Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 45 TURTLE LANE 4/30/2018 (2)
-- - f Tr_a 1,��/��iFv} coL UJ syr � p�ry ui CAU AMPAD NO. 23-176-400 -ate- e�sf AREA U saa I RATS TO r'� WAa ea w'c rQV �.� NO. 23-376-200 SETS ae North Apidoverboard of Assessors Public Access pORTry �,SSAC14Us t� Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial t r Page 1 of 1 Forth Andover Board of Assessors roperty Record Card Location: 45 TURTLE LANE Owner Name: GRIGGS, MARC LINDA BOGDANOFF Owner Address: 45 TURTLE LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 7 - 7 Land Area: 1.00 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2438 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 503,200 530,300 Building Value: 277,500 305,500 Land Value: 225,700 224,800 Market Land Value: 225,700 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=1518984&town=NandoverPubAcc 4/13/2010 . Commonwealth of Massachusetts = City/Town of System Pumping- Record Form 4 DEP has provided this form for use -by local Boards of Health. Other forms may be'used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: e Righ t of hous , Left / Right rear of house, Left / right side of house, Left / Right side of building, Left /Rig t fron of building, Left / Right rear of building, Under deck Address City/Town state 2. System Owner. different from location) Cityrrown B. Pumping Record 1. Date of Pumping 3. Type of system. ❑ 4. Cesspool(s) Zip Code E,ri 13 2015 State Zip Code Telephone Number 3 t ' — 2. Qua* Pumped Septic Tank Gallons ❑ Tight Tank ❑ Other (describe): Effluent Tee Filter present? ❑ Yep o If yes, was it cleaned? ❑ Yes ❑ Na 5. Condition of System: V\- 4Z;O,� 6: System Pumped By: rj tftrm4.doo- 06/03 Neil. Bateson Name Bateson Enterprises Inc Company contents were disposed: F5821 Vehicle License Number f6— System Pumping Record • Page 1 of 1 Owner information is required for every page. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Asses; 45 Turtle Lane Property Address Marc Griggs Owners Name North Andover City(rown MA 01845 State Zip Code APIA 27 2010 N0WH ANDAVgR TH DEPARTMENT 4/10/2010 Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Neil J. Bateson Name of Inspector Bateson Enterprises Inc. Company Name 111 Argilla Road Company Address Andover City/Town 978-475-4786 Telephone Number B. Certification Ma 01810 State Zip Code SI15 License Number 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 ❑ Fails ❑ Needs urther Evaluation by the Local Approving Authority c . & ��—� 4/22/2010 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 1 of 17 Owner information is required for every page. t5ins • 09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Griggs Owner's Name North Andover MA 01845 4/10/2010 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E / always complete all of Section D A) System 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: After permit from B.O.H., install outlet tee in septic tank & risers on D -box, inspection from B.O.H>, septic system now passes Title 5 Inspection. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for "yes", "no" or "not determined" (Y, N, ND) for the following statements. If "not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 2 of 17 Commonwealth of Massachusetts City/Town of a w° System Pumping Record w Form 4 DEP has provided this form for use by local Boards of Health. Other firREMd information must be substantially the same as that provided here. BefLA ith your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left side of house, Right side of hou- I aft front f house ight front of house, Left rear of house, Right rear of house. Left rear of building. Right rear of building. Address �r—(,A—r I e__ L*\� xja'-1-4� City/Town 2. System Owner: Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): State Zip Code State �� -0 7� ode Telephone Number Date 2. Quantity Pumped Cesspool(s) eptic Tank Gallons ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of Stem: I 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Location where contents were disposed: / 0 -LAS- 1 /\ Lowell Waste Water of F5821 Vehicle License Number Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 �L\ Commonwealth of Massachusetts City/Town of W° System Pumping Record Form 4 1,PR26Mi I TOWN OF NORTH ANDOVER DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Locatio Leff ronit of -h , ight front of house, left side of house, right side of house, Left rear of house,ht-rear of house, left side of building, right rear of building, under deck. �4 Lv\ - /Jcj4 -�� #vA� -9� City/Town State Zip Code 2. System Owner: Name Address (if different from location) City/Town State Zip Code S S - C6 Telep one Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Conditioo of System: V\' 42� 6. System Pumped By: Neil J. Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc. Company 7. Locattorrv�1ov4II e contents were disposed: "14L.S.D. Waste Wpftr Signature f , u r Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 Of ,NORT :,� ► �/ V . O 0 • Town of North Andover HEALTH DEPARTMENT SACHUSE CHECK #: �G��'�.J _ DATE: LOCATION: f%a /�/�`�� / ,b ,;I �.- H/O NAME: CONTRACTOR N10.�r r©/z) Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type. $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ .Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic - Soil Testing $ ❑ Septic -Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑Title 5 Report $ .3-0, ❑ Other: (Indicate) $ C_/'� Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Asses: 45 Turtle Lane Property Address Marc Giiggs Owner's Name North Andover Cityrrown MA 01810 State Zip Code APR 'I J mo TOYVN ►dBRTM ANDOVER 3/27/2010 Date of Inspection 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 ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 3/27/201 C Inspect is 'gnature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ***"This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. /6 '6— Flay t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 1 of 17 Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer, use 1. Inspector: only the tab key to move your cursor do not Neil J. Bateson - 4-1� - use the return Name of Inspector U key. Bateson Enterprises Inc. f Company Name 111 Argilla Road Company Address Andover Ma 01810 City/Town State Zip Code 978-475-4786 S115 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 3/27/201 C Inspect is 'gnature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ***"This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. /6 '6— Flay t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 1 of 17 Owner information is required for every page. t5ins - 09/08 � F Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner's Name North Andover MA 01810 3/27/2010 City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E / always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for "yes", "no" or "not determined" (Y, N, ND) for the following statements. If "not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ® N ❑ ND (Explain below): Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 3/27/2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 3 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner's Name North Andover MA 01810 3/27/2010 Cityfrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the 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 indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Outlet tee in septic tank & d -box extension D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/ day flow t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 4 of 17 Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 3/27/2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or the system is within 200 feet of a tributary to a surface drinking water supply tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply Area — IWPA) or a mapped Zone II of a public water supply well well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the questions in Section D. 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. t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �< dr% M trtip I ane Owner information is required for every page. vroperry Aaaress Marc Giiggs Owner's Name North Andover Cityrrown C. Checklist 01810 Zip Code 3/27/2010 Date of Inspection Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No ® ❑ El 0 ® ❑ El Z ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ Pumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined? (If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components, excluding the SAS, located on site? Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): 600 t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 6 of 17 Commonwealth of Massachusetts w v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Owner information is required for every page. Property Address Marc Giiggs Owner's Name North Andover CitylTown D. System Information Description: MA 01810 State Zip Code 3/27/2010 Date of Inspection Number of current residents: Does residence have a garbage grinder? Is laundry on a separate sewage system? [if yes separate inspection required] Laundry system inspected? Seasonal use? Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? Last date of occupancy: Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? Industrial waste holding tank present? Non -sanitary waste discharged to the Title 5 system? Water meter readings, if available: ❑ Yes ® No ❑ Yes ® No ❑ Yes ❑ No ❑ Yes ® No Yes ❑ Yes ® No Current Date Gallons per day (gpd) ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 7 of 17 Commonwealth of Massachusetts Tithe 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 3/27/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other (describe below): General Information Pumping Records: Source of information: Pumped last year, owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): t5ins - 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 45 Turtle Lane Owner information is required for every page. t5ins • 09108 Property Address Marc Giiggs Owner's Name North Andover MA 01810 3/27/2010 Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Tank original, d -box & field installed 7/5/1994; as built plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer (locate on site plan): Depth below grade: 1.5 feet Material of construction: ® cast iron ® 40 PVC ❑ other (explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): 4" Cast iron thru wall, 3" PVC in house, no leaks visible Septic Tank (locate on site plan): Depth below grade: .5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene El other (explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) Dimensions: Tx 5'x 4' Sludge depth: 2" ❑ Yes ❑ No Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 9 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane t5ins - 09108 D. System Information (cont.) 3/27/2010 Date of Inspection Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle N/A Scum thickness 2" Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet tee ok. Outlet tee corroded off. Needs to be replaced. Depth of liquid at outlet invert. No evidence of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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: Date Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17 Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 every page. City/Town State Zip Code t5ins - 09108 D. System Information (cont.) 3/27/2010 Date of Inspection Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle N/A Scum thickness 2" Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet tee ok. Outlet tee corroded off. Needs to be replaced. Depth of liquid at outlet invert. No evidence of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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: Date Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 3/27/2010 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): * Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins - 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 11 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 3/27/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D -box level & distribution equal. No evidence of leakage. Evidence of carryover. D -box 5' deep, needs extension installed Pump Chamber (locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 45 Turtle Lane Property Address Marc Giiggs Owner Owners Name information is required for North Andover MA 01810 3/27/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits ❑ leaching chambers ❑ leaching galleries ❑ leaching trenches ® leaching fields ❑ overflow cesspool ❑ innovative/alternative system number: number: number: number, length: number, dimensions: 1 field 20' x 45' number: 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. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth — top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 13 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner's Name North Andover City(rown MA 01810 State Zip Code 3/27/2010 Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 14 of 17 Commonwealth of Massachusetts M Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 45 Turtle Lane Owner information is required for every page. Property Address Marc Giiggs Owner's Name North Andover Citylrown MA 01810 3/27/2010 State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand -sketch in the area below ❑ drawing attached separately C;)I = �)i t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane Property Address Marc Giiggs Owner's Name North Andover ..A Cityfrown State D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells 01810 Zip Code 3/27/2010 Date of Inspection Estimated depth to high ground water: 4 feet Please indicate all methods used to determine the high ground water elevation: OR Obtained from system design plans on record If checked, date of design plan reviewed: 5/15/1976 Date Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health - explain: Info at health dent. Checked with local excavators, installers - (attach documentation) Accessed USGS database - explain: You must describe how you established the high ground water elevation: As per test pit data on design plan.. News stem was installed 2' higher than original system Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Turtle Lane E. Report Completeness Checklist 3/27/2010 Date of Inspection ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 17 of 17 Property Address Marc Giiggs Owner Owner's Name information is required for North Andover MA 01810 every page. CityTrown State Zip Code E. Report Completeness Checklist 3/27/2010 Date of Inspection ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 17 of 17 I I Summary Record Card generated on 3/19/2010 9:27:59 AM by Lisa Evans Page 1 Town of North Andover Tax Map # 210-106.B-0101-0000.0 • Parcel Id 17505 45 TURTLE LANE GRIGGS, MARC 45 TURTLE LANE N. ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1 Acres FY 2010 UB Mailina Index Name/Address Type Loan Number Active/Inact. From Until GRIGGS, MARC Payor 45 TURTLE LANE N. ANDOVER, MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 17440.0 - 45 TURTLE LANE Last Billing Date 1/4/2010 3170110 03 Cycle 03 Active UB Services Maint. Account No. 3170110 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 60.80 /1 UB Meter Maintenance Account No. 3170110 Serial No Status Location Brand Type Size YTD Cons 13242333 a Active ERT HH METE METE w Water 0.63 0.63 109 Date Reading Code Consumption Posted Date Variance 3/8/2010 440 a Actual 17 10% 12/10/2009 423 a Actual 16 1/12/2010 8% 9/10/2009 407 a Actual 16 10/15/2009 5% 6/4/2009 391 a Actual 13 7/20/2009 -12% 3/12/2009 378 a Actual 17 4/29/2009 10% 12/5/2008 361 a Actual 14 1/20/2009 8% 9/8/2008 347 a Actual 14 10/10/2008 -34% 6/5/2008 333 a Actual 19 7/16/2008 6% 3/12/2008 314 a Actual 19 4/11/2008 17% 12/13/2007 295 a Actual 18 1/22/2008 -22% 9/4/2007 277 a Actual 19 10/12/2007 27% 6/14/2007 258 a Actual 17 7/20/2007 -17% 3/13/2007 241 a Actual 20 4/16/2007 16% 12/12/2006 221 a Actual 18 1/19/2007 10% 9/8/2006 203 a Actual 15 10/20/2006 -15% 6/13/2006 188 a Actual 20 7/10/2006 8% 3/6/2006 168 a Actual 15 4/17/2006 18% 12/16/2005 153 a Actual 15 1/17/2006 -23% 9/13/2005 138 a Actual 20 10/14/2005 -4% 6/9/2005 118 a Actual 18 7/15/2005 -2% 3/18/2005 100 a Actual 22 4/5/2005 18% 12/9/2004 78 aActual 1;' 1/14/2005 -4% 9/10/2004 61 a Actual 16 10/8/2004 -14% 6/21/2004 45 a Actual 16 7/30/2004 -3% 4/12/2004 29 a Actual 29 5/17/2004 0% 12/11/2003 0 n New Meter 0 12/11/2003 0% North Andover Board of Assessors Public Access Of MO OTM 1 <t`'• a•'�'O F > _ V. i • K SACHUSE Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 4 A slir aril4 roperty Record Card Location: 45 TURTLE LANE Owner Name: GRIGGS, MARC LINDA BOGDANOFF Owner Address: 45 TURTLE LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 7 - 7 Land Area: 1.00 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2438 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 503,200 530,300 Building Value: 277,500 305,500 Land Value: 225,700 224,800 Market and Value: 225,700 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=1518984&town=NandoverPubAcc 6/1/2010 o PUBLIC HEALTH DEPARTMENT Community Development Division RTJ IC Arr F Off' CO�l4PGIANCE As of: April 16, 2010 ,This is to cert that the individuaCsubsurface disposal system received a SA2IS FACTO1' T I-AVSTECTIOY of the: ft&cewnt of an outlet Tee in Septic 2ankand Oistri6ution BoaC E7Ctension foran On Site Sewage D 40osa[System By: ToddBateson At: 45 Turtfe Lane Wap -106. B; Parcel —101 %orth Andover, WA 01845 The Issuance of this certificate shall not 6e construed as a guarantee that the system wiCC function satisfactorily. Susan T Sawyer, 1REAS19U Pu6lic Ylealth Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com =gel= Commonwealth of Massachusetts RECEIVED City/Town of System Pumping Record r APR 2 9 2013 Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. iut the information must be substantially the same as that provided here. Before using Ahis form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location:&& Righ of house, Left / Right rear of house, Left / right side of house, Left / Right side of building, Left / Right front of building, Left / Right rear of building, Under deck Address Citylrown 6 State Zip Code 2. System Owner. Name Address (if different from location) CitylTown State � Code B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ 4. Date Cesspool(s) ❑ Other (describe): Effluent Tee Filter present? ❑ Yes No 5. Condition f S stem: 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Location where contents were disposed: G .. S. Lowell Waste Water Telephone Number — 2. Quantity Pumped Septic Tank Gallons ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No F5821 Vehicle License Number L-�- �* -(3 Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts City/Town of RECEIVED System Pumping Record Form 4 OR ? 4 2012 TOWN OF NORTH ANDOVER DEP has provided this form for use by local Boards of Health. O enfoxmro>3 Awumd, b t the information must be substantially the same as that provided here. Betore using this torm, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Locatio<Cee Right<KE of house. eft / Right rear of house, Left / right side of house, Left / Right side of building, 4eft / Right front of building, Left / Right rear of building, Under deck Address City/Town p State 2. System Owner. 