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Miscellaneous - 497 FOSTER STREET 4/30/2018
497 FOSTER STREET t 210!104.8-0027-0000:0 APPLICANT: Kalinowski / V North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/104.11-0027-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge No Picture Available Location: 497 FOSTER STREET Owner Name: LACOLLA,JAMES V PAMELA F LACOLLA Owner Address: 497 FOSTER STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 -5 Land Area: 1.02 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 2278 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 434,800 416,100 Building Value: 266,100 255,300 Land Value: 168,700 160,800 Market Land Value: 168,700 Chapter Land Value: LATESTSALE Sale Price: 1 Sale Date: 02/09/2000 Arms Length Sale Code: F-NO-CONVNIENT Grantor: LACOLLA JAMES V Cert Doc: Book: 05676 Page: 0160 http://csc-ma.us/NandoverPubAcc/jsp/Home jsp?Page=3&Linkld=466579 7/19/2005 Residential Property Record Card PARCEL_ID:210/104.6-0027-0000.0 MAP:104.13 BLOCK:0027 LOT:0000.0 PARCEL ADDRESSA97 FOSTER STREET PARCEL INFORMATION Use-Code: 101 Sale Price: 1 Book: 05676 Road Type: T Inspect Date: 11/13/2002 Tax Class: T Sale Date: 02/09/2000 Page: 0160 Rd Condition: P Meas Date: 11/13/2002. Owner: Tot Fin Area: 2278 Sale Type: P Cert/Doc: Traffic: M Entrance: X LACOLLA,JAMES V Tot Land Area: 1.02 Sale Valid: F Water: Collect Id: RRC PAMELA F LACOLLA Grantor: LACOLLA JAMES V Sewer: Inspect Reas: C Address: 497 FOSTER STREET Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LOBO Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 :j RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 9 Main Fn Area: 1144 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: R1 Story Height: 2 Bedrooms: 5 Up Fn Area: 1134 Bsmt Area: 1144 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1 168,577 Ext Wall: AV Half Baths: Unfin Area: Bsmt Grade: 2 R 101 A 0.02 94 Masonry Trim: Ext Bath Fix: Tot Fin Area: 2278 VALUATION INFORMATION Foundation: CN Bath Qual: T RCNLD: 241867 Current Total: 434,800 Bldg: 266,100 Land: 168,700 MktLnd: 168,700 Kitch Qual: T Eff Yr Built: 1987 Mkt Adj: 1.1 Prior Total: 416,100 Bldg: 255,300 Land: 160,800 MktLnd: 160,800 Heat Type: HW Ext Kitch: Year Built: 1985 Sound Value: Fuel Type: O Grade: G Cost Bldg: 266,100 Fireplace: 1 Bsmt Gar Cap: Condition: A Att Str Val 1: Central AC: N Bsmt Gar SF: Pct Complete: Att Str Val2: Att Gar SF: 576%Good P/F/E/R: /100/100/91 Porch Tvoe Porch Area Porch Grade Factor W 127 SKETCH PHOTO 14 7 127 Sq. Picture ¢ 576 Sq.F1. FM 24 24 1I4t3 S30 q.R. 1134 Sq.R. 28 28 Rable 24 v Parcel ID:210/104.13-0027-0000.0 as of 7/19/05 Page 1 of 1 TOWN OF NORTH ANDOVER p°RTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET *^, , .�•' NORTH ANDOVER,MASSACHUSETTS 01845 S�cMuse� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX ADDRESS: 497 Foster Street MAP:10413 LOT: 27 INSTALLER: Jim Kellett DESIGNER: NEES PLAN DATE: 8/23/05 Rev: BOH APPROVAL DATE ON PLAN: 8/25/05 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11/1/05 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ®Existing septic tank properly abandoned ®Internal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ® 1500 gallon tank has been installed H-10 loading Monolithic construction 121 Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) 0 Inlet tee installed, centered under access port El Outlet tee (gas baffle) installed, centered under access port M 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present 0 Hydraulic cement around inlet & outlet Comments: Page 1 of 5 TOWN OF NORTH ANDOVER tµORTh Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss;;�N„St`' Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged 0 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) El Inlet tee installed, centered under access port 0 Pump(s) installed on stable base El Alarm float working 0 Pump On/Off float working (3 Floats) [KI Drain hole in pressure line [R] 24" inch cover to within 6" of final grade installed over pump access port 0 Water tightness of tank has been achieved Visual testing 1K Hydraulic cement around inlet & outlet Comments: D-BOX 121 Installed on stable stone base 121 Inlet tee (if pumped or >0.08'/foot) El Hydraulic cement around inlet & outlets 0 Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan Fx-1 Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed Page 2 of 5 TOWN OF NORTH ANDOVERNORTH Office of COMMUNITY DEVELOPMENT AND SERVICES ar f.o HEALTH DEPARTMENT y 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss�cNU Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Page 3 of 5 TOWN OF NORTH ANDOVERof NORTI{7 Office of COMMUNITY DEVELOPMENT AND SERVICES 3 `,,�•. a • , o HEALTH DEPARTMENT 400 OSGOOD STREET ti r NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX CONTROL PANEL 0 Alarm & Pump are on separate circuits 21 Alarm sounds when float is tripped 0 Location of control panel: Basement, rear wall ❑ Rated for exterior if placed outside Comments: Page 4 of 5 TOWN OF NORTH ANDOVER f MCRTh " Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'s'„CH„st`' Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-FAX SYSTEM ELEVATIONS Benchmark: 100.0 Rod at Benchmark: 7.14 Height of Instrument: 107.14 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 100.08 Septic Tank IN 9955 99.71 Septic Tank OUT 99.30 99.48 Pump Chamber IN 99.25 99.45 Pump Chamber OUT 99.00 99.76 Distribution Box IN 105.06 105.19 Distribution Box OUT 104.98 105.02 Manifold Lateral 1 HIGH 105.25 105.23 Lateral 1 LOW 105.25 105.26 Lateral HIGH 105.25 105.24 Lateral 2 LOW 105.25 105.24 Lateral HIGH 105.25 105.24 Lateral LOW 105.25 105.25 Lateral HIGH 105.25 105.24 Lateral LOW 105.25 105.25 Lateral HIGH 105.25 105.25 Lateral 5 LOW 105.25 105.25 Page 5 of 5 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, November 09, 2005 2:44 PM To: Sawyer, Susan; Grant, Michele Subject: Final Grade Inspection Requests Jim Kellett called to state that the following are ready for Final Grade Inspections: 240 Farnum (call to setup a time to get into see the pump--could not get inside at Final Constr. Insp). X497 Foster Street 50 Sherwood Please let me know when I can schedule. Thanks. 