HomeMy WebLinkAboutMiscellaneous - 391 PLEASANT STREET 4/30/2018 (2)N
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North Andover Board of Health
120 Main St.
North Andover Ma.01845
Haul Lic. #151 -OOH
Install Lic. # 128-0
Date Address
1111/2000 303 Chester St
11/1/2000 50 Willow Rd
11/1/2000 160 Carelton Ln
11/1/2000 165 Bridal Path
11/4/2000 174 Ingals St
11/4/2000 1062 Salem St
11/6/2000 373 Raligh Tavern Ln
11/6/2000 252 Boxford St
11/6/2000 150 Liberty St
11/6/2000 149 Osgood St
11/7/2000 255 Haymeadow
11/7/2000 850 Winter St
11/8/2000 25 Windsor Ln
11/9/2000 249 Carlton Ln
11/9/2000 767 Johnson St
11/10/2000 56 Academy Rd
11/14/2000 Sugar Cane Ln
11/14/2000 250 Abbott St
11/15/2000 195 Winter St
11/15/2000 187 Winter St
11/16/2000 85 Laconia Cir
11/16/2000 86 Willow Ridge
11/17/2000 2135 Turnpike St
11/20/2000 203 Grandville Ln
11/20/2000 391 Pleasant St
11/20/2000 124 Tucker Farm Rd
11/22/2000 394 Boston Rd
11/22/2000 728 Forest St
11/22/2000 18 Johnney Cake St
11124/2000 106 Rockey Brook Rd
11124/2000 258 Rea St
11/28/2000 1815 Great Pond Rd
11/28/2000 1420 Great Pond Rd
11/29/2000 266 Lacy St
11/29/2000 155 Laconia Cir
Andover Septic
47 Railroad St.
Bradford Ma. 01835
Gallons Comments
1000
1000
1500
1500
1000
1250
1000
1000 Leachfield Run Back/ Ex. Solids
1500
1000
1500
1250
1500
1500
1500
1500
1500
1000 Extra Solids
1500
1500
1500
1000
1500
1000 Flooded
1500
1500
1500
1500
1500
1500
1000
1000
1500
1000
1500
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Board of Health
North
An ver Haas-
.
UM
DATE
i�
j
FAIL
OK
SEPTIC SYSTEM
INSTALLATICK CHECK LIST
LOT
AVATZ Ob FAIL
1. Distance Tot
a. Wetlands
4j b. Drains
c. Well
/ 2. Water Line Location
3• No PPC Pipe
4. Septic Tank
a. -Tess -_Length & To Clean Out Covers.
b. Cement Pipe to Tank -- On Both Sides of Tank
5. Distribution Box
a. Covers & Box - No Cracks
b. All Lines Flowing Equal AWLInts
c. No Back Flow
6.- Leach Field or Trench
a. Dimensions
b. Stone Depth
c. CappedEnds
d. Clean Double -Washed Stone
7. Leach Pits
a. DiraansVepth
s
b. Stone
C. Sp Pads
d. T s •
e. C t Pipe to Pit - Both Sides
/ f. lean Double Washed Stone
/f 8. No Garbage Disposal
/ 9. Final Grading Inspection
10. Barricading Covered System
/ 11. As Built Submitted-
a. Lot Location -
�j b. Dimensions of System
c. Location with Regard -to Pere Test
j d. Elevations
e: Water Table
1
Board of Hcnl_th
North Andovor,Kass
APPROVED DATE
Provideds
SUBSURFACE DIO"OSAL DESIGN CHECK LIST
DISAPPROVED DATE
Reasons s
LOT # ,
Title pV - FAIL- it
—
Reg 2.5/ The submitted plan must show as a minimums
1 a) the lot to be served-area,dimensions lot #,abutters .
