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HomeMy WebLinkAboutMiscellaneous - 50 SHERWOOD DRIVE 4/30/2018 a�r�h iI w .. ---' w.arr*:.wrw+F,. «+rt.,,,w=•+Y..ms*rmh: .w .a ,., wood w iml�,•fly rNw� N ud�GI,'. E, m,' _ Map BlockDrive - . u 105 00606 0 W < ,,y+l" •�°�F �' nr x0 "_,�,„ r.�i _. A .., ( �' r+ n i i ,a xn wk ..� r � Vii. .JP e N F � � t w 3, � � =Srl° .., n° � w'+u w u .h' m�� a w t °'�' ��, y •�.e ;i;:a '�n` e �` . � e ° °[ t��? °k it •8. j tF � ''° ; � S fly T. ,�+m�e a A,- rte. ��,,,y ��' , Y � G a a r'Y E y�:r ✓ T �'. i ..;Ma I" x �„w. 1 a am., ct, 9.`1: }: �,,, �-:1 ura,kv ry x irz i- .. r uT ° 6 r E O FORM 11 - SOIL LVALUATOR FORA Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole............ ... inches epth weeping from side of observation hole ...... . inches Depth to soil mottles . . inches ❑ Ground water adjustment .................. feet Index Well Number ................. Reading Date .......... ...... Index well level Adjustment factor _.._-- Adjusted ground water level ........ .................__..... ......... Deoth of Naturally Occurrina Pervious Material Does at least four feet of naturally occurring pervious material exist in aJJI areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification . r I certify that on 11/94 (date) l 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 bit" 5/1/96 9 Date DEP APPROVED FOR.11.12/07/95 03-21-1996 14:36 617 932 7615 CEP NORTHEAST REGICNAL P.02 0 .0 FORM 12 - PERCOIATION TEST I Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test' -� 1 Date: Time: 12 2"1 PM Observation Hole Depth of Perc Start Pre-soak End Pre-soak 12 AL Time at 12" Time at 9" Time at 6" \ 38 Time (9"-6") Rate Min./Inch 1 ' Minimum of 1 percolation test must be performed in both the primary area AND reservee area. , Site Passed lr! Site Failed ❑ Performed By: Witnessed By:\.. 5U 5 � Comments: ..._ _... pYT Aymovm roRM.UIW7171 03-21-1996 14:36 617 932 7G15 DEP NORTHEAST REGICNaL P.02 1(x/1 FORM 12 - PERCOL.ATIQN TEST Location Address or Lot No- — 5 �1�2.wa�v bi2�v� comMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test' Date: 19 S Time: Observation Hole n �g Depth of Perc �► Start Pre-soak End Presoak , Time at 12" 1 Time at 9" Time at 6 Time (9"_6") Rats Min./inch Z Minimum of t percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ Performed By: �✓��v' �,L�'�S� Witnessed By 1J2 N`2`P r P` . Comments: _... 0g?AFMOVLo TORM-13/97/91 O Q FORM I1 - SOIL LVALUATOR FOPUNJ Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole........... .. inches_ ❑ Depth weeping from side'of observation hole .......... '.. ,inche12� s _ Depth to soil mottles .. LQLP inches ❑ Ground water adjustment .................. feet Index Well Number ........ ........ Reading Date . ..... Index well level _ Adjustment factor _.... .......... Adjusted ground water level _. .. ...._...._... .......... Deoth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on 11/94 (date) I 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. r Signature 5/1/96 9 Date DEP APPROVED FMM•12/07/95 FORINI 11 - SOIL EVALUATOR FORM Page 1 of 3 No. 14- 49 . Date: 41zcp Commonwealth of Massachusetts . aOcw� Massachusetts Soil Suitabili Assessment for On-site Sewage Disposal Date: 8 1 z gl 95 S . Performed By ........ ................ .............. .... . ..... ........... Witnessed By: Owrcr's Name.��1-/�pJ�'L'Prt-tlp �I�IL�E'fLS� 11r.1L. Lntlon Address or Address.and +i712�V� Addr s, ! 40 :j7 ewstructpair ❑ Office Review / Published Soil Survey Available: No ❑ Yes ❑ �32D Soil Ma Unit \A; C> � ��• Year Published l�g\.... Publication Scale .... .......... F exc�c.�,\a��.�! y f�"-- (,S�.oPE,.............................:...................:.... Soil Limitations Drainage Class p¢a�.�c-� - ^/ 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 L2 Yes ❑ ; nd )No LJ Y es ❑ Within 500 year flood bou ary year flood boundary No [5 Y es ❑ Within to0 y E Wetland Area: . National Wetland Inventory Map (map unit) ............................................ Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month - Range :Above Normal []Normal ❑Belc,.V Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 FOR—N 11 - SOIL EVALUATOR FORM Page : of 3 Location ,address or Lot ivo. Usmb oe—w% On-site Review Deep Hole Number 9'7'?JD Date:. 5\.Ze1.9s Time: AM Weather V:�X2 Location (identify on site plan) �j . ..SP 't "TA22 P t7t5 Posra� SrCs-fEv..t PEs�c�� Land Use Slope M Surface Stones Vegetation VsooC;'C� ( V qyt p � s. Landform �S1ce2- SA�srTA2`Q 171SP�5�. S-•4Cri�+-� QEStG,.� ((��u3 Position on landscape (sketch on the back) 'sone Distances from: Open Water Body feet Drainage way Nb—E feet Possible Wet Area feet Property Line 3.�j'+�feet (VZV-3Yvt %.-'F-c Lo-r L_t>sE) Drinking Water;Well ►4bte feet Other _. DEEP OBSERVATION HOLE LOG' Depth from -Sail Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) A int � s i i 'ZA`� l2`t G, S Z,5- 514 >< 5'CfLA-ttF►ta� -SA.-��75 C"t. � � � Z•S`f`EI4 �.161� ZTdt�-� sa.-�to�l uoat•� I MINIMUM OF 2 HOLES YVt ASIS t�E. _ Gt�rvt I REQUIRED EVERY PROPOSED Parent Material (geologic) W-TwAst\ DepthtoSedrock: Ndt3E Depth to Groundwater: Standing Water in the Hole: tzw-f // Weeping from Pit Face: N th Estimated Seasonal High Ground Water: Q Ipoy @ ULQ 1. = \33•S, DEP APPROVED FORM-12/07/95 i FOP-N-111OOIL EVALUATOR FORM Page2of3 Location Address or Lot ivo. On-site Review Deep Hole Number A-Z. Date:. -4 \e55 Time: Pt,.-A Weather 11�--PextZ Location (identify on site plan) (SSC) Land Use Slope (%) Surface Stones Vegetation • LAjoopfzp ( C> 56-4+Z'sF3S� Landform Position on landscape (sketch on the back) Distances from: • 0 en Water- Body Igo Z.;.feet Drainage way 140NE feet :Possible Wet Area�8p-2A0 feet . Property Line 3O�'� feet (v0ga n 2-T l.C:,-r t_.t�E� Drinking Water Well, IJ6NE • feet Other DEEP OBSERVATION HOLE LOG* De"pth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Gravel - i 1 Z•5y�3 �ptsk. Bov�.o�-�-t MASSW E ��ac3ti.� �. If l_1 S 5 v i MINIMUM OF 2 HOLES REQUIRED Al LVthY tJhUtJUbi:-L)UlbFUbAL AREA I Parent Material (geologic) DepthtoBedrock: +�`� - @ IpZr N Depth to Groundwater: Standing Water in the Hole: NSE Weeping from Pit Face: �SDP1L Estimated Seasonal High Ground Water: G> ES-- 133•S�� DEP APPROVED FORM-1.1107/95 i �. FOR:'YI 11 - SOIL EVALUATOR FORM r• Page 1 of 3 Date: 4 2(.c �elp No. 14--9 - 3 Commonwealth of Massachusetts �Mj�k" WVb\[Go- , Massachusetts Soil Suitabili Assessment for On-site Sewacre Disposal Date -4 Performed By. ... .. Witnessed By: _........... ....... ...... ... ..._._..__ .......................................... 0..Mf:v.�e. -r��..1�F�2-I.PaJD �l-►ti�-pC�LS, ING, aon Ad/ oy�,�•ri Q--��y/-� �Y-yG�►�,V r/C' Address.incl Telephone 1 Ad;" tion Repairwn bA•17 ❑ lh0$� 4"15— 8—I IS Office Review _ Published Soil Survey Yes Available: No ❑ 't=13?-� Soil Map Unit � D year Published` 198 Publication Scale S�-dPrc� EXC E 5s w E�'-C SEV E�rc-� .................. .. .........._...._.. ... Soil Limitations ........................... Drainage Class dea►a�" ............... Surficial Geologic Report Available: No Yes Publication Scale Year Published GeologicMaterial(Map Unit) .............................................................................................................................._. ...........;._•...._ .. ............:.............................................................. ........................................................................................... Landform Flood Insurance Rate Map: �-�/ Above `7 500 year flood boundary No. L Yes ❑ Within 500 year-flood boundary N�o Y es ❑ Within 100 year flood boundary No NIfes ❑ Wetland Area: National Wetland Inventory Map (map unit) . .................... ...............,............................................................ Wetlands Conservancy Program Map (map unit) Current Water Resource'Conditions (USGS): Month Range :Above Normal ❑Normal ❑Belcw Normal ❑ Other References Reviewed: DEP APPROVED FORA-12/07195 i J03-21-1996 14:36 617 932 2SIS DEP NORTHEAST REGIONAL P.02 0 FOR�i 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS \ 'W� , Massachusetts 110 t2'C� PcN -f Percolation Test' Date: 5 1-j �g�j Time: 1•L4� AM Observation Hole Depth of Perc58» Start Pre-soak End Pre-soak Time at 12" l Time at 9" ,Z.• 3� Time at 6" Time (9"-6") --�a �►� Rate Min./inch Z� Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed E2 Site Failed ❑ Performed By: Witnessed By':' Comments: ..._ __.. otr r►r OYM roar"•wvrna - 11 ' FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. ✓ �� � oi�� Determination for Seasonal Hiyah Water_ Table ' Method Used: �1Jp �P_c�3tiDuz��CESL E��dE-Nc� �►�'1�� ❑ Depth observed standing in observation hole............ .. inches ❑ Depth weeping from side,of observation hole_ inches ❑ Depth to soil mottles inches ❑ Ground water adjustment .................. feet Index Well Number ........ ........ Reading Date ....... Index well level _.... .. ... - Adjustment factor ...._.......... Adjusted ground water level ....................._ ..... . ..... Deoth of naturally Occurring Pervious Material j Does at least four feet of naturally occurring pervious material exist in 9,11 observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on 1 1 /g4 (date) I 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 Date 5/1/96 DEP APPROVED FOP-%l-12/07/95 iFOR 111 QDIL EVALUATOR FORM i Page 2 of 3 Location address or Lot IJo__:L-c>C 3 - SN¢,G�,soofl t�2tvE On-site Review Deep Hole'Number Date: ..�zckgS Time: AM Weather +FAk61— Location (identify on site plan) S-rt�.... Land Use Slope (%} Surface Stones Vegetation; _Woopt�� Landform Position on landscape (sketch on the back) Distances from: ~'Open Water Body Drainage way moo*'£ feet ''Possible Wet Area loo-1°5o feetr> Property Line 3p* feet Sarc'w stv_S Drinking Water Well oc;►J "feet Other _ DEEP OBSERVATION HOLE LOG* Depth from r Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel ' A FVs/L- 1-�0 +��.-�� sa���! moa►-� i Z%_ ��� 3 % GZ.s�s/s ►.soNsiL WQ�LPIaL�e rAtasS,JC_ �7, Z.5�f sI3 Iso►- 5'CtZA'C�F�bp� r-%e4'A. -co rvvASSWE I 1=t2ic�a�� 'Iz-c�cS @ lop" I MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) C>j-r ,3A-_'%A DepthtoBedrock: 6P Depth to Groundwater: Standing Water in the Hale: WAC- Weeping from Pit Face: IJCJ''�E Estimated Seasonal High Ground Water: �0-var_— DEP APPROVED FORM-11/07195 " i R. FvR'�i T"I - SOIL EVALUATOR FOR. TO'dVN OF NORTH ANDOVER/ Page 1 of 3 N BOARD OF HEALTH rEALTH MAY 2 NO. D ak, e: .4lzco Commonwealth of IM assac use s Massachusetts Soil Suitability Assessment�foon `on-site Sewage Disposal -eTE.�t� �.5. C�'ue„So'.. _... - � Date: 41 zo. t 9S Performed By: Witnessed By: _....._.... . Dwner's Name. "'��11�� -t_l .tip E an Addrus orAddress-and�jConstruction VoRepair ❑ ( 4-1 Office Review Published Soil Survey Available: No ❑ Yes X981P a 1 =137A Soil MUnit - - Year Published Publication Scale .......... E�CGEssriG�K _�1E� �SuMpE�..... Drainage Class c�eQN3 :--.-.. Soil �mltatlons Surficial Geologic Report Available: No Yes ❑ Year Published Publication Scale Geologic Material (Map.Unit) y .........................................................................:..:......................... ... . .......... . -. ......_. __..._ ..... �,SiGL�Q r --_ Landform Flood Insurance Rate Map: Above 500 year flood boundary..No LTJ Yyes . ❑ Within 500 year flood boundary No Plyl es ❑ Within 100 year flood boundary No Byes ❑ t Wetland Area: National Wetland Inventory Map.(map unit) .-•....---- Wetlands Conservancy Program Map (map unit) Cdkent•Water Resource.Conditions (USGS): Month - Range :Above Normal []Normal ❑Belcw Normal ❑ Other References Reviewed: DEP APPROVED FOR.'N.12/07/95 D� 5 +(a ►:7 D T Lj 4f-1 V[a 2Y egr- •dove aTs Z. T►2-e0e,4 C5 - y'W I ' - 7'L I �I' la"r m P tjg- l � �r b i5-r, Rae — I ��I•+o L.cA D6NG pA-T—w t�is-r, ��„�T - 13`i•z 5 G .o 01F//pr �4 3.3G r - 13�.G6 r., 0 D -Tit. v r� -rye►.tet-1 bZ - 13 , T�. A,T2P 0 FT, of -���� - � - l ��,.I S I�or`15 g L raw.CO r-P- � 2 1 I *r5, ,.r.F.;141.5 A L' APPROVED BY I y y 1 �P*� (•or Y' BOA PDOF r HEALTH � f y r NAME %A DATA n I U ort• c Q a rn M \v� I veal, reop, N�,-I Tfz EAG! I . I IS''S 1C, Pt � LE�o� S, No- r-M- A F i E-L.A Xs6jo%j E`'t'. Co 0-rd. d T m M 71-1 rt u- FI S v F'Y A LI. gyc 117r�nJ6 4TI L 6 TI QS �r1�17 S rf `_ x Z,) �.�a�T'•K-+a GT'lo a 0� 'T^P-1 L�pKd�s� �k E Nit 25• S+2-7yLA.^L.L. ewmtrsif-H -rd -t✓I-rL9 ^uo -rd, r7 i2. -rN E P P B` T}d► S c I•.l F�f Ei A`�I�'TE �, i raG, p�c1'G'� 3- I�I'-�i(o, ��� �,f � G�pY G arJ 13 E O?i-t�.I ti9t v F►,.v►-+ -I'µ� A • fes,o►, i�. OF SUBSURFACE DlSPMA . SYsTtmL ff� u Pc CPA PE LOCATED IN OoeTr4 AW POVEIZ , H-Az,6. / `30 ►2- I VC- AS PREPARED FOR E LAY DHEALTH _DATE: , 22,—Ur C� .SCALE: '� I r-f r � L► I �{- F NOR H A TH MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL (617)473=3555, 3MS721 I' 'f y R N' f.; Y al n � n D� 5 I� � Dom,i ra, �,��►►��,�Y �� ��ve►yrs 11 A Edi f' G N Z 17 Raw �� — 131•`�"o G .osF/ T �4 , ev(a ND Trz gam, PI�:P-rrz. 0 L r24. co r-a- A, PSI �– � � ��, I b►ter, �'� �`�'y ��' 1 � Y TF.s 14"5 A L` I 11 y' APPROVED BY rA sr / BOAR® C EALTH �2. NAME DATEZZj� / M � � � SEs � P �P N��� -r�E►�u-( .. 30L. e- Lt I W z- I 'p D i I / t I LIOTE7S, F7-a4-Is,-T--00 �i vw!-� 'la +�s Ga►-r�I l.Eb F►2ot-( I S"T/ ►160 rlto.Ns ? rLElo I-OS, Na' C:: --I A I FIE-Lr) Lii.J IZV E (. CO Q'rrt.*Cf O 12 : P P A W- FI ELv 1� ve:V-1 FY /*LL k�!'r!N6 yT14d'`I�S 1.9p�7 .da�rrt u GT`Ir�a o -fra G�P Ksa 1� "1'i?e 25• 5 .27 �9t lr.l.4 G�NtsstGHTV fi t-rLt 5; A uv Tm Z-2 I-I E 12 JJ 00 D D1'L. A-P�P-A,r~-I, PLOW e- 11400 AS G Q c V P A I^Tr✓S, I r%1c. DeT917 3- 14-9(,r, ��Q �� �.:. !moo ICY G arJ P�E O g-t7�►►9G!7 F h.cs�-� T) G 1. 11 , rd-.m, 4, OF SLMLW' ACE DISPOSAL . SYSTEM [JPc 2A DE LOCATED IN Z7 AS PREPARED FOR RECEIVED DATE: AUG 2 4 2005 SCALE: '� c��� �`l,, 14 j� TOWN OF NORTH ANDOVER HEAL TH QEPARTMENT MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS Oit_10 • TEL (617)473=35S3, 3MS721 i r.. F Y RESTRICTION The Restriction herein set forth shall apply to the real property located at 50 Sherwood Drive,North Andover, Essex County, Massachusetts, being more particularly described as follows: The land with the buildings thereon, in North Andover, Essex County, Massachusetts, described as follows: Lot 3 as shown on a plan of land entitled"Planned Residential Development of`Jerad Place—Phase IV', designed for Timberland Builders, Inc., 40 Sunset Rock Road, Andover, MA 01810. Dated September 1, 1995, Rev. to March 12, 1996, Thomas E. Neve Associates, Inc., Engineers— Surveyors—Land Use Planners, 447 Old Boston Road, U.S. Route 1, Topsfield, Massachusetts, 01983, 508-887-8586", and recorded on May 2, 1996 as Plan No. 12805. Being the same premises described in deed recorded with Essex North District Registry of Deeds in Book 5595, Page 222. The current owners of the property, John G. Kelly and Kim E. Kelly, hereby will upgrade the septic system on the property to the current Title V standards and have it accepted by the Board of Health for the Town of North Andover or tie into the town's sewer system prior to the sale of the above-referenced real estate. Witness our hands and seals the Tt-4 day of April 2002. John G. Kelly e Kim E. Kelly COMMONWEALTH OF MASSACHUS _=S Essex, ss April , 2002 Then personally appeared the above named John G. Kelly and Kim E. Kelly. nd acknowledged the foregoing to be their free act and deed, before me. Ga Notary Public H:\GR000\GR92R\R.est6ction.doe My Commission'FXplres' ! �.. 