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Miscellaneous - 45 BOSTON STREET 4/30/2018
45 BOSTON STREET J +� 2101107.B-0062-0000.0 � 1 a I 2,7�7 ���� ti t f Lot & Street Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit# Plan Approval: Date: Approved by: Designer: Plan Date: Conditions: Water Supply: Town Well Well Permit: Driller: Well Tests: Chemical Date Approved Bacteria I Date Approved Bacteria II Date Approved Plumbing Sign-Off: Wiring Sign-off: Comments: Form "U"Approval: Approval to Issue: YES NO Date Issued By: Conditions: Final Approval: All Permits Paid? YES NO Well Construction Approval? YES NO Septic System Construction Approval? YES NO Certification? YES NO Other? YES NO Any Variance Needed? YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: r � r � SEPTIC SYSTEM INSTALLATION CONDITIONS: Is the installer licensed? YES NO type of Construction: NEW REPAIR Vew Construction: Certified Plot Plan Review YES NO Floor Plan Review YES NO Conditions of Approval from Form U YES NO ssuance of DWC permit: YES NO )WC Permit Paid? YES NO ?WC Permit# Installer: 3egin Inspection: YES NO xcavation Inspection: deeded: 'assed: By: :onstruction Inspection: leeded: ,s Built Plan Satisfactory: 'ES: ,pproval of Backfill: Date: By: inal Grading Approval: Date: By: inal Construction Approval: Date:. By: ertificate of Compliance: Approval: Date: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION '!�i Pri t PROPERTY OWNER _ >✓ rint 100 Year Old Structure 4es na MAP NO: PARCEL: ZONING DISTRICT: Historic District yeso Machine Shop Village yes no TYPE OF IMPROVEMENT. PROPOSED USE ResiclNon= Residential ❑ New Building Ddne family ❑Addition ❑ Two or more family ❑ Industrial iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ De clition ❑ Other e is ❑Well, E! Floodplain 11 Wetlands 0 Watershed District Water/Sew I"I *Ai%- RIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print clearly) OWNER: Name:/ J- Gf2 fes , f,�;;(if1 6- Phone: �, 75 r� Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: _ Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund j Sgnatwe of Agent/Owner Signature of contractorp Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ r• Ol C7 , S �F)v A F r I s i i I i I� I I .i J �ttP r�y F,� piYE51 15 i I � I i i � v 1 ru j I N 1 C p��<<F 6o- vv vv/v , � C jL ty r� r f . Plans Submitted ❑ 'Plans Waived"❑ Certified Plot Plan ❑ Stamped Plans ❑ FT�E.OI-SEWERAGEDiSI?OSALic Sewer ❑ Tanning/MassageBody Art ❑. .. .Swimming Pools ❑ Well ❑ _Tobacco.Sales ❑ ToodPackaginglSales ❑ Private{septic tank,etc.: ❑ Pdrmanent Dimpster on Site ❑ THE-FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM -::..-DATE. REJECTED: DATE.APPROVED _ PLANNING &DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS ALTH Reviewed on / . Si nature COMMENTS �-� � ",,z �, -�`I�=. 55) Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments !Nater Seder Connectiol7/Signature& Date Driveway Permit DPW Tows Engineer: Signature: Located 384 Osgood Street FIRE DEPAI Ti II ,F NT =:Temp Dumpster on site y'es.. . no Located-at124SMair,.Street =�FireDepar`tmeiit"signature/date-'� -- -" � - COIVIM.ENTS '" F SECTION 3A 4- 100.64 PAGE 112 PERFORMANCE CURV9 DAT! ,, : Series, SE ,0,4 HP, 175ORPM R REPLACES I IV Manual $Automatic MOP 1018 bot 62 -I- 105.35 x i TOTAL NEA- -i' MTRE FT 1:b3 arra -I- 108.72 f w \/ � \ • 30 — STAMOARO t?cYPELt_ER tiIZE .p�p( po'IP V.- IAvp,Ola. N / - — 0.1 3.44" � 2° u 102.02 \ 1 t� . .::•. \ 5' Overdi ° 20 - - 10.15 \ 1 e ' 1 i50 + 103.37 0 + 103. .0 2 r - BENCHMARK: 1 _ \ - Left Outer Ccirrier of „ se 7e :za Lowest Concrete Step C 1 2 45 �' U.°.OALLONB ISOElt� 102.:97 (Aa§U..Med Datum) ' PER MINUTE LrTERa 2 3 s s s e +a Map 107B Lot 57 1500 i. 10 Cal, PERSECOND N/F 102.63 Septic unk Purrp `hamber Rudyard Wayan - d� 6B Boston St. � � p' 88 TeDtlrgle�erfonttedwithwater, �rElvkyof7.0aEie•F.o`serthridsniayvary periorm�e. Deed k. 6580 Pg. 253 103.13 / �° ill •••yyy���''++...r... i efh � PUMPS aSYSTEMS '10 ,05 2. 9 I A Cnw:a Ce.Con n y 1�k1D Lex VjA Ave. dZ0 T1iYd 31rA+4V.O.Dox 800 RJ Well OiYes gM'exty)d,f7hb 4A90,2074 F1tpM.phb ID3016M183 8nmalrinn,0:4wty Ph;(N37)776.047 Fl.:(097)77P 6p17 CenwAe L67 Wo I . v /i Fwt: 18(A )77d-1830 I FP�c(W7)773Tty Ph:pOD)187.8222 I O ;7� vrwMbwmewWwpw.min wmY.wmwp.wxq.00m Fn:(905)Itf'.2850 + •I• , #45 I St �' Gardge: 1=1, Dwelling s 1 2 REFERENCES: i 1) Deed Book 4125 Page 129 /! 