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HomeMy WebLinkAboutMiscellaneous - 490 WINTER STREET 4/30/2018 (2)pO A A cn D z O m V X N N O Z1 o m o m O � Fire & Water — Cleanup & Restoration`"' SERVPRO of Billerica/Tewksbury 978-663.9833 SERVPRO of Lawrence 978.688-2242 SERVPRO of Lowell 978-454-7577 SERVPRO of Salem/Plaistow 603-893-9700 SERVPRO of The Andovers 978-475-1199 Toll Free 800.535.6322 L5 d Like it never even happened Independently Owned and Operated SEPTIC SYSTEM INSTALLATION IS THE INSTALLER LICENSED? YES NO TYPE OF CONSTRUCTION: NEW REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO CONDITIONS OF APPROVAL YES NO (FROM FORM U) -� ISSUANCE OF DWC PERMIT �5.r;?--p J NO DWC PERMIT PAID? YES NO DWC PERMIT NO. 96'1-7— INSTALLER: /n l7j) 3lgr=�o BEGIN INSPECTION YES NO: EXCAVATION INSPECTION: NEEDED: PASSED _ ZZ 7 BY CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: c -ii -D APPROVAL TO BACKFILL: DATE: BY FINAL GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE: BY Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 RECEIVED ALe, 0 5 2013 TOWN OF NORTH ANDOVER HEALTH DEPARTM1NT DEP has provided this form for us&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, Left rear of hous eft / right side of house, Left/ Right side of building, Left / Right front of building, Left / Right rear of building, Under deck Address �� l `./ j City/Town State Zip Code 2. System Owner. .Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ q'�-�3 — 2. Quantity Pumped Septic Tank Date Cesspool(s) ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No State D _ Z Ide Telephone Number C� Gallons ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No 5. Co ditio of S 6. System Pumped By: Neil Bateson 7. Name Bateson EnterDrises Inc Company contents were disposed: Lowell Waste Water F5821 Vehicle License Number Date -(_c3 t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 701d de Tor krfcheP, en/0rf-einem - kA�LYaX 3Ys�cr� corp pon e.n� �S -7S - 07-63 S11 ullivan 1499 Winter Street North Andover, Massachusetts 01845 Lo-te- to, f999 0 �� A4-'9-� fz- 4�'� +, OLP-t. *"� �w� G d b cd�Rt �Ga z Imi �' �� -,I , 1-1 .� 6eu'ja' B4� / Y .t 0 A M I .- AA J i 1 0 -4 ') � 1[11.x. �.� �tLl . 1 a"- � 41' I .. , p. . ,,.,." .-.:,., —.,v, .. "w"1 I .� ., . . . .- . a T. ti A , m - w I � I "A.VP m � . M- ,. -- m a . . - - b� 9 1. m �-,;*.�-6i,� - m . . , . m . m , , � � �a 't , 'm : : , ,. , ,-- v �- Mm -M-�, � ,,� w I - � :mm. I m � ,a I , 6 . - m � � m : m : : ; I , - m � A ` I : M, , � : , . . , i , ,- ; � , , *, , � � m , m , mm I I . 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I , . . -..- .. . . .. �. �,, , s_3:,1 .& ,� .; q. , ; , TOWN OF L�. - -v jfi J SYSTEM PUMPING RECORD � VED DATE: L _ S SYSTEM OWNER & ADDRESS j�, l,(J �faa✓� ti � a LJ . au 9- AUG U 5 2005 TOVVPa Jr= NORTH ANDOVER HEALtH DEPARTMENT SYSTEM LOCATION (example: left front of house) V Ir DATE OF PUMPING: ` C QUANTITY PUMPED: GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.L.S.D Lowell Waste a J . p` � � '� Y 0 �: 0 kl�►JTF- F- AS BUILT PLAN OF i, IM MAK mori--. � mm M,, 0 kl�►JTF- F- AS BUILT PLAN OF SUBSURFACE DISPOSAL SYSTEM LOCATED IN "�09:�I-H A�JPov5r- i NA,�,s AS PREPARED FOR r -i ES Lj U Ll.I V^►lj DATE: A PviL, 2L+ -1`I9'l SCALE: I , Z+1-1 w ►l'i i e12 5-F MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 or TEL (617{ 473-3353, 373-5721 6 m i, �OMEN i SUBSURFACE DISPOSAL SYSTEM LOCATED IN "�09:�I-H A�JPov5r- i NA,�,s AS PREPARED FOR r -i ES Lj U Ll.I V^►lj DATE: A PviL, 2L+ -1`I9'l