HomeMy WebLinkAboutMiscellaneous - 315 CANDLESTICK ROAD 4/30/2018 315 CANDLESTICK ROAD
210/106.A-0232-0000.0
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Parcel ID:210/106.A-0232-0000.0 Community: North Andover
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Sales
F-1
C
Summary �
Residence
Detached Structure
Condo
Commercial
Comparable Sales 318 CANDLESTICK ROAD
Location: 315 CANDLESTICK ROAD
Owner Name: DININO,PATRICK&DANA
Owner Address: 315 CANDLESTICK ROAD
City: NORTH ANDOVER State: MA ZIP: 01845
Neighborhood: 8-8 Land Area: 1 acres
Use Code: 101 -SNGL-FAM-RES Total Finished Area:3540 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 702,500 737,900
Building Value: 463,800 520,500
Land Value: 238,700 217,400
Market Land Value: 238,700
Chapter Land Value:
LATESTSALE
Sale Price: 639,000 Sale Date: 02/08/2005
Arms Length Sale Code:Y-YES-VALID Grantor:FREEMAN,TONI
Cert Doc: Book: 9341 Page:260
http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&Linkld=990981 7/18/2007
Commonwealth of Massachusetts
City/Town of
° System Pumping Record
Form 4
SEP 2 31"013
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.this form;check with your
local Board of Health to determine the form they use.The System Pumpinjjk& id must tie submitted to
the local Board of Health or other approving authority.
A. Facility_ Information
1. System Location: ft Righ o ous , Left/Right rear of house, Left/right side of house, Left/
Right side of buil ' , Left/ ig t front of building, Left/Right rear of building, Under deck
Add�� ���y C �✓v`--
Cityrrown State Zip Code
2. System Owner:
Name
Address(if different from location)
Cityfrown State Zip Code
�c5 _
t
Telephone Number
i ..
B. Pumping Record
1. Date of Pumping 2. Quantity Pumped:
Date Gallons —�
3. Type of system: ❑ Cesspool(s) 04epfic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes ONo If yes, was it cleaned? ❑ Yes ❑ No.
" 5. Conditin Qf System
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Location w re contents were disposed:
L S. Lowell Waste Water
SignAtufe 9f Haule Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1
i
Commonwealth of Massachusetts
City/Town of IVWD
w]
System Pumping Record AUG Roil
w Form 4
M SV
TOWN OF NORTH AN VER
DEP has provided this form for use by local Boards of Health. Other for Is me-MIA
information must be substantially the same as that provided here. Before using this orm, Me 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:`Ceit-�front of ho sue night front of house, left side of house, right side of house, Left
rear of house, right rear of house, left side of building, right rear of building, under deck.
"3
Cityrrown State Zip Code
2. System Owner:
Name
Address(if different from location)
City(rown State Zi Code
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2• Quantity Pumped: Gallons
3. 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
5. Condition of Systev\-
6. System Pumped By:
Neil J. Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc.
Company
7. Loca ' where contents were disposed:
L.S.D. w aste Wa
�9
Signatut6 of ule Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1
Commonwealth of Massachusetts
City/Town of -
it
System Pumping Record
s
Form 4
1"C31nlhl Iry NQ!; "I4 A�p� R
DEP has provided this form for use by local Boards of Health. Other forms yl°esl3dbr l ;, ��
information must be substantially the same as that provided here. Before using this form'chec our
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 Locationeft/ ig front of house eft/Right rear of house, Left/right side of house, Left/
Right side of buil g, Left/Rig cont o building, Left/Right rear of building, Under deck
Address t — �C—�� N044AV-1
Cityrrown J State Zip Code
2. System Owner.
Name
Address(if different from location)
Cityrrown State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping
i Pum in
9 2. Quantity Pumped:
d:Date
Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No
5. Condition of System:
6. System Pumped By:
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Locati a contents were disposed:
G1,S. Lowell Waste Water
Sign a Haule Date
t5form4.doc•06103 System Pumping Record•Page 1 of 1
Commonwealth of Massachusetts RECEIVED
City/Town of
a
System Pumping Record AUG $ 4 2009
Form 4
wM s TOWN OF NORTH ANUt7�lER
HEALTH DEPARWENT
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 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 hou , Left fro=�ofuse, fight front of house,
Left rear of house, Right rear of house.
