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Miscellaneous - 422 BOSTON STREET 4/30/2018 (2)
422 BOSTON STREET 210/107.D-0046-0000.0 s� • f d* DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, August 12,_2005 10:18 AM To: G.ant""Nfichele; Sawyer, Susan Subject: 422 Boston Street 'D=Box'liispection Request r The above is ready for you to inspect,-per John.Soucy.=P-lease_call-him.at:-603216.-7175-when-all-set.Thank you_ 88gf Regaadg, Paovlwa D.00IM 1410 Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com I I 1 Driving Directions from 400 Osgood St,North Andover, MA to 422 Boston St,North An... Page 1 of 3 ko +� q E-v� �'• 11 Graduate In 15'Months; OTU Online makes if possible Start: 400 Osgood St Crock anywhere on this ad to view W"nlmr hftn rdion. North Andover, MA 01845-2909, :.one Undergraduate Programs ......•..•... us . Bachelors(BSBA)in information Technology ■ Bachelors(BSBA)in Management End' 422 Boston St • Bachelors(BSBA)in Human Resource Management . Bachelors(BSBA)in Marketing North Andover, MA 01845-6310, . Bachelors(BSCJ)in Criminal Justice us ::om mGraduatePrograms ...................... . Executive Master of Business Administration(MBA) . Master`s(MSM)in Information Systems Security • Master's(MSM)in Information Technology Management t Master's(MSM)in Project Management Directions . Distance 1: Start out going SOUTHWEST on OSGOOD ST toward 0.3 miles MILL POND. 2: Turn RIGHT onto BEACON HILL BLVD. 0.1 miles 3. Turn LEFT onto MA-133 / CHICKERING RD / MA 125. 1.2 miles Continue to follow MA-133 / MA-125. 4: Turn LEFT onto MA-114 / MA-125 / TURNPIKE ST / 2.6 miles SALEM TURNPIKE. Continue to follow MA-114 / TURNPIKE ST / SALEM TURNPIKE. O5: Turn SLIGHT RIGHT onto BOSTON ST. 1.0 miles 6: End at 422 Boston St North Andover, MA 01845-6310, US Total Est. Time: 13 minutes Total Est. Distance: 5.48 miles http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&2si=navt&1 gi=0&un=m... 8/12/2005 Driving Directions from 400 Osgood St,North Andover, MA to 422 Boston St,North An... Page 2 of 3 MA 1�4;/ T -� ti 01m1 ,40 db Wen C y ar on St dV An over Center '4 133 `o M04%P Idge Station Maim.S ♦, acpry , A � 1 1 4 ! y `�ltaver r a. Soxtord StMl*n ° N a:;. St st CL St pQuest,com,In OVe f pie-fed '(1V2005-marc. _ 'x_ _� _�l� p_ 02005N14VTEQ Start: End: 400 Osgood St 422 Boston St North Andover, MA 01845-2909, US North Andover, MA 01845-6310, US �..MAPQVSMAPOV(STe fa� � �o�ooi 000ft of � 133 Sel I g� lsr St - Qasaat St• cr Si �.• Stevelis Ceassitlg � �o �o i I d � a Bea ora Stsvern a 'gyp PD71[��, 'P2005_MapOuest.com,Inc. ® 005:NAVTEQ 1,02005 Mapquest,00 mInc'. 02005 NYAVTEQ Notes: M—AV TEQ All rights reserved. Use Subject to License Copyright These directions are informational only. No representation is made or warranty given as to their content, road conditions or route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. _ _ — — — http://www.mapquest.com/directions/main.adp.do prt&mo ma&2si–navt&lgi-0&un–m... 8/12/2005 ry ��t� -a 1E-4. - K�� -f ��Y�'•�}�'�`HI.A�`CTti;te.c. r. ..- .,. .., F t�r. •'.t-�� L} ��,"n l y k� �"Yr��f�'F,✓S a '' r .�- 7 r.��' .r'.. MAP tr LOT.:. PARCEL # STREET ^ ONS-RUCTION_APP -. HAS PLAN REVIEW FEE .DEEN PAID? YES NO PLAN APPROVAL: DATEAPP. BY DESIGNER: PLAN DATE. U �� CONDITIONS WATER SUPPLY: TOWN WELL PERMIT � � DRILLER. WELL TESTS: CHEMICAL DAZE APPROVED BACTERIA I DALE f1F=•PFiUVED Ia1�1gs BACTERIA II DATE APPROVED COMMENTS: cv FORM U APPROVAL: APPROVAL TO I 'SUE YES NU DATE ISSUED HY CONDITIONS: FINAL APPROVAL: . ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NU ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: BY: �E=PQSYS_TM_xNSI84�$LIQLI .; dry-,� -: `. r - ,\ . r; �.••-.-'.. :,,. . .> ,-.".:..' t a. .;<•-\ t ^,J• ,. 1 L: • - t IS THE INSTALLER LICENSED? NO ` r TYPE OF CONSTRUCTION: NEW REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEWESJ NO CONDITIONS OF:.APPROVAL YES NO ` f (FROM .FORM U) ; oL < ` SSUANCE OF DWC PERMIT YES NO DWC PERMIT, N0. INSTALLER: BEGIN -INSPECTION ` _ EXCAVATION . INSPECTION: ; NEEDED: ' PASSEDBY :•.:CONSTRUCTIONINSPECTIONS NEEDED: AS BUILT PLAN SATISFACTORY: ` YESs APPROVAL. TO BACKFILL: DATE: (s' BY FINAL . GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE: BY cf .C'o Commonwealth of Massachusetts Town of ,f . From: Soucy's Sewer Service Inc. Month: s Date Address Owners Name Gallons Pumped " H,G,C,D,S Contents tranfered to Condition o,fsytem 77,/VC/AUG L 3 \J G j/2pYv( /[�Llj 6 7 ' 8 l P _ . 