11 Name Address (if different from location) City/Town State 55 - `(Sca6 Telephone Number Zip Code Zip Code B. Pumping Record 1. Date of Pumping' fD 2�2uantity Pumped: Date Gallons 3. Type of system: ❑ Cesspool(s) 2" Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes 5. Condition of System: 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Locatior�_wherq contents were disposed: No If yes, was it cleaned? ❑ Yes ❑ No Waste Water F5821 Vehicle License Number Date t5form4.doc• 06/03 System Pumping Recons • Page 1 of 1 X MAPIQUEST Trip to 45 Turtle Ln North Andover, MA 01845-4922 7.66 miles - about 17 minutes Notes Michele. 45 Tule Lane - Inspection for OUTLET TEE AND D -BO INSPECTIONS. Ready 4/13/2010.--p.d. Y' 1600 Osgood St, North Andover, MA 01845-1048 1. Start out going SOUTH on OSGOOD ST / MA -125 toward ORCHARD HILL RD. Continue to follow MA -125. <S> 2. Turn LEFT onto MASSACHUSETTS AVE ® 6. 45 TURTLE LN is on the RIGHT. 45 Turtle Ln, North Andover, MA 01845-4922 Total Travel Estimate : 7.66 miles - about 17 minutes Route Map Hide Page 1 of 2 go 3.2 mi go 0.5 mi go 2.6 mi go 1.3 mi go 0.1 mi http://www.mapquest.com/print 4/13/2010 3. Enter next roundabout and take 2nd exit onto SALEM ST. (r►3 4. Turn RIGHT to stay on SALEM ST. (�1) 5. Turn LEFT onto TURTLE LN. ® 6. 45 TURTLE LN is on the RIGHT. 45 Turtle Ln, North Andover, MA 01845-4922 Total Travel Estimate : 7.66 miles - about 17 minutes Route Map Hide Page 1 of 2 go 3.2 mi go 0.5 mi go 2.6 mi go 1.3 mi go 0.1 mi http://www.mapquest.com/print 4/13/2010 GMA�v:@ufsT;i o Daddy Frye -:�HavertkiU,Str sig on. LaWren�e�, tip r �l �Soukh Lawrence i Sv i e yr rte= r Page- 2 of 2 - �/ dr _a 16013 m X74800 ft �Austvr HS t T � e Barker Halt , Ha -3 d Willow Rdsu%°"'46 Qs dHe - �` Inter"i Boxiord Batdpafetl 4FosterH& J North . a 5 1 ,. M& Hio f^ • - _.;' _133 t a .: ,'_ .: iti ' ` � ' .P?Andover � 125 L '1 Brute hr7jr .tabs Hd' a r 4chuc.k H07 Boxrcl5t �,w,�n ,4Boston Hr'1' Fegt ' 02010 MapQuest Portions @2010 M AYTEQ, Intermap All rights reserved. Use subject to License/Copyright I Map Legend Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or expeditiousness. You assume all risk of use. MapQuest and its suppliers shall not be liable to you for any loss or delay resulting from your use of MapQuest. Your use of MapQuest means you agree to our Terms of Use http://www.mapquest.com/print 4/13/2010 TOWN OF NORTH ANDOVER ,aOR7H of .a qN Office of COMMUNITY DEVELOPMENT AND SERVICES0. HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 O,.. x NORTH ANDOVER, MASSACHUSETTS 01845 "SsaCHus�j�� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 0 978.688.8476 — FAX TER LOCATION INFORM ADDRESS: MAP: INSTALLER: j aoC- DESIGNER: �o PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS Comments: SEPTIC TANK UCTION NO S LOT: ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer ❑Topography not appreciably altered ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation — Feb 2006 Page 1 of 6 TOWN OF NORTH ANDOVER o� NORT" q Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 �9SsgCHUSe��h Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: Comments: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Wastewater System Documentation — Feb 2006 Page 2 of 6 TOWN OF NORTH ANDOVER Noery Of e o 'q,y Office of COMMUNITY DEVELOPMENT AND SERVICES .HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 + Q�. , NORTH ANDOVER, MASSACHUSETTS 01845" s -SAC user{y Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 —FAX D -BOX Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) V❑ Hydraulic cement around inlet & outlets Observed even distribution Speed levelers provided (not required) SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-11/2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel -less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: Wastewater System Documentation — Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER NaRTk 4 Office of COMMUNITY DEVELOPMENT AND SERVICES �r�t'"'° °M°0 HEALTH DEPARTMENT - p 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 "ss""°'`0tth NCHUSE Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX PRESSURE DISTRIBUTION 11 Comments: -- inch manifold laterals installed with end sweeps size: material: Squirt test ft in height Equal distribution to all laterals orifice size inch as per plan CONTROLPANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation — Feb 2006 Page 4 of 6 TOWN OF NORTH ANDOVER µoRrN Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 "SS�,,5���y Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Wastewater System Documentation — Feb 2006 . Page 5 of 6 Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool . 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well. 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other) Foundation 10 (5) 20 (10) ❑ Drywells 20 25 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Wastewater System Documentation — Feb 2006 . Page 5 of 6 TOWN OF NORTH ANDOVER NORTk Office of COMMUNITY DEVELOPMENT AND SERVICES ;e °°om HEALTH DEPARTMENT o�°6.