27 2ov"{'' J Driving Directions from 400 O--ood St,North Andover, MA to 50 Sherwood Dr,North ... Page 1 of 2 ' P Start: 400 Osgood St �J4� North Andover, MA 01845-2909, US End: 50 Sherwood Dr North Andover, MA 01845-3247, us Notes: Directions Distance Total Est. Time: 10 minutes Total Est. Distance: 4.24 miles 1: Start outgoing NORTHEAST on OSGOOD ST toward <0.1 miles HARKAWAY RD. .2: Turn RIGHT onto HARKAWAY RD. 0.2 miles 3: Turn RIGHT onto STEVENS ST. 0.6 miles 4: Turn SLIGHT RIGHT onto GREAT POND RD.. <0.1 miles 5: Turn LEFT onto STEVENS ST. 0.1 miles 6: Turn LEFT onto SALEM ST. � 2.4 miles <t> 7: Stay STRAIGHT to go onto BOXFORD ST. 0.7 miles 8: Turn RIGHT onto SHERWOOD DR. <0.1 miles © 9: End at 50 Sherwood Dr North Andover, MA 01845-3247, US Total Est. Time: 10 minutes Total Est. Distance: 4.24 miles http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&2si=navt&1gi=0&un=... 10/28/2005 Residential Property Record Card PARCEL_ID:210/105.C-0060-0000.0 MAP:105.0 BLOCK:0060 LOT:0000.0 PARCEL ADDRESS:50L-3 �HERWOOD DRIVE PARCEL INFORMATION Use-Code: 101 Sale Price: 624,434 Book: 05595 Road Type: T Inspect Date_: - 07/24/2002 Tax Class: T Sale Date: 10/31/1999 Page: 0222 Rd Condition: P Meas Date: 07/24/2002 Owner: KELLY,JOHN G Tot Fin Area: 4328 'Sale Type: P Cert/Doc: Traffic: M Entrance: X KIM E KELLY Tot Land Area: 0.75 Sale Valid_: Y Water: Collect Id: SGC Grantor: SHERWOOD DEVEL' Sewer: Inspect Reas: M Address: 50 SHERWOOD DRIVE Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LM Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 10 Main Fn Area: 2162 Attic: N NBHD CODE: 9 NBHD CLASS: 9 ZONE: R1 Story Height: 2 Bedrooms: 4 Up Fn Area: 2166 Bsmt Area: 2154 Seg Type Code Method Sq-Ft Acres Influ-YIN Value Class Roof: H Full Baths: 3 Add Fn Area: Fn Bsmt Area: 1000 1 P 101 S 32693 0.75 133,771 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: VALUATION INFORMATION Masonry Trim: Ext Bath Fix: Tot Fin Area: 4328 Current Total: 839,700 Bldg: 705,900 Land: 133,800 MktLnd: 133,800 Foundation: CN Bath Qual: M RCNLD: 641756 Kitch Qual: M Eff Yr Built: 1999 Mkt Adj: 1.1 Prior Total: 804,800 Bldg: 677,400 Land: 127,400 MktLnd: 127,400 Heat Type: FA Ext Kitch: Year Built: 1999 Sound Value: Fuel Type: O Grade: VE Cost Bldg: 705,900 Fireplace: 2 Bsmt Gar Cap: 3 Condition: E Att Str Val 1: Central AC: Y Bsmt Gar SF: Pct Complete: Att Str Va12: Aft Gar SF: %Good P/F/E/R: ///100 Porch Tvae Porch Area Porch Grade Factor P 12 T 556 SKETCH PHOTO 14 gn 14196 Sq.1t.4 P Ct U- T 360 Sq.R. 12 2n1 4 No I FULB l! 4 84 FU�B/FM %36 1314 Sq.R. 3 Ava i I o&g& b I e 29 3 2 2 Parcel ID:210/105.C-0060-0000.0 as of 7/13/05 Page 1 of 1 f ;i _ .. -5. tt f- r.cr lKi y. J �y jr1 • .�•� .£���,,'jiy�..�'S.-°r ,�r �1�� � .t„_, [ ... .•, S .! 1 '/.L'T ”. ,LN)� C` I 1 ;.:mob^ MAP # ` LOT # PARCEL # STREET QO.NSTRUCTLO.N APP A.L, HAS PLAN REVIEW FEE .BEEN PAID? YES NO PLAN APPROVAL: DATE 9 Ifo APP. BY- Ad a/I/L_�_ DESIGNER: /l��V�� PLAN DATE. (C✓ �� CONDITIONS WATER SUPPLY TOWN WELL WELL PERMIT �\ DRILLER._._._._ WELL TESTS: C MICAL DATE APPROVEDHAC'TER I I DA i E 11PPRUVED BACTERIA II DATE APPROVED COMMENTS: FORM U APPROVAL: APPROVAL 1-0 ISSUE ES NO 10,19 DATE ISSUED #- BY �! CONDITIONS: FINAL APPROVAL: . ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NU SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NU ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: BY: SEPTI C"S�L�ZFLL�.NSSfl44�flT.I QN � Y n/ t � , 1 I r .. .� , yy, ." 1:''.:..�:.•-t. i •`, T A t� �fY 1 y � 1 � 1' - :'. y lir• •.1 .. . . . .. - IS"THE• INSTALLER LICENSED? NO 'REPAIR :•, .,,.TYPE. OF CONSTRUCTION. NEW CONSTRUCTION:•,... CERTIFIED PLOT PLAN REVIEW NO CONDITIONS OF:.APP ROVAL YES (FROM FORM U) SSUANCE •OF DWC PERMIT _ NO :rDWC PERMIT N0. `"0/1 .�/ _f : INSTALLER: j BEGININSPECTION YES 0: \ _ . _. . . - ._ :.: :EXCAVATION . INSPECTION: ; NEEDED: 71 . t PASSED , BY _ , CONSTRUCTION INSPECTION: NEEDED: 7N 16 r 7. AS BUILT PLAN ok- SATISFACTORY.: j YES: APPROVAL. TO BACKFILL: DATE: BY FINAL . GRADING APPROVAL: DATE 10 g`c/ Y .FINAL CONSTRUCTION APPROVAL: DATE , Y COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION-,,. , -I EHEALECE'V TH 5 2006 RTH EPART(v;,.',,�yg� TITLE 5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_50 Sherwood Drive North Andover_ Owner's Name:_Kim Kelly Owner's Address: 50 Sherwood Drive North Andover,MA 01845 Date of Inspection 9/15/2006_ Name of Inspector: Neil J.Bateson_ Company Name: Bateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ _Andover,MA 01810 Telephone Number:_(978)475-4786_ 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 the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fai Inspector's Signature: c Date: _9/15/2006_ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. ` Notes and Comments: ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Pag&2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:_50 Sherwood Drive_ _North Andover Owner:—Kelly_ Date of Inspection:_9/15/2006_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_50 Sherwood Drive_ _North Andover_ Owner: Kelly_ Date of Inspection:_9/15/2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the Ys m is not functioning in a manner which will protect public health,safety and the environment: system g — Cesspool or privy is within 50 feet of a surface water Cesspool privy is within 50 feet of a bordering vegetated wetland or a salt marsh _ sP or P �'Y 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone l of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance— "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Pagb 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 50 Sherwood Drive _North Andover— Owner: Kelly_ Date of Inspection:_9/15/2006_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or`no"to each of the following for all inspections: _No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool No_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool No Liquid depth in cesspool is less than 6"below invert or available volume is'/z day flow. _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ No_ Any portion of the SAS,cesspool or privy is below high ground water elevation. No Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ _NoAny portion of a cesspool or privy is within a Zone 1 of a public well. _ _No__ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_50 Sherwood Drive_ _North Andover_ Owner: Kelly_ Date of Inspection:_9/15/2006_ Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No yes_ — Pumping information was provided by the owner,occupant,or Board of Health No Were any of the system components pumped out in the previous two weeks? Yes_ " Has the system received normal flows in the previous two week period? No Have large volumes of water been introduced to the system recently or as part of this inspection? _Yes — Were as built plans of the system obtained and examined? _Yes_ — Was the facility or dwelling inspected for signs of sewage back up? Yes Was the site inspected for signs of break out? Yes Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No _Yes_ _ Existing information. _Yes_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[3 10 CMR 15.302(3)(b)] Page 6 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 50 Sherwood Drive_ _North Andover– Owner: Kelly_ Date of Inspection:_9/15/2006_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_R5_ Number of bedrooms(actual):_5_ DESIGN flow based on 310 CM15.203_550_ Number of current residents:_2 Does residence have a garbage grinder(yes or no Yes Is laundry on a separate sewage system(yes or no):_ o Laundry system inspected(yes or no): Seasonal use:(yes or no): No_ Water meter reading: Yes_ Sump pump(yes or no): No Last date of occupancy:_Current COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203):,gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:_Pumped three years ago,owner_ Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped: 0_150gallons--How was quantity pumped determined?