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HomeMy WebLinkAboutMiscellaneous - 31 FULLER ROAD 4/30/2018 31 FULLER ROAD 1 / - 210!065.0-0076-0000.0 ^ I II F ..� 57000 >V TOPOF FND. \ 14424(1 0) (� HOUSESEWER D BOX INLET 139 08 ( 13 8066) 13705903 783) AN .� t ! D BOX OUTLET �._ 137044( 137.66 ) LOT 13 3ti' END OF FIELD 137018( 137.45 ) TANK INLET PROFILE _138.131 ( 13844vo ) — SCALEo TANK OUTLET— VERT. I"= 4 138055( 138019 ) HORIZ. 1 =40 _NOTEoALLPIPE El FVoARE INVERTS J 'PLA N A N D IL Ro . SEWER AGE DI SPOSAL S e 1t E rSTING OWNEPo- JAYSON REALTY, TRUST FNDLOCATI ON o LOT - 13 FULLER Pd DATES 120 W U Jt, 6 D ?50 00 FULLERRpo �} ( IARK=TOP OF FNDo LOT 15 ELEV.= 1`S40 57 }_}`> �T3ENCH�; 1,, t0 __ ------ \ DATUM, SE PLAN DAT 13Y 6ELINAS AND ASSOC. �\ ED- 32 7.0 r 173v I OPOF FND. 14424 (140050) HOUSE SEYfER D-BOX INLET �S t 139085( 138066 ) F1,37,590,37.83)o .sem I D EOX OUTLET 13744( 137066 ) 0 LOT 13 END OF FIELD 137018( 137.45 ) 0 TANK INLETJ PROFILE y �1 13 8.91 ( 138e44) SCALE Q J �a TANK OUTLET- VERT. 1/= 4' 138x55( 138of 9 ) HOR 170 1 -40 NOTEO-ALLPIPE El EV.ARE INVERTS vo IL — Il 1ST r---_ _ — I FND. NE Ro JAYSON �; _AL;Y Tr;!�S . . L ;CST; t�; LD i I `_ I= L _ R RP. c 11-25- JAR FPAP,ED BY,, 4 120 W � �SN o► �,,Ss F1 00 FULLER PDQ \ =1 _� LOT 15 ELE� ` I Es i�EN_CI-� :iia�;K='E �.}� OF 1=�r�� �L= I�=�.� ��7 Boards of Health North Andover�Maas. BEPTIC SISTEM INSTALLkhCr1 CHXX LIST LOT 13 v % �_�____ i t APPROVED DATE I7I UM AVATIM M FAIL easansl - , OK 1. Instance Tot- a. Wetlands b. Drains ' c. Well 2. Water Line Location 3• No PVC Pipe - 40 septic Tank a. -Tees--_Length & To Clean*Oat Covers. b. Cement Pipe*to Tank On Both Sides of Tank �. 5• Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amoimts C. No Back Floss 6. Leach Field or Trench a. Dimensions b. Stone Depth c: Capped -Ends.. . d. Clem Double-Washed Stone' ; T• Leach Pits a. Dimensions °.. b. Stone Depth f c. Splash Pads d. Tees e. Cement Pipe to Pit - Both Sides. f. Clean Double Washed Stone 8. -No Garbage Disposal 9• Final Gradng Inspection 10. Barricading Covered System _ 11. As Built Submitted__. a. Lot Location b. Dimensions of System c. Location -.4th Regard-to Pere Test d. Elevations e: Water Table Board of health t North.•AndoversMass r SUBSURFACE DISPOSAL DESIGN CHECK LIST LOT YPROVED DATE DISAPPROVED DATE` 'rovided: Reasons: `itle © PAIL OK _. :eg 2.5 The submitted plan must show as a minimum: :a) the lot to be served-area,dimensions lot # abutters location and log deep observation Mes-distance to ties location and results percolation tests-distance to ties design calculations & calculations shaming required leaching area location and dimensions of system-including reserve area existing and proposed contours (g) location any wet areas within 1001 of sewage disposal system or disclaimer-check wetlands mapping (h) surface and subsurface drains within 100, of sewage disposal system or disclaimer (i) location any drainage easements within loot of semge disposal system or disclaimer-Planning Board files W known sources of vater supply within 200+ of sewage disposal \ system or disclaimer (k) location of any proposed well to serve lot-1001 from leaching facility location of water lines on property-101 from leaching facility location of benchmark P)q' -driveways garbage disposals no PVC to be used in construction profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Other elevations ra-maximum ground water elevation in area sewage disposal system S) plan must be prepared by a Professional Engineer or other professional authorized by lax to prepare such plains Reg 6 Septic