Address
City/Town fi v State Zip Code
2. System Owner:
Name
Address(if different from location)
City/Town State Zi ode [�
Telephone Num er -
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System:
6. System Pumped By:
Neil Bateson
Name Vehicle License Number F5821
Bateson Enterprises Inc
Company
7. Locatio ere contents were disposed:
.L. .D Lowell Waste Water
S' n ur of Haul r Date
t5form4.doc•06/03 System Pumping Record•Page 1 of 1
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�+ ', c! ORTH ANDOVER AS.
p, h p1;- g',.Reco d
OCT
DEP..ha:provided thls form for use by local Boards of Health, h'ej�qy,- rrt3Cp�3tt'tp(n9"e d must
be submitted to the.local'Board of Health or other approving au{hof _LTH oEPAir i
A .Faclllty lnfortritlon
A�tIM octant., ,::: ✓
...,,.When filling out' ..1. System Location;''
r ..
n ,
tt►e; •
only the tab.key Address a��46b
to move your / ' D• �•/lam
cursor.•do not � L
use the return' ' Clty/Town State
' ,. : p Code'.
`Y. y,`,.: i�;'�lj.•;' System Owrier
Te4 77 h'
• .:,.:+1,.. .4, ,�� Name. ,�� i
Address(if different from location) ;
. �;• • '.Cltylrown;:,,, r State //
CO/ '(p P Code
c' � -� its
Telephone Number
Pumping .Record:
'��J♦ ;•• s,�ti!,�.>).r�t,��•t:Y '!i+(1°..p r�.f•t'�,t -
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r� i1 Data;of Pumping ' Date Zl � 2, Quantity Pumped:
/.. Gallons
pf system, ❑ ' Cesspools) �ptic Tank
El Tight Tank
Other(describe);
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ue
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• '; � ,.,•..: , :,>.•.>,.�'. yes, cleaned? ❑ Yes ❑ No
,1;, Co dition'of:
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Pumped
ama:k ,r ✓ 1,�, Vehicle Ucan
^ ie Number
�P: sir 1'T4`X"ri'rf'�,�l^y 1�fid.�,��`.`��,�''��rtk' t: •�/j r f7 •
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✓�• yaL•;.ri.•r •:•i•. ai!Iq''"•i , •!i�✓.a�✓fy; Iq: �.• {;.Ir:•iy/jy'r.,+:Yid{\•r.,....
contants•yvere disposed;
aa
:t .. �%.rl Sy,•..'. /. mate
httpJ/www.mass.gov/de afar/apprGv als/t5forms,htm#Inspect
• t5forrn4.doa'o8/03 �,,. .
System Pumping Record Page 1 of 1
Commonwealth of Massachusetts � �'
City/Town of
System Pumping Record T
�.
Form 4 � ,
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 this form,check with your
local Board of Health to determine the fo m ibW use.'The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
Important:
forms on the
out 1. Syst m Location: < ��e
forms on the �_�
computer,use 1[ - `w.'
only the Y b key Address-
to move our �c�y1 l
cursor-do not City/Town State Zip Code
use the return
key.
