bradford Street C—
C)
-<
rri C:) C-') M
Referring to the above petition for a definitive subdivision in accordance with the provisions cC:* m m
Chapter 41,. Section 81U of the Massachusetts General Laws M M C-)
C�
Mp
.,,rr, C:)m
so as to allow: the definitive subdivision for a two(2) lot subdivision with one new ho
M >
existing home known as 262 South Bradford Street
C:)
After a public hearing given on the above date, the Planning Board voted
To: APPROVE the: Definitive Subdivision
CC: Director of Public Works
Building Inspector
Conservation Department
Health Department
Assessors
Police Chief
Fire Chief
Applicant
Engineer
Towns Outside Consultant
File
based upon the following conditions(attached):
1
Signe4
Alison M.,Lescarbem
John Simons, Vice Chairman
Alberto Angles, Clerk
Richard S. Rowen
Richard Nardella
Witham Cunningham
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 689-9530 HEALTH 688-9540 PLANNING 688-9535
4
262 South Bradford Street Definitive Subdivision
Conditional Approval
The Planning Board herein APPROVES the Definitive Subdivision for a two (2) lot subdivision with
one new home and one existing home known as 262 South Bradford Street. John Zahoruiko, 262
South Bradford Street, North Andover, MA 0 1845, submitted this application on June 23, 2000. The
area affected is on South Bradford Street and is located in the R-1 Zoning District.
The Planning Board makes the following findings as required by the Rules and Regulations Governing
the Subdivision of Land:
A. The Definitive Plan, dated 1/3/00, last revised on 3/16/00, 3/17/00 and 6/16/00, includes all of the
information indicated in Section 3 of the Rules and Regulations concerning the procedure for the
submission of plans with the exception of waivers granted below in Condition #11.
B. The Definitive Plan is in conformance with the purpose and intent of the Subdivision Control Law.
C. The Definitive Plan complies with all of the review comments submitted by various town
departments in order to comply with state law, town by-laws and insure the public health, safety,
and welfare of the town.
D. The Definitive Plan dated 1/3/00, last revised on 3/16/00, 3/17/00 and 6/16/00, includes all of the
information indicated in Section 7 of the Rules and Regulations concerning the procedure for
design standards with the exception of waivers granted below in Condition #11.
Finally, the Planning Board finds that the Definitive Subdivision complies with Town Bylaw
requirements so long as the following conditions are complied with:
1) Environmental Monitor: The applicant shall designate an independent environmental monitor
who shall be chosen in consultant with the Planning Department. The Environmental Monitor
must be available upon four- (4) hour's notice to inspect the site with the Planning Board
designated official. The Environmental Monitor shall make weekly inspections of the project and
file monthly reports to the Planning Board throughout the duration of the project. The monthly
reports shall detail area of non-compliance, if any and actions taken to resolve these issues.
2) Prior to endorsement of the plans by the Planning Board the applicant shall adhere to the
following:
a) A Development Schedule must be submitted for signature by the Planning Board, which
conforms to both Sections 4.2, and Section 8.7 of the North Andover Zoning Bylaw. The
schedule must show building permit eligibility by quarter for all lots.
2
b) A Site Opening Bond in the amount of one thousand ($1,000) dollars to be held by the
Town ofNorth Andover. The Site Opening Bond shall be in the form of a check made out to
the Town of North Andover that will be placed into an interest bearing escrow account. This
amount shall cover any contingencies that night affect the public welfare such as site -opening,
clearing, erosion control and performance of any other condition contained herein, prior to the
posting of the Roadway Bond as described in Condition 3(d). This Site Opening Bond may at
the discretion of the Planning Board be rolled over to cover other bonding considerations, be
released in full, or partially retained in accordance with the recommendation of the Planning
Staff as directed by a vote of the NAPB.
c) A covenant (FORM 1) securing all lots within the subdivision for the construction of ways and
municipal services must be submitted to the Planning Board. Said lots may be released from the
covenant upon posting of security as requested in Condition 3(d).
d) The applicant must submit to the Town Planner a FORM M for all utilities and easements
placed on the subdivision.
e) All application fees must be paid in M and verified by the Town Planner.
The applicant must meet with the Town Planner in order to ensure that the plans conform to
the Board!s decision. A fiffl set of final plans reflecting the changes outlined above, must be
submitted to the Town Planner for review endorsement by the Planning Board, within ninety
(90) days of filing the decision with the Town Clerk.
g) The Subdivision Decision for this project must appear on the mylars.
h) I All documents shall be prepared at the expense of the applicant, as required by the Planning
Board Rules and Regulations Governing the Subdivision of Land.
3) Prior to any lots being released from the statutory covenants:
a) Three (3) complete copies of the endorsed and recorded subdivision plans and one (1) certified
copy of the following documents: recorded subdivision approval, recorded Covenant (FORM
1), recorded Growth Management Development Schedule, recorded common driveway
easement and recorded FORM M must be submitted to the Town Planner as proof of
recording.
b) All site erosion control measures required to protect off site properties from the effects of work
on the lot proposed to be released must be in place. The Town Planning Staff shall determine
whether the applicant has satisfied the requirements of this provision prior to each lot release
and shall report to the Planning Board prior to a vote to release said lot.
3
c) The. applicant must submit a lot release FORM J to the Planning Board for signature.
d) A Performance Security in an amount to be determined by the Planning Board, upon the
recommendation of the Department of Public Works, shall be posted to ensure completion of
the work in accordance with the Plans approved as part of this conditional approval. The
performance security must be in the form of a check made out to the Town of North Andover.
This security will then be placed in an interest bearing escrow account held by the Town. Items
covered by the Security may include, but shall not be limited to:
i) as -built drawings
ii) sewers and utilities
iii) roadway construction and maintenance
iv) lot and site erosion control
v) site screening and street trees
vi) drainage facilities
vii) site restoration
viii)final site cleanup
A Performance Security may be established for each phase individually.
4) Prior to an application for a building pennit for an individual lot, the following information is
required by the Planning Department:
a) The applicant must submit a certified copy of the recorded FORM J referred to in Condition
3(c) above.
b) A plot plan for the lot in question must be submitted, which includes all of the following:
i) location of the structure,
H) location of the driveways,
iii) location of the septic systems if applicable,
iv) location of all water and sewer lines,
v) location of wetlands and any site improvements required under a NACC order of
condition,
vi) any grading called for on the lot,
.vii) all required zoning setbacks,
viii)Location of any drainage, utility and other easements.
c) All appropriate erosion control measures for the lot shall be in place. The Planning Board or
Staff shall make final determination of appropriate measures.
