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Miscellaneous - 47 EVERGREEN DRIVE 4/30/2018
r 47 EVERGREEN DRIVE I "- - ---- — �_ 210/107.C-0061-0000.0 l—�� e✓ e _. t �- f J I ,' i J i I f r 1 a r I .. Driving Directions from 400 Osgood St,North Andover, MA to 47 Evergreen Dr,North ... Page 1 of 3 Start: 400 Osgood St DW Gag North Andover, MA 01845-2909, us 1` } End: 47 Evergreen Dr North Andover, MA 01845-6001, us BEST PRICES.BEST PLACES.GUARANTEEM&O Directions Distance 1: Start out going SOUTHWEST on OSGOOD ST toward 0.3 miles MILL POND. 2: Turn RIGHT onto BEACON HILL BLVD. 0.1 miles 3: Turn LEFT onto MA-133 / CHICKERING RD / MA-125. 1.2 miles Continue to follow MA-133 / MA-125. 4: Turn LEFT onto MA-114 / MA-125 / TURNPIKE ST / 1.5 miles SALEM TURNPIKE. Continue to follow MA-114 / TURNPIKE ST / SALEM TURNPIKE. 5: Turn SLIGHT RIGHT onto CHESTNUT ST. 0.1 miles 6: CHESTNUT ST becomes EVERGREEN DR. <0.1 miles 7: End at 47 Evergreen Dr North Andover, MA 01845-6001, US Total Est. Time: 9 minutes Total Est. Distance: 3.60 miles http://www.ma,pquest.com/directions/main.aOip?do=prt&mo=ma&2si=navt&1 gi=0&un=m... 7/13/2005 Driving Directions from 400 Osgood St,North Andover, MA to 47 Evergreen Dr,North ... Page 2 of 3 f eLawro1km �ic . s i'I= s1 ox1ora0 j j /�even;cross !}} c 133 oflh An or center„ . ,�' ., f. o ds��Zewre e c 4 ILI `_a -- '� N14VTEQ Start: End: 400 Osgood St 47 Evergreen Dr North Andover, MA 01845-2909, US North Andover, MA 01845-6001, US MAP r'W1APVs- _-- -----� � nti Mill i- —1V 0�300m, 0�90O300ft 900ft Vilalo�v Sty N r , 133 �4 5 IVv 114 Park 5 � (�✓'?s�a --+,--�. le - !►t sir (� o,. Steven;Irtoss10 earn. . '9 wd Fig Stsvcn State`R� S Pond U05►+tapC�aest.com,Inc, ®_0 S:IV70.VTEQ' 2005 hd�pQuest.com,tnc., X2005 N�4VTEQ. Notes: m AVTEO All rights reserved. Use Subject to License/Copyri ht These directions are informational only. No representation is made or warranty given as to their content, road conditions or route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&2si=navt&l gi=0&un=m... 7/13/2005 Residential Property Record Card PARCEL_ID:210/107.C-0061-0000.0 MAP:107.0 BLOCK:0061 LOT:0000.0 PARCEL ADDRESSA7 EVERGREEN DRIVE PARCEL INFORMATION Use-Code: 101 - Sale Price: 247,000 Book: 02575 Road Type: T Inspect Date: 05/24/2004 Tax Class: T Sale Date: 08/20/1987 Page: 0244 Rd Condition: P Meas Date: 05/24/2004 Owner: Tot Fin Area: 1700 Sale Type: P Cert/Doc: Traffic: M Entrance: C SAMPSON,STEPHEN A Tot Land Area: 1.27 Sale Valid: Y Water: Collect Id: RRC MARCIA L M SAMPSON - - Grantor: BAILEY MARJEAN Sewer- Inspect Reas: M Address: 47 EVERGREEN DRIVE Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LOZO Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION_ LAND INFORMATION -- NBHD CODE: 6 NBHD CLASS: 6 ZONE: R2 Style: RR Tot Rooms: 8 Main Fn Area: 1700 Attic: Story Height: 1 Bedrooms: 4 Up Fn Area: Bsmt Area: 1092 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 546 1 P 101 S 43560 1 194,277 Ext Wall: FB Half Baths: Unfin Area: Bsmt Grade: 2 R 101 A 0.27 1,269 Masonry Trim: Ext Bath Fix: Tot Fin Area: 1700 DETACHED STRUCTURE INFORMATION Foundation: CN Bath Qual: T RCNLD: 196495 Kitch Qual: T Eff Yr Built: 1980 Mkt Adj: 1.2 Str Unit Msr-1 Msr-2 E-YR-BIt Grade Cond%Good P/F/E/R Cost Class Heat Type: HW Ext Kitch: Year Built: 1972 Sound Value: PT S 1 1988 A A ///83 0 Fuel Type: O Grade: AG Cost Bldg: 235,800 SE S 80 2000 A A ///98 900 1 Fireplace: 2 Bsmt Gar Cap: Condition: A Att Str Val 1: VALUATION INFORMATION Central AC: N Bsmt Gar SF: Pct Complete: 100 Att Str Va12: Current Total: 432,200 Bldg: 236,700 Land: 195,500 MktLnd: 195,500 Aft Gar SF: 625%Good P/F/E/R: /100/100/87 Prior Total: 386,500 Bldg: 200,200 Land: 186,300 MktLnd: 186,300 Porch Type Porch Area Porch Grade Factor W 225 SKETCH PHOTO dt 9 225 Sq.Ft. 9poll, •, ra 14 FM 1364 Sq.Ft. w a f v 29 15 4 24 FM 14 336 Sq.R. 1429 G 47 EVERGREEN DRIVE -.m- 625 Sq.R. 25 25 25 Parcel ID:210/107.C-0061-0000.0 as of 7/13/05 Page 1 of 1 !- North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/107.C-0061-0000.0 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge �1 47 EVERGREEN DRIVE Location: 47 EVERGREEN DRIVE Owner Name: SAMPSON, STEPHEN A MARCIA L M SAMPSON Owner Address: 47 EVERGREEN DRIVE City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 6 - 6 Land Area: 1.27 acres Use Code: 101 SNGL-FAM-RES Total Finished Area: 1700 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 432,200 386,500 Building Value: 236,700 200,200 Land Value: 195,500 186,300 Market Land Value: 195,500 Chapter Land Value: LATESTSALE Sale Price: 247,000 Sale Date: 08/20/1987 Arms Length Sale Code: Y-YES-VALID Grantor: BAILEY MARJEAN Cert Doc: Book: 02575 Page: 0244 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=468559 7/13/2005 RECEIVED Commonwealth of Massachusetts City/Town of North Andover 11AR G 12013 - System Pumping Record TOWN OF NORTH ANDOVER Form 4 1HEALTH DEPARTMENT 'GSM 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When 0 filling out forms 1. System Location: �7 on the computer, / E �� use only the tab cr) (Irivc key to move your Address cursor-do not North Andover Ma use the return key. City/Town State Zip Code 2. System Owner: reb Name reMn Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date I 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ] No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: e Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: wart's Pre-tre Plant, 20 So. Mill Bradford, Ma 01835 re Date LlSi ature of Receiving aci t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Town of North Andover NORT►, Office of the ]Health Department i+ Community Development and Services Division 400 OSGOOD STREET North Andover,Massachusetts 01845 Too t� Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax CEWTIC. 