2. System Owner:
Name
ILEI Address(if different from location)
CitylTovvn State
cog�--o4z' Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑
Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No
5. Condition of System:
\met bv", A
6. Systgyn Ppmped B�
Name Vehicle License Number
Company
7: Location ere contents were disposed:
h� S
-J7
}T Sig Hauler Date
t5form4.doc•06/03 System pumping Record•Page 1 of 1
Septic System Information
315 CANDLESTICK ROAD
Printed On:Monday,July 16, 2007
System ID: BHS-2002-0342
General System Information Latest Permit Information
Calcaluted Design Flow: Test Pits Septic Tank Disposal Trench
Design Flow: One TWO Capacity: Number:
Design Flow Provided: Minutes per inch: Width: Width:
Total Flow: Depth: Length: Length:
Seasonal: No No Depth to Water: Diameter. Leaching:
Grinder. No No Soil Type: Depth:
Laundry: No No
Hauling/Pumping Listing Quantity
Type System Type Pumped Pumped By Transferred To Disposed At Date Pumped (gallons)
Routine Septic Tank Todd Bateson 10/08/2004 TITLE 5
Inspections:
Inspected: Expires: Inspector: Status:
07/12/2007 Neil J.Bateson Passes
Comments: Title 5
GeoTMS@ 2007 Des Lauriers Municipal Solutions, Inc. Page 1 of 1
O`pORT N,N
. O
* Town ofNorth Andover
♦ s ♦
*e
;- HEALTH DEPARTMENT
,SS�CNUSt4 �J
CHECK#: (-2&7) D TE:
LOCATION:
C �✓� '
H/O NAME: x/f ,7< A11�11;xr
4,17
CONTRACTOR NAME: v�'�%C.�iS��
Type of Permit or License: (Check box)
❑ Animal $
❑ Body Art Establishment $
❑ Body Art Practitioner $
❑ Dumpster $
❑ Food Service-Type: $
❑ Funeral Directors $
❑ Massage Establishment $
❑ Massage Practice $
❑ Offal(Septic)Hauler $
❑ Recreational Camp $
❑ Sun tanning $
❑ Swimming Pool $
❑ Tobacco $
❑ Trash/Solid Waste Hauler $
❑ Well Construction $
SEPTIC Systems:
❑ Septic-Soil Testing $
❑ Septic-Design Approval $
❑ Septic Disposal Works Construction(DWC) $
❑ Septic Disposal Works Installers(DWI) $
=e5
or $
$
❑ Other. (Indicate) $
2535
Health Agent Initials
White-Applicant Yellow-Health Pink-Treasurer
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
a
5V
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address:_315 Candlestick Road_
_North Andover_
Owner's Name: Patrick Dinino _
Owner's Address: 315 Candlestick Road_ GG�
North Andover,MA 01845_ ®�
Date of Inspection 7/12/2007 1 ��
Name of Inspector: Neil J.Bateson
Compnany Name: Bateson Enterprises Inc._ ® Opp
Maili Address:_111 A Road_
Inc.—
Mailing rgiIla H
_Andover,MA 01810_
Telephone Number:_(978)4754786
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:
X Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
ails
M
Inspector's Signature: 0� Date: _7/12/2007_
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
I conditions of use.
!1
' 1
Page 2 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 315 Candlestick Road-
-North Andover
—
Owner:_Dinino_
Date of Inspection: 7/12/2007_
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 310 CMR 15.303 or in 310 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(Y,N,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 lox 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 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 315 Candlestick Road-
-
North Andover
—
Owner:_Dinino_
Date of Inspection: 7/12/2007_
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further 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 CMR 15.303(1)(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 1 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 11
I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 315 Candlestick Road_
_North Andover—
Owner:_Dino_
Date of Inspection:_7/12/2007_
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
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'/z day 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 1 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 310 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—IWPA)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 310 CMR
15.304.The system owner should contact the appropriate regional office of the Department.
Page 5 of'l l
I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 315 Candlestick Road_
_North Andover_
Owner: Dinino_
Date of Inspection:_7/12/2007 !!
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?
Yes Was the facility or dwelling inspected for signs of sewage back up? 4
_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
condition 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.