4
d) Lot numbers, visible from the roadways must be posted on all lots.
5) Prior to a Certificate of Occupancy being requested for an individual lot, the following shall be
required:
a) Sprinkler systems must be installed in the home on Lot A- 1-2 per NAFD requirements.
c) The connnon driveway must be constructed and paved to properly access the lot in question
and inspected by the Town Planner.
d) All necessary permits and approvals for the lot in question shall be obtained from the North
Andover Board of Health, and Conservation Commission.
e) Permanent house numbers must be posted on dwellings and be visible from the road.
There shall be no driveways placed where stone bound monuments and/or catch basins are to
be set. It shall be the developer's responsibility to assure the proper placement of the driveways
regardless of whether individual lots are sold. The Planning Board requires any driveway to be
moved at the owner's expense if such driveway is at a catch basin or stone bound position.
g) The applicant will ensure that the deeds for lots A- I - I and A- 1 -2 in the 262 South Bradford
Street Subdivision has language stating "the driveway being utilized for access to lots A- I -I
and A- 1 -2 does not conform to the Towrfs standards for purposes of utilization as a street, nor
will the driveway be accepted by the Town as a street unless said driveway is upgraded and
then conforms to the requirements of a street as defined in the Town of North Andover Rules
and Regulations Governing the Subdivision of Land". In addition, the applicant will also
place a note on the plan that states, the above which is to be recorded in the Essex North
Registry of Deeds.
6) Prior to the final release of security retained for the site by the Town, the following shall be
completed by the applicant:
a) An as -built plan and profile of the site shall be submitted to the DPW and Planning Department
for review and approval.
b) The Applicant shall ensure that all Planning, Conservation Cornmission, Board of Health and
Division of Public Works requirements are satisfied and that construction was in strict
compliance with all approved plans and conditions.
7) There shall be no burying or dumping of construction material on site.
8) The location of any stump dumps on site must be pre -approved by the Planning Board.
5
9) The contractor shall contact Dig Safe at least 72 hours prior to cornmencing any excavation.
10) Any action by a Town Board, Commission, or Department which requires changes in the driveway
alignment, placement of any easements or utilities, drainage facilities, grading or no cut lines, may
be subject to modification by the Planning Board.
11) The following waivers from the Rules and Regulations Governing the Subdivision of Land, North
Andover, Massachusetts, revised February, 1989 have been granted by the Planning Board:
a) Request for waiver of Rules and Regulations Section 3C4 to permit a subdivision plan
without a statement of environmental impact if GRANTED.
b) Request for waiver of Rules and Regulations Section 3D to permit a subdivision plan
without a drainage analysis is GRANTED.
c) Request for waiver of Rules and Regulations Section 3KQ) to pern-lit a. subdivision plan
without existing forested areas depicted is GRANTED.
d) Request for waiver of Rul6s and Regulations Section 3K(p) to permit a subdivision plan
without profiles of streets is GRANTED.
e) Request for waiver of Rules and Regulations Section 3K(q) to permit a subdivision plan
without cross-section of streets is GRANTED.
Request for waiver of Rules and Regulations Section 7A, 7B, 7C, 7D, 7E, 7F, 7G, 7H, 7L,
7N, 70 and 7P is GRANTED. The rationale for granting the above waivers is that although
the submission is technically a definitive subdivision plan, the proposal does not involve the
creation of a street, rather it proposes the creation of a driveway. The above granted waivers
refer specifically to the construction of a street, and therefore would not apply to this proposal.
12) This Definitive Subdivision Plan approval is based upon the following information which is
incorporated into this decision by reference:
a) Plans Entitled: Definitive Subdivision Plan of Land
Located at 262 South Bradford Street
cc.
North Andover, MA
Prepared For: John & Jean Zahoruiko
Prepared by: Scott Giles, R.P.L.S.
Scale: I"=40'.
Plan Date: 1/3/00, revised 3/16/00, 3/17/00, 6/16/00
Applicant
Engineer
File
6
Town of North Andover
Office of the Health Department
Community Development and Services Division
William J. Scott, Division Director
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Health Director
December 29, 2000
William Zahoruiko & Dana Cole
262 So. Bradford Street
No. Andover, MA 0 1845
Re: Sewer Tie-in
Dear Resident:
- ANIMMW
Telephone (9781
Fax (978) 688 -
The Health Department has been supplied with a list of all residences, currently on
septic, which have access to the municipal sewer system. Your property was listed
as having access as of June 2000 due to the completion of the new sewer in your
area. This office was notified that you were sent information from the Department
of Public Works informing you of your status and the tie-in regulation. As
previously published at a Public Hearing on March 17, 1994, the Board of Health
has adopted regulations concerning the required sewer tie-in. The following
timetable concerning your property status was adopted:
4.1 All establishments that currently do not have municipal sewer available
to them must connect to the sewer as soon as it becomes available, with a
maximum time limit of six months.
The purpose of these regulations is to safeguard North Andover's drinking water,
surface, waters, groundwater and surrounding environment. Sanitary sewer is
believed to be the most effective form of wastewater treatment. A copy of the
entire regulation can be obtained at our office.
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535
Any questions concerning this regulation should be directed to the Board of
Health at (978) 688-9540. Additional inquiries regarding the physical tie-in and
permitting process should be directed to the Department of Public Works at (978)
685-0950. Please be advised this Board intends to persevere in this regulation.
Yours truly,
da3kod'Osgood, C&airnian
Francis P. MacMillan, M.D., Member
SF/sc
Office of the Health Department
Community Development and Services Division
William J. Scott, Division Director
. 27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Health Director
January 24, 2001
John Zahoruiko
33 1 B Medallion Blvd.
Madeira Beach, Fl, 33708
Re: Sewer tie-in letter
Dear Mr. Zahoruiko:
Telephone (978) 688-9540
Fax (978) 688-9542
I must say I am a bit p=led myself as to why you received this letter. It is a form letter that goes out when we are
notified by DPW that a piece of property with an existing house has sewer available and can tie-in. The names and
addresses are generally obtained from the Assessor's Office. We've had some confusion in this particular program
before and obviously it still exists. I'll look further into the matter and see what's going on.
Hope everything is going well for you.