8agf Ra#wtd8, A~04 D¢G440e,9141.0 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 1 -AWN OF NORTH ANDOVER of Ho oT:,ti Office of COMMUNITY DEVELOPMENT AND SERVICES or •'`°� ° HEALTH DEPARTMENT 400 OSGOOD STREET • NORTH ANDOVER, MASSACHUSETTS 01845 ,ssAClluse� 978.688.9540–Phone Susan Y.Sawyer,REHS/RS 978.688.8476-FAX Public Health Director E-MAIL: healthdept@,townofnorthandover.com WEBSITE:hgp://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned.hereby certify that the Sewage Disposal System( ) constructed; oy)repaired; by Kelle44 L'xroyo,+iAa (Print Name) located at .i' e r S-i-re et (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated g a3/0,5- and last Revised on ,with a design flow of 4 O 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: Q i O 5 L� ineer epresentative(Signature) And-Print Name / Final inspection date: If el vs- Engineer Engin er Representative ZeSignature)n—� And-P int Name T— Installer: ` I '"U (Signature) Date: And-Print Name Engineer: (Signature) Date: �J 4cy G And-Print Name ;' OSGOOD,JR. '+ CIV9L `n N0.45891 A�F NAL �'��� Page 1 of 2 DelleChiaie, Pamela From: Sawyer, Susan Sent: Thursday, May 11, 2006 2:44 PM To: DelleChiaie, Pamela Subject: 497 Foster Pam, please print this complaint and response out for the Foster Street file and for the Kellett complaint file. Thanks S -----Original Message----- From: Sawyer, Susan Sent: Thursday, May 11, 2006 2:34 PM To: 'James V Lacolla' Subject: how is this???change it if you like Dear Mr. Lacolla, My review of the files shows the following for 497 Foster Street: Plan was approved September 15, 2005 Subsurface Disposal System permit was issued by the Health Dept. on October 11, 2005 Final insp. of system components occurred on Nov. 1, 2005 -no problems noted in file Final Grade inspection took place around Nov. 10, 2005 -file shows no problems noted. Basic inspection points for final grade are as follows: The inspector checks: -for the proper crown over the system, to be sure no ponding will occur. -for drainage to be heading away from the structure -completion of loaming and seeding Note: we generally do not require boulders excavated by the contractor to be removed. That would be by your contract. Our inspector did recall that this was a very rocky site and she requested verbally that the bottom of the excavation be rid of large stones that were noted upon inspection. All proper paperwork was submitted including a signed document, by the installer and engineer, noting that the installation was completed per plan. For your reference #6 on the plan lists"disturbed areas, including those damaged by vehicles and equipment accessing site, shall be finish graded as shown and topped with 4 inches of topsoil, raked free of stones, fertilized, and seeded. Existing topsoil shall remain on site" Certificate of Compliance was issued December 1, 2005 The Health Dept. keeps a file on each contractor, which is available to the public. Your complaint will be placed on file for future reference. We greatly appreciate you informing us of your concerns and observations. Please know that the N. Andover Health Dept. staff strives to ensure the protection of the public health of it citizens in all ways possible. It is troubling to me that this situation has occurred in your case. If you have need of any further information, please do not hesitate to contact me. Susan Sawyer Public Health Director -----Original Message----- From: James V Lacolla [mailto:James_V_Lacolla@raytheon.com] Sent: Thursday, May 11, 2006 11:28 AM To: Sawyer, Susan Subject: Septic Repair 5/12/2006 Page 2 of 2 Susan I wish to express a complaint against a contractor on the septic repair list in town. Late last fall I had a new septic system installed by Kellett Construction in order to pass Title V requirements to sell my house. The project was completed and inspected by the town and signed off. When spring came around and a visual inspection of the finished product could be seen we found sub standard loam was used with large quantities of rock and glass imbedded in the land. In addition rock from the old system was left in the yard as well as pieces of the old system. Mr Kellett was notified of this and after numerous calls came and picked up the piece of the old system but did nothing about the condition of the yard. More calls were made and after some additional people were involved he came and did some cleaning up but still left the yard in sub standard condition. A promise was made to return and do more work if I paid for it but as yet even that has not been done. I understand that this is probably not a town problem to resolve even though Mr Kellet blamed the town for being part of the cause for this condition. I just felt that the town should be aware there are issues with a contractor on the list for septic repair and that he is using the town as a scapegoat for the poor work. Thank you Jim Lacolla 497 Foster Street 5/12/2006 Page 1 of 1 Sawyer, Susan From: James V Lacolla [James_V_Lacolla@raytheon.com] Sent: Thursday, May 11, 2006 11:28 AM To: Sawyer, Susan Subject: Septic Repair Susan I wish to express a complaint against a contractor on the septic repair list in town. Late last fall I had a new septic system installed by Kellett Construction in order to pass Title V requirements to sell my house. The project was completed and inspected by the town and signed off. When spring came around and a visual inspection of the finished product could be seen we found sub standard loam was used with large quantities of rock and glass imbedded in the land. In addition rock from the old system was left in the yard as well as pieces of the old system. Mr Kellett was notified of this and after numerous calls came and picked up the piece of the old system but did nothing about the condition of the yard. More calls were made and after some additional people were involved he came and did some cleaning up but still left the yard in sub standard condition. A promise was made to return and do more work if I paid for it but as yet even that has not been done. I understand that this is probably not a town problem to resolve even though Mr Kellet blamed the town for being part of the cause for this condition. I just felt that the town should be aware there are issues with a contractor on the list for septic repair and that he is using the town as a scapegoat for the poor work. Thank you Jim Lacolla 497 Foster Street 5/11/2006 Town of North Andover NORTp o t,.