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Miscellaneous - 45 BEACON HILL BOULEVARD 4/30/2018 (2)
.f' .,�,.. � , VC Y MAP # LOT 4t PARCEL # -- --------- S"TIREET......_1 ....I�G «/�/ A/LG CONSTRU.CT_I ON.....ARRROVAL HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE J ----- APP. B Y. _._._...._........._....... DESIGNER: -- ---- PLAN DTII E:._ CONDITIONS WATER SUPPLY: \`TOWN WELL: WELL PERMIT -._.. DRILLE f2.-.._......_....._.... WELL TESTS: CHET+lCAL UAIE flPl-`RUVEU.. BAC T ER FA I DOTE fl!PRUVED BACTERIA IY DATE APPROVED.___._ „ CONMENTS: FORM U APPROVAL: APPROVAL TO ISSUE- YES NO DATE ISSUED DY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID YE=S 110 WELL CONSTRUCTION APPROVAL YES NU SEPTIC SYSTEM CONSTRUCTION APPROVAL YES' NO OTHER YES NU ANY VARIANCE NEEDED YES � NU FINAL BOARD OF HEALTH APPROVAL: DAIE: T:+Y: 9/z�/9z Commonwealth of Massachusetts City/Town of NORTH ANDOVER MASSAG USv� _ System Pumping Record Form 4 JUN 0 4 2008 DEP has provided this form for use by local Boards of Health. The wkwr ust be submitted to the local Board of Health or other approving Who A. Facility Information Important; When filling out 1. System Location: forms on the computer,use �tom )�eCACQn 2)1_V only the tab key Address rr -"--- to move your ( A`�G C>yo cursor-do not 0) o�_� e( �1 q use the return City/Town State Zip Code key. 2. System Owner: John `7CA SCO Name int address(if different from location) City/To" State Zip oda 9'�g -b(� Telephone Number B. Pumping Record L4 10(K 1. Date of Pumping Date I 2, Quantity Pumped: 50 Gallons 3. Type of system: ❑ Cesspool(s) E Septic Tank © Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ® Yes dND If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: �)Im Gc 11kah� Name vehicle License Number �Er '-Rlve<_ nvironmen�al Company 7. Location where contents were disposed: Signalure of Hauler pate http:llwww.mass.govldeplwatertapprovalsft5forms.htm#Inspect t5form4.doe-06/03 System Pumping Record-Page 1 of 1 gORTM O�STrao 16 to N o # # 41 HEALTH DEPARTMENT �? 9Ss�cHuSe� Complaint/investigation Intake Report - Taken by: Date of Report: Time: Catego /Type of Com laint: Address/Location ^ of Incident: Name of Per on Reporting: Phone Number: H or (W): i Phone Number: (Cell)— -- - - - - -- - -- -- - ---� YoAged Violator: Phone Number of Alleged Violator: nt De ails: �� ' Recommended cor ective action t be taken: D Q/ Immediate corrective ac ion to taken: To be Investigated by: Title: Date Scheduled for Investigation: Date Submitted for Data Entry: Date Entered: e Residential Property Record Card PARCEL ID:210/058.A-0003-0000.0 MAP:058.A BLOCK:0003 LOT:0000.0 PARCEL ADDRESSA5 BEACON HILL BLVD oad T PARCEL INFORMATION Use-Code X101 ,, Sate Pnce„ 100 „ �800k. '001108, 'R' yp ,, _ ,„Inspect Date _0 f0112004 Tax Class: TSale Date: 03/26/2003 Page: 01369 Rd Condition: P Meas Date: 04101/2004 Owner. Tot l+in Area:' '846.11 � Sal Type: P ,_ ,. 4 drtlC7od "ADO 761°85 raftic M `- Entrance. " X`•, TODISCO,JOHN P Tot Land Area: 0.23 Sale Valid: F Water: Collect Id RRC Address: frantgr ",_�DEBC1t2AH 7bISCO Sewer - lnspect Reas. 45 BEACON HILL BOULEVARD ` " "` A.111 NORTH ANDOVER MA 01845 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/L&W Indust-B/L% 0/0 Open Sp-B/L% 0/0 RESIDENCE INFORMATION LAND INFORMATION Style: "`RN ToYRabitts 5 '== Main`Fn Area:` 846 'E Attic NBHD CODE. 5 NBHD CLASS: 5 ZONE: R4 Se T e ,Code Method aSq Ft /Kcres;" Inffu YtN; .Value C ass Story Height: 1 Bedrooms 2 Up Fn Area: Bsmt Area: 846 9: ,=yP Rauf: . H PitlE baths 1; A�fd Fn Asea: u.,.` .Fn BsRat Area; 1 _ .w P 101 DETACHED 895 6.23 148,579 Ext Wall. AV Half Baths Unfin Area Bsmt Grade Masonry Tnms 'a{ .Ext Bath F"ix . __. Tot Fir Area: I. 846 ';i t _.r. RE INFORMATION ORMATI N - St r _ C1nit _Msr 1 IVlsr-2 " E YFt Bit Grad�xCond 7oGood P/F/E/R'" Cost.