Tanks a) capacities-156% of flow, water tables tees, depth of tees, access, pumping (.b) cleanout 10t from cellar wall or inground swimzdng pool (d) 251 from subsurface drains eg 10.2. Distribution Boxes ,a)" slope greater ME 0.08 eg 10.4 b) sung: +1 I j� i i Submit-face sign Check List 'Pae 2' FAIL 0K ' Leaching Pits - ! Leaching p s are preferred where the installation is possible Reg 11.2 a) calcula ons of leaching area-minimum 500 eq ft 11.4 b) spac i 11.10 c our ce drainage 2% 11.11 n co r material e 2 r.2IAII splash pad f e at elbow g no bends in pipe from d-box to pipe Leaching-Fields Reg 15.1 no greater an 20 minutes/inch b area-minimum 900 sq ft 15.4 construction of field 15.8 ) surface drainage 2 % 3.7 e) 201 from cellar van or inground swimudng pool Leachin 'a Reg 14.1 a c c 2:'m9 � eaching area-min 500 eq ft !� 14.3 b spacing-4 f 6 ft with reserve between 14.4 c dimensions 14.6 Id) construe on 14.7 e) stone 114.10 f) surfac drainage 2% v DouOM Slope s ope y x = to be shown b y/x x 150 - (to be shown Reg 9.1 a) app val 9.6 b) s d-by power Address 3 � ���-�-�2_ 12 1 Title of File Pae of .� 9 Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action-and notes action Document/ document/ Num• Action Department Board of Appeals — Board of Health — Planning Board — Conservation Commission — Building Department G� r� i .' 'CO MMoTH OF MASSACHUSETTS EXECUTIVE OFFICE QF'ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION s it Tf)wN OF td0 TR}{ VER/, BOF,Rn OF TH NOV - 6 OFFICIAL INSPECTION 1"ITLE 5 FORM•-NOT FOR VOLUNTAR ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM , PART A • CERTIFICATION Property Address: 31' Fuller-Road N- Andover MA -18 Owner's Name: Aaf (l�Rricn ' Owner's Address: C a m Date of Inspection: -9-._2 0 0 2 Name of Inspector:(please point)_John _Souc � Company Name: Snnr S 'Spwo r S �,...,... ..,�e_ry i c e Mailing Address;_P.o. Box 4158,�' fid_.oyer SMA 0181 0 Telephone Number;9 7�8-4 7 0–?4 00 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 functiOA and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to section 15;340 of Title 5(3 10 CMR 15.000).disposal The system: X_„_'` Passes —.Canditionaily Passes Needs Further'Evaluation by is the Local Approving Authority Inspector's Signature:. Date: q The system inspector shall snit a copy of this ins coon DEP)within 34 days of completing this inspection.If the System is a shared system or has as desto the Approving Authority Board of Health or ign ow of 1 000 gpd or greater,die inspector grid the system,owner shall submit the report to the appropriate regional office of the DEP.The original should be seAt 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 hpw the system conditions of use, will perform in the future under the same or different Title 5 Inspection Form 6/15/2000 page 1 Page 2 of l 1 7- Y OFFICIAL INSPECTIONY.ORM'�=NO FOR'VOLUNTARY ASSESSMENTS ' , SUBS AQ9,SEWMFUMPOS SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 31 Fuller Road n over, Owner: Pat'; 'Brien Date of Inspection: '14n V Inspection Summa7 'Check A,B C` Qr /ALWAyStc�omfete all of Section D V AXI. 44 A. System Passes: X I have not found any nformatton which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.30. 4 exist,'Any failure criteria trot evaluated are indicated below. ' 1�.L ji 4 l�� .� .(U 'b tF .hln•7.! ...... 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 pr repair`;;as approved by the Board of Health,will pass. P 7 R ...-...tu... Answer yes,no or not dete ed ,N (Y ,Nle)un the ° for the fallowing statements.If"not determined"please explain. 