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HomeMy WebLinkAboutMiscellaneous - 50 SHERWOOD DRIVE 4/30/2018 (2) 55 Sherwood. Drive �I t t ,� C . r � , j f �. -o � a v i ele L ,75 qT- ntirmary, toilet rooms ana is 430. 454 Maintenance of floors - Smooth, dampness, elevated six inches a 430. 455 (A) Adequate egress (B) Emergency egress (sleeping (C) Not obstructed, exit sign ;:x,.,;_4.30;;.<.4 56;:.,. -..;A1:1:__means of egress free ` of ob. 430. 458 Sleeping Area for Residential Permanent buildings 40 sq. ft./person - singl 35 sq. ft./person - doubl 50 sq. ft./person - specil 430 . 470 Minimum of 3 ft. between sleeri Minimum of 4 1/2 ft. between sl 430. 472 All bedding and towels cleaned a it o f ,- •v 0s ' � r-� �-r"s`'" '�' ... ,( s ,", t.�- ' " :y... �� Yr sYi � z .A 1 i �C"t.0,'•'{��q'F��1 _ t. nr i 5 2f A.. t-� •a�.fi=t , • F io•� y tk rr.+�.r�t r" ,'� { ' • t L MAP # Nx`,a LOT # `': PARCEL # STREET p . CONSTRUCTION 9PPR .__._.. HAS PLAN REVIEW FEE .DEEN PAID? YES NO PLAN APPROVAL: DATE .4 APP. BY DESIGNER: /r PLAN DA'FE. _�'11V7 CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT DRILLER WELL TESTS: MICAL DATE APPROVED BACTER I DATE 111;'hRUVE=U BACTERIA I I DA I'E APPROVED!^___ _ COMMENTS: FORM U APPROVAL: APPROVAL TO ISSUE YES NO DATE ISSUED BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL SEPTIC SYSTEM CONSTRUCTION APPROVAL YE NO OTHER YES NU ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE:. .._._........_..._ ' ' �'�L•ft_�L�]►1"t`�l.l�!<�y1�4�cLLl1`•ll.� 'x IS,THE INSTALLER LICENSED? YES NO REPAIR TYPE. OF- CONSTRUCTION: NEW NEW CONSTRUCTION: CERTIFIED PLOT 'PLAN REVIEW ES NO CONDITIONS OF:.APPROVAL NO (FROM FORM U) - f ` ISSUANCE OF DWC PERMIT ` ES NO ` INST DWC PERMIT- ND. °` ` ALLER: BEGIN, INSPECTIDN E5 N0: =::EXCAVATION . INSPECTION: ; NEEDED: PASSED 7 By CONSTRUCTION INSPECTION: NEEDED: AS BUILT ' PLAN. SAT ISFACT09Y. YES: /y " APPROVAL TO BACKFILL: DATE: BY / ' FINAL . GRADING APPROVAL: DATE • �"' DATE: BY FINAL CONSTRUCTION APPROVAL: 577 MAIN STREET HUDSON,MA 01749 800-499-1682 WINDRXER ENVIRONMENTAL RVECEIVED OCT 2 3 2006 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PROPERTY OWNER'S NAME: GINNY& SAL ANDRONICO PROPERTY ADDRESS: 55 SHERWOOD DRIVE NORTH ANDOVER,NIA 01848 ADDRESS OF OWNER: SAME (IF DIFFERENT) DATE OF INSPECTION: OCTOBER 5,2006 NAME OF INSPECTOR: DANIEL DECOSTA Commonwealth of Massachusetts Title 5 Official Inspection Farm Not for Votuntury AsrseasmenW Subsurface Sewage Disposal System Form Inspection results must be submitted on this f6ft or an the official Title 6 Inspection Form dated 61IW2000- Inspectlon forms may not be altered In any way. A. Certification Important_ When fining out 1. ProperO -11ormathw forms on omse oOc U f oputpr,use only the tab Key F'rpperty xddre— n tomovoyour "/. � v cursor-do not Owne•'s Name -use the return key, .� ,1.Ay-e- owgar's,j.'Pass q Ckyrrownzip Code Date of Inspection: E, 2. r t. rA Name or , c�,p�►y.rf�,e I Compaoy Alf drams �f I so, j MA_ 01749 C _ own Stats- Zip Code -- Tatephono Number i comfleadon s firnant. I certify that I have personally inspected the ewage disposal system at this address rand that the information reported.below Is true,accurate nd oamplete as of the time of the inspection.Theinspection was performed based on my training and ef}ence in the proper function and maintenance of on site . sewage disposal systems, I am a DEP app ved system iftspector pursu8nt to Section 16.340 of Tide 6(310 Chit 16.000):The system: Jj Passes Llt onditlonaily Posses [� Faits I urther Ev tion e 1 rov',pg Authority V scorek-' c. ata e Tnop-adoessignature i Data I The system Inspector shall subM a co dt this inspection r0port to the Appnuring Authority(Board of Health or DEP)within-30 doys.of com teting this inspection_ If the systern is a shared system or has a design flow of 10,000 gpd or grea r;the �Inspeand the system owner shall submit the report to the appropriate regional office the DEP. The original should be sent to the system owner and copies sent to the buyer, if applic abl , and the approving authority. ""This report only describes condWons the time of inspection and under the conditions of use at that time.T'hls Inspection does not dress how the"Stem will perforin In the furtive undgr tate same or different condidops of us 72 rVrckerson Rd Aahfsnd.tlaa•1112004 ! Due 5 Offidni Inspection Form:Subsurface Sewage Disposal system- Page 1 of 16 Commonwealth of:Massachusetts Title 5 Official Inspection Fort Net for Voluntary Assessments Subsurface Semge Disposal System Form A. Certification (cont.) property Address Cltyrrown sift Zip Code Owner's Name Date of Inapectlon InsperAlor:Summary: Check &B,C,D or E/always oompiste all of Section D A) SysfOM P888e34: 1 have not found any Information which indicates that any of they failure criteria described in 39.0 CMR 35.303 or in 390 CMR 35.344 exist.Any failure criteria not evaluated are indicated below. Comments: C- cx : - r a f� �4k .aLCa Ot V Ice- 4 O Lav�t i ., v G 1 le 13) System,Conditionally Passes: El One or more system components as dewribed in the'Conditional PaW section need to be replaced or repaired.The system,upon completion of the replacement or repair, as aWroved by the Board of Health,will pass. Answer yes, no or not determine!(Y, N,ND)in the®for the flowing statements. If°not determined,"please explain. 0 The septic tank Is metal and over 20 years old"or they septio 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 se9ptle tank will pass impaction 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: 72 Nk*erson Rd Ash►snd.doc•J ja004 Title 5 oMCW Inspection Form:Subsurface Sewage Deposal system page 2 of is Commonwealth of Massachusetts Title 5 Official Inspection Form, Not for Voluntary Assessments Subsurfaoe Sewage Disposal System Form A. Certification (cont) Property Address CRytTown, .ate — - 7.Ip Code Ownees Name Dab of Inspez raon JB) System Condttionaily Passes(coat): t U 0 Observation of sewage.baackup or break out or high static water level in the distflbution box dere to broken or obstrudled pipes)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 0 obstruction is removed © distribution box Is leveled or replaced ND Explain: [l The system required pumping more than 4*mLs a year due to brokers or obstructed pipe(s).The system will pass inspection If(with approval of the Board of Hsalth): broken plpe(s)are replaced obstruction is removed ND Explain.- C) Further EvaattuatIon is R"uired by the Board of Heatth.: Conditions exist which require further evaluation by the Board of Health in order to determine if the system Is failing to protect public health,sa*or the environment. 1. System wili pass unless Board of Health deter nines In accordance wRh 310 CIVIL 1&303(7)(b)that the systm is not functioning In a manner which will protect public health, safety and the envirosnownt: 0 Cesspool or privy Is within 50 feet of a surface water Ll Cesspool or privy.is within 50 feet of a bordering.vegetated wetland or a salt marsh 72 Nickerson Rd Ashland.doc•1112004 'rhle 5 OftW Inspectlon Form:Subsurrece Sasrape Disposal&ptem Pogo 3of16 'Commonwoalth of Mlasiaehusetts Title ff mad Inspection Form Not.for Voluntary Asselasments Subsurface Sewage Disposal System Form Aa Cortitication (cont.) Property Address r.+ cT w� ytftG+�Y n Zip Code Owners Name Oste of Inspecdlon C) Further Evaluation Is H.equlmd by tete Bood of Health(toot.): 2.. System will fail unless the Board of Health (aed PubI10 Water Supplier,if any) determines that the alystet>it is functioning In a manner that pm tots the public heam, safety and environment ® The-systern has a septic tank and soil absorption system (SAS)and the SAS is within I GO feet of a surface water supply©r tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS Is wl'thin a Zone 7 of a public water supply, ® The system has a septic tank and SAS and the SAS is within 50 feet of a private waW supply welt. ❑ The system has a septic.tank and SAS and the SAS Is less than 100 feet but 50 feet or more front a private water supply well. Method used to determine distance: *'This system proses If the well Nater analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds ind"tes that the well is free from pollution from that facility and the presence at ammonia nitrogen and nitrate nitrogen is equal to or less than b ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other. 72 Mokerson Rd A81h1and.doe•1 W004 TMe 5 Oftel Inspection Form:Subsurface Sawage Mpasal*Stem Page 4of18 Commonwealth of Massachusetts Tit-le 5 Official inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal "tern Moret► A. Certification (cant.) P(npejtlt Address r..