Loading...
HomeMy WebLinkAboutMiscellaneous - 30 SHERWOOD DRIVE 4/30/2018 (2)PIM9, MAP # /06 -0 - PARCEL # /4 LOT # STREET!3jMtN Ujp o & 'by, q CONSTRUCTION AP HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE $//� .7 APP. BY /j/0 DESIGNER: A) eve 19556e PLAN DATE /lo CONDITIONS WATER SUPPLY: WELL PERMIT WELL TESTS: PLUMBING SIGNOFF COMMENTS: TOWN -,,' WELL DRILLER ICAL BACTERIA II DATE APPROVED DATE APPROVED TE APPROVED WIRING SIGNO l FORM U APPROVAL: APPROVAL TO ISSUE YES NO DATE ISSUED /off /�G%/1 BY ]� CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID E~ NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED FINAL BOARD OF HEALTH APPROVAL: YES NO DATE: 4 - BY: SEPTIC SYSTEM INSTALLATION IS THE INSTALLER LICENSED? TYPE OF CONSTRUCTION: NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW CONDITIONS OF APPROVAL (FROM FORM U) 1 YES NO _NEW REPAIR YES NO YES NO ISSUANCE OF DWC PERMIT �� � 4 k YES NO DWC PERMIT PAID? YES NO DWC PERMIT N0. zf 7INSTALLER: BEGIN INSPECTION YE NO: EXCAVATION INSP CCyT��ION. NEEDED: PASSED I z � 1 7 % BY CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: YES: APPROVAL TO BACKFILL: DATE: BY FINAL GRADING APPROVAL: DATE_4e�? 5" By FINAL CONSTRUCTION APPROVAL: BY i Commonwealth of Massachusetts RECEIVED City/Town of System Pumping Record JUL 1 1 2013 FOlrnt 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other_fo s 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 Systv Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important: When filling out forms 1. System Location: on the computer, use only the tab 7a C 1,e r L,jGod -D(. key to move your Address cursor - do not Ajo , A y the return keCity/Town ,; Y Mp Cone 2, System Owner: kd6r 6;1 t ec- Name acre Address (if different from location) City/Town State Zip Code `3 73 7 Telephone Number B. Pumping Record 1. Date of Pumping Date /3 2 Quantity Pumped: SAO Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: t5form4.doc• 03/06 Name Company 7. Location where contents were disposed: SSD Signature of Hauler ` Signature -of Receiving Facility venicle license Number Date uate System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts } City/Town of Nf.ORTH ANDOVER MASSACI�U TS�� - _ System Pum in9 Record AUG o Form 4 TOWN OF NORTH ANDOVER DEP has provided this form for use by local Boards of Health. The HEALTH DEPART" .NT be submitted to the local Board of Health or other approving authoritytem-Pumping-Record mu; A. Facility Information - Important: When filling out 1. System Location: forms on the. computer, use �� only the tab key Address----- - ....._.__ -- - - _-- —--...._.—_-- — ------ - -...-- ---- -- to move your n � cursor - do not use the return y Cit /Town State Zip Code - key. 2. System Owner C� m 2 /z Name ream Address (if different f•---rom -—) ---.___.._... ._.._...._.__..__...___—.------ --------...._.._..-.--...-------...--- :..._----------------- ---- - —location _ City/Town—�-------------------------- ------ State=----- Zip Telephone Number B. Pumping Record - Date of Pumping Dat - -- 2. Quantity Pumped: ns Gallons -------- _ Type of system: ❑ Cesspool(s) (Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ® No If yes, was it cleaned? ❑ Yes ❑ No r 5. Condition of System: jjC Sy em Pumped By: Name �.1-- --- ----- --...-------- ----- - - Vehicle License Number - c5t a Company - — - 7. Location where contents were disposed: Si atureof Hau Date - - - -- http://www.mass.gov/dep/water/ provals/t5forms.htm#inspect t5form4.doc• 06/03 System Pumping Record • Page 1 of TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD D.A'1 F: SYSTEM OWNER & ADDRESS klo SYSTEM LOCATION (example: left front of house) ` D:1TE OF PUMPING: Let A N T I TY PUMPED 15YdGACLON.S ;' ' C.S 1'UU'L: NO �S SEPTIC TANK: NO YES . 