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Miscellaneous - 41 NORTH CROSS ROAD 4/30/2018
41 NORTH CROSS ROAD ad ` J - 2101038.0-0023-0000.0 - i. APPLICANT• FLORENCE ESTA'fEb 4 i r ` 5 k � .:: SEPTIC K f••,F IS THE INSTALLER LICENSED? - --YES NO TYPE OF CONSTRUCTION: NL"W F2EPAIR s,�• ? NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO CONDITIONS OF APPROVAL YES NO (FROM FORM U) ISSUANCE OF DWC PERMIT YES NO DC PERMIT NO. INSTALLER: A-110 TQ4 _ 03 BEGIN INSPECTION ,r ,+;' `,. EXCAVATION; INSPECTION: NEEDED:----- PASSED C/ BY CONSTRUCTION INSPECTION: ' AS BUILT PLAN SATISFACTORY: ' •,�;; ' APPROVAL TO BACKFILL: DATE: — _-BY__-_. —._..-----.---____-- FINAL . GRADING APPROVAL: DATE BY.__ FINAL CONSTRUCTION APPROVAL: DATE: BY -------- i 2 Z Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disp sal System Form-Not for Voluntary AssessmentsIV z / Property Address Owner O s tome information required for isevery 7 f r1 q / (�� page. ityffown State Zip Cod 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 A. General Information filling out forms on the computer, AUG [6 1U 14 � use only the tab 1. Inspector: _ ' key to move your �,_ TOWN OF NORTH ANDOVER cursor-do not ` HEALTH_DEPARTMFT NJ�T Ali use the return Name o4fJ(asp o key. �� .� 1 :S® Company Name P. 0 . G Company Addre s /,Pl/ 7 City/Town �� � A State ��^ Zip de Telephone Number �`/ License Number '7/ B. Certification 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: asses ❑ Conditionally Passes ❑ Fails Needs Further Evaluation b the Local Approving Authorit ❑ Y PP 9 Y Inspector'sSi t e Date J The syst 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 future under the same or different conditions of use. i t5ins-3113 Title 5 official Inspection Fom_Subsurface Sewage Disposal System Page t of 17 I i • Commonwealth of Massachusetts _. Zy - Title 5 Official Inspection Form Subsurface Sewage Disp sal S stem Form-Not for Voluntary Assessments J YZ AUG 281 w 4 l2n �ls Property Address i OWiV pp Plt #1Fj ;v:1gVER EPA X' 9'Y9 HEALTH DEPgRT;yl NT. .._ Owner O 's me information is C' 7 �1 4 required for every _ /,. (�� page. ityl l own Staf lection Inspection results must be submitted on this for a altered in any way.Please see completeness checklist at the e Important:when filling out fortes A. General Information on the computer, use only the tab 1. Inspector: key to move your - ,,, / cursor-do not �(/� use the return Name of�asp to key. -1lSI Company Name 0 . Company Addre s _0z ge, 7 CityfTown — � A State ��^ Zip de J'C 9 Telephone u Nmber ""//`/ 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 CMR 15.000).The system: asses ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority Inspector' Si Si to spDate The syst inector 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 future under the same or different conditions of use. t5ins-3/13 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 'i Property Address Owner Owners Name information is required for every page. Cityrrown 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 sses: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes","no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins-3/13 Tide 5 official Inspection Forth: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 V &12d:(A cqocs� ae) Property Address v Owner Owners Name information is required for every page. cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumpslalarms not operational.System will pass with Board of Health approval if pumps/alarms are repaired. 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 ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health).- broken ealth):broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh tSns-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments V IZ104-14 Property Address Owner Owners Name information is required for every page. City/Town 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 ofsurface water supply or tributary to a surface water supply. E] The syste has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system h s a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a se tic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private w er supply well**. Method used to determi distance: **This system passes if the well w r analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent an the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no ther 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 ❑ R Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ r-A Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ;� Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow ins'3113 Title 5 Official Wpection 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 od Property Address Owner Owner's Name information is required for every page. Oty/Town State Tap Code Date of Inspection B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ (A, Any portion of the SAS, cesspool or privy is below high ground water elevation. E] Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 0 Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ t4 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- 10,000gpd. ❑ -171 The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The_ system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section Yes No ❑ ❑ the s tem is within 400 feet of a surface drinking water supply ❑ ❑ the system i ithin 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is lova in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a m ped Zone Il of a public water supply well If you have answered"yes"to any question in ction E the system is considered a significant threat, or answered"yes" in Section D above the large sythem 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-3113 Title 5 official inspection Form=Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name information is required for every page. city/Town State Zip Code (Yate of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No 10 ❑ Pumping information was provided by the owner,occupant, or Board of Health ❑ V 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? ❑ F� 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) �a ❑ Was the facility or dwelling inspected for signs of sewage back up? --A ❑ Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? W ❑ 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 E] 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: ❑ 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): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w � Property Address Owner Owner's Name information is required for every page_ Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? Yes ❑ No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes 4q No information in this report_) Laundry system inspected? ❑ Yes ❑ Nff4 Seasonal use? ❑ Yes [-ITo"' Water meter readings, if available(last 2 years usage(gpd)): Detail- ^ P-% Sump pump? ❑ Yes t_y–No Last date of occupancy: 4f U� Date Commercial/Industrial Flow Conditions: Type of Establishment.