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Miscellaneous - 40 STERLING LANE 4/30/2018 (2)
40 Sterling Lane - I i I North Andover Board of Assessors Public Access Page 1 of 1 NORTH rfh Andover Board of Assessors mom..,,- 1 'SSACMU�+Et roperty Record Card Parcel ID :210/106.C-0036-0000.0 FY:2012 Community: North Andover Click on Sketch to Enlarge Click on Photo to Enlarge 1 40 STERLING LANE Location: 40 STERLING LANE Owner Name: SCIARRA JR,ANTHONY C/O JOSEPH SAPIENZA Owner Address: 40 STERLING LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:8-8 Land Area: 0.73 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2573 sqft Total Value: 604,500 604,500 Building Value: 378,900 378,900 Land Value: 225,600 225,600 Market Land Value: 225,600 Chapter Land Value: Sale Price: 509,400 Sale Date: 06/15/2000 Arms Length Sale Code: Y-YES-VALID Grantor: COOLIDGE CONSTRUCTIO Cert Doc: Book: 05777 Page: 0280 http://csc-ma.us/PROPAPP/display.do?linkId=1895834&town=NandoverPubAcc 3/29/2012 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Volunta,,-M-b 40 Sterling Lane Property Address f'IA AnthonySciarra Owner Owner's Name TOWN OF NORTH information is North Andover MA 01845 HEALTH 2 V&&ILTIVIINTLI required for every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Wright use the return Name of Inspector key. Aspen Environmental Services LLC I Company Name 270 Lawrence St Company Address Methuen MA 01844 Y� " Cityrrown State Zip Code 978-681-5023 2035 Telephone Number License Number B. Certification 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 15.000).The system: Passes ❑ Conditionally Passes ❑ Fails eds Further Evaluation by the Local Approving Authority or's Signature ate 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. ****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 kuture under the same or different conditions of use. J t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is North Andover required for every MA 01845 3/4/11 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: 2/'1have 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. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the followinatements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the sep ' nk(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration ank failure is imminent. System will pass inspection if the existing tank is replaced with a plying septic tank as approved by the Board of Health. *A metal septic tank will pass inspe on if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the t is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ ND(Explain below): ❑ distribution box is leveled or replaced Y ❑ N ❑ ND(Explain below): ❑ The system require umping more than 4 times a year due to broken or obstructed pipe(s). The system will pass i pection if(with approval of the Board of Health): Elbroken ipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ ob tFuction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 ` t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is every North Andover required for eve MA 01845 3/4/11 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 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 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 II water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent d the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provid that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No to each of the following for all inspections: Yes No ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ E!r"-,-- Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ [:]r-- Static liquid level in the distribution box above outlet invert due to an overloaded clogged SAS or cesspool ElLiquid depth in cesspool is less than 6"below invert or available volume is less than %day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No 10Required pumping more than 4 times in the last year NOT due to clogged or ,obstructed pipe(s). Number of times pumped: . ❑ L—y"/ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of 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 1 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- ,000gpd. ❑ 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 10,0009P d to 15,000 9P d. For large systems, you must indicate either"yes"or"no"t ch of the following, in addition to the questions in Section D. Yes No ❑ ❑ the syste s within 400 feet of a surface drinking water supply ❑ ❑ 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 hav answered "yes"to any question in Section E the system is considered a significant threat, or answ ed"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. t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane f Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes o ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Were any of the system components pumped out in the previous two weeks? ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were.as built plans of the system obtained and examined?