_Measured tank Reason for pumping: Inspect tank&tees_ TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool_Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval —Other(describe):_ is date installed if known and source of information:_7 years old, 9/7/1999,as ' ate age of all components, ( ) A roxmi , PP g P built plan,for original system. Cellar finished in 2005,system upgraded from 4 bed to 5 bed,30'trench added in 11/22/2005,as built plan_ Were sewage odors detected when arriving at the site(yes or no): No Page 7 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_50 Sherwood Drive_ _North Andover_ Owner: Kelly_ Date of Inspection:_9/15/2006_ BUILDING SEWER_X_ (locate on site plan) Depth below grade:_22"_ Materials of construction: _cast iron _X_40 PVC other Distance from private water supply well or suction line:' Comments(on condition of joints,venting,evidence of leakage,etc.) _4"PVC thru wall,3"PVC in house,no leaks. SEPTIC TANKS:—X — Depth below grade:_10"_ Material of construction: X_concrete`metal _fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):`(attach a copy of certificate) Dimensions:_10'x 5'x 49 _ Sludge depth:—5"_ Distance from top of sludge to bottom of outlet tee or baffle: 22"_ Scum thickness:_10" , Distance from top of scum to top of outlet tee or baffle:- 8"-Distance from bottom of scum to bottom of outlet tee or baffle:_15"_ How were dimensions determined:_Tape Measure_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc _Pumped septic tank. Inlet tee ok.Outlet tee ok. Depth of liquid at outlet invert.No evidence of septic tank leaking._ GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction: concrete_metal_fiberglass_polyethylene_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: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of l 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 50 Sherwood Drive_ _North Andover— Owner: Kelly_ Date of Inspection:_9/15/2006_ TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass__polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOXS:—X — Depth below grade _12" Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of into or out of leakage bo .)– : D-box level&distribution equal,has flow levelers. No evidence of leakage �etc Evidence of carryover,pumped d-boa to clean PUMP CHAMBER:—(locate on site plan) Pump in working order(yes or no): Alarm in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 50 Sherwood Drive_ _North Andover— Owner: Kelly_ Date of Inspection: 9/15/2006_ SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: _ leaching chambers,number: leaching galleries,number: _X leaching trenches,number,length: 3 trenches,two 67'long one 30'long_ — leaching field,number,dimensions: overflow cesspool,number: innovativelalternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):_Soil ok.Vegetation ok.No sign of ponding to surface. CESSPOOLS: Number and configuration: Depth—top of liquid to inlet invert:_ Depth of sludge layer:_ Depth of scum layer: Dimensions of cesspool: Materials of construction: _ Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page l0 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_50 Sherwood Drive_ _North Andover— Owner:—Kelly_ Date of Inspection:_9/15/2006_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Lute where public water supply enters the building Driveway House A Water Meter eptic Tank —D-Box A to Inlet Cover=17110" A to Outlet Cover=25110" A to D-Box=5411" B to Inlet Cover=24' B to Outlet Cover=2515" B to D-Box=40110" i Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_50 Sherwood Drive_ _North Andover — Owner: Kelly_ Date of Inspection:_9/15/2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_41 _ Please indicate(check)all methods used to determine the high ground water elevation: _X Obtained from system design plans on record-If checked,date of design plan reviewed:_4/14/1996 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation:_As per design plan_ Commonwealth_ -of'Massachusetts City/Town of • System Pumping Record Form 4 DEP has provided this form for use by local Boards-of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. . A. Facility Information .Important: When filling out 1. System Location: forms the computer.use the tab key Address to Sv eK-� to move your cursor-do not C. Y use the:retum State Zip Code key. 2, System Owner: Name Address(d different from-location) Citytrown. State Zip Code Telephone Number .B. Pumping Record 1. _Date.of Pumping Date 2. Quantity humped: Gallons I Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight.Tank ❑ Other(describe)` 4. Effluent Tee Filter present? ❑ Yes 0-iqo� If yes,was it cleaned? ElYes [:1No 5. Condition of System- 6. Syst,erjPumped By Name l Vehicle License Number Company -- 7. Loca77, here contents re disposed: �- . = 1 �77 - Mg ur f auler Date http://www.mass.gov/dep/watert.approvals/t5forms=htm#inspect t5form4.doc•O6(03 System Pumping Record-Page i of 1 n . Tel: (978)475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 50 Sherwood Drive, North Andover Owner: Felly Date of Inspection: 9/15/2006 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your Current septic system. Neil J. Bat son Bateson Enterprises, Inc. Summary Record Card generated on 9/15/2006 11:06:58 AM by Elaine Barclay Page 1 Town of North Andover Tax Map # 210-105.0-0060-0000.0 50 SHERWOOD DRIVE KELLEY, JOHN & KIM 50 SHERWOOD DRIVE NORTH ANDOVER, MA 01845 class 101 Single Family Property Type 1 Residential Size Total 0.75 Acres FY 2007 US Mailing Index Name/Address Type Loan Number Active/Inact. From Until VIJAYARAGHAVAN BALAFUBRAMANIAN Owner 50 SHERWOOD DRIVE NORTH ANDOVER, MA 01845 KELLEY,JOHN&KIM Previous Customer Inactive 9/18/2006 50 SHERWOOD DRIVE NORTH ANDOVER, MA 01845 US Account Maint. Account No Cycle Occupant Name ActivelInactive Bldg Id. 17860.0-50 SHERWOOD DRIVE Last Billing Date 9/15/2006 3170525 03 Cycle 03 Active US Services Maint. Service Code Rate Charge Muhiplier/Users MISCFEE ADMIN FEE 1 1 9.18 1/ WTR WATER 01 ALL METER SIZE 372.36 /1 US Meter Maintenance Serial No Status Location Brand Type Size YTD Cons 47963483 a Active ENC FR.L. NEPTUNE NEPTUNE w Water 1 1 0 Date Reading Code Consumption Posted Date Variance 9/15/2006 1657 f Final Bill 84 9/15/2006 140% 6/19/2006 1573 a Actual 41 7/10/2006 102% 3/8/2006 1532 a Actual 15 4/17/2006 -27% 12/22/2005 1517 a Actual 25 1/17/2006 -80% 9/21/2005 1492 a Actual 117 10/14/2005 405% 6/27/2005 1375 a Actual 24 7/15/2005 0% 3/30/2005 1351 a Actual 28 4/5/2005 -7% 12/16/2004 1323 a Actual 24 1/14/2005 -60% 9/24/2004 1299 a Actual 75 10/8/2004 111% 6/11/2004 1224 a Actual 19 7/30/2004 15% 4/16/2004 1205 a Actual 35 5/17/2004 0% 10-4 Z T r2-e06*4 C S - WW 1 '� - (�7't. _ � ``�" FT- o F 'r � G��I � i � ` 13�•�� �I PG. QG -rte G✓ IP►z�i1�0� �= sP G .o �F/Pr �4 , C�vCo gl✓�, E�c.t�R. � l I X0.`15 gL r26- rt"dE S g L r24. co E-P_ -- - - � T�� ZI•e) -r f 1 yew O S W 1 'd a I 1 1 ~Io S! 3 % rG t2 05 NO I I'yLv�I A �t v' t�r.�TrZ.ccT�r� ��►r�t, rtcLp E y r2 eY I I Lf� F't A LI. ^)-Jt:>'5rt't ' t I I � .. � rr'�-r'4✓�e s ) d►��s rz,.+C-r`w -- 2y• ; x 8r� 27" ewN rete- -t 't'c� -t- I TL'S ash Tom. E ►Z1JDD � � l..l G Y � A�, Ietia"I."�S, i r.1G. De-Tc� '✓- I�f'-�'t�p C� G��'�t' G�rJ �� o g�-,t I�r►-�� F�+ TFC E �, ✓-- P2 LI I L,-T— P L a t,.l o,A , f3,m, I+ OF SLWUR,FJACE guo"I"I'spMAL SYSTEM U r� .tet LOCATED IN Dora Awl POVE , �-lmss. / �� �, �I �� I c�D a Dr2- I �E AS PREPARED FOR DATE 1122 � 'S SCALE: ':. r� v' �`l,� 14 MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET ANDOVER. MASSACHUSETTS 01610 • TEL (617) 4734555. 373-5711 Town of North Andover Of„ORT►, Office of the Health Department 0� Community Development and Services Division 41 a 400 OSGOOD STREET 4 North Andover,Massachusetts 01845 ATeD'''° SACHUg� i Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax C2qwq7jCA2TE OF COgwU.GIAir CSE As Of: 1�. ecem6er 6, ZOOS" This is to cert that the individual subsurface disposal system was a Septic component — .Leach Trench by James 'ellett At: 50 Sherwood 0five North Andover, 9lA 01845 Yfas been installed in accordance with the provisions of Titre v of the State Sanitary Code and with the North Andover 0oard of Yfealth regulations. The Issuance of this cert#i�cate shall not 6e construed as a guarantee that the system will function satisfactorily. i u le E. Grant Tu6lic Yfealth Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( ) constructed; ( 4-1"epaired: by located at 5V `71.4 EV-W Dp 1._L4Vr,- was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # dated , with an approved design flow of 5_,Q6 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: Engineer Representative Final inspection date: I ,U (' — s Engineer Representative Installer: mit Lic.