°o ,° a Office of the Health Department o? 'sr Community Development and Services Division 400 OSGOOD STREET North Andover,Massachusetts 01845 �'�s�cHuse�4g Susan Y. Sawver, REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax C'EQ ' I FICA2�E 02y' CO�VItGI�1�1�C2 As of: December 1, 2005 This is to cert that the individua[su6surface disposalsystem was a Fully repaired 4 by James Xellett At: 497 Foster Street North Andover, 911A 01845 Ifas been instaffed in accordance with the provisions of Titre v of the State Sanitary Code and with the Xorth Andover Board of ifealth regulations. The.Issuance of this certificate shall not be construed as a guarantee that the system wirr function satisfactorily. �)Wichele E. Grant (Public Wealth Inspector t3OAI2.1)OF i�PPf'r11.1 688-9i-Il 131111.1)IM;688 9545 ('0VO:RV;A ZION 688-0530 lil-AIJI l 638-9540 PIANNING 688-9i35 1. I FINAL GRADE INSPECTION Date: //�a/;O5 Address: ❑ LOAMED? ❑ SEEDED? ❑ COVER PER PLAN? Other: It I � o d 4 n DelleChiaie, Pamela From: Grant, Michele Sent: Wednesday, November 09, 2005 3:43 PM To: DelleChiaie, Pamela Subject: RE: Final Grade Inspection Requests Hi Pam, I'm waiting to hear back from Jim Kellet regarding 240 Farnum Street. I've asked him to set something up for Monday with the homeowner so as I can view the Electrical Box as well as the alarm. I'm going to try and make it out to 497 Foster Street and 50 Sherwood Street tomorrow. Thanks Michele -----Original Message----- From: DelleChiaie,Pamela Sent: Wednesday, November 09,2005 2:44 PM To: Sawyer,Susan;Grant,Michele Subject: Final Grade Inspection Requests Jim Kellett called to state that the following are ready for Final Grade Inspections: 240 Farnum (call to setup a time to get into see the pump--could not get inside at Final Constr. Insp). 497 Foster Street 50 Sherwood Please let me know when I can schedule. Thanks. 88st Ragwods, Payya�A De�eBL�lfiuia 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 1 FINAL GRADE/INSPECTION Date: U Address: 17 i AMED? / SEE DED. ❑ COVER PER PLAN? Other: V V NEW ENGLAND ENGINEERING SERVICES lk INC November 9, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 497 Poster Street,North Andover,MA Septic System As-Built Plan Submittal Dear Ms. Sawyer, The following Septic As-Built plans for the above referenced property are being submitted for approval. Enclosed are the following: 1. (3) Copies of the Septic System As-Built Plan. 2. Copy of Designer's/Installer's Certification Form. Please contact this office with any questions or concerns. Sincerely, Thomas Hector Project Engineer cc: Elomeowner 1 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 NEW ENGLAND ENGINEERING SERVICES lk INC August 25, 2005 Susan Sawyer AUG 2 5 2005 North Andover Board of Health 400 Osgood Street TOWN OF NORTH ANDOVER HEALTH DEPARTMENT North Andover, MA 01845 Re: 497 Foster Street, 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 Design Submittal Form. 5. Check for the Town approval fees. Please contact this office with any questions or concerns. Sincerely, — v 00a '- 144— Thomas Hector Project Engineer 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 "`'`= =•VE 978.688.9540 healthdept(crownofnorthandover.corn AUG 2 5 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: IPF. c-7O0.S SITE LOCATION: 4 Q rJ �s s �P kok* "OW ENGINEER: 2�1/lli2[,f�c. C.. OSgw!. 6T P� NEW PLANS: YES ✓ $225.00/Plan t/ Check#: (Includes I E and one Re-Review Only) REVISED PLANS: YES $75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: 4YE NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone#: q7?- Fag#: E-mail: /1 P_2�2/l ci lam'Q 0/ C'OirL HOMEOWNERNAME:�/ li OFFICE USE ONLY When the submission is complete(including check): 1. /Date stamp plans and letter. 2. � Complete and attach Receipt 3. Copy File; Forward to Consultant 4. V Enter on Log Sheet and Database Town of No 'h Andover Health Depart�m/entDate: Location: Location: / // (Indicate Address, if Residential,or Name of Business) X//Check#: ,J//g Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-!-Soil Testing $ U' Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Trasit/Solid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) V . Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Friday, September 16, 2005 10:43 AM To: amcbrearty@millriverconsulting.com; Lisa Kozel LeVasseur; DelleChiaie, Pamela; Sawyer, Susan Subject: 497 Foster Street Plan approval for 497 Foster Street is attached. The only item of concern is that they should have used trenches as the preferred type of SAS or explained why they did not. I imagine they would come back and say the increased foot print they would need with trenches would not fit on the site. I felt it prudent to not push hard on that one for this site and we typed up an approval letter. If you see it differently let us know and we'll get a disapproval letter prepared. Dan Daniel Ottenheimer,President Mill River Consulting,Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com dano@millriverconsulting.com 1 9/21/2005 TOWN OF NORTH ANDOVER a NORT4 Office of COMMUNITY DEVELOPMENT AND SERVICES :: to- HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 ��SS�CMUb Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 15,2005 Pamela&James Lacolla 497 Foster Sreet North Andover,MA 01845 RE: Subsurface Sewage Disposal System Plan for 497 Foster Street Map 104B Lot 27 Dear Mr&Mrs.Lacolla, 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 dated August 23,2005 and received by this office on August 25,2005. The design has been approved for use in the construction of an upgrade onsite septic system.This 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. 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(31.0 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. 