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 WINDKIST FARM ROAD 4/30/2018 (3)
Y� Fj E1 rh " North Anker Board of Assessors Public Access ' Page 1 of 1 North Andover Bard of Assessors 7ZIProperty Record Card Parcel ID :210/109.0-0049-0000.0 FY:2012 Community: North Andover Click on Sketch to Enlarge 45 WINMST FARM ROAD Location: 45 WINDKIST FARM ROAD Owner Name: SCARPA, CHRISTOPHER J JENNIFER A SCARPA Owner Address: 45 WINDKIST FARM ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 8 - 8 Land Area: 1.06 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 4092 sqft Total Value: 875,100 875,100 Building Value: 644,600 644,600 Land Value: 230,500 230,500 Market Land Value: 230,500 Chapter Land Value: Price: 1 Sale 05/10/2000 Date: s Length Sale F-NO-CONVNIENT Grantor: CHRISTOPHER SCARPA Doc: Book: 05745 Page: 0122 http://csc-ma.us/PROPAPP/display.do?linkld=1 897177&town=NandoverPubAcc 6/12/2012 4 r � T , s Lot & Streets- Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid- YES NO Permit;; T Plan Approval: Date: �� a'� Gd Approved by: Designer:.,, �°��_ "n f�-�f Plan Date: V Conditions - Water Supply- own _.___ 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 y:Conditions:Final Approval: All Permits Paid? E NO Well Construction Approval? Septic System Construction Approval? NO Certification? YES NO Other S NO Any Variance Needed? YES NO FLNAL BOARD OFATH APPROVAL: DATE: 7 APPROVED BY. ,D/y e / SEPTIC SYSTEM INSTALLATION Is the installer licensed? "0 Type of Construction: NEW -v/°4'' PAIR New Construction: -..Certified Plot Plan Review S NO -Floor Plan Review YES NO — Conditions of Approval from Form ti NO -Issuance of DWC permit: - NO _DWC Permit Paid? —. NO --DWC_Permit _� Installer: p/fN So vc/ BeginInspection:_ -e YES NO Excavation Inspection: -Needed: ._Construction Inspection: Needed: Approval of Backfill: Date: � q PZ) By: ..-Final Grading Approval: Date: 2,1,lvo By: Final Construction Approval: Dater Certificate of Compliance: Approval: I MAP # lbq PARCEL # b LOT # 9 vftow STREET HAS PLAN REVIEW FEE BEEN PAID?d' YES PLAN APPROVAL: DATE APP. BY DESIGNER: PLAN DAT CONDITIONS e WATER SUPPLY: WE PERMIT WELL TESTS: PLUMBING SIGNOFF A COMMENTS: I TOWN WELL DRILLER CHEMICAL BACT NO AA /a/1/L E DATE APPROVED I DATE APPROVED Il DATE APPROVED WIRING-SIGNOFF FORM U APPROVAL: APPROVAL TO ISSUE ES NO y DATE ISSUED BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID WELL CONSTRUCTION APPROVAL SEPTIC SYSTEM CONSTRUCTION APPROVAL OTHER ANY VARIANCE NEEDED FINAL BOARD OF HEALTH APPROVAL: YES NO YES NO YES NO YES NO YES NO DATE:B r24 SEPTIC SYSTEM INSTALLATION r IS THE INSTALLER LICENSED? YES NO TYPE OF CONSTRUCTION: y !NE REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW NO CONDITIONS OF APPROVAL YES NO (FROM FORM U) ISSUANCE OF DWC PERMITNO DWC PERMIT PAID? C� NO DWC PERMIT NO. INSTALLER: BEGIN INSPECTION /l�"'" NO: EXCAVATION INSPECTION: NEEDED: PASSED BY CONSTRUCTION INSPECTION: NEEDEM. AS BUILT PLAN SATISFACTORY: YES: f APPROVAL TO BACKFILL: DATE:/,,�i,,�LBY FINAL GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE: BY TOWN OF NORTH ANDOVER - SYSTEM PUMPING RECORD DATE: SYSTEM OWNER & ADDRESS Sc rf. SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: . i D,�,Ig I t c> QUANTITY PUMPED GALLONS CESSPOOL: NO ' YES SEPTIC TANK: NO YES �y NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY:—Teti- COMMENT'S; , CONVENTS TRANSFERRED TO: _ �' r, !^ai,�r, 3,n,�t S4 . q k + 0 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. QQ i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner's Name N. Andover City/Town MA 01845 State Zip Code 07/20/12 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 Inspector: John Soucy Name of Inspector Soucy's Sewer Company Name 78 N. Broadwa Company Address Salem City/Town 603-898-9339 Telephone Number B. Certification Inc. RECEIVED HEALTH DEPARTMENT NH 03079 State 13397 License Number Zip Code 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 ❑ Nis Fu0er Evaluation by the Local Approving Authority Date 12 nature - -—�" Date Thoystem inspector shall submit, /opy of this inspection report to the Approving Authority (Board of/Health or DEP) within 30 days dcompleting 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 a t Owner information is required for every page. A Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner's Name N. Andover City/Town B. Certification (cont.) MA 01845 07/20/12 State Zip Code Date of Inspection 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): t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 2 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 Windkist Farm Road Property Address Chris Scarpa Owner's Name N. Andover City/Town B. Certification (cont.) B) System Conditionally Passes (cont.): MA 01845 07/20/12 State Zip Code Date of Inspection ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 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 Windkist Farm Road Property Address Chris Scarpa Owner's Name N. Andover Cityrrown B. Certification (cont.) MA 01845 State Zip Code 07/20/12 Date of Inspection 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the systern is functioning in w 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: 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 1/ day flow t5ins • 09/08 Title 5 Official Inspection Forth: 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 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name nformation is equined for every N. Andover MA 01845 07/20/12 equire age. City/Town 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: El® Any portion of the SAS, cesspool or privy is below high ground water elevation. 