#: Date: r: Date: DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, November 29, 2005 9:58 AM To: Dufresne Bill (E-mail); Dufresne Bill (E-mail 2) Subject: 50 Sherwood Drive Importance: High Hi Bill, Please forward the Final As-Built and Certification Form and let Jim Kellett know so that he can come in to sign, or have him pick it up from you and bring it in. Jim also owes us an extra$50 for a 2nd BB inspection. Please let him know that if you see him. Thanks. 50sl Ragwads, P4#1e010 Z00400e191410 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 ,����� � 6 � Q TOWN OF NORTH ANDOVER 0 NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 SCHUS Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: J'✓f e� P:_ LOT: INSTALLER: DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11111',a6—' /n, DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = LOADING OF SEPTIC TANK = GALLON PUMP CHAMBER = LOADING OF PUMP CHAMBER = TYPE OF SAS = DIMENSIONS AND DETAILS OF SAS: SITE CONDITIONS ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Page 1 of 4 O TOWN OF NORTH ANDOVER O NOF7H Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ~ 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845CHU swcHuse Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged Elgallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Watertightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet,of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final-grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: Page 2 of 4 0 TOWN OF NORTH ANDOVER 0 Office of COMMUNITY DEVELOPMENT AND SERVICES 3r��� � "°� HEALTH DEPARTMENT 400 OSGOOD STREET "►^, , ,r.' NORTH ANDOVER, MASSACHUSETTS 01845 s�cMuse Susan Y. Sawyer. REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution El levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM/ IX Bottom of SAS excavated down tol�soil layer, as rovided on plan 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 ❑ 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: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals El size inch as per plan Comments: Page 3 of 4 ~ 0 TOWN OF NORTH ANDOVER 0 , aoRTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET L^, NORTH ANDOVER, MASSACHUSETTS 01845 S�CHUS Susan Y. Sawyer. REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX CONTROLPANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of controlp anel: ElR Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D-Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 Town of North Andover Invoice No. 11/22/2005 400 Osgood Street Bill To Jim Kellett Address 400 Salem Street North Andover,MA 01845 Lynnfield,MA 01940 978.688.9540-Phone Web Site- www.townofnorthandover.com Phone 781-953-7146 Fax E-Man- healthdeot(o)-townofnorthandover.com E-Mail 978.688.8476-Fax Deposit Received $0.00 Invoice Subtotal $50.00 Due upon receipt Tax Rate Invoice Total $50.00 Total Amount Due 50.00 Amount Paid 50 Sherwood Drive-Charge for 2nd Inspection-not 10/31/2005 ready when called for 1st inspection. $50.00 t y Received by: Signature: r Print Name: _ - - - --- 4 i Subtotal $50.00 Tax $0.00 Total $50.00 Thanks for letting us serve you! 0 0 November 7, 2005 Susan Y. Sawyer,REHS/RS Health Director North Andover Health Department 400 Osgood Street North Andover,Massachusetts 01845 RE: Septic System Repair Inspection, 50 Sherwood Drive,Map 1-5C,Lot 14 Dear Ms. Sawyer, On November 1, 2005,Mill River Consulting performed a final construction inspection for the septic system repair for the property at 50 Sherwood Drive. The repair was performed by Jim Kellett of Kellett Excavation. The plan date was August 22, 2005,and the BOH approval date on the plan was August 30,2005. During the inspection,we verified that the length and width and approximate location of the trench addition was per plan,that the appropriate stone was used in the trench, and that the pipe elevations provide proper fall from the existing distribution box to the start and end of the new leaching line. The following elevations were recorded at the site: Distribution box outlet 139.25 (Used as base elevation) Start of lateral 139.14 End of Lateral 138.99 Please feel free to contact me should any questions arise. Sincerely, Andrew McBrearty Project Manager .......... AMU : River "J y :consu,l 'tingt RECEIVED, Your complete source for on-site wastewater management NOV. 9 2005 TOWN OF NORTH ANDOVER-. HEALTH DEPARTMENT: November 7,2005 Susan Y. Sawyer, REHS/RS Health Director'`. North Andover Health Department 400 Osgood Street North Andover,Massachusetts 01845 RE: Septic System Repair-Inspection, 50 Sherwood"Drive;Map,1-5C,Lot 14 Dear Ms. Sawyer, Ori November 1, 2005, Mill River Consulting performed a final construction:inspection for the :,septic system repair for theproperty at,50 Sherwood Drive. The repair was pe orm y Jim Kellett of Kellett Excavation. The plan date was August 22;2005;and the BOH approval date,on the plan was.August•30,2005: During the inspection, we verified that the length and width and.approximate location of the trench addition was per plan;-that the appropriatestone was used in the trench,and that the pipe elevations provide proper fall from the existing distribution box to the start and"end of the new leaching line. The following elevations were recorded,at the site: `. Distribution box outlet 139.25 (Used as base elevation) Start of lateral 139.14 End of Lateral `. 1381.99 Please feel free to contact me should any questions arise. Sincerely, Andrew-McBrearty Project Manager 2,131ackburn Cerner, Gloucester; Massachusetts 01930=2259 1 800-377.-3 .44 or 978.,-282-0014 • .Fax.9,78-282-0012 . ' info@millriverrconsulting.com o www.millriverconsulting com r 0 O DelleChiaie, Pamela Subject: Bed Bottom Inspection Location: 50 Sherwood Drive Start: -Mon 10/31/2005 11:00 AM End: Mon 10/31/2005 11:30 AM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Required Attendees: Grant, Michele; Sawyer, Susan Off of Boxford Street. 781.953.7146 -Jim Kellett. Only call if you need to cancel or reschedule (and let Pam know). Thanks! lyn ell p� �� � �� � I Town of North Andover Office of the Health Department 0r Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 �SSacaas�� Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 March 18,2002 Mr.and Mrs.John Kelly 50 Sherwood Drive North Andover.,MA 01845 Re: Application to finish the basement at 50 Sherwood Drive Dear Mr.and Mrs.Kelly: Your application to finish the basement at 50 Sherwood Drive has been reviewed by the Health Department. The application was denied on March 18,2002 for the following reason: The size of the current septic system servicing the dwelling will not be adequately sized for any additional living space without being upgraded. Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincere y, � Brian J.LaGrasse,Health Inspector cc: Building Department File i I I i BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 N a H a F a H � r r WMNs 5 mw o•xa oA ci o ^_~ W"wft LL PM i NOW i r .. W4°XWO 61 W A lis al ZO 00 ti m + m w H I a � � a�cp,>tNm► � A i O i a I� r W _N H U h W Map sl°Gk-L�t Commonwealth of.Massachusetts Board of=Health "N Permit No • BHP 2005.0294 North Andover . _-- .:,; P.I. FEE F.I. $250.00 � �ss�c ------ Disposal Works Construction Permit Permission is hereby granted DAMES KELLET - - ------------------ ------ to(Repair-Component)an Individual Sewage Disposal System. at No 50 SMRWOOD DRIVE ---- --------- -------- t as shown on the application for Disposal Works Constructing Permit No. BHP-20057429 Dated October 07,2005 ------------ Issued On Qct-07-2005 - - - ......r.......gYY..ata■r..........................f■�Y�«,ra}yr.....u................,...................................... .... a.a i............................... , rsYar'k "d Q xoxry Application for Septic Disposal !" TODAY'S bAtE pConstruction Permit - TOVN OF _ $ 250.00-Full Repair *n �� NORTH ANDOVER MA 01845 �Sk` $125.00 -Component Important: Application is hereby made for a permit to: When filling out forms on the E] Co struct a new on-site sewage disposal system* computer, use ❑ epair or replace an existing on-site sewage disposal syst / only the tab key G�.l to move your Repair or replace an existing system component cursor-do not key the return A. Facility Informa ion Y rab Address or Lot /t/, City/Town 2.- *TYPE OF EPTIC SYSTEM*: ❑ Pump F1 Gravity (choose one) **If pump system, attach copy of electrical permit to application*** Conventional 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. Owne///r I fo/�r�mation // Name _� Address(if diff``,^rent from above) ,�r X,0W6 V e,, City/Town State Zip Code Telephone Number 3. Installer Information Name Name of Company Addres CityfTow6 State s 5-YU—Zip Code , 6 Telephone Number(Cell Phone#if possible please) 4. Designer Information r Name �� � � � Name of Company � r Address City/Town State ( Zip Code __4//� / j 3 (J� Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 i aE ,RTN q Application for Septic Disposal System .a TODAY'S DATE Xonstruction Permit - TOWN OF -r:. y ORTH ANDOVER, MA 01845 CHU $ 250.00-Full Repair ° < $125.00 -Component SSASE PAGE 2 OF 2 A. Eacifity Informatio continued.... 5. Type of Building: Residential 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 Andover, and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Name Date Application Approved By: (Board of Health Representative) Name Date Application Disapproved for the following reasons: For Office Use Only: L Fee Attacbed? Yes No 2. ProjectManaer Obligation Form Attacbed? Yes v No g 3. Pump System? If so, Attacb copy of Electrical Permit Yes J No 4. Foundation As-Built?(new construction ronly): YesNo (Same scale as approved plan) Vl S. Floor Plans?(new construction only): Yes_ No Application for Disposal System Construction Permit•Page 2 of 2 0'r .y O INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at 5L_0 e~(19 199-.` relative to the application of 3,m Y66-6- dated for plans by �°� �i�, and v dated with 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. Undersign d Licensed Septic Inst 11 , / Date: 1,4171a Town of rth Andover Health Department Date: Location: e 4 (Indicate Address,if Residential,or Name of Business) Check#• Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ I ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Se!,;�ephc tic--Design Approval $ Disposal Works Construction(DWC)$C o• ❑ Septic Disposal Works Installers(DT) $ ➢ Sun tanning $ ➢ Swimming Pool ,� $ ➢ Tobacco I $ ➢ TrasWSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER(Indicate) ealth Agent Initials 125 $ White-Applicant Yellow-Health Pink-Treasurer CD TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 10/29/99 This is to certify that the individual subsurface disposal system constructed (X) or repaired ( ) by Raymond Fraser at Lot 3 (50) Sherwood Drive has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations as described in the Design Approval Site System Permit# 829 dated 5/2/96. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Ian .. oard of Health Inspector 1.0-26-1999 10:48 1 FROM P- 2 TOWN OF NOPTH ANDOVEit SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFiCATI4tq 1q°(kruFW ha�caYify tw ihoby Se+w c a8 system(v conte; ( )repairod: located at T t vi~ wah ionalled in 406=040 with the North AWwat Bverd of HeaitbWo vpd P*Sysaw Dong PftvW it _dated-----�._ with as S per 4ay. T1t0 manila$woa w�io +�O.Yea derma Bow of 44y- fu tryaem wasiusteliod in accordance Will' oti�0 apsdfi� t+e lad s,and the tai 9 Was sttb�i�with the P �Tick 3 wad acaur y>iwoaettted oo the As-built which hes boas simitted to�d of Hasth.AJI work is Dosip Date; o--Lz tic. '1' AP!OF NORTH Afn�MOVER% �; ! OCT 2 6 1999 0 Lo'-C' -.7, o �1-v e 'wvo n r,&fqe AS-BUILT UIECKLIST �C ✓ LOT NUMBER, STREET NAME x ✓ ASSESSORS MAP & PARCEL NUMBER l LOT LINES & LOCATION OF DWELLINGS LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO IAT LINES& DWELLING, WELLS ( a. FROM SEPTIC TANK b. FROM LEACH AREA ✓ LOCATIONS OF DEEP HOLES & PERC TESTS L� ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES ' W/IN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE) -� — �/ DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX /'STAMP& SIGNATURE Per CW¢T�'n '` IMPERVIOUS AREAS -DRIVEWAYS, ETC. h NORTH ARROW Nomco � T o �,uKve` FINAL CONTOURS w ' LOCATION &ELEVATION OF BENCHMARK USED LOCUS PLAN Q r4 NORTiy 'own of ` OL over ®� 0COCL dower, Mass., S /c/ DRA TE D P`P�,��� S GG 7G BOARD OF HEALTH Food/Kitchen P Septic SystemPERMIT T , �® v BUILDING INSPECTOR THIS CERTIFIES THAT...... r� . .................................... ........ ............................ ......... . . . ................................ Foundation C--- has permission to erect.............../..................... buildin s ons...... 0.. 4 ., ... !prwdw .. 1Z• Rough ,6t:u-c C---- �a w►� 3 %'fall v N J * r1A Ak- to b8 occupied as......:Svval* Chimney ........ ..... .................. ......... .. ..provided that the person accepg this permit shall in eve respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INS cTO�n VIOLATION of the Zoning or Building Regulations Voids this Permit. MAPA r PERMIT EXPIRES IN 6 MONTHS o•? s LESS CONSTRUCTIO ST S ELE ICAL E 1 pec ...... .... ...........RCI ��� a S 4 BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GA INSPEC Display i ' — p ay n a Conspicuous Place .on on the Premises Do Not Remove No Lathing or Dry Wall To Be Done RE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. .(,( SEE REVERSE SIDE Smoke Det. f 0 • FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT S'�(n_.^ oQ t2zp LLL PHONE 6�Z-237 LOCATION: Assessors Map Number /OSL PARCEL SUBDIVISION LOT (S) STREET ,54491^1J661 U/% l o t ST. NUMBER *************OFFICIAL USE ONLY**"""** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE-REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJgCTED COMMENTS FOOD INS �E��-HEALTH _.. DATE APPROVED_�; ��.- DATE REJECTEDell -1,_ StPTJd INSPE d TOR-AEALT14 BATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS ?rsG s�aTa�t Z:)R/4G` A406,- ,S G' r',"AV XI>s ?,0007 sreNd Atw.dD. A TT,ardNL'l.� DRIVEWAY PERMIT ?,Riva NJvs r N-vvd iv&t 1-4/o�P rp. POof FIRE DEPARTMENT -!L-, 3-`I y RECEIVED BY BUILDING 13PECT0 DATE t I �r h-,xet ,kl .i; xi p{ ar std tyH Sf t1 l51i�a341?tr$st ii Vt - C ���i!ia�y`�t Town of North Andover} Massachusetts Form No.3 P tdfi?. NORT#1 BOARD OF HEALTH } ptttllD IMO 19 DISPOSAL WORKS CONSTRUCTION PERMIT �"Ss„�H�SES Applicant NAM APDE55 TELEPHONE Site Location a Permission is hereby granted to Construct (L4"""'or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. O o� f • CHAIRMAN, BOARD OF HEALTH _ Fee �/� D.W.C. No. zza r - 1 _ ti.v #, t 5 r Y x t , . APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PEM IIT DATE: 8/��99 CURRENT INSTALLER'S LICENSE# LOCATION: LoT 3 S/fIIRLVOOD 1DEJOZZ LICENSED INSTALLER: /3 ZMQAQ 7- TF SIGNATURE: _TELEPHONE' CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONS TUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only 575.00 Fee Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yeses` No Approval Date: ---- QTOWN OF NORTH ANDOVER poR*a Office of COMMUNITY DEQ'E MMENT AND SERVICES HEALTH DEPARTMENT 400 OgGOOD STREET �.93°pATp i1' NORTH ANDOVER,MASSACHUSETTS 01845 SACMUSE Susan Y. Sawyer 978.688.9540—Phone Public Health Director 978.688.9542—FAX September 1,2005 Kim E.Kelly 50 Sherwood Drive North Andover,MA 01845 Re: 50 Sherwood Drive Dear Homeowners, The North Andover Health Department has completed the review of the septic system upgrade design plans,for the above referenced property,submitted on your behalf by Merrimack Engineering Services,dated August 22,2005. This plan was submitted in response to a Board of Health requirement for a deed restriction dated April 7,2002 stating the following; "hereby will upgrade the septic system on the property to the current Title V standards and have it accepted by the Board of Health for the Town of North Andover or tie into the towns sewer system prior to the We of the above referenced property". The addition of a trench to meet the criteria 5-bedroom(11-room maximum)design has been approved for use in the construction of a replacement onsite septic system.The following upgrade was approved regarding the proposed septic system. 