9 J 10 JUL - 11 TOWN OF NORTH ANDOVER ENT 12 13 14 15 16 17 18 _ 19 L.20 ----------------- *C= Cesspool, D= Drywell, S= SeotiC_ G= c;rpa�zptra„ u- u„i.,;..._ T__, TOWNOF NORTH OR FIA�A�-DOV-ESR/ SEP - 5 199 moor— Nrr,S H5E (-ar2 A H5E Cat B � Stiff `� SEPYI4- T.wK 43, z ' 201.0' '& n, 60XoX -7o.3 ' 44.6' v1 . no' LOT ? %o , 4 4, G`)G S , FF ,T Un. v d v � VOL 41 v, i C3OST-o ST: `P PeoPos�� G I?A�E 5 Gx r5rr ✓� 619ADES House our 1 oy-.Sq TAAJIG tN 1014,0-7 56PrIC- -rAAJK o✓T 10 3 . SZ I oy:3D� p-(30x IN fo3. 7&1 In3, 7� .Ow - 3ox o�T I 3 . Sl:) I d3. S9 i . E. gEGrNN/VGL!A/E f l00, �9 lod, gO� �. $ G� uwI�VG LINE Z- o1,391 IoI ,7vZO � ` ;. BEC 1 N A/I AJ Cs L/NE 3 IA)ACJIA.)G- L1�/E '� /03.S9 � 103, 5 C.vD („I ASE I. 10 0,50, J +Ui,-7 r rtiD A1 Z ,�, G I O I •CiO • � t ms's�',+' r.t pf . 1 ti, fia C,Q 6 L I N 8 3 10,21 Zo 4 1O Z. 20 s E/vo [_ IAS4 3. �� KEY• EXISTING GRADE SEPTIC S1.1roc"TEM AS—BUILT ' ' I HEMW CERTIFY THAT THIS SEWAGE DISPOSAL SYSTEM AS ILLUSTRATED ON THESE ,AS-QUILTS CONFORM TO THEP 0 7 PARCEL y� E - b - HORIZOK& AND VERTICAL REQUIREMENTS OF TITLE Y 14 Z Z B o5 TON 5 T-, `,OFXHtr;STATE ENVIRONMENTAL CODE. STREET •E s T(m -- w 0 A N D O ✓5 2 w1 } APPLIC�JJ'T L t W A L- S H k DATE A U 6 SO /996 JO'® .NO...... RAYMOND ENGINEERING .3 E.-RVI C E : 574 BOSTON RD. ' BILLERICA IIIA 4 P•E• DATE TELEPHONE N0. 508 663-5410 FAX N0. 508 . 663=-8858 7 i� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS. Z � w r DEPARTMENT OF ENVIRONMENTAL PROTECTION M V� V� 5�0 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_422 Boston Street _North Andover_ Owner's Name:_Rajender Dudani_ Owner's Address: 422 Boston Street North Andover,MA 01845_ Date of Inspection: 2/10/2003_ 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: Passes Conditionally Passes Needs F Evaluation by the Local Approving Authority IfAFaInspector's Signature: ' ���Date: _2/10/2003_ 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.Ifthe 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. a Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:_422 Boston Street_ _North Andover– Owner: Dudani Date of Inspection:_2/10/2003_ 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 —536-3—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:_422 Boston Street _North Andover— Owner: Dudani Date of Inspection: 2/10/2003_ 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 dress:r A _422 Boston Street pe d _ _North Andover— Owner: Dudani Date of Inspection:_2/10/2003_ 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 'h 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 R 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:_422 Boston Street_ _North Andover— Owner: Dudam Date of Inspection: 2/10/2003_ 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? information _Yes_ _ Was the facility owner(and occupants if different from owner)provided with 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 distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 422 Boston Street North Andover– Owner: Dudani Date of Inspection: 2/10/2003_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4T DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_440 Number of current residents:_5 Does residence have a garbage grinder(yes or no):_No_ 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:_On well water_ Sump pump(yes or no): No_ Last date of occupancy:— Current-COMMERCIAL/INDUSTRIAL Type of establishment:. Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped 2001,owner Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1500___gallons--How was quantity pumped determined? Measured tank Reason for pumping:_Inspect tank&tees TYPE OF SYSTEM _X_Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known and source of information:_7 years old. 8/30/1996 As built plan Were sewage odors detected when arriving at the site(yes or no):_No Page 7 of 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_422 Boston Street_ _North Andover— Owner: Dudani Date of Inspection: 2/10/2003_ BUH,DING SEWER(locate on site plan)X Depth below grade: 16" Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line:_>100 to septic system_ Comments(on condition of joints,venting,evidence of leakage,etc.):_4"PVC thru wall to septic tank.3"PVC in house.No leaks. SEPTIC TANK: X locate on site plan) Depth below grade:_4" Material of construction: X concrete_metal_fiberglass__polyethylene _other(explain) _ If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): _(attach a copy of certificate) Dimensions: 10'x 5'x 4' Sludge depth 4" Distance from top of sludge to bottom of outlet tee or baffle: 23" Scum thickness:_4" 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:_15" 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&outlet tee on pipes.