9TE 0'r C®�1�GL.#ImjVC2 As of: May 9, 2006 This is to cert that the individual su6surface d sposafsystem was ('uffy ..aired by James Keffett . 47 Evergreen Drive Worth Udover, 5W,4 01845 alas been installed in accordance with the provisions of Title v of the State Sanitary Code and with the North Andover hoard of ILeaCtFi regulations. The Issuance of this certifi'cate shaft not 6e construed as a guarantee that the system wilt function satisfactorily. .�' 4TY er, E7fS wy , W /2 Eu6fic Yleafth (Director BOARD OF-APPEALS 688-9541 BLJILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER ' Office of COMMUNITY DEVELOPMENT AND SERVICES �_ •';+� HEALTH DEPARTMENT r 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss;C,,,st� 978.688.9540-Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdept(t�townofnorthandover.com WEBSITE:hn://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM — INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( )constructed; (y)repaired; YV by �o���4 CJ ��C�J�� (Print Name) located at ? '-v e✓i Q (Ins lation Address) was installed i co ormance with the North Andover Board of Health approved plan, originally dated B�iZ � and last Revised on6en ,with a design flow of �® gallons 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: 21 �0 0 L Ei�gine&Representative(Signature) eAx 63, —%j And- rint Name d-010 Final inspection date: 6 G �� Enr Representative(Signature) And-/Print Name Installer: (Signature) Date: -51,91,1,f6 />e/lP7 And-Print Name Engineer: C, v (Signature) Date: <S OL And-PrinAame K `SEC EIV E® MAY �S 2006 R TOW TH DEFARTA m Tc HE t [. R I.�� CI Y El�IY 9 2Q06 TAlri�pF NORT i AiVUOVER HEALTH DEPARTMENT i 1...ETTE,R ()F ,rR:ANSy11TTA1.. North .Andover Health Department ED x ent o* ����1 X9,1, Al 6 100 Osgood Street � yt '6 o L North Andover, .MA 01845 0 „•„: �* 97R.6RR 9540 - Phone 978.688.8476 - Fax healthclept'a;townofnorthandover.com - E-mailSS rf0 ..g"���5 www.townofnorthandover.com - Website Page_of �cNu TO: DATE: A? COMPANY: FROM:Pamela DelleChiaie, Health Department Assistant �a. RE: Phone: J' -T Fax: 16/ We are sending you: L7Copy of Letter 17Plans OOther ill in below) These are transmitted as checked below: �o OAppmved oted v OForReviewandcomnxid r Muhn* capiesfor Requested OFor Your Use dish OAsRequiW y OResubmit copiesfor OForAppmxd nppro►xrl REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: I TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT « « i « 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 wCHUs Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SEPTIC SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION A ADDRESS: � ' IAP: LOT:_ INSTALLER: DESIGNER: 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: SELECT SYSTEM TYPE 1. GRAVITY DISTRIBUTION...❑ 2. PRESSURE DISTRIBUTION...❑ 3. PRESSURE DOSING...❑ 4. HOLDING TANK...❑ 5. ADVANCED TREATMENT...❑ 6. OTHER...❑ PUMP SYSTEM COMPONENT SUMMARY FROM PLAN 1. GALLON TANK = 2. LOADING OF SEPTIC TANK= 3. GALLON PUMP CHAMBER = 4. LOADING OF PUMP CHAMBER = 5. TYPE OF SAS = 6. DIMENSIONS AND DETAILS OF SAS: Comments: Pagel of 4 II i TOWN OF NORTH ANDOVER a NORTH.1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET 't/ �Obr.o NORTH ANDOVER, MASSACHUSETTS 01845 9ss�cHuset Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SITE CONDITIONS 1. Existing septic tank properly abandoned...❑ 2. Internal plumbing all to one building sewer...❑ 3. Topography not appreciably altered...❑ SEPTIC TANK 1. Bottom of tank hole has 6" stone base...❑ 2. Weep hole plugged...❑ 3. Tank has been installed (H-20) Tank Size: 1,500 2-piece ...❑ - H-40 4. Water tightness of tank has been achieved (Visual)... ❑ 5. Inlet tee installed,under access port...❑ 6. Outlet tee (gas baffle or effluent filter) installed,under access port...❑ 7. Cover to within 6" of final grade installed over one access port,must be over outlet of tank if effluent filter is present- Inches of Tank...❑ 8. Hydraulic cement around inlet& outlet...❑ ****Comments: **** PUMP CHAMBER—n/a 1. Bottom of tank hole has 6" stone base...❑ 2. Weep hole plugged...❑ 3. Pump Chamber Installed_Combo tank Gallons; (H-20) (Monolithic) 4. Inlet tee installed,under access port...❑ 5. Pump(s) installed on stable base...❑ 6. Alarm Float Working...❑ 7. Pump On/Off Float Working...❑ / 8. Total # of Floats... r' 9. Drain hole in pressure line...❑ 10. Cover to within 6" of final grade installed over one access port...❑ 11. Water tightness of tank has been achieved—Visual or Vacuum Test or Water held for 24 hours (circle) 12. Hydraulic cement around inlet&outlet...❑ I Comments: Page 2 of 4 r TOWN OF NORTH ANDOVER f NORTH , Office of COMMUNITY DEVELOPMENT AND SERVICES 10- 9 HEALTH DEPARTMENT ► m y 400 OSGOOD STREET , .- -..•,� NORTH ANDOVER. MASSACHUSETTS 01845 9Ss�cHuSe� Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX D-BOX 1. Installed on stable stone base...❑ 2. Inlet tee (if pumped or >0,08'/foot)... ❑ 3. Hydraulic cement around inlet& outlets...❑ 4. Observed even distribution...❑ 5. Speed levelers provided(not required)...