1:1® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. E]® Any portion of a cesspool or privy is within a Zone 1 of a public well. El® Any portion of a cesspool or privy is within 50 feet of a private water supply well. El® 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.] i p ❑ ® 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 r ❑ ® 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 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover MA 01845 page. City/Town State Zip Code C. Checklist 07/20/12 Date of Inspection Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No ® ❑ 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: G Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): r- 550 550 t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 6 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. Cityfrown D. System Information Description: Number of current residents: MA 01845 07/20/12 State Zip Code Date of Inspection Does residence have a garbage grinder? Is laundry on a separate sewage system? [if yes separate inspection required] Laundry system inspected? Seasonaluse? Water meter readings, if available (last 2 years usage (gpd)): Detail: See Attached 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: Gallons per day (gpd) ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No Date ❑ 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 _ v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town D. System Information (cont.) Last date of occupancy/use: Other (describe below): Pumping Records: Source of information: MA 01845 07/20/12 State Zip Code Date of Inspection Current Date General Information Was system pumped as part of the inspection? If yes, volume pumped: How was quantity pumped determined? Reason for pumping: Owner 1500 gallons Gauqe on truck 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 • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road D. System Information (cont.) MA 01845 07/20/12 State Zip Code Date of Inspection Approximate age of all components, date installed (if known) and source of information: 2000 Were sewage odors detected when arriving at the site? Building Sewer (locate on site plan): 28" Depth below grade: 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.): ❑ Yes ® No Septic Tank (locate on site plan): 14" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain) If tank is,metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 6'x10.5' 3" Sludge depth: t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 9 of 17 Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town D. System Information (cont.) MA 01845 07/20/12 State Zip Code Date of Inspection Approximate age of all components, date installed (if known) and source of information: 2000 Were sewage odors detected when arriving at the site? Building Sewer (locate on site plan): 28" Depth below grade: 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.): ❑ Yes ® No Septic Tank (locate on site plan): 14" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain) If tank is,metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 6'x10.5' 3" Sludge depth: t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °wM 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town t5ins • 09/08 D. System Information (cont.) MA 01845 State Zip Code Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle 40" 3" 5" Distance from bottom of scum to bottom of outlet tee or baffle 14"— 07/20/12 Date of Inspection How were dimensions determined? tape & sludge tool Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal Dimensions: Scum thickness ❑ fiberglass 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 feet ❑ polyethylene ❑ other (explain): • Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town MA 01845 07/20/12 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: Design Flow: Alarm present: Alarm level: gallons gallons per day ❑ Yes ❑ No Alarm in working order: Date of last pumping: Date Comments (condition of alarm and float switches, etc.): ❑ Yes ❑ No * Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 11 of 17 Commonwealth of Massachusetts H W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �.w 45 Windkist Farm Road D. System Information (cont.) MA 01845 State Zip Code 07/20/12 Date of Inspection 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.): Flow checked ok 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 Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town D. System Information (cont.) MA 01845 State Zip Code 07/20/12 Date of Inspection 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.): Flow checked ok 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town D. System Information (cont.) Type MA 01845 07/20/12 State Zip Code Date of Inspection ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: (5) 50'ea. ❑ 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.): 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 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road MA 01845 State Zip Code 07/20/12 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 Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover page. City/Town MA 01845 State Zip Code 07/20/12 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover MA 01845 07/20/12 page. City/Town 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 t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17 2iJii✓!t—i� ! i. LiEP'�G LiYGii E 3� i t,w�.: � ✓� • � :. I:.l rJ }�jY r�rl�ifisv.��n! 1Dtrf��!'`�'W�,.i EI%aly r1�SGa ��� �i_V9 G�C15T1P.i� \ -�-Sv r �•.E 32 /zl^ ✓V; -I § ASpOSAL SYS TEM coalw IN ! I !� a� oov�� � �6 .� i .�I!:�D'�i aril 20AD AS PF2EPGcRE� � ©ATE: SCALE: } MERRIMACK ENGINEERING SERVICES, INC. ` , RORSStONA! EIG'N—=;ZS ® Lk*D SUr%r=yORS ® PLANNERS 4{5M4;t 66 PAM StSrs o ANDGV'B� N SSA 3 Oi $_:G • a`ct £k+Z7} 6753 55. 3TS ° m ! Z 1 i. LiEP'�G LiYGii E 3� i t,w�.: � ✓� • � :. I:.l rJ }�jY r�rl�ifisv.��n! 1Dtrf��!'`�'W�,.i EI%aly r1�SGa ��� �i_V9 G�C15T1P.i� \ -�-Sv r �•.E 32 /zl^ ✓V; -I § ASpOSAL SYS TEM coalw IN ! I !� a� oov�� � �6 .� i .�I!:�D'�i aril 20AD AS PF2EPGcRE� � ©ATE: SCALE: } MERRIMACK ENGINEERING SERVICES, INC. ` , RORSStONA! EIG'N—=;ZS ® Lk*D SUr%r=yORS ® PLANNERS 4{5M4;t 66 PAM StSrs o ANDGV'B� N SSA 3 Oi $_:G • a`ct £k+Z7} 6753 55. 