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.):. i { Page 8 of I 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_422 Boston Street_ North Andover– Owner: Dudani Date of Inspection:_2/10/2003_ 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 carryover,pumped d-box to clean._ 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:_422 Boston Street _North Andover— Owner: Dudani Date of Inspection:—2/10/2003_ SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: X leaching trenches,number,length:_4 trenches 37'long_ leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): No sign of ponding to surface.No sign of hydraulic failure. 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 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_422 Boston Street_ North Andover– Owner: Dudani Date of Inspection: 2/10/2003_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. T — To we Garage Driveway House A B A to 1=29'6" L — Ato2=28'4" Septic Tank A to D-Box=43110" 1 2 Bto1=37'1" Bto2=33'1" B to D-Box=4014" � 3T D- Box • Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_422 Boston Street _North Andover— Owner: Dudani Date of Inspection:_2/10/2003_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 4 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:_9/14/1995 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: 422 Boston Street North Andover P Owner: Dudani Date of Inspection: 2/10/2003 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. Bat on Bateson Enterprises, Inc. TOWN OF NORTH ANDOVER °<No oTh , Office of COMMUNITY DEVELOPMENT AND SER 0-1 ' 3? HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01.845ZHU Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: MAP:_ LOT: INSTALLER: 90 DESIGNER: PLAN DATE: 1N T D BOH APPROVAL DAIE ON PLAN. DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = LOADING OF SEPTIC TANK = GALLON PUMP CHAMBER = LOADING OF PUMP CHAMBER = TYPE OF SAS = DIMENSIONS AND DETAILS OF SAS: SITE CONDITIONS ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Page 1 of 4 TOWN OF NORTH ANDOVER E NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT y 400 OSGOOD STREET ► �, ...;,;::,. . NORTH ANDOVER, MASSACHUSETTS 01845 �'S8 cmu t`g Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee.installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: Page 2 of 4 TOWN OF NORTH ANDOVER a NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES or HEALTH DEPARTMENT 400 OSGOOD STREET " �, . 4• NORTH ANDOVER, MASSACHUSETTS 01845 �,SSACHUS Susan Y. Sawyer,RENS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) Hydraulic cement around inlet & outlets Observed even distribution Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/concrete /timber/ block) ❑ Final cover as per plan Comments: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: Page 3 of 4 TOWN OF NORTH ANDOVER f po oTti , •- Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET • �, ...:,:,:.�. .. NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX CONTROLPANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D-Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 [,A2 Ir L.)2 v:;v .c Town of North Andover Health Qepariment Date: Location: �IA4g (Indicate Address,if Residential,or Name of Business) Check#: D 152�. Type of Permit or License:(Circle) 7 ➢ Animal $ _ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $. ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ' ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ept:c Disposal Works Construction(DWC)$ / ! ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) p Health Agent Initials 938 White-Applicant Yellow-Health Pink-Treasurer TOWN OF NORTH ANDOVER #ONTO♦ Office of COMMUNITY DEVELOPMENT AND SERVICES 3r°,1;`�•°;'���o� •y HEALTH DEPARTMENT p 400 OSGOOD STREET . .r NORTH ANDOVER, MASSACHUSETTS 01845 �',s•�*�•'' ' Swc+us 978.688.9540—.Phone Susan Y.Sawyer,REHS/RS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com-e-mail www.townofnorthandover.com-website APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: " LOCATION: L� � fJ d S�1? SI- LICENSED INSTALLER NAME: �C PLEASE PRIN SIGNATURE: TELEPHONE# CHECK ONE: FULL SYSTEM REPAIR: ($250 COMPONENT REPAIR(indicate what parts): �® ($125) * NEW CONSTRUCTION: * If NECONSTRUCTION,please attach the Foundation As-Built Plan. �Y $250.00 or$115 Fee Attached? Yes No Project Manager Obligation From Attached? Nom Foundation As-Built? Yes No Floor Plans? Yes Approval of Health Agent -' Date: £� 1 I 1 F i'� i _ - TOWN OF NORTH ANDOVER