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Miscellaneous - 369 SALEM STREET 4/30/2018
IF I O O rn v ca o n o m w Qo � CD M o M o m , 0 -�E:- r H N A� N. fi bac oar �f-\(�-J1 cqk�) Lot & Street S Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit# Plan Approval: Date: 116 ell Approved by: Designer: Ale . WNG -105600 h Plan Date: Conditions: Water Supply: (To` Well Permit: Well Tests: Chemical Bacteria I Bacteria II Plumbing Sign -Off: Comments: Form "U" Approval Date Issued Conditions: Well Driller: Date Approved Date roved Date Approved Wiring Sign -Off: Approval to Issue: By: Final Approval: All Permits Paid? Well Construction Approval? Septic System Construction Approval? Certification? Other Any Variance Needed? FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: YES NO YES NO r. r NO . 5 NO �f NO YES Lot & Street S Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit# Plan Approval: Date: 116 ell Approved by: Designer: Ale . WNG -105600 h Plan Date: Conditions: Water Supply: (To` Well Permit: Well Tests: Chemical Bacteria I Bacteria II Plumbing Sign -Off: Comments: Form "U" Approval Date Issued Conditions: Well Driller: Date Approved Date roved Date Approved Wiring Sign -Off: Approval to Issue: By: Final Approval: All Permits Paid? Well Construction Approval? Septic System Construction Approval? Certification? Other Any Variance Needed? FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: YES NO YES NO YES NO YES NO YES NO YES NO YES NO r s r SEPTIC SYSTEM INSTALLATION Is the installer licensed? Gip NO Type of Construction: NEW REP New Construction: Certified Plot Plan Review YES NO Floor Plan Review YES NO Conditions of Approval from Form U YES_ NO Issuance of DWC permit: NO DWC Permit Paid? YES ..� NO DWC Permit Installer: 35, Begin Inspection: YES NO Excavation Inspection: Needed: Passed: Construction Inspection: Needed: Plan Satisfactory: Approval of Backfill: Date: /�/�� 1 By: Final Grading Approval: Date: By: Final Construction Approval: Date: By: Certificate of Compliance: Approval: Date: 0 .e ARGEO PAUL CELLUCCI Governor JANE SWIFT Lieutenant Governor COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-500 December 21, 1999 Amit Banedi 369 Salem Street North Andover, Massachusetts 01845 Re: Alternative On -Site Sewage Treatment Monitoring and Reporting Requirement 369 Salem Street, North Andover, Massachusetts 01845 DEP Facility ID: SHF13 Dear Mr. Amit Banerji: . BOB DURAND Secretary LAUREN A. LISS Commissioner The Department has received a letter from J & R Sales & Service, Inc. dated October 27, 1999, requesting reduction or elimination of monitoring and reporting of pH, BOD and TSS on a quarterly basis on the effluent from the alternative on-site sewage disposal system at the above referenced facility. The Department's Approval for Remedial Use for the technology, in section III (4.) states that "After one year of monitoring and reporting, and at the requc. of the owner/operator the Department may reduce or eliminate these monitoring and reporting requirements." The Department, having reviewed the monitoring data for this technology, in general, and your system, approves the request to reduce effluent monitoring of the system, from four times to one time per year. The data has demonstrated that the technology provides environmental protection at least equivalent to a conventional Title 5 system. The change in monitoring requirements in no way changes the requirement that, throughout its use, the system shall be under an operation and maintenance agreement with a person or firm qualified to provide services consistent with the system's specifications. As a condition of allowing you to reduce effluent monitoring, however, by January 31 of each year, you must submit to the Department an annual report for the calendar year that includes: 1) a description of the operation of the system; 2) system inspection and emergency service information; 3) any other pertinent information that describes the condition of the system;. and 4) results of the annual effluent monitoring. The report shall be prepared by the operator contracted to inspect and maintain the system.. Additionally, as required by the Approval for the system, any time the operator changes, you shall notify the Department and the local approving authority, in writing, within seven days of such change. This information is asailable in alternate format by calling our ADA Coordinator at (617) 571-6872. DEP on the World Wide Web: http://www.state.ma.us/dep Ci Printed on Recycled Paper J' 1 Re: Monitoring and Reporting Requirement DEP Facility No.: SHF 13 Page 2 Please be aware this change in monitoring does not apply to any local requirements. You should discuss any changes from the local monitoring requirements, if any apply to your system, with your local Board of Health officials. Should you have any questions regarding this matter, please do not hesitate to contact Steven H. Corr, of my staff, at (617) 292-5920. Sincerely, !dGlc C/ Lealdon Langley, Dirpctori Watershed Permitting Program cc: North Andover BOH DEP- NERO, Dave Ferris J & R Sales & Service, Inc., 44 Commercial St., Raynham, MA 02767 Tbis NOV 24 '97 10:48 J & R SALES & SFRVICE, INC. 44 Commercial Street . R-.YWAu, MA 02767 TOL, (508) 823-9588 Pax. (508) 880-7232 w - 4ti I L`\ .. e. .,:. .