_
_Yes_ _—Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
distance is unacceptable)[3 10 CMR 15.302(3)(b)]
I
r
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:_315 Candlestick Road_
_North Andover_
Owner:_Dinino_
Date of Inspection:_7/12/2007
BUILDING SEWER_X_ (locate on site plan)
Depth below grade:_24"_
Materials of construction: _cast iron _X_40 PVC other
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.) _4"PVC thru wall,3"PVC in house,no
leaks visible
SEPTIC TANK: X
Depth below grade:_12"
Material of construction: X 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 5'x 4'
Sludge depth 3"
Distance from top of sludge to bottom of outlet tee or baffle: 22"_
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: 16"_
How were dimensions determined:_Tape Measure_
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 septic tank leaking._
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.):
I
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road_
_North Andover
—
Owner:_Dinino_
Date of Inspection: 7/12/2007
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 polyethylene other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallonstday
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 (locate on site plan)
Depth below grade 30"_
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 light
carryover.Box located under small landscape wall._
PUMP CHAMBER:_(locate on site plan)
Pump in working order(yes or no):_
Alarm in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
i
7
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road_
_North Andover
Owner:_Dinino_
Date of Inspection: 7/12/2007_
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 trench,number,length: 2 trenches 50'long_
leaching field,number,dimensions:
overflow cesspool,number:
innovative/alternative system Typetname 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:
Number and configuration:—
Depth—top of liquid to inlet invert:—
Depth of sludge 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 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 315 Candlestick Road_
_North Andover_
Owner:_Dinino_
Date of Inspection: 7/12/2007
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
House
Garage
A
Water Meter
Driveway
B
1
Septic
Tank
2
D-Boz
A to 1=30'9"
Ato2=39'9"
A to D-box=56'
B to 1=40111"
Bto2=47'
B to D-Boz=6315"
• Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
I
Property Address: 315 Candlestick Road_
North Andover
Owner:_Dinino_
Date of Inspection:_7/12/2007_
SITE EXAM
Slope_Yes_
Surface water_No_
Check cellar _Dry_
Shallow wells_No_
Estimated depth to ground water_4'_
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:_4/18/1989_
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: As per design plan._
I'
Commonwealth of Massachusetts
QWQ City/Town of
system Pumping Record
kIVj Foran 4 *�'
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 this form,check with your
local Board of Health to determine the WffthW use.The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
important:vWW min out 1. Sysr
Dation:
forms on'the
�
computer,use
only the tab key Address /' _ ._ t� G KA�CA.
to move your
cursor-do not CityRown state Zip Code
use the return
key. 2. System owner:
hltV\0
Name
Address(if different from location)
CitylTown
State Zip Code
Telephone Number
B. Pumping Record _ 7 `S
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑
Other(describe):
4. Effluent Tee Filter present? ❑ Yes No if yes,was it cleaned? E] Yes El No
5. Condition of System:
6. Sy 'ped V\ '� a
Vehicle License Number
Name
Company
7. Location ere contents were disposed:
�LS
Sig Hauler Date
t5fomAdoc•06103_ system Pumping Record•Page 1 of 1
Summary Record Card generated on 7/9/2007 2:32:46 PM by Elaine Barclay Page 1
• Town of North Andover
Tax Map # 210-106.A-0232-0000.0
315 CANDLESTICK ROAD
PATRICK & DANA DININO
315 CANDLESTICK ROAD
NORTH ANDOVER, MA 01845
Class 101 Single Family Property Type 1 Residential
Size Total 1 Acres
FY 2007
UB Mailing Index
Name/Address Type Loan Number Active/Inact. From Until
PATRICK & DANA DININO Owner
315 CANDLESTICK ROAD
NORTH ANDOVER, MA 01845
SHERMAN, TONI Previous Customer Inactive 2/7/2005
315 CANDLESTICK RD
NORTH ANDOVER, MA
01845
UB Account Maint.
Account No Cycle Occupant Name Active/Inactive
Bldg Id. 17640.0- 315 CANDLESTICK ROAD Last Billing Date 4/2/2007
3170310 03 Cycle 03 Active
UB Services Maint.
Service Code Rate
Charge Multiplier/Users
9
MISCFEE
ADMIN FEE 0.635/8 7.$2 11
WTR WATER 01 ALL METER SIZE 99.44 /1
UB Meter Maintenance
Serial No Status Location Brand Type Size YTD Cons
29955858 a Active ERT HH b Badger w Water 0.63 0.63
Date Reading Code Consumption Posted Date Variance
6/18/2007 288 a Actual 24 14%
3/14/2007 264 a Actual 28 /16/2007 -2%
12/8/2006 236 a Actual 26 1/19/2007 -7%
9/12/2006 210 a Actual 29 10/20/2006 -1%
6/14/2006 181 a Actual 32 /10/2006 -24%
3/8/2006 149 a Actual 33 /17/2006 1%
12/21/2005 116 a Actual 39 1/17/2006 2%
9/20/2005 77 a Actual 41 10/14/2005 16%
6/13/2005 36 a Actual 32 /15/2005 256%
3/15/2005 4 a Actual 4 /5/2005 -100%
2/3/2005 0 n New Meter 0 /5/2005 -100%
2/3/2005 1446 r Replacement 0 /5/2005 -100%
2/3/2005/ 1446 f Final Bill
6 /3/2005 19%
12/14/2004 1440 a Actual 8 1/'14/200515%
9/24/2004 1432 a Actual 9 0/8/2004 -59%
6/11/2004 1423 a Actual 12 /30/2004 _8%
4/15/2004 1411 a Actual 28 /17/2004 0%
12/15/2003 1383 n New Meter 0 2/15/2003 0%
I
Tel: (978) 475-4786
Fax: (978) 475-5451
I
BATESON ENTERPRISES, INC. i
Excavating-Water& Sewer Lines-Septic Systems&Pumping Service
111 Argilla Road Andover, Mass. 01810
Title 5 Inspection Report
Property Address: 315 Candlestick Road, North Andover
Owner: Dinino
Date of Inspection: 7/12/2007
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 further
operation of your current septic system.
