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Home My WebLink AboutMiscellaneous - 48 PATTON LANE 4/30/2018 (2) 48 PATTON LANE 210/106 000.0 L North Andover Board of Assessors Public Access y Page 1 of 1 r pORTN Illt�r�h Andover Board of Assessors :OE t�No .e.�ti0 +,r.°...`,fig r 9SSACHUSEt roperty Record Card Parcel ID :210/106.A-0165-0000.0 FY:2011 Community:North Andover t Click on Sketch to Enlarge Click on Photo to Enlarge ra r � r 48 PATTON LANE Location: 48 PATTON LANE Owner Name: CASELDEN,EDWARD C/O RAYMOND SAFI Owner Address: .48 PATTON LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6-6 Land Area: 1.00 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 3124 sqft 1 Total Value: 582,300 605,900 Building Value: 375,400 399,000 Land Value: 206,900 206,900 Market Land Value: 206,900 Chapter Land Value: i i Sale Price: I Sale 09/22/1986 Date: Arms Length Sale F-NO-CONVNIENT Grantor: CASELDEN Code: EDWARD Cert Doc: Book: 02308 Page: 0113 r http://csc-ma.us/PROPAPP/display.do?linkld=1707840&town=NandoverPubAcc 10/26/2011 Residential Property Record Card PARCEL ID:210/106.A-0165-0000.0 MAPA06.A BLOCK:0165 LOT:0000.0 PARCEL ADDRESS:48 PATTON LANE FY:2011 PARCEL INFORMATION Use-Code: -1-0-1 Sale Price: 1 Book: 02308 Road Type: T Inspect Date: 66/12/2008 Tax Class: T Sale Date: 09/22/86 Page: 0113 Rd Condition: P Meas Date: 06/12/2008 Owner: Tot Fin Area: 3124 Sale Type: P Cert/Doc: Traffic: M Entrance: X CASELDEN, EDWARD Tot Land Area: 1.00 Sale Valid: F Water: Collect Id: RRC C/O RAYMOND SAFI -- Address: Grantor: CASELDEN EDWARD Sewer: Inspect Reas: C 48 PATTON LANE NORTH ANDOVER MA 01845 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 7 Main Fn Area: 1850 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R2 Story Height: 2.00 Bedrooms: 4 Up Fn Area: 1274 Bsmt Area: 1850 Seg Type Code Method Sq-Ft Acres Inf1u-Y%N- ' Value Class Roof: H Full Baths: 2 -Add Fn Area: Fn Bsmt Area: 250 1 P 101 S 43560 1.000 206,910 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: DETACHED STRUCTURE INFORMATION Masonry Trim: Ext Bath Fix: 0 Tot Fin Area: 3124 Foundation: CN Bath Qual: T RCNLD: 360313 Str Unit Msr-1 Msr-2 ` E-YR-BIt Grade Cond%Good P/F/E/R Cost Class Kitch Qual: T Eff Yr Built: 1990 Mkt Adj: PG S 512 0.00 2000 A A /50//47 15,100 1 Heat Type: HW Ext_Kitch: Year Built: 1985 Sound Value: VALUATION INFORMATION Fuel Type: - G Grade:- G Cost Bldg: 360,300 Current Total: 582,300 Bldg: 375,400 Land: 206,900 MktLnd: 206,900 Fireplace: 2 Bsmt Gar Cap: Condition: G Aft Str Val 1: Prior Total: 605,900 Bldg: 399,000 Land: 206,900 MktLnd: 206,900 Central AC: Y Bsmt Gar SF: Pct Complete: Aft Str Val2: Aft Gar SF: 506%Good P/F/E/R: /100/100/91 Porch Type Porch Area Porch Grade Factor E 224 W 234 SKETCH PHOTO 14 V E w 16 224 Sq 116 3 234 SgFt 13 44 14 is 24 M M 9 SM6 SgFt - 1274 Sqh 28 24 28 k C 2254 3 is is 22 506 Sqft 22 48 PATTON LANE I Parcel ID:210/106.A-0165-0000.0 as of 10/26/11 Page 1 of 1 North Andover Board of Assessors Public Access Page 1 of 1 Il9�rfh Andover Beard of Assessors MATCHING PARCELS SS"CN° Click on a column title to sort data by that column 6 items found,displaying all items.1 Fiscal Year Parcel ID St.No. Street Owner Name 2011 210/106.A-0132-0000.0 24 PATTON LANE COLLINS,ASHLEY,GRANDMAIN, GINEAU 2011 210/106.A-0089-0000.0 36 PATTON LANE YOKEN,MICHAEL A,HEIDI YOKEN 2011 210/106.A-0165-0000.0 48 PATTON LANE CASELDEN,EDWARD,C/O RAYMOND _ SAFI • 2011 1210/106.A-0166-0000.0 60 [PATTON LANE KENNEDY,JOSEPH M,MONIKA MKENNEDY 2011 210/106.A-0090-0000.0 72 PATTONLANE UTTLEY,mKRISTINE, 2011 (( PATTON LANE PALMER,MARK W,SUSAN M PALMER 210/]06.A-0167-0000.0 80 6 items found,displaying all items.1 http://csc-ma.us/PROPAPP/newSearch.do?town=NandoverPubAcc&from=NewSearch 10/26/2011 RECEIVED �LN Commonwealth of Massachusetts W City/Town of North Andover APR 10 2013 TOWN OF NORTH ANDOVER System Pumping Record HEALTH DEPARTMENT Form 4 M 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 filling out forms 1. System Location: on the computer, p use only the tab d key to move your Address cursor-do not north andover Ma use the return key. City/Town State Zip Code 2. System Owner: bra a Ica Name iertm Address(if different from location) north andover City/Town State Zip Code Telephone Number B. Pumping Record Ah 1. Date of Pumping Date !