�, Y '.r _:i.. RSz6�..'SS.Gia•..� i."Ai.ai4'4b �k "4�W'l +'i IN, P. 031 r.eie Please complete all items marked mail check and sg and original contract to: Shea -P Qdy .Vts, Inc. 773 Salem Snq 62 North WilmiP=N MA. 018$7 (�-) Co S-8-aG14S- f:P,x N-)8) Cn 558 — CS4 1 INSPE& UFN][ TX$T_QLG AGREEMENT lection Agreement is entered into by J&R Sales & Service, Inc. (herein call J&R) and the FAST=' OWNER (herein called OWWRR), for the purpose of setting forth terms and conditions governing bbliSations to inspect OWNER's equipment listed below. acceptance of this agreement, MR will render the following, services only: .tent will be inspected at least 4 times per year that this Agreement remains in effect, with the first ion beginning . These inspection will include: of the sludge depth in the septic tank. power testing and clean/replace intake fitter of the air blower. of the alarm system. over-all condition of FASV System, gtify OWNER of any problems encountered. other than routine mainte=ce will be billed at an hourly rate plus travel and material. small notify the local board of health and the Department of Environmental Protection in writing within 24 of a system failure or alarm event including corrective measures that have been taken: It is derstood that by this Agreement J&R is not obligated to supply any parts. Any additional labor time will be dd to the OWNER at standard labor rates of $ 64.00 per hour. Fznt xgeacy service between regular inspections will be provided at standard rates for labor dwring normal bus' hours, after 5:00 PM and on Saturdays time and one -W and double time on Sundays and holidays, mm mum four (4) hours plus standard charges for parts plus mileage and travel charges. This agreemmat does not neWde expenses to repair damage caused by abuse, accident, theft, acts of a third person, forces of nature, orerittg the equipment. J&R shall not be responsible for failure to render the service for causes beyond its con rel, the strikes and labor disputes. ...+.:.�•.•r+r? M' •wtii�".'J'.Y.ux'Y_.,_d�hv.Ti r •. �..�tFvS,h`4Y..x'!�i:v:�4.'•?:ll3rC'r".-i^u�.c.. ,..•.. .x� �..:: ..��.vs�.Yp_ �,. OV 24 197 10:47 P.02 5096580541 P.03 •O�t understands. and agrees that J&R is not responsible for special or consequential damages, iocluding los fltime, injury to person or property unit or equipment failure. agreement is not assignable without the consent of J&R and will remain in foree until oanoeW by either ffimugh wdtum notice. TW i6 a two year service contract to be billed annually in compliance with State regulations_ Failure to comply Will t in cancellation and nullification of any warranties. MDDEL NO. SERIAL NO LOCATION ANNUALRATE HomeFAST" $350.00 NT OWNER *Si by: I/7);,�!� * Hess: *Ci State:ol_ lff Zip: Q� �..� *Te enhone: e,F,7- !,?,-)I-, J" Sales a Servim UK - Signed by: J&.R Sales and Service, Inc. 44 Commercial Street Raynharn, MA 02767 Tel: (508) 823-9566 Fax: (508) 880-7232 Effect Date of.Agreement Ts��ituE �It sample taken 4 times per year, delivered to a qualified testing lab for evaluation and with resuks sent to State and local Agencies as well as the owner. Owner is responsible for providing acceptable eto effluent to enable a grab sample to be taken for laboratory testing performed: CHECK ONE) ( ) GENERAL 00 REMEDIAL ( ) PROVISIONAL CONDITIONS PER LOCAL BOARD OF HEALTH (y) or (N) if YES, please attachod copy of per=t QCj ODs, TSS, PH ( ) pH, BOD5 , TSS, TKN, NO3 -N, Ammonia Other tjCR:P1 Maw cpoo�y T -C3 dog Cost 00 OPeotorassigned: William Everett *Engineer. *AA p(ooval for Fluent Testing. 761t,�,Aees Signature FAST System Contract and Maintenance Requirements III. Special conditions applicable to the system Owner/Operator 1. The System is approved for remedial use in connection with the -discharge of sanitary wastewater only. Any non -sanitary wastewater generated and/or used at the facility served by the System shall not be introduced into the System -and shall be lawfully disposed of. 2. If..the system will be used as a shared system as defined by 15_0.02, the financial assurance requirements for shared systems as may be required pursuant to 15.290 (2) shall apply. 3. Maintenance agreement: i... Throughout its life, the System shall be under a maintenance agreement. No maintenance. agreement shall be for less than two years. ii. The system. shall not be constructed/installed until a maintenance agreement and contingency plan are submitted" to and approved by the local approving authority which: provides for the contracting of a person or firm competent in providing services consistent with the System's specifications and the operation and maintenance requirements specified by the design engineer and any specified by the local approving authority; contains procedures for notification of the Department and the local board of health within 24 hours of a system failure or alarm event and for corrective measures to be taken immediately. provides the name of the Massachusetts certified operator or operators that will operate the System in accordance. with Massachusetts regulations 257 CMR 2:00. 