❑ - Comments: OIL ABSORPTION SYSTEM 1. Bottom of SAS excavated down to C Soil Layer,as provided on plan... 2. Size of SAS excavated as per plan...❑ 3. Title 5 sand installed,if specified on plan...❑ 4. 3/4-1 1/2" double washed stone installed...❑ 5. 1/8-1/2" (peastone) double washed stone installed 6. Laterals installed and ends connected to header (and vented if impervious material above) 7. Gravel-less disposal systems: type, number and location as per plan.........❑ 8. Elevations of laterals installed as on approved plan...❑ 9. 40 Mil HDPE barriers installed...❑ 10. Retaining wall (boulder / concrete / timber / block) ...❑ 11. Final cover as per plan ...❑ ***"Comments: ***** CONTROL PANEL 1. Alarm&Pump are on separate circuits... 2. Alarm sounds when float is tripped......❑ 3. Location of control panel: 4. Rated for exterior if placed outside...❑ Comments: Page 3 of 4 r f TOWN OF NORTH ANDOVER of NORTH , Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ' 400 OSGOOD STREET 1f G4 � x NORTH ANDOVER, MASSACHUSETTS 01845 �9SS�cHU Susan Y. Sawyer. REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS 1. Benchmark: 2. Rod at Benchmark: 3. Height of Instrument: INVERT ON DESIGN INVERT PLAN ELEVATION I Building Sewer OUT 199.96 199.65 Septic Tank IN 199.75 199.24 Septic Tank OUT 199.50 198.98 i Distribution Box IN 208.95 D-Box OUT Manifold 208.73 Lateral 1 HIGH 208.80 209.16 Lateral 1 Inv 208.71 208.69 Lateral 2 HIGH 207.20 207.54 Lateral 2 Inv 207.11 207.09 Lateral 3 HIGH 205.60 205.99 Lateral 3 Inv 205.51 205.53 Page 4 of 4 i Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Sunday, May 07, 2006 2:26 PM To: Grant, Michele; Lisa Kozel LeVasseur; Marianne Peters; DelleChiaie, Pamela; Sawyer, Susan Subject: 47 Evergreen Construction inspection performed at 47 Evergreen. Two issues need attention: Tank not certain to be watertight. Kellett was to fill above seam and have you or us return to the site. Design plan called for Standard Infiltrator-brand gravel-less chambers while Kellett placed Quick 4 Infiltrator-brand gravel-less chambers in the ground. Both are approved in Massachusetts but have different dimensions and may have different loading rates. You'll see the dimensions are not the same for the finished product which was put in the ground. We assumed New England Engineering was aware of this change since they called your office to say everything was ok for a final inspection. We should, however, get calculations from them to review before this project moves too far along. Dan I C Daniel Ottenheimer,President / Mill River Consulting,Inc. On-Site Wastewater Management Services Q 2 Blackburn Center (� Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 1� fax: 978-282-0012 www.millriverconsulting.com ' dano_�m llriverconsulting.com 50" l c I 5/8/2006 .i 3 f Town of Nogji Andover Health Department Date: r. ,2.PD L Location: L. e v a?!r"�r-•�-� (Indicate Address,if Residential,or Name of Business) Check#• Q S `y Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ `,. ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: w` ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ K k_ ❑ Septic Disposal Works Construction(DWC)$� r ❑ Septic Disposal Works Installers(DWI) $ ' ➢ Sun tanning $ ➢ Swimming Pool $ k ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ' ➢ OTHER(Indicate) f eal'h Agen`Iitials i 5 White-Applicant Yellow=Health Pink-Treasurer Form No.3 Town of North Andover, Massachusetts BOARD OF HEALTH , NORTH m DISPOSAL WORKS CONSTRUCTION PERMIT 7SSACNUSE� Applicant NAME ADDRESS TELEPHONE Site Location r Permission is hereby granted to Construct ( ) or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. i N, BOA OF HE H Fee D.W.C. No. �nNT1y Application for Septic Disposal System -off �f qti TODAY'S DATE p,Construction Permit - TOVN OF T NORTH ANDOVER, MA 01845 $ 250.00—Full Repair JR4"''T° "' iy• $125.00 Component Sr^CNUSE� Important: Application is hereby made for a permit to: When filling out ❑ C nstruct a new on-site sewage disposal system* forms on the computer, use Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component cursor-do not use the return A. Facility Information key. rah Address or Lot# ---- ----- 4?711 4A ewn City/Town -- -- -- 2.- *TYPE OF EPTIC SYSTEM*: ❑ Pump Ydravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ C ventional 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 Name ° Address(if different from above) -- City/Town ------- --- State - ----- Zip Code --- -------- i ?b__ 6 x`.13-- -7 7 - --- Telephone Number 3. Installer Information Name Name of Company Address ? ---- -- City/Tdwn Stag --- �1 `' -- — Zip Code I Telephone Number(Cell Phone#if possible please) a. Designer Information Name Name ofompany Address - ___ .. City/Town State Zip Code - --- ---Telephone Number Best#to Reach) ach Application for Disposal System Construction Permit•Page 1 of 2 i Application for Septic Disposal Sy tem TODAY'S DATE TOW+ ` OF • +• p;,Construction Permit $ 250.00-Full Repair DOER MA 01845 $125.00 -Component . NORTH AN PAGE 2 OF 2 A. Facilit Information continued.... 