` , Class Foundation CN Bath Qual T RCNLD a 75751 8 A' �A"" 50///50 Heat Type. HW itctr©ua < TElf Yr Butlt 1965 Mkt AFij 1 2 G 1 S 336 198 5,400 Ext Kitch: Year Built:" 1955 Sound Value" INFORMATION Fuel Type "t_ G aGrade A Cost Bldg ;; 90,900;r Current Total: 244,900 Bldg: 96,300 Land: 148,600 MktLnd: 148,600 Fireplace Bsmt Gar Cap. Condition: A Att Str Val1:11111. 1-1117, Prior Total: 234,000 Bldg: 92,300 Land: 141,700 MktLnd: 141,700 Central AC:':"i 'N " Bsm'Gar$F: ' > Pct Complete; Aft Sf11 �va12: Att Gar SF: %Good P/F/E/R: /100!100/77 Porch Type Porch Area Porch Grade Factor E 56 P 18 SKETCH PHOTO yyss ,. s � W e t 84Sq.R. 24 21 3 45 BEACON HILL BLVD ss Ti Parcel ID:210/058.A-0003-0000.0 as of 4/6/05 Page 1 of 1 Home Screen Page 1 of 2 TbkW1 11 Of Nam 410,vr. yoR0j q�� Df,i�+o,a{rya B d of 1"3asa.�c—. ,.� a v •�.q�`+a rye.�� tHvs R,nurn to the Home page diek on logo Parcel ID: 210/058.A-0003-0000.0 Community: Na New Search SKETCH PHOTO Stales Click on Sketch to Enlarge Click on Photo to Enh Summary �. Residence Detached Structure Condo Commercial Comparable Sales 45 BEACON HILL BLVD Location: 45 BEACON HILL BLVD Owner Name: TODISCO,JOHN P Owner Address: 45 BEACON HILL BOULEVARD City: NORTH ANDOVER State: MA ZIP: l Neighborhood: 5-5 Land Area: 0.23 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 84E ASSESSMENTS CURRENT YEAR PREVIOU: Total Value: 244,900 234,( Building Value: 96,300 92,3 Land Value: 148,600 141,; Market Land Value: 148,600 Chapter Land Value: DATE T SALE Sale Price: 100 Sale Date: 03/26/200. Arms Length Sale Code: F-NO-CONVNIENT Grantor: DEBORAH http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&LinkId=463559 4/6/2005 'Tbhe Commonwealth of Massachusetts William Francis Galvin-Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Boston, Massachusetts 02108- 1512 x . Telephone: (617) 727-9640 MERRIMACK IRRIGATION, INC. Summary Screen Help with this form Request a Certificate The exact name of the Domestic Profit Corporation: MERRIMACK IRRIGATION, INC. The name was changed from: MERRIMACK IRRIGATION SERVICE, on 7/25/01 Entity Type: Domestic Profit Corporation Identification Number: 000753799 Old Federal Employer Identification Number(Old FEIN): 000000000 Date of Organization in Massachusetts: 06/01/2001 Date of Voluntary Dissolution: 07/05/2002 Current Fiscal Month I Day: 12131 Previous Fiscal Month/Day: 00100 The location of its principal office in Massachusetts: No. and Street: 45 BEACON HILL BLVD. City or Town: NO. ANDOVER State: MA Zip: 01845 Country: USA If the business entity is organized wholly todo business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: The name and address of the Registered Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the corporation: Title Individual Name Address(no Po Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT JOHN TODISCO 45 BEACON HILL BLVD.,NO. http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&... 4/6/2005 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 ANDOVER,MA 01845 USA TREASURER JOHN TODISCO 45 BEACON HILL BLVD.,NO. ANDOVER,MA 01845 USA SECRETARY JOHN TODISCO 45 BEACON HILL BLVD.,NO. ANDOVER,MA 01845 USA DIRECTOR JOHN TODISCO 45 BEACON HILL BLVD.,NO. ANDOVER,MA 01845 USA business entity stock is publicly traded: The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares No Stock Information available online. Prior to August 27, 2001, records can be obtained on microfilm. Consent _ Manufacturer _ Confidential Data _ Does Not Require Annual Report Partnership _ Resident Agent _ For Profit _ Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS Administrative Dissolution Annual Report Application for Reinstatement Application For Revival View Filings New Search Comments ©2001 -2005 Commonwealth of Massachusetts All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True&.... 