3" 3tT'F'• CC1lGi[t�k�(Si 3L i y +x,r� �•} J, The septic 1 p tank is metal end pve 2p ears 9. 1 'or tb1c septic tank(whether metal or not)is structurally unsound;exhibits`substantialktpflttlon'o` filtrtion'ortat}k'failure is imminent.System will pass inspection if the existing tank is replacod`W thla cp nP.Yu g i eptie�tank as'approved by the Board of Health. *A metal septic tank will pass,it}spection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years gld is available,' i, ND explain: Sa4I('.tj#Utp # dkf!fu',t is� # ; {�l 63i]tL#lfv . Observation of sewage backup or break out or high,static'water level in the distribution box due to broken or obstructed pipe(s).pc dye.,tga.hnpkep,sottlen or uneven distnbiition.box.System will pass inspection if(with approval of Board of Health '' €, '�`#. . broketi;pipe(s)ara roplaced ;.�.i,ar. . ;f; 3,.'Astction pis rani9ved-w i t 1 . .7;, z: :,a,*tu i.tft� d �• , rr�rfstrnbuknoA box is leveled oat4replaced.: :! U`t faP, a6:.t ibIV ND explain: The system requ.iredpiupping'more{tbait a times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Boor d of Health) " =7 broken pip (s)are replaced , { obstruction is removed �a ;'iz3,F aq4►ai'10 9s t.�:F#;`. � . 71 mdtFtiil wsWl 0j4 w#6AYW'07Xtk1 w 7''l S LVA ll}qY [u.:�i.ld ND explain: - TV . S t 2 Page 3 of 1'1 OFFICIAL 'ISNTOM; OT`FOR VOLUNTARY ASSESSMENTS SU$SUR-F'kCVA F PIROS,AUUMEM INSPECTION FORM t CE$TIFIATI4N( Qutimiued) ' Property Address: 31 .'Ful ler 'Road . ) N Andover MA 01845, i Owner: r 13r1 A r''� Date of Inspection 1 0 09 02 C. Further Evaluation is Required by the Board of Health, . Conditions exist which re' quue further,,onluatton by the orad of Health in order to determine if the system is failing to protect public health;safety or t>te en it Y omlmeAt i:, 1. System will pass.uoless,B,eardfait6 determacewith 310 CMR 15.303(1)(b)that the System!s not fuu(e lQpju ,j�&mt!une yrlucb y�-- Protect public health,safety and the environment: —.'Cesspool or pAYy.ts,wtthut',�O feox'.of a sarfacerwater lrz �v;� Cesspool or pnvy is withi4 50 feet of a bordering vegetated wetland ora salt marsh +t t t.1��st�'S��� Il+rh",v�r F"Y�[1><�4:{•rj� il� , F 3. .� � F.:a9'('}i :�fa }��� r *�,,�4.{'�• ,,rl�1e 7.,N r .. t X�,I'�rptki .} (s'(f Qt.tE(tt klydf} 14}1J ki.yv'f r dt:f(liltj.l �'S1'<.l fYiit` `�C?kf'klie' :. t; ?�j 'J t.:l � ,et471". 2. System will fail unless the$oard of Health(and Pubbc'Vyater Supplier,if any)determines that the system is functioning in a maminer..tlmt pkois",the public bcalth,safety and environment: �• t1��F:�.1�<ktld ;;� �Vt��£�'e1'Y{��Ec sit 3,s,,�'.;{���rt#iu, r; _ ce system_has },seFttc sAil,absom�tion SystAm(SAS)and the SAS is within 100 feet of a surface water supPly 6r 1� 1 1 a titer s !Y suPPlriia.:p r � f 11 LAO ulb,ci4v 13klit Tt��F�*��tfi ISS y+aldtak� V�R�°5G ?t'} i..: —' P sYsm hgslAh� nk�a �SS andathG,St�S,isk�+ithi}i a Zone 1 of aublic water supply. P PP Y• • r Mrr3,� 4atr3�*�ttt��tgi1 W'AI],fq�fi,tu$il Z fr�3(�a ��1�k;j#!�dG'rt�3 ', "r• system has a septic t and SAS,a>1d,tliukSASiis, rithiA SO.feet of a private water supply well. _ The system has It sePU�Wk,04 SAS.andathe SAS,is lc$s,.than 100 feet but 50 feet or more from a private vYaxerj5upplY•welj+�-,�Met .od used to,de r rmmiiiie�du#an 3 ) :� i�11Y,1}.}?�AJ�•It:4:-l�f'}Ifj'r'}�q���YG:I�d ! 1 .'(: ... *"This system passes mf the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic•Gompouuds indicates that *,Well is free from pollution from that facility and the presence of ammonia nitrg9en and nitrate nitrogemi is.equal to or less than 5 ppm,provided that no other failure criteria area ggeicd,, ecq YS iached,to this form. :�F �i/1�.