=f&3 2. Quantity Pumped: Gallons� 3. Type of system: ❑ Cesspool(s) [X 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: x 6. SystemPu ,ped By: Name ' Vehicle License Number Stewart's Septic Service Company 7. Location re contents were disposed: Stewart s P,r)-treatment Plant, 20 So. Mill Bradford, Ma 01835 nature of Hauler Date Signature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane Assessor Map 106A Lot 165f ' - Property Address Edward &Donna Caselden /t 46-'6'r s S Owner Owner's Name information is required for North Andover MA 01845 June 9, 2010 every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Paul LeBlanc cursor-do not Name of Inspector use the return key. Leblanc Surrey Associates, Inc. Company Name 161 Holten Street Company Address Danvers Ma 01923 " Cityr town State Zip Code 978-774-6012 S11967 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority A" 101-14 / June 9, 2010 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 48 PATTON LN NORTH ANDOVER•08106 Title 5 Oficial Inspedion Forth:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward& Donna Caselden Owner Owner's Name information is North Andover MA 01845 June 9, 2010 required for every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: The septic system does not meet any of the failure criteria listed in Title 5 at time of inspection, but the septic system is 25 years old and should be maitained on a yearly schedule. System Conditionally Passes: ❑ e or more system components as described in the"Conditional Pass" section need be rep d or repaired. The system, upon completion of the replacement or repair, a pproved by the Boa of Health, will pass. Answer yes, no o of determined (Y, N, ND) in the ❑ for the following state nts. If"not determined," please lain. ❑ The septic tank is met nd over 20 years old*or the septic to (whether metal or not) is structurally unsound, exhi i substantial infiltration or exfilt Ion or tank failure is imminent. System will pass inspection i existing tank is replac with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection i it* tructurally sound, not leaking and if a Certificate of Compliance indicating that the tank is I an 20 years old is available. ND Explain: Xpasnspection ewage backup or break out or high static water level in th istribution box due tructed pipe(s)or due to a broken, settled or uneven distribute box. System will if(with approval of Board of Health): ipe(s) are replaced ion is removed 48 PATTONLN NORTH ANDOVER•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165 ) Property Address Edward & Donna Caselden Owner Owners Name information is required for North Andover MA 01845 June 9, 2010 every page. Cityrrown State Zip Code Date of Inspection Certification (cont.) B System Conditionally Passes(cont.): distribution box is leveled or replaced ND Expla : ❑ The system requ\tionif than 4 times a year due to bro n or obstructed pipe(s). The system will passapproval of the Board of Healt ❑ broken p❑ obstructi ND Explain: C) Further Evaluation is Required by a Board f Health: ❑ Conditions exist which require fu er evaluation by a Board of Health in order to determine if the system is failing to protect p lic health, safety or a environment. 1. System will pass unles Board of Health determin in accordance with 310 CMR 15.303(1)(b)that the sys m is not functioning in a man er which will protect public health, safety and the enviro ent: ❑ Cesspool privy is within 50 feet of a surface water ❑ Cess of or privy is within 50 feet of a bordering vegetated we nd or a salt marsh 2. Syst will fail unless the Board of Health(and Public Water Supp r, if any) Bete nes that the system is functioning in a manner that protects the blic health, saf and environment: The system has a septic tank and soil absorption system (SAS) and the SA 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 pub' water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private wa r supply well. 48 PATTON LN NORTH ANDOVER•08/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 48 Patton Lane Assessor Map 106A Lot 165 Property Address Edward&Donna Caselden Owner Owner's Name information is required for North Andover MA 01845 June 9, 2010 every page. Cityfrown State Zip Code Date of Inspection Certification (cont.) C) Furthe valuation is Required by the Board of Health (cont.): ❑ The syste as a septic tank and SAS and the SAS is less than 100 feet b 0 feet or more from a p to water supply well". Method used to determine I nce: *"This system passes if the well water analysi erformed at a DEP certified laboratory, for coliform bacteria indicates absent and the presenc amm 'a nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no oth ailure criteria a riggered. 