�tyRown. Staff .�+, Z1pCode Qwner's Nama Dole of Inspeoffan D)System Failure Criteria Applicable to All Systems: You moat indloate"Yes"or"No,"to each of the follt;Wng for aff inspections: Yes No Ve Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Core Discharge or ponding of efflue=nt to the surface of the ground or surface waters due.to an overloaded or clogged SAS or cesspool Static liquid level in the dlWbutlon,box above outlet invert due to an overloaded or clogged SAS or cesspool o .^ Liquid-depth in cesspool Is less than So below Invert or available volume Is less than%day flow Required pumping.more than 4 times in the last year NO'rdue to clogged or 0 Vee obstructed pipe(s). Number of times primped: Any portion of the SAS,cesspool or privy is below high ground water elevation. Cl Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. {] 'Any portion of a cesspool or privy is within a Zone 'I of a public well. ( 0910 Any portion of a cert or privy Is within 50 feet of a private water supply wall. Any portion of a cesspool or privy is less than 104 feet but greater than 50 feet Rom a private water supply well with no acceptable water quality analysis. [This system.passes If the well water analysts,performed at a DEP cerdfled laboratory,for conform bacteria and volatile organic compounds Indicates that the well is free f enc pollution from tfrat fac:illy and the presence of ammonia'nitrngerr and"n1-Wa a Oman Is equal to or leis than b ppm„prodded that no comer failure criterla are brlggeratt.A copy of the analysis must be attached to this Norm.] . Yes No Q / The system I have determined that one or more of the above facture ctiteda exist as described in 31d CMR 15.303,therefore the systema falls.The system owner should contact.the Board of Health to determine what willbe necessary to correct the failure. 72 M*erson Rd Ashtand.doa 1112004 Title 6 official Inspection Form:Subeurfaca Sewage Disposal System page-$of 16 Commonwealth of Massachusetts "title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) drug '+•fir .�"�;ws. C Y SfMa Zip Code ownees Name Date of Inspection E) targe.Systems: To be considered a Largs system the systsm midst some a facility wltb a design tlowo€10,000 gpd,to l&OW gpd- For large systems, you must indicate either"yes"or°no°to each of the following, In addition to the questions In Section D. YES No. 1:1 0 the system is within 400 feet of a surface drinking water supply (� the System-is within 200 fest of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area. MlPA)or a mapped Zone It 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 wyee 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 m=rdanoe with 310 CMR 15.304.The system owner ahould contact the appropriate regional office of the Department. A Title V inspection is often misunderstood to suggest that we are conducting a complete inspection of your system. A Title V inspection is limited to determining if, , at the time of the inspection,the existing septic system is functioning. The State of Massachusetts has outlined specific tests that are to be performed,which will be completed during your Title V inspection. However,a Title V inspection, and the inspection that Wind River Environmental is performing hereunder,does not evaluate if the system was installed correctly,has been engineered in accordance with state and local regulations, or whether the system will continue to function in the future. It also does not evaluate whether the system would meet the past,current,or future Board of Health or State DEP regulations. A system can pass Title V but still not meet state or local requirements or be suitable for continued use. If the customer would like a complete inspection of their system,including an evaluation as to the design and suitability of your system,Wind River Environmental can provide a quote as to the cost of such services. As well,Wind River Environmental strongly recommends persons interested in buying a home to have a full and complete system evaluation before purchasing a new home. A new home buyer should not rely on a Title V inspection in determining if the system will function in the future,and instead should commission a complete system inspection. 72 Nloketson Rd Ashiand.doc•11/2004 Title 6 Official lnapecilon Form.Subsurface Sewage Disposal System Page 6 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 0, Checklist Property Address cilyfrown State Zip Code owner's Name date of Inspection Check If the following have been done.You must indicate°yes° or"nor as to each of the following: YES NO . ❑ Pumping.information was provided by the owner, occupant, or Board of Health ❑ + Were any of the system components pumped out In the previous two weeks? ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this Inspection? Were as built pians of the system obtained and examined?(If they were not available note as WA) ❑ Was the W4 or dwelling inspected for signs of sewage bac up? ❑ Was the site inspected for signs of break out? ❑ Were all systern components, excluding the SAS,located on site? Q Were the Septic tank manholes wnocwered, opened, and the interior of Me tank Inspected for the oondition of the baffles or tees, material of construction, dimensions,depth of liquid,depth.of sludge and depth of scum? ❑ Was the facility towner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? Thee slzte and location of the Soil Absorption Sy*Wm(SAS)on the alta has been 4stermined.based on: } ❑ i xleting-information.For example,a plan at'the Board of Health. ❑ Determined in the field(if any of the fallure criteria related to fart C is at Issue approximation of distance Is unacaeplablo)1110 CARR 15.302(S)(b)) 72 NkkemomRd Ashtand.doc t 1*004 ` T1118-5 official Inspec oon Form:5ubsurfecs sewage Disposal system Page 7 of 16 Commonwealth-of Massachusetts Title 5 Official Inspection For Not for Voluntary Assessments Subsurface Sewags Disposal System Form C. System Inforxnatlon " ^x ,�ldraaa r..*; Town State Zip code owner's Nome Date of Insaection Rftidentisel Flow Gondltions: k Number of bedrooms(design): Number of bedrooms(actual): - - DESIGN flow based on 310 CMR 15.203(for example: 110'gpd x#of bedrooms): �n d� Number of current residents: Does residence have a garbage grinder? ❑ Yes No Js laundry on a separate sewage system?(if yes separate Inspection required) ❑ Yes !sd No Laundry dystern In:speded? U Yes C9''No Seasonal usa? - ❑ Yes 03'No Water meter readings, If available(last 2 years usage(gpd)) Sump pump? ❑ Yes 61"No Last date of occupancy: Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gaffs per day(gpd) Basis of design flow(seats/personstsq.k etc.): Grease trap presont? Q Yes 0 No Industrial waste holding.tank present? ® Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes 19 No Water-meter readings,If available: Last-date of occupencyluse: Date Other(describe): 72 Nic"on Rd Ashland.dac•1112004 TWO 5 offkdal inspection Farm:Subourrace Sewage Disposal system Fags 6 of is Commonwealth of Iillassachusetts Title 5 Official inspection Form Not for Voaluntary.Assessments Subsurrtace Sewage Disposal System Form C. System Information (oont.) Property Address -, �"ityl3 ewR . statte ZIp Code Owrrmt's Nsrt►e Date of inspection Gonerai Informagon Pumping Records: Source of fnformation: Was SyStern pumped 89 part Of thO inspection? , Yes No If yss,volume pumped: .! 5 Ov gallons Wow was quantity pumped determined? Reason for pumping: lube&tw" Ce Type of System: Septic tank,distribution box,soil absorption system Cl Single cesspool ❑ 4verf UW cesspool ❑. ply C7 Shared system (yes or no)Of yes, attach previous inspection records, if any) Li tnnovativetAltermative technology.Attach a;eopy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Mbar(desoribe): Approximate pge of all components, date installed(if kn,o/wnm)and source of information: Per- Were sewage odors detected when arriving at the site? [] Yes 91NO 72 Nick8mon Rd Ashland.doo+11f2004 Title 5 Official InspeGttorl FCWM:Subsurface Sewage Disposal System o Page 9 of 413 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) Properiv Addras! C(ty/iown State Zip Code Owner's Name Date'of Inspection Building Sewer{locate on site plan): e� Depth below,grade: teat Material of construction: [7 cast Iron GK44O PVC other(explain): town water Distance from private water supply well or suction line: .feet Comments(on edition of joln venting,evidence of leakage, etc.): CSS P fe- 2 6� AD Septic Tank(locate on site pian): /! Depth below grade: Material of construction: Vconcrete [J metal ❑fiberglass ❑polyethylene ❑other(expleln) If tank is metal, list age: year Is age confirmed by a Certificate of Compliance?