Sincerely,
Sandy Starr, � �HZ
Health Director
Cc: W. Zahoruiko
T. Zahoruiko
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION688-9530 NURSE 688-9543 PLANNINTG689-9535
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Town of North Andover
Office of the Health Department
Community Development and Services Division
William). Scott, Division Director
27 Charles Street CHU
Sandra Starr North Andover, Massachusetts 01845 Telephone (978) 688-9540
Health Director Fax ( 978) 688-9542
December 29, 2000
YVZ4-1?-
William Zahoruiko & ana ole
4
262 So. Bradford Street
No. Andover, MA 0 1845
Re: Sewer Tie-in
Dear Resident:
The Health Department has been supplied with a Est of all residences, currently on
septic, which have access to the municipal sewer system. Your property was listed
as having access as of June 2000 due to the completion of the new sewer in your
area. This office was notified that you were sent information from theDepartment
of Public Works informing you of your status and the tie-in regulation. As
previously published at a Public Hearing on March 17, 1994, the Board of Health
has adopted regulations concerning the required sewer tie-in. The following
timetable concerning your property status was adopted:
4.1 All establishments that currently do not have municipal sewer available
to them must connect to the sewer as soon as it becomes available, with a
maximMam time limit of six months.
The purpose of these regulations is to safeguard North Andover's drinking water,
surface waters, groundwater and surrounding environment. Sanitary sewer is
believed to be the most effective form of wastewater treatment. A copy of the
entire regulation can be obtained at our office.
BOARD OF AIWALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535
Any questions concerning this regulation should be directed to the Board of
Health at (978) 688-9540. Additional inquiries regarding the physical tie-in and
permitting process should be directed to the Department of Public Works at (978)
685-0950. Please be advised this Board intends to persevere in this regulation.
Yours truly,
Ga3kolrosgood, Cliairniain
Prancis P. MacMillan, M.D., Member
Jol ei'4-;2'_j
SF/sc
Town of North Andover, Massachusetts Form No.2
14ORT#f BOARD OF HEALTH
DESIGN APPROVAL FOR
C14U SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant -
Reference Plans and Specs
r
)z
NGINEE
6
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
Fee LZr
-14-'j
—CHAIRMAN, BOARD OF HEALTH
Site System Permit No. //,32 -
�4
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
A. Bottom of Bed Yes NO Init
1. Excavation to proper depth
2. With trenches, sides of excavation are beneath B horizon
3. Edge of excavation specified distance from foundation, etc.
Comments:
B. Retaining Wall
1. Wall height and width as specified
2. Waterproofed
3. Wall minimum 10'to leaching facility
4. Wall meets specifications of plan
Comments:
C. Building Sewer
1. Pipe diameter minimum 4"
2. Schedule 40 pipe
3. Watertight joints
4. Inlet to tank cemented
5. Slope minimum 0.0 1 or 1/8" per foot minimum
6. Pipe properly set on compact firm base
7. Pipe laid on continuous grade in straight line
8. Cleanouts precede all change in alignment and grade
9. Manholes at any 90' change
10. 10' minimum offset to water line
Comments:
D. Septic Tank
1. Level
2. 1,500 gal minimum
3. Gas baffle present on outlet
4. Manhole to grade
5. Manholes over center and each tee
6. 3-20" manholes
7. Inlet tee minimum 12" under invert
8. Outlet tee minimum 14" under invert
9. Outlet line cemented
10. Air space 3" above tees
11. 2" - 3" drop from inlet to outlet
12. Pipe set
13. Compact base with 6" of %" crushed stone under tank
14. Tank is watertight
Comments:
.A
Yes NO
E. Pump Chamber
1. If separate from tank, compact base with 6" of3/4" stone underneath
2. Minimum 2" pipe to d -box if gravity system
3. 20" access manhole
4. Tank level
5. Watertight
6. Tank size agrees with plan specification
7. Manhole to grade
8. Check valve and bleeder hole present
9. Alarm in building on separate circuit
10. Alarm fimctions
11. Manual operating switch
12. Pump delivers liquid to d -box
Comments:
F. Distribution Box
1. D -box level
2. Minimum 0. IT' (2") drop from inlet to outlet
3. Minimum 6" sump
4. Outlet pipes show equal distribution
5. Compact base with 6" of stone beneath box
6. Box is watertight
7. All lines cemented with hydraulic cement
8. Schedule 40 pipe
Comments:
G. Soil Absorption system
1. All stone double -washed - 1/4" - 1 '/2"
- pea stone
Bucket test done?
2. Minimum T'. of pea stone above distribution lines
3. Minimum 6" stone beneath pipe
4. Distribution lines capped or connected together
5. Grading meets 3:1 slope
6. Minimum of 9" of fill graded over system
7. Toe of slope stops minimum 5' from edge of property; if not, then swale.
Comments:
R Leach Trenches
I . Minimum 2 trenches
2. Length of trenches agree with plan. (Max. length 100')
3. Width of trenches agree with plan - Minimum 2% maximum - 4'.
4. Vent present if <50 feet or specified
5. Distance between trenches minimum 4' and maximum of 6'
6. Minimum distance between trenches 10'
7. Pipe slope minimum 0.005 or 6" per 100'
8. Depth of trenches below outlet invert minimum of 6".
.4
Yes NO
9. Pipes set on stable base.
Comments:
1. Leach Field
1. Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6" per 100'
3. Separation between pipe 6' maximum
4. Pipes connected at end
5. Separation between adjacent fields 10' minimum
6. Pipes set on stable base
7. Maximum 4' separation from edge of field to first line
8. Minimum two distribution lines
9. Maximum perc rate 20 mpi
Comments:
J. Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between IT' and 48" wide
4. Access manholes on each pit
5. Pipes cemented with hydraulic cement
Comments:
K. Final Grade
1. Slope over soil absorption system minimum 0.02
2. All system components covered by at least 9" soil
3. Cover soil free of stones larger than 6"
4. Grading slopes away from dwelling
5. No areas over system that may pond
IA
L A
FORM - U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from
Boards and Departments having jurisdiction have been obta mied. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
Odom OWN 0 own WOUNSEARENEWUNN EVEN W 0
`7F
APPLICANT PHONE i -07-e63�
ASSESSORS MAP NUMBER IOYC LOT NUMBER 3 6
SUBD I -VISION LOT NUMBER
STREET NUMBER 7— 70
A �a_
STREET I &1 111 �_ -
OFFICLAL USE ONLY
...............