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 %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 48 PATTON LN NORTH ANDOVER•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts UpTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments . 48 Patton Lane(Assessor Map 106A Lot 165 ) Property Address Edward & Donna Caselden Owner owner's Name information is required for North Andover MA 01845 June 9, 2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. arge Systems: To be considered a large system the system must serve a facility with d ' n flow of 10,000 gpd to 15,000 gpd. For large Sys , you must indicate either"yes"or"no"to each of the followi , n addition to the questions in Sectio Yes No ❑ ❑ the system is wit 00 feet of rface drinking water supply ❑ ❑ the system is within ee tributary to a surface drinking water supply ❑ ❑ the system i Gated in a nitrogen se ' 've area(Interim Wellhead Protection Area— A)ora mapped Zone II of a pu ' water supply well If you have answer e es"to any question in Section E the system is co ' red a significant threat, or answered" In Section D above the large system has failed. The owner o erator of any large system c erecta significant threat under Section E or failed under Section D sha rade the syst in accordance with 310 CMR 15.304. The system owner should contact the appro . e conal office of the Department. 48 PATTON LN NORTH ANDOVER•08M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165 ) Property Address Edward&Donna Caselden Owner Owners Name information is required for North Andover MA 01845 June 9, 2010 every page. Cityrrown State Zip Code Date of Inspection C. Checklist 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)] 48 PATTON LN NORTH ANDOVER•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward &Donna Caselden Owner Owner's Name information is n 2 required for North Andover MA 01845 -June 9, 010 every page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd))' 648 GPD see attached sheets Sump pump? ® Yes ❑ No Last date of occupancy: Presently Occupied C mercial/Industrial Flow Conditions: Type of Es ishment: Design flow(based o 0 CMR 15.203): Gallons per day(gp Basis of design flow(seats/perso q.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged a Title 5 system? ❑ Yes ❑ No Water meter readin , I available: Last d occupancy/use: Date Other(describe): 48 PATTON LN NORTH ANDOVER-08106 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward & Donna Caselden Owner Owner's Name information is required for North Andover MA 01845 June 9, 2010 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Per Owner every two years-last time 11-26-08 Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Size of tank Reason for pumping: To inspect the structural integrity of tank and baffles 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: installed in 1985 Were sewage odors detected when arriving at the site? ❑ Yes ® No 48 PATTON LN NORTH ANDOVER-08106 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165 ) Property Address Edward& Donna Caselden Owner Owner's Name information is North Andover MA 01845 June 9, 2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 10"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town water feet Comments(on condition of joints, venting, evidence of leakage, etc.): The plumbing in the basement was in good condition no evidence of leakage at time of inspection. Septic Tank(locate on site plan): Depth below grade: 8 inches feet Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) e: =Z;; 71s7age confi �eo Compliance?(attach a cop Yes ❑ No Dimensions: 10'-6"x 5'-8"x 5'-8" Sludge depth: 3"+/- Distance from top of sludge to bottom of outlet tee or baffle 2'5' Scum thickness Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 1'+/ How were dimensions determined? Measuring stick and visual 48 PATTON LN NORTH ANDOVER•08106 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward & Donna Caselden Owner owner's Name information is required for North Andover MA 01845 June 9, 2010 every page. Cityfrown 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.): The liquid levels were normal at time of inspection, the concrete baffles still attached with signs of slight deteriorating these baffles should be routinely inspected. rease Trap(locate on site plan): Dept elow grade: feet Material of nstruction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethyleneother(explain); Dimensions: Scum thickness Distance from top of scum to top of outle a or baffle Distance from bottom of scum to bottom of out t or baffle