(If they were not available note as N/A) L2' ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑❑l Was the site inspected for signs of break out? L� LJ Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ❑ 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: �J' ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): Number of bedrooms(actual): L Ii ff DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): V t5ins•09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts lugTitle 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes 0---Vo�c Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes C? No Laundry system inspected? ❑ Yes ❑ No m� Seasonal use? ❑ Yes 0,-No 7 Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes E3-'K-o-- Last date of occupancy: Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons Per day(gpd) Basis of design flow(seats/persons/ ,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste ho ng tank present? ❑ Yes ❑ No Non-sanita aste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available:. t5ins-09108 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 7 of 17 . i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yy< 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is requiredfor every very North Andover MA 01845 3/4/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): .General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes E;-I-o-- If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: b.k 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09108 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes No Building Sewer(locate on site ) Ian : p Depth below grade: 1 feet Material of construction. ❑ cast iron 0 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): a Depth below grade: feet/ Material of construction: concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal lista e: g years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No i Dimensions: f/ Sludge depth: t5ins•OWN Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System.Form-Not for Voluntary Assessments .' 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. City/rown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 3 Q Scum thickness Distance from top of scum to top of outlet tee or baffle (� f/ Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? �ze`� Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum/ Distance fr top of scum to top of outlet tee or baffle Distan from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '( 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and o tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence akage, etc.): 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: gallons per day I jAlarm present: ❑ Yes ❑ No I Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumpin Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page t t of 17 'Commonwealth of Massachusetts u°lTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 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.): Pump Chamber(locate on site plan):. Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, con ' ' of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate onsi , excavation not required): If SAS not located, explain why: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is North Andover MA 01845 3/4/11 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: 2-- , leaching trenches number, length: ❑ 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.): .:5 G� cry 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/osspool Dimensio Materialson Indication of groundwater inflow ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 t d Commonwealth of Massachusetts RE- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 7�Ue 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ❑ and-sketch in the area below drawing attached separately t5ins-09/08 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form `o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope ❑ Surface water Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: Lt�J' Obtained from system.design plans on record If checked, date of design plan reviewed: Date ❑ 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: /Z Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 40 Sterling Lane Property Address Anthony Sciarra Owner Owner's Name information is required for every North Andover MA 01845 3/4/11 page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist Ins ection Summary: A, B, C, D, or E checked Inspection Summary D (System Failure Criteria Applicable to All Systems)completed Ird Sy m Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 17 of 17 if0 \\ \\ 'os Rol oil . C013 -------------------------- ---\---------------'-- — ---------------E-7 -— —— C915 DMH/A OAlH�2 carTER.SING A E -- ----- --- ---- ---- -- --- -- ----- zf f E CENTER BOX . p .W.=125 I / CULVERT ` 9 32' APPROX/A/A'TE LOCATION •' '�'::aa' T.O.W.=1241 EL=108.7' >1 to' I' �. '. I T OF.-'UNDERGROUND � � 'x.+y� � W _ MOM.1ELEPHONE AND CABLE.TV WIRES . . :', `� I TITLE 5 i \ I RETAINING WALL \\\ EDGE OF BORDERING r :� \ 'P F\p,�°��•. VEGETATED WETLANDS rW SEPTIC TANK / �1 _ . EAS /NG �Ol1NDAT10N TOW 175 Y 1�, - Sts Mary Reeurd Cen3 gwwuW an 3/3012019 IM-39 PM by Lisa Evens Pape 1 Town of North Andover Tax Map # 2104 06-C-0036-0000.0 Parcel Id 17670 40 STERLING LANE SCIARRA, ANTHONY 40 STERLING LANE NORTH ANDOVER, MA 01845 _ Cuss 101 Single Fanlity Property Type 1 Residential Size Total 0.73 Acres FY 2011 UB Maillna In NamelAddress Type Loan Number Activelinact. From Until SCIARRA,ANTHONY Payot 40 STERLING LANE NORTH ANDOVER.MA 01645 UB Account Maim. Account No Cycle Occupant Name Activelirtactive Bldg Id,13874,0.40 STERLING LANE Last Bluing Date 312/2011 2100706 02 Cycle 02 Active UB Services Ma nt. Account No,2100706 Service Code Rabe Charge multlpiierltlsers MtSCFEE ADMIN FEE OAS 518 7.82 1/ WTR!NATER 01 ALL METER SIZE 72.20 11 UB Meter Mainjenance Account No.2100705 Serial No status Location Brand Type size YTD Cons 99885624 a Active ERT METE METE w Water 0.63 0.63 417 Date Reading Cade Consumption Posted Date - Variance 2/412011 1748 a Actual 19 3/1512011 -53% 11/1/2010 1729 a Actual 38 12113/2010 -43% 6/3/2010 1691 a Actual 68 9/1312010 274% 513!2010 1623 a Actual 18 61912010 -10°x6 2/112010 1605 a Actual 20 3111/2010 -46% 11/212009 1585 aActual 37 12/1112009 81% 813/2009 1548 a Actual 20 `-911112009 3% 6/8/2009 1528 a Actual 20 611812009 5% 2/312009 1508 a Actual 19 3116/2009 -31% 11/312008 1489 a Actual 28 12/10/2008 -79% 8/1/2008 1461 a Actual 130 9112/2008 354% 5/1/2008 1331 a Actual 28 6/16/2008 59% 211/2008 1303 a Actual 18 3/1412008 -74% 11/1/2007 1285 a Actual 69 1115/2008 5% 0/212007 1216 a