(attach a copy of certiftt�tbt3) //.�� J. 0 )Y�e$ ❑ NQ Sludge depth: i Distance from top of sludge to bottom of outlet tee or baffle Soon thickness 1�. Distance from top of scum to top of outlet tee or baffle Distance from bottom Of scum to bottom of outlet tee or baffle — - How were dimensions determined? �' ��`' "" i 72 Nickorson Rd Ashland.doo•11/2004 Title b Off1dal Inspeaon Form:Subsurface Sewage Disposal System Page 10af10 it ` Commonwealth of Massqichusetts Title 5 Official Inspection Dorm Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) proa�rtr Addr+ees GkvfTaum State- Xip Code owner's Name Sate of Inspectlon Comments(on pumping recommendations, inlet and outlet too or baffle condition, structural Integrity, liquid levels as related to outlet.invert, evidence of leakage,etc.); Recommend annual pumping Inlet and outlet tee in good condition structural Integrity is good,licipid� level to outlet invert no evidence of leakage. Grease Trap(locate on site pian): Depth below,grade: feet Material•of construction: ❑concrete ❑me 0 fiberglass 11 polyethylene other(explain): Dimensions: Scum thickness 4istance from top of scum to top of outlet tae or baffle i Distance from bottom of strum to bottom of outlet tee or baffle I Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet Invert,evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: El concrete 0metal ❑fiberglass Q poly®thylene other (eocpl$in); 72 Nickerson Rd ashtend.dec•1112004 Idle 5 Offidal Inspection Form:Subsurface Sewage Dispossi systema Page ii of 16 Commonwealth of Maesuchusetts This 5 Official In' spection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) Pmoprty.Addmik Cityfrown state Zip Code owner`s Name Date ofinspecdon Tight or Wding Tank(cont.) Dimensions: Capacity: galiona Design Flow: gallons per day Alarm present: Yes No Alarm level: Alarms in working order, Q Yes❑ No Date of last pumping: I Dodo - -- Comments(condition of alamn and float switches, eto.): Distribution Box(if present must be opened)(locate on site plan):y.e`� 4t Depth of liquid level above outlet Invert Comments(note if box Is level and distnbution to outlets•equal, any evidence of solids carryover, any evidence of lo-kaq*int or p ut pf tic etn l•.. _ t- 66 Vt> t o W Le PUMP Chamber(locate on site plan): Pumps in working order El Yes ❑ No Alarms In working order. 0 Yes Q No 72 Nickerson ltd AetAsnd.doc•7112004 Title 6 Mimi Inspacdon Form.Submrfsce Sewage Dlspos*System- Page 12of16 Commonwealth of Massachusetts Fills 5 Official Inspection Form Not.for Voluntary Assessmerrt$ Subsurf=ace Sewage Disposal System Form C. System information (cont.) Propertv.Addreas '-'Y Code Owner's Name~ Date of Inspection Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Soil Absorption System(SAS)(locate on site pian, excavation not requiroci): If SAS not located, explain why: Type: Cl leaching pits number. ❑ leaching chambers number. - [] IeeChing galleries number laaching trenches number, length: - — leaching fields number,dimensions: . ' (01 ❑ overflew cesspool number: ❑ innovative/aromative system Type/name of technology. Comments(note condition of soil;signs of hydraulic failure, level of ponding,damp soil,condition.of Clcl ..j l �J i �'e+eS (`C, ��rP � of V L i 72 Nickerson ltd Ashland.dw+11/2004 Me 5 MOW Inspea6an Farm:Subsurfaod Sawage Disposal System Page 13 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessmants Subsurface Sewage Disposal System Form C. System Information (cont) Prcpertv,Address Cftylrc►am We 4 Code Owaar'a Nannz Data of Inspealon Cesspools(Cesspool must be pumped as part of Inspaction)(locate on site plan) Number and configuration - Depth—top of liquid to inlet invert dry Depth of solids layer Depth of scum layer - - Dimensionii;of Cesspool Materials of construction Indication of groundwater inflow D Yes No Comments(note condition of sell, signs of hy4raulic failure, level of ponding, condition of vegetation, ata-1• privy (locate on site plan): Materials of construction. Dimensions Depth of Aids Comments(nota condition of soli, signs of hydraulic failure,level of ponding,condition of vegetation, etc-)- 72 NfOkOrson Rd Ashland.doc•1 f x004 Title 5 QfAclat tnepeadon FOO Subsurfnoe Sewage t?laposal System Page 14 of 16 ' Comrnvttweslth of lUlassahuse " r� Title 0 �cinl Inspect c Form Not for Volunta Assessments ' Subsu' rtaos Sawago Disposal Sysfam farm. Ca System Information (Cont) Pmp"Addrv4s •Ctgr/�o+vn Ststs zip 00de nses None Date Nuapewon SksWh,Of Sego 01spoaal System:Provlda a aWoh of the aowage'disposel syttem lheludIng ties to at least fwa per marmt refeance lmadmob or benchmarks. Locate all was within 100 feet. Locate where public water supply enters the building.-F;o V\—\ •' ♦ DA a�= A;Z-e'a, R 16106P.49•11/2004 Clue 6 0110141 lnsPwXaa Faun:SlAsul ' Shwa a D12a al • - F'�ge 4� 49 Commonwealth of MasSaahusetts Title 5 Official Inspection Fora Not for Voluntary•Assessmants Subsurface Sewage Disposal System Foran C. System information (cont.) PropeAv Address Cyfrawn Stag .'. ?Ip Code Owner's Name Date of inspection Site IEurn: Slope Surface water Check cellar Shallow wells Estimated depth to ground water: J�'. Please indicate all methods used to determine the high ground water elevation, Obtained from system design plans on record If checked, date of design pla-i reviewed: Dote �- c Observed site(abutU g propWobservation hole within 180 feet of SAS) ,rte r` Checked with local Board of health-explain: ❑ Cheokesd'with local excaVators, Installers=(attach documentation) Q Aocewd USGS database explain: You must desorlbo haw you estattiiahed the high ground water elevation: 72 Nickerson Rd Astdand dos 11/2004 Title 5 Official fr4pecdon Form:Subsvrrace Sewage Disposal system Page 10 of I$ MAKE UYIIMENTS To . Silting e TOWN OF NORTH ANDOVER Information t20 MAIN STREET (976)688-9550 NORTH ANDOVER MA 01845 Reading W-armation ON OR r 578-688-9550 (978)688-9570 BEFORE 05117M X9.52 ONCE HOURS Man to Fri. 8:30atn to 4.30pm 3170532-416731248 4/17/2006 RETAIN THIS PORTIONFOR YOUR RECORDS MOVING?PLEASE CALL 978-688.9570 IN ADVANCE 1/12006.3/3112006 05117/46 55 MERWOOD DRIVE ANDRONIOD,SAI,&GINA 55 SNERWOOD DRIVENORTevious balance 01845 ANDOVER,MA Payments T1aouglt04117/2006 (108.78) 01845 Adjustments/Late Charges Interest as of.5117/2006 Balance Forward WATER USAGE WATER 12rsA5 6 24.34 3!8106 4 10 6 Actual 76 ADMIN FSE 9.1$ Sub-Total. 29.52 Total MESSAGE - PA-YWENTS SHOULD BE MADH: TOWN HALL � 184 , NMDFORD, MA 02155 I20 MA1TN STRBOUR 1I OR .BY MAIL TO OUR OCKBOX @ P.O. BOX Water rate: First 20 units $3 .34 Over 20 units $5.30 Sewer rate: First 20 units $3 . 81 Over 20 units $5.49 Bypass Meter Water rate : all units ... _ ._..... .T)T T!�nT1♦l Tl'T tri r.rr..a............��._ MAKE P&YMENTS TO Billing_ Information 1QFV1Y UR NORTH ANDOVER (978)688-9550 120 MAIN STREET NORTH ANDOVER MA 01845. Reading l89-957tiout BEFORE 02117!46 8108.78 978-689-9550 (978)688-9570 OFFICE HOURS Mon to Fri. rMr 8:30amto 4:30pm 3170532-416731248 V17/200-6 RETAIN THIS PORTION FOR YOUR RECORDS 10l1/Z005-12!31!20(}5 02117/46 MOVING?PLEASE CALL 978-688-9570 IN ADVANCE 55 SHERWOOD DRIVE AMRONJOO,SAL&GINA 55 SHERWOOD DR1V1r pats 871. NORTH AI3I�UVER,MA ugb 011/712006 {871.98) 01 845 Adjustments!Late Charges Interest as of 2117/2006 Balance Forward WATER USAGE WATER 26 :9"9.609alrasADMIN FEE 1086 1108 22 Replaceinent 28W1910s - Soli-Total 0 0 0 New.Meter U Total to:l��rs t2r22MS 0 4 4 Acival 64 MESSAGE PAYMENTS SHOULD BE MADE: TOWN. HALL @ 120 MAIN' .STREET CiR BY KkIL TO OUR LOCKBOX A.O. BOX 1.84, -MEDFORD, MA 02155 Water rete: First 20 units $3. 39 Over 20 units 55. 30 Sewer rate: First 20 u-nils $3 . 81 Over 20 units 55 .49 Bypass Metcr Water rate: al.l units 0 $5 .30 MAKE PAgMENTS TO nc Billing . _ TOWN OF NORTH ANDOVER Information $ 120 MAIN STREET (978)688-9550 NORTH ANDOVER MA 01845 ON OR tg information sEFORE 11/14/11 S$7I.4$ 978-688-9554 )688-9570 OFFICE HOURS )4(an to Fri. 3170532.416731248 10/1412005 8:30am to 4:30pm RETAIN THIS PORIYON FOR YOUR REOORDS MOVING?PLEASE CALL 978.68&9570 IN ADVANCE7111100E•913412005 11114/05 55 SHERWOOD DR ANDRONIICO,SAL&GINAMEMBEEIM 55 SHfiRWOOD DRIVE Previous Bt3lance 105.05 NORTH ANDOVER,MA Payments Through 101I412DO5 Oi 845 (103.05) Adjustments 1 Late Charges Balance Forward MEE ...WATER USAGE _ _ _IMIM __ IADNIIN ATER . 