5. Type of Building: esidential Dwelling or[]Commercial B. Agreement ce of the The undersigned agrees to ensure the construction on-site sewage disposal system in accordancewith the provisions of Title 5 off the afore-described tions for the Town Of Environmental Code, as well as the Local SubsurfDisposal ia Certlfl ate of Compliant has North Andover, and not to place the system moperation been is d by this Board of e Date Na Application A �oved�Byi Boa of Health Representative) Date Nam , Application Disapproved for the following reasons: For Office Use Only: Yes No— t. Fee Attached? No 2. Project Manager Obligation Form Attached? Yes— — No� 3. Pum System? If so,Attach copy offlectrical Permit Yes— No 4. Foundation As-Built?(new construction ronly): Yes— (Same scale as approsed plan) Yes No� S. Floor Plans? (new construction only): — ' Page 2 of 2 Application for Disposal System Construction Permit• INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North +Andover licensed installer for the construction of the septic system for the property at `l `-� ��� . relative to the application of dated for plans by AI C 5 and dated with revisions dated -� I understand the following obligations for management of this project: I. As the installer I am obligated to obtain all 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 manger, 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 Tile 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 Board of Health, 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. 4. As the installer I understand that only I may perform the work(other than simple excavation) required 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 to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. 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 or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. 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. Undersi d Licensed Septic nst r G �--�— Date: (�7 I TOWN OF NORTH ANDOVER e NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREETt, • 4ne✓'�4y NORTH ANDOVER, MASSACHUSETTS 01845 'ssArHUse� 978.688.9540—Phone Susan Y. Sawyer, REHS/RS 978.688.8476—FAX Public Health Director E-MAIL: healthdepttLatownofnorthandover.com WEBSITE:http://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( ) constructed; ( ) repaired; by Jj ids SLG et-7�_ (Print Name) located at L-1 7 6'vc-rL_ !:E-E�'j 4� (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated and last Revised on , with a design flow of gallons 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 rr r y r the Board of Health. Bed inspection date: . Engineer Representative(Signature) And-Print Name Final inspection date: Engineer Representative(Signature) And-Print Name Installer: (Signature) Date: And-Print Name Engineer: (Signature) Date: And-Print Name r `TOWN OF NORTH ANDOVER pORTM Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET •�' NORTH ANDOVER, MASSACHUSETTS 01845 CM�Stt Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 7, 2005 Stephen Sampson 47 Evergreen Drive North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 47 Evergreen,Drive,Map 107C, Lot 61 Dear Mr, Sampson: The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property, submitted on your behalf by New England Engineering Services, Inc. dated July 28, 2005. The design has been approved for use in the construction of an upgrade onsite septic system. Generally, a new plan approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover.. The time period, for which this plan is valid, is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. The 5-bedroom(11-room maximum) design has been approved for use in the construction of a replacement onsite septic system. This approval is subject to the following conditions: I 1) If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2) It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board,Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. The entire parcel is not shown. At issue are both the property bounds and the abutters. This may be submitted as a separate attachment. —220(4)a),NA 8.02a I I i o 0 Additionally, you might wish to consider using an effluent filter in the septic tank. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system, which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincere , 4 Su Y. Sawyer, REHS/RS Public Health Director cc: Benjamin Osgood, P.E. New England Engineering Services, Inc. File AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ✓/I ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCL �t�. _�3JES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK ✓b. FROM LEACH AREA LOCATIONS OF DEEP HOLES &PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION �9OCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM `�- LOCATION OF WATER, GAS, ELECTRIC LINES CABLE ✓y DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK &D-BOX ORIGINAL STAMP& SIGNATURE ✓ IMPERVIOUS AREAS -DRIVEWAYS, ETC. ✓ NORTH ARROW / LOCATION & ELEVATIONS OF BENCHMARK USED I NEW ENGLAND ENGINEERING SERVICES INC September 9, 2005 Susan Sawyer " "`• a North.Andover Board of Health 400 Osgood Street SEP — 9 2005 North Andover, MA 01845 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Re: 47 Evergreen Drive, North Andover, MA Septic System Design Plan Re-Submittal Dear Ms. Sawyer, The followingplans for the above referenced property are being submitted for approval. This is an addendum to plan entitled, "Proposed Subsurface Sewage Disposal System, 47 Evergreen Drive, North Andover, MA, Assessors Map 107C, Lot 61." Dated July 28, 2005, prepared by j New England Engineering Services, Inc. This plan addendum is a result of a phone conversation at 4:00 PM on September 7, 2005 between Susan Sawyer and Thomas Hector. Please