�•> 21. A 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 SgcHus���s Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX SYSTEM ELEVATIONS Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW INVERT ON DESIGN PLAN FIELD INVERT ELEV. Wastewater System Documentation — Feb 2006 Page 6 of 6 wary Commonwealth of Massachusetts Map -Block -Lot $ro�,,.a 106.60101 '' °t Board of Health .. s Permit No North Andover BHP-2010-0525----------------------- P.I. HP-2010-0525P.I. FEE A- swc�Nus��F.I. $125.00 DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Todd -Bateson to (Repair -OUTLET TEE & D -BOX EXTENSIONS) an Individual Sewage Disposal Syst at No 45 TURTLE LANE as shown on the application for Disposal Works Construction Permit No. 131HP-2010-052 Dated April -02,-2010 - - ----------------- �! Issued On: Apr -02-2010 1 Board of Health f 14ORT4 �i Commonwealth of Massachusetts Map -Block -Lot �'©`- • ,; sant 106.60101 Board of Health ----------------------- North Andover �►•-.,,.�-' CERTIFICATE OF COMPLIANCE �S3�c wu�Ei THIS IS TO CERTIFY, That the Individual Sewage Disposal System (Repair -OUTLET TEE & D -BO by ---Todd -Bateson ------------------------ -------------------------------------------------- -- -- Installer at No -4-5-TURTLE-LANE has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. _BHP -2010-052-_ Dated ... April_02,_2010_------ -------- --------------------- Printed On: Apr -02-2010 Board of Health sS�C NUSt CHECK #: LOCATION: H/O NAME: CONTRACT( ` q 4724 Town of North Andover HEALTH DEPARTMENT Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic - Soil Testing $ O0 Septic - Design Approval $ 3-- eptic Disposal Wor Constructio DDW;C) $ 1,4 idl-�ot' �vi5 ❑ Septic Disposal orks Installers (D $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ 17 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer t� OF*N Ok Application for Septic Disposal System t 4 ~~,- , I• -Construction Permit-, TOWN O TODArS DATE "• •-�-• •� • ORTH ANDOVER MAO 4���1��� $ •00 —Full Repair ��s ^^n• '' $12 .00 -Component S"`"`� MAi 2010 Important: Application is hereby made for a permit to: When filling out ❑ Construct a new on-site sewage disposal ��E NORTH ANDOVER forms on the LTH DEPARTMENT computer, use ❑ Repair or replace an existing on-site sewage disposal system - only the tab key to move your ®air or replace an existing system component — What? cursor - do not _ use the return A. Facility Information �' � x Z�` key. 1�1 Address or Lot # CityrTown o' - K d v -t./Z- 2.- *TYPE OF SEPTIC SYSTEM*: ❑ Pump Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. Owner Information 3. 4. Name Address (if different from above) CdyRown State Zip Code Telephone Number Installer Information Name Address Cityrrown Desiqner Information Name Address Cityrrown Name of Company 111 ARGILLA ROAD' state �� 0, MA o1810 Zip Code Telephone Number (Cell Phone # lfpossible please) Name of Company State Zip Code Telephone Number (Best # to Reach) r Application foDisposal System Construction Permit - Page 1 of 2 i' � ,rO TN Application for Septic Disposal System TODAY'S DATE AConstruction Permit TOWN OF ORTH ANDOVER $ 250.00 -Full Repair ' °�,.�� MA 01845 $125.00 - Component 9SS^ONUSES I PAGE 2OF2 A. Facility Information continued.... 5. Type of Building: esidential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issue by this Board of Health. Na Date I Appl For Office Use Only: 1. Fee Attached. n Approved By: ( -ard of Health Representative) Date n Disa ``roved for th following reasons: 2. Project Manager Obligation Form Attached. 3. Pump System? If so, Attach copy ofElectrical Permit 4. Foundation As -Built. (new construction ronly): (Same scale as approved plan) 5. Floor Plans? (new construction only): Yes L/ No Yes_ No Yes_ No Yes No Yes No Application for Disposal System Construction Permit • Page 2 of 2 y SEPTIC SYSTEM. INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: 75 / r t 1. kA, �-N . (Address of septic system) For plans by Relative to the application of t eso/✓ (Installer's name) And dated Dated � —/d o ay s ate With revision I understand the following obligations for management of this project: 1. As the installer, I am .obligated to obtainall permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer, I.must call for any and all' inspections. If homeowner, contractor, project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall. be applicable. 