4. Effluent from the System shall be monitored quarterly. At a minimum the following parameters shall be monitored: pH, BODS, TSS. Every time the System is monitored, the water meter reading also shall be recorded. A11 monitoring data sha-11 be submitted to the Department by January 31 of -each -year. After three years of monitoring and at the request of the owner/operator, the local approving.authorit.y may reduce or eliminate the monitoring requirements. 5. The owner/operator of the System shall at all times properly operate and maintain the System. 6. when a sanitary sewer connection becomes feasible, the owner/operator of the System shall obtain necessary permits and connect the facility served by the System to the sewer within 60 days of such feasibility and shall abandon the System in compliance with 310 CMR- 15.354 MR15.354 unless a later time is allowed in writing by the Department. WILLIAM J. SCOTT Director , (978)688-9531 DATE: TO: FROM: CC: RE: Town of North Andover f NORTH OFFICE OF 3a o COMMUNITY DEVELOPMENT AND SERVICES 9 27 Charles Street North Andover, Massachusetts 01845 MEMORANDUM November 23, 1998 Richard Rowen, Chairman, Planning Board Kathleen Colwell, Town Planner Sandra Starr, RS. Bogumila Duda File 369 Salem Street Bond Fax(978)688-9542 I have spoken on a number of occasions with the previous owner of 369 Salem Street, Mrs. Bogumila Duda, about the fact that the Planning Board holds her bond of several thousand dollars for the purpose of insuring a sewer tie-in at 369 Salem Street when municipal sewer becomes available. Since she no longer owns the property, and since the Board of Health has regulations which require sewer tie-in when it is made available, I would recommend that her bond be returned to her. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE#, IT LOCATION: $(4rl LICENSED INSTALLER:: SIGNATURE: TELEPHONE# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT 1. Administrative Use Only $75.00 Fee Attached? Yes/ No Foundation As -Built? Yes Floor Plans? Yes - No Approval /aLA hz� Date: &1_14z_ cc,� T/HCl /9 5 D &-7/9-1 c &'o Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protectil William F. Weld Connor Trudy lboxe Secretary, EDEA David B. Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO PART A CERTIFICATION Property Address: ?b �a � m Address of Owner: Date of Inspection:l6 — q to (If different) Name of Inspector. -t^�� �„ Company Name, Ad ress and Telephone Number: 5 -feu oc C'-+- S S e-P#ct SPo' wt C.et wl.idAvlo „�_ , - SUN 1 4 1996 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes _ ds Further Evaluation By the Local Approving Authority Fails Inspector's Signature: .y.� ate: ^",% "5, � .( The System Inspector all submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 -CMR 15.303. Any failure criteria not evaluated are indicated below. BJ SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approvedi by the Board of Health. , (revised 8/15/95) One Winter Street a Boston, Massachusetts 02108 a FAX (617) 556-1049 a Telephone (617) 292-5500 i0 Printed on Recycled Paper v It SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: e Owner: ;oN r -t Date of Inspection: , B] SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout -or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system nas a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system hasaseptic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution f'om that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D] SYSTE FAILS: zI have determined ,that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. (revised 8/15/95) Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or+ cesspool. 2 I 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 36 9 Sa ter % 5t- Owner:-S,,� v Date of Inspection: D) SYSTEM FAILS (continued): Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of,a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow • of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 Q.. P SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: �j � 1 'e t^ " Owner: Jo h I i 4 IJV Date of Inspection: Check if the following have been done: _ umping information was requested of the owner, occupant, and Board of Health. V one of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ Asbuiltplans have been obtained and examined. Note if they are not available with N/A. VThe facility or dwelling was inspected for signs of sewage back-up. he system does not receive non -sanitary or industrial waste flow _ he site was inspected for signs of breakout. I system components, excluding the Soil Absorption System, have been located on the site. LeThe septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. _4/he size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non -intrusive methods. e facility o,tiner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub- surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 301 Sq 1'e /-A Owner: J p AIJ 0L V ., r )Q (:tck Date of Inspection: RESIDENTIAL:. Design flow:sallor�s Number of bedrooms: y" Number of current residents:_ Garbage grinder (yes or no): j-767 Laundry connected to system (yes or no):_ Seasonal use (yes or no):A-0 Water meter readings, if available: Last date of occupancy: 1.4 FLOW CONDITIONS COMMERCIAUINDUSTRIAL• Type of establishment: Design flow:gallons/day 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: OTHER: (Describe) Last date of occupancy: . GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)$ If yes, volume pumpeiv-�C4 allons Reason for pumping. 