SYSTEM PUMPING RE CORD DATE: -03 -- SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: a-10—O&ANTITY PUMPED (—��GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED EY: COMMENTS: CONTENTS TRANSFERRED TO: �' �" Address , -�� /385 7-6 IV -S7- Title of File Page of Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes. action Document/ document/ Num. Action Department Board of Appeals — Board of Health — Planning Board — Conservation Commission — Building Department Form No.4 Town of North Andover, Massachusetts BOARD OF HEALTH mai temhPr 1 619-96 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( X) or repaired ( ) by Charles Todd INSTALLER at 422 Basfon Street SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 771; dated10116/95 19 . The issuance of this certificate shall not be construed as a guarantee that the system will ws- function satisfactorily. BOARD OF HEALTH I uhf' Coma ionvve lth of Massachusetts ai--A�Massachusctts System Pumping Record System Owner System Location S4— Date of Pumping: �J' � ' � Quantity Pumped: [ �pi- gallons Cesspool: No Yes Septic Tank: No Yes L System Pumped by: vaecdoo re4no tew License# Contents transferrred to : Greater Lawrence Sanitary District llate: __ Inspector- (, nAm�on vealth of Massachusetts %d v`�( � " , Massachusetts System Pumping Record System Owner System Location C) Date of Pumping: 7�— Quantity Pumped: l � gallons Cesspool: No l.l+--�Yes L.-) Septic Tank: No Yes L � System 1 umped by: Feri(coorc if aided License# Contents transferrred to : Greater Lawrence Sanitary Dlstrict Date: _ Inspector t ~ NORTH0 er -: Tovm s`► L O �i; ,<<„t'; � VIA F� �� y�y rtyi No. 011 AA o�Pwl* �� ort: dover, tvk k 19 CA , COC HIC Ht wilri � ay ADRATED BOARD OF HEALTH Food/Kitchen Septic SystemJ, _,�AA BUILDING INSPECTOR PERMIT T D THIS CERTIFIES THAT.. .c .(L1.1C -.......... t. a.W...................... ...................................................................... oundatio has permission to erect..4 .? .. /tYl�buildings on .42z.... .... .............:....................... Rou n to be occupied asQT— accepting .... ��eh�ii f� tJb.....U� ..... .�IG.... Arw.*........... ........... Chimne vie that the erthislli eeve res a conformtothe terms of thea lication on file inpro d d a p ry p PP final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, rtI nd Construction of -- Buildings in the Town of North Andover. 4130 FOUNDATION ONLY PLUMBING INSPECTOR REGULATED BY PARA. 114.8-S. B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MON144S FEE PAID LECTCAL IN UNLESS CON JC I C Tc" ESPE TOR o�g 4:f// 9� �0n" �. . ............... ...... L G EC R ��- 1 0 UOsuE Occupancy Permit Required to Occupy Building '' AS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DE ARTMENT Until Inspected and Approved by the Building Inspector. Burner � � )z Street No. ) t / Smoke Det. 1,�1v�o Town of North Andover, Massachusetts FO""No. pORTH BOARD OF HEALTH A. DESIGN APPROVAL FOR SSACNUSft SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant ����'y Test No. Site Location Reference Plans and SpecAy /V� ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CH RMAN,BOARD OF HEALTH Fee d Site System Permit No. , TH 0 Of 0 � . ver r If rt " dover, N k S 19� 'Q coCHIc HE"VI(K 1 ORATED PaC-) 5 ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 4 t iy j r,� BUILDING INSPECTOR THIS CERTIFIES THAT.. .(�t1.�2. 1C�,........ZA.."W............................................................................................ oundatio has permission to erect..(0?!-cx�>...rvmk buildings on .'4 -.... ....�-.�. ......... Rou to be occupied as . . . x. .... 1'1.ICS. f1.,.tt�.b.....U1��....2..�0( --..4o�Q,Arw.�.......�-'... ........... Chimne thprovided that the ersdn accepting this per it shall in eve res ect'Conform to the terms of the application on file in is office, and to the provisions of the Codes and By-Laws relating to the Inspection, r os%PP Construction of incl Buildings in the Town of North Andover. OUNDATION ONLY PLUMBING INSPECTOR REGULATED BY PARA. 114.8-S. B.C. a _ � VIOLATION of the Zoning or Building Regulations Voids this Permit. Du L t;l PERMIT EXPIRES IN 6 MON'TITIS ----- EE PAID UNLESS CON ITR C T ( ELECT CAL INSPQE TOR �- - L NG 1'EC R F' o UZUE Occup Permit Required to Occupy Building - ' XS INSPECTOR �T Ulf Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRED ARTMENT Burner Street No.%9 l l G 1 Smoke Det. ` Form No.3 Town of North Andover, Massachusetts ))) ,40RT1y BOARD OF HEALTH Of , 7A 19 �. 9 DISPOSAL WORKS CONSTRUCTION PERMIT SAONUS ApplicantQii NAME ADDRESS TELEPHONE Site Location �4 � SAL . 