5 NATURE OF SERVICE: ROUTINE EMERGENCY 0I3SERV.,kTIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER ` 1'S, 1.►LM PUMPED BY: CUNINIENTS: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) (.UN'1'I,N"CS TIZANSFEIZIZED TO: c r TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 06/16/99 This is to certify that the individual subsurface disposal system constructed ( X ) or repaired ( ) by Ben Osgood, Jr. at Lot 1 Sherwood Drive has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations as described in the Design Approval Site System Permit # 937 dated 08/11/97. The Issuance of this certificate shall not be construed as a.guarantee that the system will function satisfactorily. Board of Health Inspector P. 2 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (A) constructed; (' ) repaired; by— Benjamin C. Osgood, jr located at was installed in conformance with the North Andover Board of Health approved plan, System Design permit i#q�, dated/ with an approved design how ofyp 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 3110 CMR 15,000, Title S and local regulations, and the final grading agrees substantially with the approved plan, Ali work is accurately represented on the As -built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection date; Engineer Representative Irutaller:,s-;Lica. Date: / Design Engineer: Date: K No. 3rM t�14E i e,vr 0'f I; : TN it, ft,.4, .1 # Gtr f1 F►4A-rfv�.l I'S JaT A �� �1L/k ►1TY O �'f ►� C '506 e7UW�eGg 12.4po*lu 4'(f7TEN , ST ii, A e p,,ww of -rr; E l&A-r W ANC? C I•E VAIIO01 of -rel E, e,- `ri Nei *Ye> r &VH r0W r&i4 rAi. � J i AS BUILT PLAN 12OF �Yc �Eenc -rA,\j it SU,BSURFACE DISPOSAL SYSTEM LOCATED 1N pog _r A►J�O�I ►�-, `� Lam'(" i ZaN c K iJ Cov� i9 \1 E AS PREPARED FORK L G6Wp10-,L Vli.l.A66 M ��' ' 'CIVIL DATE: + 2b -q 9 NO -37752 o.3» .� SCALE: Zo' r► 1 v `' C `TEP 1 44 ,. Tv MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS 0 LAND SURVEYORS • PLANNERS ��' % 7I 66 PARK STREET 0 ANDOVER. MASSACHUSETTS 01310 or TEL (617) 475-3533, 373-57?i n AS -BUILT OIECKLIST [/ LOT NUMBER STREET NAME ASSESSORS MAP &; PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS 4@Sc LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS -a. FROM SEPTIC TANK -b. FROM LEACH AREA rZQ416sr LOCATIONS OF DEEP HOLES & PERC CSEE Ot ,(6A( tt,&)) TESTS G/ ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES W/IN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF / TANK & D -BOX STAMP & SIGNATURE / M- IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW FINAL CONTOURS LOCATION & ELEVATION OF BENCHMARK USED m- LOCUS PLAN Srii�7 vsrc.aj Ply 0 b --U I- 1 W�y 1 I: -3&AM f -N M TOWN OF NORTH .ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby cenify that the Sewage Disposal System %) constructed, (') repaired; bYi BeajaoniA c. Osgood, jr locced at_.o was iumhed is conformance with the North Andover Board of Health approved plan, System Desig=11?ernnt N? , datedwj(q ti with an approved design flow of JJL 3 used WM in confo gaitons per day. The m�ateriair�cnanee with those specified on the approved plan, the system was installed in accordance with the provisions of 310 CMR 15.000, Title S and local regulations, and the final grading agrees substantiaDy with the approved plan, All work is accuratdy tepresented on the As -built which has best submitted to the Hoard of fIealth. Bed inspection date: Final inspection date: Iustalier: Engineer Representative Httg' eer Represarnstive Date: D. 2 AS -BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCELER LOT LINES & LOCATION OF DWELLINGS a� l V i LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES W/IN I50' OF SYSTEM LOCATION OF WATER, --GAS, ELECTRIC LIVES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D -BOX STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW v-' FINAL CONTOURS LOCATION & ELEVATION OF BENCHMARK USED LOCUS PLAN CO) 10 CD C• Z CD o d =r CL S. .. ... C "O CO) CD O CD CD y. CD y CD O C CD CCD m C 2 ? d %; O Q y ac m y' mamma I m? ym,ac l = a� IA =°^'CD y -n C . -.d m O ® y O y CDCD = O � C=3 n -al t .