11, K, f24't TYPE OF YSTEM 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) Other (explain) APPROXIMATE GE of all components, date installed (if known) and source of information: 140 f . Sewage odors detected when arriving at the site: (yes or no) (revised 8/15/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property �Adddlress: a I P J r► ,! � Owner.. — Z�') '' ll --"o 4, USS � � C( ` Date of Inspection: U 1 -17 6 SEPTIC TANK: (locate on site plan) ` O �r Depth below grade: Material of construction: _oncrete _metal _FRP —other(explain) Dimensions: i�, S? ' Sludge depth: 6 ,r Distance from top of sludge to bottom of outlet tee or baffle:_/J0_L Scum thickness: "����� � Distance from top of scum to top of outlet tee or baffle: Jazw_' Distance from bottom of scum to bottom of outlet tee or baffle: zmr & Comments: (recommendation for pumping, conditio. QPf inlet and outlet tees or ba Jes, depth of ligw level In relation to outlet invert, structural integrity, evidence of leakage, etc.) (k1 M0 � +u K �Afs�e//r-t !c>oo�Qd 0C'—fR GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP —other(explain) Dimensions: Scum thickness. Distance from top of scum to top of outlet tee or baffle: Distance from bottom of Brum tn bottom of outlet tee or battle! Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 8/15/95) 6 M SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: '5C Owner: -To �0 Cano Date of Inspection: ' /6' TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP —other(explain) Dimensions: Capacity: eallons Design flow: eallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_V (locate on site plan) , Depth of liquid level above outlet invert:�d�,,r% Comments: (note if level and distribut;c^ i eGua!, evidence of solids c r yover, evidence of leakage into or out of box, etc.) _ . - i .n .. — ,.6 a:. , ,..c_ � ., -, �.. - - ., i Fy `i r'1 .2_ - A r. PUMP CHAMBER:_ (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM (INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 3641 S ek (e /— S I' r. � Owner' 8,7 V t � b -) L44{ Date of Inspection: ` SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non -intrusive methods) l If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: /�� '2'9'K overflow cesspool, number: (note condition,of soAsigns of hydraulic failure,,level of ponding, ogdition of CESSPOOLS: (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 (cesspool must be pumped as part of inspection) 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.) (revised 8/15/95) s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:,?(, 07%— Owner: �17P� cis %3o rj'Us �c� �uG� Date of Inspection: l6 "Q -C SKETCH OF SEWAGE DISPOSAL SYSTEM: t include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' z DEPTH TO GROUNDWATER Depth to groundwater: 3 , feet method of determination or approximation: L P—.-, w (revised 8/15/95) 9 Town of North Andover OFFICE OF R COMMUNITY DEVELOPMENT AND SERVICEOTa N NORTH 4 .30 School Street WII.LIAM J. SCOTT North 28 North Andover, Massachusetts 01815 p Director NOTICE OF DECISION Any appeal shall be filled within (20) days after the date of filling this Notice in the Office of the Town Clerk. -- Petition of Bogusha Duda Premises affected 369 sal = St -rt -At 0 Date' October 27., 1997 Date of Hearing October 21, 1997 Referring to the above petition for a special permit from the requirements of the.' north Andover zoning Bylaw Section 4.136 so as to allow to install a new subsurface disposal system in the same location as the failed system . After a public hearing given on the above date, the Planning Board voted to Approve the Special Permit - Watershed based upon the following conditions: CC: Director of Public Works Building Inspector Natural Resource/Land Use Planner "Health -Sanitarian Assessors Police Chief Fire Chief Applicant Engineer File Interested Parties Signed`- (��^\r- ��- -; Richard S.Rowen, Chairman Alison Lescarbeau, V. Chairman John Simons, Clerk Richard Nardella Joseph V. Mahoney Planning Board CONSERVATION 688-9530 HEALTH 688-9540 PT.ANNTNr, 688-9535 Town .of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES WILLIAM J. SCOTT Director October 27, 1997 Ms. Joyce Bradshaw Town Clerk 120 Main Street North Andover, MA 01845 30 School Street North Andover, Massachusetts 01845 Re: Watershed Special Permit -369 Salem Street Dear Ms. Bradshaw, The North Andover Planning Board held a public hearing on Tuesday evening October 21, 1997 at 7:30 p.m. in the Department of Public Works, upon the application of 369 Salem Street, North Andover, Ma 01845 requesting a special permit under Section 4.136 Paragraph 3 (b) (ii) Watershed Protection District of the North Andover Zoning Bylaw. The legal notice was properly advertised in the North Andover Citizen on October 1 and October 8, 1997 and all parties of interest were duly notified. The following members were present: Richard Rowen, Chairman, Alison Lescarbeau, Vice Chairman, John.Simons, Clerk, Joseph V. Mahoney and Richard Nardella. The petitioner was requesting a special permit to allow to install a new subsurface disposal system in the same location as the existing failed system. The premises affected is land numbered 369 Salem Street