+�{tYa:,�i;a1i'(� Fttif 4}�';-1�Jli.�,L2r`!f,�c�•. 3. Other: f ., .__ F. - ,'v4"F r'•'+ 1�,,,+d;7+ r rt .:'.k% }�!.!:'�. fr, rel=,,rai t• 111 r3'tj k'RIP ttslt� l7t .t g .. r, t • �!F ttra t(,f,�id�,�� ��3� r;s .}�t ��1l�'t„�� ,?k:r.��r,�{+.t��1 i�.�.6J , ,•,c,i aai7T�t��,G`grr i Page 4 of 11 OFFICIAL,INSpECTIONjFORM1,r NOT`FOR V.OL'UNTARY ASSESSMENTS • SUBSURFAOV.;SEWA(;E,!-DISPOSAL; SYSTEM INSPECTION FORM PART:A-011° CE tTIFICATIOX(conxinued) Property Address: 31' Fu7.ler Road " N 'Ancloveri MA 01845 Owner: P t: 'O'Brien° Date of Inspection: 1 0 09, G2 D. System Failure Criteria applicable W44 systems You must indicate!`yes;;or,6,tiR"�tereaChAfe�following for$Il.:inspections: . u Yes No 1Baclntp Qf sewageduto"facihty:ofstela Gpmpoaipat due;to overloaded or clogged SAS or cesspool Dischargo.or:pandmg�of eiliieAt,xo the surface o> the ground or surface waters due to an overloaded or clogged SAS or cesspool 4' �,' — -_X' Static liquid level'n the distribittioii box above outlet-invert due to an overloaded or clogged SAS or cesspool �l�ist&� 1e♦ ; �a Cpt f,a31;. lt'ud — __X Liquid depth m cesspool is'less than 6"below invert or"available volume is less than'/z day flow „_X�Required pumping more then 4 times in the last year V T due to clogged or obstructed pipe(s).Number Of times Peed Any portion of the.$AS,cesspool or privy is below high ground water elevation. _. Any portion of cesspool or pn�ry is,within 100 feet:of a surface water supply or tributary to a surface water supplyalab('Cr,a 1 Qttaiigg aw-aiIdoIt l}ta�)u�. Any portion ofa4sepopl=_pftuj,,as withiWa;Zonql4 a public well. Any portion of g cesspool or privy is within SO feet of a private water supply well. X:Any portion;of�'oessttpol.ctx p }+y19,C0111444.OQ:fee0btit•greater than 50 feet from a private water supply well With no acceptabl,s watdr qualitXiitnalysisf[This system passes if the well water analysis, performed ata DEt'certifed'labpratory,far coliform bacteria and volatile organic compounds indicates that toe. rgll,ijs;: rgnjlppllu�on frpp':tfiat facility and the presence of ammonia nitrogen and ttitrate'uitrogen'i. equal to or less than 5 ppm,provided that no other failure criteria aretriggered;, pf theihalysis.must'be•attached to this form.] Nn (Yes/No)The system fails.-I liey sted;,that ons iljiiore of theabove failure criteria exist as r described in 3 IR15 03°thet4�orp;:the.systepl;fajls.tThe system owner should contact the Board of Health to detertnine what avtll be necessary to corlrpq the failure. 1f?tu�J- "Tda ,# r f( F3� f �dS qJa"it,"�i JfdlC4 i E1'C.YIrtf '1', t r �LdJ �! It-� k7' nQ ,ir,`i S jf,fi# ,41 4a y1M'1�E•r�l;, ' fiw,tr..1�3�51 ✓a+4r;� . E. Large Systems. r''n 'il >tal`1r�0 l4,1*?!� To be considered a large system the systemtmOstUrve'a facility'•with a design flow of 10,000 gpd to 15,000 gpd. a You must indicate either"yes".or"no"io each of the following. (The following criteria apply,to largo systems in addition to the Criteria above) �s yes no — the system is within 40A feet o f g surface dru}luig vtilr dip 1 H� P y _ , the system is within 200feet ofbptary to_;tutfng Yater supP1Y i the system is located, a nitro en sensitive $ } . . area(IntPrlrun Wellhead Protection Area–IWPA)or a mapped Zone II of a public water supply well, ty 'r'. a F If you have answered"yes"to'a! question in."'a ion E the system is considered a significant threat or » 1 answered `yes in Section D above the IU8q s stem iias failed. � d g. Y The owner'or operator of any large system considered a significant gn ant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The's tem owner r should Contact the•appropriate regional office of the Department. ^f 4 Page-5 of 11 " TYPRVOLUNTARY ASSESSMENTS ' SUS ' 9,,PJ$ X ,P0SA STEM INSPECTION FORM Property,Address:_ 31 "F.iiller Road `•`;`- N.' Andover FA-0 1 .8 4 5 Owner: P t D'•Br en.;: Date of Inspection: 10 09 :02 Check if the following have been done You must indicate`. es'll-or"no"as to each of the following: Yes No '"X -- Pumping infoimQ .