contact this office with any questions or concerns. Sincerely, Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 47 EVERGREEN DRIVE N/F BAILEY N/F MENREY ASSESSORS MAP 107C, PARCEL 61 55,200± SQ. FT. N/F HONEYCUTT o A$ 5 �g5 pp N/F DENITTO EXISTING SHED LEACHING 1500 GALLON FACILITY N/F ARMSTRONG SEPTIC TANK .W 0'J O Ek�STj b� N/F HENRY Oka REQ'Irj tss-D DECK t SEP - 9 2005 TOWN Vi` `O HEALTrf 0;_`F-Ar url ry 1"i OF 0 O tCJ v SENJAMIR1 C. o OSGOOD JR. a CML NO.45891 .off ��01 E L=147.13' sso VRVt LOT LOCUS ADDENDUM 47 EVERGREEN DRIVE NORTH ANDOVER, MA ASSESSORS MAP 107C, LOT 61 6.0 0 PREPARED FOR STEPHEN A. SAMPSON „ 47 EVERGREEN DRIVE N01020 10 E NORTH ANDOVER, MA 01845 SCALE: 1" -- 50' SEPTEMBER 8, 2005 N W ENGLAND ENGINEERING SERVICES, INC. THIS LOT LOCUS PLAN IS AN ADDENDUM TO PLAN 60 BEECHWOOD DRIVE ENTITLED, "PROPOSED SUBSURFACE SEWAGE DISPOSAL NORTH ANDOVER, MA 01845 SYSTEM, 47 EVERGREEN DRIVE, NORTH ANDOVER, MA, (978) 686-1768 DRAWN SHEET CHECKED ASSESSORS MAP 107C, LOT 61 ." DATED JULY 28, 2005, BY�FILE T.H. #: 1 of 1 BY: B.C.O. Jr. PREPARED BY NEW ENGLAND ENGINEERING SERVICES, INC. x: DESIGN 1057-LOCUS-9-8-05 BY: B.C.O. Jr. 47 EVERGREEN DRIVE N/F BAILEY N/F MENREY ASSESSORS MAP 107C, PARCEL 61 55,200± SQ. FT. N/F HONEYCUTT o SO 265 p0 N/F DENITTO EXISTING SHED LEACHING 1500 GALLON FACILITY N/F ARMSTRONG SEPTIC TANK ,W CID (Z) �Jti o'ti Fx�ST D� N/F HENRY RECEIVI�..� DECK SEP - 9 2005 g W TOWN OF NORTH A. J HEALTH DEPAh lCJ� OF t� c cv BENJAMIN C. OSGOOD,JR. CIVIL i NO.45891 FFG! E L=147.13' ON IAT LACUS ADDENDUM 47 EVERGREEN DRIVE NORTH ANDOVER, MA ASSESSORS MAP 107C, LOT 61 6.0 0 PREPARED FOR STEPHEN A. SA1(PSON N01020'10"E 47 EVERGREEN DRIVE NORTH ANDOVER, 11A 01845 SCALE: 1" = 50' SEPTEMBER 8, 2005 N W ENGLAND ENGINEERING SERVICES, INC. THIS LOT LOCUS PLAN IS AN ADDENDUM TO PLAN 60 BEECHWOOD DRIVE ENTITLED, "PROPOSED SUBSURFACE SEWAGE DISPOSAL NORTH ANDOVER, MA 01845 SYSTEM, 47 EVERGREEN DRIVE, NORTH ANDOVER, MA, (978) 686-1768 DRAWN SHEETCHECKED ASSESSORS MAP 107C, LOT 61 ." DATED JULY 28, 2005, BY: T.H. #: 1 of 1 BY: B.C.O. Jr. PREPARED BY NEW ENGLAND ENGINEERING SERVICES, INC. FILE /: DESIGN 1057—LOCUS-9-8-05 BY: B.C.O. Jr. 47 EVERGREEN DRIVE N/F BAILEY N/F MENREY ASSESSORS MAP 107C, PARCEL 61 55,200± SQ. FT. N/F HONEYCUTT o, 0 p'3 pg 2 , S 265 p0 N/F DENITTO EXISTING SHED LEACHING 1500 GALLON FACILITY N/F ARMSTRONG SEPTIC TANK ,W CID O O � (*ti 0'ti Fk�ST 0� N/F HENRY �wF<<Nc RECENED DECK - SEP - 9 2005 G� TOWN OF NORTH ANDOVER HEALTH DEPARTMENT cocv ,. co SH OF 00 BENJAMIN C. o OSGOOD,JR. a CIVIL NO.45891 _ .off SFO! E L=147.13' o E U I V vt R _t LOT LOCUS ADDENDUM 47 EVERGREEN DRIVE NORTH ANDOVER, MA ASSESSORS MAP 107C, LOT 61 6.0 0' PREPARED FOR STEPHEN A. SANPSON N 0102 0'10"E 4EVERGREEN NORTH R MA 01H ANDOVE01845 SCALE: 1" = 50' SEPTEMBER 8, 2005 N W ENGLAND ENGINEERING SERVICES, INC. THIS LOT LOCUS PLAN IS AN ADDENDUM TO PLAN 60 BEECHWOOD DRIVE ENTITLED, "PROPOSED SUBSURFACE SEWAGE DISPOSAL NORTH ANDOVER, MA 01845 SYSTEM, 47 EVERGREEN DRIVE, NORTH ANDOVER, MA, (978) 686-1768 ASSESSORS MAP 107C, LOT 61 ." DATED JULY 28, 2005, B y- T.H. SHEET of 1 BYCHECKED B C.O. Jr. PREPARED BY NEW ENGLAND ENGINEERING SERVICES, INC. OESIGN 1057-LOCUS-9-8-05 BY' B.C.O. Jr. A LETTER OF TRANSMITTAL North Andover Health Department o�.po oTH6' s 400 Osgood Street 3't d`.` _ '_ '" ° �oL North Andover, MA 01845 0 978.688.9540 -Phone 978.688.8476 - Fax 04 COC" meaa healthdept(i ,townofnorthandover.com - E-mail �.qs 44reo www.townofnorthandover.com - Website Page of S^CHus TO: DATE: Benjamin C. Osgood, Jr., P.E. 71f I'col-.51— COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant New England Engineering Services, Inc. RE: Phone:978.686.1768 Fax: 978.685.1099 We are sending you: Wlan Review Letter 04PROVED NOTA PROVED OS stem Construction Follow-Up cher y P These are transmitted as checked below: or our File ZAs Required OAs Requested L'For Your Use Y 9 9 REMARKS: 19 all all COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed s- • ACTIVITY REPORT ,z TIME 09/09/2005 15:26 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 NO. DATE TIME FAX N0./NAME DURATION PAGE{S} RESULT COMMENT 09101 15:17 978 458 8994 01:12 02 OK RX ECM 0087 09102 08:11 816038930733 19 01 OK TX ECM #088 09102 11:21 812032848514 40 02 OK TX ECM #089 09102 12:38 817818903223 25 02 OK TX ECM #090 09/06, 12:27 819782820012 36 02 OK TX ECM #091 09107 09:11 819782820012 19 01 OK TX ECM 09107 09:46 39 04 OK RX ECM 09107 10:05 978 557 8633 01:04 03 OK RX ECM 09107 14:15 17756281633 02:28 03 OK RX ECM #092 09107 14:55 819784588994 54 03 OK TX ECM #093 09107 16:23 816175561049 38 04 OK TX ECM 0094 09108 15:52 819783721130 58 02 OK TX 09109 12:47 01:25 00 NG RX #095 09109 14:56 819784091269 02:35 07 OK TX #096 09109 15:21 1 89786851099 05:17 18 OK TX ECM BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION / OUT OF MEMORY CV COVERPAGE POL POLLING RET RETRIEVAL PC PC-FAX I ,1 TOWN OF NORTH ANDOVER NORTH , Office of COMMUNITY DEVELOPMENT AND SERVICES F' •` `'�O�A HEALTH DEPARTMENT 400 OSGOOD STREET �°+ 11 • NORTH ANDOVER,MASSACHUSETTS 01845 "C" Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 7, 2005 Stephen Sampson 47 Evergreen Drive North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 47 Evergreen Drive, Map 107C, Lot 61 Dear Mr. Sampson: The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property, submitted on your behalf by New England Engineering