2 Plan #4830 of 1963 3 Plan ##9742 of 1984 Elft. Coni,fti _ 4 Plah #3465 of 1957 i . I ; r . EXISTING SITE PL�AIV Town of North Andover Of"°or"�a Office of the Health Department 0ai6•_ Community Development and Services Division * c h 27 Charles Street ��- '� "An. North q°J North Andover, Massachusetts 01845 9ssaCHUS Heidi Griffin Telephone (978) 688-9540 Actii7g Public Nealth Director Fax (978)688-9542 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 9/WO3 This is to certify that the individual subsurface disposal system constructed O or repaired (X) by John DiVincenzo at 45 Boston Street has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not he construed as a guarantee that the system will function satisfactorily. Jonath Markey Chairman,North Andover Board of Health BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 PETER M.MIRANDI,M.P.H. Registered Sanitarian—Certified Health Officer 30 Washington Street,Danvers,MA 01923 978-774-3001;PMMirandi@aol.com BOARD OF HEALTH-NORTH ANDOVER,MA CERTIFICATE OF COMPLIANCE Massachusetts DEP form 3-A Description of Work: Complete System The undersigned hereby certifies that the Sewage Disposal System Repaired by: Stewart's Septic Service, Bradford, MA at: 45 Boston Street has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans dated: June 15, 2003 (revised 07-30-03)* *Pump modifications were made and approved in the field. Use of this system is conditioned on compliance with the provisions set forth below: • No garbage disposal allowed. • System pumping and routing maintenance in accordance with 310 CMR 15.351 • Approved design flow: 504 gallons per day Designer: Peter M. Mirandi, R.S. ' Date: September 3, 2003 THE ISSUANCE OF THIS PERMIT SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION AS DESIGNED. Oct-17-03 07:50A chemwood 798 372-0973 P.01 nuR I n MnyuvtK 9786889542 p-2 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION (hrc dll,4; ed hereby certify that elle Sewage Disposal System( j Constructed; by—_ --J _ �., Q Y1 C e A) O located at was installed in conforaauoe with the North Andover Board of Health approved plan, System Design Permit g .plan dated with a design flow of gallons per day. The materials used wva a in eo"ormance with thoge specified on the approved per;the sysk=was installed m a000rdanoe with the F ulnions of 310 CMR 15-MIX Title S and local regulations,and the final grad ft agrees substantially with the approved plan. Alt work is accurately represented on the As-built which has bora submitted to the Board of Haft. Bed Wspect ion date: Engineer Representative Final inspection date: Engineer Represehtative Installer: k ` Datc:16- /0– Q3 Engineer: Date: Town of North Andover, Massachusetts Form No.2 of Noe*M� BOARD OF HEALTH 19 w s ' t ; r°• ''' DESIGN APPROVAL FOR HU � SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant p � Test No. Site Location d�ST�i� vT Reference Plans and Specs. 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. CHAIRMAN, BOARD OF HEALTH Fee Site System Permit No. �filo p✓2 G?�;��f�� Town of North Andover, Massachusetts Form No.-3 f NORTFt A BOARD OF HEALTH �? 0-4, _, O a GLS/ O 0 H 13 61 DISPOSAL WORKS CONSTRUCTION PERMIT • ,SSACMUSFt Applicant NAME` ADDRESS TELEPHONE Site Location : Permission is hereby granted to Construct ( ) or Repair ( an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. CH MAN,BOARD Of HEALTH Fee ` 8�� aye Town of North Andover, Massachusetts Form No.3 • f 40R7q BOARD OF HEALTH C • O 9 ♦ - - - :� • DISPOSAL WORKS CONSTRUCTION PERMIT ��SSACMUSEt� Applicant � %/�/r/����© /�c�/G�• �`��� �f� NAME ADDRESS TELEPHONE Site Location "rl, : Permission is hereby granted to Construct ( ) or Repair ( "an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. CH MAN,BOARD O HEALTH C7 Fee �`�� + D.W.t No_. �c �� r , TOWN OF NORTH ANDOVER U� BOARD OF/HEALTH v Location Permit # -5 Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers /$ Disposal Works Construction"-"$ D' Soil Testing $ Design Approval Permit $ Dumpster Permit $ Burial Permit $ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Well Construction Permit $ Funeral Directors Permit $ Massage Establishment License $ Massage Practice License $ Suntanning Establishment $ Offal/Trash Hauler $ Other $ U 1- Health Agent White - Applicant Yellow - Dept. Pink - Treasurer APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: e-/3-03 CURRENT INSTALLER'S LICENSE# LOCATION: XJ Leo & re ri kcl LICENSED INSTALLER: :rd ILA) SIGNATURE: UTELEPHONE# 978-&2A- y9 1 CHECK ON/ REPAIR: NEW CONSTRUCTION: IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. LVS-c- ative Use Only 2Sa $+�5. Fee Attached? Yes No Foundation As-built? Yes /1J No Floor plans on file? Yes _ No ApprovalAl Date: )JJ ILII III��IIIIII�IIIIN ��. � - �`��'�u1111�sa�?