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(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. 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 Y. Sawyer,REHS/RS Public Health Director cc: Merrimack Engineering List of N.Andover licensed installer I MERRIMACK ENGINEERING ERV CINC. CCS L��1 OO I �1 ° GJ�1Mty L�4�° LL Engineers • Surveyors • Planners 66 Park Street ANDOVER, MASSACHUSETTS 01810 DAT JOB No. (978) 475-3555 ATTENTION y Fax (978) 475-1448 TO 4z U 5a ) RE: " RECEIVE TOWN OF NORTH ANDOVER WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via HFAI H DEPARTMtheTfoll wing items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: L?For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints > ❑ For review and comment ❑ ❑�FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US ' REMARKS $A 0 , 1a", i �-�� ANt2 if,5LL -nom Ong - F, � ��T Misers r o �iz%A all COPY TO SIGNED: OULZ if enclosures are not as noted,kindly notify us at once. Comcast Message Center �-y http://mailcenter2.co,mcast.net/wmc/v/Wm/42D13FDC000815EE00...(1 ( ) 0 \ INBOX: kim.e.kelly 12 Help - Storage o 16%used Move to Folder U GET EMAIL COMPOSE VIDEO REPLY RE..,-VkALL FORWARD DELETE RE RT PRINT EMAIL MAIL AS SPAM C3 MESSAGE CENT& INBOX: Email 1 of 158 riextemaii C3 INBOX(5) M Draft From: kim.e.kelly@comcast.net[Add to Address Book][View Source] I M Screened Mail I To: Healthdept@townofnorthandover.com [EMPTY] Subject:2002 deed restriction on prop built in 1999 FI-17EC-EED C3 SentMail Date:Sun, 10 Jul 2005 15:29:24+0000 C3 Trash[EMPTY] + My Folders[EDIT] Susan Sawyer Health Dept. 05 A Address Book i Mailbox Manager ®Email Options We are preparing to market our home at 50 She od-drive-with- r3son Real Estate with Karen Merli this coming week of 7-11-05; ? Help I we have financial constraints due to Divorce and Court order to sell said X Sign Out homewith 2 underage daughters and need the septic system issue clarified prior to any sale/offers rec'd by Realtors between parties concerned. we purchased said home November 1999 and applied for a building permit in ma Comcast PhotoShow 2002 to finish our lower level basement area as a playroom and was rejected by Deluxe Brian Lagrassi/Sandra Starr. Director at time on 03-18-02 indicating the need FREE DOWNLOAD,$89 I for or a deed restriction for a system ypgrade in regards to leach trenches. Special Offer Emails SIGN UP NOW on 4-7-02, we executed the Deed restriction with Atty. John Mahoney "that current owners of property John Kelly and Kim Kelly hereby will upgrade septic system on property to Current Title 5 standards and have it accepted by Board of Health for Town of North Andover or tie into towns' sewer system prior to sale of real estate. Susan, what is the current Title 5 standards relative to 2002 standards? we have a 1500 gallon tank and leach trench system with 100% future reserve for Lot #3 50 Sherwood drive according to my copy of the #as -built" I septic plan" by Merrimack Engineering services, Daniel Koravos on 9-7-99 1. we have an estimate from John T. Shaw, III @ Wildwood in Andover to install 70 ft leach trench for $4k dated 4-9-02 2. we have a verbal (from Ben Osgood-local Engineering firm from 4-02 that 1 more trench perhaps extending by 30 ft. on ea. side??? he indicated that the tank itself is big enough presently 3. 3 years ago was the formula calculated by #of BRs divided by 2? is the formula now determined by just # of rooms? 14. prior to purchase in november 1999,the builder submitted plans to the town as a 9 room hosue indicating a 3 season porch; this is incorrect as it is a sunroom fully heated and A/C I hope i haven't confused you with the above, and I need your feedback and 1 of 2 7/10/2005 11:34 AM Comcast Message Center : http://mailcenter2.cJo'mmcast.net/wmc/v/Wm/42Dl3FDC000815EE00... professional opinion on this situation fairly soon. Again,the property is 50 Sherwood drive i u can contact me @ 978-691-1115 as well as Karen Merli @ carlson office here in North Andover thank you! Kim E. Kelly INBOX: Email 1 of 158 eextemail comeast 0 2005 Comcast Cable Communications,Inc.All righty Priyacy Statement Terms of Service Contac III i i i 2 of 2 7/10/2005 11:34 AM 0 r DelleChiaie, Pamela From: kim.e.kelly@comcast.net Sent: Sunday, July 10, 2005 11:29 AM To: DelleChiaie, Pamela Subject: 2002 deed restriction on prop built in 1999 Susan Sawyer Health Dept. We are preparing to market our home at 50 Sherwood drive with Carlson Real Estate with Karen Merli this coming week of 7-11-05; we have financial constraints due to Divorce and Court order to sell said homewith 2 underage daughters and need the septic system issue clarified prior to any sale/offers rec'd by Realtors between parties concerned. we purchased said home November 1999 and applied for a building permit in march 2002 to finish our lower level basement area as a playroom and was rejected by Brian Lagrassi/Sandra Starr. Director at time on 03-18-02 indicating the need for a deed restriction for a system ypgrade in regards to leach trenches. on 4-7-02, we executed the Deed restriction with Atty. John Mahoney "that current owners of property John Kelly and Kim Kelly hereby will upgrade septic system on property to Current Title 5 standards and have it accepted by Board of Health for Town of North Andover or tie into towns' sewer system prior to sale of real estate. Susan, what is the current Title 5 standards relative to 2002 standards? we have a 1500 gallon tank and leach trench system with 100% future reserve for Lot #3 50 sherwood drive according to my copy of the #as -built" septic plan" by Merrimack Engineering services, Daniel Koravos on 9-7-99 1. we have an estimate from John T. Shaw, III @ Wildwood in Andover to install 70 ft leach trench for $4k dated 4-9-02 2. we have a verbal lfrom Ben Osgood-local Engineering firm from 4-02 that 1 more trench perhaps extending by 30 ft. on ea. side??? he indicated that the tank itself is big enough presently 3. 3 years ago was the formula calculated by #of BRs divided by 2? is the formula now determined by just # of rooms? 4 . prior to purchase in november 1999, the builder submitted plans to the town as a 9 room hosue indicating a 3 season porch; this is incorrect as it is a sunroom fully heated and A/C I hope i haven't confused you with the above, and I need your feedback and professional opinion on this situation fairly soon. Again, the property is 50 sherwood drive u can contact me @ 978-691-1115 as well as Karen Merli @ carlson office here in North Andover thank you! Kim E. Kelly 1 HHH-08-2002 15=5A s HATEM and MAHONE I' LLP 978 682 1712 P.01/02 OLAW OFFICES 0 22 127 TURNPIKE STREET NORTH ANDOVER.MASSACHUSETTS 0154SW95 www.hatemandmahoneYIIP-com PHONE: (978) 685.3368 VICTOR L. HATEM ALSO ADMITTED IN N.H. _ FAX: (978) 682-1712 JOSEPH V. MAHONEY PETER L. HATEM ALSO ADMITTED IN N.M., MAINE AND FLORIDA JOHN E. MAHONEY ALSO ADMITTED IN N.H. FAX COVER SHEET Date: 411PO A From: ( ) Victor L. Hatem ( } Joseph V. Mahoney Time: 3: LIS' e. M• ( ) Peter L. Hatem (X)John E Mahoney Client Name: It/R1 1-j O Judy Clark O Suzanne Champagne File Number: 60deP ( ) Bridget Distefano ( }Christine Warden Please Deliver the Following Pages To: NAME: flf-P7" d' 94b6. FAX NUMBER: We are sending oR pages, including this cover sheet. ,If you do not receive all the pages, please call back immediately. Thank you. MESSAGES: x ,de �� Gde �� � THE INFORMATION CONTAINED IN THIS FAX NIESSACE IS INTENDED ONLY FOR THE PERSONAL AND CONFIDENTIAL USE OF THE ABOVE RECIPIENTS. THE INFORMATION MAY BE AN ATTORNEY CLIENT COMMUNICATION AND AS SUCH PRIVILEGED AND CONtIDENTi.