Actual 66 9114/2007 268% 51312007 1150 a Actual 14 6122/2007 0% 212112007 1136 a Actual 22 3/23/2007 -30% 11/1/2006 1114 a Actual 26 1212212006 -13% 6/1/2006 108e a Actual 29 9/13/2006 74% 5/4/2006 1059 a Actual 17 6/2012006 -14'/6 2/212006 1042 a Actual 20 311312006 -90% 11/2/2005 1022 a Actual 198 12114/2005 288% 812/2005 824 aActual 51 9112/2005 124% 5/2/2005 773 a Actual 22 618/2005 -9% 212/2005 751 a Actual 25 3/1512005 -12% 1112/2004 726 a Actual 26 12117/2004 -59% 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Thursday, March 29, 2012 2:52 PM To: 'Sapienza, Joe' Subject: RE: 40 Sterling Lane-Scanned copy of Septic As Built Importance: High Follow Up Flag: Follow up Flag Status: Flagged Hello, When a homeowner contracts with an offal(septic)hauler to have their septic system pumped,the hauler,by regulation,is supposed to submit copies of the pumping records within 30 days to the BOH. Unfortunately, not all haulers submit their documentation,but we don't have the ability to police all of the homeowners who have their systems pumped or who they hire. Therefore,the BOH is merely a"keeper of the records"for any information that we receive or generate ourselves for a particular property. For your own peace of mind, I would advise you to contact the current homeowner and request copies of the pumping records since 2003,or at least provide you with the name of the company they hired to do the pumping, and contact the company directly for copies of the pumping records. If you do get copies,please send them to me,and I will put them in our file for the record. Thank you. Pamela DelleChiaie Health Department Town of North Andover 1600 Osgood Street I Bldg.20 1 Suite 2-36 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email odellechiaieCeDtownofnorthandover.com Web www.TownofNorthAndover.com , rra404 A. From: Sapienza, Joe [mailto:Joseph.SapienzaCai)cambridgetrust.com1 Sent: Thursday, March 29, 2012 2:38 PM To: DelleChiaie, Pamela Cc: 'Joseph Sapienza' Subject: 40 Sterling Lane - Scanned copy of Septic As Built Importance: High Hi Pamela, 1 ..-(Thanks for resending the document I was able to open it. Can you please tell me the last time the septic was pumped and which company did it? After reviewing ail the documents you sent me I only see one record of the system being pumped and that was back in May of 2003 by a company called Andover Septic. I'm concerned because the title V inspection completed on March 2011 by Aspen Environmental Services LLC stated the system had been pumped "last year" (page 8 of the title V report). I would then assume the system had been pumped sometime in 2010 but again I don't see any records stating as such. I'm just trying to find the company that pumped the system last so I can schedule another appointment for them to pump this spring. I'm I missing something or has this system not been pumped since May of 2003? Thank you for your help. Joe Sapienza 40 Sterling Lane North Andover, MA 978-204-1354 Septic As Built To:Joseph Sapienza 978-204-1354 Dear Mr. Sapienza Per your information request,I have scanned the septic as built for your reference. I will be sending another email with the remaining information from the file. Please call with any questions. Have a great day! Pamela DelleChiaie Health Department Town of North Andover 1600 Osgood Street I Bldg.20 1 Suite 2-36 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email pdellechiaieCcDtownofnorthandover.com Web www.TownofNorthAndover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. DISCLAIMER: ******The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material.Any 2 Town of North Andover NORTH OFFICE OF 3?Oy 1t e o ,e 1140 COMMUNITY DEVELOPMENT AND SERVICES ° 27 Charles Street North Andover,Massachusetts 01845 WILLIAM J. SCOTT 9SSACHU Director (978)688-9531 Fax(978)688-9542 August 11, 1999 Christiansen&Sergi 160 Summer Street Haverhill, MA 01830 RE: Lot 1 Sterling Lane Dear Mr. Christiansen: This letter is to inform you that the proposed septic plan for Lot 1 Sterling Lane, North Andover has been disapproved for the following reasons: 1. Septic tank missing manhole to within 6" of final grade. (310 CMR 15.228(2)) 2. Plans for the reinforced concrete retaining wall must be submitted,reviewed and approved prior-.,to septic plan approval. Please do not hesitate to call the Health Department at 978-688-9540 if you have any questions. Sincerely, Sandra Starr,R.S. j Health Administrator Cc: Coolidge Construction File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Aug-11-99 09: 53A Paul D. Turbide, PE/PLS 508-465-0313 P.02 August 11, 1999 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE, Title V review for Lot 1 Sterling Lane (Map 106c Lot 36) j Dear Sandra, Enclosed find the "Checklist for North Andover Septic System Plans" for the above- mentionedi w' s to The following is a list of all the Problem areas and deficiencies Port i Engineering has found. i o The septic tank must have a manhole brought to within 6" of the final grade 310 CMR 228(2) u This design shows a reinforced concrete retaining wall to be used as an impervious barrier in lieu of the required fill. The plans do not show a definitive design for the retaining wall but rather state that before the retaining wail is installed that the owner must have an engineer design the wall. Therefore approval of the design plans should be conditioned upon the submittal and review of the retaining wall design. If you have any questions or comments please feel free to contact me. Sincerely Carlton A. Brown, PE/PLS Sterlinglo. .doc r` PORT ENGINEERING, Civil Engineers& Land Surveyors One Harris Street Newburyport,MA 01950 (978)465-8594 CHRISTIANSEN & SERGI, INC. PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830-6318 (978)373-0310 FAX: (978)372-3960 August 27, 1999 Ms. Sandra Starr: North Andover Board of Health 27 Charles Street North Andover, Ma 01845 Re: Lot 1 Sterling Lane Dear Ms. Starr: We have received your August 11, 1999 letter of disapproval for the Septic System Design for the above referenced lot. The following is a list of our responses to each of your reasons for disapproval. In order to facilitate your review of this information, we have reproduced each of your comments in Italics, and our response to each of your comments immediately follows. 