Date of last pumping: Date Comments(on pumping recommendati , inlet and outl tee or baffle condition, structural integrity, liquid levels as related to outlet inve vidence of leakage, ): /below (tank must be pumped at time of inspection) (locate \siteplan): :metal ❑fiberglass ❑ polyethylene \(e 48 PATTON LN NORTH ANDOVER•08M Title 5 Offidai Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward &Donna Caselden Owner Owner's Name information is North Andover MA 01845 June 9, 2010 required for every page. Cityfrown State Zip Code Date of Inspedion D. ystem Information (cont.) Tight or Iding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gal per day Alarm present: Yes ❑ No Alarm level: Alarm i rking order: ❑ Yes ❑ No Date of last pumping: Date Comments(conditi of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ® Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-Box has deterioted over the years but was still level with equal flow and no evidence of leakage at time of inspection. E r(locate on site plan): ng order. ❑ Yes ❑ No g order: No 48 PATTON LN NORTH ANDOVER•08106 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward &Donna Caselden Owner Owner's Name information is required for North Andover MA 01845 June 9 2010 every page. Cityrrown State Zip Code Date of Inspection D. formation (cont.) Comments(note condition of pump c ndifi ps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 1 -900 Sq. Ft ❑ 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.): No signs of hydraulic failure or ponding at time of inspection, leach field located in raised area in back lawn 48 PATTON LN NORTH ANDOVER•08!06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward&Donna Caselden Owner Owner's Name information is North Andover MA 01845 June 9, 2010 required for every page. City/Town State Zip Code Date of Inspection System Information (cont.) Ce ools(cesspool must be pumped as part of inspection)(locate on site plan): Number d configuration Depth—top o 'quid to inlet invert Depth of solids lay Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of h raulic f 'ure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments to condition of soil, signs of hydraulic failure, level of ponding, condition vegetation, etc.): 48 PATTON LN NORTH ANDOVER•08M6 Tinea 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward&Donna Caselden Owner Owner's Name information is North Andover MA 01845 June 9, 2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. SG2 Fr•J bCcK a —rAAI 14 JAI 4e 7- pante B L = 3 g� '7 '7 a , b J 3 " .7 11 A -/_ = 41 ' .3 If 48 PATTON LN NORTH ANDOVER•08M Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 48 Patton Lane(Assessor Map 106A Lot 165) Property Address Edward &Donna Caselden Owner Owner's Name information is required for North Andover MA 01845 June 9 2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to ground water: >4' below SAS per design plans on file at B.0.H. office Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: May 25, 1983-Soil Logs 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: The soil logs conducted on May 25, 1983 had ESWT @ 105.5' per design plans, 4' below SAS. The bottom of the sump pump located in cellar was 8'10" below the top of foundation, the inverts in the D- Box were located @ 2'3" below finish grade plus 8"to top of foundation equals inverts @ 2'11" below top of foundation, which makes inverts of SAS >5 feet to the bottom of sump pump. More recent soil testing was performed at 80 Patton Ln, but greater than 500'away. The SAS located in the back lawn is located at the highest elevation on property. Using my best professional judgment, based on methods described in Title 5(310 CMR 15.302 )the SAS in out of groundwater. The septic system was not designed for a garbage grinder and it should be removed. 48 PATTON LN NORTH ANDOVER•08/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 5�0 LlV 0--31 -£�'� c w y 0 till /6706 5� � S113S� s o' � s rr Jun 09 10 12:55p DPW 9786689573 p. 1 Summary Record Card generated on 619/2010 11:51.31 AM by Lisa Evens Pae 1 n D Town of North Andover Tax Map # 210-106.A-0165-0000.0 Parcel Id 17309 48 PATTON LANE CASELDEN, DONNA 48 PATTON LANE N.ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1 Acres FY 2010 UB Mailing Index Name/Address Type Loan Number Active/InacL From Until CASELDEN,DONNA Payor 48 PATTON LANE N.ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Activennactive Bldg Id.17375.0-48 PATTON LANE Last Billing Date 4/2/2010 3170045 03 Cycle 03 Active UB Services Maint. Account No.3170045 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 60.80 /1 UB Meter Maintenance Account No.3170045 Serial No Status Location Brand Type Size YTD Cons 13242457 a Active ERT HH METE METE w Water 0.63 0.63 612 Date Reading Code Consumption Posted Date 11 466 Variance --- 3/8/2010 1718 a Actual 16 4/14/2010 -75% 12/10/2009 1702 aActual 1/12/2010 50964 -51% �9Qa r099S6 9/9/2009 1634 a Actual 1/ 21 10/15/2009 155% 6/4/2009 1487 a Actual 7120/2009 982 141% 317/21108 1105 a Actual 3/12/2009 1437 a Actual 4/29/2009 '2449-4 -34% 12/5/2008 1413 a Actual 1/20/20095-5- 84% 918/2008 1380 a Actual 10/10/2008 i b 315% 6/4/2008 1156 a Actual 7116/2008 37400 135% 4111/2008 S 5'1G8 58°h 12/10/2007 1085 a Actual 55 1/22/2008 -66% 9/4/2007 1030 a Actual 138 10/12/2007 �� Q/1 152% 6 /14/2007 892 aActual 61 7120/2007 Q`7 3/13/2007 831 a Actual 30 4/16/2007 15% 1216/2006 801 a Actual 24 1/1912007 bt V B y 730 -85% 9/8/2006 777 a Actual 157 10202006 289% 6/12/2006 620 a Actual 45 7110/2006 11% 316/2006 575 aActual 33 4/17/2006 // 4v PJ -20% 12!16/2005 542 a Actual 48 1/17/2006 (d "r/ -68% 9/14/2005 494 a Actual 157 10/14/2005 199% Trouble Code:03 6/9/2005 337 a Actual 45 7/152005 17% 3/18/2005 292 a Actual 46 4/52005 4% 12/92004 246 a Actual 38 1/14/2005 -67% 9/152004 208 a Actual 130 10/8/2004 204% 6/102004 78 a Actual 26 7/30/2004 9% 4112/2004 52 a Actual 52 5/172004 0% p T�' _ 8 GlcL°VS 2 l�` 6�i4 DJ� LA0), Mc -7-1 0,A) r Commonwealth of Massachusetts �1 W City/Town of NORTH AN MASSACHUS TS System Pumping Record WM ey'. Form 4 DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. pa Ar A. Facility Information N V Important: When filling out 1. System Location: APR O 5 2006 forms on the computer,use r Q OWN OF NORTH ANDOVER only the tab key Address to move your /► - /��/�� cursor-do not use the return City/Town State Zip Code key. 2. System Owner: Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record r�12 1. Date of Pumping 2. Quantity Q t t Pum ed: Date Y p Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Name Vehicle License Number Company 7. Location where contents were disposed: Signature uler Date hftp://www.mass.gov/dep/w er/approvals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 x.11 " ommonweaith of Massachusetts City/ToWh. NORTH -ANDOVER MAS SACf 7�S�ET systemPumping Record Y .Form 4 DEC 6 2006 DEP has provided this form for use by local Boards of Health. S - besubmitted to the.locai Board of Health or other approving a the H D k J� ord mu; X Facility Information Important: When filling out 1. System Location:: fomes on the .. 1 computer,use � . only the tab key Address to move your cursor-do not _ use the return City/Town Stat y�� '•—_--. ---- key. Zip Code 2 System Owner. Name —--- _..__--.—----------- -_ Address(if different from location) City/Town _...___ ______-- State --------- _... . C, Zip Code Telephone Number B. Pumping Record ate.of.PumpingDate -- 2. Quantity Pumped: y._____. Gallons 3. Type of system: ❑ Cesspool(s) c� Tank ❑ Tight Tank ❑ Other(describe): _______..-----•------.—----___�.....___ _._..—___—._ 4. Effluent Tee Filter present? ❑ Yeso If yes, was it cleaned? ❑ Yes ❑ No. r 5. Condition of System: 6. Sy em Pumped By: ame s V� Q Vehicle License Number ` Company ` 7. Location where contents were disposed J Si slur e of Mau Date — http://www.mass.gov/dep/water/ proyals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record-Page 1 of 1 m i' �' ' ' MASSACHUSETTS QS ' Record RECEIVE �0 Rho; p/ovlde0 ;hliyl01r,rl ep 00 -�/rlllod ,o the local 8.9rc: c', ' 50Y 51 ¢y1 8oarcr of n 09 ^ 1,�E J7 G(J rso A, Facility In(ortr ton U . TOWN EALOT NORTH ANDOVER �OCBUon: H DEPARTMENT �T a '•�' . � �X'J, 1, ^"". 6 11 IaAC ------------- G oopo� -�y2t a� �M nim, ;': . ram buUon) Cla�pw:1 ------------ 29> T0477. n,mp„ I ;IumP��g Rekord ��. 0a.0 o! PumDin2 v.' X711 rYpa P� ay�lem;.. C999po01(9) " .Q%ofhar (describa' e�. EMenTl Teo Fl 1(0( Y 09.. C' jl Yo 9. n'B7 C'9a�6�7 y,, i S p , Y 4mpod 8y' I�,t��^�y'��i�Sy�� Y!/• I \ ,I' {1� (1 � ///� IV! /Uy/) +I h'':,'-dl on.�her9 Corll9nU'wera dlyposao: .i.'.:,' it ••p. a0l X1/1 '� ', Jai. ,.\•�''''`I"''ri; ., ��I Ivy/„•I,�rl .. / ` -- , �./•'i�l.''•'', Sl�n{twi o1 h'JVaG/� (/�U( masa.gor/daphralar/app(OYa)Wform 3.P.ngIn5pm �r17 • 1 n : f 5 fr � a a1,,Awra i . ir}�`ti ,rr+7�N�f rsyrtl � tt.•:.t a4?.