- Design stablishment:Design flow(based o 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(se s/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank pre 'nt_ El Yes ❑ No Non-sanitary waste discharged to the 5 system? ❑ Yes ❑ No Water meter readings,if available: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form MUMSubsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name information is required for every page_ CityrTovm State Zip Code Date of Inspection D. System Information (cont.) ylgn 4-T 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-�L No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: 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): I I t5ins-3113 Title 5 Official 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 Vo untary Assessments Property Address Owner Owner's Name information is required for every page. Cityf town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: X"06-` 6 a Were sewage odors detected when arriving at the site? ❑ Yes JN-No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: 016s-t iron 40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting, vidence of leakage, etc.): C Septic Tank(locate on site plan): �f Depth below grade: feet Material of construction: oncrete ❑metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: tSms-3113 Title 5 Official tnspection 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 Property Address Owner Owners Name information is required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) t Distance from top of sludge to bottom of outlet tee or baffle Scum thickness s/ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle / 7 How were dimensions determined? �� ��' Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of constructi ❑concrete \Eletal ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum totop of o et tee or baffle Distance from bottom of scum to bottom`of outlet tee or baffle Date of last pumping: Date t5ins-3/13 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 Property Address Owner Owners Name information is required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related too t invert,evidence of leakage, 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 Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order. ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switch etc.): I � Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ns-3113 Title 5 Official kispedion Form=Subsurface Sewage Disposal System-Page 17 of 17 Commonwealth of Massachusetts Title 5 official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments iC nL- no�.s Property Address Owner Owner's Name information is required for every page. Cityfrown 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 utlets equal,any evidence of solids carryover, any evidence of leakage into or out of box, etc.): m L 2 pc c� � Ll 4 7 64 Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ Not Alarms in working or r: ❑ Yes ❑ No* Comments (note conditpump chamber,condition of pumps and appurtenances, etc_): *If pumps or alarms are not in working order,system is onditional pass. Soil Absorption System(SAS)(locate on site plan, excavation of required): If SAS not located,explain why. t5ins-3113 Title 5 official inspection Forth_Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments lai-OnA 60C-51 Property Addre Owner Owners Name information is required for every page_ Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: / i leaching chambers number: kSS�fin ❑ leaching galleries number: ❑ 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.): 11 � o G tkiC' oVE12 �A AAA t Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid t\inflow Depth of solids layer Depth of scum layer Dimensions of cessp Materials of construc I Indication of groundw ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage pDisposal System Form-Not for Voluntary Assessments !L0 �t" r �C'y q6 Property Address Owner Owners Name information is required for every page. Cityfrown 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.): Privy(locate on site plan): Materials of construction.- Dimensions onstruction:Dimensions Depth of solids Comments(note condition of 1, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3113 Title 5 Official Inspection Forth:SubsuAace Sewage Disposal System•Page 14 of 17 Page Mora OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 North Cross Road_ North Andover_ Owner: Date of Inspection:y SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the buildin . Driveway A to 2=15'$" A to 1=22'2" House Water Meter Garage A to D-Box=133'6" A B to 1=42'6" B Bto2=51'1" B to D-Box=150'6" Deck Septic Tank 2 1 50' D-Box ED- 5 ameration chambers 50' on bed of stone I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4'/ /112- �i �✓Z OSS' j� Property Address Owner Owner's Name information is required for every page. City(Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope Qk6u-rface water peck cellar 61_Shallow wells Estimated depth to high round water: p g g e feet Please indicate all methods used to determine the high ground water elevation: ❑ 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: Pro hs Z!