1.. Septic tank missing manhole to within 6"of final grade. (310 Cllr 15.228(2)). The profile view on the Septic System Design specifies that the cover over the tank shall be 9 inches minimum to 12 inches maximum. With this range of cover over the tank,the manhole is not necessary. 2. Plans for the reinforced concrete retaining wall must be submitted, reviewed, and approved prior to septic plan approval. The design of the reinforced concrete retaining wall will be submitted by a structural engineer in a separate submittal. Since the only outstanding item remaining for the approval of the septic system is the retaining wall design, our design plan does not require any revisions. Could you please send us confirmation that the plan as submitted has received conditional approval pending the submission and approval of the retaining wall design? Please contact me if you have any questions regarding this matter. gely yo , P . isiansen TC✓i,+,1 OF NORTH ANDOVEV Ow;-37f-LTH C.C. Coolidge Construction AUG 311%9 Town of North AndoverNORTH OFFICE OF 3�Oy ,e,�0 COMMUNITY DEVELOPMENT AND SERVICES A . ; 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT SSACMUSe Director (978)688-9531 Fax(978)688-9542 September 3, 1999 Philip Christiansen 160 Summer Street Haverhill, MA 01830 Re: Lot 1 Sterling Lane Dear Mr. Christiansen: This letter is to confirm that all aspects of the septic plan design for the referenced lot are acceptable and have been approved. The only item remaining is the design of the retaining wail which, as I understand, is to be designed by others. When the Health Department receives this design, reviews and approves its construction,then the plan will be fully approved and a Form U can be signed. Please feel free to call me at 978-688-9540 if you have any questions. Sincerely, Sandra Starr,RS. Health Administrator Cc: Coolidge Construction File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 t 13 G. J. Bruno Associates Architectural Designers 28 Berkeley Road N. Andover, MA 01845 978-683-1153 10105 c1 ZV� ROBERT G .iosEP'M MANNING -+ co No 4/149 O roll ,607 l aid - s ®' PeA t-jT LaT I �T�paLI l_lci l-,�� q E_ ISI, A W ewCj No 98. 2,44-,no9 REINFORCED CONCRETE RET IM WAS PRIOR TO ANY CONSTRUCTION, A DESIGN FOR THE REINFORCED CONCRETE RETAINING WALL SHALL BE SUBMITTED TO THE BOARD OF HEALTH, THE DESIGN OF THE RETAINING WALL SMALL MEET THE FOLLOWNG SPECIFICATIONS, AS PER 310 CMR�16.2W2) AND THE RULES AND REGULATIONS OF THE NORTH ANOOVER BOARD OF HEALTH.- A) EALTH:A) THE RETAINING WALL.SHALL BE CONSTRUCTED OF REINFORCED CONCRETE. SHALL HAVE NO WEEP HOLES, AND SHALL BE WATERPROOF. B) THE RETAINING WALL. SHALL BE DESIGNED BY A REGISTERED PROFESSIONAL ENGINEER, ��"OF l,f S14 N4i0 SHALL CER71f1' THAT THE ABOVE CONDITION l5 MET By THE.SUBMITTED DESIGN. /oer:r,� a/ . C) THE UPORADIENT SIDE OF THE RETAINING WALL SMALL .BE WATERPROOFED... s ;p,Epy `,<< t5 MAIVMNG D) CONSTRUCTION OF TFIf RET A/N1N0 MALL SHALL B£ SUPERVISED BY tK DESIGN ENGINEER, ,�, Iva.Z/jay c�) E) AN AS—BUILt PLAN SHALL; BE PREPARED AID. CERT`fnEG BY THE DESIGN ENGINEER THAT THE WALL HAS BEEN CONSTRUCTED 'IN ACCORDANCE WITH THE APPROVED DESIGN PLAN. . 'sj .•; — - F) THE'ELEVATION OF THE TOP OF THE RETAINMIG.WALL SHALL BE NO Lbwp THAN ?HE y �i 'BREAKOUT' ELEVATION, WHICH IS THE ELVATION OF THE-TOP OF THE FOUR. INCH LAYER OF 1/8 INCH 10 4/2 INCH WASHED.STOME.AG(JREGATE COVER. 1CUtr�! f r� a+1at*!�J ��43%� G) THE DISTANCE•FROM THE WALL to THE EDGE OF THE LEACHING AREA:SHALL BE AT F `V' `21D GFINEALTH LEAST TEN FEET. H) CONSTRUCTION OF THE SEPTIC SYSTEM SHALL NOT START UNTIL TIME RETAINING WALL IS 2 -j 1999CONSTRUCTED,. CERTIFIED BY THE DESIGN EN0INEER, AND INSPECTED SY THE BOARD OF. ; HEALTH. T 0 o ���� fort �� over No.,,50 J. r O �. North�'Andover, Mass., B' ' BOARD OF HEALTH Food/Kitchen PERMIT TO UILD Septic System i J ) 0 THIS CERTIFIES THAT....... BUILDING INSPECTOR ........ . . . .. ................ 'itFoundation has permission to erect..........�....................... ... buildings on l*+'l...�'.yo..... 7�+c�lI N � Rough //I, c ,• u'O�y/u'Z to be occupied as.. ...R OOH... ...� ..... p ' ......SI..... r 0.1 ........... ...I.y....Rftidamt. ........ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Final p Y g p Alteration and Construction of Buildings in the Town of North Andover. $twi l ' It PLUMBING INSPECTOR, VIOLATION of the Zoning or Building Regulations Voids this Permit. 1 � ELECTI4&1L SPE ... ! / Is • BUILDIN SPECTO i , , : • ;�; In `v �� �N AS INSPECT R�. Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done FIR EPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Q ( (� SEE REVERSE SIDE Smoke Det. ?�G • Pf�F _ SEPTIC SYSTEM INSTALLATION CONDITIONS:,. Is the installer-licensed' ? YES NO Type-of'Construction.- _ NEWS? REPAIR New Constfuctioni' Certifiietl Plot.Plan Review - a Floor Plan Review Conditions of Approval from Form U YES NO ry Issuance of DW.0 permit. - YES NO.