-► O y� n • m N � . a CLo aa: CD ® y CD y d y CL ;` Q CL i �1 O to y2 C m y� O m m > m CO moc :. CD .-. C=D': =co(,viy c: om:�:�: m . o'0 no c,j CD Ab Fil It OG ; `c7 5' n o y G o G o D O OQ r T c\ d •�ti � +4 � � ^7 w 1`` Ct 9-09-1995 d:SOAM FROM P.2 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (y() constructed; ( ) repaired; by �..,. located at was installed in conformance with the North Andover Board of Health approved plazz, System Design Permit #2&-L , dated g / _with an approved design flow of `�yZ� ;allons 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 fugal trading 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.- Final ate: Final inspection date: Engineer Representative Engineer Representative Installer: 9-ZLica: Date: ,26 rDate: -//-& �< 'Toys �T�t� ��4hG.• is 9-09-1995 4:50AM FROM Date m . to Permission is hereby granted to Construct ( ) or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. `/3 7 CHAIRMAN, B ARD OF HEALTH Fee �-s D.W.C. No. /Oyy Town of North Andover, Massachusetts Form No. 3 NORTH BOARD OF HEALTH 01 ' h A —19 t � '°�,,.o:•'`� 9SSACHUSEt DISPOSAL WORKS CONSTRUCTION PERMIT Applicant / ' k -A NAME cjADDRESS TELEPHONE Site Location l Permission is hereby granted to Construct ( ) or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. `/3 7 CHAIRMAN, B ARD OF HEALTH Fee �-s D.W.C. No. /Oyy APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# LOCATION: LICENSED INSTALLER: v SIGNATURE: TELEPHONE# C, 06 - (7 6 CHECK ONE: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. $75.00 Fee Attached? Foundation As -Built? Administrative Use Only Yes No Yes �� No Floor Plans? Yes No Approval Date. 140RTh ACHUS Town of North Andover, Massachusetts BOARD OF HEALTH Form No.2 DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant— Test No. T Site Location Reference Plans and Specs TE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN, BOARD OF -HEALTH Fee Site System Permit No. Q(3 w: oma: �: WILLIAM [3A P2 TT SI �lN00n mvI IAf - I -0" MIL2M, Or- FINS HOMrS "FIRSfFLOOR PLAN � fGVP HOOpF-P O i a� w: oma: �: WILLIAM [3A P2 TT SI �lN00n mvI IAf - I -0" MIL2M, Or- FINS HOMrS "FIRSfFLOOR PLAN � fGVP HOOpF-P a S rd WILLIAM t3Al2�'E 1"1' " 9f ONOOt717t?N� I Of - I ��` OY, TOnn HOO-F-P A v 6 C3uILl2�t? OF �IN� NOMAS —""`� S�GONI7 FI.00f? t'I,AN o ' �a aI� S rd WILLIAM t3Al2�'E 1"1' " 9f ONOOt717t?N� I Of - I ��` OY, TOnn HOO-F-P A v 6 C3uILl2�t? OF �IN� NOMAS —""`� S�GONI7 FI.00f? t'I,AN Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES WILLIAM J. SCOTT Director August 12, 1997 Mr. Thomas Neve Neve Associates 447 Old Boston Road Re: Lot 91 Sherwood Drive Dear Tom: 30 School Street North Andover, Massachusetts 01845 This is to inform you that the proposed plans for the site referenced above have been approved. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp CONSERVATION 688-9530 HFALTH 688-9540 PLANNING 688.9535 JUL 1 19097 THO NEVE ASS''CuTgS9INC. ? N June 26, 1997 Board of Health 30 School Street North Andover, MA 01845 Attn: Sandy Starr Re: Lot 1 Sherwood Drive Dear Sandy: On June 1'7, "1997 our office sent you a letter with revised septic plans for the above -referenced lot but inadvertently omitted the $25 revision fee. Find enclosed a check for $25 for your review of the plan. If you should have any questions please do not hesitate to contact our office. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. �L* Kathy Molina Personal Assistant Enclosure #1449 7ANUSZ. WPS • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 SEPTIC PLAN SUBMITTALS LOCATION- LnT- i NEW PLANS: YES REVISED PLANS: YES DATE: /4 1 1 qP93-- DESIGN ENGINEER.