SCALE: I , Z+1-1 w ►l'i i e12 5-F MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 or TEL (617{ 473-3353, 373-5721 6 m FORM U - IAT 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 local or state law regulations or requirements. , ****************Applicant fills out this section***************** APPLICANT: r� Phone 97.5- 200 LOCATION: Assessor's Map Number Parcel Subdivision - Lots) � Street G l • St. Number -Y/ ************************Official Use Only************************ RECO DATIONS OF TOWN AGENTS: v" - Date Rejected Conservation Administrator Rejectefected /U ed Comments�%1 I) i1 a _440-1, �'( _J ,1) 1 r ( (J C, Town Planner Date Approved Date Rejected Comments Food I ctor-Health Date Approved i Date Rejected pti Inspector -Health Date Approved Date Refected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building -Inspector Date 4 -�ft MAP AND PARCEL [ A- / 0 1 ' ,r ADDRESS 11uc "'t'4 OWNER 6�� SIZE OF LOT IN SQUARE FEET a Olt OL.tI�-e # BEDROOMS / SEPTIC SYSTEM LOCATION (For example, FRONT YARD SOUTHEAST CORNER) FINAL GRADING DATE 1-0' -�� AS BUILT PLAN IN FILE? —t— INSTALLER DWC PERMIT DATE 7-!3 7 CERTIFICATE OF COMPLIANCE DATE ENGINEER 2 Town of North Andover, Massachusetts Form No. 2 ,AORTh BOARD OF HEALTH r p • s ♦ t DESIGN APPROVAL FOR SSACHUSi< SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM RAS a�o3 Applicant Test No. 0 Site LocationU-)\A±JA SA Reference Plans and Specs.��"ti�--'— Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. 0^ Fee- Ion _ CHAIRMAN, BOARD OF HEALTH Site System Permit No.�Y. -- Form No. 4 Town of North Andover, Massachusetts BOARD OF HEALTH Apri 1 R 19 98 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired (X) by Todd Bateson INSTALLER at 499 Winter Street, North Andover, MA SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 891 dated 1/30/97 19 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD OF HEALTH APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: ?_ ,7 ( CURRENT INSTALLER'S LICENSE# LOCATION: �/� �- �� l 'S/ LICENSED INSTALLER: �•� %� S SIGNATURE: 6��TELEPHON_Eg CHECK ONE: REPAIR: NEW CONSTRUCTION: IF. NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. $75.00 Fee Attached? Foundation As -Built? Approval A' Administrative Use Only Yes v No Yes No Date: Town of North Andover, Massachusetts Form No. 3 e NORTH BOARD OF HEALTH O "a., 1 a+oo � 19_ �...�. �# DISPOSAL WORKS CONSTRUCTION PERMIT 4 "o.4 R` ,SSACHUSEt Applicant NAME ADDRESS TELEPHONE Site Location f Ci1-9 / iU TC7,2 c�Tl2EE1 Ep��4c 7-hlU,k Permission is hereby granted to Construct ( ) or Repair (individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN, BOARD OF HEALTH Fee:34 D.W.C. No. tr�■�■■ut�� s.LAO Xos �L:afii spry tt JW ?1 '3 z • � V s.LAO Xos �L:afii spry tt FORM 11 - SOEL EVALUATOR FORINJ Page 1 ti Date .... f~-Lg�� Commonwealtrr of Massachusetts Massachusetts Soil Suitability Assessment brl On-site Sewa ie osal Performed By: .....8...-....:.... Wimessed By: � ............... ...... :........ :........ ......a ............ .:.............. .°........... ; . a ................................................................................................................................. ............................. :... r....... laouoa Aderns a , � �g *., .e 5 !/:vu.•.. /� Lag Aftas. ane 9 Wl•� f•�i— 51 A Vk.71 /Tr%o00v4, TelepMx.t T New Construction ❑ Repair ' Office Revi''dw f Published Soil Survey Available: No ❑ Yes , /' V0 Year Published../00/ Publication Scale ....:./...:� Sod Map Unit ............. Drainage' Class ��-,� g P2 Soil Limitations ............................................................ ...................: . ' Surficial Geologic Report Available: ' :No Lam' Yes ❑ Year Published Publication Scale Geologic Material (Map Unit).... . ..... . .:............:.. .......................... ............................................. Landform....... ........ ...... .... .......... ...................*..... ................................... . Flood Insurance Rate Map: Above 500 year flood boundary : No ❑ Yes L`1 Within 500, year flood boundary.. No L Yes ❑ ^� Within' 100 year flood boundary No L�" ,Yes El Wetland Area: National Wetland Inventory r to y Map (map unit) Wetlands Conservancy Program Map (map unit)..:............................................................ :........_ Current Water Resource Conditions (USES): Month Range : ` Above Normal ❑ Normal ❑ Below:Normal ❑ : . Other References Reviewed: FORT 11 - SOIL EVALUATOR FORM Page 2 On-site Review Deep Hole Number OP t. Date: Time: 71 /Of"" Weather Location (identify on site plan) .. . ... .... ..................... ............................... .. ................... Land Use .... Slope ft 0-'M Surface Stones .. -/2P$%..A ...... ....... ....... ..... .. Vegetation. ..... . .......... ... . ......... . ......... .... .. ... ........... .. - Landform.. . . ....... .... ... ... . . .. .. ..... ... ...................................... .... Position on landscape (sketch on the back) .............................. ............. . ............ .. . ........... ... ... ... .. Distances from: Open Water Body .(feet Drainage way >Laq( feet 4 Possible Wet Area> Wmp I feet Property Line t , feet Drinking Water Well >to& feet Other DEEP OBSERVATION HOLE LOG Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones. Boulders, Consistency, % Gravel) ,.io-6,11 /V Wi 1 41 - Y& - If ik C V, 6 Y Wu &12. Parent Material (geologic) . ......... -t7Depth to Bedrock: ... ............................................ Diath to Groundwater: Standing Wazzer in the Hole: oo4zV eeping from Pit Face: Estimated Seasonal Hign Ground Water: 3 co- FOMI 11 - SOIL EVALUATOR FORM Page 2 On-site Review --4 Deep Hole Number 0 -Zr Date: '7—?SSG Time: Weather Location (identify on site plan) .5 I 040-- .. .... ..................... ............................... .. ................... Zzel Land Use ..k.��!........� _ Slope ft Surface Stones ..j0%?t--e . ....... ........ ................ Vegetation.......... ................ . ......... . ............... ... ........... ... Landform9-115"01004 . . . .. ... . .. . ...................................... .... .... . Position on landscape (sketch on the back) ....... . ................................. ........... . ........... .. . ........... ... .. ... ... Distances from: I Open Water Body feet Drainage way>..!" feet Possible Wet Area LIQ)( feet Property Line ..ZSR` feet Drinking Water Well >� feet Other . ...... . .... ... DEEP OBSERVATION HOLE LOG Depth trorn Surface linchesi Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, % Gravell A— ffy -7.5 Uic Y'00P 49 r Via V# 4:-y WZ Parent Material (geologic) ... ......................................... ..... Depth to Bedrock: Djoth to Groundwater: Standing Water in the Hole: jj&tA- Weeping from Pit Face: . /WL4, Estimated Seasonal High Ground Water: 17 FORAi 11 - SOEL EVALUATOR FORM Page 3 Determination for Seasonal High Water Table ,Method Used: s Depth observed standing in observation hole ............:.... mcheS ❑ Depth weeping from side of observation hole .................. inches ., , Depth to soil mottles .