° as , . Paid?' --: Permit PaW n = YES NO DWC Permit Installer: . ,Begin Inspection - 'Excavation Inspection --Needed:- ' _, 1 � 1c � W/ (-6 d � r ~.Passed Y BY r Construction Ins ection. - _, Plan, -A.sfactory;-,',, ,YES: r - N, 4. .:-Approval of Backfill Date . By. Final Grading:A royal 'Date. , ' .B : pp` _ Final Construction Approval: Date: I l� By: � Certificate of Compliance: Approval AZy Date: a a i _ E FO FORM U LOT RELEASE RM .. INSTRUCTIONS: This form is used to verify that all—necessary approvals/permits from Boards and Departments having.jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************A F P L I C A N T FILLS OUT T H 1S APPLICANT �l_ D %/D�tJLO„�,C'. PHONE97J //7- 0,0, LOCATION: Assessor's Map Number PARCEL S U S D I V I S i 0 N �� _ /Ul �,p�c'sT TT1� LOT (S) STREET-tS�— 4//(/G t1-41V ST. NUMBER USE ONLY******************* ************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED O DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONSvv DRIVEWAY P�j?�11T FIRE DEPARTMENT I RECEIVED BY BUILDING INSPECTOR DATE i Revised 9197 jm I TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 6/14/00 This is to certify that the individual subsurface disposal system constructed (X) or repaired () by Dave Maynard at Lot 1 Sterling Lane has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector r TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the ( System Sewage Disposal S constructed; P Y ( ) r�epaired;- by � A J e R Ct_! l V A fir^Ct, located at 4 ® e L 1z4-AZ,., �-- .41- was installed in conformance with the North Andover Board of Health approved plan, System Design Permit# , dated , with an approved design flow of 2mb gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative Installer: Lic.#: 7 Date: 6 -2 --02voc> Design Enginee Date: 7 � AS-BUILT CHECKLIST (/ LOT NUMBER, STREET NAME y ASSESSORS MAP &PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS y LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES &DWELLING, WELLS a. FROM SEPTIC TANK r b. FROM LEACH AREA y LOCATIONS OF DEEP HOLES & PERC / TESTS l/ ELEVATIONS OF DISPOSAL SYSTEM (/ TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM (/ LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX (/ ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW LOCATION&ELEVATIONS OF BENCHMARK USED Received May-05-99 10:22 from 9786857878 - G page 2 05/05/1999 11:31 9786857878 COOLIDGE CONSTR PAGE 02 Pt"AM n= uacGraior. Rapt t treklmes, P.c. _ 105 KRnota Avenue • P.O. lax 744 Msverhllt• Nass"huaetts 09831-0412 T MoSRONVORTTs QDI"�CLAIM DNB}] GEORGE H. PAM and SDA R. PMR, husband and wife, of 216 Paleigh Tavern Lane, North Andover, Essex County, MA for consideration paid, and in gull comideration of rive XVYDRBD PIPTY TROUSARD and no/i00 ($550,000.00) DOLLARS grant to JOW 7. NeGAMY, Trustee of the Oak Trust under declaration of Crust dated August 14, 1980 and recorded with the Essex North District Registry of Deeds at Book 1448, Page 150, of 401 .Andovear street, North Andover, MA 01845 with quitalarim covenants �,•, Certain parcels of land, being shown as Lots 1 through 6, Open Space Parcei W , Open Space Parcel '8' , the fee In Snarling Lanes, and the 23.4 acre +/- parcel described as "Remdining Land" on a plan of land entitled: "DEFINITIVE SUBDIVISION OF PLANNED RESIDENTIAL DEVtLOPMENT, SALEM FOREST IV, IN NORTH ANDOVER, PfASSACHUSETTS." Owner and Applicant. Farr Better Homes, Inc, , George Farr, President, 216 Raleigh Tavern Lade, North Andover, Massachusetts; Scale,: 111 a 2001 : Date: June 21, 1996; Hancock Survey Agsoeiates, Inc. , 235 Newbury Street, Danvers, ?SSA 01923, Said plan is recorded at North Essex Registry of Deeds As Plan No, 13035. NAS; '5TJ=-?.3 subject to the germs and conditions of a Covenant by and among George H. Farr, Wanda K. Farr, Farr Better Hotness, Inc. , and Jchn F. McGarry, Trustee of Oak Trust, dated March 151 1099 and recorded herewith. For Orantors title- rase dead& recorded with the Essex North District Registry in Book 1089 Page 314 Book 2039 Page 269. EXECUTED as a Sealed instrument this 15th day of March, 1999 PARRCOMMOM42ALTH OF MASSACHUSETTS ESSEX, SSS March 15, 1999 Thanersonall appeared p . Y FP area the abpva-named GEC8l0E K. FORA, and IIAl'fflA R. FWM and acknowledged the foregoing instrument to be their free act and deed before me i � NotgVv P iC My ism tssion expires: TAAiNA •lAw00/10lf VVJ 4T• r• nvr aa,rnsetn I I II STL t�LI NG LAA/E r e G 77' 303' rnr p i EXITING LOT 2 r t+vl�ii..►►/Q'.{ ca ON iDr 3 AS OF @I i bg REFERENCE PLAN: NO. I JOJ5 FOUNDATION LOCATION PLAN Y YMY nes,gr.�r snauC=WOW cewvfts m Atm � F Zea or-tA lA► EfTEfCT MJdE'H c�nvucrEa. t r m t, N Alf: ,,� c£prr utmw fiats moi ea�rsra�r�,v oneEp Gl d£NF: COOLI °'E £OATS.�LIMO. CO.. INC � �Cj� �.�",us�erwn��saicrins, THIS CERT/FlCATlON IS A(ADF AND LIMITEDo�Q SWLL NOT W WO�yAYW wM TO THE A00ifF CLIENT wNtMv �, �said tic. rimm"low T'9s aaA~ es rw coprWooffm PNS mly cw CH*d7Duom �AYi WC. AND ANY iJdifiWROW Va isspvAb►aARFA t SEW TAKES No NfSPOASf�Prrr LOCATION: NORTH ANDOVER , MA. �ii(i►aw c011/7AM!(o NE7PFN ai ' aJi An;aViaA- �tM OF Mgslp SCALE: 1"= 60' GATE: iZ/1.4/99 , A cy CHRISTIANSEN &SERGI � V h S G� ,8, $U ANO$ NO Sr NANrA/IR ML 0830 ML 97D- YS-010 VfYaft � ®im Rs cummrw(mm t SS'96f lNc. C' 00 WG.NO.r98024005 MAR "" 9 INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initials A. Bottom of Bed 1. Excavation to proper depth 1 2. With trenches,sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation,etc. Comments: J a 1 a-nq '&Jes ca //ea� D. 0 `C©nne/% Z/Jil/ 45,0P ay) 5 l Ae l� consider- 0��%Q�25 B. Retaining Wall 1. Wall height and width as specified ✓ 2. Waterproofed rj 6 3. Wall minimum 10'to leaching facility 4. Wall meets specifications of plan Comments: e - W /J 4-- C. Building Sewer ��/�� 1. Pipe diameter minimum 4" =� 2. Schedule 40 pipe 3. Watertight joints _ 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8"per foot minimum 6. Pipe properly set on compact firm base r/ 7. Pipe laid on continuous grade in straight line �t 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change f �/ 10. 10'minimum offset to water line _� O Comments: c2 D D. Septic Tank - 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20"manholes 7. Inlgt tee minimum 12"under invert 8. Outlet tee minimum 14"under invert �! 9. Outlet line cemented t/ 10. Air space 3"above tees 11. 