Services, Inc. dated July 28, 2005. The design has been approved for use in the construction of an upgrade onsite septic system. Generally, a new plan approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work,and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period, for which this plan is valid, is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. The 5-bedroom(11-room maximum) design has been approved for use in the construction of a replacement onsite septic system. This approval is subject to the following conditions: 1) If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2) It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board,Building Inspector,Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. The entire parcel is not shown. At issue are both the property bounds and the abutters. This may be submitted as a separate attachment. —220(4)a),NA 8.02a Additionally, you might wish to consider using an effluent filter in the septic tank. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system, which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincere , Su Y. Sawyer, REHS/RS Public Health Director cc: Benjamin Osgood, P.E. New England Engineering Services, Inc. File Town of North Andover Health Department Date: I14f �. Location: (Indicate Address,if Residential,orjVame of Business) Check#: - Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ } ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: 0 Septic-Soil Testing $ tic-Design Approval $ w; ❑ Septic Disposal Works Construction(DWC)$ 0 Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Trash/Solid Waste Hauler $ r ➢ Well Construction $ ➢ OTHER:(Indicate) ., �. f ♦ ' Health Agent Initials 9,30 White-Applicant Yellow-Health Pink-:Treasurer it e - s NEW ENGLAND ENGINEERING SERVICES INC July 28, 2005 Susan Sawyer VED North Andover Board of Health 400 Osgood Street North Andover, MA 01845 JUL 2 8 2005 ANDMI I-H �tTIV1ENT Re: 47 Evergreen Drive, North Andover, MA Septic System Design Plan Submittal Dear Ms. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. 2. (2) Copies of the Form 11 Soil Evaluator Sheets. 3. (2) Copies of the Form 12-Percolation Test Sheets. 4. (1) Copy of the Septic System Submittal Form. 5. Check for the Town approval fees. Please contact this office with any questions or concerns. Sincerely, Thomas Hector Project Engineer i 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 { Town of North."Andover . HEALTH-DEPARTMENT 27 Charles Street North Andover,MA 01845 978.688.9540 healthdepWownofnorthandover..corn SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION:_ Z v I y oZ 8, a 0 0,5- SITE SSITE LOCATION: 7 E_Varjreev\ 1Dr�ye ENGINEER: Me W Enqj,J Eh triee1, er %11c.as _TAC ft NEW PLANS: YES $225.00/plan X .00 Cek#: 8�O a (Includes I# '' and one Re-Review Only) REVISED PLANS: YES $75.00/Plan Check#: i Q SITE EVALUATION FORMS INCLUDED: 6a) NO LOCAL UPGRADE FORM INCLUDED: YES NO- /V Telephone#: ��7$� 8(.- P(8 F mail• neesegg GZ cd Cory, HOMEOWNERNAME: JeffVe64 Say n.Sa,n OFFICE USE ONLY When the submission is complete Cnclu&ng check): 1. Date stampplans and letter GN. . }a" 2. Complete and attach Receipt O P JUL 2 8 L Oi,S 3. Copy File; Forward to Consultant TOWN OF NOth HEALTH DEPRF�i 4. Enter on Log Sheet and Database i Commonwealth of Massachusetts City/Town of IV,� �oevv- Percolation Test Form 12 'GSM Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. 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 the local Board of Health to determine the form they use. Important: When filling out A. Site Information forms on the computer, use Stephen A. Sampson only the tab key Owner Name to move your 47 Evergreen Drive cursor-do not use the return Street Address or Lot# key. North Andover MA 01845 City/Town State Zip Code Q (978) 683-7911 Contact Person(if different from Owner) Telephone Number B. Test Results 7/13/05 8:30 Date Time Date Time Observation Hole# PT1 Depth of Perc 37/22" Start Pre-Soak 8.38 End Pre-Soak 8:54 Time at 12" 8:54 Time at 9" 8:59 Time at 6" 9.07 Time (9°-6") 8 MIN. Rate (Min./Inch) 3 MIN. PER INCH Test Passed: ® Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Thomas K. Hector Test Performed By: Andrew McBrearty, Mill River Consulting Witnessed By. Comments: t5form12.doc•06/03 Perc Test•Page 1 of 1 1 - . FORM 11.- SOIL EVALUATOR FORM Page I of 3 No. Date: a l oS Commonwealth of Massachusetts Alor+h Ay over , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal .' r Performed By: ?hvo^z... ........C�.ec_�'.0..1.'....................................... Date: 7.13 oSS Witnessed By: A.tic t..w....t' ...3rea►.r4y...,.-A.'1!......R'tvec._...CDVa S.V - !A�t ............: ':........._........ � 1o«tio.Address x +f`� EVe rq re-e^ Dr.�e oww's Ham, Stephen �4'. Sp mfSoA Nor+h ,Loto Aft�v4over, AA y Cver9ri �n eDr� Je • No r-4 Av%c(ode r.AA o1bw ew construction ❑ Repair 0178 to83- 791( Office Review Published Soil Survey Available: No ❑ Yes Year Published q$�....... Publication Scale 11,154Soil Map Unit Pod Drainage Class Ue t.... Soil Limitations SIA ......... ....... ............................................................. _ Surficial Geologic Report Available:No Nr Yes ❑ Year Published w. ....... Publication Scale -Geologic Material (Map Unit) ...................... .._.....Landform. ...................................................................................._- . .......................................:.................... .