RECOMMENDATIONS OF TOWN AGENTS
DATE APPROVED
E0--NSERVATION ADMR41STRATOR
�- D /�- \ -S-5,j -C, J It 1 _7 d
DATE APPROVED
TO NER DATE REJECTED
CONBEWUS
DATE APPROVED
FOOD INSPEC3,QR - HEALTH DATE REJECTED
DATEAPPROVED
,Tfe, DOWECTOR - HEALTH DATE REJECTED
COMN&-NTS
2-0 4c
PUBLIC WORKS - S8*0OR WATER CONNECTION
DRIVEWAYPERM rr//-ZV,P0
DATE APPROVED
HERE DEPARTMENT
DATE -REJECTED
COMNIENTS -
RECEIVED BY BUILDING INSPECTOR DATE
INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction of the septic system for the property
at 7,& 2, .57, fri a relative to the application of Bew%La C_ nr"� .0"o- J -z-
1-1 C1.1
dated i 6.1> for plans by i1se, and dated /c,/z3/pp with
L
revisions dated /1/017/00
I understand and a4gre"e to the following obligations for management of this project:
11. As the installer I am obligated to call for any and all inspections. If homeowner, contractor,
project manger, or any other person not associated with my company schedules an inspection
and the system is not ready then item two shall be applicable .
2. As the installer I am required to have the necessary work completed prior to the applicable
inspections as indicated below. I understand that requesting an inspection, without completion
of the items in accordance with Title 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 BOH, after which installer calls for inspection time. Installer must be present
for this inspection. With pump system all electrical work must be ready and able to cause pump to work and
alarm to function.
c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site.
3. As the installer I understa�d that persons or companies not associated with my company may
not perform the work required by my company to complete the installation of the system
identified in the attached application for installation. I ftirther understand that work by others
unlicensed to install septic systems in North Andover can constitute reasons for denial of the
system, and/or revocation -or suspension of my license in the Town of North.Andover plus
significant fines to all persons involved.
4. As the Installer I understand that I must be on site during the performance of the following
construction steps:
a). Determination that the proper elevation of the excavation has been reached.
b) Inspection of the sand and stone to be used.
c) Final inspection by Board of Health staff.
d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components.
5. As the installer I understand that I am solely responsible for the installation of the system as per
the approved plans. No instructions by the homeowner, general contractor, or any other persons
shall absolve me of this obligation.
Undersigned Licensed Septic Installer
Date:
BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: I L!;- c, 0 CURRENT INSTALLER'S LICENSE#
LOCATION: ;2(:,,Z IP
r=,k fD
LICENSED INSTALLER: 41 C,0 'd 0,
SIGNATURE:
TELEPHONE#
CHECK ONE:
REPAIR:
NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
Administrative Use Only
$75.00 Fee Attached? Yes kNo
a ,
Foundation As -Built? Yes 15 PZA No
Floor Plans? Yes:z No
Approval
Date:
Fj�OUT eLL-VATIOJ
TLOOP-
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TOWN OF NORTH ANDOVER
BOA" OF HEALTH
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 01845
SANDRA STARR, R.S., C.H.O.
Health Director
November 13 2000
Ben Osgood, Jr.
New England Engineering
60 Beechwood Drive
No. Andover, NIA 01845
Re: 262 So. Bradford Street
Dear Ben:
%%0RTjf
emu
Telephone (978) 688-9540
FAX (978) 688-9542
This is to notify you that the septic plans dated 11/9/00 are approved for new construction
with a maximum of nine (9) rooms.
If you have any questions, please do not hesitate to call the Board of Health Office at
978-688-9540.
Sincerely,
Sandra Starr, R.S., C.H.O.
Health Director
SS/smC
cc: Tara Leigh Development
File
NEW ENGLAND ENGINEERING SERVICES
INC
November 9, 2000
Sandra Starr, Administrator
North Andover Health Department
Town Hall Annex
27 Charles Street
North Andover, MA 0 1845
Re: 262 South Bradford Street, North Andover, Septic system design
Dear Sandra:
Enclosed are the following documents concerning the above referenced property.
I . 3 sets of revised design plans, I with original signatures.
2. Submittal form for revised plans.
3. Check to cover the fee.
The following changes have been made to the plan.
1. Benchmark has been added to the plans.
2. The vent and a note specifying that the end of the pipes shall be tied to the vent has
been added in the profile view.
3. The foundation drain with an elevation has been shown on the profile view.
4. The benchmark note has been revised..
If you have any questions please do not hesitate to contact this office.
Sincerely,
Benja C. Osgoo r., EIT
President
F3,
60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099
May -27-99 1,?!:4SP Nor--th Andover- Com. Dev. S08 688,9542 P . 01
SEPTIC PLAN SUBMITTAL FORM
LOCATION: Zio-Z S. t=z�, (-�-o
NEW PLANS:, YES $125.00/111an
REVISED I)LANS: S 60.00/Plan—,
SITE EVALUATION FORMS INCLUDED: YES NO
DATE:
DESIGN ENGrNEER:
toe
DATE TO CONSLrLTANT:
*If you want your plans expedited, please submit three plans and, included a
stamped envelope with the correct amount of postage to mail plans to Port
Engineering.
When the submission is all in place, route to the Health Semtary-
j
T(- �A �)Cv*'=R/
Nov -06-00 11:35A Paul D. Turbide, PE/PLS 978-465-0313 P.02
PORT
ENGINEERING,
Civil Engineers &
Und Surveyors
One Harris Street
Newburyport, MA
01950
(978) 465-8594
October 31, 2000
Sandra Starr
North Andover Board of Health Administrator
Office of Community Development and Services
30 School Street
North Andover, MA 01845
RE: Title V review for SDS new construction at 262 Soutb Bradford Street
Dear Sandra,
Enclosed find our review of the "Checklist for North Andover Septic System Plane' for
the septic system upgrade at the above-mentioned site. The following is a list of
technical deficiencies that Port Engineering has found.
• Elevation of foundation drain is not shown as required by NA 8.02y'
• Benchmark is not shown on the plan as required by 3 10 CNM 15.220(4)(q)..-,
• Distribution lines are not capped as required by 310 CMR 15.251(9).,,/
If you have any questions or comments please feel free to contact Tne
\\Server PNABIMS84\SO BRADFORD 262.DOC
NEW ENGLAND ENGINEERING SERVICES
INC
October 23, 2000 ,
Sandra Starr, Administrator
North Andover Health Department
Town Hall Annex
27 Charles Street
North Andover, MA 0 1845
Re: 262 South Bradford Street, North Andover, Septic system design
Dear Sandra:
Enclosed are the following documents concerning the above referenced property.