2"-3"drop from inlet to outlet 12. Pipe set 13. Compact base with 6"of 3/4"crushed stone under tank �L 14. Tank is watertight Comments: e Yes NO E. Pump Ch ber 1. If separ from tank,compact base with 6"of/<"stone underneath 2. Minimum "pipe to d-box if gravity system 3. 20"access m ole 4. Tank level 5. Watertight 6. Tank size agrees with p specification 7. Manhole to grade 8. Check valve and bleeder hole pre t 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum 0.1 T'(2")drop from inlet to outlet 3. Minimum 6"sump ✓ 4. Outlet pipes show equal distribution 5. Compact base with 6"of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-3/4"- 1 %2" -pea stone Bucket test done? 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') l� 3. Width of trenches agree with plan-Minimum 2';maxim 4. Vent present if>50 feet or specified 5. Distance between trenches minimum 4'and maximum of 6' 6. Minimum distance between trenches 10' �. 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". i J I I Yom—es NO 9. Pipes set on stable base. Comments: I. Leach Fre d 1. Maxim• length of field 100' 2. Pipe slope inimum 0.005 or 6"per 100' 3. Separation b en pipe 6'maximum 4. Pipes connecte t end 5. Separation betwee adjacent fields 10'minimum 6. Pipes set on stable ba 7. Maximum 4' separation om edge of field to first line 8. Minimum two distribution ' es 9. Maximum perc rate 20 mpi Comments— � J. Leaching Pits `mow 1. Minimum inlet pipe 4"� 2. Pits of concrete 3. Sidewall between 12"and 48"wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement Comments: ' K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond F i APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERT-MT DATE: CURRENT INSTALLER'S LICENSE Al LOCATION: 6 LICENSED INSTALLER: f„ SIGNATURE: TELEPHONE;",-,�/ 92�—3 5-- CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only 575.00 Fee Attached? Yes r No Foundation As-Built? Yes No Floor Plans? Yes No Approval 7 Date: F MAR - 9 i s ' INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at �/11 ,S`71c /, �,r, relative to the application of c dated y /3—9g for plans by and dated , — 9 64 with revisions dated I understand and agree to the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable . 2. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed—generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final Inspection—Engineer must first do their inspection for elevations,ties,etc. As-built or verbal OK from engineer must be submitted to BOH,after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 1> 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank,D-box,pipes,stone,vent,pump chamber,retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer Date: MAR - 9 Received Apr-29-99 13:52 from 508 688 9542 - G page 1 Apr-29-99 01 :30P North Andover Com_ Dev. 508 688 9542 P.01 � ig98>0 BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: o/q _ LOCATIONOF SOIL TESTS: LT / Sg /r-o, r vie s I Assessor's map & parcel number: /M /o4 e- 1.o'T OWNER: e.��cP _ � �� TEL. NO.: ADDRESS: �0 57-. cJ-ey� ENGINEER: ftr,S1 TEL. NO.: 7 © 3 0 CERTIFIED SOIL EVALUATOR: 4), ///S Intended use of land: residential subdivision, I�op commercial Repair testing Undevx N. A. Conservation Commission Approval: 0EP Fiat # Z412 " 9"2-0 THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing, 6. Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. T(3�1UNB0ARQ OAF WEAL HOER/ SAY - 61999 1 f ;'c,;:• //BX \ \ I � 'tel. 1 N X4 a -1-- •2a.s- -��• >� ' _ �;moi � - 1 / sU(GE TED l_ ..-- i� UJB/L/T Q \\ LOGmTI, O 1� GQR 5 FL THREAD OF \ ( 7 1 92-2 �� / u• \ \ /NT -RA/TIENT • \< ' STREAM lit 4,6 / �3%� �•�� '`�o� 95 4 T2,9 - / H /FDI MICHAEL 8 MARILYN PH/LPOTT CN1R 10,99 `1 1n., 216 Raleigh Tavern Lane Salem Forest IV f farm 5 OEP F;4 r+a• [`242-820 (,o t,..vu+xi,rr Dy UEPJ Gly.tow� North Andover Commonwealth �- of Massachusetts Farr. Better Homes, Inc. Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131 §4U and under the Town of North Andover' s Bylaw Chapter 3 .5 From NORTH A:`1DOVER CONSERVATION Cot-L1,IJSSION Farr Better Homes, Inc. To George Farr, President Same as Applicant (Name of Applicant) (Name of crouerty ovlr,er) 216 Raleigh Tavern Lane Address No. Andover MA 01845 Address Same as Applicant copy: Hancock Environmental Consultants, 235 Newbury Street, Danvers, MA 01923 This Order is issued and delivered as follows: C1 by hand delivery to applicant or representalive on (Cole) xQ-x by certified marl, return receipt requested on (uaI Chis project is lo.,ct,_d 2, ^ o off Raleighl Tavern Lane, Tax Map 106C, Lots 22, 33, 36, 37, - 38 & 103 The property is recorded at the Registry of Nri r-rlip rr, r7gcZ. � _ � Y 9 III Book 1087; 2039 Page 314; 269 Cer-tificate (it registered) The Notice of Intent for this project was filed on July 3, 1996 (dale) The pudic hearing was closed on (date) Findings The North Andover Conservation Commission has reviewed the abovo-1el,?r011Ced tlphc�? 01 Intent and plans and has held a public hearing on the project. Based on the Informallon a,,arlacle to u,e iIACC at this lime. the _�iLr'r' _ h is delernmied Pint the area on which the proposed work is to be done is significant to the Icliovfin;, interests ,n acc-re;lr,ce —11`1 each A(� C ect to Protec.iori ander me the Presumptions of Significa�tce s,e1 orth in the regulations or _,.,,h _a Su 1 Ch. iib ),/ Recreation Act (check aS appropriate): Ch. 178: X Prevention of Erosion & Sedimentation Ch. 178 X Wildlife Z Pubiic water supply Flood control ❑ Land containing shellllslt Private water supply ® Storm damage cre-�eriticn ® Fist)eries Ground water supply CZ Prevention of pollution Protection of wildlife habitat Total fling Fe_ Submitted $1030 (+$25 Town fee) $502.50 Filing o c State Shari? ---- r i- n + f ' City�cwn Share $527.50 (+$25 Town fee) ( ._ le.. in rxcc- s c � '-•I Total r=efund Due S City(Town Portion S State Portion S (1/; total) ('r total) Jun-02-99 03: 14P Paul D. Turbide, PE/PLS 508-465-0313 P.01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Carlton A. Brown Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 465-0313 Date JUNE 29 1999 Pages Including This Cover Page: 3 Comments: Enclosed is the pert and soil evaluation for Lot 1 Sterling Thanks, Canton TOWN OF NORTH ANDOVER/ BOARD OF HEALTH i JUN 3- 1999 Jun-02-99 03: 15P Paul D. Turbide, PE PLS 508-465-0313 P.03 --s t 4 ! f fQ*1 1 i 1 se. 1 / i iti 1 wV I NZI �. ' n 4 _ .