{tia fpr t } _ _9 Commonwealth of Massachusetts City/Town of NORTH ANDOVERtRECE CHUSETT r System Pumping Record , .L rm 4 NOR H ANDO T RDEP has provided this form for use by loyal Boards ping Record must be submitted to the local Board of Health or other approving authority. A..Facility Information Important: When filling out 1. Syste Location: forms on the computer,use only the tab key Address to move your cursor•.do not CI /Town use the return tY State Zip Code key._ 2. System Owner. de-n • Name Address(if different from location) %/—Town State Zip Code Telephone Number B. Pumping Record 1. - Date of Pumping Date 2. QuantityPumped: Gallons 3. Type of system ❑ Cesspool(s) Veptic Tank ❑ Tight Tank Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes,*was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. Fystem Pumped By: Ce me2EPA� ^ � Vehicle License Number Company \. 7. Locatio where contents were dispose �k— d We r� qWfure of Haae HaDate h :/ _• � /www. a by mss. ov/de /.water/a royal 9 p pp s/t5forms.htm#inspect t5form4.doc•l)8/03 System Pumping Record•Page 1 of i _iii• ❑ Stewart's Septic Service ❑ Andover Septic ❑ Stratham Hill Septic ❑ Roto-Ram , (978) 372-7471 (978) 475-2593 (603) 772-5548 (978)452-9022 58 South Kimball Street, Bradford, MA 01835 Date �Nio I PAY FROM THIS BILL Customer Name: ❑ Reg. Nature of Service I,C 0 ❑ N/C ❑ Reg.Maint. Service Location: ❑ Emergency '� '� `� Septic Tank Pumping and Cleaning ❑ Day ❑ Night Phone: p � p� 9 9 Contact: "Done the Right Way" Billing Address: Not Responsible for Covers City: Zip: or Irrigation Systems / �1 q/ Special Instructions la-Completed ❑ Incompleted Reason: Per: AM/PM Services Rendered Vacuum Pumping Observations Drain Cleaning U ❑optic Tank 2-6rood Condition ❑ Main Line ❑ Drywell ❑ Leechfield Runback ❑ Toilet Bowl l v C ❑ Leech Pit/Overflow ❑ Riding High ❑ Kitchen Sink ❑ D-Box (liquid level) ❑ Bathtub/Shower ❑ Pump Chamber ❑ Full to Cover ❑ Vanity ❑ Grease Trap ❑ Excessive Solids ❑ Floor Drain ❑ Catch Basin Top/Bottom ❑ Vent 2. l/ ❑ Portable Toilet la-U—se No Powdered Soap ❑ Sewer Jet ❑ Other A' eavy Grease ❑ Other Qty: ❑ Roots Footage: Size: ❑ Suggest Electric ❑ Under 1000 gallons ❑ 1000 gallons ❑!'1500 gallons Rootering ❑ 2000 gallons ❑ 3000 gallons ❑ 4000 gallons ❑ Van Called ❑ 5000 gallons ❑ Other ❑ Other Misc. ❑ Digging Charge. ❑ Backhoe ❑ Inspection ft./in. hrs. Ll Location LI Consultion Ll Certification: P/F � ❑ Service Call ❑ Estimate Reason: ❑ Labor ❑ Portable Toilet Rental ❑Pump Repair ❑ Waiting Time ❑ Baffle ❑ Repair * Digging Charge is Per Driver ❑ Chemical Treatment Discretion ❑ Other Description of work Recommendations Terms of Payment / Parts Vacuu r.Pumping Drain Cleaning r. Month Yr. Month NET 15 DAYS Tax Terms&ConditionsDiscount ❑ Cash L) Check Ll Credit 1. Not responsible for damage beyond curb line. 3. 1.5%per month will be charged to accounts past due. Total 2. All complaints shall be reported within 48 hours. 4. The purchaser agrees to pay all cost of collection. Customer Signature Serviceman �� Residential Property Record Card PARCEL ID:210/106.A-0165-0000.0 MAP:106.A BLOCK:0165 LOT:0000.0 PARCEL ADDRESS:48 PATTON LANE FY:2010 PARCEL INFORMATION Use-Code: 101 Sale Price: 1 Book: 02308 Road Type: T Inspect Date: 06/11/2008 Tax Class: T Sale Date: 09/21/86 Pager 0113 Rd Condition: P Meas Date: 06/11/2008 Owner: Tot Fin Area: 3124 Sale Type: P Cert/Doc: Traffic`. M Entrance: X CASELDEN,EDWARD Tot Land Area: 1.00 Sale Valid: F Water: Collect Id: RRC DONNA M CASELDEN Address: Grantor:. CASELDEN EDWARD Sewer: Inspect Reas: C 48 PATTON LANE Exempt-B/L% / Resid-B/L% 100/100 Comm-B/L/'/o Indust-B/L% / Open Sp-B/L% ! NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 7 Main Fn Area: 1850 Attic: NBHD CODE: 6 , NBHD CLASS: 6 ZONE: R2 Story Height: 2.00 Bedrooms: 4 Up Fn Area: 1274 Bsmt Area: 1850 Seg,. Type Code Method Sq-Ft Acres, Influ-YIN Value Class Roof: H Full Baths: 2 Add Fn Area: . Fn Bsmt Area: 250 1 P 101 S 43560 1.000 206,910 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: DETACHED STRUCTURE INFORMATION Masonry Trim: . Ext Bath Fix: 0 Tot Fin Area:. . 3124 ` Foundation: CN Bath Qual: T RCNLD: 383937 Str. Unit Msr•1 .Msr-2 E YR-Blt Grade Cond%Good P/F/E/R Cost Class Kitch Qual: T'. Eff Yr Built: 1990 Mkt Adj. PG S 512 0.00 2000 A A /50//47 15,100 1 Heat Type: HW Ext Kitch: Year Built: 1985 Sound Value: VALUATION INFORMATION Fuel Type: G Grade: G Cost Bldg: 383,900 Current Total: 605,900 Bldg: 399,000 Land: 206,900 MktLnd: 206,900 Fireplace: 2 Bsmt Gar Cap: Condition: G Aft Str Val 1: Prior Total: 681,000 Bldg: 472,300 Land: 208,700 MktLnd: 208,700 Central AC: Y Bsmt Gar SF: Pct Complete: . Aft Str Val2: Att Gar SF: 506%Good P/F/E/R: /100/100/91 Porch Tvoe Porch Area Porch Grade Factor E 224 W 234 SKETCH PHOTO 777. 