�I�III�I�I!��11 r !� 111111111111■II�IN �' ��� IIIIe11RI1INUFO, 111 1 IIIIIIIINIIIIIIIIIII . .,: , . � .� 11111111111111 111111/1 � . . 1 IIIIN11111111 11111111, .�� ,�,,_�� , - 1 1 IIIIIIII�i111��/li■IQ�ii � g•:�: � �, 1 111 IIIIIIIIIIIIIIIIIIII . ����� 11 1111111111 IN 1 NIIIIIIIIIIIl1 :11?J 1111111111111111!ICII 11 11111111111111111111 ,, ���� 11IIIIIIIIMEN IIIIINI 11111111111111111111111 _ ' • , n11111�1111111111111111 1 111111!�a®f!IIIII!!l�il III 1111 n111i✓�III�IIIC'II��IIII ��; � �� 1 1 111 111111��®y1111�11i:(i ����� i� 11 11 IIZIIfiCIClEr�i��111 � 1 1IIIIIIn��ir�1�1�I!1. �� 1 IIIIIIIIINIIIIII _ - . �,��� � ■ 111111111111111111 - � ; F.'����� v 'L�'` IIIIiI IIIIIIINII! ��� � 45 BOSTON STREET JS-2003-0628 Proiect Detail Report Printed On:Mon Sep 08,2003 Project Name: GIS#: 7658 Project No: JS-2003-0628 Owner of Record LETIZIA,MICHAEL J& Map: 1073 Date Submitted: Apr-25-2003 45 BOSTON STREET Block: 0062 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Septic System Work Location: 45 BOSTON STREET Zoning: Proposed Use: Residential District: land Use: 101 Proposed Use Detail Single Family Home ISubdivision Description Soil Testing of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2003-0018 8/27/03-Failed inspection on 8/26,but B of B&Tank Inspection are fine per Brian. 8/25/03-Bottom of Bed&Tank Inspection request by John of Stewarts septic. Please call 978.807.9722. I 8/6/03-Plans approved by Sandy. Letter prepared for h/o and eng re:approval, H/O called and notified.—p.d. 7/31/03-Received letter from Arcadia Associates re:7/29/03 inspection of the site and resulting Wetlands disclaimer. File not in drawer. Forwarded report with letter to Sandy's Design inbox.--- p.d. 7/18/03-Denial&deficiencies sent to eng. 7/18/03-Fri-Received e-mail this a.m.from Sandy saying that she took 45 Boston Street file with her and will e-mail the engineer with her response.—p.d. 7/17/03-Mary and Bill Calder have called every day this week looking for the final result of review. They moved their closing date from 7/15/03 to 8/15/03 due to holdup of plan review,and they want to be sure everything will be fine by new closing date,as they also have an elderly mother they are concerned about with regard to the move. Sandy spoke with Mary Calder by phone today. She told Mary that she would have the review complete by Friday. 7/10/03-Peter Mirandi called and left a msg. Per Peter: He would like to know if you can e-mail him your minor revisions to be put on plan. Does not think revisions need to be put on plan until plan is completely reviewed. Just compile your comments in writing and forward via e-mail to try and expedite this,and he will work off his checklist. He will put all revisions needed on final revised plan when review is completely done.—p.d. 7/10/03-Both parties were called;left message for engineer&spoke to homeowner,who requested and received an extension to the end of the month GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. Page 1 of 2 . 45 BOSTON STREET JS-2003-0628 Proiect Detail Report Printed On:Mon Sep 08,2003 7/9/03-Wed-Mary Calder left a message requesting that you call the engineer regarding any changes on the plans for 45 Boston Street today,as he will be on vacation next week. She said that she recently spoke with you,and that you would be calling the engineer about the changes,and wanted to be sure that you did it before he went away. The engineer is Peter Mirandi. Mary's number is: 603-432-7307. Please call Mary to let her know that you spoke with Peter. 7/7/03-H/o called. Plans 1/2 reviewed. Tobe called before 15th. 6/26/03-Thurs.-Received check from Mary Calder. Processed and placed file in Sandy's plan review inbox on 7/l/03.--p.d. 6/25/03-Wed.-Mary Calder,h/o called looking for status. Left message with Peter Mirandi, engineer that we are waiting for applications and plan review fee to go with below booklets/plans submitted last week,as they are design plans,not just related to the repair soil testing. H/o will also call Mr.Mirandi to follow-up. She is concerned re:time status,as they are closing on the house on 7/15/03,and moving her elderly mother out. Can plans be reviewed while waiting for check from engineer? Please call h/o at:603-432-7307 to let her know,as there is a time factor involved.--p.d. Wed.6/18/03-Received 3 plans and booklets of Pump Specifications and Buoyancy Calculations 1 dated 6/9/03 which also contains:Soil Suitability Forms and Impervious Barrier Specifications. Placed Plans and booklets in Sandy's Soil Test inbox.