in the Residential - 2 (R-2) Zoning District and the Watershed Protection District. Mr. Simons read the legal notice to open the Public Hearing. Ben Osgood Jr. was present to represent 369 Salem Street. Mr. Osgood stated that the property has a failed septic system in the watershed. Mr. Osgood stated that the new system will be in 65' of wetlands in the watershed. Mr. Osgood stated that they are planning to tie into town sewer as soon as it comes down Salem Street, but DPW says that won't be until the year 2,000. Mr. Rowen asked if the tank that they are putting in will only be good for 5 years. Mr. Osgood stated no, it will be good for the life of the house. Mr. Nardella asked what they have to do for the Board of Health. Ms. Colwell stated that they need to get waivers from them. Mr. Mahoney asked when does the applicant have to tie into the sewer once it is brought down Salem Street. Ms. Colwell stated that the Board of Health requires the applicant tie in within 1 year if they are in the watershed. Ms. Colwell suggest that the Planning Board hold a bond so we can guarantee that the applicant does tie in as soon as CONSERVATION - (978) 688 9530 • HEALTH - (978) 688-9540 • PLANNING - (978) 688-9535 *BUILDINGOFFICE - (978) 688-9545 • *ZONING BOARD OF APPEALS - (978) 688-9541 0 *146 MAIN STREET possible. Mr. Nardella asked what the cost would be to bring sewer down Salem Street. Mr. Osgood stated that it would cost $70,000 - $80,000. Mr. Rowen asked Ms. Colwell to check and see if the Board of Health is going to make the applicant post a bond because we don't want them to have to post two bonds. On a motion by Mr. Simons, seconded by Ms. L;escarbeau, the Board voted unanimously to close the Public Hearing. Attached are the conditions. Sincerely, Richard S. Rowen, Chairman North Andover Planning Board 369 Salem Street Special Permit - Watershed Protection District The Planning Board makes the following findings regarding the application of Bogusha Duda, 369 Salem Street, North Andover, MA 01845, dated September 26, 1997, requesting a Special Permit under Section 4.136(3)(c) of the North Andover Zoning Bylaw to the replacement of an existing system within the Non -Disturbance Zone of the Watershed Protection District. FINDINGS OF FACT: In accordance with 4.136(4) the Planning Board makes the finding that the intent of the Bylaw, as well as its specific criteria, are met. Specifically the Planning Board finds: As a result of the proposed construction in conjunction with other uses nearby, there will not be any significant degradation of the quality or quantity of water in or entering Lake Cochichewick. The Planning Board bases its findings on the following facts: a) The existing septic system is failing and is depositing effluent directly into the groundwater with no treatment. The potential exists for the effluent to travel to the wetlands and streams which would convey the untreated effluent directly to Lake Cochichewick. b) The Town sewer will not reach this property for at least five years and it is cost prohibitive for the owner to connect to sewer individually. C) The replacement of the septic system will eliminate the known pollution hazard on a temporary basis until the sewer is installed in the street by the Town. d) The new septic system will be raised above the groundwater table so that the effluent will be treated in the sand below the leach bed prior to it entering the groundwater. e) Although the design does not meet the specific requirement of the Bylaw, it does comply with the guidelines of Title 5 for maximum feasible compliance. f) The Board of Health and the Conservation Commission will also be reviewing and approving the septic system prior to construction. 2. That there is no reasonable alternative location outside the Non -Discharge Buffer Zone for any discharge, structure or activity, associated with the proposed driveway construction as the lot is located within the Non -Discharge Zone. In accordance with Section 10.31 of the North Andover Zoning Bylaw, the Planning Board makes the following findings: A. The specific site is an appropriate location for the proposed use as all feasible stormwater and erosion controls have been placed on the site; B. The use will not adversely affect the neighborhood as the lot is located in a residential zone; C. There will be no nuisance or serious hazard to vehicles or pedestrians; D. Adequate and appropriate facilities are provided for the proper operation of the proposed use; E. The Planning Board also makes a specific finding that the use is in harmony with the general purpose and intent of the North Andover Zoning Bylaw. Upon reaching the above findings, the Planning Board approves this Special Permit based upon the following conditions: SPECIAL CONDITIONS: 1. This decision must be filed with the North Essex Registry of Deeds. The following information is included as part of this decision: a) Plan titled: Special Permit Site Plan Lot 5 Great Pond Estates Saile Way North Andover, Mass. Applicant: Eight Meadows Realty Trust Great Pond Road -• North Andover, MA 01845 Scale: 1" = 40' Date: 8/28/97, rev. September 30, 1997 Prepared by: Civil Construction Management Inc. Merrimac Road, Box 225 Newton, NH 03858 b) Report from: Dennis G. Qunital, PE President Civil Construction Management Inc. Dated: July 28, 1997 2. Any changes made to these plans shall be approved by the Town Planner. Any changes deemed substantial by the Town Planner will require a public hearing and modification by the Planning Board. 