3TS ° 2 FINISH OWE TO BE D S <' K SCM, f0 PVC PIPF LOANED h Er'DfD S >< t SC (NIH.) FIMISFI GRADE SHALL BE LOANED t SCEDEO Mry)2X WN. fC, a'�Tjf,B (Mrw(Li 12' NIM, CDVER 2' OF 1/B'-3/8' STORE Z?JO 2' OFF 3/8' t' OK PERF: SM 40 PVC 50.003 fT _ i 7%Jo''iF% - ILS -z 3-1 ` 6rsof CAP P11£ END 1 i/2' SYptE 3, ��) ,.So FIS �p ' �rK) 4,2(x) � p• t5 �FT..E I:: 14 STOR (Tri•) 1 �4'� HWATER �SN)N LEACHING TRENCH =JU✓1 t'tA GLY d Sla�� Ty - END SECTION N.rs. F �pTIG'iAv-lL�I�' 2zi1 •�L% C'>=�•17r.J 11 {.lo=gic ruT-( I oCS co�Pl yep. FCo►1 -A w6ma5 l4 : rL¢c�cas PI'fi, Rot a+- : 2 Bio• 54 G?c 15f) {J4L Liu I Tei l>act`71 1,z,+) -1 1 8f I.F OGr+2 ii 4,)TX-�o.�t e,A; A..,o ¢cP..c.c IaTra 5pw _dFJDfE: TaaE fxVffl )d 5Y5TVH.? 7=516 isGca a4t3�RN•C`�R'�' �.iAL4 PrP NG �iu�u. ac �t'DI•r i}IE D`I.I EFG , To apo 2 pooHs 1 11 T4 E f3i -ri-T 0 h. a .+o r- 'T'1{E p6TSLL.44 -TTS ypptt+-ic_ VY' 17:C1NI-ra-1. t%,j-,fr +6 T&,.11r 5u. O's 1L,r.¢F✓.s•W6 -r,4e 6Y41rCri LJrLL, 8£ 2E-6vAu1ATCV Foe n YjB5161J FLad - r%P6- PLP ��o .t `fse Fo+� Lo.L cCE Awa ;.'3«t5 �.L.0-ns i sfPrcTro DESIGN CALCULATIONS ^WP ¢se6Ac L7 IF we sxv..-Y•A "s B.Pou 51tAu- v,¢ I,+vrru.cp .-r-rHc C DESIGN FLOW BEDROOMS x ' GAL/DAY/BDRN Y+FG'fA+.Yi iUe+•t- FSE xyPLAta 0 Ip ISg�Sc�eT, DESIGN PERC RATE: 3� N1N./IN. (fay -f du6dJ<L 175f-tC :� �J raE jljy JiufYi.L6 ;�lL Gu1Gf 4cC+*'f°H DESIGN FOR LEACHING TRENCHES (SEE DETAIL) r ALA. 6CI�'`r.l&1 I.ITiIIfrES 2[Fpt� C !a+,kV tr,�,lay, uT u'rlYS :R7A'1'J oa .�15 �i EFFECTIVE WIDTH = - EFFECTIVE DEPTH L5r95 A�„s yFy ><.c l�sflu6 R•+✓�'-'N'7 eELaDf --3rr66r- SOIL CLASS: �p0 Atf l�rf.OflriA f. � TRENCH CAPACITY=&,ff`S:F./Fr. 4.--e GAL/S.F. =2•eG GAL./FT. 550 GAL/Z_ AL./FT. =Z�Ff. OF TRENCH REQUIRED USES TRENCHES AT F✓' 0 FT. =;K�FT. OF TRENCH PROVIDED 1 CERTIFY THAT ON MAY 9, 1996, 1 PASSED THE EXAMINATION APPROVED BY THE DEPARTMENT OF ENVIRONNENTAL.PROTECTION_ AND THAT THE ABOVE ANALYSIS WAS PERFORMED BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPER17SE.JAND EXPERIENCE DESCRIBED IN 310 CMR 15.017. SIGNATURE (/ .�C[•+� l .L� DATE - •-L7� 4 pkia 23 OF §UBSURFACE [)ISposAL SYSTEM! aocATED IN 000r-A,�, o� F�2�o tk OF AS PREPARED FORDANIEL °s KORAVOS -rH ; pct CIVIL DATE: JL,IL`{ 272-6V4, mo. 37752 SCALE: AS S�Iow 3� S EPS° MERRIMACK 'ENGINEERING SERVICES, INC. PROFESSIONAL ENGSdEM • LAND SURMORS • PtAWeRS U 66 PARR SSAW 0 ANOOV R, #ASSA` OHUSEO1ti0 0 TEL (617) 473-3-%S- 35721 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover MA 01845 page. City/Town State Zip Code D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells 70" 07/20/12 Date of Inspection Estimated depth to high ground water. feet Please indicate all methods used to determine the high ground water elevation: /1 Obtained from system design plans on record It kdd fd ; I d' 07/18/00 I chec e , ate o esign p an reviewe . Date Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Dug hole with Auger in low drop off area no water at 48". 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 45 Windkist Farm Road Property Address Chris Scarpa Owner Owner's Name information is required for every N. Andover MA 01845 page. City/Town State Zip Code E. Report Completeness Checklist 07/20/12 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 Town of North Andover = Y. 120 Main Street North Andover, MA 01845 (978) 688-9550 SCARPA, CHRIS 45 WINDKIST FARM ROAD NORTH ANDOVER, MA 01845. OFFICE HOURS PAYMENT ON • - BEFORE SERIAL # READINGS USAGE 12/15/2011 $605.73 Monday to Friday DAYS 8:30am to 4:30pm I . Ar✓C�UhTT x :-., BIEUNG LC7:2 I 1090455 11/14/2011 Billing Information: 688-9550 j SERuloE BATE ;'Dt1E DATE (978) 107/22/2011-10124120111 12/15/2011 _ _ 32948540 1,673 Actual 07/22/2011 95 J Reading Information: (978) 688-9570 I r SEFi1lIGE ApRE$Sy rr I _� 45 WINDKIST FARM ROAD RETAIN THIS PORTION FOR YOUR RECORDS MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE SERIAL # READINGS USAGE NB OF Current Type Date DAYS 32948540 i,767 ACtuai 10/24/201+ 114 I I 94 i I $0.00 SERIAL # READINGS USAGE NB OF j Previous Type Date DAYS _ _ 32948540 1,673 Actual 07/22/2011 95 91 1 32948540 1,578 Actual 04/22/2011 17 87 I � :i TRAN$ACTIONS7y1SP'ER1DD�: A�IOUNT� ��v PREVIOUS BALANCE $501.43 ' PAYMENTS THROUGH 11/04/2011 ($501.43) ADJUSTMENTS THROUGH 11/04/2011 $0.00 INTEREST AS OF 12/15/2011 $0.00 BALANCE FORWARD $0.00 CURRENT BILL DETAIL USAGE/UNIT AMOUNT WATER USAGE 114 $596.55 ADMINISTRATIVE FEE $9.18 Sub -Total $605.73 TOTAL .� MESSAGES ----- -------- NOTE PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 1 WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 1 SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 Pay Online at BYPASS METER WATER RATE: ALL UNITS @ $5.55 www•townofnorthandover.com Town of North Andover 120 Main Street North Andover, MA 01845 (978) 688-9550 SCARPA, CHRIS 45 WINDKIST FARM ROAD NORTH ANDOVER, MA 01845 NEW OFFICE HOURS PAYMENT ON OR BEFORE PREVIOUS BALANCE Monday 8:00 - 4:30 06/08/2012 $90.73 Tues 8:00 - 6:00 $0.00 IN i EREZ) i AS Or 06/08120 i 2 Wed 8:00 - 4:30 Thurs 8:00 - 4:30 1.— ACCOUNT:f'_ MLONG.-DATE:` 1 Fri 8:00 -12:00 1090455 05/09/2012 Billing Information: �:�:�!,�. DUE DATE-: (978) 688-9560 01 /23/2012-04!23/2012; 06108/2012 Reading Information: :'.��ERVIC§-AD (978) 688-9570 45 WINDKIST FARM ROAD RETAIN THIS PORTION FOR YOUR RECORDS MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE SERIAL # READINGS USAGE NB OF Current Tvp e Date DAYS i 32948540 1,831 Actual 04123/2012 21 91 TRANSAGTI0N8:`TH15-A AMOUNT PONT: PREVIOUS BALANCE $101.83 PAYMENTS THROUGH 05/02/2012 ($101.83) ADJUSTMENTS THROUGH 05/02/2012 $0.00 IN i EREZ) i AS Or 06/08120 i 2 $0.00 BALANCE FORWARD $0.00 CURRENT BILL DETAIL USAGE/UNIT AMOUNT WATER USAGE 21 $81.55 ADMINISTRATIVE FEE $9.18 alt r7 SERIAL # READINGS USAGE NB OF ^ L Previous Type Date DAYS Sub -Total $90.73 32948540 1,810 Actual 01/23/2012 23 91 32948540 1,787 Actual 10/2412011 114 94 TOTAL MESSAGES - - --------- NOTE* PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184. MEDFORD, MA 02155 WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 Please note our office hours have changed, effective 4130. See above. SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 Pay Online at ,BYPASS METER WATER RATE: ALL UNITS @ $5.55 www.townofnorthandover.com OFFICE HOURS ON OR 13EFORE t,. , Town of North Andover03/14/2012 $101.83 120 Main Street Monday to Friday — i North Andover, MA 01845 8:30am to 4:30pm I _fir ACCOUNT BILLtNGDATE (978) 688-9550- -` - — _ 1090455 --- 02/13/2012 DUE DATE:: _- Billing Information: SERVICE DATES:` SCARPA, CHRIS (978) 688-9550 10/24/2011-01/23/2012: 03/14/2012 45 WINDKIST FARM ROAD Reading Information: _.