--p.d 5/27/03-Received back from Sandy-Soil Testing date set for Friday,May 30th at 10:30 a.m. Left msg.For Peter Mirandi,and told homeowner who called again.--p.d. 5/6/03-Bill Calder(wife is homeowner)called asking status of Soil Test Application. Told him I that Peter Mirandi sent plot plan yesterday,and it is in for review with the Health Director. 5/5/03-Peter Mirandi called-he will fax plot plan and copy of tax bill or deed for soil test.--p.d. 4/29/03 Spoke with Peter Mirandi and told him that there is nothing in the file on this address and that he needs to submit a plot plan with th application. He will get a plan and send it in. --p.d. Note: Allison from Conservation said that she can accept a hand drawing of the layout showing where the test pits will be. However,Health Dept.Requires a plot plan. --p.d. GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. Page 2 of 2 Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer'<info@milldverconsulting.com> To: <blagrasse@townofnorthandover.com>; <pdellechiaie@townofnorthandover.com> Sent: Monday, September 08,2003 9:31 AM Attach: Boston Street#45 Final Const Insp-2nd visit.pdf Subject: 45 Boston Street Brian and Pam, Attached please find the second inspection report for 45 Boston Street. The SAS was removed and re-built with clean stone. All was ok in the end. Brian, you may want to check closely the final grading on this job. The plan calls for a lot of fill material and this is sometimes an area that gets pared back in the construction phase. Dan Mill River Consulting n Septic System Management Services U 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com Q 9/8/2003 Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer"<info@millriverconsulting.com> To: <blagrasse@townofnorthandover.com>; <pdellechiaie@townofnorthandover.com> Sent: Thursday, September 04,2003 6:53 PM Attach: Boston Street#45 Final Const Insp.pdf Subject: Construction Inspection#45 Boston Street Brain and Pam, Attached please find the results of the construction inspection at this site. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com 9/8/2003 Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer"<info@millriverconsurdng.com> To: <blagrasse@townofnorthandover.com>; <pdellechiaie@townofnorthandover.com> Sent: Thursday, September 04,2003 8:45 AM Subject: 45 Boston Street I spoke with Stewart's Septic this morning and we are all set for an inspection tomorrow morning (upon the completion of the soil test we are witnessing on Oakes Drive). I am guessing it will be at around 11:00. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com 9/8/2003 Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer"<info@milldverconsutfing.com> To: "'Pamela DelleChiaie"'<pdellechiaie@townofnorthandover.com> Cc: "'Heidi Griffin"'<hgdffin@townofnorthandover.com>; "'Brian LaGrasse"' <blag rasse@townofnorthandover.com> Sent: Friday,August 29,2003 12:23 PM Subject: RE: System Final Requests: 224 Summer . &45 Boston St. All set. Going to Summer Street this afternoon and Boston street on Wednesday. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com -----Original Message----- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com] Sent: Friday, August 29, 2003 11:22 AM To: Dan Ottenheimer Cc: Heidi Griffin; Brian LaGrasse Subject: System Final Requests: 224 Summ t. &45 Boston St. Importance: High Hi Dan, Two requests for you: John Soucy has a request for a System Final on 224 Summer St. He was hoping to have it done today, as he did not want to leave it open all weekend and risk getting the stone dirty. His cell#is: 603.216.7175 (left v.m. as well). John DiVincenzo has a request for a System Final on 45 Boston St. for next Wednesday, 9/3 @ noon. Please call him at 978.807.9722. Please notify me with regard to whatever you schedule. Thank you for your assistance. Pam 8/29/2003 NORTh TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845 * 9S K pis�< S^CMUSE Sandra Stan,R.S., C.H.O. Telephone(978)688-9540 Public Health Director FAX(978)688-9542 August 6, 2003 Mr. Peter Mirandi 30 Washington Street Danvers, MA 01923 Dear Mr. Mirandi: The Health Department has reviewed the revised plans dated July 30, 2003 for the proposed repair of the septic system at 45 Boston Street,North Andover. The plans have been approved. Please call me at the above number if you have any questions. Sincerely, Sandra Starr, R.S., C.H.O. Health Director /pfd it CC: Homeowner: Ms. Mary Calder, 7 Heritage Lane, Derry,NH 03038 File: address Chrono John Jacobi,-Sanitarian and C.H.O. Site Evaluator 508-281-7791 ARCADIA ASSOCIATES P. O. Box 165 Manchester, MA. 01944 978-281-7791 —='114T14 ANDO TU-Aq of-No Bee,r OF N t July 29, 2003 Ms. Sandra Starr, Agent North Andover Board of Health 27 Charles Street N. Andover, MA. 01845 RE: #45 Boston Street North Andover, MA. Dear Ms. Starr: On July 29, 2003, I inspected the subject site for any condition that may afford review by the Conservation Commission for a distance of 100 feet horizontally to the lot lines. I hereby attest to the fact that was no evidence found of any jurisdictional wetland within the 100 feet of the subject site. rTha ohn Jacobi Soil and Wetland Specialist CCI Peter Mirandi Town of North AndoverNORTR Ot 4S♦ �`���° Office of the Health Department F p Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 1sSA Sandra Starr Telephone(978)688-9540 Public Health Director Fax(978)688-9542 July 18,2003 ® Peter Mirandi 30 Washington Street V Danvers,MA RE: 45 Boston Street,No. Andover Dear Mr. Mirandi: The Health Department has reviewed the plan dated June 15,2003 for the proposed repair of the septic system at 45 Boston Street,North Andover. The plan as submitted cannot be approved at this time due to the following technical deficiencies: 1. The lot must be shown in its entirety. 310 CMR 15.220(4)(a) 2. Distances to all components missing from plan. (NA 8.03a-c) 3. Waterline,drains,other utilities missing from plan. (3 10 CMR 15.220(4)m) 4. Wetlands disclaimer missing. (NA 8.02s) 5. Please add to note 2 of construction notes, "Contaminated soil to be removed and properly disposed of offsite. Tank to be crushed and removed. 6. Please explain the need for an impervious barrier on all four sides of the absorption field when grading can achieve breakout on 3 sides. 7. Barriedretaining wall to be poured concrete or a variance requested. (NA 9.02) 8. Gas baffle on outlet of tank missing. (310 CMR 15.227(4)) 9. Access manhole within 6"of final grade over tank missing. (3 10 CMR 15.228(2)) 10. Specifics of tees in tank missing or unreadable on detail (3 10 CMR 227(1)(4)(6)) 11. Specifications on stone beneath tank,pump chamber and D-box missing or unreadable. (3 10 CMR 15.221(2)& 15.228(1)) 12. Pump'elevations incorrect;currently set to have alarm come on before pump does. Please check all calculations concerning pump. Also,on page one of computation sheet note D 1 speaks of 12 feet instead of 12 inches. Liquid level in chamber is generally about 6 inches;please check pump specifications. 13. Please specify exact model of pump and controls. 14. Sump specifications for D-box missing. (3 10 CMR15.232(3)(e)) 15. Statement that first 2 feet of pipe from the d-box are to be laid level missing. (3 10 CMR 15.232(3)(c)). 16. Number of pump cycles per day missing(3 10 CMR 15.220(4)(r), 15.254(1)(d)). 17. Calculations showing 24-hour emergency storage capacity above"pump on"missing. (3 10 CMR 15.231(2)). BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I 18. Pump specifications for solids size, sequence,controls,alarm equipment,alarm power,manual operating switch missing or unreadable. (310 CMR 15.231(2),(7),(8), 15.220(4)(r),NA 12.01) 19. Missing specification of one childproof 24"riser to final grade for pump chamber. (310 CMR 15.231(5)). 20. Amount of stone beneath field unspecified. (3 10 CMR 15.252(2)(8)& 15.247(2)). Please address these items and,if possible,when re-submitting,highlight changes and additions. This will help to speed up the re-review process since I understand that your client is under a time restriction. Please e-mail me at slstarr2 e juno.com with any questions or comments you may have since I will be out of the office from July 21 to July 28h. Thank you for your cooperation. Sincerely, Sandy Sandra Starr,R.S., C.H.O. Public Health Director Cc: Homeowner File Town of North Andover, Massachusetts Form No. 1 ' NORTH ' BOARD OF HEALTH 3�0�tt`Eo `gtioL /�/� O p °°° °.w. ' APPLICATION FOR SITE TESTING/INSPECTION SACHus���y Applicant f NAME X ADDRESS TELEPHONE Site Location E�tST Engineer �IZWOI NAME ADDRESS TELEPHONE Test/Inspection Date and Time Ci L�o6�w CHAIRMAN,BOARD OF HEALTH Fee Test No. �10 eli<--'X1aARV1 y19rzv S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. t ltr' �`_f Towr`of No h Andover, Massachusetts Form No. 1 NORTH ~ BOA, D OF HEALTH , 32 5� 96Bs OL APPLICATION FOR SITE TESTING/INSPECTION AOAA TED PPP`�h ��SSACHu5�� Applicant —eAm- xz�l"'a z & NA,MMEE / ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time C IRM A N'BOA RD OF HEALTH Fee— d� Test No. moi''�o?