Neil J. Bateson
Bateson Enterprises,Inc.
I
1
I
Commonwealth of Massachusetts
N 0 f4y\ AA�o vey , Massachusetts
System Pumping Record
System Owner System Location
Date of Pumping: �/� Quai►tity Pumped: 1 5a() gallons
Cesspool: No (. Yes L) Septic Tank: No Ll Yes lLi
System Pumped by: gcitedo.t Effrevv ivied License#
Contents transferrred to : Greater Lawrence Sanitary District
.Date: _ Inspector:
17
COMMONWEALTH OF MiNVIRONMENTAL
SACHUSETTS
EXECUTIVE OFFICE OF AFFAIRS
u DEPARTMENT OF ENVIRONMENTAL PROTECTION
d
RECEIVED
V
OCT 19 2004
TOWN OF NORTH ANDOVER
T E 5 HEALTH DEPARTMENT
OFFICIAL INSPECTION FORM—N T FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 315 Candlestick Road-
-North
oad__North Andover
Owner's Name:_Toni Freeman
Owner's Address:_315 Candlestick Road_
—North Andover,Ma 01845_
Date of Inspection: 10/8/2004_
Name of Inspector: Neil J.Bateson_
Company Name: Bateson Enterprises Inc.
Mailing Address:_111 Argilla Road
_Andover,Ma.01810_
Telephone Number:_(978)4754786_
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:
X Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
F ils
Inspector's Signature: Date: _10/8/2004_
The system inspector shall submit a copy o 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.
i
. ,.; . _.
� _
.. .
Page 2 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 315 Candlestick Road-
-North Andover
—
Owner:_Freeman_
Date of Inspection: 10/8/2004_
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 310
CMR 15.303 or in 310 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(Y,N,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 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 315 Candlestick Road-
-North Andover
—
Owner:_Freeeman_
Date of Inspection:_10/8/2004_
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further 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 CMR 15.303(1)(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 1 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:
y � � -
"i ..
� ..'
Page 4 of 11
OFFICIAL INSPECTION FORM—NOTFOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 315 Candlestick Road_
_North Andover—
Owner:_Freeman_
Date of Inspection: 10/8/2004
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
_ _No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
_No Discharge or ponding of eluent 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 V2 day 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.
_144o_ 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 1 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
' rate nitrogen is equal to or less than 5 m provided that no other failure criteria
nitrogen and nit ,
og � 9 PP
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 310 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
Ypd-
ou 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
T _ 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—IWPA)or a mapped
Zone II 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 310 CMR
a
, �
.. .
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 315 Candlestick Road_
_North Andover—
Owner:_Freeman_
Date of Inspection:_10/8/2004_
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
condition 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.