� lJ �G ...... mchas { ,,• `s. ' °:E] Ground water adjustment .... feet y I'dex'Well Number ....... I .... .. Reading Date t ............... Index well level ...........�..... Adjustment factor ............. Adjusted ground water level ................................................,... . Deoth of Natuna Iy Occurring; Pervious Material Does at least four feet of: naturally occurring pervious material exist in all areas observed throughout thj area proposed for the soil absorption system?; . If not, what is the depth of naturally occurring 2 ' . g pervious material. : Certification I certifythat on t' , . ��o (date) I have passed. ttie examination approved by the Department of Environmental Protection and that the above analysis was performed by'me consistent with the required training, expertise and ecperience locribed in 310 CMR 15.017. a Sigratur ` 9 ��d�dd � ate FORNI 12 - PERCOLATION TEST COMMONWEALTH OF M'ASSACH'USETTS Massachusetts Terco'lation Test Date:' Observation Hole :# Depth of .Pere Start Pre -S oak End Pre.soak Time at 12" 30 Time at 9 Time at 6" Time (9"-6") Rate Min./Inch 7 hrf; PITS MIN 440 LEACHING MIN 1 (13'x16') PIT MANHOLE/PIT GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x ##) (2x(L+W)xD x ##) (G/ft2) CHAMBERS MIN 440 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60' X 60') MIN 13' X 16' PIT BOT (L x W x ##) + SIDE X LOAD = TOTAL (2 x (L+W)xD x ##) (G/ft2) FIELDS MIN 440 GPD 900 ft2 BED GW MIN 4' BELOW BOTTOM OF FIELD PIPE ENDS JOINED? 4" PEA STONE? DIST LINE SLOPE .005? >31COVER-VENT SCH 40 MIN 12" COVER RATE ( X ) X = TOTAL L W LDG DOSING TANKS AND PUMPS DIMENSIONSIL-34 X_ X= PUMP CAPACITY —gPm L W D Vol. DISCHARGE SIZE ,A6,� 6• DISCHARGE RATE 4-0 DISCHARGE TIME 9Pm MANHOLES TO GRADE ALARM SEP. CIRC. -"L GW (Min. 1' below inlet) HWL 3,6 LWL4 CHECK VALVE --'BLEEDER HOLE MANUAL J OP. SWITCH ENUF STORAGE? TDHWEIGHTED? Copyright 0 1996 by S.L. Starr c► p o� o 041 � a 7`06e-' - s-�s PLA � 5T � �i- ADDRESS X 2 Tv �V 545 Zfj GENERAL 3 COPIES STAMP Z/ L SCALE �. A &5b CONTOURS Cf PROFILE �''� D'r- c5/95 TG SOIL & NSG PERCS ELEVATIONS,_ � A16 �J & WETS WATERSHED?/f/0 DRIVEWAY 3 1 DRAIN--- SCH40 t- TESTS CURRENT? SOIL EVALIC%(� SEPTIC TANK MIN 150OG10w6 .17 INVERT DROP GARB. GRINDER (2 comps +200) 10' TO FDN f MANHOLE �� ELEV - GW ## COMPS. GB D -BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET - OUTLET (2" OR .17 FT) TEE REQ'D? LEACHING / MIN 440 GPD? L" RESERVE AREA ,'/ 4' FROM PRIPRARY? \� 20 SLOPE 100' TO WETLANDS '160` TO'-WE{LLS 4' TO S.H.GW i/ (5'>2M/IN) 20' TO FND & INTRCPTR DRAINS 400' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY N.IN 12" COVER C�-' FILL? (15'), BREAKOUT MET? fes/ TO �p®L JO TRENCHES MIN 440 gpd SLOPE (min .005 or 6"/100') v� SIDEWALL DIST. 3X EFF. W OR D (MIN 6') i ' RESERVE BETWEEN TRENCHES? t,-" IN FILL? MUST BE 10' MIN. LY 4" PEA. STONE?_L,.,--- VENT? L--� (>3' COVER; LINES >50' ) BOT� -O + SIDL' r )06 X LDNG f b0 = TOT �7' ¢�6 (Lx #) (DxLx2x#) (G/ft2) Copyright © 1996 by S.L. Starr APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: / � / — ( ( CURRENT INSTALLER'S LICENSE# LOCATION: LICENSED INSTALL SIGNATURE: Grp TELEPHONE# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only $75.00 Fee Attached? Yes No_ Foundation As -Built? Yes No Approval Date: �� �— Town of North Andover, Massachusetts Form No. 3 of NORTN BOARD OF HEALTH 19 L -- F 9 DISPOSAL WORKS CONSTRUCTION PERMIT SACMUS Applicant 1 NAME 3 ADDRESS TELEPHONE Site Location 4q q Permission is hereby granted to Construct ( ) or Repair ( k-�'an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN, BOARD OF HEALTH Fee D.W.C. No. 0 I� 2 i0 SOIL PROFILE & PERCOLATION TEST DATA Town/City, No. &Stree t Lot No.