3. Prior to any work on site: a) A performance guarantee of three thousand five hundred ($3,500) dollars in the form of a check made out to the Town of North Andover must be posted to insure that construction will take place in accordance with the plans and the conditions of this decision and to ensure that the as -built plans will be submitted. This guarantee will also be held until such time as the existing home is tied into the Town sewer system. b) All erosion control measures as shown on the plan must be in place and reviewed by the Town Planner. c) The site shall have received all necessary permits and approvals from the North Andover Conservation Commission, Board of Health, and the Department of Public Works and be in compliance with the above permits and approvals. 4. Prior to release of the Performance Bond: a) The applicant must connect the existing home to the Town sewer system within six (6)' months of the sewer line becoming available to this lot. b) The applicant shall submit a certified copy of an as -built plan which shows all construction, including topography, sewer lines, storm water mitigation trenches and other pertinent site features. This as -built plan shall be submitted to the Town Planner for approval and shall be stamped by either a Registered Professional Land Surveyor or Practicing Engineer in Massachusetts. C) The Planning Board must by a majority vote make a finding that the site is in conformance with the approved plan. In no instance shall the applicant's proposed construction be allowed to further impact the site than as proposed .on the plan referenced in Condition # 1. 6. No open burning shall be done except as is permitted during burning season under the Fire Department regulations. 7. The Contractor shall contact Dig Safe at least 72 hours prior to commencing excavation. The provisions of this conditional approval shall apply to and be binding.upon the applicant, it's employees and all successors and assigns in interest or control. 9. This permit shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced. cc. Director of Public Works Building Inspector Health Agent Arn-nI s' -all be filled -:in (10) enys after the uai� cf ,i.::jg of tl-.is I\'ctice in the Office of the To,. -.!.n Clerk. o n ,SSACNUSt�4 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS RECmr _ JOYCE BRAG::iIAW TOWN CLERK NORTH ANDOVER OCT ZO 1 53 M '91 NOTICE OF DECISION 369 Salem St. NAME: John Duda DATE: 10/16/97 ADDRESS: 369 Salem St. PETITION: 031-97 North Andover, MA 01845 HEARING.- 10/14/97 The Board of Appeals held a regular meeting on Tuesday evening, October 14, 1997 upon the application of John Duda, requesting a Variance from the requirements of Section 4.136: of the Watershed Protection District, paragraph 3C: of the Non -Disturbance Buffer Zone, and (2) construction of any septic system, to allow installation of septic system within 100 feet of a wetland in the watershed district, of the Zoning Bylaws which is in R-3 Zoning District. The following members were present: William J. Sullivan, Walter F. Soule, Raymond Vivenzio, John Pallone, Ellen McIntyre. The hearing was advertised in the Lawrence Tribune on 9/30/97 & 10/6/97 and all abutters were notified by regular mail. Upon a motion made by Walter Soule, and seconded by John Pallone, the Board of Appeals unanimously voted to GRANT relief requested in the applicants petition, section 4.136 of the Watershed Protection District, Para. 3C: of the Non -Disturbance Buffer Zone and (2); construction of any septic system, to allow installation of septic system within 100 feet of a wetland in the watershed district of the Zoning Bylaws, and on the grounds that the Board of Health approve the system. Voting in favor: William J. Sullivan, Walter F. Soule, Raymond Vivenzio, John Pallone, Ellen McIntyre. The petitioner has satisfied the provision of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a Building permit as the applicant must abide by all applicable local, state and federal and building codes and regulations, prior to the Issuance of a building permit as requested by the Building Commission. BOARD OF APPEALS /decoct / 4Jullivan, WilliaChairman NEW ENGLAND ENGINEERING SERVICES INC September 19, 1997 North Andover Board of Health Town Hall Annex School Street North Andover, MA 01845 Re: Septic System 369 Salem Street Dear Mr. Chairman: TOWN OF NORTH ?."C' BOAR01 C SEP 19 1997 Please accept this letter as a request to be included on the next Board of Health agenda for the meeting scheduled September 25, 1997. The purpose of this request is to consider the following local upgrade approvals or local bylaw variances for the above referenced property. LOCAL UPGRADE APPROVALS 1. Reduction in offset distance from a subsurface disposal system to a wetlands bordering a tributary to a water supply from 100 feet to 62 feet. 2. Reduction in offset distance from a subsurface disposal system to a tributary to a water supply from 200 feet to 105 feet. LOCAL BYLAW VARIANCE 1. Allow a system to be installed in the watershed of the lake to be installed without a primary treatment system. I will be at the meeting to discuss this matter further. Sincerely, Benjamin C. Osgoo/Jr.,IT 33 WALKER RD. - SUITE 22 - NORTH ANDOVER,_ MA 01845 - (508) 686-1768 SEPTIC PLAN SUBMITTALS LOCATION: 5 �' NEW PLANS: YES $60.00/Plan REVISED PLANS: �__ $25.00/Plan�w�... DATE: l 1 1 2) r. DESIGN ENGINEER: Ilu tom..