� SERVICE;ADDRESS i NORTH ANDOVER, MA (978) 688-9570 01845 45 WINDKIST—FARM ROAD TRANSACTIONS,;THIS PERIOD AMOUNT-`` . PREVIOUS BALANCE $605.73 y j PAYMENTS THROUGH 02/06/2012 ($605.73) j ADJUSTMENTS THROUGH 02/06/2012 $0.00 i RETAIN THIS PORTION FOR YnoR RFrnanc INTERFST AS nF m/1a/?n12 $0.00 MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE i BALANCE FORWARD $0.00 -- --- ' SERIAL # READINGS USAGE NS OF, — --- - -- CURRENT BILL DETAIL USAGE/UNIT AMOUNT i-- Current_ Type _Date _DAYS -- –...- ----- — ------ - — ---- 32948540 1,810 Actual 01/23/2012 23 21 i V"JA TER USAGE 23 $92.65 ADMINISTRATIVE FEE $9.18 I I i SERIAL # READINGS USAGE NB OF Previous Type Date_ DAYS_! j -------- ---- Sub -Total 32948540 1,787 Actual 10/24/2011 114 94 $101.83 32948540 1,673 Actual 07/22/2011 95 91 TOTAL i MESSAGES :*NOTE* PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 SEWER RATE: FIRST 20 UNITS @ $5.83OVER 20 UNITS @ $8.22 Pay Online at www.townofnorthandover.com BYPASS METER WATER RATE: ALL UNITS @ $5.55 Town of North Andover 120 Main Street North Andover, MA 01845 (978) 688-9550 SCARPA, CHRIS 45 WINDKIST FARM ROAD NORTH ANDOVER, MA 01845 RETAIN THIS PORTION FOR YOUR RECORDS OFFICE HOURS PAYMENT ON BEFORE PREVIOUS BALANCE -OR 09/14/2011$501.43 Monday to Friday -- .- 8:30arn to 4:30pm A CCbUNT --:, lj_ BILLING DATE 1 INTEREST AS OF 09/14/2011 1090455 08/15/2011— 8/15/2011Billing BillingInformation: SERVICE DATE& - DUE DATE (978) 688-9550 04/22/2011-07/22/20111 09/14/2011 z , - , Reading Information: ..SERVICE ADDRESS (978) 688-9570 45 WINDKIST FARM ROAD MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE SERIAL # READINGS USAGE NB OF Current Type Date DKi'S- 32948540 1,673 Actual 07/22/2011 95 91 i7SERIAL # READINGS USAGE NB OF Previous Type Date DAYS 32948540 1,578 Actual 04/2212011 17 87 32948540 1,561 Actual 01125/2011 18 96 N AC TRA S TIONSjHIS PERIOD. AMOUNT PREVIOUS BALANCE $73.78 PAYMENTS THROUGH 08/15/2011 ($73.78) ADJUSTMENTS THROUGH 08/15/2011 $0.00 INTEREST AS OF 09/14/2011 $0.00 -,BALANCE FORWARD_- $0.00 CURRENT BILL DETAIL USAGE/UNIT AMOUNT WATER USAGE 95 $492.25 ADMINISTRATIVE FEE $9.18 Sub -Total ub $501.43 TOTAL MESSAGES NOTE* PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 WATER RATE: FIRST 20 UNITS@ $3.80 OVER 20 UNITS @ $5.55 SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 ,BYPASS METER WATER RATE: ALL UNITS @ $5.55 Town of North Andover OFFICE HOURS 120 Main Street 06/15/2011 73.7$ North Andover, MA 01845 Monday to Friday (978) 688-9550 8:30am to 4:30pm 4'4 ACCOUNT BILI:ING DATE l 1090455— —j - 05/16/2011 — Billing Information: �„ :SERVICE DATES. DUE DATE J SCARPA, CHRIS (978) 688-9550 01/25/2011-04/22/2011`— 06/15/2011 45 WINDKIST FARM ROAD — — _--- - ----- — ----� NORTH ANDOVER, MA Reading Information: ;' SERVICE ADDRESS. 01845 (978) 688.9570 45 WINDKIST FARM ROAD L TRANSACTIONS THIS PERIOD AMOUNT j PREVIOUS BALANCE — — — —- $77.58 I PAYMENTS THROUGH 05/16/2011 ($77.58) ADJUSTMENTS THROUGH 05/16/2011 $0.00 RETAIN THIS PORTION 1 -OH YOUR RECORDS ; 114 1 tKtS I AS OF 06/15/2011 $0.00 MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE BALANCE FORWARD $0.00. SERIAL #------------- READINGS USAGE Current Type Date — --- --------------- -- -- NB of ! CURRENT BILL DETAIL USAGE/UNIT AMOUNT - 32948540 1,578 Actual 04/22/2011 17 _DAYS 87 j i WATER USAGE 17 $64.60 f i ADMINISTRATIVE FEE $9.18 � i SERIAL # READINGS USAGE NB OF Previous Type _Date DAYS 32948540 1,561 Actual 01/25/2011 18 96 Sub -Total $73.78 32948540 1,543 Actual 10/21/2010 134 91 TOTAL 3 ;J MESSAGES- ------ -----------_------------- -- _ _ ----- ------ - ._. x NOTE*PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 J WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 BYPASS METER WATER RATE: ALL UNITS @ $5.55 i Town of North Andover OFFICE HOURS PAYMENT ON OR BEFORE 120 Main Street 03/14/2011 North Andover, MA 01845 Monday to Friday .$77.58 (978) 688-9550 8:30arn to 4:30pm ACCOUNT SILLNG DATE :. 1090455 02/1112011 Billing Information: ATE SCARPA, CHRIS (978) 688-9550 10/2112010-01/25/2011 03/14/2011 45 WINDKIST FARM ROAD NORTH ANDOVER, MA Reading Information: i E LR; = ADDRESS 01845 (978) 688-9570 45 WINDKIST FARM ROAD TRA NT PREVIOUS BALANCE $717.88 The Town is still experiencing a Water Drought. PAYMENTS THROUGH 02/11/2011 Call the Water Treatment Plant at 978-688-9574 for conservation kits ($717.88) information. i'ADJUSTMENTS THROUGH 02/11/2011 $0.00 RETAIN THIS POOTICA I Fn 0 1/01-hR I NlTP0C:CT A 0 nCA��14 A 1nf%4 A I I - �" I— . .1 . 1 1-1 1- 1 o - —1 1 $0.00 MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE BALANCE FORWARD $0.00 SERIAL # READINGS USAGE Current Type NB OF CURRENT BILL _DETAIL USAGE/UNIT AMOUNT Date DAYS 32948540 1,561 Actual 01/2512011 96 WATER USAGE 18 $68.40 ADMINISTRATIVE FEE $9.18 SERIAL # READINGS USA_GENB OF Previous Type - 32948540 1,543 Actual 10/21/2010 134 91 S u -Total b $77.58 32948540 1,409 Actual 07/22/2010 142 91 :TOTAL y MESSAGES NOTE PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 BYPASS METER WATER RATE: ALL UNITS @ $5.55 Town of North Andover 120 Main Street North Andover, MA 01845 (978)688-9550 SCARPA, CHRIS 45 WINDKIST FARM ROAD NORTH ANDOVER, MA 01845 OFFICE HOURS PAYMENT ON • • BEFORE 12/13/2010 Monday to Friday $717.88 8:30am to 4:30pm ACCOC!!JT BiLL1NG�DA E I 1090455 11/12/2010 Billing Information: VtCEt3ATES DUB DATE ` =:I (978) 688-9550 107/2212010-10121/20101 12/13/2010 Reading Information:SERICEA{JbRESS,,; J (978)688-9570 The Town is experiencing a Water Drought. Watch For information, visit web site, or call the Water Treatment Plant at 978 688-9574. RETAIN T' IIS Pv^RTIvN FOR YOUR, iciwrCu0- MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE SERIAL # READINGS USAGE NB OF Current Type Date _ DAYS 32948540 1,543 Actual 10/21/2010 134 91 i SERIAL # READINGS Previous TypeDate 32948540 1,409 Actual 