✓ location and log deep observation holes -distance to ties
location and results percolation tests -distance to ties
design calculations & calculations shoving required leaching area
(e)- location and dimensions of system -including reserve area
existing and proposed contours
✓° (g) location any wet areas i.thin 1001 of sewage disposal system or
disclaimer -check wetlands mapping
�h}-surface and subsurface drains -.d.thin 100, of sewage disposal
f' system or disclaimer
'i).location any drainage easements within 3.001 of sewage disposal
system or disclaimer -Planning Board files
,j,Yknown sources of water supply within 200, of sewage disposal
system or disclaimer
k,� location of any proposed well to serve lot -1001 from leaching
,l) location of water lines on property -101 from leaching facility
riocation of benchmark
a)' driveways
p3."garbage disposals
p,,11 no PVC to be used in construction
q) profile of system -elevations of basement.. plumb, pipe, septic
zdistribution box inlets and outlets, distribution field piping
Other elevations
)'maximum ground water elevation in area sewage disposal system
s) plan rmst be prepared by a Professional Engineer or other
professional authorized by law to prepare such plans
Reg 6 '' Septic Tanks
(a))capacities-150% of flow, water table, tees, depth of tees,
/ access, pumping
(b)-bleanout
_- (0-10t from cellar umll or inground sing pool
1___1(d) 25+ from subsurface drains
Reg 10.2 ,�' Distribution Boxes
Reg 10.4 slope greater 0.08
-° b)sunp
facility
tank,
and
J
Subsurface NA ` Check List Pae 2
' FAIL OK
Leaching Pits
Leaching pits;ire preferred where the installation is possible
Reg 3-1.2 a) calculatio fs of leaching area -mi ni nt m 500 eq ft
11.4 b) spacing su
11.10 c rface, drainage 2%
11.11 d� cover : b'terial
e) 21x2li40 splash pad
f)tee at elbow
g) no ends in pipe .Brom d -box to pipe
1
Leaahin -Fie1
Reg 15.1 f no er t asri 20 minute inch
ares mem goo, -s, q,i.�ft` "
15.4 r c) ons ction of,; eld /
15.8 ,sur ce e 2 %
3.7 ) from cce� W?Lll or inground swimming pool
1
�,eachillg Trc31che8
Reg 14.1 �° calc s�%aching area -min 500 sq ft
14.3 acing -4,h min 6 ft with reserve between
14.4 c dinerisions
12x.6 dYc�tarEz+ction
14.7 a stun ,
14.10 )surface draipage 2%
Domhi.11 o e
a) s opey ; to be shown)
b) :7/x % _ (to be shown)
Reg 9.1 �a) app val.9.6 b) a1
d-by power
c
206 ANDOVER ST., SUITE 11
ANDOVER, MA 01810
(508) 475-1237
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART A - CERTIFICATION
Property Address: 391 Pleasant Street, North Andover, MA
Address of Owner (if different): Owner Deceased
Name of Inspector: Peter F. Reilly
Company Name, Address, Phone #: F.P. Reilly & Sons, 206 Andover St., Suite 1 1
Andover, MA 01810 (508) 47.5-1237
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information 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
N/A Conditionally Passes
N/A Needs Further Evaluation By the Local Approving Authority
N/A Fails
Inspector's Signature: ka, Date: 11/16/95
Peter F. Reilly
The system inspector shall 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 of has a design flow of 10,000 gpd or greater, the
inspector and the system owner shall submit the report to the 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:
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.
— SERVING ANDOVER & VICINITY FOR OVER 40 YEARS —
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART A - CERTIFICATION (continued)
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: 11/16/95
B. SYSTEM CONDITIONALLY PASSES:
N/A 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, ND). Describe basis of determination in all instances. If "not determined", explain
why not)
N The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or extiltration, or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of health.
N Sewage backup or breakout or static high 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):
N/A broken pipe(s) are replaced
N/A obstruction is removed
N/A distribution box is leveled 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):
N/A broken pipe(s) are replaced
N/A 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 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:
N/A Cesspool of privy is within 50 feet of a surface water
N/A Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh.
2. SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF
APPROPRIATE) DETERMINES THAT THE SYSTEM 1S FUNCTIONING IN A MANNER THAT
PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
N/A The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or
tributary to a surface water supply.
N/A The system has s septic tank and soil absorption and is within a Zone I of a public water supply well.
N/A The system has s septic tank and soil absorption and is less than 100 feet but 50 feet or more from a private
water supply well, unless a water well water analysis 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.
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART A - CERTIFICATION (continued)
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: 11/16/95
D. SYSTEM FAILS:
N/A I 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.
N Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
N Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
SAS or cesspool.
N Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
N/A Liquid depth in cesspool <6" below invert or available volume < 1/2 day flow.
N required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped: none
N Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water
supply.
N Any portion of a cesspool or privy is within a Zone I of a private water supply well.
N Any portion of a cesspool or privy is within 50 feet of a private water supply well.
N 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 a large system in addition to the criteria above.
N/A 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:
N The system is within 400 feet of a surface drinking water supply
N The system is within 200 feet of a tributary to a surface drinking water supply
N The system is located in a nitrogen sensitive area (Interim Wellhead Area (IWPA) or a mapped Zone 11 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 DEP for further information.