I . 5 sets of design plans with original signatures.
2. Soil evaluator forms.
3. Application for approval.
4. Check to cover the fee.
Also enclosed is a priority envelope with postage addressed to Port Engineering. I have
enclosed this to hopefully speed the delivery process to Port.
If you have any questions please do not hesitate to contact this office.
Sincerely,
BeWjja - CCO-sgo ir., EIT
President
60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099
No.
FORM 11 - SOIL EVALUATOR FORM
Page I of 3
Date-A7/�010
Commonwealth of Massachusetts
MO. , Massachusetts
Soil Suitabft Assessment f-Qr On-site.Sewage-Disposal
Performed By: ...... :7�� ... * ...... �� �e- 4�9 --1�0
........... Date: / /
WitnessedBy: ...... . . .......... .. .... ........................ . ..... ......... ............................. . . ... .......
Lmllan Addras or owmrs Nam, A;0.� Z�P, z
Aftess. aM
TckpMne
New construction El Repair E3 6-? -7
Office Revie*v
Published Soil Survey Available: No 0 Yes ZS
Year Published ................. Publication Scale Soil Map Unit .. .... ..... .. ....
z . ..... ...... . 5Z
Drainage Class ..... Soil Limitations �4,P
�7
Surficial Geologic Report Available: No An Yes
Year Published Publication Scale
GeologicMaterial (Map Unit) .. ...................................................... ........ . .................................... .... ..... ..
Landform. .. ...... I ............................ ................... ................................................................................. 11 ............................. .. - ........... ..
Fl�od Insurance Rate Map:
Above 500 year flood boundary No E]Yes N
Within 500 year flood boundary No EJ Yes D
Within 100 year flood boundary No []Yes El
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
-'5�
Current Water Resource Conditions (USGS): Month
Range :Above Normal ONormal R13ekwNormal El
Other References Reviewed:
NoDEP APPROVED FORM - 12107195
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No.
On-site Review
Deep Hole Number Date: Time:. Weather�/_Vl_
Location (idgatify on site plan)
Land Uso Slope Surface Stones
Vegetation.
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet Property Line ��.tF feet
Drinking Water Well_ feet Other...,.._.—-..-...
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
iMunsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
"d
ef:�z5 :5
7
Parent Material (geologic��/,Py
Depth to Groundwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water: -46'1
DEP APPROVED FORM - 12107195
Weeping from Pit Face: —
FORM 11 - SOIL EVALUATOR FORNi
Page 2 of 3
:�50
Location Address or Lot No. �6-2-
On-site Review
DeepHoleNumber ime:
Weather��//
...........
Location (identify on site plan) .... ...... .... .
Land Llse� Slope Surface Stones
Vegetation .
Landform
Position on landscape (sketch on the back)
Distances from:
feet
Open Water Body -4 ��o feet Drainage way . 7
Possible Wet Area !��Ae> feet Property Line feet
Drinking Water Well ., -7... f eet Other... .... . .. .......... .
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
iMunsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
.5:4r
�-216; _5
jo
veryRtw
- miimivium vr 4 nuLco nrwvinry P%p cvrni rnwvw,�vv wfor
Parent Material (geologic)
��71 / /- Z—
Depth to Groundwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water:
DEP APPROVED FORM - 1210719S
M"Lm
Weeping from Pit Face: —
y12
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. 2C,2 jo.e
0
On-site Review
Deep Hole Number Date:.Ae/`/`I�� Time: /0: /0
Weather
Location (identify on site plan) .......... . .. . ... ... .....
Land Use SlopeM -4, Surface Stones
Vegetation .
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet Property Line f eet
Drinking Water Well feet Other,
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
iMunsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
7-4 W
494
::14 C,
gY
C'0N*fV#
1/9.
2)1 lvcr
mimmum tir z MULCO nrUVInCLI P% I rvr"T F"WFW'JQW W50F
Parent Material (geologic)
Depth to Groundwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water: 4
W '
DEP APPROVED FORM - 12107/95
MnQ�
Weeping from Pit Face:
Y
Y/e
FORM 11 - SOIL EVALUATOR FOJINI
Page 2 of 3
Location Address or Lot NQ9�Alo. �V�Elv
On-site Review
Deep Hole Number Date Time:/41.* _�10 Weathe
Location (identify on site plan)
Land Use . Ap-&55�POV7�� Slope M Surface Stones
Vegetation
Landform
Position on landscape (sketch on the back) 1-7r"l-P - 5_7,4
Distances from:
Open Water Body -- feet Drainage way eet
Possible Wet Area feet Property Line .... feet
Drinking Water Well feet Other ... ... .... ... . ......
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
Woe
'00
IL
<
- ivmvuvivrA vr 4 riuLco nrwwricu j6% i L;v rn i rnwr%jorw wior%jN�%6 P%"FP%
Parent Material (geologic) DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water:
DEP APPROVED FORM - 12/07195
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No.,-'�'4:�;.2
Determination for Seasonal.High Water Table
Method Used:
11 Depth observed standing in observation hole ................... inches
r 1 Depth weeping from side 0 observation hole ........... .... inches
W1 Depth to soil mottles inches -F&=
El Ground water adjustment ................... feet 4!5"' 4"'
Index Well Number .................. Reading Date .................. Index well level ....... . ... ...
Adjustment factor ................... Adjusted ground water level ...................................... . ..............
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system?
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on: (date) I have passed the soil evaluator examination
"--6z -5—
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.
WX
9ionature
WDEP APPROVED FORM - 12/07195
May,27-99,12:4SP Nor -t -h Andover- Com. Dev- jS08 688 9542
SEPTIC PLAN SUBMITTAL FORM
LOCATION.- 2(,Z -S
NE NV P L AN S:
$12 .00/1'1,
q
REVISED I'LkNS: YES S 60.001P Ian—.
SITE EVALUATION FORMS INCLUDED: NO
DATE:..
DESIGNENGFNEER:
,DATE TO CONSLrLTANT:—Lb
*If you want your plans expedited, please submit three plans and included a
stamped envelope with the correct amount of postage to mail plans to Port
Engineering.