- �� G� '"� t Yom ., S�►�u.sC j , When the submission is all in place, route to the Health Secretary SEPTIC PLAN SUBMITTALS LOCATION: 4� S� n NEW PLANS: YES $60.00/Plan REVISED PLANS: YES $25.00/Plan DATE: //,/, 7 DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary b. TO: FORM L DEPARTMENTAL REFERRAL FORM Building Inspector Conservation Administrator .Director of Community Development Director, Public Works Fire Chief f -Health Agent Police Chief FROM: Town Planner and/or Clerk, Planning Office RE: Preliminary Plan Definitive Subdivision L Special Permit Site Plan Review Date: Qyko 17 ` -7 A ubliq Hearing h been scheduled for % ,*�d p.m. on 02 to discuss the plans checked above. (Preliminary plans do not require public hearings.) The Technical Review Committee Meeting is scheduled for: Thank You. PLAN REVIEW CHECKLIST ADDRESS 349'9 ENGINEER GENERAL 3 COPIES STAMP C/ LOCUS NORTH ARROW SCALE v CONTOURS PROFILE L ----(Sc) SECTION c--' BENCHMARK — SOIL & PERCS ELEVATION WETS. DISCLAIMER— WELLS & WETS WATERSHED?�C6 DRIVEWAY WATER LINE L---' FDN DRAIN—" M&P SCH40`�' TESTS CURRENT? SOIL EVAL SEPTIC TANK MIN 150OG .17 INVERT DROP GARB. GRINDER A (2 comps +200) 10' TO FDN MANHOLE ELEV GW ## COMPS. GB D -BOX /� SIZE ## LINES `T' FIRST 2' LEVEL STATEMENT INLET 149- %? - OUTLET /100 'w = ( 2" OR .17 FT) TEE REQ' D? k� LEACHING MIN 440 GPD? RESERVE AREA 4' FROM PRIMARY? 20 SLOPE 100' TO WETLAND 100' TO WELLS C/ 4' TO S.H.GW "- (5'>2M/IN) 20' TO FND & INTRCPTR DRAINS &--- 4649J- TO SURFACE H2O SUPP� 4' PERM. SOIL BELOW FACILITY MIN 12" COVER(`� FILL? x/(15') BREAKOUT MET? TRENCHES MIN 440 gpd SLOPE (min .005 or'6"/100') SIDEWALL DIST. 3X EFF. W OR D (MIN 6') RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? BOT + SIDE (L x W x #) ( DxLx2x## ) Copyright Q 1996 by S.L. Starr VENT? (>3' COVER; LINES >50') X LDNG = TOT (G/ft2) PITS MIN 440 LEACHING MIN 1 (13'x16') PIT MANHOLE/PIT GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x #) (2x(L+W)xD x #) (G/ft2) CHAMBERS MIN 440 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60' X 601) MIN 13' X 16' PIT BOT + SIDE X LOAD = TOTAL (L x W x #) . (2 x (L+W)xD x-#) (G/ft2) FIELDS / MIN 440 GPD 900 ft2 BED v GW MIN 4' BELOW BOTTOM OF FIELD L---"' PIPE ENDS JOINED? 4" PEA STONE? C-/ DIST LINE SLOPE .005? >3' COVER-VENTL-'' SCH 40 tom- MIN 12" COVER vim/ RATE ( I z X 20 ) X = TOTAL 6-40 L W LDG DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY 102 s 9Pm L W D Vol. DISCHARGE SIZE DISCHARGE RATE 9Pm MANHOLES TO GRADE L`� ALARM SEP. CIRC.. inlet) HWL LWL CHECK VALVE OP. SWITCH L--' ENUF STORAGE? Copyright 0 1996 by S.L. Starr DISCHARGE TIME GW (Min. l' below BLEEDER HOLE ` MANUAL 9 / 7 -DIV PLAN REVIEW CHECKLIST ADDRESS_ _ :� S1 cl�I ENGINEER GENERAL ��r �__--- 3 COPIES j STAMP,: LOCUS NORTH ARROW SCALE CONTOURS PROFILE c'�(Sc) SECTION L,-"-" ,-". BENCHMARK `-� SOIL & PERCS ✓ ELEVATIONS `" WETS. DISCLAIMER it/ WELLS & WETS WATERSHED? yc-5 DRIVEWAY WATER LINE FDN DRAIN M&P SCH40 t/ TESTS CURRENT? ✓/ SOIL EVAL SEPTIC TANK MIN 1500E `-- .17 INVERT DROP L---- 10' /10' TO FDNX MANHOLEj�g ELEV GARB. GRINDER (2 comps +200) GW # COMPS. GB SIZE # LINES FIRST 2' LEVEL STATEMENT INLET - OUTLET _ (2" OR .17 FT) TEE REQ'D? LEACHING MIN 440 GPD? RESERVE AREA 4' FROM PRIMARY? 2% SLOPE 100' TO WETLANDS 100' TO WELLS 4' TO S.H.GW L/' (5 >2M/IN) 20' TO FND & INTRCPTR DRAINS L-- 4' PERM. SOIL BELOW FACILITY L--," BREAKOUT MET? v TRENCHES 400' TO SURFACE H2O SUPP Xc� MIN 12" COVERZ Ll ---- FILL? L-'�(15') MIN 440 gpd SLOPE (min .005 or 611/100') SIDEWALL DIST. 3X EFF. W OR D (MIN 6') RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? VENT? (>3' COVER; LINES >50') BOT + SIDE = X LDNG = TOT (L x W x #) (DxLx2x#) (G/ft2) Copyright 0 1996 by S.L. Starr PITS MIN 440 LEACHING MIN 1 (13'x16') PIT MANHOLE/PIT GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x ##) (2x(L+W)xD x ##) (G/ft2) CHAMBERS MIN 440 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60' X 601) MIN 13' X 16' PIT BOT + SIDE X LOAD = TOTAL (L x W x ##) (2 x (L+W)xD X—#) (G/ft2) FIELDS f MIN 440 GPD 900 ft2 BEDy GW MIN 4' BELOW BOTTOM OF FIELD_ PIPE ENDS JOINED? 4" PEA STONE? L/" DIST LINE SLOPE .005? >3' COVER -VENT c/ SCH 40 L--' MIN 12" COVER -Af---'- RATE (--IL X ZU ) X " 66 = TOTAL &�'6) L W LDG DOSING TANKS AND PUMPS DIMENSIONS X X = /G'd© PUMP CAPACITY /D Z,y— L W D Vol. gpm /. DISCHARGE SIZE—/'016- DISCHARGE RATE _ gpm MANHOLES TO GRADE4 ALARM SEP. CIRC. inlet) HWLY2.zLWL7 CHECK VALVE G/ OP. SWITCH ENUF STORAGE? TDH� Copyright 0 1996 by S.L. Starr Lj DISCHARGE TIME All GW'zMin. 1' below BLEEDER HOLE L/ MANUAL WEIGHTED? 08/10/1992 06:35 6889573 N.X. DPW PAGE 01 I O NN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STReET, 01845 I.WIt,LtAM MMURGIAK. P. DIRECTOR Telephone (508) 685-0950 Fax (508) 688-9573 nS NORTH 1 Post -It® Fax Note 7671 Date Pof aoe$0, To ji �.