— Flood Insurance Rate Map: Above 500 year flood boundary No []Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ........................................................... -Wetlands Conservancy Conservancy Program Map (map unit) -Current Water Resource Conditions(USGS): Month -TV6?- 01Z00S Range :Above Normal A ormal Ehelc,i Normal ❑ Other References Reviewed: DEP APPROVED FORT!-12107/95 TORVi 11 SOIL EVALUATOR FORM 1 Page 2 of 3 Location Address or Lot No. ree.t► D'we, ko oVer On-site Review Deep Hole Number ... Date:,, :f� : 7 QS � :.� :. Weather Location (identify on siteplan) ... V Land Use :I-,45,t. .er-k Slope (%} ..,�% Surface :.....::... . ..: Vegetation :.:.:. .OQ.c�.e d:........::.:..w Landform :v: Wr~.5 .::: ct.�:n r ..:...:...,:.N-..-..: ..-::... .:....:.....w:.:.....:. ...:.,.:..:.. ...... ........ ... ... Position on landscape (sketch on the back) Distances from: ; Open y :.:: Od.:... Water Body �.3-�, feet Drainage way. feet .: ., , Possible:Wel(Area:.,.:COQ.: feet Property Line ..��?-�,;...:.: feet -Drinking Water Well ASO feet Other DEEP OBSERVATION HOLE LOG*, G Depth from Soil Horizon Soil Texture Soil Color Soil Dir Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravel) }= - 13 h )OYR31 Q ramSJ$ 3$ 101 L S 2.5y IS°fie Crr'•►ue1 i0% C a66s MUM OF'1 HOLES IR Parent Material(geologic) OQ�e t C �JgcL. DepthtoBedrock: y Depth to Groundwater: -Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: 1611 DEP APPROVED FORM-12/07/95 i FORM 11 =SOIL I,'%' AT*OR FORIlq y Page 2 of 3 Location Address or Lot No. 47 Fyet-A re r�v e /yoA Ahdrwer Ori-site Review beep Hole Number :T?+cZ..... Date:• : 1 es .moo �: Time:.�'.::::::� Weather .Fac.. O° Location (identify on site plan) ....:�J� s : �. Land Use �' p M ,Jr Surface Stones ..���4..:t�K1.V...�..: .�.:.:...::. Sloe :::...... ..,...::.:::...�::. Vegetation l at14Qc Landform vn.cl�.t�.�sh:.:�:�o.�t�::.:._.:.... k ....:.:...,.:.�..,...:.�:,x:.:�..,.:..,._M.�:-..:..:.�.......�._.. :..... ......... .:... .. Position on landscape (sketch on the back) Distances from: Open Water Body z.�:3 �., feet Drainage way_._,qob:,., feet PossibleMet Area 400,., feet Property Line ...30 .:...M feet Drinking Water Well feet :Other DEEP OBSERVATION HOLE LOG* Depth from Soil HorizonSor7 Texttue Soil G+lo< c,,:l Surface(inches) (USDA) IMunseln Mottling (Structure,Stones,Boulders,Consistency, 96 Graven .5.L G ' 33 51.. toYR�-1s 3 -� I!a C Gr, L S. 24 9b R �Jalc i�g 93tl 0% Cobbs A Parent Material(geologic) -FrOaLIA V�L.-)41 DepthtoBedrock: �-- Depth to Groundwater: 'Standing Water in the Hole. Weeping from Pit Face: _ Estimated Seasonal High Ground Water- DEP aterDEP APPROVED FORM-12/07/95 II . FORM 11 - SOIL.LVALUATOR FORM Page 3 of 3 Location Address or Lot No. 47 EyerareQh UI'wo AloC6 A-�riAovef Determination for Seasonal High Water Table Method Used: I Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole .................. inches » 1 n O�Dep.thjo soil mottles 96,}:q inches CRS TPtJ C93 TPa� ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor ................... Adjusted ground water level ........................................................ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? _a/zs If not, what is the depth of naturally occurring pervious material? — ifica Certion t certify that on (date) I have. passed the soil evaluator.examinatio.n 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 J I Date 7 at off' DEP APPROVED FORM-12107195 Tow Nxbrth Andover Hearth lbepartment Date: Location: (Indicate Address,if Residential,or Name of Business) Check#: Type of Permit or License:(Circle) > Animal $ > Dumpster $ > Food Service-Type. > Funeral Directors $ > Massage Establishment $ > Massage Practice $ > Offal(Septic)Hauler $ > Recreational Camp $ > SEPT[CPERA,1ITS: Lsi ,.-S ptic-Soil Testing U Septic-Design Approval Q Septic Disposal Works Construction(DWC)$ Ll Septic Disposal Works Installers(DW[) > Sun tanning > Swimming Pool $ > Tobacco $ > TrashlSolid Waste Hauler > Well Construction $ > OTHER:(Indicate) Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer i 1. 4 1 LETTER OF TRANSMITTAL North Andover Health Department of No oT b 400 Osgood Street North Andover,MA 01845 �o p 978.688.9540 - Phone 10L 978.688.8476 -Fax healthdent(a townofnorthandover.com - E-mail 9SSACHuS�K www.townofnorthandover.com - Website Page / of TO: DATE: Daniel Ottenheimer COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting RE: Phone: 1.800.377.3044 or 978.282.0014E�.'� Fax: 978.282.0012 I I We are sending ou: ' oil Test, OPlans for Review OOther ill in below) These are transmitted as checked below: OFor Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: �. TRANSMISSION VERIFICATION REPORT TIME 06/2212005 10:27 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 06122 10:26 FAX NO./NAME 819782820012 DURATION 00:00:46 PAGE{S} 04 RESULT OK MODE STANDARD ECM i i I BOARD OF HEALTH NORTH ANDOVER,MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 4 MAP&PARCEL: E LOCATION OF SOIL TESTS: Q? Cl/P� Prate • bhl-7 /Aa(,Ooe(.. � f OWNER: Ml �� UP U��t�4dh TEL.NO.: ADDRESS: 9? LUe%✓(ergyrl 4. N6l'7I'/ Akwq k14 ENGINEER: 0S 06 1, P E TEL.NO.: CERTIFIED SOIL EVALUATOR: / Ocr/ • Qr1QIGYW4,S /f Intended use of land: Residential Subdivision VSingle Family Home Commercial'' Is This: Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No r/ THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes.and