4/6/2005 i i Todisco Irrigation Systems, sprinkler systems near boston MA massachusetts Page 1 of 2 i Our Todisco Irrigation Systems will provide inground sprinkler systems for your commercial or residential!avm on the north sho massachusetts. Our installation team avill perform meticulous work on your irrigation system. Office/Fax: (971 email, info odiscoirr r MA Installa i tI• r rocess r < a �` 9 Company Profile For ten years, I worked for my father John +° ,I P. Todisco Sr who owned Merrimack Irrigation. Last year, my father.decided to pursue other interests. It was decided to change the company's name to Todisco Irrigation. As the new president and owner, I am excited about the growth of }" my company and the continuance of servicing my fathers former clients. xw Todisco Irrigation will continue they tradition of providing all of its customers with quality products, and as always superior service. We look forward to serving all your Irrigation needs! Yours Very Truly, John P. Todisco, Jr. President/Owner Todisco Irrigation http://www.todiscoirrigation.com/profile.html 4/6/2005 Todisco Irrigation Systems, sprinkler systems near boston MA massachusetts Page 2 of 2 SkF VV ^ +w ,n r �g DRi a`ae Boston web design laser marking and engraving laser software Boston ma law firm new york ny law firm Us Radiant Heat I Resources 1 Resources 2 http://www.todiscoirrigation.com/profile.html 4/6/2005 P a g' FILE SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOA' s; �; Address of property �C'D✓� ����{Y��/� ,y1 Owner's name p y �"✓� ��� Date of Inspection 03 J/ ki \, PART A ' CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board-'Of.' AC Health. _ None of the system components have been y p pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was . inspected for signs of sewage back-up. The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. _Z The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. . The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. ; SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION A; Lh FLOW CONDITIONS , If. re anti #gra number edrooms { �, number of cu' -renrt residents "�:.,. �.r,.. _,V0 garbage grinder es or .�� laundry connected y dto system, es or ho seasonal use, "yes or If nonresidential, calculated flow: Water meter readings, if available: 16412 Last date of occupancy GENERAL INFORMATION Pumping records and source of information: � System y m pumped as part of inspection, es or no if yes, volume pumped 15z?C� Reason for pumping: /� I 1/WIaQ�n r�?/IC�v�r.0 !/Iny agiG Typ of system Septic tank/distribution box soil absorption stem / P Y Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) Approximate age of all co pon nts. Date installed, if known. Source of information: Sewage odors detected when arriving at the site, yes or no y l4�. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B s:" SYSTEM INFORMATION continued ;. SEPTIC TANK• (locate on site plan) depth belowgrade: material of construction: concrete metal FRP other(explain); � r x�; dimensions:- sludge imensions:_slud e depth � distance from top of sludge to bottom of outlet tee or baffle ; 4 scum thickness r �' distance from top of scum to top of outlet tee or baffle ,�_ distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) ✓ZP l z c-ov DISTRIBUTION BOX: —A/ (locate on site plan) d / depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out f bo , recommendation for repairs, etc. ) PUMP CHAMBER: 14 (locate on site lan) Pumps in working