07/22/2010 i 32948540 1,267 Actual 04/22/2010 MESSAGES USAGE NB OF _ DAYS 142 91 20 91 45 WINDKIS I FARM ROAD � Tf2ANSAG'f'IONS i'IiIS-PERIOD AiU1�3UNT , PREVIOUS BALANCE $762.28 PAYMENTS THROUGH 11/12/2010 ($762.28) ADJUSTMENTS THROUGH 11/12/2010 $0.00 IAITCnrnr n ��r IL-,.;, r,,3 OF i 2i i 3i20'I u $0.00 BALANCE FORWARD $0.00 CURRENT BILL DETAIL USAGE/UNIT AMOUNT WATER USAGE 134 $708.70 ADMINISTRATIVE FEE $9.18 Gv Sub -Total $717.88 `'foTAL till NOTE PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 jBYPASS METER WATER RATE ALL UMTS @ $5.55 Town of'Noi th Andover OFFICE HOURSPAYMENT 120 Main Street 09/15/2010 , $762,28 North Andover, MA 01845 Monday to Friday ----. I —_ (978) 688-9550 8:30am to 4:30pm ACCOUNT - IL IN 1090455 — 08/16/2010 Billing Information: i r SERVICE DxtTEZ -DUE DATE,:. (978)688-9550 — SCARPA, CHRIS 10_4/_22/2010-07/22/20101 09/15/2010 45 WINDKIST FARM ROAD Reading Information:I NORTH ANDOVER, MA SERV[CE 01845 (978) 688-9570 1---- 45 WINDKIST FARM ROAD TRAN8ACTION51`HIS PEl�IOD AMOUNT ;� PREVIOUS BALANCE - $85.18 i PAYMENTS THROUGH 08/16/2010 ($85.18) ADJUSTMENTS THROUGH 08/16/2010 $0.00 i RETAIN THIS PORT' 17CR}'Cvn y �.J I hJ Vi Uy/ I0/LU IU $0.00 MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE ;BALANCE FORWARD $0.00_; SERIAL # READINGS USAGE NS OF CURRENT BILL DETAIL USAGE/UNIT_ AMOUNT _, Current Type_ Date DAYS — 32948540 1,409 Actual 07/22/2010 142 91 I WATER USAGE 142 Q —' ,,753.10 i ADMINISTRATIVE FEE $9.18 i I I 1 I SERIAL # READINGS USAGE NB OF Previous Type — — Date _ _ DAYS_ j 32948540 1,267 Actual 04/22/2010 20 91 (+ Sub-Total $762,28 1 i 32948540 1,247 Actual 01/21/2010 17 91 A' TOTAL ; MESSAGES - -----_ ---_.� * NOTE PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 i WATER RATE: FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 i SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 ,BYPASS METER WATER RATE: ALL UNITS @ $5.55 i t - ' Town of North Andover =r - 120 Main Street North Andover, MA 01845 (978) 688-9550 SCARPA, CHRIS 45 WINDKIST FARM ROAD NORTH ANDOVER, MA 01845 OFFICE HOURS • . - : .. Monday to Friday 06/11/2010 ----... ___ _ $85.18 8:30am to 4:30pm — - ACCO0. BILLING DATE i ADJUSTMENTS THROUGH 05/12/2010 _ 1090455 ! 05/12/2010 Billing Information: SERVICE DATES DUE DATE;._ -- �— (978) 688-9550i.01121/2 _ _-.�_ 01/21/2010-0�-06/11/2010 Reading Information: � SEfiUICE ADDRESS (978) 688-9570 �_ 45 WINDKIST FARM ROAD RETAIN THIS PORTION FOR YOUR RF_ CnRn.,�- MOVING? PLEASE CALL (978) 688-9570 IN ADVANCE SERIAL # READINGS USAGE NB OF Current Type Date __20___ DAYS 32948540 1,267 Actual 04/22/2010 20 __- _91 ; TRANS 4CTIONS THIS PERIGD AMOUNT ' PREVIOUS- BALANCE $73.78 PAYMENTS THROUGH 05/12/2010($73.78) ADJUSTMENTS THROUGH 05/12/2010 $0.00 INTEREST AS OP OF/11/2n1n $0.00 _BALANCE FORWARD —CURRENT $0.00_, BILL DETAIL— USAGE/UNIT AMOUNT WATER USAGE 20 $76.00 ADMINISTRATIVE FEE i SERIAL # READINGS USAGE NB OF 1 Previous Type Date DAYS 32948540 1;247 Actual 01/21/2010 17 91 (JJ 32948540 1,230 Actual 10/22/2009 105 90 ti J MESSAGES * NOTE O if $9.18 Sub -Total $85.18 TOTAL PAYMENTS SHOULD BE MADE: TOWN HALL @ 120 MAIN STREET OR BY MAIL TO OUR LOCKBOX @ P.O. BOX 184, MEDFORD, MA 02155 WAT ER RATE. FIRST 20 UNITS @ $3.80 OVER 20 UNITS @ $5.55 SEWER RATE: FIRST 20 UNITS @ $5.83 OVER 20 UNITS @ $8.22 .BYPASS METER WATER RATE: ALL UNITS @ $5.55 DE E P Tri VIL±L' -� T -I A« rent' VA -m: 7-18 -Oo st-� P�4wa - 6, P,10 -0-4Q B\/dU4Atr•Oe,: 9 , DU 15� 23 -Viz c14CN 4 W'e I,4' p�e5c) U �-c�llr• � �EGj 'jpmtr-rrle: j 57klo, 1z" -1I" Dravr" Z.7►-1is 41% (01 75� 1-114, pew 26 Ke 1, I.� tiE Pr►G �iYGi'(E Nt R^,l i Lo 10 1 w p i4`q-f' t Ar � OY DAr1 ro AAL2+I.I9;, Z ENA I L) E E! VI -1,s ra 5kT6p 5 -21 -qQ�, �< o / CX�/L N. m OAj r LA -Lill _� \ r` \ TOWN OF NORTH ANDOVER Ap roved Date ov Signature L�3 rA 0- --1 rz,OA D 2EPai� P�,�1/uwAoe OF SLOSUWXE USi'OSAL SYSTEM LOCATED IN fJ o12 1 � QQ Dov 5 e AS PREPARED PE)R DATE: J U L Y 27 20c" -r M : 10� SCALE: 1= 40' FA -j rZoAD -)- r P 0-e-0014' MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS 0 LAND SURVEYORS * PLANNERS 66 PARK STREET • ANDOVER. MASSACHUSETTS 01910 • TEL (617) 475-355.5, 373-S?71 23 h0 -r 101 F Z 4' DIA. SCM. 40 PVC PIPE S = 0.005 (MIN.) M 12" MIN. COVER 1,5s: -J e"ANOF3 4'- J ' ' CAP PIPE END 1 1/2' STONE 50 FT LjuIii I-Ise1z-�( e F TwyE Ty INV & F v-rhJ. , 23 2,02 (exlhr;) • FINISH GRADE TO BE LOAMED & SEEDED MIN. F.G. 2' OF 1/8'-3/8" STONE Fr. = ZSR ?jO s ,3o Pr I�►) 4,2(x) I 5 6AIIGH WATER EL s 2' OF d' - 318- S /d'STONE(TYP.) T� 5 �I-12. STONE (TYP.) FINISH GRADE SHALL BE LOAMED k SEEDED LEACHING TRENCH SEND SECTION N.T.S. :Z3v.g 3 I 1 "�X r1G TA-WV-Iti' Z-iI •�l'. (Ex.l--�-T--� 4x TIG -rA-*T. 231,50 (>y1CIhT%) 4.1o'?;✓S 1,) POP? GRTY u ►.IES PI L'eD 17 IyT . BCC a 2-M- 7 4 (enc I hr') fGICm Q 6 PL.^►, 4 i ICux vs L Ae44 -rz e �Lyr. (pct-� -i"'rLZ Z 3_0. ASO (-i�osen ''5) 3.) A'u_ F� w .v�l.�.+. PTE � �k G..a�++Gri.a►GE s}� LGMA/E A�•1. 'rOp 4v� Sv04o1 L, Q.o�T•i � • `7 Awo rlcp"C'6 1,4eri A'Tv-Atl w PILAW WmHdw .VQOTE; 114E Exkir106 `5Y5TEH ! DE�IAK3 I5 Focz A�gplzrt.(4q +�'�, �i,)ALL. PlPlwG S�..u., -ro g oi4 o e rc Pr , -1'o Avo z p?c-,oNtS 14 T 4e r>va , jWCXeA-,-0-J6 'r f' VW, LLI"4 TV O�bPW-He-. BY OEFiNI't'IGr-1- �,.iTi�e E�c1�f��,6 '1-eaw 5u..u. tis Tr4e 17YyrE►-I IJILL BE RE'Ev-LLLATEp Foe A/7j1,60 rLaA Pr-55P6r7 i l `17.►ao .l G''LD FOIL Lakk- :l<- DESIGN CALCULATIONS ANO Itc 0 . I p ,JrrcKs,•mLY, A 4Af g.&ffL-o y14A6-1- ft IP4W*r"1;15T •TN* L_ �'�I�� DESIGN FLOW = BEDROOMS x GAL./DAY/BDRM = J e��• 'r" "ro+*, 5 4 ft OCIPLACZ0 1p r4�5tk� DESIGN PERC RATE: MIN./IN. (Fad deJ6 40 A L. VE5 44#4) R G Rs !�►,.0v%j l.cr:�►•� o N DESIGN FOR LEACHING TRENCHES (SEE DETAIL)i i -6j- 6LIyf' "(a 6)1-1 LI fl t5 f[FpCr ������ EFFECTIVE WIDTH = 36" - EFFECTIVE DEPTH = s ' ��11�5'• u�'"1 '�'+�O''I" a1J -fu t5 1 Ocu.f 1'r�or-I Ti ISTI uE>t Pw•t+'� �rt.1rJ a PGaKPs SOIL CLASS: ff RC6 �'�rIGOV I r•W7'is; , //-- ,,�� TRENCH CAPACITY = rS.F./FT. xQI& GAL./S.F. = Z-4 GAL./FT. 5'OGAL./Z•�GAL./FT. =q:4- %FT. OF TRENCH REQUIRED USE 5 TRENCHES AT 5C FT.