174 862.80 9/21,05 FE>i 916 1084 170 Actual 86 9.18 Sub-Total 871,98 TOW MESSAGE PAYMENTS SHOULD BE MADE: TOWN HALL Q 120 MAIN STREET OR BY MAIL 7O OUR LOCKBOXaft P O gOX 184 , MEDFORD, MA 02155 Water rate: First 20 units $3.39 Over 20 units C $5.30 Sewer rate: First 20 units 2 $3. 81 Over 20 units $5 .49 Bypass Meter.Waterrate_ at units {p $5 ,30 MAKE R�YMENTS TO Billing TOWN OF NORTH ANIilOi'EI� In#otmation 120-MAIN STREET (978)689-9550 =B=EFORE NORri AldDl?VIR MAO 1846 a8/J 51b5 SIDSM 978.6$8-9554 Reading Infarmatiort (978)688-9570 'q OFFICE 3170532-416731248 7/15n005 RS Fri. Mon too Fri. 8:30am to 4:30pin RETAIN THIS POR77ON FOR YOUR}�Ct3ItDS L 411/2005.61O( 05 08/15J05 MOVING?PLLASE CALL 978.688-957o DWO�!�' . �sL r 55 SHMWOOD DP ANDRON100,SAL&GINA OF 55 SHERWOOD NORTHANDO ISRIVE.' � ltoys Previous Balance 31:58 VER, Pa' ents'lhrnugh D7/IS(2005 (31.58) 41845 Adjustments fLate Charges _ Balanoe Forward _ OEM 7WAKRUSArG4. WATER 29 95.87A)NfIN FEE 9.18 29 Actual 89 Sub-Total 105.05 Total MESSAGE PA)MMNTS SHOULD BE MkDE.: TOWN HALL @ 120 MAIN' STRttr OR BY MAIL TO OUR LOCKBOX 8 P.O. BOX 184 , MEDFORD, MA 02155 Wafer ratz: Firs( 10 units .@ $2. 80 Over 20 units � $4.43 Sewer rater P'i'rsi .20 " its (c S4.. 56 Over 20 units $6. 56 Bypass Meter Water rate : .al units $4 .43 MAKE PAYMEN7S TO Billing ,. TOWN OIC`FORTH ANDOVERInPorrrtation 120 MAIN STREET (978)6884550 7ON-ORNORTH ANDOVER.MA 01845 E QSrT61Q5 978-688-9550 Reading kfbrmation (978)689-9570 OFFICE HOURS 131760532-416731248- 4/15/2OD5 mm to Fri. S:3 Om to 430pm RETAIN THIS OVING PB AS TION FOR-YO UR RECOM � trALL 478-688-9570-IN ADV 1 �F ' � 11-/2005-3/3112005 '0571'6!05 ANDRONICO,SAL&GINA ASF` 55 SHERWOOD DA 55 SBFAWOOD DRIVE NORTHANDOVER,MA 01.845 'Previous Balance 7(49.38) PWments Through 04105/2005Adjustments I Late Charges Balance Forward WATER USAGE 7WATER g x,40K FEE 879 887 8 .AcW[ 104 9.18 Sub-Total 31.58 Total IvIESBAGE PAYlIW1,NTS SHOULD BE MADE: TOViN BALL @120 MAIN STREET OR SY MAIL TO P.O. BOX 124, 1,lORTH ANDOVER, MA 01945 Water rate.: _ First 20 .units � $2. 8D Over 20 units @ $4 .4-3 Sewer raic: First 20 snits $4 . S6 Over 20 anit5 $6'. 56 BYP$ss Meter_ Water rate: a1.I units A. &4 :43 7. MAKE PA. rrMTS TO Billing TOWN Old NORTH ANDOVER Irifortnatiou 120 MAIN STREET (978)688-9550 NQKIIi ANI3QVER MA 01843 ON OR Re g Rion $DPOK£ fl:4/05 $4&38 978-688,9550 {978)688-9570 .- OFFIt;;B HOURS 3170532-X16731248 Ikon to Fri. 1f 1412005 8;3 Dam to 4:30pm Z'.5,.�..i IN t.p:�. :'• RETAfNTHIS POR T'I4NFOR YOUR RECORDS MOVING?FLEASE CALL-978-6889570-IN ADVANCE 11)(112004-12/31/2004-1 021I- ANDRONICO,SAL&GrMA 55 SHF.1tWOOD DRIVE "l ' :. :; 55 SEIfiRWOOD ?It NORTH ANDOVER,MA 7`u 01845 'Previous Balance 299.38 Payments Through 01/14/2005 (299.38) Adjustn=ts;Late CBtarges Balance Fomiiard WATAGE x vs =FE 14 39.20 79424M �vioua fi 865 879 14 Actual 83 9.18 Sub-Total 48.38 Total MMSAGB PAYMHNT-s SHOULD BE MADE: TOWN HALL (a3 120 MAIN STREET OR BY MAIL To P .0. BOX i 24 , NORTH AN VER, MA 0 18 4 S iter Tate ; F-irst 20 units @ $2.80 Over 20 Units54 ,43 SesrSr rate: First .2U v-nits @ 34 .56 Over 20 units. nits $6 . 56 B}� jd'ss -Ale ter Nater rate: alt units @ $4.43 MAKE PAYMENTS TO - - TOWN OF NORTH ANDOVER In#'ornmeou 120 MAIN SMBT (978)689-9550 NORTH ANDOVER MA 01845 Reading mo t► ON-OR 978-688-9550 (978)688-9570 DEPORE -08/09106 X98.44 r- OFFICE HOURS Mon to Fri. 8:30am to 4:30pm 3170532-416731248 7/10/2006 RET"THIS PORTION FOR yOUTR$£&CORDS MOVING?PLRASE CALL 978-688-9574.IN ADVANC& 41112A06-650/2006 08/09/m, 55 SHERWOOD DRIVB ANDRONIC0,SAL&GINA 55 SHERWOOD DRIVE rmous Balance NORTH ANDOVER,MA Payments'Through 07!10/2006 X9.52) 0I845 Adjustments I Late Chargee Irnerest as of 819!2006 , Balance FoFwud WATER--USAGE. WATER X x06 6119!06 25 89.26 L0 35 25 Actual 103 ADMIN FEE 9.18 Sub-Total 98A4 Total MESSAGE PAYMENTS -SHOULD 8E MADE: TOWN HALL Q 120 MAIN STREET OR BY .184:, MEDFORDMA 02155 MA1L TO OUR LOCKBOX ® P,O. $p}{ , Water sate : First 20 units 6;) $3..39 Over 20 unite $5-30 Sewer rate: First 20 units $3. 81 Over 20 units $5.49 Byyass Meter Water rate: all units Q $5 . 30 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 4/4/00 This is to certify that the individual subsurface disposal system constructed (X) or repaired ( ) by Ben Osgood, Jr. at Lot 17 Sherwood Drive (55) has b.vn installed in accordance with the provisions of Title V of the State Sanitary Code and} Jth the North Andover Board of Health regulations. Thp fssuance of this certificate shall not be construed as a guarantee that the system will fu ion satisfactorily. Board of Health Inspector TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( /Constructed,- ( nstructed;( ) repaired: by OS Cc�v J!:n-. located at 1--v7- 1-7 5'wkwf"rxp /q/z.'V e-;- was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # dated with an approved design flow of 14bgallons per day. The materials used were in conformance with those specified on the approvedplan; the system m 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: Engineer Representative Installer: Lie.#: Date: Design Engineer: Y �1Lok Date: /7r7-7";�' 24 s c AS— BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS C-27:-FROM SEPTIC TANK FROM LEACH AREA ( LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAMS, WATERCOURSES W/N 1 50' OF SYSTEM LOCATION OF WATER,-GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D-BOX l/ -- STAiMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. V NORTH ARROW FINAL CONTOURS LOCATION & ELEVATION OF BENCIUvARK USED LOCUS PLAIN v wock-) AS-BUILT CIIECKI.,IST LOT NUMBER, STREET NAME ASSESSORS MAP& PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES& DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA IJ✓� LOCATIONS OF DEEP HOLES & PERC (Lo t3 TESTS t/ ELEVATIONS OF DISPOSAL SYSTEM L/ TOP OF FDN ELEVATION _ LOCATIONS OF WELLS,DRAINS, WATERCOURSES WIIN 150' OF SYSTEM L/ LOCATION OF WATER, GA$, ELECTRIC LINES, CABLE I — / DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX STAMP& SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. -FI,4K of 4MICY ✓ NORTH ARROW Co cid FINAL CONTOURS M I LOCATION &ELEVATION OF BENCHMARK USED NCR- tirel LOCUS PLAN AS-BUILT UIECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP& PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATION & DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES& DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC p �/N jIiAjS TESTS t/ ELEVATIONS OF DISPOSAL SYSTEM L11 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 IMPERVIOUS AREAS -DRIVEWAYS, ETC. h-f -Fir-4K of SuruiEY ✓ NORTH ARROW foi-+ icY� FINAL CONTOURS LOCATION &ELEVATION OF BENCHMARK USED lel• 5rfl LOCUS PLAN 7f - FEB t I TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( instructed; ( ) repaired: by l ey OSCC�C'v Je_. located at LST 1-7 0124 was installed in conformance with the North Andover Board of Health approved plan, System Desi Permit # dated , with an approved design flow of 'W-;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: Engineer Representative Installer: Lic.#: Date: Design Engineer: Date: . /717—/"P 7.{ 4.P - 0r ',Ef _ t7 ,i -.£2�„FIl.f5':d, t i ..:.,eF.� -,I•;'i.r�,.�d,�,' C. -'` .. '�a 4�ky � -•j' t .�� s, .L. � d. �....,. .., ,.,, .. z:�q^, i�rn <. o- 3. •.I+: �. .• ., i ...d a:;,•.�!: ..! f..g;r,3 ,,:. fi:.:r.- 1.. -, .af 4Y,. .r •`'47 t 1 :• :4 v., -s�s.t'.,1.,�' 7 k•,. $ ar ,,..:,,X..:x { , :d .'1a. ,._pN-'2 .r i- . 1. i vl nPe'E -8 �. t� r �1. 'er. 'et. s .,q,W> ,, :::.,, :, c ,� r::. '„, 3.,tilt t '.,:,<.-•i. t'.F" - t ak. c .�. .,k -) 3-.,..u: d;y,..(,i• J3- ..i,g=- 9.,.r ;.3,.Y Pt- 4dt. !G .� S :^... +I, 'r,.ja:1 4i T�.i ''��-.i.} r- :y - � - } F �,A'� s. s '.gy, ,.i ti !tf_�r`fY, ,_ yE�• � ,:!{ it4 r'.-#,,.ra.. p it:6�,u 'fa ..5.., d > " rT t --5�'.5L.Psk�ss�3iF..:�Cw..�.r«..,.a •t.,,:�:��.:.s�ucclj:.tc aa.�,..,� � -(.! .::,#:� 8.i�-a' ,''•�...£y> -.' a � i 1 K Town of North Andover, Massachusetts Form No,3 BOARD OF HEALTH NORTH - - � � �ti:�a 4 _ O�t�•w e - .. - ti o p 19 DISPOSAL WORKS CONSTRUCTION PERMITCM ` is '!: V Applicant � - NAME ADDR SS TELEPHONE Site Location Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption s Sewage Disposal System as shown on the Design Approval S.S. No._ X77 CHAIRMAN, BOARD OF HEALTH Fee � D.W.C. No. l� r al r r. z: r E. F i k J,l t t 1 L Er j, .a t , 'v. I t-. , f APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# LOCATION: L o - -7 S kerw oo):) 2, c/e LICENSED INSTALLER: �',� ;�, (ADS, aC-9- SIGNATURE: K, 12 TELEPHONE# 179 8 CHECK ONE: REPAIR: NEW CONSTRUCTION: V IF NEW CONSTU CTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative.Use Only $75.00 Fee Attached? Yes No Foundation As-Built? Yes �' No Floor Plans? Yes_L_�. No Approval '^ Date: l/ 9 9 �'��/� ' /.A4 FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary ,approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local 'or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: �2✓ GJDY�� �21/2�y�0in�.