��� �'v7�'"� •�-� :, ._" S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. NUMBER FEE 1086 COMMONWEALTH OF MASSACHUSETTS $20000 North Andover Board of Health LETIZIA, MICHAEL J& A LT &MARY LETIZIA CALDER--_DOROTHY_ NAME 45 BOSTON STREET -------------------------------------- ---------------------------------------------- - ADDRESS IS HEREBY GRANTED A PERMIT Application For Site Testing/Inspection This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires____________________________________________________unless sooner suspended or revoked. ----------------------------------------------------------------- Apri129,2003 ---------------------------- ------------------------------------ Board ----------------------------------------------------------------- of - -- Health ----------------------------------------------------------------- NUMBER FEE 1086 COMMONWEALTH OF MASSACHUSETTS $20000 North Andover Board of Health LETIZIA, MICHAEL J&DOROTHY A &MARY LETIZIA CALDER--__LT_ NAME 45 BOSTON STREET ------------------------------------------------------------ -- - --- ------------ ----- ------ --- ADDRESS IS HEREBY GRANTED A PERMIT Application For Site Testing/Inspection This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires----------------------------------------------------unless sooner suspended or revoked. ----------------------------------------------------------------- April 29,2003 ----------------------------------------------------------------- Board ---------------------------------------------------------------- of ---------------------------------------------------------------- Health Y TONIN OF NORTHANDOVR 03 BOARD OF HEALTH Location / ✓ �"—T�� �' Permit Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers $ Disposal Works Construction $ Soil Testing (/ $ v2O� Design Approval Permit $ Dumpster Permit $ Burial Permit $ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Well Construction Permit $ Funeral Directors Permit $ Massage Establishment License $ Massage Practice License $ Suntanning Establishment $ Offal/Trash Hauler $ Other $ 6u72 Health Agent 4Jhi-te - Applicant Yellow - Dept. Pink - Treasurer BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 APR 2 5 2W3 APPLICATION FOR SOIL TESTS 37 �a •2� DATE: �l J' MAP&PARCEL: LOCATION OF SOIL TESTS: OWNER: /"� � �l TEL.NO.: 603 ADDRESS: qJ /L5?�J 57 ENGINEER: Are— kl� ����� TEL.NO.: CERTIFIED SOIL EVALUATOR: Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing Undeveloped lot testing In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$206.60 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the.BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A.Conservation Commission Approval: Date Received: Check Amount: Check Date: Detach - - - - - - - - - - - - - - - - - - ReturnTopVoucherwithPayment - - - - - - - - - - - - - - - - - - Detach I .: ` ABATEMEyT APPLICATIONS MUST BE RECEIVED BY THE ASSESSORS OFFICE NO LATER THAN 02!03/2003 Interesc�at:the r2te of 1.4.E per annum will accrue on oyit er.d..ue payments from the :due dat2 untilpayment is made Map i07 B Blk 0062 Lot: 000U.0 Location: 45 BOSTON STREET 2Q03 REALIESTATE Lantl (sf3: 1 Bldg V2lue: 122,000 Res Exemptn:> 0 4823 RE. 61AB Cred: 0 Tot Tax Val:' 267,900 Land Value; 145,900 Totl Value: 267,900 FY 2003 Tax: 3,5$0.94 TOTAL TAX'& SP. ASSMTS. 3,580.94;:; Deed! 01. 4125 129 Other ad 210107B006200000 FEB 03, 2003 AMOUNT 3. 013.57`:: Description Class Valation Sped: gssmnts Aitiount Comm :Int MAY 01, 2003 AMOUNT l 013.65 . ONE FAM 10V 257.900 CP GPA 66.09 0:00 PRIOR AMOUNT BILLED 2.567.29 TAXES & SP. ASMNTS PAID 2,567.29 `. EX EMPTIONIABATEM:ENT 0.00;:1 PRIOR AMOUNTS OVERDUE 0.00 LETTZIA, MICHAEL J .&.DOROTHY A :LT INTEREST :: 0.00 MARY LETIZIA CALDER 45 BOSTON STREET gMOUNT DUE MAY 01, 2003: 1,013.65 NORTH ANDOVER MA 01845 a,. T t,:x l) !;'XCaj,::.! If -ro-,F �x W, "o N n"E &%h- m y M i Q02 T -,;i v- t Ai it I I &t*, t e "'3P-. wal" aIE F A, -too K", "jifn'nj'j': 4j'( - , SK me al A -0&-m U,N_�"Mn no j"M, k , z "% i 'ui P- v WA 'x "Am LWOM 4"�"""Womm"v 0 1"( nswoc wow! YL a ca s-n*a wo 6xx wo Nbs 6A ppwo "t w-q ., N.,,, t KQ. t -1 �' 111%, 1'1' - I �'- i', "'I'levor i_- ,e,�. I[e% r,.^-..Vo cm) 2 .i� W,W np„f^A 4 W nhpj;!Or,ft ea xi 'i .1 paylll£a4W F W-'_wy V 2n A am M"S"" m ✓ &nov, I'Vfte! J.;,mb,,r '-:'sa -ill .0i-.PUZ''I DII r t,,!"Jjt( •:'T ": .r_J ti I,<ib)bc 'Lj, :i:t'% ; --,"J taC; v VL:: " 10,. .cripwo : ,V"e vllssed em, so an L .7 'on ru I yomt. W PVE NT OEM MA", uInjo I"p we a W 7 .,:nw ji jo,Q ya,- w vwi cW. � . , QQ" ar wri . y Rbaieu i ! ,c .:eiieve syalza "" Virmmimnorl f ,.lu""I!-,x�.i ):*o'q KZ01 'S Wt",r"4.avAwn 1 Mx- .