_Yes_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
distance is unacceptable)[3 10 CMR 15.302(3)(b)]
Page 6 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 315 Candlestick Road_
_North Andover—
Owner:_Freeman_
Date of Inspection:_10/8/2004
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_600_
Number of current residents:_2
Does residence have a garbage grinder(yes or no):_No_
Is laundry on a separate sewage system(yes or no):_No_
Laundry system inspected(yes or no): _
Seasonal use:(yes or no):_No
Water meter readings: Yes,143360Ft3_
Sump pump(yes or no):_No
Last date of occupancy:—
Current-COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,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: Pumped 4 years,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: _Inspect tank&tees
TYPE OF SYSTEM
_X_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
obtained 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:_13 Years old,
12/12/1991,As built plan._
Were sewage odors detected when arriving at the site(yes or no):_No
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road-
-North Andover_
Owner:_Freeman
Date of Inspection_10!8/2004_
BUILDING SEWER_X_ (locate on site plan)
Depth below grade:_15"_
Materials of construction: _cast iron —X 40 PVC other
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):_4"PVC thru wall,3"PVC in house,no
leaks visible
SEPTIC TANK: X
Depth below grade: 3"_
Material of construction: X 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 5'a 4'
Sludge depth8"_
Distance from top of sludge to bottom of outlet tee or baffle:_22"_
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:_19"_
How were dimensions determined:_
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._
II�
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.):
i
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road_
_North Andover_
Owner:_Freeman_
Date of Inspection: 10/8/2004_
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 50'long_
leaching fields,number,dimensions:
overflow cesspool,number:
innovative/alternative 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 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road_
_North Andover_
Owner:_Freeman
Date of Inspection_10/8/2004
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 50'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 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road-
-
North Andover
—
Owner:_Freeman_
Date of Inspection: 10/8/2004_
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.
House
Garage
A
Water Meter
Driveway
B
A to 1=30'9"
Ato2=39'9"
A to D-Bog=56'
Bto1=40'11"
Bto2=47'
B to D-Bog=63'5"
1
Septic
Tank
i
2
D-
Bog
. Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 315 Candlestick Road-
-North Andover
Owner:_Freeman_
Date of Inspection: 10/8/2004
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water _4'._
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:_4/18/1989_
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:_As per design plan_
i
Summary Record Card generated on 10/14/2004 1:49:30 PM by Melissa Powers Page 1
Town of North Andover
Tax Map # 210-106.A-0232-0000.0
315 CANDLESTICK ROAD
SHERMAN, TONI J Since Jan 2003
315 CANDLESTICK ROAD
NORTH ANDOVER, MA
01845
Class 101 Single Family Property Type 1 Residential
Size Total 1 Acres
FY 2005
UB Mailing Index
Name/Address Type Loan Number Activellnact. From Until
SHERMAN,TONI Payor
315 CANDLESTICK RD
NORTH ANDOVER, MA
01845
UB Account Maint.
Account No Cycle Occupant Name Active/Inactive
Bldg Id. 3235.0- 315 CANDLESTICK RD Last Billing Date 10/8/2004
—3170310 03 Cycle 03 Active
UB Services Maint.
Service Code Rate Charge Multiplier/Users
MISCFEE'ADMIN FEE 0.635/8 7.82 1/
WTR WATER 01 ALL METER SIZE 25.20 /1
UB Meter Maintenance
Serial No Status Location Brand Type Size YTD Cons
37394155 a Active ENC F.RT. ? w Water 0.63 0.63 0
Date Reading Code Consumption Posted Date Variance
9/24/2004 1432 a Actual 9 10/8/2004 -59%
6/11/2004 1423 a Actual 12 7/30/2004 -8%
4/15/2004 1411 a Actual 28 5/17/2004 0%
12/15/2003 1383 n New Meter 0 12/15/2003 0%
METER DATE FISCAL YEAR COMMITMENT READING USAGE
31 7031 0 10/1/1999 2000 13 1055
3170310 1/7/2000 2000 23 1082 27
3170310 3/31/2000 2000 33 1101 19
3170310 6/21/2000 2000 43 1120 19
3170310 9/20/2000 2001 13 1147 27
3170310 1/3/2001 2001 23 1171 24
3170310 4/12/2001 2001 33 1192 21
3170310 6/20/2001 2001 43 1209 17
3170310 9/24/2001 2002 13 1228 19
3170310 1/31/2002 2002 23 1251 23
3170310 4/9/2002 2002 33 1261 10
3170310 6/11/2002 2002 43 1272 11
3170310 9/17/2002 2003 13 1289 17
3170310 12/17/2002 2003 23 1306 17
3170310 3/13/2003 2003 33 1320 14
3170310 6/10/2003 2003 43 1343 23
3170310 9/16/2003 2004 13 1364 21
3170310 12/15/2003 2004 23 1383 19
Tel: (978) 475-4786
Fax: (978) 475-5451
BATESON ENTERPRISES, INC.
Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service
111 Argilla Road Andover,Mass. 01810
Title 5 Inspection Report
Property Address: 315 Candlestick Road,North Andover
Owner: Freeman
Date of Inspection: 10/8/2004
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 further
operation of your current septic system.
4eJj. tson
Bateson Enterprises,Inc.
AA ress � A-�l�l�� � T t��.I /�-� -
Title of File
Page of
Date File open: Date file closed:
Doc Document/Action Tifile Date of Refer to other
action Document/ document/ Purpose of Document/ —on—and notes.
Num.— Action Department
LJ
--------------
Board of Appeals — Board of Health Plann ng.Board _ Con
servaton Commission — Boi6din De
� partnlent
FORM U
TOWN OF NORTH ANDOVER
LOT RELEASE FORkI
SUBDIVISION l=-.D p C"?`, C
ASSESSORS MAP
f t ► a. �l l� �Pd
SUBDIVISION LOT(S)
PERMANENT AD RES `C �1-SSI GIJ.� BY D.P.W.
STREET t��
APPLICANT PHONE
` �. DATE OF APPLICATION
TOWN USE BELOW THIS LINE
PLANNING BOARD
DATE APPROVED
TOWN PLANNER DATE REJECTED
CONSERVATION COMMISSION
. DATE APPROVED
CONSERVATION ADMIN. DATE REJECTED
BOARD OF HEALTH
DATE APPROVED
HEA TII SANITARIAN ` DATE REJECTED
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT
SEWER/WATER CONNECTIONS
FIRE DEPT.
RECEIVED BY BUILDING INSPECTION
` DATE
This form shall be signed by the agents of the Planning and Health Boards,
the Conservation Commission prior- to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement orBylaw.
MAP # I cx-ok.. LOT #
PARCEL # STREET'Q_�............. ..................
CONSTRUCT I.Q.N__A_PPR.Q.vA.L. .
HAS PLAN REVIEW FEE BEEN PAID? Y S NO
PLAN APPROVAL: DATE APP.
. ........................
DESIGNER: PLAN DA*TE.---(o
CONDITIONSYL
C-1,�o e
WATER SUPPLY: TOWN WELL
WELL PERMIT DRILLER
................................. ...............................
WELL TESTS: CHEMICAL DATE APPROVED
BACTERIA I DATE APPROVED
...................I............
BACTERIA II DATE APPROVED._.__._______._._
COMMENTS:
FORM U APPROVAL: APPROVAL TVZSS YES NO
DATE ISSUED
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID YES NO
WELL CONSTRUCTION APPROVAL YES NO
SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO
OTHER YES NO
ANY VARIANCE NEEDED YES NO
FINAL BOARD OF HEALTH APPROVAL: DATE: BY:
IS THE INSTALLER LICENSED? YES NO
TYPE OF CONSTRUCTION: NEW REPAIR
NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO
CONDITIONS OF APPROVAL YES NO
(FROM FORM U)
ISSUANCE OF DWC PERMIT YES NO
DWC PERMIT NO. .�.__._ INSTALLER.'._..._... .. _
7 ` ..y._......_.
BEGIN INSPECTION
EXCAVATION INSPECTION: NEEDED: _
.................
_T...__..
/ i t
PASSED _�_- BY.__
CONSTRUCTION INSPECTION: NEEDED a
r _ � ubLA c ......_......._............-.........__._.... _ _.......
Gtr
AS BUILT PLAN SATISFACTORY: YES:
APPROVAL TO BACKFILL: DATE:—It BY__
FINAL GRADING APPROVAL: DATE ?Z� 2- BY
-- ------.. _._.._ ._.. ..............-..........
_._._......_....
FINAL CONSTRUCTION APPROVAL: DATE:_._ ..'.;.,. '2-BY _.„_ . .
2CARD OP NFA i i-;- nor Z�I C�1✓Dc�.STi
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