two percolation tests required for each disposal area. Fee of$360.00 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. Please Do Not Write Below This Line N.A.Conservation Commission Approval:' Date Received: Check Amount: Check Date: u 5 I apo 1 AJ i �- i4-2t C of oarct� y r m - KGs_ _ N r 1 LOTrn L' T -19 � rr� 1 L_ N7.t5 -'� .!15J P�S 6,, EYE EG � _lvc I MORTGAGE INSPECTION PLAN UYER gAMPE��E� M�I�51-IA IOCATEO IN,.; TO THE I jZ[, I ts: � h P AND ITS TITLE INSURERS I HEREBY CERTIFY THAT I HAVE EXAMINED THE PREMISES AND ALL EASEMENTS, MASSACHUSETTS ENCROACHMENTS AND BUILDINGS ARE LOCATED ON TIIE GROUND AS SHOWN. DelleChiaie, Pamela From: DelleChiaie, Pamela Sent:, Wednesday, June 22, 2005 9:07 AM To: 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: Sawyer, Susan Subject: 47 Evergreen Drive-Soil Test / 1312 Salem Street- Perc/Deep Hole / 1365 Salem Street- Perc/Deep Hole Importance: High Hello, Kim from NEES dropped off an application for the above yesterday afternoon which I will be faxing soon. She also had a note about one more deep hole and perc test for 1312 Salem Street and 1365 Salem Street needed for those sites, and can it be scheduled the same day as above? I also have a question as to whether the requests for the additional deep hole/perc test(s)would be considered an additional charge, or if these would be included as part of their initial applications? Please let me know asap. Tx. P &W Ropafd8, Pa�rya�a Dal��eG�lfiai¢ Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com I I 1 NEW ENGLAND ENGINEERING SERVICES,INC. _ - / 7976 - - -----------... .- ------ ------- -------------------- ------- ------ --------- - ---- ----- -- _-------------- -- - - - -------- - ------------------- NEW ---- -=NEW ENGLAND ENGINEERING SERVICES,INC. - . 7976. . p 4-1 tl a s - W a ° d i a � r x d za 1T � � � rt � • b �� _ a ix 3. _ - � - ��� � �� d}$'�. < � Y ` � 4�� *, $ ( xe. ? PRODUCT LT104C i;, USE WITH 9379 ENVELOPE .x MUNRO GRAPHICS (978)682.0699 - 'PRINTED IN U S A.'. t3 ,... A " �'° e n n ©. 4 0376 -. _. Al �. ._> — , .. .. - _ �.. ,<.. ., � .e. as.. .•. n a.}.m y.o._ 1 ..«.`4 ............ RECEIVED ''OWN OF NORTH ANDOVER NOV - � 2004 UA rt //��(� SYS M PUMPIN(} RECpiu., TOWNOFHEALTH DEPARTMEM SYSTEM OWNER & ADDRESS SYSTEM LOCATION DATE OF PUMPINO: _•_•._• -..••. Q_ ...____...-Q!•IA1VTiTY PUMPED: C 0SPOOL: NO YES-.- YES..,. .._.... 500c Tank: NO YES NA PURE ON SERVICE: RUU'flNl OBSERVATIONS: GOOD CONDITION X FULL .lam COVER t, HEAVY GREASE BAFFLES IN PLACE. ROOTS LEACHFit?,L,D RUNBACK EXCESSIVE SOLIDS FLOODED SOLID CARRYOVER. . OTHER EXPLAIN Jystom Pumpcd by C' .-rlQ. �-'UMMENTS. CUN I EN I'S r'KANS}'t✓RRED 1.0 1' �� d OR'lfi�l�A •� � ®� ' • -°'��� � ,i ,� e '„ �' •'t , T•T S m Rec,o• rd prOYldvd Ihli (orrn for �B0 NORTHANGC';`/�°'` pv 1':brrlilod to llta local BCerc: c( moa cn'a, boar Tlsvg Fr�bE�A�T D(cIp C/ C(ftvr�.l nprl(y. - A' Faclllty Inforrrlaftn "', 5/ ocaUOn: ,' -'"•) '•'•4 ��.>.e r ;�^^,611 C i:r 00f1Q1 �''�L( C►n/Torm t � sY;;:•�;,�'2 S spam 1,4v'"4 Of 901f Jn( (QM IQ"U0n) Q"O,.'1 C•.b'.o om] %!� - a Pumping,Regord _ Oa;a of Pim / v ..� Php, 0�!1 �. �':a( .'^r r• . 060 r bEa_.. f TYPO pl eyalom; '- t,(. Dl'C Tens ' ^I Ta n, Fr �a Emuon! Too FIllo �1 (P(p�ont? r' Y no 'ln. 09 If y69, n'69Wi; '6a ave — .:: . : ' •�'� :;� ,. � ion Pf;ey,j;�m;''�:'�, . — '�.�;i',r�.�.�1 J/.1.11',)•,,,�':i:','M. '!•1(/,•' ._ i .� SY Pvmpad •' ,. . 1r'`,,,,+^�ti,.; Sf:k� ��' � .•(;I '�, •�• ( VehlcJe Joon+l n�,.T. -.. ...'�1. :.j ��'� '; Y';{Lv'+ /`' 11 ��{) •1 I r, BVI(�(/ i�r�•��,�.�;'(`,!,� '�/,ly:,'1,1:A 1i',�,al•;'af,JY,V��• ����i�1}V�'•�•'�1��•, on.�ihare co lsn 0 U� .era I w . d ^/ •,..,• � i of h'�vlr(;y�.,,��;,,..,•,..,,1 . n �mass.gov/deF.�waler/eDPrOYa�s/fblorm9.hl'T1ALr19p8C! �Y(1 s FORM U - LOT RELEASE FORM INtTR,UCTIONS: 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT bav ik 0-VI-dC4 n PHONE L 0 I _t ` P -77Y 5— LOCATION: Assessor's Map Number PARCEL_ SUBDIVISION LOT (S) STREET ST. NUMBER USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS 1 TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED / DATE REJECTED COMMENTS i PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE JUN ',. Revised 9197 jm low i t ( �T 5 I �7k V9, ov • 1 �Q9 C f of 1 Ful- 1 N i I< ' m I C_= 147 t3 �D•oo — of �C,c�P..a'J. .l, ve ' I MORTGAGE INSPECTION PLAN UYER JAMP� �rq� e J MACSi44 LOCATED INS,.'' TO THE H /� SO K P AND ITS TITLE INSURERS �-• G�I T I HEREBY CERTIFY THAT I HAVE EXAMINED THE PREMISES AND ALL EASEMENTS, MASSACHUSETTS ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN. TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: : SYSTEM OWNER& ADDRESS SYSTEM LOCATION '���, (example: left front of house) �7 � - � �Ale DATE OF PUMPING: /0-"5"q/ QUANTITY PUMPED /W� I GALLONS CESSPOOL: NO SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: -° -GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE _ ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: n00Vpr-- S'.6�c-, COMMENTS: 1 j CONTENTS TRANSFERRED TO: rn , M� r� M647 AML6ver 2.6. 4.- STF3"T S I» �14i SEPTIC TANK SERVICE n Sf 47 RAILROAD STREET Na A BRADFORD, MA 01835 W-q.0 I Lit- 1 Sl-a p 978-372-7471 �rnS'��ll L4 r- # /.w MONIST OF iber 4 eo MOrTI'HLY REPORT FOR TQgN OF /' z'� . �('y DATE ADDRESS GUWNS CMIM /6 a 763 UJ D n-first: ------------------ s � is a ► 2? Oho 3}-rr, 1SO ° 1 Cher-k.5L ��� 1 Eue Fd t IS_.? 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