�� �10[ f,9-fel) Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name information is required for every page- City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Inspection Summary A, B, C, D, or E checked Inspection Summary D(System Failure Criteria Applicable to All Systems)completed Q"'System Information—Estimated depth to high groundwater P 9 CK'Sk etch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ISI r Summary Record Card generated on 8721!201411:40:21 AM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-038.0-0023-0000.0 Parcel Id 13025 41 NORTH CROSS ROAD WALKER, PETER& CERI 41 NORTH CROSS RD NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1 Acres FY 2015 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until WALKER,PETER&CERI Payor 41 NORTH CROSS RD NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 13996.0-41 NORTH CROSS ROAD Last Billing Date 6/3/2014 2100540 02 Cycle 02 Active UB Services Maint. Account No.2100540 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 38.00 /1 UB Meter Maintenance Account No.2100540 Serial No Status Location Brand Type Size YTD Cons 36207087 a Active ERT HH b Badger w Water 0.63 0.63 265 Date Reading Code Consumption Posted Date Variance 8/5/2014 288 a Actual 11 14% 5/9/2014 277 a Actual 10 6/12/2014 -40% 2/7/2014 267 a Actual 18 3/17/2014 -10% 11/1/2013 249 aActual 18 12/20/2013 -7% 8/5/2013 231 aActual 21 9/18/2013 11% 5/2/2013 210 a Actual 17 6/18/2013 -2% 2/6/2013 193 a Actual 20 3/13/2013 17% 10/31/2012 173 aActual 15 12/13/2012 -9% 8/6/2012 158 a Actual 18 9/26/2012 19% 5/4/2012 140 a Actual 14 6/20/2012 4% 2/7/2012 126 a Actual 15 3/14/2012 16% 11/2/2011 111 aActual 12 12/15/2011 -28% 8/4/2011 99 a Actual 17 9/14/2011 39% 5/4/2011 82 a Actual 12 6/13/2011 -16% 2/3/2011 70 a Actual 15 3/15/2011 0% 11/1/2010 55 aActual 14 12/13/2010 13% 8/5/2010 41 a Actual 13 9/13/2010 -20% 5/5/2010 28 a Actual 16 6/9/2010 8% 2/3/2010 12 a Actual 12. 3/11/2010 -100% 11/21/2009 0 n New Meter 0 3/11/2010 -100% 11/21/2009 2379 r Replacement 0 3/11/2010 -100% 11/21/2009 2379 aActual 17 12/11/2009 2% 8/5/2009 2362 aActual 14 9/11/2009 0% 5/6/2009 2348 a Actual 14 6/16/2009 -6% 2/4/2009 2334 m Manual estimate 15 3/16/2009 24% MSG 11/4/2008 2319 a Actual 12 12/10/2008 -25% 8/5/2008 2307 a Actual 16 9/12/2008 35% 5/6/2008 2291 aActual 12 6/18/2008 -21% COMMONWEALTH OF MASSACHUSETTS A EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a d DEPARTMENT OF ENVIRONMENTAL PROTECTION F A� Q 1 SVO TITLE 5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 41 North Cross Road_ North Andover_ Owner's Name:_Michael Brandt_ Owner's Address:_41 North Cross Road_ North Andover,MA 01845_ Date of Inspection:_7/12/2002_ Name of Inspector: Neil J.Bateson Company Name: Bateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ _Andover,Ma.01810_ Telephone Number:_(978)475-4786_ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fai ///—c Inspector's Signature: Date: _7/12/2002_ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 41 North Cross Road- -North oad__North Andover— Owner: Brandt Date of Inspection:_7/12/2002_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_41 North Cross Road- -North oad__North Andover_ Owner: Brandt Date of Inspection:_7/12/2002_ C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 North Cross Road- -North oad__North Andover_ Owner: Brandt Date of Inspection:_7/12/2002_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _No_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ No Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ _No_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. No Any portion of a cesspool or privy is within a Zone 1 of a public well. _No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 41 North Cross Road- -North oad__North Andover_ Owner: Brandt Date of Inspection:_7/12/2002_ Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _Yes_ — Pumping information was provided by the owner,occupant,or Board of Health No Were any of the system components pumped out in the previous two weeks? Yes_ — Has the system received normal flows in the previous two week period? No Have large volumes of water been introduced to the system recently or as part of this inspection? Yes _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) Yes_ _ Was the facility or dwelling inspected for signs of sewage back up? Yes_ _ Was the site inspected for signs of break out? Yes _ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Yes_ — Existing information.For example,a plan at the Board of Health. No Determined in the field(if any of the failure criteria related to Part C is at issue approximation of diancste is unacceptable)[3 10 CMR 15.302(3)(6)) —Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 41 North Cross Road- -North oad__North Andover_ Owner: Brandt Date of Inspection:_7/12/2002_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_600 Number of current residents: Does residence have a garbage grinder(yes or no): Yes_ Is laundry on a separate sewage system(yes or no): No_ [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):_No Water meter readings:_Dec.99 to Dec.01=17,800 Fe x 7.5=133,500 Gals./730 Days=183 Gals./Day_ Sump pump(yes or no):_No_ Last date of occupancy:— Current-COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:_Never pumped since system was replaced,owner_ Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1500 gallons--How was quantity pumped determined?_Measured tank_ Reason for pumping:_Inspect tank&tees,&tank never pumped_ TYPE OF SYSTEM _X_Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information:_10 years old. Nov 1992 Info at Board of Health Were sewage odors detected when arriving at the site(yes or no):_No Page 7 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 North Cross Road- -North oad__North Andover— Owner: Brandt Date of Inspection: 7/12/2002_ BUILDING SEWER(locate on site plan)X Depth below grade: 15" Materials of construction:—X—cast iron _X_40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.):_4"Cast iron thru wall,4"PVC out to tank. 3"PVC in house.No leaks. SEPTIC TANK: X locate on site plan) Depth below grade:_3"_ Material of construction:5—concrete_metal_fiberglass_—polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 10'x 5'x 4' Sludge depth: 10" Distance from top of sludge to bottom of outlet tee or baffle: 15" Scum thickness: 12" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle:_1111 _ How were dimensions determined:_Subtract scum&sludge depth to tee length._ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Pumped septic tank.Inlet tee ok.Outlet tee ok.Depth of liquid at outlet invert.No evidence of leakage._ GREASE TRAP: (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_41 North Cross Road- -North oad__North Andover_ Owner: Brandt Date of Inspection: 7/12/2002_ 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_X (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:_0_ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover;any evidence of leakage into or out of box,etc.):_D-box level&distribution equal.No evidence of leakage.Evidence of solid carryover. PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 North Cross Road- -North oad__North Andover— Owner: Brandt Date of Inspection:_7/12/2002_ SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ X leaching chambers,number:_5chambers on bed of stone 50'x 50'_ leaching galleries,number: 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, _Soil