� LoC . % Subdiv. ., 11 P1 an Owner^'~l 0 6 - Investi-gator a //v Observer r SOIL PROFILES -DATE 112717-1 1' Elev, ?` Elev. 3' Elev. 4'Elev. 0 . ,.,..... 0 0- 2 - 2 V t 4 5 6 7 V Q 3 4 5 M 1.1 E 1 2 3 4 5 6 7 wo VE 10 (I 10 10 Benchmark Location Elevation Datum percolation Tests -Date 2 %7� Pit Number 1 2 3 4 S Start Saturation '2 7 Soak -Mins. t, Start Test-T'3,e�Me Z Dropof 3" -Time :5b':. Prop of 6 Tjtfie', : G O Mins .1st 311Dr'e Mins o 2nd 3 "Dro 'Notes & Sketches on Back Frank C. Gelinas & Associates, North And. GAB Business Services, Inc. ROX 9Q NAl,41,7.WAX 111A Date l� r Building Commissioner/Inspector of Buildings Board of Health/Board of Selectmen ;jm NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139 Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the cap- tioned insured, location, policy number, date of loss, and GRAB file number. Insured: 0 01 %W (/`( L) a / No k'i Property Address: W / Al719f S1 (Signature) Title: On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Signature and date Form 645 (2/78) Commonwealth of Massachusetts Massachusetts System Pumping Record System Owner 5 v (,� v llate of Pumping: -- �— l System Location PPR 30 t9g� �=(qR (ivy weer= Sf_ Quantity Pumped: a� gallons Cesspool: No ( Yes Septic Tank: No U Yes System Pumped by: t5aredoft5'r1&n,64a d License # Contents transferrred to : Greater Lawrence Sanitary District Uate: Inspector: Board of, Heal t�l North And9YerjKae8- SEPTIC SISTEM INSTALLATICK CHECK LIST LOT i APP9 OPID DATE DI Pt7ClPID — AVATI OK FAIL J: G �''`` gel �/fi `�" � �".� •� !/�;,'' eaBDnst r OKv A4T-- fN 1. Distance Tot a. Wetlands ' b. Drains c. Well 2. Water Line Location I. No PPC Pipe 1?C' e A 4 r- fre 4. Septic Tank ------ a. Tess -_Length & To Clean Ont Corers. _ b. Cement Pipe to Tank - On Both Sides of Tank - = 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flow Q �F� b. Leach Field or Trench a. Dimension b. SESth c. ed Ends d!Clean Double Washed Stone K 7. Leach Pits a. Dimensions b. Stone Depth- e. epth c. Splash Pads d. Tess e. Cmmt Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No Garbage Disposal 9. Final Grading Inspection 10. Barricading Covered System 11. As Built Submitted - . , , 7� - a. Lot Location b. Dimensions of System c. Location with Regard -to Pere Test d. Elevations e.. Water Table Ja C 5 r v r,� ISO-- Itf°pLIV ItsZON Sa4LTOOSSV I SeuTT90 0 Nusaj xoatt t10 satr��avr 6 IF L 9 S 17 Z I - ZLZz Z4. a�pa-s4sas u T42 ooaad wnqaa uoz4aoo7 oI L w 17 c of 0 0 uozqEnaTa x.zewuauag o - 0 0 0 �I 'naTS—� �°naT� °£ `°naT3 �Z°naT3 ° I 21VCI-S3'IIJOHd 'IIOS .zaAZrasgp`".,"� ✓q zo abt sanuz �auMo UPTd _.�. nTpgnS/ • ooq Q/ ' oN 407 � � c,+" —7-yn baa :r4 S'8 • oN. 110 4T'/urnoy viva sS3s uolsvrIo:)Idsd 12 3zidoua lzos . ---r-� suTW �3T'suT14 2 awzs-,,9 3:0 do a 0§7 awzs-„ £ go o za awry-4sas za�S °suTW-3[e0S uoz4e.an4eS :;T24S S T7 £ Z T .zagwnN d 6 IF L 9 S 17 Z I - ZLZz Z4. a�pa-s4sas u T42 ooaad wnqaa uoz4aoo7 oI L w 17 c of 0 0 uozqEnaTa x.zewuauag o - 0 0 0 �I 'naTS—� �°naT� °£ `°naT3 �Z°naT3 ° I 21VCI-S3'IIJOHd 'IIOS .zaAZrasgp`".,"� ✓q zo abt sanuz �auMo UPTd _.�. nTpgnS/ • ooq Q/ ' oN 407 � � c,+" —7-yn baa :r4 S'8 • oN. 110 4T'/urnoy viva sS3s uolsvrIo:)Idsd 12 3zidoua lzos . 2-9 Lo+ 79 - J�f — pcol,: 4-* --.Y el s; Lo OD fp cy 71 16. V SOIL, PROFILE & PERCOLATION TEST.,DATA ..._.r...