=aSDFT. OF TRENCH PROVIDED I CERTIFY THAT ON MAY 9, 1996, 1 PASSED THE EXAMINATION APPROVED BY THE DEPARTMENT OF ENVIRONMENTAL PROTECTION AND THAT THE ABOVE ANALYSIS WAS PERFORMED BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE,,AND EXPERIENCE DESCRIBED IN 310 CMR 15.017. SIGNATURE DATE 7-27-&dR 4 PAIa R"*j OF SLWUWACE DISPMAL SYSTEM LCC n- D IN 0ooi,14 ANI�ov�:12 , ISIAx. /�-5 kl � � o�� F�►Zr-i ��D AS PREPARED FOR -J E p 0 I Ft✓ p-� 6442 1'�P DATE: 2-7, Z000 SCALE: AS `24ow J �e,- A r- P� 1+] MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURMORS • PLANNERS " PARK STREET • ANDOVER. AAASSACHUSETTS 01810 0 TEL (617) 475-3535. 373-Snl 23 .tNOFMan_ DANIEL KORAVOS CIVIL No. 37752 5 N T. Z OF 2 + 1+] MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURMORS • PLANNERS " PARK STREET • ANDOVER. AAASSACHUSETTS 01810 0 TEL (617) 475-3535. 373-Snl 23 .tNOFMan_ DANIEL KORAVOS CIVIL No. 37752 5 N T. Z OF 2 I'll AS -BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS La4--? Zvf"JkSI ELEVATIONS OF DISPOSAL SYSTEM t/ TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES W/IN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D -BOX +� STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. v NORTH ARROW FINAL CONTOURS LOCATION & ELEVATION OF BENCHMARK USED LOCUSPLAN AUG 3 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (V/ consmxted; { ) repaired; by -PAg6 >✓JA�-f J0 T I Ma 1.4 PRO. IPA was Wsta W in conformance with the North Andover Board of Health approved plan„ System Design Permit # , dated ,with an.approved design flow of .gaUous per day. Ilse materials used were in conformance with those specified on the approved plan; the system was. installed in accordance with the provisions of 310 CMR 13.000, Title 5 and local regulations, and the final grading agrees substaratrially with the approved pian, All work is accurately represented on the As -built which has been submitted to the Board of Health. _j I TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 11/28/00 This is to certify that the individual subsurface disposal system constructed ( ) or repaired (X ) by John Soucy at 45 Windkist Farm Road 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 be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION Th7ep( signed hereby certify that the Sewage Disposal System ( ) constructed; ( airei by J,-44 0 2c u cq located at +7 LX21f-yw�'r FAW2 _, k&'*W was installed in conformance with the North Andover Board of Health approved plan, System.Design Permit # dated with an approved design flow orfEgallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bed inspection date: Final inspection date: 1 0-2G,- t2 Installer Design Engineer Representative n Leer Representative Date: I I — j -e -6A0 Date: 11.4,600 �s t2o► r to►,},,L 1 b0 C pp wE"rL AAgVep '`o AK) >%s igri r,)C 5Y 5-r -'1 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at U(1410k''s f relative to the application of S'e- /* S s'x� , dated 10-1-7-00 for plans by ,,weP,46and dated -2 - ,? -7 —1c'O with revisions dated I understand and agree to the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable . 2. 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 my company. a) Bottom of Bed — generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final Inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to BOH, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersim6d/Licensed Septic Installer Date: to " 1-7 -60 f7 W C c Z � Z S O +O E d 0 LL J LLJ n — _ i16 �O N w O LL Z U � Q 3 o C O Z O L `A a Ln U Q w L a L LV L_ fN Q L Q Q i LL O Q b0 O _' Q U s N Y L a� o Q o ce 0 Zm 3 ' v o c 0 3 N o o 0 a Q s a b p rz a`o E a� lz N L (n U_ v1 .2 C: I..,r�'n C b O M 1,;I ,° Ubo e N J .E 'o �Mp.L 10 Q to CL N LL BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 i50) 7 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: d --1 —1 — 00 CURRENT INSTALLER'S LICENSE# LOCATION: LICENSED INSTA R: d �i�n etc SIGNATURE: TELE HONE# t/ `70-1 L/C)o CHECK ON REPAIR: I / NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As -Built? Yes No Floor Plans? Yes No ,I Approval Date: 17 NORTI♦ Town Of North Andover Community Development & Services 27 Charles Street •-==�--�� North Andover, Massachusetts 01845 Fax 978-688-9542 Board of August 21, 2000 Appeals (978) 688-9541 Bill Dufresne Building Merrimack Engineering Department 66 Park Street (978) 688-9545 Andover, MA 01810 Conservation Department Re: 45 Windkist Road (978) 688-9530 Health Dear Bill: Department (978) 688-9540 This is to inform you that the revised septic system plans dated 08/8/00 for the site referenced above has been approved for expansion. Public Health Nurse Ifan ou have questions, lease do not hesitate to call the Board of Health (978) 688-9543 y y 9 p Office at 978-688-9540. Planning Sincerely, Department (978) 688-9535 A Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: Scarpa File William J. Scott Director (978) 688-9531 Aug -07-00 08:09 North Andover Com. Dev. Aug-03-uu u3:4Ur vaui u. Furoiae, rt/ray PORT RGINERING, Civil Er, jonrer, & Land Survr) urs One Harris Slrrr.1 New•Lurypurl, MA 01950 (978) 465.8194 August 3, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 508 688 9542 P.01 716-YDO-'VJ1J r VL RE: Title V review for Lot 3 Windkist Farm Road Dear Sandra, Enclosed find the "Checklist for North Andover Septic System Plans" for the above. mentioned site. The following is a list of all the `Problem' areas and deficiencies Port En ineering has found. '�r t is my professional opinion that this plan is not a repair plan/upgrade, but is in fact new construction because an extra bedroom is being added. Therefore a new reserve area must be designed to complement the new fifth trench. it is also my professional opinion that existing and proposed contours should be shown. It appears that thv final grading over the new trench will be one foot higher than the existing gritdt. It is not dear if the final grading required by the regulations will encroach on the existing paved driveway, nor is it clear how much fill will be required to the east of the proposed trench. If you have any questions or comments please fed flee to contact me. Sincerely Carlton A. Brown, PElPLS/ Windkist1doc � Post -It'" brand fax transmittal m �• emo , 67f Mor Papas , / c,. M 9 i ,9A 911 ,9,11 9A JP NmO ,0.L A ,0 6 ADW^0 ,O L x ,0.6 4 DW^0 ,0.4 9. 