When the submission is all in place, route to the Health Secret:ary.
P.01
V%ORT#t
Fax 978-688-9542
Board of
Appeals
(978) 688-9S41
Building
Department
(978) 688-9545
Conservation
Department
(978) 688-9530
Health
Department
(978) 688-9540
Public Health
Nurse
(978) 688-9543
Planning
Department
(978) 688-9535
Town Of North Andover
Community Development & Services
27 Charles Street
North Andover, Massachusetts 01845
November 6, 2000
Ben Osgood, Jr.
New England Engineering
60 Beechwood Drive
No. Andover, NIA 0 1845
Re: 262 So. Bradford Street
Dear Ben:
William J. Scott
Director
(978) 688-9531
This is to inform you that the proposed plans for the site referenced above have
been disapproved and have technical deficiencies as followed:
1. Elevation of foundation drain is not shown as required by NA 8.02y.
2. Benchmark is not shown on the plan as required by 310 CMR
15.220(4)(q).
3. Distribution lines are not capped as required by 310 CXM 15.251(9)
If you have any questions, please do not hesitate to call the Board of Health
Office.
Sincerely,
Sandra Starr, R.S., C.H.O.
Health Director
cc: Tara Leigh Development, LLC
file
Town of North Andover, Massachusetts Form No.1
�40RTkj BOARD OF HEALTH
0 19-
0
13
APPLICATION FOR SITE TESTING/INSPECTION
TED
CHU
Applicant
NAME ADDRESS TELEPHONE
G>Z
Site Location 'Al J
-4-0 r
Engineer—
NAME ADDRESSJ TELEPHONE
Test/Inspection Date and Time
CHAIRMAN, BOARD OF HEALTH
Fee— Test No.
S.S. Permit No.-D.W.C. No.________C.C. Date-Plbg. Permit No.
EA
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Intended use of land: residential subdivision, single family home, commercial
Repair testing Undeveloped lot testing
N. A. Conservation Commission Approval:
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 $275.00 per lot for new construction. This covers the minimum two deep holes
and two percolation tests required for each disposal area. 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
disposal area.
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.
BOARD OF HEALTH
wD
TEL.
21"
8-9540
NORTH ANDOVER, MASS. 01845
APPLICATION FOR SOIL TESTS
DATE:
0 P -
LOCATION OF SOIL TESTS- I-Crr
5��Jwf
P-2 12 iq P f ba
0
Assessor's map& parcel number: loil-e
loye- e 1
OWNER:a;,m&; 7#weojko
TEL. NO.:
ADDRESS: �? G -a -711,� 2p,
rt--,cO Cp
el, -
ENGINEER: Nc--, &�
V
TEL. NO.: (�-1 7 G
CERTIFIED SOIL EVALUATOR:
Ct 00 CQ
Intended use of land: residential subdivision, single family home, commercial
Repair testing Undeveloped lot testing
N. A. Conservation Commission Approval:
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 $275.00 per lot for new construction. This covers the minimum two deep holes
and two percolation tests required for each disposal area. 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
disposal area.
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.
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John F. Zahorulko
262 South Bradford Street
North Andover, MA 0 1845
Benjamin Osgood, Jr.
New England Engineering Services, Inc.
60 Beechwood Drive
N,orth Andover, ?vLA, 01845
September 6, 2000
Dear Be-,).:
I hereby give you, Or any persons or organizations working with, for, or all your mquest, my
consent to enter upon the pren-iises at 262 South Bradford Street, and to file all applications with the
To,Am of North Andover or any other regulatory authority, for the purposes of performing, soil tests and
other site evaluations associated with the research, design, and approval of a septic system.
Since
re
John F. Zahoruiko
ZO'd OtC3-699-809 oo ---�LudLAC] L16ta-1 le.,OL�J_ dl:q:E30 00-OT.-ClaS
BOARD OF HEALTH TEL. W8-'9540!;;
NORTH ANDOVER, MASS. 01845
APPLICATION FOR SOIL TESTS
DATE:
LOCATION OF SOIL TESTS: i—c7- 9 rvF2 Q
Assessor's map & parcel number:,,oAjj9 loje pri;eeel
OWNER:a-.,,-H&., -24woa )j)<L) TEL. NO.:
ADDRESS:
ENGINEER: /V TEL. N 0.:- 7
CERTIFIED SOIL EVALUATOR:
Intended use of land:. residential subdivision, single family home, commercial
Repair testing Undeveloped lot testing X
N. A. Conservation Commission Approval: Zl�t'�Y
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 $275.00 per lot for new construction. This covers the minimum two deep holes
and two percolation tests required for each disposal area. Fee of $75.00 per lot for
repairs or up -grades.
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
disposal area.
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.
TOWN OF NORTH ANDOVER
DIVISION OF PUBLIC WORKS
384 OSGOOD STREET
NORTH ANDOVER, MASSACHUSETTS 0 1845
J. William Hmurciak, Director
TimotkyJ Willett
Raff Engineer
April 18, 2000
Ms. Heidi Griffin
Town Planner
27 Charles Street
North Andover, MA 0 1845
RE: Proposed house Lot A- 1-2, '
Adjacent to 262 South Bradford Street
Dear Ms. Griffm:
Telephone (978) 685-0950
Fax (9,78) 688-9573
The Division of , Public Works has reviewed the plan by Scott Giles, R.P.L.S., for John Zahoruiko, for the proposed
house adjacent to 262. South Bradford Street and has the following comments to make.
I . We are opposed to the construction of a roadway because it is an excessive amount of infrastructure for two
houses. The existing driveway should be made into a common driveway as shown on the plan.
2. The current Town Sewer Project, known as Phase 3C, will not provide a sewer service to 262 South
Bradford Street. The sewer will end in front of house 250 South Bradford Street due to elevation
limitations. The Phase 3C. design was intended to reach 262 South Bradford Street originally, after which
250 South Bradford Street was built. The construction of 250 South Bradford Street took away some
frontage from 262 South Bradford Street, where the sewer connection was supposed to go. The sewer main
on South Bradford Street will be installed at great depth and expense to reach these houses.