•�f Phone z '��� LOCATION: Assessor's Map Number 1C Parcel Subdivision TAnn �ULT Lots) Street fV1,2.^W 00 St. Number --L..__ ************************Official Use Only************************ RECOMMENDATIONS O�F� TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Cy -� v U ( Date Approved .,Town Tlanner / Date Rejected Comments / Date Approved Food Inspector-Health Date Rejected Date Approved �. S ,e-pt-tc/'124eAEor-H4&1th Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date �k FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this ,s/ection***************** APPLICANT: 2✓ Wa�� �21/2Ly�0�Q�f �-LC Phone LOCATION: Assessor's Map Number ZQ IC Parcel Subdivision r� Lot(s) Street 6u00e'L �(` 1 �� St. Number 7 �� ************************Official Use Only************************ REC DATIONS OF TOWN AGENTS: Date Approved /0 C/b ACon4saLtion Admini trator y� Date Rejected Comments (r{r7 J L Date Approved Z Sc ToGin neX Date. Rejected Comments Or Approved Food Inspector-Health Date Rejected D7222 � Date Approved Septic Inspector-Health Date Rejected Comments � X//)')UI)') Public Works - sewer/water connections —driveway permit Fire Department Received by Building Inspector Date k IAO TH Q D own of over to No. 33a -- _� dover, Mass. q ORATED P'P�L �C) 15 BOARD OF HEALTH PERMIT TFood/Kitchen ,Septic System/ BUILDING INSPECTOR THIS CERTIFIES THAT......... .h W..&.0 �S ................� . ......... . ,,....C............................... Foundation 11 has permission to erect..........4.......................... buildings on . ..............�. ....�. ,, .,5,1�1WiDRough-�i leftqto be occupied as.... .IN .. ..... �.I.. ...... w.�.��lAl. ...... ..... a��..... CO c i� provided that the person accing this permit shall ieve respect** es ect confor .to the terms of the application n every P pp 0 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 SP R VIOLATION of the Zoning or Building Regulations Voids this Permit. u S PERMIT EXPIRES IN 6 MONTHS ina u I UNLESS CON�TRL7C O T TS ELEC I Of like C* 6I .. ......... �5 y BUILD INSPECTOR in Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Pr -- Rough P Y P emeses Do Not Remove n G 3 No Lathing or Dry Wall To Be Done ! FIR EPARTMENT Until Inspected and Approved by the Building Inspector. Burner a -Y& --- _JA Street No. SEE REVERSE SIDE Smoke Det. FORM 11 SOIL EVALUATOR FORM Page 1 of 3 No. Date: Commonwealth of Massachusetts North Andwaf, Massachusetts Soil Suitabilitv Assessment for On-site Sewag Performed By: Ti-,o•�+45 Ne.�c Date: Witnessed.By:. S c.ndv Starr Location Address or Owner's Name T;Mbtrr 1 a d Lot# 1-7 Address and Bj;1 d',e-r-s I a C— 51"�G�wood� priVC. Telephone# IS Genn � ccJft Nave,rl-,�11 SMA 018 32 Y73- 1539 New Construction Repair Office Review Published Soil Survey Available: No Yes Year Published 1 c�a Publication Scale 1": i 32 0' Soil Map Unit C. G D Drainage Class 12> Soil Limitations Surficial Geologic Report Available: No F>7< Yes Year Published Publication Scale Geologic Material(Map Unit) Landform Flood Insurance Rate Map:. Above 500 year flood boundary No Yes X Within 500 year flood boundary No X Yes Within 100 year,flood boundary No X Yes Wetland Area: National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month Range: Above Normal Normal Below Normal Other References Reviewed: DEP APPROVED FORM-17!07/95 30devai.aam" -- 1097 FORM 11 -SOIL EVALUATOR FORM Page2 of 3 Location Address or Lot No. L o 1 -7 — S h a r a co d. Dr-v e- Off -Site Review Deep Hole Number 91-1'7 Date 8I Zo) 9-7 Time P M Weather -7 o` '5 y Location(identify on site plan) Se-c. P 1 o.n Land Use Rte„cke,};A 1 Slope(%) —1 `7e Surface Stones Vegetation _ �a000Eo Landform. Position on landscape(sketch on the back) Distances from: Open Water Body 1 aA feet Drainage way N A feet Possible.Wet Area feet Property Line. -30 feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency,% Gravel) O- 4.,, A cr9a.,,c. rnpt. N o 4 - Zo B.ni Grr, F.S.Q.. 10-lit 4/to 1.30 Massi.►G/Fr;obic 10'/6 Sfiar+:g 10'/0 61-me, � ZOn--7 44 C 1 G L.S. Z-515/4 ►Jb mass,.rt� Fc-gable 107- Gobbles (Nava. t3obtc�� * IINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) Depth to Bedrock: Depth to Groundwater: Standing Water in the Hole: o Weeping from Pit Face: /,Je Estimated Seasonal High Ground Water. ►Jo„e DEP APPROVED FORM-17!07/95 wilmlxm { FORM 11 -SOIL EVALUATOR FORM Page 3 of 3 Location.Address or Lot No. - Lot 1-7 Determination-for Seasonal Mght Water Table a Method Used: 1�10 C�roa.,d. .�ate,r ti10 Rcdo�c ti10 .Jeer�S Depth observed standing in observation hole inches Depth weeping from side ofobservation hole- inches aDepthto soil.mottles inches Ground water adjustment. feet Index.Well Number Reading Date. Index. well.level Adjustment.factor. Adjusted groundwater level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in.all areas observed throughout the area proposed for the soil absorption system? y�S T If'not, what is the depth of naturally occuring pervious material? Certification I. certify that. on 1 9 S (date) I have passedthe: soil, evaluator examination approved.by the. Department of Environmental Protection.and that:the: above analysis was performedby me consistent with the required training, expertise. and experience described.in 310 C 5.017. Signa ate. 47 ;a- ? 7 i DEP APPROVED FORM-17107/95 wileval sam 1 FORM 11 -SOIL EVALUATOR FORM Page 1 of 3 No. Date: g Commonwealth of Massachusetts North Ar+dovQ,r , Massachusetts Soil Suitabilitv Assessment for On-site Sewage Di Dosal Performed By: Ti-,ON.4s N�.►a Date: 6Z ZO/ -Z>-7 Witnessed By: Sar,d_�, Stec Location Address or Owner's Name Lot#- L_o t 1$ Address and 13 u i l olar S 3 tic- Telephone# 1S Gltr-.L^b- Govrf h;11 � N+A o I 83L 3"73--1539 New Construction Repair Office Review Published.Soil Survey Available: No Yes F 7x Year Published 1 C2)81 Publication Scale "c 1 s Zo' Soil Map Unit C-c.D Drainage Class Q Soil Limitations Surficial Geologic Report Available: No F>7< Yes Year Published Publication Scale Geologic Material(Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No Yes X Within 500 year flood boundary No ,>c Yes Within 100 year flood boundary No X Yes Wetland.Area: National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month Range: Above Normal Normal Below Normal Other References Reviewed: DEP APPROVED FORM-17!07/95 wileval sam FORM 1 l -SOIL. EVALUATOR FORM Page-2 of 3 Location Address or Lot No. Lot t S - 5►-.e r oo d- » �- Orr -Site Review a Deep Hole Number g-7_I S Date 8170/,57 Time p l; l Weather .�0 Location(identify on site plan) SGe_ Land Use 2a S; ,�;a 1 Slope(%) -1-7. Surface Stones Vegetation W coolt.d. Landform Position on landscape(sketch on the back) Sic n 10.r1 Distances from: Open Water Body N f_\ feet Drainage way Q A feet- Possible eetPossible Wet Area_ Z,c feet. PropertyLine: .4.0 feet Drinking Water Well t3 A. feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(Inches) (USDA) (Munseil) Mottling. (Structure,Stones,Boulders, Consistency,% Gravel) Co- ZZ Bw FS.I-. IoYR 4/(i 1.10 ZZ- -14 C �'S 2.5`/54 aO 1079 co661.cs� It. (rraJGl *MIMMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) Depth to Bedrock: tj o 0,e. DDpth to Groundwater. Standing Water in the Hoie: Ajo Weeping from Pit Face: tj p Estimated Seasonal High Ground Water. Nonce DFP APPROVED FORM-17107M wilavd aim FORM 11 SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No_ L o t l Q> - S Determination for Seasonal High Water Table Method Used: ),jo G� r_.�o aP5 N-Jo ZEC>oX Depth observed standing in observation hole inches Depth weeping from side-of'observation hole inches Depth to soil mottles inches aGround water adjustment feet Index.Well.Number Reading Data Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet:of naturally occurring.pervious material exist in all areas observed throughoathe:area proposed for the soil absorption system? v es If not,what is the,depth of naturally occuring pervious material? Certification I certify that: on I 5 (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:(7 '77 DEP APPROVED FORM-17!07/951C+1++� FORM 12-PERCOLATION TEST Location Address or Lot No. Lot -7 Lot- l8 S},crd Dr -t- COMMONWEALTH OF MASSACHUSETTS Nor+%­, Anddo.it(' ,Massachusetts Percolation Test* Date:: g/Z.o !cD-7 Time: Observation Hole A:-*AM It)-1-1 -7 'n-7 - 18 Depth of.Perc Start-Pre-soak 45 End Pre-soak J.