14 ra r E 16 224 5qJ1 16 234 SgFt 13 FM M - , , � FUIFM/B 576 SgFt ■ ■ qF ® ■j 1274 S Ft 24 24 28 q 28 -ii # t 4- 234 22 506 SgFt 22 48 PATTON LANE Parcel ID:710/106.A-0165-0000.0 as of 5/24/10 Page 1 of 1 1 a 106A Map 105D "' 237 238 Map 106B 265 2.09 �4356Q S 43560 S 239 266 1 13A 143 264 1.75 A 145 22.05 A "a r 43560 S 42253 S 37026 S 1.04 A 17 yqo � !.. 32.9.9 A 236 `=, 142 146 439%S E9� ' 240 1.42 A 106 A 241 43560S 261 260 e_ y; 43560S 087S 18.06 A } 141 =. 147 ! _ ' 263 1.21 A 1.09 A 242 225 42253S 215 43560S 2.37A 3.01 A 14 0 51 243 26 , 43560 S 29185S 1.03 A 43996S )s 36 267 st 1.03 A It 224 40075S u' 244 40075S 192 4394 S e 156 177 247 40511S 112` 223 1 3.17 A 439%S '` 1.03 A 131 268 1.62 A 40075S 14 '',r < 13 7462 .16 A 136 2.02 A 2 A rd 1.5 A N+ Stutsc�(tock R° "�_`'' `222 `'` 130 43996 S u;. ,. 221 34948S 217 1.12 A 40075S 11 1.02 A 219 134 A 43560 S 16 l5 222 2.96 A 1.99 A 189 2 A 22 38 0 ,-� 3.5 A 1.74 A 5.21 A 72 ;60 S pots Nx 221 216 $2 2 A S ,y 2 A 28 3.49A 79 80 218 149 4.74 A 54 78 37 r 1.7A 39 I.8A 1.8A 3.0IA 8.2A 46A 1.52 A 1.8 A 81 0 77 3.14 A 83 75 1.6 A 6.01 A 2.1 A 53 1.02 A 76 27 17 A 29 1.56 A 91 74 7.13A 1.06A 2A 17 2, 18 43996S >' I. A 20 19 1.02 A 21 43996S 43996S 1 &� 1.9 A 22 439%S �' 30 208 160 164 120 996S „- - 1.04 A 1.26 A 209 43996 S 3.7A 163 1.36A ,. 2.12A I.uA :•, s 23 2 162 'J!' 31 2 A 6 a 161 '•` Jp 25 1.12 A 1.2 A ' 32 43560S 24 1.6 A 158 159 26 43560 S 1.7 A 09A 1.11 A 139 x 43996S 90 "` \e�S Y 43996 S 137 3.1 A µr "° ,5''' 138 43996S 132 152 1.07A 166 43996S '7 u,, 151 1,24 A ':. ¢4 167 " ' 3560 S * 126 L1AQ 165 3.14A 125 1.09 A 155 S 123 124 1,07 A 43996S 102 A 150 89 " 43560 S b: 1.02 A . 35 43560S 153 1.15A 4356(5{ 4 A 1.02 A 30 67157 80 Qs�pP 11.4 A 43560 S; 66 106A 31 681.06RAA 1.13A .03 A 56os 106C ala 106B 76 1.07A I3.SA iap 11)611 1 65 I8 0 560S Legend 2 C3W..God G U-".tttW Road s 31y 1,2009) �� ::� F: O�oMr -+Ral u,e106A mo I'mti a ^may t M w Soda; 1 eu H«La 1_Faaer..M Feet ' RHed Ajri 23.2M a Of ,��y `;� 4826 :•. o � p Town of North Andover `,�'•>,;:o:: �' HEALTH DEPARTMENT CHU CHECK#: D T f LOCATION: / H/O NAME: �! CONTRACTOR NAME: Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type. $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ T:t�le ,Its-pector $ d7 TReport om' itle5R ort $ O' ❑ Other:(Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer FORM U - LOT RELEASE 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 or requirements: *****************************APPLICANT FILLS OUT THIS SECTION****'`*�***''�***"*""* APPLICANT rc>(i,,aie �-1JchYLA Co-s elefeil HONE 9tT- I' �SSZ LOCATION: Assessor's Map Number C) PARCEL SUBDIVISION LOT(S)_. STREET a ST. NUMBER '/ o ** *************OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED— COMMENTS— TOWN EJECTEDCOMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS - FOOD INSPECTOR-HEALTH DATE APPROVED. — _ DATE REJECTED------- -- '� SEPTIC INSPECTOR-HEALTH DATE APPROVED — DATE REJECTED__ COMMENTS --- — ti J - Q / O eo ........./// 1 N `) �ocjn ; N ® PLANS MAY BE MODIFIED AT lUILDERS DISCRETION K _ v Z V ��'[X b�1�U ✓ti'9 Loti ny - J mak•4'—O i r' IOA� 4 V J 130 _ 1 CV I p uP �Ll o N �{ - O - 1 vi Room PLANS MAY BE MODIFIED AT BUILDERS DISCRETION = c c i- F U y-e j/' cyl ------------------ 1 tet'4'-O I FDUN Cry" iOi\) _,4'..V BoaT4 of Health Nor' k,j:ndover,Mass SUBSURFACE, DISPOSAL DESIGN CHECK LIST LOT # :3 PA—Mov APPROVED DATE ( DISAPPROVED DATE____r__ Provided: Reasons: h " Title V FAIL OK Reg 2.5 The submitted plan must show as a minimums a) the lot to be served-area,dimensions lot #,abutters b location and log deep observation hoes-distance to tiess c location and results percolation tests-distance to d design calculations do calculations showing required leaching area e) location and dimensions of system-including reserve area M existing and proposed contours g) location any vet areas ,vithin '100' of sewage disposal system or disclaimer-check Wetlands mapping (h) surface and subsurface drains Within 100' of sewage disposal system or disclaimer (i) location any drainage easements within 1001 of sewage disposal system or disclaimer-Planning Board files (0) known sources of water, supply within 200' of sewage disposal o . system or disclaimer (k) location of any proposed.well to serve lot-1001 from leaching facility (1) location of nater lines on property-101 from leaching facility (m) location of benchmark (n) driveways (o) garbage disposals (p) no PVC to be used in construction (q) profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Other,elevations (r) maximum ground. water,,elevation .in area sewage disposal system (s) plan 'must be pre�ared'by a Professional Engineer or other professional..authorized by law to prepare such plans Reg 6 Septic Tanks (a) capacities-150% 50% of flog, water, table, tees, depth of tees, access, pumping (b)_ cleanout (c) -3.01 from cellar wall or inground swimming pool (d) 251 from subsurface drains Reg 10.2 7 Distribution.Boxes (a) s"lope greater than 0.08 Reg 10.4 b) sunp TO: NORTH ANDOVER, MASS 19 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at LG / 4-;. -- `a ly Z/9/YC North Andover, Mass. SITE LOCATION The grades and construction are as specified in mir plans and specifications dated 19 .L� y N,,-v, /� Safi �'ES �a coAfko w 0 eg. n er/ye n ian fa / 74.E1i?�.._ o4r' COM,y�N/y U! ? w a y Nm o Div o S113S� s � d 9 .A_.._.__. .________._..-_.__._ Board of Health, : SEPTIC SZSTEi North AnooverLHaas. INSTAM ATICK CHECK LIST CND DATE DI PRO ID AVATICHd OK FAIL APPRunst OKf 1. Distance To': �j-2-5 a. "Wetlands b. Dra.ias c.. Well 2. Water Line Location 3. No RPC Pipe Septic Tank 1N7 a. ..'.Fees -_Length & To Clean Out Covers. b. ement Pipe to Tank Oa Both Sides of Tank 5. Diz tribution Box a. Covers & Box .- No Cracks b. All Lines Flowing F Vial Amounts C. No Back Flow 6. • Leach Field or Trench a. Dimensions b. Stone Depth c; Capped Inds d. Clean Double Washed Stone 7. Leach Pits a. Dimensions _.._ b. Stone Depth j c. Splash Pads d.. Tees e. Cement Pipe to Pit - Both Sides f'. . Clean Double Washed Stone ---- 8. No Garbage Di spo sal 9. .71hal Grading Inspection 10. Barricading Covered System 11. As Built Submitted a. Lot Location b. Dixensions of System c. Location with Regard-to Perc \Te,- t r d. Elevations e: Water Table .tf iC✓t � �� fop i u I �X�1"e✓f0✓ W4��S. . I �. C✓eufe wirt� sTaR6LJZ room 3, Creu4e 2 c1v5e.+ ct,(eas-M b"t+;h(e- LI, Ad J c(v o p c e; A / eo �bvDYQ o M e I ; 5 k+s N i,yt N 4- d(.c�i e�s wee✓e 1 r 1 ►x.22� ed, (30� ;n �- ,=;v;is�, util�fylwoRk ROOM :a V�� un�� UILDERS DISCRETION Fust ` PLANS MAY BE MODIFIED AT v v � STara�e - .� 1 6- _o I �4'-0 I .ti4•-D� I 1 I I - _ C 1 FORM U. TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT ADDRESS (ASSIGNED BY D.P.W. k---'STREET 11-OA 7-DA1 Lf /24� - t/APPLICANTr 0 L PHONE vHATE OF APPLICATION rA' TOWN USE BELOW THIS LINE PLANNING BOARD /�- DATE APPROVED TOWN PLANNER DATE REJECTED CONSERVATION COMMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVED ev HEALTH SA TARIAN s P�d�•/ Av DATE.REJECTED Ctltfa�'! �OtS DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. f f ` RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Y t J , i — } 4y�vl ! '� } 4 ,b ,r 4s.a 1`l("'1� pac��in;d 2•''t.4�..�:+S }t. '�/1v7�.�f<f�, "'ti1^a. � - - O - 77� 4 4"�.1 ';h i�^yj:'�(h''.N�1✓A ,h }4 + �y �_._J •r �y� t t� i.; 4 f{`�''r1�s.'K tk> S Kk w' t .ri f � ✓. . ' { - rJ w S 4• �• y r/ 1 ,,,kik-'�'�,�,,,'�''�i fit `S r",�'` ••/'y ! .�} t Owl XX y.�� +�{ti�'s"'4.€+3f Y �. 3l �� < '•M1 J P - ` 1 y 1 ( a! " r t C'�.`ty� 43,xJn [�.l�'YM t} 1 is V 4 .y Y }. a a 1 Y tY - RR- r3 wa.Y i 1 It i f_• it„>ah } a •�4� J�r$ 1�,r�� q K:S Y 4 r r ! `� '4 r �R j I�t tie�K r •.'� :g `y��''`t`'rJgl7` `e�'�'Y a,. � r,' f4St •y „-.•4 5•,r , r Vy4.. ,d�} blas? lh`it J,.. y,. +. •��:•. �- ,�,.•` 5 ?: .f �� [xi�.j'Jd J'��}�y�n}•F �t�•r,q - t � .. ,,1 i i", .� A1.'r � .' , Z" '1�','�1"S°sit++s' :`1. a•;i r, -t I� S � •.,;,�'-'',,. .. r 1 - . .r' , rs '".�•r�li*xr + ��.ai�� ' t c's.' / a '� ,� � r,,, / * "' ,` a• y, f 1' 1. � i .. I i1 � .�i�bs` r1 Ct s r'"3S t.9Y ; t �. '��. , ('/'t�%:� 7.�� .• � � t/r f.-s..�.T c r,�`__}} =:sir + ° .r` i t�,•-`� > s e „x.. t 1 . .r✓� t. ?. Y� a` � ✓/✓ �' , to �j �4 i•t�,i r'y` i t 'y. _ t.,. t. � r / ' � ' T- i/Y' i �4 ��y„'�,�,�IC�,y�.Rf q+ltlu,... Wh• '�Ia✓l•'�,�+�a[��1.N„r t`', Commonwealth of Massachusetts 7MR E City/Town of 15 a System Pumping Record / Q1j Form 4 TOWN OF NORTH ANDOVER M sve�. HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of house, Lefttp igh rear of hous , Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/Right rear of building, Under deck Address Cityrrown State Zip Code 2. System Owner: Name Address(if different from location) Cityrrown Stat Zip Code �q��17 Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes �o If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of,Sys�temU�� Ccup— n 41nv,�- 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location where contents were disposed: G.L S. Lowell Waste Water Sign to a Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1