� ../ Town/City _No.&Street Lot No. //d Loc d' Subdiv. i., � �^ plan Owner , 6 . Investigatof �a qallo Observer SOIL PROPTLES-DATE 112717.1 1' Elev. Elev. Elev. 4. Elev. I-----� 0 ..�....�....:.: 0 . - 0 an 7 E. 9 10 0 9 10 1 2 K 4 5 6 7 0 10 I 2 3 4 5 6 7 RE 9 10 Benchmark Location M Elevation Datum jercolat on Tests -Date 11127 P.,It Number 2 3 4 S Start Saturation Soak -Mins Start Test -Time: 2' Drop of 3"-T Drop of 6 "-T�me't . G M.ins.lst 3"DroV- Minso 3"Dra E,2nd /� �,., ivvtes Z)Kercnes on Back Frank C. Gelinas & Associates, North And. r ,E t f f u � � h it n i ,II �, gee• �' F ,� r :t •L i}.t s X _ - ))f � i,j, `� � ,'i Vie' ,� � u h ,i a •'' t � } j I C lw Jill 31 a t C �[ Id i,-�k � i i -!, � ,� t� -; j �fTF� r^�,i 'i :�' �j ✓4�`� � ,.s. iy �x f R{ � i "�` ,d 4 � [ # ,3 A ) t f f u � � h it n i ,II �, gee• �' F ,� 1v s t f f u � � h it n i TOWN OF NORTH ANDOVER, o,-, l �. . SYSTEM PUMPING RECORD 12 5-v3 5-� ( I c, -Uc-,�� (example: left front of house) DATE OF PUMPING: �� `5 ti3 QUANTITY PUMPED �' GALLONS CESSPOOL: NO vYES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER P PUMP B• SYSTEM U Y. COMMENTS: CONTENTS TRANSFERRED TO: 6 FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) .904 XAORTH q �Q�tS IED 16460 p�RATE DE PPp` .(5 �9SSACHUS�� Applicant Site Location Engineer Town of North Andover, Massachusetts Form No. 1 BOARD OF HEALTH 19 IL APPLICATION FOR SITE TESTING/INSPECTION Test/Inspection Date and Time C � Fee �S . CHAIRMAN, BOARD OF HEALTH Test No. 1% (0 D— S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. E ,} Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH QF t LEp ib �•r0 r- 19 � m 1 f APPLICATION FOR SITE TESTING/INSPECTION \RATED PQp`•.C% Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time Fee CHAIRMAN, BOARD OF HEALTH Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. MERRIMACK ppppppcNGINEERING SERVICES INC. Engineers -9 Surveyors • Planners 66 Park Street ANDOVER, MASSACHUSETTS 01810 (508) 475-3555 Fax (508) 475.1448 TO / fictJCJ� �T�c`Q� 0 WE ARE SENDING YOU ❑ Shop drawings ❑ Copy of letter ILIECTUIM 0IF 1 ° MMUTTQL DATE I --I:r,� JOB NO. ATTENTION RE: 9 O u.trt Jaz same-' Q — � (tDAATEE ` (e ( ' ❑ Attached ❑ Under separate cover via the following items: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Change order ❑ COPIES NO. DESCRIPTION Q — � (tDAATEE ` (e ( ' a� THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ For your use ❑ As requested ❑ For review and comment ❑ FORBIDS DUE REMARKS COPY TO ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections ❑ Resubmit ❑ Submit _ ❑ Return — —copies for approval _ copies for distribution corrected prints 19 ❑ PRINTS RETURNED AFTER LOAN TO US SIGNED: If enclosures are not as noted, kindly notify us at once. N Commonwealth of Massachusetts City/Town of I { System Pumping Record Form 4 4, v 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. . A. Facility Information Important: When filling out 1. forms on the computer, use only the tab key ` to move your cursor - do not Sy em Location: Address 1--,f q Ce use the;retum Cityfrown key. 2. System Owner: Name Address (if different from loc, Cityfrown k—, 6 State Zip Code ILT CEIVED FTH ANDOVER pT Telephone Number .B. Pumping Record 1. Date of PumpingDate 2. Quantity` Pumped: Gallons I Type of system: ❑ Cesspool(s) El-Te-ptic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes EIAIe—* If yes, was it cleaned? ❑ Yes ❑ No 5. Conditio f System: tau; 6. System um a y Name r Vehicle License Number Company -- 7. Locati where content a di ed: http://www.mass. gov/dep/water/approvals/t5forms. htm#inspect t5form4.doc• 06/03 System.Pumping Record •'Page 1 of 1 y A 4w:. a I Vic--trrWar2p C A r- IHA`! 