-Woo ..A, . m:- "0 bi an ar" -et."y 1 201 a em, 4 On 'v,u "'m an DK yOw 3'KR,3, LmAw.n P T,) an exer,�..,cr�c! A� a oi.may�L_klilrj f, ft()R .; Uj'�01 Tj:X T,f:f,i, 4vnAn tar wvwnVro. a, K YK aD wo 31 VAI . ? mOAmax0- . "A6.W*W.Rei Maxv Ilex O4—emss W rm%- ON vv v, A:I L- 'A."7 I, '!I "adv,!un,,r bEtf)re or?Na} I 'x'W,3,c,.i(:any= n,,thr.li t,':Tcx . ..i�'nt v1"",laio.it M(' 1 dmlm 4 a a,Was=wow wMr Q nA§K f j A�>!an n, a 3 num A"QAUV, IQYV 4 j lne. "e^ -' 1 bV+1 OW17=-Ur S-L-n&I f PTdeadMI 1 2) 1 V TV! 10"W vo �wr 1;:'-" �.'s')f ' :, 'r.:.: tl'� ' . .' f--jl -'r-IS 1 Ov 7y the Ur,e;l Slw, qLp -Isbc'n" x '.f ..-.,ii.,..: ' t ` ' BOARD OF HEALTH =' NORTH ANDOVER, MASS. 01845 978-688-9540 APR 252003 APPLICATION FOR SOIL TESTS DATE: J o-3 MAP&PARCEL: LOCATION OF SOIL TESTS: 1CW& 06E ANSIL OWNER: O"L A� CA-0 L�---X TEL. NO.:� ADDRESS: ENGINEER: V�� G /�L l �D 1 b TEL.NO.: CERTIFIED SOIL EVALUATOR: Intended use of land: Residential Subdivision Single Family Home Commercial Is This: t Repair testing Undeveloped lot testing In the Lake Cochichewick Watershed? Yes No v THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$200.60 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the.BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write elow This Line / N.A. Conservation Commission Approval: f f Gs� 145 �an (A)t- 1411JS , �(r,�e(4N Date Received: Check Amount: Check Date: . 80A PL)OF PEAL71 H MAY 2M r. y5 a ' r a •� YiUMd ti F. O. 6o0aA4 u E• �...... ^ X90 � •• '' l r �,. R4t4 f/ G�•srs nt .. . _. _.. _._-.. _ n. .. - ....�__ _ .. �4aEA�44,.7' a .i...._. .. _• .. �-p. ._ .. _... g 4 0 •~ - a ! m � ` a •� z Sys ��► 9 q O t � Q BOSTON ST. aa� 3 cR�s • , 4Na b NORTH ANOOV R , MASS* owNE v By PLatiIDd BOARD APPRORA N C S S 0. G O O D H U E 00PIM BVIDI VISION COATROL Sc^&-z 1"��� JULY l4j6s W? 007 Rimul D PLAMNC BOARD 08 1J RTH A!.POV/R� MA59. ;Ivy , = U ljlaAs��uR . A�oci.►.rc.a NgY4!lH�f.<� MASS- COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS Z R d DEPARTMENT OF ENVIRONMENTAL PROTECTION w En TITLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_45 Boston Streets _North Andover " Owner's Name:_Mary Calder { Owner's Address: 7 Heritage Lane_ MAY 2 Z�Q3 Derry,NH 03038_ Date of Inspection:_4/12/2003 - - 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 Further Evaluation by the Local Approving Authority _X ils Inspector's Signature: Date: _4/12/2003_ 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.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Boston Street_ _North Andover_ Owner: Calder Date of Inspection: 4/12/2003_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of l l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 45 Boston Street_ _North Andover_ Owner: Calder Date of Inspection: 4/12/2003_ 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 privy is within 50 feet of a bordering vegetated wetland or a salt marsh Cesspool or p vy g g 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 I 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: i Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 Boston Street _North Andover— Owner: Calder Date of Inspection: 4/12/2003_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or`Yid'to each of the following for all inspections: Yes No _Yes_ _ 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 `Yes_ _ 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 1/2 day flow _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ No— Any portion of the SAS,cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _No_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _ _No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered A copy of the analysis must be attached to this form.] _Yes_(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 1Td- 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 II 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: 45 Boston Street _North Andover— Owner: Calder Date of Inspection: 4/12/2003_ 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? N/A _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _Yes _ Was the facility or dwelling inspected for signs of sewage back up? Yes _ Was the site inspected for signs of break out? Yes_ _ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no N/A _ 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: 45 Boston Street _North Andover— Owner: Calder Date of Inspection: 4/12/2003_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_N/A_ Number of bedrooms(actual):_3_ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_N/A Number of current residents:_1 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: Yes_ Sump pump(yes or no):_No Last date of occupancy: Current COMMERCIALIMUSTRIAL 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 four years ago,owner Was system pumped as part of the inspection(yes or no): Yes If yes,volume pumped:_1000_gallons--How was quantity pumped determined?