3. The plan does not call for installation of a septic tank effluent filter but one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use, if you choose to install one. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely, r' S n Y. Sawyer, ES/RS Public Health Director encl: List of licensed septic system installers cc: New England.Engineering Services file Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@milIriverconsulting.com] Sent: Friday, September 16, 2005 10:43 AM To: amcbrearty@millriverconsulting.com; Lisa Kozel LeVasseur; DelleChiaie, Pamela; Sawyer, Susan Subject: 497 Foster Street Plan appro for 497 Foster�theysshould attached. The only item o cb e n is t have used trenches as the preferred type of SAS or explained why they did not. I imagine they would come back and say the increased foot print they would need with trenches would not fit on the site. I felt it prudent to not push hard on that one for this site and we typed up an approval letter. If you see it differently let us know and we'll get a disapproval letter prepared. Dan x Daniel Ottenheimer,(President Mill River Consulting,Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com dano@millriverconsultina.com V ` ' r 1 ` LETTER OF TRANSMITTAL North Andover Health Department of % oTN, �,� 400 Osgood Street bd� _ 6`6 0 North Andover, MA 01845 0 978.688.9540 - Phone 978.688.8476- Fax '� �4A c«»I�:wK.. health dept(&townofnorthandover.com - E-mail us www.townofnorthandover.com - Website Page-of TO: DATE: Benjamin C. Osgood, Jr., P.E. O COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant New England Engineering ineerin Services, Inc. Phone:978.686.1768 RE: SJ77, Fax: 978.685.1099 We are sending you: OPlan Review LetterPROVED 17NOT APPROVED OSystem Construction Follow-Up OOther These are transmitted as checked below: r` l r your File As Required OAs Requested DFor Your Use REMARKS: COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed TRANSMISSION VERIFICATION REPORT r- TIME 09/2312005 15:53 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 09123 15:52 FAX NO./NAME 89786851099 DURATION 00:00:47 PAGE{S} 02 RESULT OK MODE STANDARD ECM TOWN OF NORTH ANDOVER f NORTH ` Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 400 OSGOOD STREET "► ,:,.�r« NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss^CHUb`� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 15,2005 Pamela&James Lacolla 497 Foster Sreet North Andover,MA 01845 RE: Subsurface Sewage Disposal System Plan for 497 Foster Street Man 10413Lot 27 Dear.Mr&Mrs.Lacolla, 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 dated August 23,2005 and received by this office on August 25,2005. The design has been approved for use in the construction of an upgrade onsite septic system.This 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. This approval is subject to the following conditions: I. 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. 3. The plan does not call for installation of a septic tank effluent filter but one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use, if you choose to install one. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely, S n Y. Sawyer, RE S/RS Public Health Director encl: List of licensed septic system installers cc: New England Engineering Services file Torn of Orth Andover Health De*14 ftment Date: e dff� Location z z / � t (Indicate Address, if RReesidential,or Name of Business) Check#: 11sY2 Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ O:- tic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) Health Agent Initials �C3 White-Applicant Yellow-Health Pink-Treasurer � f 1 •�' of °co'bgti A_ pplicat on`tor Septic Disposal Syste6i-I r TODAY'SA5AX Construction Permit - TOWN OF • * ° ' NORTH ANDOVER MA 01845 $ 250.00-Full Repair 4'°•T�^•'�� ' $125.00 -Component SS�CHUS� Important: Application is hereby made for a permit to: When filling out * forms on the ❑ C nstruct a new on-site sewage disposal system 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 key. A. Facility Information 4/li ! rab Address or Lot# &elt7 „ City/Town 2.-/TYPE OF SEPTIC SYSTEM*: Pump ❑ Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ onventional 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 le Name -'/f7 179� S Address(if different rom above) A k4 City/Town State Zip Code Telephone Number 3. Installer Information Name Name of Company Address City wn State .3Zip Codee? L1 Telephone Number(Cell Phone#if possible please) 4. Designer Information t Name61 Name of Company Addre s r/, City own StateZip`-Cod S; d 4 � �� Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 pORTH Application for Septic Disposal System 4oq~�� TODAY'S DATE pConstruction Permit - TOVN OF `., ~,9 $ 250.00-Full Repair "SSACHU°+F4� ORTH ANDOVER, MA 01845 $125.00 -Component PAGE 2OF2 A. Eacility Information ntinued.... 5. Type of Building: esidential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North ArWover, and not to place the system in operation until a Certificate of Compliance has been ' = by this Board of Health. Name Date Appli i n Approved y: (Board of Health Representative) 0!1 f/ O e Date Application Disapproved for the following reasons: For Office Use Only: L Fee Attached? Yes No 2. Project Manager Obligation Form Attached? Yes_ No 3. Pump S, sy tem? If so, Attach copy of Electrical Permit Yes_ No 4. Foundation As-Built?(new construction ronly): Yes_ No (Same scale as approved plan) 5. Floor Plans?(new construction only): Yes_ No - Application for DisposSystem Construction Permit•Page 2 of 2 �a .• . INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at 7 7771e it relative to the application of U.b, �� dated for plans by V ' e"'3 and dated 4n 2S with revisions dated I understand the following obligations for management of this project: 1. 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. Undersigne Licensed Septic l aller Date: r , FORM .11-- SOIL EVALUATOR FORM Page 1 of 3 _ No. .Tp�,Ta Date: 71_S Commonwealth of Massachusetts AJ04h ;�� over, Massachusetts oil Suitabili Assessment or O1 -site Seivaprp Dis osa t Performed By: 13963.. g _ n �..... ... ,.........