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART B - CHECKLIST
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: 11/16/95
Check if the following have been done:
✓ Pumping information was requested of the owner, occupant and Board of Health.
✓ None 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.
✓ As built plans have been obtained and examined. Note is they are not available with N/A.
✓ The facility or dwelling was inspected for signs of breakout.
✓ All system components, excluding the SAS, have been located on the site.
✓ The 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.
✓ The size and location of the SAS on the site has been determined based on existing information or
approximated by non -intrusive methods.
✓ The facility owner (and occupants, if different from owner) were provided with information on the proper
maintenance of SSDS.
PART C - SYSTEM INFORMATION
FLOW CONDITIONS
RESIDENTIAL:
Design Flow:
Number of bedrooms:
Current residents:
Garbage grinder:
Laundry connected to system:
Seasonal use:
Water meter readings, if available:
Last date of occupancy:
COMMERCIAL/INDUSTRIAL:
Type of Establishment:
Design Flow:
Grease trap present:
Industrial waste holding tank
Non -sanitary waste discharged
the Title 5 system
Water meter readings, if available:
Last date of occupancy:
OTHER:
Describe:
Last date of occupancy:
400 gallons
4
0
no
yes
no
N/A
not occupied more than one year prior to inspection
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART C - SYSTEM INFORMATION (continued)
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: 11/16/95
GENERAL INFORMATION
PUMPING RECORDS and source of information:
not known (owner deceased and dwelling not occupied more than one year)
System pumped as part of inspection: N/A
if yes, volume pumped: N/A gallons
Reason for pumping: N/A
TYPE OF SYSTEM
✓ Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
NO Shared system (yes or no - if yes, attach previous inspection records, if any)
Other (explain)
APPROXIMATE AGE of all components, date installed (if known) and source of information:
Original system installed about 13 years ago, when dwelling was constructed. "As built" plans were available
and utilized. Ties to all components were not reliable.
Sewage odors detected when arriving at the site NO
SEPTIC TANK: ✓ (locate on site plan)
Depth below grade: <6"
material of construction: ✓ concrete metal FRP other (explain)
Dimensions: rectangular - 1,500 gallons
< l " sludge depth
48" distance from top of sludge to bottom of outlet tee or baffle
< 1" scum thickness
6" distance from top of scum to top of outlet tee or baffle
21" distance from bottom of scum to bottom of outlet tee or baffle
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, recommendations for repairs, etc.)
Liquid level was about 10" below outlet invert, implying tank was leaking. Level was raised to invert and then
subsequently dropped to original level. Tank was replaced on 11/16/9.5.
Property Address:
Owner's Name:
Date of Inspection:
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART C - SYSTEM INFORMATION (continued)
GENERAL INFORMATION (continued)
391 Pleasant Street, North Andover, MA
Estate of Austin
11/16/95
GREASE TRAP: N/A (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 scum to bottom of outlet tee or baffle
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, reco►runendations for repairs, etc.)
N/A
TIGHT OR HOLDING TANK: N/A (locate on site plan)
Depth below grade:
material of construction: concrete metal FRP other (explain)
Dimensions:
Capacity:
Design Flow
Alarm level:
gallons per day
gallons per day
Comments: (condition of inlet tee, condition of alarm and float switches, etc.)
N/A
DISTRIBUTION BOX: ✓ (locate on site plan)
0" depth of liquid above outlet invert
Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box,
recommendation for repairs, etc.)
Three lines accepting effluent evenly, No solids carryover evident. Box cover about 16" below grade.
PUMP CHAMBER: N/A (locate on site plan)
N/A pumps in working order, yes or no
Conunents: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,
etc.)
N/A
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART C - SYSTEM INFORMATION (continued)
GENERAL INFORMATION (continued)
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: 11/16/95
SOIL ABSORPTION SYSTEM (SAS): ✓ (locate on site plan, if possible; excavation not required, but may be
approximated by non -intrusive methods)
If not determined to be present, explain: not applicable
Type
leaching pits and number
leaching chambers and number
leaching galleries and number
leaching trenches, number, length
leaching fields, number, dimensions
overflow cesspool, number
N/A
N/A
N/A
3 trenches, 4' x 40' ea. per plan
N/A
N/A
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
recommendations for maintenance, repairs, etc.)
Soils look good, no hydraulic failure, no ponding or vegetation over leaching area.