�' .1sividgd b}utbe owner,Qccupant,or Board of Health 77 j,- ' X Were any of the system components pumped out in the previous two weeks? _._ Has the system received normal flows in the previous two weekperiod? _ x Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) h Was the facility or dwellui,uts [cted for si of sews.e back u �. t � 1 .. g p . X ., Was the site inspected for signs of break out? _X _ Were all system components,excluding the SAS,locatCd.on site , _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of Gonstructi dunensions; ept}1 Q f liquid,depth of sludge and depth of scum? A ; ,X _ Was the facility owner(and occupants if dtf fer f0 from owner)provided with information on the proper maintenance of subsurface sewage disposal systems k t 'i Y t f <.., �^135[az#��'}t�,�}•.ls` ,t#(.E}� Biu it{} '.. The size and location of the$oil Absorption$y_sten(SAS)on the site has been determined based on: Yes no X. Existinginfo rmation For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 0.302(3)(b $ , tir fi�iiY }1 r({V..il a rix n4ifq t"L'eS}:' t ( 4 t 'w.N '• �..yyl .tet. „ i f Ma» . (rCairtat3fti.Tt9 �r Page 6 of 11 OFFICIAL. NS PECTIONTORM;"aLNOT QR-VOLUNTARY ASSESSMENTS SUBSURFA►CE:SEWAGE-DISPOSALf-,$YSTEM INSPECTION FORM PART. .` 4 SYSTEM II' FQItMATION Property Address: . " 31, Fuller Road N. AMA 01845 � ,' Owner: Pat O'Brien Date of Inspection:- 10 10-9102 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): =tt ,. Number of bedrooms(actual):, '4 DESIGN flow based on 310 CNiRK.15 203(for example 110 gpd x#of bedrooms): 4 4 0 Number of current residents;" _ Does residence have a garbage,lder ye ` sor no).. Is laundry on a separate sewagQ sYstem,4yesur , ifY �inspection required] Laundry system inspected(yes or no): ? P P q ] Seasonal use:(yes or.no) �c �13p ra+t7 r1 6?V1:7 qtr i�lY"� ►�a l) Water meter readings,if available(last 2 years usage(gpd)): `St Attached Sump pump(Yes or no) No'' Last date of occupancy; (A(f, COMMERCIAL/INDUSTRIAL Type of establishment:, Design flow(based on 310 CMR 15.203). . aad Basis of design flow(seats/persons/sq#I,etc.)4 Grease trap present(yes-or, Industrial waste holding tankpresent(yes or no) '•, ,;,, , ; Non-sanitary waste discharged to the Tatle S system(ye s or no) Water meter readings,if available. Last date of occupancy/uses t� f•�ws r ii 1�N'»f i a it#s�f��LAt.>,�,I C � r.. t OTHER(describe) a Ie_" i t _s rr..'?�'s ti3'�'r P•i tirF " , f+t tf:"� {i. . a a i�r Nb,*e1�E illy. GNERALINFORMATION PumpingRecords Source ofinfdrmation:``Pumped Q41._" L approx every third year Was system pumped as part of the his pectiO4(yes or no) Noy If yes,volume pumped; pai.9n$-, Hq was quamdty pumjped determined? Reason forpumping . Maint•era�rtd ' <.and,fs' ptig;,, ink , inspee ion TYPE OF SYSTEM X Septic tank,distribution box,'soil absorption system;a� Single cesspool ;. OVerflO V`9§sPoo Privy x` r Shared system(yes or ti o)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology Attach,a copy of the current operation and maintenance contract(to be obtained from system owner):;:,., r' `;; '. r L• —Tight tank ,_Attach acopy of the,PEP approval —Other(describe): ' Approximate age of all components,date installed(if known)and source of information: 20 Years Were sewage odors detected when arnvuig at the site(yes or>o): y . 