%L IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR AN AGENT RESPONSIBLE FOR DELIVERING IT TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT YOU HAVE RECEIVED THIS DOCUMENT IN ERROR AND THAT ANY REVIEW, DISSEMINATION. DISTRIBUTION, OR COPYING OF TMS NIESSAGE IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR.PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL MESSAGE TO US BY MAIL WE WILL GUAR.INTEE POSTAGE, THANK YOU. HrK its-��t�� 1J HH I LM and MHHUNLY LLP 13`118 682 1712 P.02/02 ,1 d 0 D'u ST RICTION The Restriction herein set forth shall apply to the real property located at 50 Sherwood Drive,North Andover, Essex County, Massachusetts, being more particularly described as follows: The land with the buildings thereon, in North Andover, Essex County, Massachusetts, described as follows: Lot 3 as shown on a plan of land entitled"Planned Residential Development of`Jerad Place--Phase IV', designed for Timberland Builders,Inc.,40 Sunset Rock Road, Andover, MA 01810. Dated September 1, 1995,Rev. to March 12, 1996, Thomas E. Neve Associates, Inc., Engineers—Surveyors—Land Use Planners, 447 Old Boston Road,U.S.Route 1, Topsfield, Massachusetts, 01983, 508-887-8586", and recorded on May 2, 1996 as Plan No. 12805. Being the same premises described in deed recorded with Essex North District Registry of Deeds in Book 5595, Page 222. The current owners of the property, John G. Kelly and Kim E. Kelly, hereby will upgrade the septic stem on the property to the current Title V standards and have it accepted by the P Y . Board of Health for the Town of North Andover or tie into the town's sewer system prior to the sale of the above-referenced real estate. 1 he 7 ' Witness our hands and seals da of t Y April 2002. lZ� John G. Kelly _ Kim E. Kelly COMMONWEALTH OF MASSACHUSETTS Essex, ss April 7 , 2002 Then personally appeared the above named John G. Kelly and Kim E. Kelly and acknowledged the foregoing to be their free act and deed, before me. Cage r Notary Public H:�GBOOONGS928NRAIsiriai0i,.da,z My Commission Expires: a,.r 27 2 DO— TOTAL P.02 0 0 Town of North Andover AORTN OFFICE OF 3?0 y t��� ,��°c COMMUNITY DEVELOPMENT AND SERVICES ° F• D # ` 146 Main Street .� North Andover,Massachusetts 01845 �,9"`4;r;;-:%•'��y SSACHUSE June 10, 1996 Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot 93 Sherwood Drive Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: .Trenches shall be used whenever possible (3 10 CMR 15.240 (6)). .Wetlands disclaimer not present (N.A. 6.02 0). .Tank less than 25 feet from foundation. .Designed for less than 660 GPD and not on 165 GPD. Map & parcel missing. Elevations of perc tests not present. If you have any questions, please do not hesitate to call the Health Office. Sincerely, G. Sandia S;.arr, i:.;, Health Administrator cc: Bob Janusz J � BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ffS DATE U Sheet of BOARD OF- HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE__ l!�` ' PERMIT # DATE RECEIVED dZ 46 APPLICANT ���' -1 Aa1U S ASSESSOR'S MAP ADDRESS PARCEL # LOT # STREET ENGINEER ADDRESS PLAN DATE '�w�9/�� REVISION DATE CONDITIONS OF APPROVAL: APPROVED DISAPPROVED "SUSC--' /J- 2-�40 � , c��r�A,v►�s � s � Nor (Ail /V . c� 7 a PITS MIN 660 LEACHING MIN 1 (131x16 ' ) 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 3 MIN 660 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE . 005 BED/TRENCH (Bed max. 60 ' X 601 ) MIN 13 ' X 16 ' PIT BOT + SIDE X LOAD = TOTAL (L x W x #) (2 x (L+W) xD x #) (G/ft2) FIELDS MIN 660 GPDZ 900 ft2 BED t✓ GW MIN 4 ' BELOW BOTTOM OF FIELD PIPE ENDS JOINED? 4" PEA STONE? t/ DIST LINE SLOPE . 005? >31COVER-VENT SCH 40 L-,-' MIN 12" COVER / RATE LDG X 660 = 700 X '�� = TOTAL G/ft2 REQ'D (ft2) LXW DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY gpm L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME gpm MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1 ' below inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL OP. SWITCH Copyright C 1995 by S.L.Starr 0 PLAN REVIEW CHECKLIST ADDRESS .,L J1j6-e_ 000 -D,e. ENGINEER GENERAL / 3 COPIES STAMP,L" LOCUSy NORTH ARROW SCALE v CONTOURS C,-' PROFILE L--' SECTION t_, � BENCHMARK �� SOIL & PERCS ELEVATIONS WETS. DISCLAIMER WELLS & WETS v WATERSHED? DRIVEWAY ,--(Elev) WATER LINE/ FDN DRAIN SCH40_tZ TESTS CURRENT? ✓ SOIL EVAL SEPTIC TANK MIN 150OG (/ . 17 INVERT DROP `' GARB. GRINDER14V6)(+200% EDF) 25 ' TO CELLAR MANHOLE ELEV GW # COMPS. D-BOX SIZE # LINES FIRST 2 ' LEVEL STATEMENT INLET 138- -9 CI - OUTLET l38 T? (2" OR . 17 FT) TEE REQ'D? �0 `a q. /,J` LEACHING Ljh(y po r T�`/UC NCS Pr✓ MIN 660 GPD?,y RESERVE AREA V/ 4 ' FROM PRIMARY? �/2% SLOPE 100 ' TO WETLANDS f/ 100 ' TO WELLS i,-"' 4 ! TO S .H.GW I/ (•5 ' >2M/IN) 35 ' TO FND & INTRCPTR DRAINS'L--"'- 325 ' TO SURFACE H2O SUPP 4 ' PERM. SOIL BELOW FACILITY✓ MIN 12" COVER L----FILL? (25 ' if above natural elev; 101if below) BREAKOUT MET? p TRENCHES v 91MIN 660 gpd_ SLOPE (min . 005 or 611/1001 ) Vl' SIDEWALL DIST. 3X EFF. W OR D (MIN 6 ' ) RESERVE BETWEEN TRENCHES? L,.-' IN FILL?/ MUST BE 10 ' MIN. Ll4" PEA STONE? VENT? L,-' (>3 ' COVER; LINES >501 ) BOTy� � + SIDE aa.�v -/-- X LDNG 'k-5/6 = TOT (L x W x #) (DxLx2x#) (G/ft2) Copyright© 1995 by S.L. Starr Q Town of North Andover o a NORTH 1 OFFICE OF 3� COMMUNITY DEVELOPMENT AND SERVICES _ . p t - 146 Main Street North Andover,Massachusetts 01845 SSACHUSe April 17, 1996 Mr. Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lots 3,4,5,7,14,15,16,12,&19 Sherwood Drive The above named lots at Sherwood Drive have been incompletely submitted. The submission of new designs after January 1, 1996 requires the inclusion of soil evaluation forms. Until these forms have been received, the above mentioned plans will not be considered submitted. Should you have any questions, please call me at the number below. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 THOMAS E. NEVE ASSOCIA771"', INC. LMVV y OT 4nQ��)NOVVQIL Engineers • Land Surveyors • Land Planners 447 Boston Street US #1 TOPSFIELD, MASSACHUSETTS 01983 I DATE _4 22!5 JOB NO. (508) 887-8586 1 IS 19 ATTENTION FAX (5008) 8887-34p80 f"« TO �Y r/r 1 i/ L t"t RE: 0'OTFit 4hlDOVE,i1// 14 2 " WE ARE SENDING YOU Attached. ❑ Under separate cover via �Ilowjngtems: ❑ Shop drawings Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 3 p�.�►� _t �p,`l Ubu`-� c'S��Ot�111►.1C7 -InVIZZE IrOSM.,4 -05A r#,4 9 2 N t449 r7�`a p155(��. lC�/1 G St iF C.D'T S, 1449 >i G) THESE 1 THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS Pst't,<E-5 I.a \tJ a t�. C 1 e P�p01—Ct6f_�W__, P- �t1O tiS �Pr 1�-��) 1 ��CS►J S -� '� _ 04—=y t s 10 t,� eVA Ly AT =o��ns L I COPY TO c Err PAPER: gP Contents:40%Pre-Consumer•10%Post-Consumer SIGN If enclosures are not as noted,kindly notify us at once. / r SEPTIC PLAN SUBMITTALS LOCATION: 0—��- NEW PLANS: YES $75.00/Plan REVISED PLANS: YES $25.00/Plan DATE: Ch L A L _.. DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary Town of North Andover, Massachusetts Form No.2 f NORTh. BOARD OF HEALTH 19 o ti � a ' DESIGN APPROVAL FOR 7JS,C"usEt� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM. Applicant—.... Test No., C Site Location._ Lo T 1�^ i Reference Plans and Specs. ENGINEER DESIGN DATE Permission is granted for an :individual soil absorption sewage disposalsystem to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee Site System Permit No.