order, yes or no Comments: - (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B 11 SYSTEM INFO TION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: TYPe ,. leaching pits and number ;;: leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for .maintenance or repairs,etc.) PRIVY: (locate on site plan) materials of construction r / dimensions depth of solids Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) 1 2��^4a'"•v7ip r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' ' ` PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: t� include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' <� n )4—s a 1 f2\ DEPTH TO GROUNDWATER f depth to groundwater method of determination or approximation: Z7 V—,el S 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. k.. r• FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) ` .: Backup of. sewage into facility? Discharge .or ponding of effluent to the surface of the ground or x . surface waters? Static liquid level in the distribution box above outlet invert? i.fLiquid depth in cesspool <6" below. invert or available volume< 1/2 day flow? Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? J Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? within 50 feet of a surface water? within 100 feet of a surface water supply or tributary to a surface water supply? _ Lwithin a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS)? within 50 feet of a private water supply well? less than 100 feet but greater .than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analys` for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. F i 13 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Ac_• �� •. Name of Inspector Company Name d � ; Company Address I f" Certification Statement •• •�• I certify that I have personally inspected the sewage disposal system at ;, . this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and manit ance of on-site sewage disposal systems. Che ma,/ one: I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15.303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined 310 CMR 15.303 . The basis for this determination is provided the FAILU RITERIA section of this form. Inspector's Signature Date p3 Original to system owner Copies to: ISC2�G Buyer (if applicable/G_Oad Approving authority I pcQe e ' '3 SMUUB04A./CS/VO4/LO1:3 - - _ __ I-OWN Cl F' NORTH ANDOVER 4 I E t2MlNAL Nb kt:J` DA t✓. 05/ 24,x"_4; CONSUMER METER p-./M t":C ML: 14:36: 18 a Acct 241-5 3f_>([4Qt4240-0 FARLEY, JAMES Mt-t 7#:. 45 BEACON HIL. L BCt! _- h7� _..._ Br��.k: - a Ccrr,rect�rr, r qe,_ :sE,0+ , k"tilttlt+ 4h Meter,:-h'ltg -+i4----L'1 ]�igits'e3 L�iYn''Cd: Ft3 t+fttltzpl zer,„ 9 Mir;F' Cd •` -- j Units Ar , 40 Req: - --- Pi pe; Size: „ - b ## ype: I 11 Wrk Cd.- I hit Cade: Di sc.A... . ..--- ... J Met Loc: .-Cct-:__rL4j _ ._." . _ 42; Nates: 5/8 TRI _ .. -- � rr,/Glut : a Ser,i�2 JE: �� � L. Cita^: 73.f A Pr^ev: 0121t.L--4205 J From: 01/31/95 To. r �• 9L--.'5 A 2nd Pr-`ev: 917 E C. 7 "- 04/i-'4/ 5 t-,ltr^i: Next : Cris Cr: M th B 0 .3 l'r^eve: User-: Z_:=rrfr_-L1Rrpt i.or, X rifr_<r-•snat i. =err - - 1=zr^st 12 Billing Months --••--- 06/95 C 1J ► -__ _ _ Last 12 Billing Months -C�+J12/93 - `- : — - - -- - - - --- ---____ o - 1 /91► , A' ..x+6/93 Ft j 7'A - Qty/•94 8 C03/93 7 A t . 6/94 f-._A _- ? 03/94 7 E 09192 � Total :F z rst 1: 78c --- - -- Last 12 Total us• <ESC> to En er- New If - NUrr3Ncr� 12 -- {MD odi fy, <W elete Crr` <N> ext iJ - 35r 142 ' _ .__ __ -- _ - 14 x- •may 13672 IaEO O QT i.} :Q 1.2-t ,c+• °' U�c ESL- 1�1.c2.At1p�) Pt.T� USS Sc-E+c.DuL.E, 40 �P�/. G. (J 1J p 3I4-1i�2„ A' -e .��P.�-.rte�•lPd.tBa' A•� Ott Re=-c- -'mu�T 'S.L.G iL QE . S. STAP` 1,}.(�.1 l•F'v. I �� ToP� uu� 2�.�. 