6 Page 7 of 11 a ` OFFICIAL;-INSPECTIOMTO r NOT` OR VOLUNTARY ASSESSMENTS SUBSURPA CESEWAGEDISPOSALtSY.STEM INSPECTION FORM • PART.O i c„ s a . . s SYSTEM,EVORMAt,TION(continued) Property Address: 'R gad N_ An8nue.r, ma Owner: pa+ n'B pn Date of Inspection: 10/09/02 BUILDING SEWER(locate onsite , Depth below grade: 1 8�' ` Materials of construction:)iki cast iron"4r FYC other(eXplain):. Distance from private water supply well or suction line_ N[A Comments(on condition ofigints,venpng;evidence of leakage, } SEPTIC TANK:_X(locate on site plan) Depth below grade:. 15" ` Material of construction, X conprete•� Tfiberglass polyethylene _other(explain) If tank is metal list age: ';a age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) <• Dimensions: 6' X `1?0 5' ' :'air '// _ Sludge depth: 0 Distance from top of sludge to bottom o f outlet tee or baffle:'` 3 9" Scum thickness: ,! t JiI Distance from top of scum to top,of outlet tee,or baffle A Distance from bottom of scum tp bottom of oto kqt tee or baffle How were dimensions determined '.,Tare and Sludge Tool Comments(on pumping treeommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of:leakage,etc.): . Pump annually.'recommend' no garbage,"disposal. r y 5 •:i ' GREASE TRAP;n[,locate Ow site plan)+ #g Depth below grade: Material of construction concrete ' ass'�� pof eth lene other(explain): _ Dimensions } Scum thickness: Distance from top of scumtop of outlet tee or baffle. _ Distance from bottom of S'cum bottom of outlet tee or baffle: " Date of last pumping: _ , Comments(on pumping recolnntendations,offer and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc J: : . 7 . . "Page 8 of 11 OFFICIAL;.INSPECTI4NiFORM`-NOT'FPR-VOLUNTARY ASSESSMENTS SUBSURFACErSEwAGEIDISPOSAV4YSTEM:INSPECTION FORM PARTZ.V4 r.�;SYSTEM:INFORMATION(continued) Property Address: 31 Fuller, Road N. An over MA 184.5 Owner: Pat O'Brien, •i , DateofInspection: Octgj�er�'09 2002 ` TIGHT or HOLDING TANK n/a{tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction concrete `metal ,i (frglass; _polyethylene other(explain): ••-•r—,— ...., Dimensions: } k t } Capacity: "gallons' Design Flow: ' allons/day 1 _� Alarm present(yes or no): ' Alarm level: ,Alarm m w9rk6 order(yes or no)' }' Date of last pumping: condition of ( al d Warm ati. Aoat switc Comments hes, '�St514r1»� �'!E..r max! .•r• • to W J J4 (GJ vii i }7 ttP+{ r z DISTRIBUTION BO7� (tf present mast be opened)(iocate on site plan) y , Depth of liquid level above qutlet tnyert Comments(note if box tslevel and distnbut;on to outletsequal;,any evidence of solids carryover,any evidence of _I leakage out of box,etc.); ` into or r ..Yi fit Flow checked'!okay. not sign'of r Wrauli:c failure, 1 r 4f t 1t: 3 StPt1� C [Its� t�,M;f W" PUMP CHA11%IBER:N/A on'sq flan) Pumps in working order(yes or Ito): >. Alarms in working ordgr(yes or no):` Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): .r V 3 a j t <71i 4Ar't > bJiJatJta? It'�13js3Jttm k, 'J' ff IE} z :i {1 �1Ji.3 j t • I t s. . •tie E 8 Page 9 of 11 , OFFICIAL ,lORNOLUNTARY ASSESSMENTS SUBSUrRRFrD; YSTEM INSPECTION FORM .. f #ARTO SY TIr. �41Q1`(continued) r s Property Address: '31 Fuller Road N.Andover_MA 01 845. Owner: Pat O'Brien Date of Inspection: 10 0 9/0 2 z' SOIL ABSURPTIQN SYSTEM (locate on site plan,excavation not required) r } N •��t ,` a a i If SAS not located exPY, A,ee�s �'�l;te i -r(. ii'a z• iY`Ex � :3:fiif r- rp.w ;r. Type , leaching pits,number' leaching chambers,number:- leaching galleries,number