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, BOARDOF HEALTH _ 6-0 FeeD.W.C. No. � ::::: 1�15Z� L-0 T Z 441 90 s� TOP off ' �Li- oe • � dN 7- BUILDING CERTIFICATION PLAN I CERTIFY THAT THC SUll.Otl GS AND/ '� ' OR STRUCTURES ARE LOCATCD At MAP 1022 PARCEL. aC�E "`-s° IN OF M SH"AND CONFORM TO THE ZONM YA RAYMOND ss� , a RECAr MON" STREET �2 z f3oSTON S7; `d', .REAR RD AM ftMIACK ...........' ..� v 1, WMt CONSTRUCTED. rj Rb �'lIAA I CERTIFY THE Wt DOES/DOES MDT' Q AND THE BUALOW DOES/0M MOT �� 1-5 H SSlO� FALL WnNIP A FLOOD HAZARD ARlA► Mal AS SHOWN ON FJAX.FLOOD 94URAMM A Pie!�-- 1$ I gal b � MAPS DATED: DAl`E J00 NO �juuE 2, 1993 . 574 �p STt3N R�►a . . SUMMIT SURLVEY SERVICE BILLERICA, MA "9083 w 6 46*74 py!«'��Tl�PP t 1 f# fs,1 TES 4 MAY 2 41996 o_�_.%�"' BOARD OF HEALTH ,SSACHUSEt NORTH ANDOVER, MASS. APPLICATION FOR WELL AND PUMP PERMIT Permit # L� Date A permit is requested to: drill a well install a pump_. LOCATION:Za �U S �7- , / R Lot /, # Owne Addres 3 f ' Tel S��'- /,&/, /7- Well Contrct� �l�N�A _!� Add.�ea2���«r nTel/ Pump ContrctAdd. 5Z-&^f f Tel WELLS (To be completed attimeof pump test. ) / Type of well �/JZ Ile L1/ — Use— Diameter UseDiameter of well Size of casing r� Depth of bed rock Depth casing into bedrock /a � Seal been tested? Yes ( E/ No (_ Date of test 17) 3 i� Depth of well ��*� Water-ba:�aring rock Depth to water 160 Delivers_ GPM for (how long?) Drawdown / U feet after pumpinghours at GPM Date of completion 3 GS! Signature of well contractor PUMPS (To be .filled in before installation. ) Name & size of pump �Z Type��b �f S Size of tank 2 U Pump delivers S _ GPM Pipe used in well: Cast iron , I',,.Ialvanized Plastic (Z) Sleeve used to protect pipe? Yes (__) No (� Typ well seal /�A/L�AKD Date-�-/�' (� / ure of pump installer Date water analysis report submitted to Board of Health Plumbing inspector Wiring inspector Board .of Health Department of Environmental Management/Drv9i of Water Resources 9 vwaWELL COMPLETION REPORT WELL LOCAON GEOGRAPHIC'OESCRIP�TION Address G�' } (!r0 t? ® S Q W of ueQerl !alrclal + City/Town Well owner 1. L-� tH Iroadl Addresses/g� �q t J S E. W Of . .•. i ���>^/GIl' ��r �/G 2� InN.In tenths /clydel - Board of Health permit obtained: yes no❑ in(ersect. w/ lro.dl i. WELL USE WELL DATA Domestic Public❑ Industrial ❑ Total well depth Monitoring❑ Other Depth to bedrock ft. Water-bearing rock/unconsolidated material: Method drilled Description Date drilled - Water-bearing zones: CASINGO tet& f)From /6a To /7 Type 2. ) From To i Leggthft. Dia(.I.D.) in. 31 From To Length into bedrock /Z ft. 1 Gravel pack well: Via. Protective well seal:a lr Screen: dia.- Grout-0' Other�' Slot" length from_to STATIC WATER LEVEL(all wells) Static water level below land surface �.1 ft. Date WELL TEST(production wells) DrawdowtiZpr99 ft. _after pumping_L—hr. min.at —gpin, How measure/t rF14-Recovery B" R. after—hr. min. 0 LOG of FORMATIONS COMMENTS a Materials From I To Driller G K FirmLsc.� Address ? City/Town /1/W. zv Supervisi er Reg.# r i —Signature o supervrsln rc /l driller Pws.prinrrirmly DRILLER COPY II TOWN OF NORTH ANDOVER/ BOARD OF HEALTH 12-21-1995 04:09PM FROM 2 TO 15086'785763 P.01 SC"CJ—A77a �t.•rarl rrcurl nl.�«+ yT ®PN6R7FI74NDOVE / yu°'`�""�yl`' c- V" BOARD OF HEALTH AMERJC4.NN EN Ulm LABORATORIES, ORATED 'o ` ' .. 4411 M F PQ/I1), >;I nckgR. ;.: MARS' w E P'it E 2 AMP'I, $SC W :�'. 2 Bosto a Ali' vP, � R Azz a . .... Y . -ANA��.Y,Y I_CAL RESULTS. XCI, T DES ITP �O 4. ? -..• -- - . ...---- .•-�:.:,^ COLIFORM BACTERIA NEGATIVE NEGATTVP ANIMAL/VEGETATT014AL BACTERIA[P) SODIUM 7. 06 28. 0 MG/L I'Mgs. D-V-P CUVXDELINE [S) POTASSIUM 1. 62 NO LIMIT A COMPONENT OF SALT [s) COPPER 0. 023 1 . 30 MG/L INDICATES PLUMBING CORPOSION(Sj Ve '422`9, * 0. 30 MG/L BROWN STAINS, BITTER TUTS (S) ,�GANE E 0 5 z 0 . 05 MG/L AWAY CAUSE LAUNDRY STAINING [5) MAGNESIUM 4 . 58 NO LIMIT A COMPONENT DY IIARDNIESS CALCIUM 22.6 NO LIMIT A COMPONENT OF HARDNESS ALY-kLINITY 42 .5 NO LIMIT.' ABILITY TO NEUTRALIZE; ACID [5) CHLORINE ND NO 1,1 M'TT A U1 S.IN rECTANT (BLEACH) CHLORIDE 12. 5 250 MG/L A COAtPONENT OF SALT is ) HARDNESS 75. 3 NO LIMIT 0-75 IS C NSID 4 FRFIk7 SOFT NITRATE 0. 19 10 . 0 MG/L INDICATOR OF SIOLOG. WAS S�E,' ) NITRITE ND 1. 0 IdGI'L INDICATOR Cl1•' C)RC WASTE�ANIC hAS�E. [P] AMMONIA SCAN ND NO LIMIT GAS FROM ORGANIC DECOMPOSITION SULFATE 21.7 250 MGI"L HIGIT LFV. Al..i'ECT TASTe&UUUTt [ a) pH 6. 55 6. 5-8 . 5 SU ACTI)TC/BASIC DETERMIRATION [ 5) CONDUCTIVITY 180 NO LIM17 ELECTRICAL RES IST.ANCE(umhos/cm) SEDTMENT NE(;A'1'!VF; NEcGATiVE 'PRESENCE' OF °TFYI)IMENT ESTIMA'1'Ell cSOT.TDS 108 500 MG/L TOTAL MINERALS PRFRENT COLOR, 4.:2i0iii* 15 . 