�............... Date: �?J Witnessed By: ....t�,;1.U.y........, �lr....1.. /�l�!( - ;. ltlor�n AmLver, /uA Td*QW I 4q7 -FosF+ee S`h'eet ew Construction 11 Repair iVor ► �4tive�,�,� 018�F.5- Office Review Published Soil Survey Available: No ❑ Yes Year Published 4"J.... Publication Scale Soil Map UnitDraina a Class G .WellSoil CC Limitations Surficial Geologic Report Available: No Yes ❑ -" • Year Published Publication Scale Geologic Material (Map Unit) v� . ................................... .. Landform _ ....--._-------•-......._-_•----_ ........................................... `` -lood Insurance Rate Ma ............. - 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) / /�W/A .Wetlands Conservanc Pro '.. .................................._.----_.._y gam Map(leap unit) ... .................- 'Current Water Resource Conditions(USGS): Month Range :Above Normal ,®N normal ❑Bely.i Normal ❑ N Other References Reviewed: ' DEP APPROVED FORM-12/07/95 :FOR�Vi 11 = SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 417 '17f('eei-, On-site .Review Deep Hole Number .:: 1. a.. Dat ...�bo� ate <� Time:-8100 Weather Location (identify on site Ian) .:ti1.1 �!�.'�ar'.......v�.:,. o - Land Use 51 eta .:.. ,._::.... Slope M) Surface Stones :.... . . �' 5 Vegetation a . .....:—.::..:.:._.�,:.::.:...w.........:.�...�.��:,.....�...-::.....::....:�.�..:...:::.:..,....�..�::.-..:�.::_.�.�...,�,w...N.,,,,...:..�.:.�.::,:.,.�..v...:... Landformr�T I,n1R,S ..w. �4t�►'1_.:...:.:::.��M:.:..:.:.... .. ... :,..: Position on landscape (sketch on the back) .:. Q 4k-:: e, Distancesfrom: .... �.` . .....:...,..�:,H..V........: .....:.:�........ . ,:.�. . ...�. _ Water ater Bod ,: 00 . _ Y � .�.., feet Drainage way_.�� feet _ Possible'.Wei Area .: ...., feet Property Line .Af...-..., feet -6rinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Sol Texture Soil Color p- Surfar ace.(Iriches) (USDA) - (Munsell) Mottling (Structure.Stones,Boulders,Consistency, % Gravel) 3.. 05Y 57 MR (-rr�w. MUM OF 2H I EVERY PRO PID§FD DISPOSAL AREA Parent Material(geologic) rD�p,a�I as DepthtoBedrock: Death to Groundwater: 'Standing Water in the Hole: Weeping from Pit Face: - x Estimated Seasonal High GiOund Water: 301 DEP APPROVED FORM-12/07!95 M11 SO .. • . ;FOR IL EVALUATOR T<ORM Page 2 of 3 Location Address or Lot No, g7 On-site Review Deep Hole Number Date: lb oS Time:..N �..C>C> Weather Location (identify on site Ian) Land Use Slope M Surface Stones Vegetation �r�5 x,:........;.:.:......,.,..:...._::..._..:.M...:�.��:...,:.�.� ...� :�......... ..... .. .. .. . Landform k.. t�a�ct.4.:..,....: .....A.l. .:..:... .:: : :.:.._.v:. Position'on landscape (sketch on the back) ... .�< ._. Distances from: ..^����..`..^.._.�.M�-_.... .., .^..,..,,,........:.,..`.....::'..� .•,... N.�. , Open Water Body ,,QSPID-., feet Drainage way..OZ. _ feet Possible:We Area,,,:.a . ..... feet Property Line feet Drinking Water Well kV9 feet Other DEEP OBSERVATION HOLE LOG* Depth from' Sod Horizon Soa TextweSoil Co!oi ISOR C•" Swface.pnches) `_" (USDA) (Manse!() Mottling (Structure,Stones,Boulders,Consistency,9� Gravel) D P, If Jaries vo.rto ,die 3 161 ) ` a 13 L., 16YR 30 / /g IbYj ll �Y MINIMUM OF FRMSED DISPOSACAREA Parent Material(geologic) 4 (Ig DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: 3;L DEP APPROVED FORM-12107/95 FORM 11 - SOIL_LVALUATOR FORM Page 3 of 3 Location Address or Lot No. q R7 �;54er ,5freeh{/)at-4 A ,2yer Determination for Seasonal High. Water Table Method Used: Depth observed standing in observation hole..............:..:. inches ❑ Depth weeping from side of observation hole................... inches Dep�hjo soil mottles 'l. ... inches ("7 Pl "Tl ok) ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor ................... Adjusted ground water level ..............................................._..... .. Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in It areas observed throughout the area proposed for the soil absorption system? es If not, what is the depth of naturally occurring pervious material? Certification I certify that on ov lqq,6, (date) 1 have. passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature C Date 2 0 DEP APPROVED FORM-12/67195 Page 1 of 1 DelleChiaie, Pamela From: Lisa LeVasseur[lisal@millriverconsulting.com] Sent: Wednesday, July 27, 2005 12:52 PM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: soil tests 183 Forest Street is set for 8/2 at 8:30 (a �os ;?treet is set for 8/10 at 8:30 795 Johnson Street is set for 8/10 at 1:00 (or immediately following 497 Foster) Thanks, Lisa Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 7/27/2005 LETTER OF TRANSMITTAL NORTH North Andover Health Department 0 q,I, 400 Osgood Street �2 ats�4so '466 poL North Andover,MA 01845 p 978.688.9540 -Phone 978.688.8476 -Fax '� 04 c««t:«,tea go'►•�rEo n�''�yq`� healthdent(i ,townofnorthandover.com -E-mail ,9SSAGHt1s�`� www.townofnorthandover.com -Website Page—/ of—& TO: DATE: Daniel Ottenheimer D COMPANY: FROM:Pame a DelleChiaie, Health Dept. Assistant Mill River Consulting RE: or Phone: 1.800.377.3044 or 978.282.0014 Fax: 978.282.0012 We are sending you: OSoil Test OPlans or Review L7 Other all in below) These are transmitted as checked below: OFor Review and comment OAs Requested OAs Required 17For Your Use REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: TRANSMISSION VERIFICATION REPORT TIME 07/2012005 08:55 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 0004J120960 DATEJIME 07120 08:55 FAX NO./NAME 819782820012 DURATION 00:00:34 PAGE(S) 02 RESULT OK MODE STANDARD ECM 07/20/2005 08:31 9786851099 NEW ENG ENG PAGE 01 07/1912005 16:25 9786808476 HEALTH PAGE 01/02 WMMMOAMMITAL North Andover Health Department � AOR � o K��,ra .� 4• 400 Osgood Street North Andover,MA 0 845 97$.6$$.9540-FhArwe * ��,� �w � 978.6$$.8476-Pat � AL healthde ere E-mail D +r"� www.tawothorthaudoverticg-Website Page of �'�IG1 TO: DATE: Be "amin C. 0s� ood Jr., P.E. COMPANY:: � New p land En neerin Selrvlees Inc. FROM:Pamela DelleChiaie,HealthDept.Assistant Phone:978.696.1760 RE. Pax: 978.685.1099 �e,< We are seuding your OPlan Review Letter DAPPROTE.D 17NOTAPpROVED OSystent Construction Folrow-U,p 00ther These are transmitted as'decked below: V For your.Fife VAs Required QAs,Requested OFbr Your Use COPY TO; Fax# . or Mailed COP'Y'TO: Fax# or Mailed COPY TO: Fax_7 # or M,aaied ��y r���y" ���u.