_Measured tank_ Reason for pumping:_Inspect tank&baffles 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: Unknown 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: 45 Boston Street _North Andover— Owner: Calder Date of Inspection: 4/12/2003_ BUILDING SEWER(locate on site plan)X Depth below grade:_16" Materials of construction —X—cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.):_4"Cast iron thru wall to septic tank.No leaks present 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: 6'x 4' Sludge depth 12" Distance from top of sludge to bottom of outlet tee or baffle: N/A Scum thickness:_12" Distance from top of scum to top of outlet tee or baffle:_N/A N/A Outlet baffle off. Distance from bottom of scum to bottom of outlet tee or baffle:_N/A_ How were dimensions determined:_Subtract scum&sludge depth to baffle 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 baffle ok.Outlet baffle corroded off.Depth of liquid above outlet invert.No evidence of leakage._ GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass__polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_45 Boston Street North Andover— Owner: Calder Date of Inspection: 4/12/2003_ 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:_4" 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. Evidence of leakage.Evidence of carryover. PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Boston Street _North Andover— Owner: Calder Date of Inspection: 4/12/2003_ 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: 3 trenches 30'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.):_Soil ok.Vegetation ok.No sign of ponding to surface.Sign of hydraulic failure,liquid above outlet inverts. CESSPOOLS: (cesspool must be pumped as part of inspectionxlocate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Boston Street _North Andover— Owner: Calder Date of Inspection:_4/12/2003 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. Driveway House Water Meter Garage A Enclosed porch B Septic Tank D- Box Ato Tank=26'3" A to D-Box=35'7" 30' B to Tank=13'3" B to D-Box=16'8" • Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 Boston Street_ _North Andover— Owner: Calder Date of Inspection:_4/12/2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water >6 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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) X Accessed USGS database-explain: Essex County Soil Map_ You must describe how you established the high ground water elevation:_Essex County Soil Map,Sheet#36. Canton Soil,Water>6' deep_ - - lr - - t - Q�rc�ii� s` `.Arne' nea vi ^'aitei_4:O- . .... ..: ....:. - --_ Micria-softy - ___ - - _ago ModemTest:- .p¢river.aspc: Cltaii Clem � uadaws - � _ E aw 3 '-- r - r ��� '�.� �c =' c=•_.�"�' ;�F ?=.tet .�:c ..: ..;?a `�"��a�:.. :.�,'=- :;s�+.r- .a a D� 15 ppv"it S_ WATER BILLING HISTORY 1090352-LETIZIA, HICHAEL METER 01 : 1'090352 --------------------- 45 BOSTON ST _ . a 0 CYCLE SERUICE PRIOR CURRENT USE WATER SEWER FEES TOTAL CD A _ ''• .... :;; - r.;; 1 2000-1 08/04/1999 944 975 31 84.63 0.00 0.00 84_63 2 2000-21 11/20/1999 975 7 32 87.36 0.00 0.00 87.36 ;1:. x EgsloterrReceivi� 3 2000-31 03/02/2000 7 36 29 79.17 0.00 0.00 79-17 v a - b 2000-41 05/15/2000 36 57 21 57.33 0.00 0.00 57.33 ; z = , 5 2001-11 08/01/2000 57 81 24 65_52 0.00 11_00 76_52 6 2001-21 11/06/2000 81 106 2S 68.25 0_00 11_00 79.25:' :;,... iol� iit tb Rec} 7 2001-31 02/08/2001 0 18 24 65-52 0.00 11.00 76.5 f'iir Ekey_" 8 2001-41 OS/02/2001 18 39 21 S7-33 0.00 11 .00 68.33: t; 9 2002-11 07/24!2001 39 62 23 60_17 0.00 5.55 65.72 10 2002-21 11/14/2001 62 91 29 81_71 0.00 5.55 87.26. 11 2002-31 03/11/2002 91 122 31 81.05 0.00 5_SS 86.60 rn Ott��nuk 12 2002-41 05/10/2002 122 138 16 39-52 0-00 5.55 45_07 co E:scpress° s13 2002-CRD 11/15/2001 91 91 a -6_72 0-00 0-00 -6.72 14 2003-11 07/24/2002 138 157 19 45.22 0.00 5.97 51.19' Go 315 2003-21 10/28/2002 157 176 19 4S.22 0.00 5.97 51.19. : r i ,�,-�•-,x m 116 2003-31 01/28/2003 176 191 15 35.70 0.00 5.97 41.67: _ = � �en�odei95:•sr_�s �- - __= walk'ip;4,-'1i-*, 4: 7tEUIEW CHOICE. 0 or (ENTER> MORE HISTORY: : O d� 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:45 Boston Street, North Andover Owner: Calder Date of Inspection: 4/12/2003 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. Bateson Bateson Enterprises, Inc.