leaching trenches,number,length -X_leaching fields,number,dimensions overflow cesspool,.number >; innovati e/alt o 3at ye s stem- . ' � ', TYP.e$ _- ce ohnology. .Comments note condition of oil,si1of hydraulic failure,level ofponding,damp soil,condition of vegetation, etc.): No sign of fhydraul' c failure. I , CESSPOOLS:j La(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 es or,4o): Comments(note condition Q€soil,signs 9f hydraulic failure,level of ponding,condition of vegetation,etc.): r PRIVY: n[a(locate on site plan) Materials of construction, "` { Dimensions }.. •� Depth of solids: ' Comments(note condition of soil,signs of oydraulic failure,level of ponding,condition of vegetation,etc.): 9. ° , t i .Page to of 11 N i OFFICL 1 INSPECTIONYORM�-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWA ,E DISPOSAL SYSTEM INSPECTION FORM • ,,k ��. . *RT•'C:�' SYSTEM INFORMATION(continued) Property,Addrm:- _141 Fill 1 Far Road Owner: Pat O'Brien a Date of Inspectiou: Y f..y, SKETCH OF SE V* WAGE DISPOSE,,SYSTEM r } Provide a sketch of the sCWa d benchmarks.Locate all wells wnthw 1pin,,i sygem,inclpding ties to at least two permanent reference landmarks or p feet:Locate where public water supply enters the building. '.t .•;{, 31 Fuller R ads` 1 xth .udov+er eMA 01845 .. 4 r.' y. �. GD , F7 t'f" {f 2v y •i Yr y .� r. a I .;•z kr ry �. .. v s rwr.n �yyrws�r,.R.•5,,,,., .YSZ T+'•r ..m�,T,(n'..T. '"`� w f.,rs• Cti �, v `- er k �'Y n��`r lit, o. a � s kW �'yp r i # ! >• 'Y3�'' �. a�,�, it�, a �� �+t�_,^yrs � i.�'�y e2.� '� '" ,• ' ' e Y?,'r ��i a. d •.*s"�a.�+t'r� r ft4t�Y'�i a rf� �i}"j i<�� �,, • ,.r Sa 1n Page l 1 of 11 a OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE:DISPOSAL, SYSTEM INSPECTION FORM �, PART C N t i k r SYSTEM INFORMATION(continued) Property Address: 31 k'Fdllei 'Road F �,N Andover MA 1018451 Owner: Pat Q, Brien ' Date of Inspection:"—'} 1 x/0910.2 T SITE EXAM i Slope Surface waterCC i • i ;•,a 1`..�rY alt`i;,wi ra t� Check cellar X , Shallow wells Estimated depth to ground Please indicate(check)allethods used de � #o glume tate high ground water elevation: Obtained from system design dans on record If phecked,date of design plan reviewed: Observed site(abutting propetty/Qbseri4iap hole within l�,Q feet of SAS) Checked with local Boar4:q#'pelth-explatua Checked with local excat!ators,installer ;(attach d to 'on) AccessedUSGS database. , . ;F� t f T { You must describe how you established the btgtion: Duo t hole with au erg 4 "feet ydown;in:.low drop off area near woods Found no �water :resent:,"4 t. V.`f .I !' ♦{ '. ,41x1 3.+a 7 _ • 1 F 1-[2 f Y � tt 1 � `� fi 4 1 > ^ {, 1 •N f.k� xkrn'S,1 k't F A'�qt `y � 4,7 x T •1:.. b 4 s lk f t rt1 k i jj ,i, S Y 1 + �p • � f i'4;N ti! 14,21 � ��� � R �•u>si . i . V 1 e +u s! '� a. 1. .k R ! i._ 1 c;UG niU:v IUPAA I b I IL14;');JUU_ Tflb SAVINGS 13ANK CC�002 E PAYlENVS TO .:TOWN OF NORTH ANDOVER 15719 23 ���L �1 � 3/12/2Q02 CYCLE 20Q2 WATER/SEWER BILL # Account: 3160277 5 ,t Meter: 3160277 l Service: 31 FULLER RD a i. f f $ •i ��'�3. i `! J'. f;t�'-lw rt,P d.S.tj�7.rt<+�lrs.7,tr 'tistaSx4.•.t1y�.El ' •'r:;'``+�:u�•NKUM 43vpY�011n�+',ti.�ytt.,4.�2�:nt}.r ff9sfi•$Dft)yd,?�^;L49+��',yy�y, kre t?b.' �}`},`#;v rgy ,s �{ i;.•,?�aT:. 'p . ....,.scr'..(.,#.,,i:7::.. ..... ...... .i._.. '�fi��. �� :�Rv,:$;+•d<•�if�sE'��'.+S:fk'+���'�'G:'rd'Kyrt+�'73' ''ri`ii' ` 'r ' Y ;e„' } 3 {'��rw't!d'�¢���.�fi,''�''�•`'' �sem.:. r' r.o 0r BRIEN, JOHN F 31 FULLER ROAD N. ANDOVER MA 01845 r. by5 ,ff ygr, Retain this. voucher for your r(cords ,.}�• _ $ x¢ary,�,Gy�or• '';�Y,'�rYs�.•'.$��''" ,{'s•'' '�''r,�;'•,fi�,.'