oL Vegetation oL No sign of ponding to surface.Camera inside of all chambers,no water in same. CESSPOOLS: (cesspool must be pumped as part of inspectionxlocate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): ►-Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_41 North Cross Road_ North Andover — Owner: Brandt Date of Inspection: _7/12/2002 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the buildin . Driveway A to 1=2212" House Water Meter A to 2=15'$" Garage A to D-Boz=133'6" A Bto1=42'6" B Bto2=51'1" B to D-Boz=150'6" Deck Septic Tank 2 1 50' D-Boz 5 ameration chambers 50' on bed of stone Page l l of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_41 North Cross Road_ North Andover Owner: Brandt Date of Inspection:_7/12/2002_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 4.7 feet Please indicate(check)all methods used to determine the high ground water elevation: _X_Obtained from system design plans on record-If checked,date of design plan reviewed:_7/31/1992_ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: As per design plan_ Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 41 North Cross Road, North Andover Owner: Brandt Date of Inspection: 7/12/2002 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. Neil J. B eson Bateson Enterprises, Inc. FORM U - LOT RELEASE FORM 1 n � ' C 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. *****************************APP`LICANT FILLS OUT THIS SECTION*********************** APPLICANT 171111,4;1 �l QC�50� PHONE/-?79`,,3,3 V 6 / ,9 LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) STREET ���� �CJ�QSS S ,I,. �i�4/cx1P� ST. NUMBER ************************************OFFICIAL 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 / i DATE REJECTED J / COMMENTS (gQ/-hQ4 e Q T /ha �� �� C)� 7 ✓J � 1reVY��I/�� 0G�yP�,� PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 im - FORM U - LOT RELEASE FORM A '. tC- 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. ******************J**j*/******-*�****/A,�PPLICANT FILLS OUT THIS SECTION*********************** APPLICANT t�/1/�J//� Jf�C'/�SO/V PHONE /-9��--, �--; � a6o/� LOCATION: Assessor's Map Number PARCEL SUBDIVISION_ LOT(S) STREET ��� C'�'MS S 7- /UG/G ST. NUMBER_ ************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED iY COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECT0"- EALT— ll-- DATE APPROVED f� Co's COMMENTS1 ���5 l r� '�. J PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm FORM U - LOT RELEASE FORM 'i '�'. 1,4 tL INSTRUCTIONS: This form is used to verify that all necessary approvals/permits I Ciro Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT_(/ PHONE �' 3 LOCATION: Assessor's Map Number PARCEL SUBDIVISION t LOT(S) STREET ��/ CP) O4S S T- N,(j 41YI)gv�— ST. NUMBER�� ************************************OFFICIAL 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 DATE REJECTED !1 COMMENTS2� 5 tA - e PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9\97 jm I e : , • , t�i�%F w' �tr'�iG1L- �, � I j ,t ,- i � r - __ _ -- - — i c.. { CP int - _ -- I EE I l� _ r f 3 I : I _ 9 { I } I i i I ' I ' i , : s I i I , A � L 0 —4 r p—.----. 7-0 1 czD 1) P,c�dr� �! R PI 43 Pt4 7 6 OA LTJ{ Q x-Ir Peii I ;FACX5ory j 1, s I l i bAIIA _ tv C1 - - 0/C/ f� ivoshr�y� l ' YID - �/ P1�� G/NpJ ?paN7tl X71 1717nd,4 /A' r b/vj i A13 G �40RTH 3? .v°� BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 SACMUSEtAy NORTH ANDOVER, MASS. 01845 Ext. 32 41 North Cross Road: Mrs. Starr presented to the Board an update of the failed septic system at 41 North Cross Road. She stated that the failed system was due to be in place by todays date and at the present time is not. A bottom of bed inspection was done today and the final inspection should be done tomorrow stated Mrs. Starr. Dr. MacMillan agreed that the repair should continue as scheduled. Town of North Andover, Massachusetts Form No.3 BOARD OF HEALTH NOR7H, of +�''°.,.,;.•�`� DISPOSAL WORKS CONSTRUCTION PERMIT • 1SgACHUSEt Applicant ",KIIA—, i'11A—, NAME oADDRESS 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. CHAIRMAN,BOARD OF HEALTH Fee D.W.C. No. t kORTN 1 `...o BOARD OF HEALTH Y • # 120 MAIN STREET TEL. 682-6483 SACH US�tty NORTH ANDOVER, MASS. 01845 Ext. 32 October 23, 1992 Michael Brandt 41 North Cross Road North Andover, MA 01845 Dear Mr. Brandt: With regards to your letter requesting a hearing date to modify the Order letter sent by this office on October 7, 1992 ; Last evening at their regular Board of Health meeting in lieu of a hearing date, the Board granted you an extension on the system repair. The motion was made and passed that the repair of the septic system on 41 North Cross Road be completed by the next Board of Health meeting date or the owner of the property shall be required to be present at that meeting. The tentative date for the next meeting is Thursday, November 19, 1992 . If you have any questions about this decision or about the process to repair your system, please do not hesitate to call. Sincerely, Sandra Starr Health Agent SS/cjp cc: Karen Nelson, Director, Planning & Comm. Dev. Of pORTN 3? t •� °�° BOARD OF HEALTH IO A ` 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext. 32 Minutes: October 22, 1992 41 North Cross Road: Mrs. Starr stated that an order letter went out to Mr. Brandt in reference to his failed septic system and the compliance date is October 30, 1992. Mrs. Starr stated that she was out at 41 North Cross in July with an engineer and the system is like a bath tub. Mrs. Starr stated that she has plans that she approved August 26 and nothing has been done. Mrs. Starr stated thatthenproblem is that the contractor that originally put in the house has guaranteed the owner that he would fix the septic system and this is the hold up. Mrs. Starr believes that this has been hanging about too long. A letter was received requesting extended time and wants a hearing date to modify the order. Mrs. Starr stated that what she found was a fairly large leach trench and an area on the lowest pipe that had effluent running out of it and when she opened up the system in the back area the whole area was flooded and the next to the last pipe was crushed the fill was the basic North Andover fill with rocks and a huge rock that crushed the pipe. Mrs. Starr added that they brought in fill that was not approved fill, it was layers of top soil and subsoil. The owner is requesting additional time. The system was placed in 1988. Mrs. Starr stated that there was effluent coming out when she was there last. Starr if it was