� , �-� ��x����,� �c✓y�f���` tom ,,,; ���,u(-. 07/20/2005 08:31 9786851099 NEW ENG ENG PAGE 02 07/19/2005 16:25 9786888476 HEALTH PAGE 02102 • •1� n � ..r-••r°^;iY '+' ., 4�w,v� '�M lyyw,yM,�,w„ .:•—.•+,-�...,.'•x-�,Sp;w.•R�r s 4, ENGINEERING 969 WASHINGTON STREET BRAINTREE;.MA 42184 .'Ile. '1 ' 1r:�ly. I,' ' ,i '�r � ,.4 '`int�•• �.J , •�. , ''� i �,� �' � � I. "' •.,'• •! .'A/ �y�.� r U SCIFTit #Ok,14EUAGEDILS AL,S 7LM'%tVC #'EC ORO s , � Y SYS.rE)W)NPCAtA7' PN-*ntinued). Property Addregg, �L �' g ,, JQefal ilsr• IJYt, i 5!"w~ „ Owner. L' Dat*of Inspection: c, SKETCH OF'SEWAGE DISPOSAL SYSTEM- Inr1u tier,to,st lea tm war�nt,retere I1Rd�rartcs.ar bench r� 41 i, . ' IIP •' • j� • • • w ♦, ♦w� �M •'\ r a • • w � • w I Y • •��I -�• ��•I•'�'�Fl 1, w Rik , Y �a' h5 ,♦ It' .VII .' 11. I++„• ,. ,� • �� � , ~ • •' �• a •. '. , 'Ili • • r• I •�� � I,1! .• 'r � '1'.' � I'll +li.. ��, ';1 •„ „ '• Ji •� � r�. • . w • • ♦� ji ,;.+:.y .tel.. .. - 'I r; �.;^'I. M�p�m '�r�?:Yk,I ',IJI•I,,� •'•1 r' �IIV�".�y^�-,Sid!°F•'I^('fM.' ,;}; f:SJtll'r, •';, ` �} :.�.t�ft ,� tt �y.� P' .'J•. jj - .;l;v. 1s � .�,4 ��'':' P5 tl.,eh'�'�!�r•:? ��{.1 1{�'�9•'M"11r.i-'.- ,♦ 'lug:'. :. . '., w.'1"�, ''� • .r.�nliu±�Ip��I,• ��I'' .41,E• �.� I.'X,;•`� l=� `�:, �� 1 ,� e • . 1'' • . • 11 DEPTH vbmoUNIMA'1f M' dapth to giUftaer: a '' te®t' ' Medio Of de#errMnation or approxlmatidn: Nvb n Nnz 7 ; n LETTER OF TRANSMITTAL North Andover Health Department o� N�oT 6 q�'p 400 Osgood Street 0 North Andover,MA 01845 978.688.9540 -Phone 978.688.8476 -Fax healthdeptCa)townofnorthandover.com -E-mail www.townofnorthandover.com - Website Page of ss'�GHU`�EK TO: DATE: Benjamin C. Osgood, Jr., P.E. COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant New England Engineering Services, Inc. RE: jPhone:978.686.1768 �-�- Fax: 978.685.1099 � sT�•� We are sending you: OPlan Review Letter OAPPROVED ONOT APPROVED OSystem Construction Follow-Up OOther These are transmitted as checked below: OFor your File OAs Required OAs Requested OFor Your Use REMARKS: e�10.1'1 COPY TO: Fax# . or Mailed COPY TO: Fax# or Mailed COPY TO: Fax# or Mailed TIGER ENVIRONMENTAL: ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 :617-8.49-00,88 SUBSURFACE.SEWAG'E DISPOSAL SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION(continued) Property Address: L4 41 Fos-frm N • 'Aij D©Very. v" n Owner: tT I M L ACc>,LL A Date of Inspection: 3 - 6•el SKETCH OF SEWAGE DISPOSAL SYSTEM: Inclu a ties to at least p two rmanent refere ces,.landmarks or.benchrai�rks .,. y ... � . . .., � � J Loci g all w lls rithjrn 1 q0' R = i� � • . . . . . . . . . . . . . . . . . . . . . 6: Sol w3G � . . . . , . . • • • . • • • . • • • . • . • C TtWit . . . . . • ,�'tSpX . .. . . . . . . _ . . . . . . . . . . . . . .'• i ... , �. � }-.-:.L{� :.4.� ! ��� •NYr,Y ,��Y '�' m'Ri `�,1 ��• . .� '.r"� ��...} {..�.. +1..�,. _ i ze.i P,l�'A �, • . • . . . • . • . • • . . • . • . • • • . • . . . . • . • . . • . • . . . . . . . • . . . . ... • • . . • . . . . . • • • . . . . . . . . . . . . • . . . . . . . . . . . . • . . . . . . . . . • • . . • • . DEPTH TO GROUNDWATER: Depth to groundwater: (v feet , Method of determination or approximation: "a whAe�2 10 Su.w►1 11t-� (0-4, v 9 Town of North Andover Health Department Date: Location: "/ / / � c Qom_`-� (Indicate Address,if Residential,or Name of Business) Check#: �ClJ Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPUC PERMITS: ✓� Septic-Soil Testing ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) 913 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Town of North Andover r Health Departo±ent Date: Location: 1-79 (Indicate Address,if Residential,or Name of Business) Check#: �Vwx Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: f a_Septic-Soil Testing ova ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate)/n _Heath Agent Initials 9 ,13 White-Applicant Yellow-Health Pink-Treasurer 1 LETTER OF TRANSMITTAL orth Andover Health Department of No oT a f1�0 400 Osgood Street North Andover, MA 01845 0 978.688.9540 - Phone 978.688.8476 - Fax �o ••K• `'� healthdept(a)townofnorthandover.com - E-mail �.q o�,TOW ►� �`� www.townofnorthandover.com - Website Page of SS�CHU`�E� TO: DATE: Daniel Ottenheimer COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting RE. Phone: 1.800.377.3044 or 978.282.0014 Fax: 978.282.0012 We are sending you: �oiilTest O 17Other ill in Belo 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: s BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: �I'�� O MAP&PARCEL: LOCATION OF SOIL TESTS: OWNER: -3N4*S ?Av F-L.A L-Ac ®L-1-A TEL.NO.: ADDRESS: 4ct'l F o SFtR St Rte+ ENGINEER: KRW iAkLetUlb TEL.NO.: '! Cc IN -17(08 CERTIFIED SOIL EVALUATOR: FK&aA vu u+t I vtUwvt=-s K. 070 ,Tvoe.,, 1 Intended use of land: Residential Subdivision Single Family Home Commercial"" Is ommercial.- Is This: Repair testing X Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No. X 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 Ir-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: Q . r LOOT d,12.Ed=1.l3ac.± ` �I I 41_± y ISOOGa� fsNK \ \ \ l r I tY� Ou_\ EI..EVL1.T► ONS. �%�GGCI�-� or 9o&.+ A% e.--T AS UT OF"Se. loc. 00 109,Z`1U I LT To IOS78 IOe.a3 T FT IOS.Z1 IOS-74 SVB-SU2rAGE DISC:105A1_ NTo o. I0S.31 —"—__" SY5T EM i0514 -" " �P p 104.70 104 8 1 I N I.jv r ox. 104.El 104.74 NOtZTN A mpo o E12 MA, tuv GNn'D r-" F�IPE- . 1104 30 104-31 ,v EL:r-OF {�IPE"z oa"30 104 33 Fort INv ENo Or- plr�E 3 04 .30 IG14.2� A) maj V-ALIWOWSV l ABGA LE I"- 20' DATH;wov 10,1983 (�IGHG2-D F K",pM�NSr� pti�pSSOGIOTES ZI.Ic. ENGIN EE 2..SpGG1-/ITEGTS� L,pN� PLdNN E2SpND Su2v EYOGS NOeT F-I pNDOVEce OFGIGE GLaZK- No2T1-+ 6NGGV E�,MA _ Ieewp DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, July 19, 2005 3:19 PM To: McKay, Alison; Merrill, Pamela; Wedge, Donna Cc: Grant, Michele Subject: Soil Test Applications- 183 Forest Street, 4E Foster Street Hello, I thought that I would try something new....when I receive new applications, I forward to our consultant to schedule and give you a copy of the request to check on the wetlands. As I receive them in, I will also notify you via e-mail as a heads up. Also, Michele likes to attend the testing when it is scheduled, and would want to know if there are any wetland issues. Just forward the paperwork sign-off back to me when all set. Thanks! 