-Os Time at:12" =05 Time at 9" I tk Time-at-6" Time(9"-6") 18 Rate Min./Inclr *Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site.Passed Site Failed n Performed By: Ti,o nn aS E. Ne ger Witnessed By: S t OX r Comments: i RAND & YOUMATZ� P.C. 23 CENTRALSTR�ET ANDOVER, MASSACHUSETTS p1810 I GEORGE A. RAND VINCENT W. YOUMATZ (MASS. & N.H.) TEL: (508) 470-0477FAX: (sob) 475-4544 VIA FACSIMILE 617-654-1735 and FIRST CLASS MAIL Jude 5, 1997 Toknr N7F 91997 Kathleen M. 0.'Donnell, Esq. ! Kopelman and Paige, P.C. 31 St. James Avenue Boston, MA 02116-4102 RE: Robert Janusz/Timberland Builders, .'Inc. North Andover Board of Health Lots 17 and 18, Sherwood rive Dear Ms. O'Donnell: I am in receipt of your letter dated June 4, 1997 . My understanding was that the Board of ealth .wanted ;an opinion from you that the proposed septic s.y tems for thejabove- captioned lots would not be in violation of the provisions of Title V, provided of course, that thIy met..with the technical approval of the Town. I just want t� be .s.ure, ;that . the Board knows, from you, that the proposedd sign .is :legall.y acceptable, so that they will proceed with theirliechnical review. It is clear that this is a "twin-track" re view, and.;I just want to make sure that it is coordinated so hat the :review is not stalled with Each side waiting for the other.,.' Please call me. Ver' rul uzs, • i, e Rand GAR/hld cc: Sandy Starr, North Andover Boald of" Hearth Robert J. Janusz i r LEONARD KOPELMAN KOPELMAN AND PAIGE, P. C. JEANNE S. MCKNIGHT DONALD G. PAIGE JUDITH C. CUTLER ELIZABETH A. LANE ATTORNEYS AT LAW RICHARD BOWEN KATHLEEN M.O'DONNELL JOYCE FRANK 31 ST. JAMES AVENUE CHERYL ANN PERRY JOHN W. GIORGIO DAVID J. DONESKI BARBARA J. SAINT ANDRE BOSTON, MASSACHUSETTS 02116-4102 SANDRA CHARTON ILANA M. QUIRK JOEL B. BARD BRIAN W. RILEY EVERETT J. MARDER BOSTON OFFICE JOHN J. KENNEY, JR. PATRICK J. COSTELLO (617) 556-0007 MARY L. GIORGIO JOSEPH L. TEHAN, JR. FAX (617) 654-1735 KATHLEEN E. CONNOLLY MICHELE E. RANDAZZO ANNE-MARIE M. HYLAND NORTHAMPTON OFFICE PETER J. FEUERBACH (413) 585-8632 - MARY JO HARRIS WILLIAM HEWIG 111 THOMAS W. MCENANEY THERESA M. DOWDY WORCESTER OFFICE WILLIAM J. MURPHY DEBORAH A. ELIASON (508)752.0203 JONATHAN M. SILVERSTEIN KATHARINE 1. GOREE June 4, 1997 George A. Rand, Esq. Rand & Youmatz 23 Central Street Andover, MA 01810 Re: North Andover Board of Health - Lot 17 and Lot 18 Sherwood Drive Dear Mr. Rand: You have asked us to review the form of easement you propose to submit to the Board of Health in connection with the septic systems for the above referenced lots. Please be advised that the Board has informed us that technical approval of the septic designs has not been granted. Given the current status of the plans, the Board has instructed us to hold off on our review pending resolution of the issues before the Board. Very truly yours, Kathleen M. O'Donnell cc: Board of Health PRINTED ON RECYCLED PAPER sJ Town of North Andover Q NORTN , OFFICE OF 3r o "� °0 4. COMMUNITY DEVELOPMENT AND SERVICES A 30 School Street North Andover,Massachusetts 01845 WILLIAM J. SCOTT SSAcwUSE Director May 15, 1997 Mr. Thomas Neve 447 Old Boston Road Topsfield, MA 01983 Re: Lot 417 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: 1. No deep holes in primary leach area. (3 10 CMR 15.102(2)) 2. No perc in reserve area. (3 10 CMR 15.104(4)) 3. Previous design as discussed was based on 165 GPD; prefer higher design here. 4. Insufficient leaching for 10 rooms (510.72)Need at least 550. Also, see 93, above. (3 10 CMR 15.002) If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S. Health Administrator S S/cjp S _ CONSERVATION 688-9.30 HEALTH 688 9540 PLANNING 688-9535 A ' t� 'A �p Ot APRIL 30, 1997 ,Mph GEORGE RAND ESQ. 23 CENTRAL STREET ANDOVER, MA. 01810 DEAR ATTY RAND: I ATTENDED THE BOARD OF HEALTH MEETING ON APRIL 24 TO REVIEW THE CONCERNS OF MY LETTER DATED APRIL 22, 1997. THE BOARD ADDED A THIRD REQUIREMENT FOR THE PROPOSED LOCATION OF TWO SYSTEMS ON ONE LOT: 1) THE SEPTIC DESIGNS WOULD HAVE TO BE APPROVEDBY SANDY STARR; 2) THE EASEMENT AGREEMENT WOULD HAVE TO BE APPROVED BY TOWN COUNCEL; AND, 3) TOWN COUNCEL WOULD HAVE TO RENDER AN OPINION THAT THE LOCATION OF TWO SYSTEMS ON ONE LOT IS SANCTIONED BY TITLE V. I HAVE RECEIVED APPROVAL FROM THE TOWN TO SOLICIT AN OPINION OF TOWN COUNCEL AT MY OWN EXPENSE. I WOULD LIKE YOU TO CONTACT KOPPLEMEN AND PAIGE AND ASK FOR THIS REVIEW AND OPINION. YOU SHOULD INSTRUCT TOWN COUNCEL TO ADDRESS ITS REPLY TO THE NORTH ANDOVER BOARD OF HEALTH, AND FORWARD THEIR INVOICE TO EITHER YOU OR ME FOR PAYMENT. SINCERELY, I ROBE JANUSZ 40 SUNSET ROCK RD. ANDOVER, MA. 01810 508 373-7539 CC: NORTH ANDOVER BOARD OF HEALTH NORTH ANDOVER BOARD OF HEALTH 1 DESIGN REVIEW REPORT DATE U /7 FEE: PERMIT ## DATE RECEIVED 4 ,-lg1g7 APPLICANT A)05" MAP PARCEL ADDRESS LOT ## STREET ## ENG. ,SIEVE STREET ENGINEER' S ADD. 1 PLAN DATE_ $�i 197 REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED -- REASONS FOR DISAPPROVAL: /UQ lj E � /��G /iU /�.�1 �4�y L_6f9C/- � A 3/0 C,/7e a � /vo - A51� pti 16.5- 6 Pb� 19 (0-10,7Z) 197 OVA RAND & YOUMATZ, P.C. 1991 �t 23 CENTRAL STREET ANDOVER, MASSACHUSETTS ❑181❑ . . ^' GEORGE A. RAND -- TEL: (SOB) 470-0477 VINCENT W. YOUMATZ.(MASS. & N.H.) FAX: (508) 475-4644 May 5, 1997 Joel B. Bard, Esq. Kopelman & Paige, P.C. 31. St James Avenue Boston, MA 02110 RE: North Andover Board of Health/Robert J. Janusz Septic System for Lots 17 and 18 Sherwood Drive Dear Mr. Bard: Regarding the above-captioned, please note that I represent Robert J. Janusz in connection with his application to the North Andover Board of Health for permits for septic systems for the above-captioned lots . The Board has given technical approval to the septic designs submitted to them, but they -have requested that you, as Town Counsel, review the proposed systems for compliance with Title V. I am informed that the Town Manager has approved the request for review, and my client has agreed to pay for the review. By way of background, my client and his engineer, Thomas E. Neve, originally appeared before the Board to seek approval of a shared system under Title V for these two lots . After discussion and further review, it became obvious that since Lot 17 had the capacity to accommodate two (2) separate leach fields , it made more sense to build two separate systems rather t"—n a shared system. As now proposed, beth leach fields would be located on Lot 17 , and the septictank on Lot 18 would be connected to the leading field on Lot 17 . A perpetual easement would be granted to Lot 18 to allow for access, use, maintenance, operation and repair. This scenario is simpler technically and it avoids the need to form a homeowners association and other requirements of a shared system under Title V. As I stated above, both the Board and my client favor this proposal over a shared system, and technical approval has been granted. I am. forwarding herewith a form of easement that I believe would be sufficient to burden Lot 17 for the benefit of Lot 18 . Page 2 May 5, 1997 The Board has asked that you review same and provide them with your opinion concerning the easementand compliance with Title V. I would appreciate it if you would forward your opinion directly to the Board of Health, with a copy to me along with your invoice . I would be happy to discuss this matter with you should you have any questions or comments . I Very truly yours, George A. Rand GAR/hld Enc . cc: North Andover Board of Health Robert J. Janusz Thomas E. Neve, P.E. r NEVE ASS MATE 1 NCe April 22, 1997 , T01!!;N OF N�R?if 6E�11��3VLR BOA€ i�iN HEALTH Ms. Sandy Starr M 2 2 iQ-7 Board of HealthLI 146 Main Street North Andover, MA 01845 Re: Lots 17 & 18 Sherwood Drive 7erad Place Phase IV Dear Sandy: Y Find attached plans for the above-referenced lots which have been designed in accordance with the Board of Health meeting on March 27, 1997. Also find attached the easement document which allows this system to be installed and maintained with no greater effort than if it did exist on its own lot. Kindly send the plan and easement document to Town Counsel for their, hopefully expeditious, review once you have approved same we will prepare a survey easement plan to be recorded Y pP P P Y with the deed. If you should have any questions regarding this matter please do not hesitate to contact our office. Very truly yours, T OMAS VE ASSOCIATES, INC. Thomas E. Neve, PE, PLS President, CEO TEN/km Attachments #1449 JAN17-18.WPS • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 C4-.. '717 j IDO .19:7- FRIDI Panas-oriic FP`11' PHOirlE 1-10. �_3 17 c 45INF7., APPAL 22., TOWN OF TNORTIR ANDO�7�R, BOARD OF PT- V -,Py -- J M i N S T '{yl JMA, 0184.