7C lGS = 33oG,.RC� 4-: r-:' S�cam%/ ,.�a ZX Z Y, X .5 = 2.c� G.P.D _ cZ A-r----i ct►1 Fi.t E, �n. 3 32 G..P,D. Ta f A C 1 � ��•.> �soo Gac.. S'r• T4NK v/ 0 bb A CON H4 LL 5 L _ _ Form 4 -- stem Pumping Record SY Prn9 Commonwealth of AAassachusetss Massachusetts / System Pumping Record OCT 3 0 200 System Owner ^ \ System Location (a-d 1 s Ccs ell Type: Emergency Routine Cesspool: No Yes Septic tank: Wo Yes �� 1 Gate of Pumping: C a Quantity Pumped: iGa d Gallons System Pumped.By: Wind I?iW EnVhVft enfo% LLC Permit M Contents transferred to: Contents Disposed at: I Date: Pumper Signature: i Condition of System/Other Comments I I Dep Approved Eros► - 12/07/95 Address .��� �3 r a mat X4,"LL- 30iOTitle 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 — Suilding Department ``{' r• s FORM 4-SYSTEM PUMPING RECORD C ER jr EPTIC O DRAIN SERVICE , 4 10,7 OREST STREET,MIDDLETON,.MA 01949 F .(978)774-27.72 COMMONWEALTH O�,MASSACHUSETTS MASSACHUSETTS =i ' SYSTEM PUMPING RECORD -SYSTEM OWNER k SYSTEM LOCATION: tee— I vvlt e �` �71 ti ' it%.= ., � '�'eA �q DATE OF PUMPING .�� QUANTITY PUMPED: f GALLONS CESSPOOL 'ANO YES SEPTIC TANK; NO YES a o SYSTEM PUMPED BY:'CURRIER SEPTTC`&DRAIN SERVICE dw ,CONTENTS TRANSFERRED TO 11 �' Ae4s r w.DATE INSPECTOR: a �, ra _� � r s� � �v�{� aY ,+Rz•"art A . 71 3 b Z r G .:.. •f^e s: s� 3 ���� ����.-�'% _ _ _ -���c�?-ems _ c 1 - ►'� SOUL dAJ.. - L s Mg s PON I' 1 j i i 'VICYSEWER ,� �� A), M%vA. Yom. 119 west street SERVICE Methuen,MA 01844 (508)683-5709 v � --� P--jo GSLVO, .m I 1pul�yLL/N6 J 1= nielai br.G,hyebuni b�ir � i _ ,4ORfly BOARD OF HEALTH 49 � n ' 120 MAIN STREET TEL. 682-6483 CM„SE� NORTH ANDOVER, MASS. 01845 Ext. 32 M E M O R A N D U M TO: Francis P. MacMillan, M.D. John S. Rizza, D.M.D. Gayton Osgood FROM: Sandy Starr, Health Agent xJil DATE: September 23, 1992 RE: waivers given to North Andover regulations By authority of M.G.L. 111 Ch. 30, I have given several waivers to the North Andover septic regulations for an emergency repair at 45 Beacon Hill Blvd. , a small two bedroom house. Specifically, I have allowed a design flow of 157 GPD instead of the 165 required by N.A. 2. 14; I have allowed the septic tank to be placed 10 feet from the foundation and the leaching trenches to be placed 20 feet away. The distance between the trenches is 7 feet instead of the required 10 feet of N.A. 17.03. All criteria meet the requirements of 310 CMR 15.00 Title V of the State Sanitary Code. I will be happy to answer any questions you may have. cc: Karen Nelson, Director, Planning & Community Dev. JFile SLS/cjp Of X- SF�C.Tp� Y �StE�►E4 i._l o TZT tk — �'t tAMO S�a�-rte ��'= 20 `���-�(�R 2� � ~•O Sra�t E. --� -• 2>1 S.L.GS . S. SrA� i.l.[�,.N•Pte. 3 ✓`.� 2.`-4' .�rc. ��•.aD �.J iTH Sc r.T 4-X�• �C 2�Xo.33 = 't �_yL' G�i?v.��oT-r- /�lS 2X5ox2x2X .5 = 2� G.R� . =MM N.Jac.� Ct - J r-T SAV I TANK 0 r - Y12,3 qz 6EA CON HxLL 5LVD COMMONWEALTH OF MASSAC91USETTS r TOWN O; Y.,y BOAT CF.-:F.= N EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS I DEPARTMENT OF ENVIRONMENTAL PROTECTON'' �) , $ 1997 ONE WINTER STREET. BOSTON. NIA 02108 617-292-5560 1 WILLIAM F.WELD TRUDY COXE Govemo. Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A CERTIFICATION Property Address:45 BEACON HILL BLVD. ,NO. ANDOVER, MA Address of Owner: Date of Inspection: 6/20/97 (if different) Name of Inspector:g� I am a DEP approve sys em inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: NEW ENGLAND ENGTNEERTNG SERVICES, INC. Mailing Address: Pfl BOX 536, NORIN ANDOVER, 9A 91245 Telephone Number: 59R�Rt,�l � CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _v Passes _ Conditronaliv Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signatur r Date: /y The Svstem Inspectotshubmit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the syred system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: 1 have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: BI 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. Indicate yes, no,or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web http:ih~.magnet.state.ma.us/aep JR n.:.._o".. im P.