�g fg�ok5d ��;,,� I� .r� .. ., ..{: QQ ��$� •.d`}•: 'r'.•'�, t;:f••,;:•2'�.,�.�':••ri+v�':'f �t,,�¢'n. s �01+ S�.r } �3 ;+,� 0:. 'f,• �!� ? Yi ,{.f:¢��'+'' +,�";c;}'�'> 56',tY %S' h,' 'fk r `'' y2,i,+•t {..i' 8. �•n.. :>�.' 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'`i"r'rr.`� 1 .., .,. :{::.n ...u. .r•�Jt�^•,., �r,f' ,Z,,.,..,N.;:+},::�r'•..a�,:.:v:.::. ,art: dS• 7 ter,:[,.•:''a;,,.;.,=;:;^t. i; C�fa'l;C;U PL:as t 4ara�ch t^ e '.,.+,:h...t!..:en'.::^.ez......... .......::s:.,,,.:.iy. ,r>c�:,.,:, r Lr and return the bottom voucher with ,your payment x DETACH TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD 911-1-7 o �l STEM OWNER & ADDRESS SYSTEM LOCATION (example: left fron( of house) U \"I'C OF PUMPING: QUANTITY PUMPED 5J Od J C >.51'UUL; NO YES SEPTIC TANK: NO YES \ ATURE OF SERVICE: ROUTINE EMERGENCY (f(l.�FRV.��TIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PL.ACE ROOTS LEACHFIELD RUNBACK CXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OCHER (EXPLAIN) �)'I'l M P U M PCD BY' r� U ENTS: U'� rFN r TRANSFERRED TO: °o of the walls family dwelling conversion shall share a con structure without foundatir) for at on and no structeast 7 5/ure,which is (or floor's) surface. No unheated structure, entirely or partially a garage shall be considered as meeting the 75%requirement. 2.35 Dwelling Unitdesigned as One or more rooms,including cooking facilities and sanitary facilities in a dwelling structure, a unit for occupancy by not more than one family for living and sleeping purposes. 2.36 Erected " "altered","enlarged" The word"erected"shall include the words"built","constructed","reconstructed , and"moved". 2.37 Family One or more persons occupying the same premises and living as a single housekeeping unit as distinguished from a group occupying a boarding house,lodging house, club, fraternity or hotel. 2.371 Family Suite (1987/22) f A se arate dwelling unit located within a single family dwelarance oft e building as atsingle-family l -p and separated from it in a manner,which maintains the appearancethan 25%of the dwelling. The size of the family suite is not to exceed 12 quare feet or not more may my be occupied by broth gross flo area of the principal.unit,.whichever is lesser. The 0sfamily s maternal parents and-grandparents, in-laws and or children ri m required ed by health and building ing owners of the principal sister , dwelling unit. In no case shall an apartment be smaller than the mi q codes. 2.38 Frontage between lot sidelines measured along the street line. The continuous distance 2.38.1 Floor Area,Gross (1987/20) Gross floor area shall be the floor area within the perimetecolumns orof the he building wit ou other features deduction for hallways,stairs,closets,thickness of walls, 2.38.2 Floor Area,Net (1987/21) et floor area shall be actual occupied area(s)not to include hallways, stairs,closets,thickness of walls, N column or other features,which are not occupied areas. 2.38.3 Floor Area,Ratio (1989/32) The ratio of the floor area to the lot area, as determined by dividing the gross floor area by the lot area. 2,39 Guest House A dwelling in which overnight accommodations hall be deemed to include touristohomesbut not hotel,motel or compensation. The term guest house s multi-family dwelling. 2.39.1 Hazardous Material(s) (1990/34) pose a An chemical or-mixture of such physical, chemical,or infectious human characteristics as such to ubstance orlml significant, Any Petroleum actual or potential,hazard to water supplies,or other ding were discharged to land in waters of the Town, including but not limited to organic chemicals,p 22