CESSPOOLS: N/A (locate on site plan)
number and configuration
N/A
depth -top of liquid to inlet invert
N/A
depth of solids layer
N/A
depth of scum layer
N/A
dimensions of cesspool
N/A
materials of construction
N/A
indication of groundwater inflow (cesspool
must be pumped as part of inspection)
N/A
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
recommendations for maintenance or repairs, etc.)
not applicable
PRIVY: N/A (locate on site plan)
materials of construction N/A
dimensions N/A
depth of solids N/A
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
recommendations for maintenance or repairs, etc.)
not applicable
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART C - SYSTEM INFORMATION (continued)
GENERAL INFORMATION (continued)
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: 11/16/95
SKETCH OF SEWAGE DISPOSAL SYSTEM:
indicate at least two permanent references, landmarks, or benchmarks
locate all wells within 100' N/A
F3
SEPTIC TANK TIES: A
to Inlet
(I)
41'2"
B
to Inlet
27'5"
A
to Center
(C)
4217"
B
to Center
2916"
A
to Outlet
(0)
44'2"
B
to Outlet
31'10"
D -BOX TIES: A
to Box
4716"
B
to Box
3610"
NOTE: Ties are for new tank and box installed 11/16/95
DEPTH TO GROUNDWATER
4' depth to groundwater (below bottom of SAS)
method of determination or approximation:
No groundwater was evident at time of original inspection 7/29/95. When new tank was installed on 11/16/95, reinspection
revealed groundwater at a point about 4' below bottom of SAS. Sumner of 1995 was extremely dry, Fall of 1995 was extremely
wet.
ADDENDUM
Property Address: 391 Pleasant Street, North Andover, MA
Owner's Name: Estate of Austin
Date of Inspection: original 7/29/95 - reinspection 11/16/95
Initial inspection on 7/29/95 revealed a leaking tank. At the request of the North Andover Board
of Health, a new 1,500 gallon concrete tank was installed on 11/16/95 and the system was
reinspected. During excavation for the installation of the new tank, the D -box was accidentally
cracked and it was replaced with a new box as well.
During the initial inspection, the liquid level of the tank was raised and D -box was filled, with
flows indicating that the SAS was functioning adequately. No effluent was in any of the outlet
inverts and each line was accepting effluent evenly. The new D -box was filled at the time of
the second inspection, with the flows being the same as the initial inspection.
The groundwater levels were different at the time of both inspections, probably due to extreme
summer drought and recent heavy rains in late October and early November. The inspection on
11/16/95 revealed that the current groundwater level is close to four feet from the bottom of the
SAS.
Inspector's Signature
Z -6—u& -
Peter F. Reilly
Dated: November 16, 1995
TOWN OF`NO�TH ANDOVER
SYSTEM pUWING RECORD
DATE %I a/ -v3
SYSTEM LOCATION
SYSTEM OWNER & ADDRESS1.0
Jr'iC
2`L
DATE OF PUMP
INO J . QUANTITY PUNiI'ED
SEPTIC TANK NO-- YES
CESSPOOL NO
EROENCY
�5---
NATURE OF SERVICE:;:RQUT--
OBSERVATIONS FULL TO COVER -�
GOOD CONDITION, BAF IN LACE.
CAVY ORE
_... LEACHgIELD RUNBACK
ROOTS FLOODED
EXCESSIVE SOLIDS-- OTBER EXPLAIN
SOLID CARRYOVER -
SYSTEM PUMPED BY
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ystem Pumping'Record
•nl _; fForm -4.'.—,:-,,.k yt
DER.has provided this form for use by local Boards of Health. The System
rPumping Record must
be submitted to the local Board of Health or other approving authoity.
PER 0 6 20.07
A Facility Information I
>>^lmqortant.
TOWN OF Nc tT A^:OVER
YVt18ri flllin9 Out:,' : ; �.;. System location HEA-1 H b-': +
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uter, use;•
only the tab key Address
to move your
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.. use the Tatum Clty/Town :. State
Zip Code
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Name
Address (If different from location)
City/Town State Zip Coda
Telephone Number
1 B Pumping Record
Date of Pumping 2. Quanta Pumped:
p Gallons
31Type of system ❑ Cesspool(s) [I SepticTank ❑Tight Tank
❑ Other (describe]
4 Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ ' No
5 Co�tdition of System
- r IUB riA ��••
6 Sy em FM
Pumped By
.: ,G
Name r a
Veh1Ge License
Company
i y • IJ 1 � N'i to
1
7 Locaflon where contents were disposed:
k, Signature of Hauler'::; : Date
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System Pumping Record • Page 1 of 1
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