3. If 262 South Bradford Street is determined to be within the Lake Cochickewick Watershed, (which is
unclear at this point), then it should be connected to the new sewer along with the proposed house. There
are two ways to accomplish this. The first way is to obtain a sewer easement from the owner of 250 South
Bradford Street and run two 6" PVC sewer lines - one for 262 South Bradford Street and one for the
proposed house. It appears from the topography of the lots that gravity lines could service both houses. If
an easen. ent cannot be obtained, ther. sewer lines for 262 Soulki. Bradfor A Q—eet and t e prcposed hause
must be installed through the proposed common driveway. Sewage will have to be pumped to the end
manhole in front of 250 South Bradford Street.
If you need more information, please contact me.
Very truly yours,
Timothy J V Willett
Staff Engineer
CC: Bill Hmurciak, Jim Rand, Sandy Starr, Richelle Martin, Ben Fehan AM
TOWN OF till!
SYSTEM PUMPING RECORD
DATE: co
SYSTEM OWNER & ADDRESS
SYSTEM LOCATION
(example: left front of house
DATE OF PUMPING: 6 -,& QUANTITY PUMPED:
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
6'. (— - 'sl . /0.
CONTENTS TRANSFERRED TO:
6 20M
GALLONS
Samuel F. McCormack Co., Inc.
Insurance Adjusters and Appraisers
ADJUSTERS AND APPRAISERS
Town of North Andover
Board of Health
North Andover, MA 01845
RE ASSURED: James Nyhan
Gentlemen:
11/13/2003
. I V 7 , 'I"
LOSS LOCATION: 270 South Bradford Street North Andover, MA 01845
POLICY NO:
HP2168423
TYPE OF LOSS:
Lightning
DATE OF LOSS:
11/11/2003
OUR FILE NO:
2003-04141
Claim has been made involving loss, damage or destruction of the above -captioned property, which
may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to
be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 319 is
appropriate, please direct it to the attention of this writer and include a reference to the above -
captioned insured, location, policy number, date of loss and claim or file number.
Thank you for your anticipated cooperation.
Very truly yours,
Edward F. Bennett
Adjuster
cc: Building Inspector
222 Forbes Road m Suite 304 oBraintree, MA 02184
(781)-843-1222 m MA WATS 800-972-5399 oFax (781)-849-8191
Samuel F. McCormack Co., Inc.
Insurance Adjusters and Appraisers
.%mupl F Wrmmaek rA ine
11/13/2003
Town of North Andover
Board of Health
North Andover, MA 01845
RE ASSURED: James Nyhan
LOSS LOCATION: 270 South Bradford Street North Andover, MA 01845
POLICY NO:
HP2168423
TYPE OF LOSS:
Lightning
DATE OF LOSS:
11/11/2003
OUR FILE NO:
2003-04141
Gentlemen:
Claim has been made involving loss, damage or destruction of the above -captioned property, which
may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to
be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 313 is
appropriate, please direct it to the attention of this writer and include a reference to the above -
captioned insured, location, policy number, date of loss and claim or file number.
Thank you for your anticipated cooperation.
Very truly yours,
Edward F. Bennett
Adjuster
cc: Building Inspector
222 Forbes Road m Suite 304 oBraintree, MA 02184
(781)-843-1222 m NIA WATS 800-972-5399 mFax (781)-849-8191
Commonwealth of Massachusetts
City/Town of
System Pumping Record RECEMW
Form 4 17 _� I n 47,)
JUL r- Lu I&
DEP has provided this form *for use by local Boards of Health Othe forms may be 'used, but t e
information must be substantially the same as that provided �ere. NjQInjCkhb#aMjW4 k with your
local Board of Health to determine the form they use. The System 3.%jffffARTAffiMe s ibmitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location: Left / Right fron Left / Right rear of house, Left / right side of house, Left
Right side o di
W , , e / Right front building, 6�i �t rear of building, Under deck
I QCityjrrown
vs
2. Sys wrier
Name
Address (if different from location)
City/Town
Sul -A
1
Zip Code
State _C06 ip Code
Z20�3 R7Z
Telephone Number
B. Pumping Record 0 , / "� 2�
1. Date of Pumping Date--- 2. Quantity Pumped: Gallons
3. Type of system: El Cesspool(s) DIS—eptic Tank E] Tight Tank
El Other (describe):
4. Effluent Tee Filter present? [] Yes D_iq_o�
5. Conditi no Systern.-
6. System Pumped By:
. Neil Bateson
Name
Bateson Enterprises Inc
Company .
7. Location
pontents were disposed:
G L S.
� . L �Sp Lowell Waste Water
t5form4.doc- 06/03
If yes, was it cleaned? [] Yes F� No
F5821
Vehicle License Number
e _(q - (1:4
Date
V\ -
System Pumping Record - Page 1 of 1
Commonwealth of Massachusetts
City/Town of
System Pumping Record
Form 4
DEP has provided this form for use� by local Boards 6 f Health. Other forms may be *used, but the
information must be substantially the same as that provided here. Before using.this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location: Lefttj���h Left/ Right'rear of house, Left/ right side of house, Left/
Right side of building, Left Right ftbnt of building, Left / Right rear of building, Under deck
Address '7- -7 4
Aj
City/-rown State Zip Code
2. System Owner
S-1ji"
Name'
Address (d different ftm location)
Cityfrown
Stat
eoCode
Telephone Number
B. Pumping Record
1. Date of Pumping 2. Qu tity Pumped:
Date Gallons
3. Type of systern. El Cesspool(s) 0 --Septic Tank Tight Tank
Other (describe):
4. Effluent Tee Filter present? Yes If yes, was it cleaned? [:3 Yes F1 No,
5. Conditioij of.System:
6. System Pumped By. -
Nell. Bateson
-Rame
Bateson Enterprises Inc-
-dompany .
7. Locpfief�)�contents were disposed:
Waste Water
F5821
Vehicle License Number
Date
t5fbrm4.doe- 06/03 System Pumping Record - Page I of 1
TOWN OF
SYSTEM PUMPING RECORD
f;:�- �REC�EIVOD
DATE:
SYSTEM OWNER & ADDRESS
z %n
DATE OF PUMPING: L —)-9 -
SYSTEM LOCATION
(example: left front of house)
QUANTITY PUMPED:
f
SEP - 7 2005
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
�OW^Z5--C
GALLONS
CESSPOOL: NO j YES SEPTIC TANK: NO YES J
NATURE OF SERVICE: ROUTE14E 7 EMERGENCY_
OBSERVATIONS:
GOODCONDMON
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER.