odoriferous? She replied MacMillan asked Mrs. asked if the neighbors are complaining?'nin ?' dyes" . Dr. MacMillan "no". g• Mrs. Starr replied, On a motion by Dr. Rizza, seconded by Mr. Osgood, the Board voted unanimously that the system at 41 North Cross Road be installed by the next Board of Health meeting or they will be requested to come before the Board. m October 13, 1992 Sandra Starr North Andover Board of Health 120 Main Street North Andover, MA 01845 Dear Ms. Starr: I am filing a written request for a hearing in regards to modifying the attached order which I received on October 8th to begin repairs on my septic system. Please advise. Sincerely, Michael Brandt 41 North Cross Street North Andover, MA 01845 (508) 686-7562 pORTh 3? °+° BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 $A HUS NORTH ANDOVER, MASS. 01845 Ext. 32 October 7, 1992 Michael Brandt 41 North Cross Road North Andover, MA 01845 Dear Mr. Brandt: In July of this year tests were done on your property on 41 North Cross Road to determine what would be needed to repair your failed septic system. Plans were submitted by your engineer and were approved on August 26, 1992 . To date no permit has been issued for the repair of this system. The continuing failure of this septic system constitutes a violation of 15. 02 (19) of the State Sanitary Code. Under 310 CMR 15.23 (1) you are hereby ORDERED to begin repair of this septic system by October 30, 1992 . You are entitled to a hearing to show cause as to why this Order should be modified or withdrawn. If you desire a hearing, you must file a written request with the Board of Health within 7 days after receipt of this ORDER. According to 310 CMR 15.26 (2) "Any person who shall fail to comply with any Order issued pursuant to the provisions of this Title shall, upon conviction, be fined not less than 10 nor more than 500 dollars. Each day' s failure to comply with an Order shall constitute a separate violation. " If you have any questions, please do not hesitate to call me at the office any Monday, Weunesday or Friday. Sincerely, Sandra Starr, Health Agent cc: Karen Nelson, Director, Planning & Comm. Dev. File i I I 1 I a I Of ,10RTM 1 p + 3? BOARD OF HEALTH O g 3 i y9 +„o.;`�y• 120 MAIN STREET TEL. 2-6483 �SSACHUS�t NORTH ANDOVER, MASS. 01845 Ext. 32 41 North cross Road: Mrs. Starr stated that 41 North cross Road has a failed sewer disposal system le area needs repair.with some cattails , but Starrs. stated that there is a small swa conservation does not consider this a wetlands. Mrs. Starr stated that As far as conservation looks at it, it is not considered wetland. M i stated that Conservation does not consider this awetland, then i does not need a variance. Mrs: Starr just wanted to be reassured by the Board that a variance is not required. STOWERS ASSOCIATES, INC. L[EUTEQ 01F cTQMORMUIL P.O. Box 92 METHUEN, MASSACHUSETTS 01844 DATE JOB NO. A 2 Phone 685-5262 ATTENTION Saddy Starr RE: TO Mrs. Sandy Starr North Cross Road North Andover Health Dept forth Andover > WE ARE SENDING YOU -T* Attached ❑ Under separate cover via the following items: ❑ Shop drawings tk Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 1 Aug 6/92 Progress Print THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints XM For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS Dear Sandy This PROGRESS PRII`T will indicate what we are basicallt trj.ng to do. It is NOT COMPLETE. I think that this area may be the only clean area available to use. TE ypu bave any specific problem with the approach we are taking please let me know as soon as possible and We can try something ?????? else. COPY TO SIGNED: George PRODUCT 240-2 IM,Groton,MSR.01471. If enclosures are not as noted, kindly notify us at once. c�Uss /Z�X5 z tan K IV - -- - - 7 /h Aff �2 �- /0,' Z fes- - -- - - > ,47- 91Z �� /Z -36 '= P-0413D of HES i c-( 1-,&*M cRUSS EST,o7�s D WELL- AP oyCD IYJrC s S C Sy s iEM -PES1 6,AJ -q qr /12v►�v6 /urho,-�►ry P(AA) DE5► &A.) Fav 014V: 'D IATErel vr<Jit/ /2�V-t) Tc0 coo! JIB GEti �, D� .3 y S� ScPT"�c SYSTEM ��s�A�T►o� ,-FYe V4T(©lJ )AJ (PE.GT(O,\jD/JTG 3/a 9I�� ►�/JsS Fl F41L- �'�}" b� �„ �.�%��''�-'� �G `�,s)� � � 4�.. ( - , �e- � f'► c� w,�� Lam'. FINAL W 5pF--r1onj /�PPI�CJUEJ� �i�TL APPr�ovIA)6 AUTHOII 11T,/ NST4U&(� 4D�►T�p�,QL. (�S�c.i�jti5 X11=A"'Y) D�S�iPt'�ovED DaTC FRAC APPROVAL DOTE ,. APP►�0�/�6 ��i Hod► �`/ Board of Health Lot 7 ko2Xn North Andover, Mass Applicant.'/ . Water Supply 1 Town Well Approved Date S.S. Septic System Design Approved Date Approving Authority CONDITIONS+ Disapproved Date Reasons= DWC Septic System Installation Excavation Inspection Date 'Y12- la Pass Fail Final Inspection Approved Date Ll�/��9� Approving Authority Additional Inspections (if any) ,y / 14/ -Y Disapproved Date Reasons Final Approval Dafe 4il14l" Approving Authority r (�4R� of HFa_.Th� nor �%--r CKO,35 5 T &101" TH Au�vEl�, M.4. (� 5 rQT wgTc--R s�PF�y . ^rbw�l 0 WELL- AP�ovCD�aTG SS 5 PrIc Gy s TEA VeSt6,� �PPi{ovt� �A-r67-7�6 APIT�ovIN6 iun-,oI'�,Ty �oN�l`�oNS Z D1PPRavEp �qiE D 5t -r c SY$TErt'1 i'Aj s lA LLAT,OA J E74V4T(oAJ ),vcs''EG F41t_ FINAL I u5PFGTlotj 4PPRoVEP PUC- 2 � �6PPr�vr�vG A�r�tor�i ry _ z ���IT�o�Ar✓ ��s .,SNS ���-any) t L. W FM D�SAPP►�ovED D,a rC FkvAI APPROVAL Forn1.5 DEQE File No. 24 -488 _ �\ (To be provided by DEQE) Commonwealth City/Town North Andover 13! = of Massachusetts Applicant Allen Cuscia & Jose Levis Lots 1 & 7 North Cross Road Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131 , §40 . and under the Town of North Andover's Town Bylaw, Chapter 3.5 A&B From North Andover Conservation Commission To . .Allen Cuscia & Joseph Levis Same (Name of Applicant) (Name of property owner) Address 25 Center St. , Methuen, MA 01844AddressSame This Order is issued and delivered as follows: ❑ by hand delivery to applicant or•representative on (date) by certified mail, return receipt requested on February 22 1989 (date) This project is located at Lots &7,• North (Toss Road - The property is recorded at the Registry of Northern Essex Book 2743 Page 55 Certificate(if registered) The Notice of Intent for this project was filed on October 24, 1998 (date) The public hearing was closed on November 22 1988 (date) Findings The North Andover Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based on the information available to the NACC at this time, the NACC has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions of Significance set forth in the regulations and precedent and practice under this Town's ByLaw for each area subject to protection under the Act and ByLaw: EPublic water supply Flood control El/^ Land containing shellfish C?