— ----------------- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 BEACON HILL BLVD. , NORTH ANDOVER, MA Owner: JOHN BURKE Date of Inspection: 6/20/97 Bl SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. The system will pass inspection if'(with approval of the Board of Health)- Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pipets). The system will pass inspection if(with approval of the Board of Health): broken pipets) are replaced cbstrvction is.removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require iunher evaluation by the Board of Health in order to determine if the system.is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SA ) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than t00 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Pay 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A / CERTIFICATION (continued) Property Address: emp,—0 � G� 6��4. AV, N+�� Owner: r 6G e,E'/Z Date of Inspection DJ SYSTEM FAILS: You must indicate either "Yes" or"No" as to each of the following: have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Anv pon ion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Anv portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copv of well water analysis for coliiorm bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/15/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: G` 61�` Ad Owner: Date of Inspection: i Check if the following have been done: You must indicate either "Yes"or'No"as to each of the following: Yes No ►� _ Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available wit A. v _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. Y _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened. and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner rand occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. ✓ _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(6)] (r.vi..d 04/25/97) Pag. 4 of 10 . r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C N SYSTEM INFORMATION Property Address: Y�- — Owner: 9, B�Qk-4 Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: t.p.d./bedroom for S.A.S Number of bedrooms: Z Number of current residents: Garbage g,v.der(yes or no):_& Laundry connected to system (yes or no)--y— Seasonal use (yes or no): /77 Water meter readings, if available (last two (2)year usage(gpd): Sump Pump (yes or no): 1/ Last date of occupancy: �yPQ+�✓I� COMMERCIAUI NDUSTRIAL: Type of establishment: Design flow: tzallons/day Grease trap present. (yes or no)_ Industrial Waste Holding Tank present (yes or no)_ Non-sanitary waste discharged to the Title 5 system:.(yes or no)_ Water meter readings, if available: Last date of o:cupancy: OTHER: (Describe) Last date of occupancy. GENERAL INFORMATION PUMPING RECO��DS and source of information: .f�'vnrJ�/T/) `-'iI /y///� 0/2 /1%� ��/L ` � .6?✓, L/Z // C pQ/ 0 n, ee0 System pumped as part of inspection: (yes or no) lL If yes, volume pumped: gallons 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) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known)and source of information: `y''LS �C�7�n Sewage odors detected when arriving at the site. (yes or no) A/ (revised 04/25/97) Page 5 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: 7V tin Date of Inspection: 6,/�v /1-7. BUILDING SEWER: (Locate on site plan) Depth below grade:v7y Material of construction: tl-�s t iron_40 PVC_other (explain) Distance from private water supply well or suction L, Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ (locate on site plane Depth below grade:/c- Material of construction: &"'concrete _metal _Fiberglass _Polvethylene _otherlexplainl If tank is metal, list age _ Is age confirmed by Cemitcate of Compliance (Yes/No) Dimensions: /S U 6?