0 C.U. CLARITY(0 ) /DISCOLORA,'TION( IS) [ S ) ODOR ND 3 . c? T.�7.ht r 0OR 1717x'. TO C014TAMINATION [S ] '1UAT) )TTY 5. 00 .FAT) T ;;(:AN ND5 . 0 14.4% l Pltk,`,k:NC'E, OF PAR'T1CL) S 0 . 015 MG/T, A 11AZA)ID00METAJ•. [1') t 4 FOR THE ITEMS TESTEIIO '3,'E PAGE ONTYr, ..xRzB SA2RL)✓ ;GOIDELINES FOR DRINKINQ WATER l F ARTXS f... �..... ..`....... .! . Y��... ._. S-sFC6?I LIARY t ] NEITHER: I TOTAL P.01. i TOWN*OARD-HEAD OVER/ 61996 1_a T Z 441 a 3� 9a iso 00 S 7- BUILDING CERTIFICATION PLAN I CERTIFY THAT THE BUILDINGS AN0/ MAP °� OR STRUCTURES ARE LOCATED AS PARCELSCALE 1 .,_ N OF � _ SHOWN AND CONFORM TO THE ZONING .� REQUIREMENTS REGARDING MINIMUM STREET 42 Z 6 n 5 To�y 57" RAYMOND ti� SIDE YARD,REAR YARD AND SETBACK ca J. WHEN CONSTRUCTED. GARCIA TOWN ,e19416 Qv 1 CERTIFY THE LOT DOES/DOES NOT ms O,c► AND THE BUILDING DOES/DOES NOTAPPLICANT L--, w A 1--5 H A FLOOD HAZARD suRV " AS SHOWNss% FALL WITHION F.I.R.M.FLOOD INSAURANCE MAPS DATED: DATE A P e t t- 18 129 C- JOS NO IELZ iukiE 2, 1993 574 BOSTON ROAD R.L.s. SUMMIT SURVEY SERVICE BILLERICA, I 569083 1� ��`?�:�.��*`t�Z��i",.,���n rpt r•�ro� ;S•�. � ., '.r " �lthi�(¢t ty y' a�rx •`it. r 1t7f9ItyS t}t 6'iti�y a a a �' „�'-���t `r!�•����#i���F�f�+ti�a3ir(''a'ai } A ,, `•I,,i a1 'i',fit°�1. ���i�S,��,3g': r I I � 4 a I I ! r i I //l X17 C I—I--!__!._1—�07 _i23{..J�� !��!=1� I �L` t' y�"1�$ it�SRI•' NS/} ! I I�—.—�V�/_G_V_G� I I �'YSs�,�>a'A1F➢���� �'it�fr+t{r`f �� 7i+`Y�tF �{�'t i��lif Ilt irri, tl t rt.i ---•--- !�- ( I I I -.ITSI,. a la4{tr,. rhili Hit t(f 41 i in'�':by �r IU I II � �1��J ry ••��a�a! I� Y� �}+•�d',fiu 1 I a7' ��kµb,: #r ,�'��Lei'112 "�t4,1"rt a ,lJi��� 14 !�I �J[ ' I I I�✓cv ! :. � ��I UO. �--r. '.�. ' i il. I} V p I,� ` �1. �`!�i r a;°�, A+,I.1 , 1(�ltty,1i � Yl j i i I l I11 I I 4I I rr kq, G i ,—�� �i !�i �4Jtf�slr�� 5 ! I�I� � I U I ,I I I I i I ! I I ! I I I I� r I � _ � _.�—r— ``� n Ff.4 rp i•.. � �I �� / I I I � I ----J.�� ��. � -`�".�'� �' ,ar rr. li,-• °Slt, tir• 1 Il I I I ! I I tFiST Y � f rA , y, I i I 21621 I/I I I �� ni•i }{ qI i ��i' (� Y I IjI rt I 'I!j �— I IL— • I I JIT � � I i r l l I �I }I''�� I 4�t��S.°., t }a rp 4 a r I ' � I���� I I I I I i ' I � � —�' ( �yft�#} i• +r ^�4.' 4 � tc� i � f - I ! I _ - - - - - -- IK. G _ : -- - --� - -- c�--- - --- CO ^. -ar mom FEE NUMBER THE COMMONWEALTH OF MASSACHUSETTS NORTH ANDOVER TOWN ...................... of ....................................................... o Certify that ......... 11j)q_q------------------------------------------------------------- This is t NAME ................................................ ...p ................... �Qad.F....ac-LrrinqtO-n.,.-.N.-H- ...2.3...Pier.ca ADDRESS IS HEREBY GRANTED A LICENSE Well Permit - 422Boston Street-- ............................................................ For -------------------------------------------------------------------------------------------- --- ....................................... .................................................................................................................................... ................. .................................................................................................... ....................................................... .......... .. ....................................................................................... ....... ......... ..... ............ ... .. ... .........This.license.is granted..in..c.o.nformi.ty..wi th the Statutes and ordinances relating thereto, and ......3-9.9.5...............unless s�oyr Bus ended revoke expires...... . ......... . . .... - - -------- ...... far. --------------- ---------- December...12. 41- - ------ - -------- .-----. ..................,... 19. .. ......... ... ....................... ..................... FORM 499 H&W HOBBS&WARFENTM 66 "7-60`/.0 Nor th Andover Conservation Commission 3 December 6, 1995 stated the plan is accurate. All wetlands on site are depicted on the plan. M. Howard recommends a Positive Determination be issued for: Plan of Land in North Andover, Mass. Prepared for Riding Realty Trust, Lots 6B & 6C Salem Turnpike" dated Revised: Dec. 5, 1995. Flag # ' s 101-113, B-1-B16, C1-C32 . Offsite Wetlands not delineated with this filing and stream labelled "Ditch" adjacent to Turnpike only. Motion by A. Manzi to Issue a Positive Determination of Applicability, second by J. Lynch. Vote: 5-0-0. 