�; SUBJECT' MINUTES OF BWVPT1 OF HEALTIR MEEI INO -97 VAPJANC-RE, 't.fF, T,-( c D D.IRIV - DEAk -BOARIj MM�NIPFR��: I WOULD LIKE TO ASK CLAPiFiCATION CIN i-HE MIINUTtat- COIIITCE-;'>�-INCY THE VARJAINCE REQUES-1 - LOT 17/18 SJERWOOD DRIVE - T/0,101, 1) BACKGROUND, THE PL14RPOSE OF THE MEETIN(i'tVAF) TO PJPV-V1iV -�`,-TF APPLICANTS REQUTFST IFOR TWO SEPARATF SYSTEX-VIS L.',-")CA-, T Y-4 C a 0 N .)NF LOT -,-C) _ -TAKED" - 'I'STFAI 1MR, N LCUS 17 AND 18, RA-Tl4P-R THAN A SINGE COMMON" OR ",$r TO BE SERVED BY THF Rin-COMMENDI D THAT SINCIETHERE'VERE T WO L )TS '- COMMON SYSTEM, TWO SEPARATE SYSTE'14S LOCATE-iD ONONFLOT WITR APPP%0P!0A.'*F11'- EASIEMENTS7 WOULD BETTER Slf-RVE FIOME ("WN.-ER' NE'LET-)S. 2)PAR-ALGRAPf-I ONE OF Tllr--INIUNUTES STATES TRAJ WE, -PF-,Qf(-F ;1 STFEDTOCCA-V: BEFORE THE 130A RD °rOPROPOS,E .," OF TNVO SEPARATE S YSTUMS LOCATED ON ONE LOT," i S UBI MITT THE -[D-F A" OF TVV SEPAItAl-E SY81"EMS ON ONr:�LOT IS CORRECT, BUT THE RrfFEpJ,--,NCF. To .6. SHAIZIFIL'') SYSTEM. IS LNTCORRECT- THE PROPOSED S STEMS WOULD BP LKDEPF?\9)kNT AND BY - A(1-1 R01NJE fkAVNER, THE MOTION INDICATES THE BOARD "ACTREED TC-11 THE 'CONCEPT OF 1ik 'r\VQ LOT SIHAP-RF) SEPTIC SYSTEM 'FOR LOT 17/18 SHERWOOD DRIVE. A-ND CiO FORWARLD V17IT'R T-H-''> Cr-slcN MINUTES NEED TO lKWCATETHE BOARD AG.UREI)TCS'T'I-IF: CONCEP T 01" TWO '�-'(4Tl O-N d THE MIN CUES INDICATE THAT "141". OSGOOD SUGGEST-ET) C'r!AR(.-ffNG H SPjtf-'LAL FEEFWA SHARED SEP11C SYSTP.M. -W-HICH W01JT.D COVER TJ-Tr74 COSI- OF: 7 F-r FbirS. IMS, STAP'L.R STATED THAI'THE TOWN MANAGER MIGHT SAY THAT J.-iEWON'TPAN COY TOWN COUNSEL BEC"',USE.THEPUDGiFf" IS OVER i7-XTENDED." I BELJE,-1VFTH.'F. LASTSENTENCE --SHOULD HAVE THE F-TR*,S1' S.iN('F COMIMON PRACTICE TO HAVETHE A:RPLICANT PAY FC,1R OUTSIDE (7f)NrSrfJt.TATT(',,,NS Tlflz- "EASEMENT AND AGREEMENT FO-R SUBSURFALC1,2 SANITARY DISPOSAL SYSTEM I RAS rN1, TO HAVE -rVUE D()17Uh1l0EN-T BEEN DRATTED AND SUPIAU't TED TOT9--t SOART-) Al%,T)WE I ED I M'�'V`EWED BYTOWN CGIUNICIL. Sim-'E 1 VVILL PA-;' FOR THTS REVIPW. WESTJJ--.t.N17F*f) , QUESIIN 'Vlfl) OBTAK111,KiRls APIR OVAIL " PARAGX,WH 2.19 OF BOH REGULATIONS iOVER'I'A' NIULTTPLE UISEA ND 5'1'A7TS '-rH!-,T -TfTh TBATOINTIF1,01- is -PRCIHMIT L D. ONLY ONTE S(IJBSURFACE- DISPOSAL SYS TE-Ni* B.F .L V A, i�FSIDENJIAJ, LOT," AS WRI178N, I RELIFNIE T14-F. PARAGRAPHIWOMLD DTSAjj,( -M J SYSTEM. AS WELL -AS TWO �EPAP 'CATFF) -1< SHAR D , RATE �3�YSTEIN,IS f-C, FF'lDM R=ria scn i c F'x. 3Y'_TEtl PHOh•IE h.10. Apr. 199'7 0'9: G-PM P2 LC)'E VVIiAI j'vl( DIFICATIC ;. OR,CRI.'NGE:S S-P-1(ji_) B�: Nf: E TC)THIS _PA.1),ACR.A t! r t ORDER F0 PUIRSir14 THE "COiNCEPT'"? SHOULD T PARA rt. ,giC L . TI 1 Dl, l :uN; ,'i �, Tf-IYF, TWO SYSTEMS -HAVE SEEN CONRT-�--lM;ANM S?.I.WMITTI�; A-L NC,WIT I HE Er`'SE.'rVIEN'T AND AGREEMENT NT FO TIM - YSTFiY. I Wt i E TO REQUEST T14A T -VV—j--.J-i'�VE THE F.ASEr-.4)5N7iAGR-F—E'Mi'lI,'T'REViEVV J, BY TP,.W'N 'ui;NC:FsI , ��J41L..E S�?I DY' IS R VI�`1�3i'+G THE�;�PE RA-rl-- DES- TMS FOR THE. TWO f� iv ;N -Y73-7539 . :. UPD 01 I d-W, TUST BEEN- f;DSE's THAT THE?'t TWNt T�1.4.PwTA C—rER H:?s APPROVED TBE PJHQIJE;�-f oLiTSIDNE'RE.'II-,WBy TO-WN COUNSEL, ON BA I;, TgAa I WILL Pt\Y FOR T-14TS itEVIT s. I4I.e: ECi,F -RY I r-)i h'1I T—) :SHE<V1.i_ A xVtL e.q.NTTY' C5I To: Sandra Starr North Andover Board of HealthThoFrom: Thomas Neve (508) 887-3480 4117/9 15:46:40 Page 1 of i FI I Date: 4117/97 Time. 15:46:24 Page: 1 T o: Sandra Stair Company. North Andover Board of Health Fax#r: 688-9542 Frond: Ti iornas Neve f Title: President, CEO Company: Thomas E. Neve Associates, no. Address: 441 Boston Street Topsfield, MA 01983 USA r.ax 141: (508) 887-3480 Voice ti: (508) 887-8586 T Message: Re: Lot 17 and 18 Sher�.vood Drive, Bob Janusz. Hi Sandy: I called your office today and asked Caro' to check to see when I was scheduled to re-appear before the Board on the above referenced matter. It seen-s that the minutes reflect a vote from the Board on the concept and the Board further directed me to design the systems and submit same to you for your approval.Wrn over 40.. .They say your memory is the first thing to go...:-chat next ???) My question is, do I have to go back to the Board with the final designs or is your approval all I need. The designs will be done tomorro-,,�/and i vviil drop them off or, Monday. If 1 need to return to the Board kindly put me on the agenda fcr ?-r,uis-ia,,. On another matter, I know you have been busy and I tr_ist that you have not had time to check with Town Counsel about the fees associated with re6ewing the easernent docurneni.s for the above system. Bob is going to pay the biii any lay. T[,,= documents will be subrnitted with the glans on Monday so you can h,,avti them revie.Ved. Please let rrie h ncv%l if you need arryfihing frorn i-Tie. .......Thank you..........Tom To: Sandra Starr North Andover Board of HealthThoFrorn: Thomas Neve (508) 887-3480 419197 '17:14:24 Page I of 1 A1 M IL VER PAGE Date. 4/919 7 Time: 17:14:08 Page: 1 To: Sandra Starr Company: North Andover Doard of Health Fax#: 688-9542 From: Thomas Neve Title: President, GEC Company: Thomas E Neve Associates, Inc. Address: 441 Boston Street. Topsfield, MA 01983 USA Fax#: (508) 887-3480 Voice#: (508) 887-8586 !V�essage: Dear Sandy: Re: Lot 11118 Sanitary Disposal System At the Board meeting on 3/27 you were going to check the follov ing 4th your Town ;counsel. 1. Whether an easement with the proper terms and conditions could be granted by a lot owner for an abutting lot owner to use his/her land for a leaching facility. The deed language would allow for the construction, maintenance: repair and replacement as would be req!.uOred by the user or the Board of Health; with unlimited rights. WOV''1 basically lot 17 would grant an easen-ent to tot '18 for the intended purpose. The decd v%,ould be recorded and allow a forever riga(to exist. (I am sure that a deed can be written v✓hich WOUld satisfy to^,1n counsel its just a matter of the terms and conditions.; 2. The other issue was money. Bob Janusz is to pa,;,f Town Counsel. either directly. or through your Board: for the legal fees associated with revie%t�ijri , the doc_s' eats. This work is supposed to be completed by the ;text Board meeting (!,%/hich I think is on 4/214, please confirm.....) so that the Board can vote on the systems. I am working on the easement language with BoUs Latktyer George Rand and I can be read;v after Friday to review the Pians and documents with you. oefore they go out to Town Counsel. Please help me....vdhen car! I come over to see you') I ^rill make myself available on ivlonday or Tuesday. at your convenience.Plea se`Call. Thank you............. ..Tom cc. George Rand THO r NEVE ASS IATES INC. !AR l 91997 March 14, 1997 Sandra Starr, R.S. North Andover Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 17 & 18 Sherwood Drive Jerad IV Dear Sandy: Please take a look at the attached sketch. I came up with an idea which might be simpler for all concerned. The original design was to propose a common leaching area for both lots; the area would be on Lot 17. Lot 17 and 18 would have their own septic tanks and will service same. They will "share" the leaching area. They will have maintenance agreements and other particulars which are required by the code. An alternative to the proposal above is to install 2 leaching fields, both on Lot 17. Each lot will have its own septic tank and they will each have their own leaching field, both being on Lot 17. They will also have "dedicated" future reserve areas. I prefer the alternative for the following: 1. I believe Title V contemplated more than two users in developing the "shared system" regulation. 2. A simple easement can be granted to the owner of Lot 18 to use the land on Lot 17 for "sewage disposal purposes." This grant of easement would be individual in character and would not be "shared." If the field fails in the future, the right would be there to construct and repair the system and the sole cost would be in the individual lot owner. This would be very similar to individual lot ownership. The benefit is that two people are not involved in the "sewage disposal business." • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 Sandy Starr Page 2 March 14, 1997 Their individual lifestyles, financial situations are not a function of a "future" repair. Please consider this alternative. I would be happy to discuss this further with you or the Board if you feel it is appropriate. Thank you for your consideration. Sincerely, THO AS E. ASSO ATE C. Thomas E.Neve, PE, PLS President, CEO TEN/ew cc: Robert Janusz George Rand Tom\1536.doc i r TCJV!