*,z Sludge depth: ' Distance from top of sludge to bottom of outlet tee or baiflely � 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: /S�•, How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) 7Itn/l J5 r,7 two 66 4 O,'A:w 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: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (ravixed 01/25/97) Paga 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C c, SYSTEM INFORMATION (continued) Property Address: 41S 'dow-(In �r L �L�r It'd Owner: 47. eve lea Date of Inspection: TIGHT OR HOLDING TANK: .Tank must be pumped prior to, or 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 _gallon/da\ Alarm level. Alarm in working order_ Yes, _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site pian) v Depth of liquid level above outlet invert: P Comments: (note if level and distribution is equal,evidence of solids carryover, evidence of leakage into or out of box, etc.) -/fur �S QGB�Kh dH Gfiv�j �vtir�. PUMP CHAMBER: (locate on site plan) Pumps in working order: (Yes or Noi Alarms in working order(Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C yy SYSTEM INFORMATION (continued) Property Address: P9 G 0,1 �i✓l. �� 'do�C� Owner: QT. B b e Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching pits, number:_ leaching chambers. number:V leaching galleries, number:_ _ leaching trenches, number,length: , /pPelGf1/!ts _ leaching fields, number, dimensions:_ overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs.of hydraulic failure, level ofponding, condition of vegetation, etc.) %PSR of t`�ID Ss Oe/ /2j. l Xy 4, 41,L)'e-o7ot CESSPOOLS: _ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert. Depth.of solids layer: Depth of scum laver: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as pan of inspection) i Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:_ (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/2S/97) Page a of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ,/ SYSTEM INFORMATION (continued) Property Address: �S 13PgLvd //.,IG �vt'• Aj Ai,",104, Owner: �o h ti DU e k�Z Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 7 7� y 13.1 0.= (revised 04/25/97) Page 9 of 10 i 179--3.; SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: yS L�� i GU IU (,-L Owner: To k+'tf3()e v Li— Date of Inspection: o 5 Depth to Groundwater feer -,�()44o& 0(Z I oeanC l4 U-,A joe '-,rvt90u�" eLowTe(z h Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record �Observation of Site (Abutting property observation hole, basement sump etc.) Determine it from local conditions Check w!th loca! Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) I �ac� Jw�S Tho r��:1 �ePa9�`tZ Show: S�n�� CC-A � `2 8 . Til•S So S Feo e o i? C,.( 40 c J�L a K,, o tZ pe e c k(F b Lu A' -v' e 'tin-g t-it -, SPl2�`w , S PAP AP WYL C[r1 G Lk k cz S (revised 04/25(97) Page 10 of 10 'b`NN OF N RTH 'Ar00VER SYSTEM PUN1pIN_0 E �OR33.. �� ,` •^�� �� � 203 i �1 � 1 EM UADDRESSSYSTEM�LOTIOr (ex4rnp e; Icft (� ou�:i QUANTITY f'UMpED L NO. YES SEPTIC TANK: NO Yn,S _ TUKE.0 E R Y I C E f ROUTINE. EMERGENCY FRVAT10NS; `::� 4':,�UD'CUNU.17'ION,. FULL TU CUYCil --- :fl(:rl``(Y GKkASC' -W3 LLS IN 1)LACc BUOYS'. LEACHFICLD IZUNUACK... GXCESSIYC SOLIDS F1�00.DED S011u� CARRY0Y4R ftR %A.IN) --_ CM Pum PC, 0:0 y C U 1-11�I f�T 5 1t� --- A