� Private water supply Storm damage"prevention Fisheries Ground water supply C Prevention of pollution L►1 Protection of wildlife habitat 5-1 FItPrtivn 1111187 Therefore, the NACC hereby find , that the following conditions aro "necessary, in accordance,with the Performance Standards set forth in the regulations, to protect those inter- ests checked above. The NACC orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the fol- lowing conditions modify or differ from the plans, specifications or ollicr proposals submitted with the Notice of Intent, the conditions shall control. General Conditions 1. Failure to comply with all'condilions staled herein, and wills:ill relalcd statutes and other regulatory meas- ures, shall be deemed cause to revoke or modify thin Ordor. 2. This Order does riot grant any property rights or eny exclusive privileges' it docs not authorize any injury to private properly or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable feoeral, slare or local slattrles. ordinances, by-laws or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of [lie following apply: (a) the work is a maintenance dredging.projec( as provided for in the Act; or (b) the limn for completion has been exlended to a specified date more tlian three years, but less Char five years, from the dale of issuance and both that date and.the special circumstances warranting the extended time period are-set forth in this Order. . 5. This Order finny be extended by the is suing nulhority for one or more, periods of up In three years cacti upon application to the Issuing authority at least 30 clays prior to the expiration date of the Order. 6. Any fill used in connection with this project :Miall be clean fill, conlainipU no trash, refuse rubbish or de- bris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts of any of the foregoing. 7 . No work shall be undertaken until all adininistralive appeal periods.from.lbis Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which file land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Granlor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, the Final Order shall also be noted on tiie Land Court Certificate of Title of the owner of the land upon which the proposed work is, ci be done. The recording information shall be submitted to the NACC on the form at the end of this Order prior to comrrmencement of the work. 9. A sign shall be displayed at the site not less Ihan two square feel or more than three square feet in'sizo bearing the words, "Massachusetts JDepartment of Environmental Quality Engineering, File Number 242- 01) 10. Where the Department of Envlronmental Quality Engineering is requested to make a determination and to issue a Superseding Order, the C.onservalion Commission sliall be a party to all agency proceedings and hearings before the Department. 1 1 , Upon completion of the work described herein, the applicant shall forthwith request iii writing that a Certificate of Compliance be issued staling that the work li.-a been satisfactorily completed. 12. The work shall conform,to the following plans and special conditions: i Page -3- Order of Conditions - .:Lots 1&7 North Cross Road DEQE #242-488 12. The work shall conform to the following plans and additional conditions: a. Notice of Intent submitted by Allen Cuscia and Joseph Levis prepared by R.A.M. Engineering dated October 24, 1988. Seven (7) sheets. b. Letter from R.A.M. Engineering dated November 25, 1988. One (1) sheet. c. Letter from R.A.M. Engineering dated January 23, 1989 One (1) sheet. d. Plans entitled "Lot #1 North Cross Road at Frances Estates" and "Lot #7 at Frances Estates" prepared by R.A.M. Engineering dated September 1988 and August 30, 1988 respectively. One (1) sheet each. GENERAL CONDITIONS 13. The following wetland resource areas are affected by the proposed work: bank, land under water, bordering land subject to flooding, and bordering vegetated wetland. These resource areas are significant to the interests of the Act and Town Bylaw as noted above. These resource areas are also significant to the recreation interests of the Bylaw. The applicant has not attempted to overcome the presumption of significance of these resource areas to the identified interests. 14. The NACC disagrees with the applicant's delineation of the wetland resource areas on Lot #1, but agrees with the delineation on Lot V. In particular, the NACC finds that the land subject to flooding on Lot #1 has been delineated consistent with the wetland regulations under the Act (310 CMR 10.57) of the Town's Bylaw. Specifically, in response to NACC's request for delineation of the flocd plain on Mosquito Brook the applicant has submitted information dealing with culvert inverts far downstream from the site. At the public hearings, abutters testimony indicated the possibility of flooding directly from the brook onto this lot. With the invert elevation of the outlet of the culvert under Rea Street/North Cross Road being very close to the elevation of some portions of Lot #1, the NACC finds that additional information is required to judge the impact of the proposed work on the wetland resource areas and its compliance with wetland and other town requirements (e.g. , setbacks for the septic system) . 15. This Order of Conditions is issued in addition to those issued under File No. 242-273. (Frances Estates) PERFORMANCE/DESIGN STANDARDS/CHANGES: 16. For the reason given above the NACC denies under this Order the proposed work for Lot #1 and approves the proposed work for Lot #7 as modified by the following conditions. The applicant may refile for the same work on Lot #1 with better information on the delineation of the wetland resource areas, or may refile for a different project. Page -4- Order of Conditions Lots 1 & 7 North Cross Road DEQE 4242-488 17. Prior to the start of any work on Lot V, the applicant shall submit a written plan prepared by a registered professional engineer describing how the proposed grading an I.ot #7 shall provide for all site drainage to be directed to thc dEtention pond on the site, plus how the overland runoff from Lot #6 will not be affected by the proposed work. This plan shall be reviewed and approved'by the NACC prior to the start of construc- tion. 18. No earthen embankment in the buffer zone shall have a slope steeper than 2!1 . Any slopes of steeper grade shall be rip-rapped to provide permanent stabilization. 