0,6 n )<tc .9.1 K E €" i b 9, ,YF .h .. .9,f As i Pns 10 ' pf --------- L �` x 1 e1 to h} -d b k -I I .0F As A.Y A,Y x ALL At x .0.L .s,5 x .= SS x AZ .0,9 , F ,Y,Y .O,Y 9,o1 ,9,f A AM Ar ox o• • A - J /rte V to I nb'•LI n059L � ,ZAOI-a .,z/lor,9 o-,91 „o-•6 „0-,c i 1 T bL N „O •W itFV. R � � ! a T I ZO III �p � I X11 Ti OL, II � �1061'tiMORfi�i►— �� '' ! I'MU b 1 m I i dAoF.9 Z/1O i, fl — — — — — — — — — — — — — � h •4 Ndit Y r `o, a Z6- z 4 r----------� I t N I 1 _ I r I � I ► I I 1---------_--1 i dDAG �._.. _ _ _ } ,w ,,�. i6Ak 'I ,�-� I � ,aJz rY VLTY V l� t dg d w z September 24, 1998 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE This is to certify that the individual subsurface disposal system constructed (x ) or repaired ( ) by North Andover Licensed Installer Dave Maynard at Lot #3 (Street #45) Windkist Farm Road, North Andover, MA 01845 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 as described in the Design Approval Site System Permit Number 1025 dated June 2, 1998. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. CA Board of Health Inspector i w 0- z Z O U D H N Z O U N Y ce O 3 J Q N O C.. N W 0 **. I o.Jfa O .0 O V a L NM a1 #y• Q N t C O a L O ut 1ywJ N Q ¢ LU � = O LL. Z o O o U Q 3 c - m o c � o Z Z ¢ o! L rd rd � U Q � a Lo a Q c U L � c 0 c U 0 o c 3 0 L b ro � N N LA \n Q. O � L 3 � CL N a� APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: �,' - a,9 -jam CURRENT INSTALLER'S LICENSE# r/ f LOCATION: �� �' CJ Y✓a �cs�S7i3� LICENSED INSTALLER: SIGNATURE: CHECK ONE: REPAIR: TELEPHONE# NEW CONSTRUCTION: __Z IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. $75.00 Fee Attached? Foundation As -Built? Administrative Use Only Yes No Yes Z/ No Floor Plans? Yes No Approval Date: l vi £O'd £I£O-S9tb-8L6 Std/3d `ap�q.Anl 'O LnRd V9b=0i 00-VZ-Lnc BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: 15`31 o LOCATION OF SOIL TESTS: 45 6UbV,*4197— �&44 Assessor's map & parcel number._ 7wi /o9 OWNER: _ S 0d"//' TEL. NO.: ADDRESS:_ 7— _f ENGINEER:je—'TEL. NO.: �/-75— SS CERTIFIED SOIL EVALUATOR: _ RIC,& Inte e o land: residential subdivision, single family home, commercial R air testin kex) Undeveloped lot testing N. A. Conservation Commission Approval: 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 J2Z5.00 per lot forenv construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $75.00 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. FOF_N1 11 - SOIL EN' a .;: yTOR FORM Page 2 of 3 Location Address or Lot Ivo. tN 1 rd k� St o/Vm c On-site Review Deep Hole Number 3�� Date: l f //� Iq l: Time: Weather Location (identify on site pian) Land Use ._ fcJ 00 Slope (%13 —�' Surface Stones Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE _OG Depth from Soil Horizon Soil Texture Soil Color Soil Surface (Inches) ( (USDA) (Munsell) Mottling S- 12 a �v F sL .2,.51 #5- ,jr 41,j `. i0 �iQ578 G Other (Structure, Stones, Boulaers, Consistency, % Gravel., e -f F-r/6ca::�, .. .AkSS,'0( r i" I—' - Veens � F. Lt V61 tel _. MINIMUM OF 2 HOLES RE_UUIHtur I tvrr%1 rnw'v.,�+ --••- - - Parent 'Material (geologic) -7- / L"�_ DepthtoBedrock: Depth Groundwater: Standing Water in the Hole: �- Weeping from Pit Face: Estimatea Seasonal High Ground Water: eaDEP APPROVED FOR.At - 12107195 iC8 .............................. No................ _....... THE Cot.1MOMWEALTFI of MASSACHUSETTS BOARD OF HEALTH ALTH ....TQUtJ N. _. .OF.. .....!V.Q.,.�L[... ... A11}i[1ruthltt flit Uhiilowd W>< rlin C�I1tl�itl•ttrti><�tt �r�x ittit Application is hereby ntacle for a I'ertnit to Construct) or Repair ( ) an Individual Sewage Disposal System at: vVll Kl. r— --•• - W../ �M....-•�o......•..............I....---..........-- ................................................... .... of i/t n tl n 1 Co-oNrc.... v���,."._:._x`!...�'°,/°--- 'o Tv2tip�f.....5�i--...c...o--�oou n,t,t, era o„ „qf .................. ..... ................................li,„tape.r �/ TYPof J3uilling . ....Sq. feet /� Galba e Grinder ( ) Dwelling — No. of fiedt'"tns---------------1........ t1?xf,ansinn Attic ( ) g `-i other—Type of {;Wilding ............................ No. of Pci sons............................ 5howets ( ) Cafeteria ( ) oa R+ Other ftxtllrc. ...:............. .................................................... .. -,1..1./.............. Design 1'low..............................gallons per Person Per yl/�y. 'i'�,I�l c�niJyi/flc,w._.-.... - 7`T".. g ll�ns.// ��' , t g t'� ..... ��Tidl t..o........L....... 1)i:unctcr....— -.... ScPtic 1 ank - 57 Ltcluul caac ty..... b; Iluns� Lcn lh_.....-... 1-7!q—sq. ft. • ��� 1'otallcachln 1rc•t %�.7 W, Disposal Trench --- No. ..., .. ............. ��1idth..................- Total Length........-- .--. g ` Seepage Pit No ........ ............ Diameter....-----...... llepih below inlet.--------........... Total leachutg area. ................. sq. ft. Other Distribution box ( ) Dosing t nk z ( ) / Percolation Test Results Performed hy... 11 minutes x r inch Dc rtlt of Test Pit ........ �Q�j... Depth to ground water.. :.........:..... Test Pit No31 ----..✓ -- per ! r -'i nrinlites ,er inch, Depth of Test, Pit......�0 0..-.. ltepth to ground \vater........... ?-O..-..... "fest Pit No��.”.-�-� ! •....................................................•---........................................ ...... -................................. O Description of Soil.......... S.lei/1-L�......(�.O..a/7n......................................................................... :. U I ........... V Mature of Repairs or Alterations -- Answer when npPlicable....................................... ................. ........................................ ............................................•-- ----..................................-•-- Agreement The undersigned aF;rees M instal) the aForedescrihed litdividua) Sewage 1)isPosal S}•steal in a accordnce with it the provisions of T ITLV, 5 of the State Sanitary Code -- The undersigned fill titer agl ces not to Place the system in operation until a Certificate of Compliance has been issued by the hoard of health. Signrxl.......................