- 2nDh—k- $60.00/Plan $25.00/Plan P�L When the submission is all in place, route to the Health Secretary TH(2 June 17, 1997 Ms. Sandy Starr Board of Health 30 School Street North Andover, MA 01845 Re: Lots 1 & 10 Sherwood Drive Dear Sandy: EVE INC. 7 JUN 18 1997 Please find enclosed three (3) prints of the revised septic design for Lot 1 Sherwood Drive. All of the requested revisions according to your June 2, 1997 letter have been made except for #5. As allowed under 310 CMR 15.002, definition of bedroom, our client would like to grant to the approving authority a deed restriction limiting the number of bedrooms to four (4) for Lot 1 and Lot 10 (see disapproval letter dated 6/2/97). It is my understanding that we will need to present this request to the Board of Health. Therefore, we ask that you schedule us for your next Board of Health meeting so that we may discuss this issue. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. John M. Morin, P.E. Civil Engineer JMM/kmm Enclosures • ENGINEERS • 447 Old Boston Road (508) 887-8586 • LAND SURVEYORS • U.S. Route #1 #1449 JANUSZ.WPS • LAND USE PLANNERS • Topsfield, MA 01983 FAX (508) 887-3480 To: Sandra Starr North Andover Board of HealthThoFrom: Thomas Neve (508) 887-3480 FACSIMILE COVER PAGE Date: 6/25/97 Time: 14:41:50 Page: 1 To: Sandra Starr Company: North Andover Board of Health Fax #: 688-9542 From: Thomas Neve Title: President, CEO Company: Thomas E. Neve Associates, Inc. Address: 447 Boston Street Topsfield, MA 01983 USA Fax 4: (508) 887-3480 Voice #: (508) 887-8586 Message: Re: Lot 1 and 10 Sherwood Drive, Timberland Builders (Janusz) Dear Sandy: 6125197 14:42:04 Page 1 of 1 I met with Bob Janusz and he made the decision to redesign the systems on the above referenced lots to accomodate a five bedroom design, even though his plans call for 4. This would allow a future buyer flexibility. Please remove us from the agenda tomorrow evening. Thank you. Sincerely........ Tom NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT DATEz ll? FEE: PERMIT #qJ 7— DATE RECEIVED /`� /C/ % APPLICANT--- J.�/UUSZ MAP PARCEL ADDRESS LOT # STREET ## ENG. vel STREET JSA�<.-?f)Og P2 ENGINEER'S ADD. PLAN DATE ih 19k196 REV. DATE CONDITIONS OF APPROV APPROVED DISAPPROVED REASONS FOR DISAPPROVAL: /U & W&r4 4,06 S 3. 5�/�/S�T� ��/j3L�.4�ra,c� )—ae )4is missIrv('. AG F p� 9c 1961 69 -1- 5,(0 c �2 /,3-, -)Lo 6- June 2, 1997 Mr. Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot 1 Sherwood Drive Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: If new plans satisfactorily addressing all the following issues are submitted to the Health Department by _ J U IJ 6- , then approval for the plans should be given by JU eJ6- o� J i/i. Elevations of peres missing. (N.A. 6.02j) il. No wetlands disclaimer. (N.A. 6.02) 01�3. Soil/site evaluation forms missing. :i4. Missing note: First 2 feet of pipe from D -box to be laid level. (3 10 CMR 15.232(c)) Insufficient leaching for 5 bedroom. (3 10 CMR 15.002 & 310 CMR 15.203) If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 30 School Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT Director June 2, 1997 Mr. Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot 1 Sherwood Drive Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: If new plans satisfactorily addressing all the following issues are submitted to the Health Department by June 16, 1997, then approval for the plans should be given by June 23, 1997. O p � 1 � 9. < 1. Elevations of peres missing. (N.A. 6.02j) 2. No wetlands disclaimer. (N.A. 6.02) 3. Soil/site evaluation forms missing. 