19. Any changes in the submitted plans, Notice of Intent, or resulting from from the aforementioned conditions must be submitted to the NACC for approval prior to implementation. If the NACC finds, by majority vote, said changes to be significant and/or to deviate from the original plans, Notice of Intent, or this Order of Conditions to such an extent that the interests of the Act and Bylaw cannot be protected by this Order of Conditions and would best be served by the issuance of additional conditions, then the NACC will call for another public hearing within 21 days, at the expense of the applicant, in order to take testimony from all interested parties. Within 21 days of the close of said public hearing, the NACC will issue an amended or new Order of Conditions. 20. Any errors found in the plans or information submitted by the applicant shall be considered as changes, and procedures outlined above in Condition 419 for changes shall be followed. 21. In conjunction with the sale of Lot V, the applicant shall submit to the NACC a signed statement by the buyer that he is aware of an outstanding Order of Conditions on the development, has received a copy of this Order of Conditions, and has received notice about Condition #36 below. 22. No underground storage of fuel oils shall be allowed on any lot within one- . hundred (100) feet of any wetland resource area. This Condition shall survive this Order of Conditions, and shall run with the title of the property. 23. Fertilizers utilized for landscaping and lawn care shall be of the low nitrogen content variety, and shall be used in moderation. Pesticides and herbicides shall not be used within 100 feet of a wetland resource area. DURING CONSTRUCTION , 24. In advance of any work on this project the applicant shall notify the NACC, and at the request of the NACC, shall arrange an on-site conference among the NACC, the contractor, and the applicant to ensure that all of the conditions of this Order are understood. This Order also shall be made a part of the contractor's written contract. Page -5- Order of Conditions Lots 1 & 7 North Cross Road DEQE #242-488 25. The applicant, or its successors, shall notify the NACC in writing of the identity of the on-site construction supervisor hired to coordinate construction during the work on the site and to ensure compliance with. this Order. 26. Prior to any activity on the site, a filter fabric fence batked by a single row of staked hay bales shall be placed between all construction areas and wetland areas per Soil Conservation Service or D.E.Q.E. Standards. This barrier shall be inspected and approved by the NACC prior to start of construction. This row of hay bales and filter fabric shall remain intact until all disturbed areas have been mulched, seeded, and stabilized to. prevent erosion. 27. Upon completion of construction and grading, all disturbed areas located outside resource areas shall be stabilized permanently against erosion. This shall be done either by sodding, or by loaming, seeding, and mulching according to Soil Conservation Service Standards. If the latter course is chosen, stabilization will be considered once the surface shows complete vegetative cover has been achieved. 28. No exposed area shall remain unfinished for more than thirty (30) days, unless approved by the NACC or its agent. 29 All erosion prevention and sedimentation protection measures found necessary during construction by the NACC will be implemented at the direction of the NACC. 30. There shall be no stockpiling of soil or other materials within twenty-five (25) feet of any resource area. 31. During and after work on this project, there shall be no discharge or spillage of fuel, oil, or other pollutants into any wetland resource area. If during any phase of site preparation, construction, or clean-up, there is a spill or = discharge of any fuel, oil, or other pollutant, the NACC shall be notified by the applicant as soon as practical. No vehicles are to be stored within 100 feet of/ etland resource areas, and no vehicle refueling, equipment lubri- cation, or maintenance is to be done within 100 feet of a resource area. 32. Washings from concrete trucks, or surplus concrete, shall not be directed to, or dumped in, any drainage system or wetland resource area. 33. All waste generated by, or associated with, the construction activity shall be contained within the construction area, and away from any wetland resource area. There shall be no burying of spent construction materials on the site, nor shall any waste be disposed of on the site by any other means. The applicant shall maintain dumpsters at the site for the storage and removal of such spent construction materials offsite. 34. Members of the NACC or its agent shall have the right to enter upon and inspect the premises to evaluate compliance with this Order of Conditions. The NACC reserves the right to require, following field inspection, additional information or resource protection measures. Page -6- Order of Conditions Lots 1 & 7 North Cross Road DEQE 4242-488 35. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. OTHER CONDITIONS: 36. The provisions of this Order shall apply to and be binding upon the applicant, its employees, and all successors and assigns in interest or control. 37. Issuance of these conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage, or any other form of damage due to wetness. 38. A proper bond or a deposit of money or negotiable securities running to the Town of North Andover shall be provided in the amount of $2,000, which shall be in all respects satisfactory to Town Counsel, Town Treasurer, and the NACC, and shall be posted with the Treasurer of the town of North Andover before commen- ment of work. Said bond or deposit of money shall be conditioned on the completion of all conditions hereby, shall be signed by a party or parties satisfactory to the NACC and Town Counsel, and shall be released after completion of the project, provided that provision, satisfactory to the NACC has been made for performance of any conditions which are of a continuing nature. The applicant may propose a bond release schedule keyed to completion of specific portions of the project for the NACC's review and approval. This condition is issued under the authority of the Town of North Andover Wetlands Protection Bylaw. 39. Prior to the issuance of a Certificate of Compliance, the applicant shall submit a letter to the NACC from a registered professional civil engineer certifying that the work is in compliance with the plans referenced above and all the conditions hereof. 