11 1815 S 4 pry �„ 10 *qf hf y i \1 J Ut r - r 0 - VZZ T '44 !z" MIN. IoPs4ti CovSPL 3" WASHP-OpEASTONE Ile -316' ,� . ` • "� J � �_ '^ "' 4"P�.RFOKAiEU «R,AN6 R . , � //-� 1�"WA:.HED CKu5�E4S'Tor►E�y''-i'/2 AB SOii PT t ON MMA k! ABSORPTION BED END SECTION e, Z r a Ul ^ � �� �� ice. J d J J ♦ q � Q I s dr 40 SE t!�• �i?eSnr 'TAtvr< DISPOSAL SYSTEM PROFILE Af--,so,- F,V ion AREA = �� 14 - ABSORPTION DED PLAN I. ' 9.tP4QQ ALL yolk, lu PAgit7 AZUWA AVO A Crat'AhNGrx, CF 6' At..L PiRa-C "ImA, rwV-AMb-5T st/M AWAY F940-1 AM&A - OBS. HOLE PERC, HOLE' PERC BATF 0 PERC TEST TL'`` Z4 4110) , TEST DATE 5-I.o-7.T a James and Linda Sullivan 499 Winter Street North Andover, MA 01845 Home Phone (508) 975-2203 Work Phone (508) 681-0969 June 12, 1997 Town of North Andover Office of Community Development and Services Ms. Sandy Stan- Board of Health 146 Main Street North Andover, MA 01845 Dear Ms. Starr, . We have been advised by our builder, Kevin Smith of North Andover that we may need a variance in order to begin construction on a family room and extended bedroom space. We recently had a new septic system put in by Bateson and designed by Merrimack Engineering so that we could do the addition. In reviewing the present site plan it appears that the end of the septic tank will be seven to eight feet away from the foundation of the new room. The foundation will be a frost wall not a full foundation. Please see enclosed plan. We are expecting our third child in August and really need to begin construction on July 1 st. Could you please review this site plan by Monday June 16th. I am trying to schedule an appointment with you on Monday so that you can let us know if we will need to have a variance so that we can be put on the agenda for June. Thank you very much for your immediate attention. Sincerely, - G Jim and Linda Sullivan / / / / W (3? 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O Z U N W WQ Z (n W 2 <.2 Q W W it J LL O W _Z J O \ Y� QH \ Im Cl) W \ U) W \ O \ \ \ \ m Z) Z � m w cit \ Q < \ W of w Ix w 2 // O v 2 LL Z w> Z^ wmZO'1 m^W1—� \ =UQZ \ NaZ3: \ U�t�wO J O (n W (n am�06< \ Q 00o \ LL: x� \ � �� \ _N Q \ U) \ \ // \ Y J >-m �- F¢-mrnW .Z cl ww a< n O LL J 0 D ()w Q LL m * 2 w> Z^ wmZO'1 m^W1—� \ =UQZ \ NaZ3: \ U�t�wO J O (n W (n am�06< \ Q 00o \ LL: x� \ � �� \ _N Q \ U) \ \ t 4 pj � ~ \ \ Ii A t 4 -C-\ Commonwealth of Massachusetts p City/Town of W° System Pumping Record Form .4 �M Jug I tali TOWN OP NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may Se usea, But Me 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 front of house, right front of house, left side of house, right side of house, Left rear of ho e, right rear of o e, _O side of building, right rear of building, under deck. H91 W\1kka-1V- si- Cityrrown 2. System Owner: Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ l j "'zv' State Zip Code soaiu--;�t" Stat Zip�de 6 -�� Telephone Number Date 2. Quantity Pumped Cesspool(s) Septic Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No 5. Conditi n of System: (&JA \ 6. System Pumped By: Neil J. Bateson Name Bateson Enterprises Inc. Company 7. Location where contents were disposed: L.S ' . /?Lowell AALaste Aater 1"S -4:7-d Gallons ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No F5821 Vehicle License Number Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1