-....----................ l/alr ........................................ Application Approved 13 ............... ................................... trace Application Disapproved Jor ilrr follo-wing renmls:...........................••-•-••--•--•--•--- ......•••-•--- -----------------------------•-----•-•--....................... nate Issited ------------------- THE COMMONWEALTH OF MASSACHUSEVTS BOARD OF HEALTH ........................................................ (g>erfif ira;ctle lit C�nttttlliftttrp T111.5 IS TO CFRTIFI•, That file individcral Scwage UisPosal Systrtii constructed ( ) or Repaired ( ) fly..................... ................................................................................... lltf f............._....... _.... _..... ............................................ ........................ ... has been installed in accordance Willi the 111-mrinns of TITLE 5 of The State Sanitary Code as described in the > dated.. __ .. ......... ...................... application for Dispnsal Work Conslrnction f crnut No ................................. -- . TIIE ISSUANCE OF TiIIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE TtIAT VIE SYSTEM WILL FUNCTION SATISFACTORY. . lois ector--------------•- FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *************/***Applicant fills out this section***************** APPLICANT: z2fC ZZ'G Phone b/ AZ -LOCATION: Assessor's Map Number Parcel Subdivision /�i/L��K is�2/.� Lot (s) Street St. Number ¢5 Use Only************************ RECOMMENDATIO OFWN ENTS: -'' Date APP �AY7roved Conservation Administrator Date Rejected Comments Town Planner Comments Food Inspect r -Health S `ic Ifisect�or--ffealth Comments Date Approved Date. Rejected Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections �JU ���-)/9 - driveway permit ��,:�%7 G ,� Q ivthc� Fire department . ) /, Received by Building Inppector Date fNSPECTION CHECKLIST FOR SEPTIC SYSTEMS A. Bottom of Bed 1. Excavation to proper depth 2. With trenches, sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation, etc. Comments: B. Retaining Wall 1. Wall height and width as sp cifie 2. Waterproofed 3. Wall minimum 10' to leaching fa 4. Wall meets specifications of plan Comments: i C. Building Sewer 4 1. Pipe diameter minimum 4" 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to tank cemented, 5. Slope minimum 0.01 or 1/8" per foot minimum 6. Pipe properly set on compact fir n base 7. Pipe laid on continuous grade in s�aight line 8. Cleanouts precede all change in align ent and grade 9. Manholes at any 90° change 10. 10' minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas baffle present on ou%ea 4. Manhole to grade 5. Manholes over center an4 tee 6. 3-20" manholes 7. Inlet tee minimum 12" under mve�t 8. Outlet tee minimum 14" under invert 9. Outlet line cemented 10. Air space 3" above tees 11. 2" - 3" drop from inlet to outlet 12. Pipe set 13. Compact base with 6" of 1/4" crushed stone under tank 14. Tank is watertight Comments: "IYes 415' s�-- z e'"S�'� 7 NO Initials .SVs-Iozdf i 1"77- Yes NO E. Pump Chamber 1. If separate from tank, compact base with 6" of 114" stone underneath 2. Minimum 2" pipe to d -box if gravity system 3. 20" access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade � 8. Check valve and bleeder hole p sent 9. Alarm in building on separate circus t 10. Alarm functions It. Manual operating switch 12. Pump delivers liquid to d -box Comments: F. Distribution Box 1. D -box level 2. Minimum 0. IT' (2") drop from inlet to outlet 3. Minimum 6" sump -yam 4. Outlet pipes show equal distribution 5. Compact base with 6" of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double -washed -'/4" - 1 ''/z" - pea stone Bucket test done? 2. Minimum 2", of pea stone above distribution lines 3. Minimum 6" stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9" of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not, then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan - Minimum 2'; maximum - 4'. 4. Vent present if <50 feet or specified 5. Distance between trenches minimum 4' and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6" per 100' 8. Depth of trenches below outlet invert minimum of 6". v Yes NO 9. Pipes set on stable base. Comments: 1. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6" per 100' 3. Separation between pipe 6' maximum 4. Pipes connected at end 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: I Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12" and 48" wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9" soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond pORTN O � F w A S�CHUS t� Town of North Andover, Massachusetts BOARD OF HEALTH DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Form No. 2 Applicant 13111 00,t-frif / fll- DVVI Test No. Site Location Z 1-1-3- 14 /- 1I 1() OST- 1;t m W& Reference Plans and Specs. CA7sh4"yJ� 901le-f41114k IS('1/. Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. --4 /-- a/-, I —�' � HAIRMAN, BOARD OF HEALTH Fee 25 Site System Permit No. /1)Z5' e MORTq o � Is F w P ,SSACHUSEt Town of North Andover, Massachusetts RnARD nF HFAI TH Form No. 2 DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant �}- Test No. Site Location— 3 w Reference Plans and Specs. U_' q— Permission is granted for an individual soil absorption sewage dispo tem to be installed in accordance with regulations of Board of Health. CHAIRMAN, BOARD OF HEALTH Fee U% Site System Permit No A' --y c E - o+ 2 Nr O Q H om cm -0ti =cmc o m Z Nmac 3 y d to H C CL 0 m �gm COD m y -0 G ,m•► COD C") -% o !IC2 m 'CD O �y -: 0.0 CO) A r m a m o m 06 n m ` a C/) m m CA v� c (/) m O c am y n y C O CK cr 02 z O Q CD m V/ d44 U2 CD m CL -� y ...« 0 1 ycr / m \Y 1 w� —= m co CD O CD 0 0 CD co) o mo 0 y m O '-� m Cco CA L 7D om: CD yp CO) %� co '••F : i Cr _ C O L/ p h o y, CD 0 � �V'/ yr ,�h.. f9 �1 /r W G x ':l IV W f➢ G x iJ b r �l O •1 w G T G7 VJ it b 0 n a o 0to C/) x d rr j 0 Iz 0 r.L 0 c cool G 4