3. ` As the installer, I am required to. have the necessary work completed prior,to the applicable inspections as indicated below. I understand that requesting an inspection without completion of the items in accordance with Title 5 and the Board.of Health Regulations may result in a $50.00 fine being levied against me and/or my co=anny- a. Bottom of Bed - Generally, this is the first (15) inspection unless there is a retaining wall, which should be done -first. The installer must request the inspection but does not have to be present. . b. Final: Construction. Inspection — Engineer must first do their inspection for elevations, ties, etc. As -built of verbal OK (or e-mail to: healtl dept@townofnorthandover com) from the engineer mast be submitted to :the Board of Health, after which installer .calls for an inspection time. Installermust be present for this. inspection. With a pump system, all electrical work.mustbe ready and able to cause :pump to work and, alarm to function. c. Final Grade — Installer must request inspection when all grading is complete. Installer does not have.to be on-site. 4. As the installer, I understand that only I may perform the work (other than .ri)VIe excavation) and I am required to complete the installation of the system identified in the attached application for installation. .1 fiuther .understand that work done bv others unlicensed to install se tics stems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover. significant fines to allpersons involved are also possible 5. As the installer, I understand thatI must'be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. A Inspection of the sand and stone to be used. c. Final inspection by Board ofHealth staff or consultant. d. Installation, oftank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I.am solely res12onsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or ane other persons shall absolve me of this obligation. ATO FROA ur Imtf ` ,a..� - - r • C i Cl) jui C� r ~ SIGNED AMPAD NO. 23-176-400 SETS NO. 23-376-200 SETS , OOc.E�//d JH DO ER, MASS _ �RD F H LT,N � IGN ENGINES d.� This is to certify that I have inspecte Ozr� .k c 19 7," Re: Soil Absorption Sewage System Inspection construction of the said disposal system at %Lu K L .L1,I/YE7-`5^ North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated O C 7' 8 �3 19 7-C. � i eg. Pr . E eer/Reg. S itarian 4111 lqq 0� T&ice 4,9. TOWN OF NORTH ANDOVER REPORT OF PERC TEST NORTH ANDOVER BOARD OF HEALTH ADDRESS OF SYSTEM V�em �J�' DATE DATE ,(S NAME OF PROFESSIONAL ENGINEER. Cit SANITARIAN CONDUCTING TESTS NAME OF LOT OWNER � ADDRESS SHOW APPROXIMATE LOCATION OF PITS ON SKETCH ON REAR OF THIS SHEET Soi�X5/74 -- Total Loy: To :Subsoil Depths &`mopes WgtPr LPvP_].. Pit Dmth I &/°I `/ 7G Time to Time to Perc Tests Depth Saturation Time Drop 12" - 91, nrnn Qtl - 61, Other Considerations: 15 n +�L 4202VI /g 1-,2, v4/ 1�/ ,!Z/ /',/* 74-) /7 Recommendations: A2&= f Signature Ize 's 241-17 I r. 2 !,,}}4: yi!'S, '(,�<�7 �+. `:lSy �. �R. l�.i" i f. �`i�. 4ti3 �� �:i, !, �•�. . r. ... •.. .. - �` , .r' .. ... .. �. �-.:'7-.i k1.��� tS`c�� n'7d+r.`/.\J.�.t }';Y1 y�/iS�',. .i 1. a\ 1: I.4, ,�1 ` •' ` ` � �, fir. \ Town of North Andover, Massachusetts . Form No. 3 NORTH BOARD OF HEALTH 0 p 19 (�T �,'°•,• "� DISPOSAL WORKS CONSTRUCTION PERMIT SSAC 1H Applicant_ 1 VM—E ADDRESS TELEPHONE Site Location Permission is hereby granted to Construct ( ) or Repair �an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. / CHAIRMAN, BOARD OF HEALTH ;L Fee D.W.C. No. t7( -j Form No. 4 Town of North Andover, Massachusetts BOARD OF HEALTH _Airi1 11, 19q5— CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired ( X) by Tnhn So i .y INSTALLER at aS Tnrt1E+ Lane, North Andover MA 01845 SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 680 dated 1111 y 19 94 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. ARD OF H EA (PHONE CALL FOR DATE 16 —:::22 2TIME M PHONED OF �� ?D RETURNED PHONE YOUR CALL AREA CODE NUMBER EXTENSION PLEASE CALL MESSAGE WILL CALL AGAIN' . CAME TO SEE You WANTS To SEE YOU ` SIGNED TOPS '"' FORM 4003 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 120 MAIN STREET NORTH ANDOVER, MA 01845 Telefax Transmittal Form June 27, 1994 Date Addressee: Name: Gayton Osqood From: Firm: Street: City, State, Zip: Telefax phone number: 508-686-9192 Town of North Andover Health Department 120 Main Street North Andover, MA 01845 Telephone # (508) 682-6483 Ext. 32 Telefax # (508) 682-2996 Total number of pages, including transmittal form 2 If you do not receive all pages, notify sender immediately. Additional Comments: Gayton, if you have any questions, please give me a call. Let me know what needs to be done on my part, i.e. issue DWC permit. Thanks. Carol � lo)-? Iq V Karen: I have a little dilemma. John Soucy, an installer, called this morning and wants to pull a Disposal Works Construction Permit for a repair at 45 Turtle Lane. I told Mr. Soucy that Sandy was away for two weeks, and I would check with you. In the meantime, Mr. Dougherty, the owner, called Mr. Gordon and spoke with Melissa. Melissa, in a round about way, told him he will probably have to wait for Sandy to return. Mr. Dougherty mentioned that Sandy told him that a design was not needed. As you will see from the file, this problem started in April. I did not see any notes indicating that Sandy said that no design was needed. Mr. Dougherty stated that the engineer was Les Godin. Please advise me as to what to do about this. See me if need be. Thanks. Carol CY Mr. Dougherty number is 1-508-524-5221 John Soucy 683-5709 g —CdVI 6nc� rX 0Nq I.l f t . G' '94 10:05 FAX F. r �,�L%POsdG SU�suxrxAG� ,�WA6.E Dls�� SVsrEr✓r. ,.tAJQ ! Pk'dvase� Lor b$�.,4�r,vG � tScA:.e J' Dare : �-; i 9 i 6 {. V� s I � � r P . 