40. Special Conditions #22,23, and 31 shall survive the issuance of a Certificate of Compliance for this project. Lots 1, 7 & 8 North Cross Road D.E.Q.E. #242= Issued By North Andover Conservation Commission Signatures �lz, 52 This Order must be signed by a majority of the Conservation Commission, On this 15th -day of February 19'89 , before me personally appeared Guillermo J. Vicens , to me known to be the person described In and who executed the foregoing Instrument and acknowledged that lie/she executed he sam as his/her tree act and d d. September 9, 1994 _ Not I ublic My commission expires The applicant,the owner,any person aggrieved by this Order,any owner of land abutling the land upon which Ills proposed work Is Io be done or any len residents of the city or town In which such lend is located ere hereby notified of their right to request the Department of Environmental Ouality Engineering to Issue a Superseding Ordor,providing Ilio request Is made by certified mail or hand delivery Id" the Department within ten days from the date of Issuance of this Order.A copy of Ilio requosl 611311 at the samo time be sent by certified mall or hand delivery to the Conservation Commission and ills applicant. If you wish to appeal this decision under the Town By Law, a complaint must be filed in -Superior Court. . Detach on dotted line and submit to the NACC prior to commencement of work. ........»»....»............«».......«.....»...»..........................................«.................................. ................................................. Issuing Authority Tt;, Please be advised that the Order of Conditions for the project at 242- and File Number has been recorded el the Registry of • , 1e has been noted In the chain of title of the effected property In accordance with General Condition 8 on If recorded land. the Instrument number which Identifies this transection Is II fegistered land.the document number which Identifies this transection Is Applicant. Signirture R.A.M. ENGINEERING ROBERT A. MASYS, P.E. ONE MASYS WAY HAVERHILL, MA 01 830 PHONE: (61 7) 372-0449 March 26, 1990 Town of North Andover Board of Health 120 Main Street North Andover, MA. 01845 RE: Lot # 7 - North Cross Road Dear Board Members, Please be advised, that in June, 1988, our office submitted a revised septic system design for the above, lot # 7 . This revised plan was in accordance with the State Title 5, and with the Town' s requirement of being a minimum of 100 ' from the detention pond that was built as part of the project . If I can supply any further information, please contact me. rv'.x-"i'xraw Very F Robei ^' a� �' y � P '° tl aZA/ 3NACAUD t � ILI t. 10-1 r _ t`< "'"'� . '� � '"�� ...,..- �� H U / � ��• Obi � �� j I _ e. _ ICA , P 844 208 118 Certified Mail Receipt No Insurance Coverage Provided t® Do not use for International Mail u«-r,S..,ES (See Reverse) V0sTusS vlCE Sent to Mi nhAi-1 t_ Street&No. P.O.,State&ZIP Code osage 5 2. 29 Certified Fee Special Delivery Fee Restricted Delivery Fee OReturn Receipt Showing 0) to Whom&Date Delivered r Return Receipt Showing to Whom, Date,&Address of Delivery 7 TOTAL Postage p &Fees 00 Postmark or Date M E 10/7/92 irnUO- (D a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). y m 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. 0 3.If you want a return receipt,write the certified mail number and your name and address on a rn return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to the back of article.Endorse front of article RETURN c RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, p- endorse RESTRICTED DELIVERY on the front of the article. Cl) 5.Enter fees for the services requested in the appropriate spaces on the front of this receipt.If E return receipt is requested,check the applicable blocks in item 1 of Form 3811. L?- 6.Save this receipt and present it if you make inquiry. *u.s.G.P.O.1990-270.153 _ d I� SEINDER: V • Complete items 1 and/or 2 for additional services. I also wish to receive the • Complete items 3,and 4a&b. following services (for an extra Gi (WO • Print your name and address on the reverse of this form so that we can fee): return this card to you. • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address 22 does not permit. y • Write"Return Receipt Requested"on the mailpiece below the article number. 2. ElRestricted Delivery a ++ • The Return Receipt will show to whom the article was delivered and the date m C delivered. Consult postmaster for fee. m 3. Article Addressed to: 4a. Article Number c m P 844 208 118 Mr. Michael Brandt 4b. Service Type E Al North Cross Road ❑ Registered ❑ Insured 0 Im North Andover, FSA 01845 aCertified ❑ COD ❑ Express Mail ❑ Ret or Z chan IG G 7. Date of Delive �4 `•- �6 1C 6,t o�C 5. re ( dre s e 8. Addressee' Add Ire Onlyy a ue t if w and fee is paid) ! `1T q 6. S ture 112ent) Ll 0 q PS For 811, De ember 1991 tr U.S.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT r � UNITED STATES POSTAL SERVICE Official Business PENALTY FOR PRIVATE USE TO AVOID PAYMENT ILISMAIL OF POSTAGE, $300 Print your name, address and ZIP Code here +. ANDOVER BOARD Of HEALTH 120 MAIN STREET N.ANDOVER, MA.01845 gORTIy Of a-1 BOARD OF HEALTH O p «•�' ,'° '� 120 MAIN STREET TEL. 682-6483 "SS,,�,,,,SEt NORTH ANDOVER, MASS. 01845 Ext. 32 October 7, 1992 Michael Brandt 41 North Cross Road North Andover, MA 01845 Dear Mr. Brandt: In July of this year tests were done on your property on 41 North Cross Road to determine what would be needed to repair your failed septic system. Plans were submitted by your engineer and were approved on August 26, 1992 . To date no permit has been issued for the repair of this system. The continuing failure of this septic system constitutes a violation of 15. 02 (19) of the State Sanitary Code. Under 310 CMR 15.23 (1) you are hereby ORDERED to begin repair of this septic system by October 30, 1992 . You are entitled to a hearing to show cause as to why this Order should be modified or withdrawn. If you desire a hearing, you must file a written request with the Board of Health within 7 days after receipt of this ORDER. According to 310 CMR 15.26 (2) "Any person who shall fail to comply with any Order issued pursuant to the provisions of this Title shall, upon conviction, be fined not less than 10 nor more than 500 dollars. Each day's failure to comply with an Order shall constitute a separate violation. " If you have any questions, please do not hesitate to call me at the office any Monday, Wednesday or Friday. Sincerely, Q Sandra Starr, Health Agent cc: Karen Nelson, Director, Planning & Comm. Dev. File