84sf R1004141 A0AV,00w A00404 O!liwie Health Department Assistant Town of North Andover 400 Osgood Street North Andover,MA 01845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 1 Fv r4c r- 4L J y ► 1f, Cj , •�' (-, /?,nay Quip N. .C7 !,7 ol i r ( t` $ ' VIC 57. i _ s Commonwealth of_ ( assachusetts offilcial Use Only No. Tt q, 7f Departmeni of Fire Sei-vi(;-S i Tts�' I�Occupancy aud Fee Checked TION REGU*L' BOARD OQ FIRE PREVEN ATIONS [Rev. 11/99] '1%,blank) Ij APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work!o be performed in accordance%vifli the Nfassidiusetts Elecuicll Code I M EC),527 CN k (PLEASE PRINT 1N TNK OR TYPE A LL�JN1-_0RVfA TION) Date: City or ToNvn of: Vg-g_ To the h7SPC'Ct01-of TFire.y: By this application the undersignec gives notice of his or her intention to perforw, the electrical work described below. Location (Street& Number) 419 5'f`111,- G te,e_ e 4 ONvner or Tenant 7-/," &AC010,4% 'releplione No. 0 %ner!s Address SA('el-e is this permit in conjunction with a building permit' Yes ❑ No (Z (Check Appropriate Box) Purpose of Building Utility Authorization No. — Existing Service Amps Volts Overhead ❑ Undp-d❑ No. of Meters New Service Amps I Volts Overhead❑ Uridgid ❑ No. .fMeters Number of Feeders and Arnpacity Location and Nature of Proposed Electrical Work: C V V -&J1 Al SA�J 4C '37 Of n A-Z Y'r,1 C Completion of thcfollowing table niavbe waived bF the hapector o `f gyres. No.of Total No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans Transformers kVA No.of Lighting Outlets No. of Hot Tubs Generators KVA t<7 trng No.of Lighting Fixtures Swimming Pool Above o In- 0. ot Emergency izrnd. ❑ arlid. 13atten- Units No.of Receptacle Outlets No. of Oil Burners FIRE ALARNIS lNo. of Zones JNo.of Switches No. of Gas Burners No.of Detection and Initiating Devices No. of Ranges No.of Air Cond. Total No. of Alerting Devices i Tons lNo.of Waste Disposers Heat Pump I Number Tons KW No. of Self-Contained —Totals,I DetectionlAierting Devices Local 0 -!Nlunlc'P? [I Other Connection Security Systems: 44 No.ol"Devices or Equivalent Data Wiring: Date.... .... ..... ..... No.of Devices or Equivalent Telecommunications Wiring: No.of Devices or Equivalent AORTH 0 TOWN OF NORTH ANDOVER 10 "A ailt)"desirca"oras required by r.he Inspectorafffwe-, PERMIT FOR WIRING )rmance ofc)cctrical work- may issue unlcs� wcragc or its substantial eauivalent. 'Fnc to the Permit iSSUMV 0111cc. CH tExpiration 11-itc) This certifies that .... ......................................................................................... Z' IEC Rui;- 10. and upon coinpletioll. ..........i........................................................... wtio;, i�frue and compicte. has permission to perform ........ , 'L fi1c. NO.: 114 wiring in the building of.......)'- '� _'F/ .......................................I.......11........I................. ------ ------- ............ ............. at ....... . . . ........................ ..... .North Andover,Mass. 1311s. J"Q1. .%It. 'yet. No.: Lic. No. ...... ..........'. ... .... Fee.,....... ...... . J . . ........... ELECTRICAL INSPECTOR (clic'i,on��)1-1 owr)cr ov'-Flcr's w-cn— J Check # I-'RJ!JTF'EE: S a LETTER OF TRANSMITTAL NpRTh North Andover Health Department o� qt.-a o , '��►o 400 Osgood Street 3�' •`: _ '_ `' • o� North Andover, MA 01845 p 978.688.9540 -Phone 978.688.8476- Fax healthdent(&.townofnorthandover.com - E-, www.townofnorthandover.com -Website l �— La`�-�— >ti .Mu Daniel Ottenheimer - COMPANY: � � _ `a, ,�' Dept. Assistant Mill River Consultingv -t Co Phone: 1.800.377.3044 or 978.282.0014 Fax: 978.282.0012 We are sendin ou: PSoQ1 Test Urians ur-llG r A below) These are transmitted as checked below: L7 For Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: L-> �� 0 LETTER OF TRANSMITTAL �� E NORTH 1 North Andover Health Department o 400 Osgood Street 3? ��`•. _ _ ''�'• ooL North Andover, MA 01845 0 p 978.688.9540 - Phone i 978.688.8476 - Fax healthdept(a-)townofnorthandover.com - E-mail .1 ��'"•" '�'�' www.townofnorthandover.com -Website Page ofJ sS•�cNusE TO: DATE: _ Daniel Ottenheimer ///9 D COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting RE. Phone: 1.800.377.3044 or 978.282.0014 Fax: 978.282.0012 We are sending you: 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: Lr LM ` BOARD OF HEALTH NORTH ANDOVER,MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: �'�� '0 MAP&PARCEL: LOCATION OF SOIL TESTS:. � � OWNER J AWLS ?AyKF-LA LAC-OL-L-A TEL..NO.: ADDRESS: 4C rl d ENGINEER: RRW ig"UO "ntra"awfr _ TEL.NO.: &J'7$- $6 -J'7&8 t CERTIFIED SOIL EVALUATOR: I ijs-aX 11A C ©S.( O r7i2 E i,.WVM-s K, b4-+9A Doe,', Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing X Undeveloped lot testing Upgrade for addition T In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WrM THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$4425_00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of3S 60.00 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. Pull 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: '�T���� Date Received: Check Amount: Check Date: W I � � A,D( � cow M0,- 6k�eII)rlIq mcq 0PV ,Tse SJUG FJ (acern rt P � � 1 2 L6T2p6crr . lam t TIGER ENVIRONMENTAL ENGINEERING _ 969 WASHINGTON STREET BRAINTREE, MA 02184 LIOFP� 617-849-0088 R SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPE PART A CERTIFICATION Address of Property: q7 �OC2i"L—(L- Address of Owner: (if different) Town: N kN% C)V Cf MA; Owner's Name: ►M e-ofrlo� Date of Inspection: '2• b ❑ Voluntary Assessment Name of Inspector: AM K �-)COoc-4 (Not Reported) Name CERTIFICATION STATEMENT: 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 inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ,--<asses Conditionally Passes Needs Further Evaluation By The Local Approving Authority Fails Inspector's Signature: Date: U The system inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired.The system,upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not). The septic tank is metal,cracked,structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. 