4. Missing note: First 2 feet of pipe from D -box to be laid level. (3 10 CMR 15.232(c)) 5. Insufficient leaching for 5 bedroom. (310 CMR 15.002 & 310 CMR 15.203) If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R. S. Health Administrator SS/cjp CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary . approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this LLL Phone APPLICANT: �A2✓ W a -Y S I/y�OmQ�� �-LC Phone �9t7 Z 'd�� LOCATION: Assessor's Map -Number z Parcel2�L_ Subdivision (� Lot(s) Street '30h2.^C�1Do�l(� �� St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments o2'7 02 O Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments 1)120,}Ilinyly) 0.f 9 Public Works Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved 9� Date Rejected Date LOCATION: - NEW PLANS YES REVISED PLANS: YES DATE:— 3—// -3—h - DESIGN ENGINEER: SEPTIC PLAN SUBMITTALS S60.00/P1an_____Z $25.00/Plan When the submission is all in place, route to the Health Secretary Homes of this stature are few and far between. With over 4,200 square -feet eet of living space, this stunning dream home offers a traffic -free formal living room and dining room with :a breathtaking library off the foyer. For the entertainer, The Springmanor offers an over- sized gourmet kitchen, a convenient service entry and rear stairway. Its striking two-story foyer will be the talk at even, social occasion. The Springin . anor also offers four luxurious bedrooms and three and a half baths. e rin manor Lot ATUMbel- I LOFT BZ Caw 'j, 7 BEDROOM 3 el V, 3 'EDA0 2 sows a�zaqtsA. • BEDROOM 4 NIGHTS PESER—, 0- I—aaIII'a SECONDFLOOR PLAN MASTER SUITE t-�=—IWAAIAST gearLAUNDRY PROS l=' 1) PR 2 -CAR GARAGE j- SIL III DINING LIVING 0 FOYER (Di SCHOLZ DESIGN LIBRARY ALL e..INTS FIES MD. FIRST FLOOR PLA PLAN REVIEW CHECKLIST ADDRESS Z/ 5/�,6,eZX)6Q-b ENGINEER /V�(/� GENERAL 3 COPIES t-STAMP&�-' LOCUSy NORTH ARROW SCALE CONTOURS PROF ILEf,:�--(Sc) SECTION// BENCHMARK SOIL & PERCS ELEVATIONSz,.'�C WETS. DISCLAIMER WELLS & WE::T:S�4--- WATERSHED?'DRIVEWAY WATER LINE c---- FDN DRAIN 4--'*' M&P SCH40_1,� TESTS CURRENT?�� SEPTIC TANK MIN 150OG V/ .17 INVERT DROP 10' TO FDN i/ MANHOLE 6X D -BOX SIZE ELEV ## LINES A SOIL EVAL GARB. GRINDER #0 (2 comps +200) GW ✓ ## COMPS . j GB &--- FIRST / FIRST 2' LEVEL STATEMENT - INLET) T �a - OUTLET III, %a ,2 ( 2" OR .17 FT) TEE REQ' D?__A& LEACHING / ,/ MIN 440 GPD?L✓ RESERVE AREAy 4' FROM PRIMARY?/ 20 SLOPE"L—­- 100' TO WETLANDS X100' TO WELLS i-' 4' TO S.H.GW Z-� (5'>2M/IN) 20''TO FND & INTRCPTR DRAINS ZI-� 400' TO SURFACE H2O SUPP 4' 4' PERM. SOIL BELOW FACILITY MIN 12" COVERI-'*' FILL?&---" 1 BREAKOUT MET? TRENCHES ��1 / �1,/ Y MIN 440 gpd V SLOPE (min .005 or 6"/1001) k/ SIDEWALL DIST. 3X EFF. W OR D (MIN 6'1 v RESERVE BETWEEN TRENCHES? I -"'IN FILL? �-� MUST BE 10' MIN. 4" PEA STONE?v VENT? 01A'e" (>3' COVER; LINES >501) BOT Q0 + SIDE = LS X LDNG '= TOT (L x W x ##) (DxLx2x##) (G/ft2) Copyright 0 1996 by S.L. Starr ... ...... ... TOWN OF R NO I D SYSTEM Pum 'n SYSTEM OWNER. -ADDRESS DATE OF PUMPING: I ANDOVEE 0 RECORL) ro _QUANTITY PUMPED: CL'SSPOOL: NO____"y SOPtic Tank: NO NA ruRb OF SERVICE: Rou'rINE.... L____ FLMERGEN('y YES RECEIVED OCT 0 5 2004 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 013SERVA MONS: GOOD CONDITION -.,L--FULL 'r)0 COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK BXCF,SSIVE SOLIDS FLOODED SOLID CARRYOVER-.... OTKER EXPLAIN systomPumped by CPO--. CSI;._ . ,L3raa�drz�; 177a. OJMMENTS. CON FEN FS FKANSYERRED I-0 0 -tea � ,•.,� S>'S;Qm loca�'on: JA, •,,v•;t,;;'�,-'• �`�'�:,!:'�' •. :�,;,:..::,,,� � Siler 71 vt- F4 (I(QVfrrinl rlnn l .. P,umA�f18 Rt e�ord' ' TY➢�. vl � � I' ' i'�r7�On, n,mpl, ,,,• Yslem,.. )►1�enI Tee Fllle(;pIp�enr7 r' Yo9 .,I, ,�nlr•t,�:•.�I,, Inti !,. Im P ' pod �^aj•.1:� ' ;IY'ry�l' ,y I f, I1V'I i(�1 '.f(�I {I'I r: ��" I S7' ^..S•,,'�, oq4, on, h .. .'I,•.:,��I,'„ ,.�� o(�`ppr��Onla;waie vl,possa: V., ;r.mesa.porlderelef/89 P(9YeJallblorm�,r,"nain9�bcl ^ 1-� .T la,-. It ya'. as c aanao� �? res