1. Pl � uTos��N fA+e sAc5?,& C R's. / WezrwARb C(Pcte MA -S-5, c',d�s/ratir pArA :6"w _' ' rYPE "r BU/LQ!d1G,E2f� a4R*;4r 0 co"AR Pee1Me1A14,146 SEPfr� 7'AA./k f-. J GA S r4Bs�ae��ror✓ AeEA �o�¢r�car/aA '6s� rz zr 7VP GLEdArlo^' M�rr� Ae4 .SOIL 7"YPE5 r mr'ri +�� AAJD WA7---g 7A49LE BorydM ELEL'ArrdN / 2 a4 Z TEST ,.tQl1G7ED BY AM)4W C- cc1GrN i5P7: r7 WrrN� Sr61;6Z)By: NO. 4, 4S4 rrOAJ no�ni, /Z"re 9" D,P,OP hl/N Vf/N. PBkYDL+�Y/O,i/ I QRT� :.= M"•^ /u• �f(- 7-E57- PITS �� arr3 M�rr� Ae4 .SOIL 7"YPE5 r mr'ri +�� AAJD WA7---g 7A49LE BorydM ELEL'ArrdN / 2 a4 Z TEST ,.tQl1G7ED BY AM)4W C- cc1GrN i5P7: r7 WrrN� Sr61;6Z)By: NO. 4, i Jun.29 '94 10:04 r^ FAX. Solve SEWER SERVICE 830 Livingston Street Tewksbury, Massachusetts 01876 Main Office: (508) 851-8839 �AX poges . 3 � lzq q.q, r F. 1 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. v11 Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 DEC 2 2 2008 TOLVSJ CF hQR'i H A' KFf. TH CEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location. eft fron left rear, left side of house. Right front, right rear, right side of house. �i 5 I utf Et L -v\- Address City/Town State Zip Code 2. System Owner: Name Address (if different from location) Cityrrown B. Pumping Record State Zip Code Telephone Number 1. Date of Pumping I [ �' — 2. Quantity Pumped: (O pL Date Gallons 3. Type of system: Cesspool(s) Septic Tank 0 Tight Tank Other (describe): 4. Effluent Tee Filter present? 0 Yes NT"No If yes, was it cleaned? p Yes R/No 5. Condition of System: , � Of in6 ( � -e�f ic ( I - V�- 76� � 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Location where contents were disposed: of Lowell Waste Water F 5821 Vehicle License Number Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 � Commonwealth. of Massachusetts City/Town of IR� �1 System Pumping Record Form 4 DEC 1 8 2006 DEP has provided this form for use by local BoarX64 Pealth,, FThe Syt Pumping Record must be submitted to the local Board of Health or othe appec�irFiti A. Facility Information Important: When fining out forms on the 1. System Logon: V� /� computer, use �_ only the tab key to move your cursor Address - do not use thereturn City/Town / State Zip Code key. 2. System Owner: Name Address (if different from location City/Town State Zi Code' Telephone Number B. Pumping Record ��- 1. .Date. of Pumping Date 2. QuantityPumped: Gallons 3. Type of system: ❑ Cesspool(s)Septic Tank ❑ Tight.Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No ` . If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System:. 6. System umpeQ3 Name c Vehicle License Number Company --- . 7. Location,where contents were posed:: Signa re uler Date h4p://wWw.mass.gov/dep/w ter/. -pprovalsft5forms.htrn#inspect TOWN OF _ 4\-xA�g,, f SYSTEM PUMPING RECORD' DATE: `",1' c? S SEP — 7 2005 SYSTEM OWNER & ADDRESS TOWN OF NORTH ANDOVER HEALTH ;JLr3ART%1ENT SYSTEM LOCATION (example: left front of house) t-r� 1*a + dT 6kS-c DATE OF PUMPING: Le - Q CS QUANTITY PUMPED: T p (� GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.L.S.D _Z Lowell Waste TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: Q� SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) F'I-zv� ����� c> DATE OF PUMPING: tl U 2 QUANTITY PUMPED f5'ot GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) ,, J. � r .:� ` �. x Uj r --::;1�.�✓R. }�}• H tji d vi '+��#-ray �r�c t �i:^i � ,� `y� a hd Q z . z0a tai U ' n 1-3 ci 0 til 0 oz En G x H H H 0 IMV 1-3 trj dU. O z mz . (gyp C3 � N Q oci H 0 z Thursday, July 07, 1994 45 Turtle Lane This was an emergency repair to a failed system. Upon excavation it was discovered that the original system was set at too low an elevation, there was roots, debris and clay in the leaching bed. The old system was completely removed, sand was placed in the bed to raise the elevation about two feet. The new system is constructed the same size as the original system and in the same location except that it is about two feet higher. This system was inspected three times. 1. When the old system was removed 6/29/94 2. When the bottom of the bed was brought to the new elevation. 6/30/94 3. Before backfilling 7/1/94 Gayton Osgood .. .-w 1 10 le Nso A J t J, i� 0 Ti9 IA(. -/g-? 5Z) CX// BdrTdM = �.3/ o0 1 tt� I�z fh Tj b mmo o a�y� you L Zb(�m to mm U ml � o a I n m o o � y � y z ae p �y ml M/til. I Ch o ae p �y 20' J M/til. I r ^ w . - '. 4w