422 Boston Street Lawrence Walsh Installation of Well in BZ Lawrence Walsh, the applicant, addressed the commission. The request is to install a well within the buffer zone. The plans were reviewed by the commission. M. Howard stated the plan is accurate. The is new home construction, not a replacement well. M. Howard recommends a Negative Determination with silt controls as noted on plan. An abutter asked if the siltation fence would be temporary or permanent. G. Reich stated the fence is temporary. Motion by J. Lynch to Issue a Negative Determination of Applicability, second by D. Feltovic. Vote: 5-0-0. 90 Boston Street, Paul Johnson, Replace Septic System within 100 ' of a Bordering Vegetated Wetland Paul Johnson, the homeowner, was present. The request is to replace a septic system and abandon the existing system. The plans were reviewed by the commission. M. Howard approved the wetland line. M. Howard recommends a Negative Determination with erosion control shown on plan. Motion by J. Mottola to Issue a Negative Determination of Applicability, second by D. Feltovic. Vote: 5-0-0. Notices of Intent 242-777 , Lot 9 Lost Pond Lane Continued from October 18 , 1995 John Morin of Neve Associates addressed the commission. Revised plans dated 12/6/95 were submitted. The revised plans show a deck, house, partial driveway and regrading within 100 ' buffer of wetland. The house and deck are 50 ' from the wetland. To the rear of the property is a flood storage area (as filed with 242-718) . G. Reich asked if the electrical is underground. D. Kindred stated Town of North AndoverNORTN OFFICE OF 3?O�'• ° ",��a� COMMUNITY DEVELOPMENT AND SERVICES - p f i : # 146 Main Street 'ts o°4...°dam` ty KENNETH R.MAHONY North Andover,Massachusetts 01845 9SSACHUSEt Director (508) 688-9533 October 24 , 195 Raymond Engineering Service 574 Boston Road Billerica, MA 01821 Re: 422 Boston Street This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1) All pipe to be SCH 40 2) No foundation drain 3) Septic tank less than 25 feet from foundation 4) Leach area less than 35 feet from foundation 5) Where is water .supply well for existing house? 6) Benchmark must be within 75 feet of system 7) Please add note that leach area excavation shall be at least 6 inches into parent material 8) Reserve not 4 feet from primary 9) What are elevations of deep holes and perc tests? 10) 4 inches of pea stone required If you have any questions, please do not hesitate to call the Board of Health Office at the number below. / Sincerely, Sandra Starr, R.S. ^�L PEN N U�O� Health Administrator COQ �o M�l y �< Ssicjp BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Parrino D.Robert Nioetta Michael Howard Sandra Starr Kathleen Bradley Colwell N A G PLAN REVIEW CHECKLIST ADDRESS 4aa rBO6TON �52- ENGINEER /9 Y/LIO N b �JNG GENERAL 3 COPIES /' STAMP 6---'LOCUS LNORTH ARROW 6--fSCALEC-- CONTOURS bl PROFILE SECTION I--- BENCHMARKS SOIL & �isri,V6 PERCS ELEVATIONS WETS. DISCLAIMER WELLS & WETS /souk 7 WATERSHED? DRIVEWAY '-�(Elev) WATER LINE &--' FDN DRAIN SCH40X TESTS CURRENT? f SOIL EVAL 'z5 • `37-/gels SEPTIC TANK MIN 150OG t/ . 17 INVERT DROP GARB. GRINDER(+200% EDF) 25 ' TO CELLAR MANHOLE / ELEV GW # COMPS. D-BOX SIZE # LINES FIRST 2 ' LEVEL STATEMENT INLET Ib3• `h� - OUTLET ��✓� Jo = . 17 (2" OR . 17 FT) TEE REQ-D?,/i/6 LEACHING MIN 660 GPD? -�\' RESERVE AREA '--' 4 ' FROM PRIMARY?Ai 2% SLOPE 100 ' TO WETLANDS V� 100 ' TO WELLS 4 ' TO S.H.GW (5 ' >2M/IN) 35 ' TO FND & INTRCPTR DRAINS,Z 325 ' TO SURFACE H2O SUPP (7 / 4 ' PERM. SOIL BELOW FACILITY MIN 12" COVER L' FILL? �/ (275-1, if above natural elev; 10 ' if below) BREAKOUT MET. TRENCHES MIN 660 gpd-%C SLOPE (min .005 or 6"/1001 ) ✓ SIDEWALL DIST. 3 EFF. W ORD MIN '� ? V ? ( _6 )) RESERVE BETWEEN TRENCHES. IN FILL. MUST BE 10 ' MIN. / 4" PEA STONE? VENT? (>3 ' COVER; LINES >501 ) BOT + SIDE X LDNG = TOT (L x W x ##) (DxLx2x#) (G/ft2) Copyright 0 1995 by S.L. Starr NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: PERMIT # DATE RECEIVED APPLICANT MAP1070 PARCEL �ro l8� 5�l�nT �D Bic..c-�/�icq c3i8z/ ADDRESS LOT # 4o ENG. YMD U t) - ��ie►//C� ST. -B j5,r-o IU 57- ADD. STADD. 0-74 _7306TdA,) �D_ /uG C'/CA ///�,t� o/C6,/ PLAN DATE 0077, /Z� /9�? REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED --�� REASONS FOR DISAPPROVAL: 7-0 6CI-I Ir-7,ea" 77A6iv d v A 010 7-/11--,Pl 7' Z !�e--/ll i32�/9 1,9T '!5io 7',:576 77,5 © Ifs �E19 -5 7-0 L"Ile-4D �seer+y-ri. - .. r _i.y`�. •. �a.d^ G _ - FORM:II -:-IAT F7.FASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from .Boards-aiid_Departments having jurisdiction have been obtained. This doesnotrelieve the applicant and/or landowner ,from compliance with, any applicable local 'or state law, regulatios or requirements:-..: ****************Applicant fills out this section***************** APPLICANT: LAI,,R F-vc F IAI1l Phone S o 9 G d 5 y - S16 LOCATION: Assessor's Map Number /o7 J Parcel . U Subdivision Lot(s) Street �� i o .