�.G _ i I� •a ' -4. - --- -- - - - - M -t . ----- . --- - - . • �n ---+ - T -- - -- .. - -•- -- _ _ - -- -- �-- _- --- -.ice I t, a R► r 'K CF- BMW MUMf+ M V � t, �M� MM EV ���� ��' ' �s�ii�ata' MM� W,, � ■r waw �wr� ►y�ii■�►anima ���� ����i �� • - w MSE ll iv it rilV teMM' !, RS :mow : ::�� �tlA�t� 1���` Li F +„rum M M r gum Stezwilom F-7 no . ��i . r•� WE �� N � �4tii`i ���tUi�lit��i► � Y.s. . y.7 Vis„ ,,1 .a,. c•_X:1���Yc+a?�ry�a�dt�';d.::.raf JwS}.kaf �'t, � Lpl�. FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 Date: -7130)" No. Commonwealth of Massachusetts /yCepj 1gN00Vf-C , Massachusetts Soil Suitability Assessment for On-site Sewa a Dis osal �l,� G Performed By: ..STEN.N.t.N.....!�U� ...r.��N _ocoury � NI; w�t�u S Date: _.:. .... ......... �( S1l+rcYt ....j... Ud. � sM�ra IS._.... c tt wti. ...� �-!rV............... ......... Witnessed By: ...... .N.S.3U.�a. ._.... . B�io�S� r e/Z/917 L�3T / Owner's Name, GppLr(7GY� Ca�sT�u��c7'roN C0 e Location Address or Address,and NB Lot p Telephone/ U1 NOOUEX STEIZ.L�NG G NuY,-TN At400V>�,M1q Or64� . NvWTN 1gH00v�j 11171, New construction Z Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes ft� • 1 L r3z0� � ' ... Publication Scale 1 Soil Map Unit C _ ........ Year Published i9 26� S IvN" Drainage Class Wf�L L)K MF—D... Soil Limitations .Sf p......}.................... ......................... Surficial Geologic Report Available: No L� 1'es ❑ Year Published Publication Scale - GeologicMaterial (Map Unit) ............................................................................................................ ...... ..... .... .................... Landform ................................................................................... ..................... ..................................................................................... t Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No [ Yes ❑ Within 100 year flood boundary No ED/Yes eS ❑ Wetland Area: ..... .. ............................ National Wetland Inventory Map (map unit) .......-.. .................. - _.. Wetlands Conservancy Program Map (map unit) ............................................................ Current Water Resource Conditions (USGS): Month - Range :Above Normal ❑Normal ❑Belt v Normal ❑ Other References Reviewed: T01N OF NORTH AN� BOARD OF HEALTH AUG - 3 1;10Q9 DEP APPROVED FORA-12/07/95 ---- ' FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. L d 1 / S����NG 01A, 'l. On-site Review q Deep Hole Number Date:. � � Time: . Weather Location (idertify on site plan) Land Use ..... Slope (%) Surface Stones Vegetation Landform ._. . ...:::...... . Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet i�. Possible Wet Area . . feet Property Line _ feet Drinking Water Well .: _ feet Other DEEP OBSERVATION HOLE BOG 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulle11rs, Consistency, % Grav7 5 - -2, � ,, 3 -vb 'If i � 'i MINFMUM OF 2 HOLES RFQulKED AT EVERY PROP z>tu ujt)POSAL AREA Parent Material (geologic) _ DepthtoBedrock: > a4- Depth to Groundwater: Standing Water in the Hole: N(3 Weeping from Pit Face: NV 3�It Estimated Seasonal High Ground Water: --- i DEP APPROVED FORM-12/07/95 l ' FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. COT I S— -146— LIN li On-site Review '' Deep Hole Number 1. �.� Date:.. :I�o�J ,�g Time:. .j�' 3o Weather p G�ub`� S6 Location (identify on site plan) Land Use WOQ-9.5 Slope (%) LS"Z�rSurface Stones 90(4 "��'LS.1 S 7UM�S Vegetation _vAK, -W Hf P1114 .r , 0Ap Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area ./-!SP feet Property Line .. 3Q.. feet Drinking Water Well feet Other I DEEP OBSERVATION HOLE LOG' �! Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boullddl,rs, Consistency, % Grave1 Ur :S r0`l►2�'3 GYz/�NtillfZi 11. �121�r31-1� 1 l (3-�5 Qw r=SL Iuyfi2¢�C� 51 16'3 u R1 ASS (Z4 A�ti 15 a .b 45; i�� � '�� sivl�y Z,s�5�¢ � � S L , M A-Ss r u cl F�f2+� 3� XTI/o co✓o c'cS ZSR'/� SibN�S K 014(,V( 1S dy i 1 il Parent Material (geologic) L _ DepthtoBedrock: 1 Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: d __ Estimated Seasonal High Ground Water: -- DEP APPROVED FORA►-12/07/95 I 1 FORM 11 - SOIL EVALUATOR NORM Page 2 of 3 Location Address or Lot No. LC 'C ST auu(7- 1 On-site Review otqct-ffavc �S° Deep Hole Number l l' Date: 612 6°l Time: Weather Location (identify on site plan) Land Use .E-06k. Uv W°obS- Slope (%) f.! -- Surface Stones Vegetation . .OAK- I MFF(�.L�L � f./.Kf�i.:.:..l�W� Landform ... KW:f% . . :: i Position on landscape (sketch on the back) - .:: Distances from: Open Water Body feet Drainage way feet �1 Possible Wet Area feet Property Line . 304/'feet Drinking Water Well feet Other DEEP OBSERVATION HOLE _OG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % �i p C.iR►9Wtiu�+l2 111ANy sma-SIV, -MAZIUC, vb r-lu4 !SVL,, LO,,,,A ,o.N IQca'3rs �I 26- `19 G , V v Z,S`t 7/3 (.00s11i' U. S�Ny d2oo(a GRAU+LC , ,2,0°lo co �S lob U°l-0 Si3Ai441 03"16 1 Parent Material (geologic) / It,( _ DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: //VO Weeping from Pit Face: A/O' _ � Estimated Seasonal High Ground Water: -- DEP APPROVED FORM- 12/07/95 i FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. LOT I On-site Review Deep Hole Number Date: ILI Time: Weather CAXA'L Location (identify on site plan) _ Land Use Slope (%) ��S� Surface Stones Vegetations Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet I . Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE "—OG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % GravePtC4I4 JJ L& M r9n�y i?.orJi3 �I RO/4 oss�"fkp fFt�t..1 I2ov?'s v Go 1 V ,s Parent Material (geologic) T1 U-1 _ DepthtoBedrock: o Depth to Groundwater: Standing Water in the Hole: N O Weeping from Pit Face: Estimated Seasonal High Ground Water: cc)r� S III DEP APPROVED FORM-12/07/95 1 II !I FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. 1 ( S f1`M_(-WC` t-MAl% Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole ......... inches i ,�❑-,/Depth weeping from side of observation hole ... . orches lam' Depth to soil mottles .3G..... inches ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date .................. Index well level ...... .... ...... Adjustment factor ................... Adjusted ground water level .......................................... ... Depth of. Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �✓ES If not, what is the depth of naturally occurring pervious material? Certification I certify that on 10 Jq (date) I have passed the soil evaluator examination approved by the Depa tment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date -2 3d L DEP APPROVED FOR,'11-12/07/95 i FORM 12 - PERCOLATION TEST Location Address or Lot No. GQT I S(Y'zVUW& L/Kk)� COMMONWEALTH OF MASSACHUSETTS (\((}vtN p 040 UkYL , Massachusetts Percolation Test* Date: C,f Z'59 Time:. Observation Hole # Depth of Perc &0 Start Pre-soak 7 Z4- &A GS End Pre-soak Time at 12" f �� Time at 9" Time at 6" J � 3D Time Time (9"-6") �(A/ Rate Min./Inch L 5C) SSC �l1( G Z M�� �/N * Minimum of 1 percolation test must be performed in both the primary area AND P P P Y reservee area. Site Passed 19"/ Site Failed ❑ Performed By: CyIyV/i. Wf LL"S Witnessed By: (i14Q_L__1_01V Comments: :.:: :::........ .:::::....: .::::. DEP APPROVED FORM-12/07/95 I FORM 12 - PERCOLATION TEST Location Address or Lot No. WT (iV/, COMMONWEALTH OF MASSACHUSETTS *YuN AA1#00VCK— Massachusetts Percolation Test* I� zz Date: �� �2 Z Time:... ..: Observation Hole # P , J Depth of Perc S4 it t/ Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" Time (9"-6") Rate Min./Inch �i Z.. Mfnl/[A) 4 NI tN /fU * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ......................................................................................................................................_..._........_......_. Performed By: (Yz_V w o takuo Witnessed By: Comments: DEP APPROVED FORM-12/07195 Town of North Andover, Massachusetts Form No.-3 BOARD OF HEALTH NORTH S 3 3? e•f. of �''��„,o..•' h DISPOSAL WORKS CONSTRUCTION PERMIT SA US • I Applicant NAME ADDRESS TELEPHONE Site Location Permission is hereby granted to Construct ( Or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No, /03 L CHAIRMAN,BOARD OF HEALTH Fee �� D.W.C. No. 116-3 i Town of North Andover, Massachusetts Form No.2 f NOR7y BOARD OF HEALTH ° 19� p * i _ w DESIGN APPROVAL FOR ,SSACHUSE�� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No.— Site Location Reference Plans and Specs. 1 71— /07/� ENGINEER DES'I DATE— Permission EPermission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH ' Fee Site System Permit No. � --- I � t 1 No. THE COMMONWEALTHOF MASSACHUSETTS FEE BOARD OF HEALTH ?'ObuW OF 1v VI APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (&)Repair ( ) Upgrade ( ) Abandon ( ) - Complete System ❑Individual Components Go? l sruLclo- I'../9No C,ao0o61L coNsrI rLqcr'iuti co . 1Nc. Location Owner's Name A SS€SS ol2S A1010 10ro C 4,077 3(p 4vl A NOOUelk ST. AID. P?&190U"u ,41# Map/Parcel# Address / (58-7-0/09 Lot# Telephone# M4 C IfK/l'r1nAvaGU Installer's Name Designer's Name �J&() S ilp r7�2 S�`, N�1(lltl'L/IJu, it-1p Address Addres - ; 373- 0 /0 Telephone# Telephone# Type of Building: Lot Size 31, 62 7 Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required)4`0 gpd Calculated design flow gpd Design flow provided440 gpd Plan: Date . JVLY Z 7,1 99 Number of sheets �_ Revision Date Title SEPTIC SNSTXF 7 0 S/6A) - W / SIMCIAI& C-4AP(t Description of Soil(s) ,$Y 5 Ib M Y vq Mv Y 1,o4A4 Soil Evaluator Form No. Name of Soil Evaluator SiVV&J'u)td0 Date of Evaluation 5/3,3 Ir VANIEL O'C"'VC14- S�Jfa�9U DESCRIPTION OF REPAIRS OR ALTERATIONS r WILLIS r The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and furth 4 grees not lac the system in operation until a Certific to o Compl' nce has been issued by the Board of Health. Signed / Clige ,�l. /.� M1 Inspection ~ FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificate shall riot be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 Town of North Andover, Massachusetts ?oNO°r axb qti BOARD OF HEALTH Foam No. Oe. 0L * z rte:" 9 q°RATE°APR`y 9SSgCHUSE��� APPLICATION FOR SITE TESTING/INSPECTION Applicant /2 E N E �f& `e 1 Site Location 'A DOES �,� d " TELEPHONE L Engineer S, , A E Test/Inspection Date and Time-, ADDRESS TELEPHONE Fee ��°' C HAIRMAN,BOARD OF HEALTH Test No. S.S. Permit No. D.W.C. No. C.C. Date —Plbg, Permit No. i i ~. .. SMA /00 YEAR k a+^ 1-r }Yyc R ri ` t A,OW -PLA/N���- ` , . .L ��z i Y } � x� '+� Z+�V /06.o \ �\ WETLAND REPLICA 770N. x24 //p OOOt S.FJ B COMPENSATORY FLOOD TORAGE ' AREA (/, 900. C.F.) \ \ _ REAl x23 /07X5 x20 5 6 ��RROPOS ;9&v7wo r� 'sem � Q g x2/ --— (TYPICAL/ /06X9 \� 1O �..�..1 N, �4i 109X 0 P / — �, \ RS Seo OU, io8x4 �•D� S1 J 7 it co „'/q. J i rulvF o '@ \ �� 1 UFFER /NV. A'^ (ro v _ c \\ > > SET)(TYP./� �/ / —— --1/6— X9 i. BOULDE�hry / X�/ / X9 3® Q INI .017 107.4. 118 \ 4t 1 \ D F -0.96- s 1\ SURGE TED/Jo All 1 tul AL i � / , I Fo Ec /oN 6 IN. JLOF4 1 / /3a �\ S C SI'Elm A �\ t 1 \ /T 7 `\� \? 95`3 o Rl� S /5"o _ MR£AD OF W /NTE-RM/TTENT • OH�� �� �\\ '� STREAM lik x.924� 4X6 LH /FDI MICHAEL 8 MAR/LM PH/LPOTT UN 140 � ti