FULL TO COVER
BAFFLES IN PLACE
LEACIIF1ELD RUNBACK
FLOODED
OTBER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: G-L.S.D V Lowell Waste
commonwealth. of Massachusetts
C'
ity/Town of
System Pumping Record
Form 4 107
FEB 0 8 2007
1, VVJ
DEP has provided this form for use by local Boards: of Health. h
qj$ystdfhRPd
T A ord must
be submitted to the local Board of Health or other approving a th6 TH DEP",
..A. Facility Information
Important:
When filling out 1. System Location:
forms on the
computer, use
only the tab key Address
to move your OA -4%_k
cursor - do not
use theretum Cityrrown
State 4. e
key.
System Owner:
v -A
Name
Address (if different from location)
City./Town
State/I e,
Telephone Number
13. Pumpifilg,.Red-ord
Date of Pumping � -1 �V
Date 2. Quantity Pumped:
Gallons
I Type of system.. EJ Cesspool(s) trSepric Tank TightTank:
El Other (describe)�
El Yes
4. Effluent Tee. Filter present? No If yes, was it cleaned? Yes:fl No
5. Condition of Sy
V�-
6. System Pump
Name
Vehicle License Number
Gompany
Location whWe t t
n, Pon s were dispo^,
e3co
Siqnaiure of
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
J*--- ----h
Commonwealth of Massachusetts RECEIVED
City/Town of I I
System Pumping Record
FEB 10 2009
Form 4
TOO OF NORTH ANDOVER
&U
DEP has provided this form for use by local Boards of HeaK Mq kw���
�s d, but the
information must be substantially the same as that providea-r-ere. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location: Left front, left rear, left side of hour�-fkigh�tfr�� right rear, right s6jj:�
Address D -"7D
Cityrrown
2. System Owner:
Name
Address (if different from location)
Cityrrown
B. Pumping Record
1. Date of Pumping
3. Type of system: 0
State
MA
k
Date
Cesspool(s)
C
Zip Code
State a F. Zip Code
C
0 _C�D 4� "7
Telephone Number
2. Quantity Pumped
0 Septic Tank
,4.)
Gallons
Tight Tank
Other (describe):
4. Effluent Tee Filter present? Yes [9-11� If yes, was it cleaned? Ej Yes r] No
5. Condition of System:
6. System Pumped By:
Neil Bateson
F 5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. LocatpiQ where contents were disposed:
7��. Ir-S-1,5�7- Lowell Waste Water
N --f-1 A
tignafu-re of
t5for4doc- 06/03
/ �)
Date L,
System Pumping Record - Page 1 of I
RECEIVED
Commonwealth of Massachusetts
JU
City/Town of JUN 2 4 2013
TOWN OF NORTH ANDOVER
System Pumping Record LT r
::r
Form 4 FHEALTHCDEPARTMENT
DEP has provided this form for use� by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using Ahis form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Locatior� eft i g h (:f:� :Kc i :n :hou �el-eft / Right rear of house, Left / right side of house, Left
a. R It t:o:f s
t;
0 116
ft / Right front o building, Left / Right rear of building, Under deck
Right side of builc ing, Lei fron b
Address
r
��-) r7 D
<q-�:)tAkA,
,
6 4 1
f - — *L6�
Cityrrown
State Zip Code
2. System Owner
uu I
C
Name
Address (if different from location)
City/Town
B. Pumping Record
1. Date of Pumping
3. Type of system: M
State C e
Telephone Number T
Date 2. Quantity Pumped
Cesspool(s) * 8 --Septic Tank
Other (describe):
4. Effluent Tee . Filter present? Yes a-N-�o
5. Condilb. Unf System. -
6. System Pumlied By:
t --1
,!:) 4--e�
Gallons
El Tight Tank
If, yes, was it cleaned? El Yes r-1 No
vco� I (&e -a -p C-) �� t � C-�" \ V-\
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Location where contents were disposed:
GL
Lowell Waste Water
Date
t5form4.doc- 06/03 System Pumping Record - Page 1 of 1
ICN Commonwealth of Massachusetts
City/Town of RMBIVE11
System Pumping Record MAY ? 8 2010
Form 4
TOWN OF NORTH ANDOVER
DEP has provided this form for use by local Boards of Health. Other f(jrmNUftTHb9E1WWNWMe I
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location: Left side of house, Right side of house, Left front of hous ht fro i� 11: of house,
Left rear of house, Right rear of house. Left rear of building. Right rear of building.
Address
City/Town
2. System Owner:
Name
Address (if different from location)
Cityrrown
B. Pumping Record
1. Date of Pumping
3. Type of system: F1
F-1 Other (describe):
State Zip Code
Date
Cesspool(s)
State Code
az
Telephone Number
2. Quantity Pumped:
E—S—eptic Tank
Gallons
El Tight Tank
4. Effluent Tee Filter present? E] Yes 2-11�`o, If yes, was it cleaned? E:1 Yes 0 No
5. Condition of System-
(\,ux�z�
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Locat ntents were disposed:
L/(3. D Lowell Waste Water
of
Date
C)
t5form4.doc- 06/03 System Pumping Record - Page 1 of 1
t
' r 1 r
Commonwealth of Massachusetts
City/Town of
S item Pumping. Record RECEIVED
YS
Form 4
JUL
DEP has provided this form'for use -by local Boards o f Health. Oth R.# TIN, jbq\q!jedFb.qt the
information- must be substantially the tame as that provided here. 10elpl:p -gAhis.,ifbrM, check with your
qn
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility. Information
1. System Location: a)RIgh �o�lntof ho�usf, Left/ Right'rear of. house, Left/ right side of house, Left/
g M oq
Right side of building, Left / R%1 7n uildifig, Left / Right rear of building, Under deck
Address
01��-
Cftyfrown State Zip Code
2. System Owner
GX-)-J\
Address (if different from location)
Cityfrown State
Zip Code
A
Telephone Number
B. Pumping
1. Date of Pumping
3. Type -of system-. E]
4.
Date 2. Quarift Pumped:
Cesspool(s) ' G-S'eptic Tank
Gallons
Lj Tight Tank
Other (describe):
Effluent Tee Filter present.? El Yap 0-9-0--� If yes, was ft cleaned?
5. Condition I Nem
6; System Pumped By. -
7.
t5form4.doo- 06/03
Nell BatesFon
Name
Bateson Enterprises Ina
Company
contents- were disposed:
El Yes El No..
F5821
Vehicle Ucense Number
System Pumping Record - page I of I
41