1 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE_ DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 4AI F0 VER N. kNT�o dam- Owner: "�d►n I_Aco l L 0, Date of Inspection: 3•(o•� B] SYS M CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled,or uneven distribution box.The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are placed obstruction is removed C] FU HER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surfacewwater Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well. r The system has a septic tank and soil absorption system and is within 50 feet of a private water { supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 2 TIGER ENVIRONMENTAL • ENGINEERING "YMa 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 60424em N• PcN1 ue-a . M A, Owner: i,M Date of Inspection: 3 �► q{„ Check if the following have been done: ✓ Pumping information was requested'bf the owner, occupant, and Board of Health. (/ None of the system components have been pumped for at least two weeks and the system'has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the System recently or part of this inspection. ' As built plans have been obtained and examined. Note if they are not available with N/A. ✓ The facility or dwelling was inspected for signs of sewage back-up. 1 The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. All system components, excluding the soil absorption system, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge,depth of scum. The size and location of the soil absorption system on the site has been determined based on existing information or approximated by non-intrusive methods. . w The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of subsurface disposal system. 4 . _ i • �` TIGER ENVIRONMENTAL r ENGINEERING t 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: K q'? fe-'., N• Ar xVO Lrwrz-- Owner: 73 ►yo Date of Inspection: 3 • Co• `i Sewage odors detected when arriving at the site: (yes or no) SEPTIC TANK: (locate on site plan) Depth below grade:QLD , Material of construction: ✓concrete metal FRP other(explain) Dimensions: W 5/ D Sludge depth: '3`' r Distance from top of Judge to bottom of outlet tee or baffle: @ Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: I /a' Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) j3p TEFL&S oo - t if/LA r 9 L e Lje j, Ar t36,4 � or nL,4(_O+- ►10 ifj1i7E1JC'0 oL L-ekkK",f- S41?txC4-MWAi, rN4-e9(Z , Ci o l2 I NLP-I- )NVetZ r r Lge ke P 8&/ 268E1K AN D R<.14-c a'3 yH-4; /Le i4 R P o R Lae' f i, 4,A n u.-4- - aft�thr�e^ D t Rg•++rN 9 r:)A Pp 0`4 0262"C-/5 r y Sib - S G��S T 'P a M o 11-9 �.�1 ;�r.� `-'��`I 6 4-0 IEWI I o I'f GREASE TRAP: 11 iA (locate on §ite plan) Depth below grade: 41 Material of construction: /oncrete metal FRP other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of lea age, etc.) y l 6 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 14 ei 1 li�q St�2 N /10j Dn vim. r~.r4 Owner: i nn L AC a c L Date of Inspection: 3 • to q fv TIGHT OR FOLDING TANK: N k a (locate onsite plan) Depth below grade: Material of construction: concrete metal FRP other(explain) Dimensions: / Capacity: gallons Design flow: gallons/day Alarm level: Comments: (con)tion of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (note'if;lev laid-distribution=is'71equal evidenq oi`solids ca#ry over,evidence of leakage into or out of boz, etc.) box L•-e�l_ - 2StR6ogt4d-roti FigoAL.- No �An f D e—"A, 01/ew-- No gnli r).o^) w moi' e44 k Alne PUMP CHAMBER: N (locate on site plan) Pumps in working order: (yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances; etc.) 7 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: `/ 7 Fosig-r, N,rA),jpp7J`�2 M A- Owner: Si M L Arc 0Lt. 0, Date of Inspection: 3 -& - I (a SOIL ABSORPTION SYSTEM(SAS): V (locate on siterplan, if possible-excav tion not required, but,may be approximate d.,by non-intrusive,4methods) rt If not determined to be present, explain: t Type: .� Leaching pits, number: Leaching chambers, number: Leaching galleries, number: Leaching trenches, number, length: _'3 -1.2ewc 4e-7 AfpR )e y o' t-o+-j A-, pL.Arj Leaching fields, number, dimensions: Overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) N-0 IficAr3tF Eyinew<e;7 a' ti�pkkut- c. 6-rkrc-16 uta- b(1'e 10 SN-o� 49,dn� r> c.cr✓c41— CESSPOOLS: A (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication df.6rou'd6water,.: ,. Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, leve/Ifponding,condition of vegetation, etc.) 3 PRIVY: N A (locate on ite plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of by raulic failure, level of ponding, condition of vegetation, etc.) 8 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: s-441') Fn S-rM N • Anj Do VeTz, rIVI A Owner: 1 ,M L 1RGo LL A Date of Inspection: G,•I � SKETCH OF SEWAGE DISPOSAL SYSTEM: i Include ties to at least two permanent refere9 esu, landmarks or benchmarks Loc e all wells Withjn,,100' ',' �; to + R E > . . _ /7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O= 'fa, 61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A . .g . . . . . . . . . . . . . . . T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �-sox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DEPTH TO GROUNDWATER: Depth to groundwater: &4 feet Method of determination or approximation: N'D Wf AqZ 10 sL W+p 11-{- (D-+ 9 . Page 1 of 1 DelleChiaie, Pamela From: Andy McBrearty [amcbrearty@millriverconsulting.com] Sent: Tuesday, November 22, 2005 11:29 AM To: DelleChiaie, Pamela Cc: Daniel Ottenheimer(E-mail); Lisa LeVasseur(E-mail) Subject: Several Const. Inspections Hi Pam, Here are inspections for: L f 5 Gray St(revised from earlier report) 497 Foster St(11/1) 795 Johnson St(11/1) 46 Raleigh Tavern lane (11/17) Am sending these compressed in the hope that you can get/read them better than when sent as direct attachments. -andy 11/22/2005