`�%i, f From ur ��i►:tI/C�R�. CioMept Phone a no Fax R r V(7 FOX11 c November 5, 199' Board of Health 34 School Street North Andover, MA 01 445 Re: 369 Salem Street, Septic System Repair Dear Sirs: At the request of Mr. Benjamin Osgood Jr. of New England Engineering Services we have reviewed the plans for the proposed subsurface sewage disposal system at #369 Salem Street. We believe that construction of tate proposed system is the best available solution to the existing or potential pollution problem. Plans for a sewer- extension, to the property are included in the current five (5) year capital improvement plait. The property is in the Phase 4A sewer area which should be funded at the Mav 2000 Annual Town Meeting. ;tt rs, i J. William Hrnurciak, P,E. Director of Public Works JWH/cs NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT DATE FEE: PERMIT # APPLICANT DATE RECEIVED MAP PARCEL ADDRESS LOT # STREET #$ ENG. - 0 S (sdob STREET ENGINEER'S ADD. PLAN DATE CONDITIONS OF APPROVA APPROVED REASONS FOR DISAPPROVAL: 1415.5 /ti 6 LvC.u-5 REV. DATE DISAPPROVED -7, Fe,�C G 11s A116514)6 r. s cy- A/ m155 -//u6 . 681� (flwe ",-1-- 0a k 3 13 - ------ 0a Town of North Andover, Massachusetts Form No. z Of "o"TM BOARD OF HEALTH 41 c p 192—z— DESIGN DESIGN APPROVAL FOR Ss�cNusEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant U1jA Test No. Site Locationl Reference Plans and Specs. S�a� JP ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. FeU C14A1 �RDOTH SiteSystem Permit No. V Form No. 4 Town of North Andover, Massachusetts BOARD OF HEALTH December, 18 19-9Z_ -...... CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired ( yj by Ben Osgood Jr. - INSTALLER at 369 Salem Street SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design 993 Nov. 19 -97 Approval Site System Permit No. dated 19. The issuance of this certificate shall not be construed- as a guarantee that the -system will "function satisfactorily. - -- BOARD OF HEALTH {xi APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE:e� CURRENT INSTALLER'S LICENSE# l IT LOCATION: LICENSED INSTALLER: SIGNATURE: TELEPHONE#'r CHECK ONE: REPAIR: NEW CONSTRUCTION: S-BUILT:.:: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT'.-,'- Administrative Use Only Administrative $75.00 Fee Attached? Yes—,,,� . No Foundation As -Built? Yes ,ems Floor Plans? Yes No Approval //_J /G/i� Date: LO 196 ��cotiT� y - /��"� ol� L SS WA 6R So ppnj ' a �4 PPS C4ti T_ WPI ❑ WELL APNovCD 11l -r, StP7"I G SY S I�,cM �ES�� a /6 P�{i�V l.► 1/ e 4PrzovW6 Aunioi?,Ty k PLAN) VO4 6NC1- Ptd�v D,4 r �{ Co�DJT�o�s t �► 5,4 PP>za vE� D/�iE /leGV��- �` t D 5fprf STA l.(,,QTIoAJ I r. p --WAV JT(oJ,) JAJSPI�SG i i0^J FAIL- f=wA� A PPROVEP �IJTC �4��IT�o�AL. i�5�., �N5 �►� may) D►�3PPRvvED R£/j,�o NS FML APftV,,4L D,d TC APPrOvwG AUT+to/Rmy I NST&bt -R CHH w I XeR C,�,T 6� 6 L') I b� D,o�� APP)3OvVJ6.4u; Ho 40 VWS, FfbW 13 tIA106i� P004-, Pli,P5 ., APPLICATION FOR SEWAGE DISPOSAL INSTALLATIONN 3�p� GUS TZ HEALTH DEPARTMENT - NORTH ANDOVER, MASS. V GvRR . vtvu:DLAW I hereby m e application for a permit for a sewage disposal installation at � . I will install this system in ac- cordance with all the laws of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre- ceding the septic tank, where the grade shall not exceed 2%. I will install a con- crete septic tank of in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 3-/ 0 lineal (square) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree not to cover any portion of this installation until approved by the inspection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application. DATE Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE Si atur of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE ! 13 (Yr 4 Signature of 19pecting Officer Percolation Test Garbage Grinder HIV BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. -y-- '-)U 3Sv 1. NAME ?�JAMAMAA-lwwsp-/ JDATE 4 - ` -- t Cl°, b 9 2. ADDRESS 323 Sp��---`"" LOT,*. 3. NO. OF BEDROOMS 4- DEN YES `� NO 4. GARBAGE GRINDER YES NO 5. SHOW DIMENSIONS OF HOUSE i 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT` 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE 4/ NAME OF APPLICANT LOCATION Address of lot no. BUILDING: Dwelling Other SYSTEM: New Repair GENERAL DESCRIPTION OF LAND SUBSOIL: Clay____ aavel Sand PERCOLATION TEST t� minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK gallon capacity, LEACH FIELD lineal feet of drain pipe, t illi_.am J. Dr's of -, Engineer Board of Health --J r A BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE 4/ NAME OF APPLICANT LOCATION Address of lot no. BUILDING: Dwelling Other SYSTEM: New Repair GENERAL DESCRIPTION OF LAND SUBSOIL: Clay____ aavel Sand PERCOLATION TEST t� minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK gallon capacity, LEACH FIELD lineal feet of drain pipe, t illi_.am J. Dr's of -, Engineer Board of Health --J N W 0 Z LL ❑ Q 0 J J p . 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W J ILL r O U) J 0 O X -I- w a 0 w w z -z 0 ¢ ¢ a I V) N td z O W O z a Z ou' J J � 7 m m N N S ❑ z )- w O' -) ¢ w m W w LLJ 0 Z N Z z z a i o z a a a 0 o Ir 0 m m y rl , z O F- a J m O r l 7 w w W W Z O W 1 Q 0 J m m Z °w - r g mO LL Z ❑ > 0 0:O IL IL ` N 0 S. 0 U N a 0 Z Q ❑ 100") Q m 0 W , U) a jo .w! m r j- ❑ Z O W Z a I. 0 .❑ � w x U F- i a f ¢ a � � , W• F F 0 W . o w u a