� S T.• St. Number epi z; ************************Official Use Only************************ RECOM24ENDATIONS OF TOWN S: !i. Date Amnroved 21 b5�'-- Conservation Administrator Date Rejected Comments eD (dLDate Approved �Z q Town Planner Date Rejected Comments1� �vC.� U Date Approved . Food Inspector-Health Date Rejected )2L) Date Approved 9 . 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I v;! cr f o ' .a q Town of North Andover, Massachusetts Form No. 1 NORTH .1BOARD OF HEALTH - ..6 O19L ADRATED PPP\�y APPLICATION FOR SITE TESTING/INSPECTION �SSACHUS�� Applicant NAME ADDRESS TELEPHONE Site Location L4 Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee 1-45t) Test No. G q 5 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 pORTH BOARD OF HEALTH _ F q41 . /b o a0 1 9 O 7 # + % APPLICATION FOR SITE TESTING/INSPECTION SSA C H115���h Applicant NAME ADDRESS TELEPHONE Site Location L Engineer .. + NAME ADDRESS TELEPHONE Test/Inspection Date and Time y CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. I DOYLE & DOYLE AUG 2 8 ATTORNEYS AT LAW a SHETLAND OFFICE PARK,BUILDING ONE , ....._ 27 CONGRESS ST. SALEM,MASSACHUSETTS 01970-5541 JOSEPH F.DOYLE(1912-1981 -' TELEPHONE JOSEPH F.DOYLE JR.(1957-1991) SALEM (508)740-0470 PETER F.DOYLE PEABODY (508)532-7710 FAX (508)741-2368 August 24, 1995 Mr. and Mrs. Lawrence Walsh 184 Salem Rd. Billerica, MA 01821 By Fax to Broker and Regular Mail Re: Sale of 422 Boston St. North Andover, MA Dear Mr. and Mrs Walsh, Please be advised that this office represents Margaretjean Colman relative to the sale of the above captioned property. Mrs .' Colman informed me today that you are authorized to enter upon the property for the purposes of conducting a "perc" test and also to do any work associated with a septic system. You agree that any costs or liability arising therefrom are your responsibility. If you have any questions or concerns, please do not hesitate to contact me. Thank you. V truly yours, Peter F. Doyle PFD/lyd enclosure NO©FAQ-TVA 80A'��D TOWN OF NORTH ANDOVER FES _ 2002 SYSTEM PUMPING RECORD DATE: SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: `aQUANTITY PUMPED C��GALLONS CESSPOOL: NO /YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: a � Commonwealth of Massachusetts u City/Town of NORTH ANDOVER MASSA HUWft S-' ` System Pumping Record MAY 19 Zf,j Form 4 TOWI\I,Of tri v,;0C1,VER DEP has provided this form for use by local Boards of Health. ThS'stem Pu-mpingtRUco must be submitted to the local Board of Health or other approving authority. � A. Facility Information Important: When filling out 1. System Location: forms on the computer,use only the tab key Address / { to move yourduse the retet cursor- not City/Town State Zip Code urn key. 2. System Owner: Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date Gallons 2. Quantity Pumped: oss " 3. _ Type of system: ❑ Cesspooi(s) ,Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes [3..eDlo If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. 9., stem Pumped By: Na�e } r Vehicle License Number r , .�`: � 1fi/ . Company 7. Location where contents were disposed: y „ Signaturg9 Hauler Date http://www.mass,gov/dep/water/approvals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 I If Fib_ TOWN OF NORTH ANDOVER/ BOARD OF HEALTH s FSEP X96 Ll ri5a ccK A HSE Czf 3 ` en ?3, LOT Z 'co $C+.Cc , sr. PeoPG Ela 6F�AJF_ : .mac 61_4Ut: S Oc} S� �f,41 rt n,:rte PJ 1(,t4 G-7 r i Dal ^NK O✓' ► O� . � 1 I r,-4,30r D- 3c.x !A./ tC3 . '7& tG,, 7L- t7- r2 ✓ J� jJr 1 c) S9 r✓h/rV/ , LrA/L t t GG, 3 too. L,CGi A/AV:A,, /,Ac SLi tnI , Z;✓G e e 6 1 n1A11 v 3 13 � til r_1 ! r-)6-, L riu E y !G ?..�`' J o 3, 59 A�D L e A✓E. r� t c ca.� 1 Q 1 0,'-7 r �C1 , zo, Df . (D C ti3 102, Zo E �vr L 1 4 0:11 lc3. �C KEY: EXISS'nNG GRADE r SEPTIC SYSTEM AS-BUILT 1 HEREBY.CERTIFY THAT -I HAVE INSPECTED THE MAP 10210 PARM 4C, SCALE i S70 CONSTRU&I'lON OF THIS DISPOSAL SYSTEM AND THAT MEET 4f ZZ Bos T0,v 5T, THE CONSTRUCTION AND FINAL GRADING HAS BEEN TOWN _ ,,i 0 . A A/o e VG rz � /W/I IN ACCOR TH THE DESIGNER'S INTENT AP JCA1�tT L, W A L S W AND TH IALS USED CONFORM TO THE P SB641F N ONS AND 310 CMR 15.00 RATE A 0 6 3 D /C)9& JOB NO. a WILLIAMS _r+, F RAYMOND ENGINEERING SL-RICE 574 .BOSTON RD, BILLER! At MA ` DATE TELEPHONE NO. 508 663-5430 FAX NO. 508 1563}8658