/N OF NORTH ANE)01,"—P f30A DB2 c7F::�'if�i JAN 2 8 1997 TSI® NEVE ASSO►CIAT January 23, 1997 Mr. Robert Janusz 15 Clement Court Haverhill, MA 01832 Re: Lots 17 & 18 Sherwood Drive, North Andover Dear Bob: I spoke with Sandy Starr on the phone recently and she is prepared to recommend to her Board that the shared system for Lots 17 & 18 be approved subject to the following conditions: 1. Her receipt of the-Covenant required by Title V which I had given you several weeks ago 2. Her observing deep hole observation test pits on Lot 17 to verify that a system could be installed on the rear of-the lot in accordance with Title V. Please call me so we can discuss this and submit the documents required. I wanted to schedule a public hearing soon while this information is fresh in her mind. I will also schedule these test pits to be done as soon as weather permits. I will let you know when they are scheduled so that you can furnish us with a backhoe. Sincerely, THOMAS E. NEVE ASSOCIATES, INC. Thomas E. Neve,-PE, PLS President, CEO cc: Sandy Starr, NABH #1449 JANUsz.wrs • ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS • 447 Old Boston Road U.S. Route #1 Topsfield, MA 01983 (508) 887-8586 FAX (508) 887-3480 Town of North Andover cf 40RTlI OFFICE OF 3� y`t, ooc COMMUNITY DEVELOPMENT AND SERVICES A 41 146 Main Street • a ,• x North Andover, Massachusetts 01845 WILL AM J.SCOTT SSACHUSEt Director November 27, 1996 Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot 17/18 Sherwood Drive This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. Missing proposed operation and maintenance plan; description of how system protects public health, safety& the environment; form of ownership; description of financial assurance mechanism, etc. (see 310 CMR 15.290). 2. Trench system not proposed (3 10 CMR 15.240(6)). 3. Pipe under driveway should be protected by encapsulation within larger pipe. 4. Lot 18 still requires testing to prove a system could be installed. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S., Health Administrator SS/cjp cc: File Bob Janusz BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I' Town of North Andover, Massachusetts Form No,s NORrti BOARD OF HEALTH of .�., rya / ... 9_2 Vin + ��b,,,,;,.••�- ^ DESIGN APPROVAL FOR ss"`""SEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM `rApplicant - `lJ4'(Y Test No. Srte Location `I :.Reference Plans and'SPecs. NEER DESIGN h.- - - ENGINEER Permission is granted-for°an individual soil absorption sewage disposals ed "'`In accordance with regulations of Board of Health. .. - _ AIRMAN,BOARD OF-.H EA LTH w Site System Permit No. - r o-r - \o r IC 1 r � V.7 v -� q � 1 q S i f rY r i m i i NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: PERMITDATE RECEIVED h I � APPLICANTte, MAP PARCEL . - ADDRESS ARCEL .ADDRESS LOT ## STREET ## ENG. STREET ENG. ADDRESS j PLAN DATE IZ� / / ` � REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED �I REASONS FOR DISAPPROVAL: �' �9-r/6.0 � /�I/�"/�/,r�.,r/�9-tip• �'�/��, 14 66IA.J6 C7P --�.eGT�GTS U GSC v AD /=' T� ?-/fes "1D6-sc/2//0TID,k) T itiAA,)e,� `/ �i0 .G� c /� 5554 173 BK ■ G OUITCLAI� r Sherwood DemlopneW Compoy,LLC,a Massachusetts Limited Liability Cornpmy with a weal plum of b=in's at T=Vike Strout,North Andover,Essex County,Maswuh=c ts, in consideration of FIVE HUNDRED SEVENTY FIVE THOUSAND SIX HUNDRED AND 00/100($571,600.00)DOLLARS grants to Jampb H.Bance:and Nanq L.Bargees,husband end wife,of 2iLl • Shrawood Drive,North Andovac,Harem Cvesnty, as tenants by the entirety, WITH QUITCLAIM COVENAN'T'S PROPERTY ADDRM Lot IS, Sherwood Dr.,No. Andover,MA 01845 flue kind,wdh tine beMW ttie ftv.iu Nw&Andover,Boat County,Mewachuretts, did r&Nerve: Lots 18 as shown on a plan of land entitled"Planned Residential Development of'Jerad Place-Pham IV',designpd for Timberland Buildws,Inc.,40 Sunset Rook Road, Andover,MA 01810. Datod September 1, 1995,Rev.to March 12, 1996,Thomas E. Neve AwvciAW Inc.,Engineers-Surveyors-Land Use Planners,447 Old Boston Road, U.S.Route 1,Topsfiald,Mwsachusette,01983,508-887-8586",and recorded on May 2, SEp 1ts'99 AM91-0 1991 as Plan No. 12805. Thefee to the roadway shown as Sherwood Drive on said plan is not hereby conveyed, however the Grantor heareby grants to the Grantees the permanent right and easement to pass and rspm over uld mood Drive,and the right to use Sherwood Drive for all purposes for which public ways are customarily utilized in the Town of North Andover. The within eonvoyanoo is subject to eaeeueaezts,re*ictions and conditions as shown on ]I the Plan reeoa W as Plan No. 12805 and the tams of the Special Permit PRD Approval recorded at Hook 4164,pep 309.. Also subject to a Declaration of Reshictive Covwww for bread Plm-Phase IV,dated August 28, 1997 and rec'ded at Book 4830, c Page 97.Also object to any and all outstanding Orden of Conditions. � O This eonvayance does not constitute a sale of all or substantially all of the assets of Sberrewod DwdopmeW Coaepauy,LLC. H COHEN LAW OFFICES, P.C. 873 TURNPIKE STREET NORTH ANDOVER, MA 01845 PLAN REVIEW CHECKLIST ADDRESS LOT 17119 _ENGINEER GENERAL / 3 COPIES v STAMP LOCUS NORTH ARROW SCALE CONTOURS PROFILE SECTION BENCHMARK SOIL & PERCS J/ ELEVATIONS, _ Tc; DISCLAIMER L,--- WELLS & WETS WATERSHED? lVb DRIVEWAY ��Elev c� ( ) WATER. LINE FDN DRAIN SCH404/. TESTS CURRENT? SOIL EVAL_ SEPTIC TANK MIN 1500G ( . 17 INVERT DROP GARB. GRINDERd �(2 comps +200 10130 FDN MANHOLE ELEV GW-(te # COMPS. GB D-BOX -SIZE # LINES.Z FIRST 2 ' LEVEL STATEMENT 17 INLET ) '/. 1 - OUTLET k0, _ (2" OR . 17 FT) TEE REQ-D? s3 � F�ACHING �11,56pr) MIN 440 GPD? RESERVE AREA v o 4 ' FROM PRIMARY? L- 2� SLOPE 100 ' TO WETLANDS1f 100 ' TO WELLS ✓ 4 ' TO S.H.GW (5 ' >2M/IN) 20 ' TO FND & INTRCPTR DRAINS 400 ' TO SURFACE H2O SUPP L--- .41 PERM. SOIL BELOW FACILITY XIIN 12" COVER Ll--,"" FILL? "-�(1151 ) BREAKOUT MET? TRENCHES MIN 440 gpd SLOPE (min .005 or 6"/1001 ) SIDEWALL DIST. 3X EFF. W OR D (MIN 61 ) RESERVE 13ETWEEN TRENCHES? IN FILL? MUST ,BE 10 ' MIN. 4" PEA STONE? VENT? (>3 ' COVER; LINES >501 ) BOT + SIDE _ X LDNG = TOT (L x W x #) (DxLx2x#) (G/ft2) Copyright © 1996 by S.L. Starr PITS MIN 440 LEACHING MIN 1 (13 'x16 ' ) PIT MANHOLE/PIT GW MIN 4 ' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x ##) (2x(L+W)xD x ##) (G/ft2) CHAMBERS MIN 440 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60 ' X 60 ' ) MIN 13 ' X 16 ' PIT BOT + SIDE X LOAD = TOTAL (L x W x ##) (2 x (L+W)xD x ##) (G/ft2) FIELDS MIN 440 GPD 900 ft2 BED -'� GW MIN 4 ' BELOW BOTTOM OF FIELD PIPE ENDS JOINED? f 4" PEA STONE? C/" DIST LINE SLOPE .005? >31COVER-VENT SCH 40_L_::,' MIN 12" COVER RATE ( VD X c3 /-" ) X -5-6 = TOTAL /dG L W LDG -�F7 /,�- DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY 9Pm L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME 9Pm MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. l ' below inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL OP. SWITCH ENUF STORAGE? TDH WEIGHTED? Copyright © 1996 by S.L. Starr SEPTIC PLAN SUBMITTALS LOCATION: \� L ' NEW PLANS: YES $60.00/Plan REVISED PLANS: YES $25.00/Plan DATE: i DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary •s i �54,A-tl ��� Gs'FL— EASEMENT AND AGREEMENT FOR SUBSURFACE SANITARY DISPOSAL SYSTEM Lot #17 and #18 Sherwood Drive North Andover, MA THIS EASEMENT AND AGREEMENT made this day of , 1.997 by and between of , Massachusetts, (hereinafter called "Grantor" ) , and , of , Massachusetts, (hereinafter called "Grantee" ) , WHEREAS, the Grantor is the owner of the property known as Lot #17 shown on a plan entitled "Planned Residential Development, Jerad Place - Phase IV, designed for Timberland Builders, Inc . , 15 Clement Court, Haverhill, Mass, prepared by Thomas E. Neve Associates, Inc . of Topsfield, Mass . dated September 1, 1995 and revised to March 12, 1996" said plan being recorded at the Essex North District Registry of Deeds as Plan No . 12805 . WHEREAS, the Grantee is the owner of the property known as Lot #18 shown on the aforementioned Plan No. 12805 . WHEREAS, the Grantee proposes to construct a septic system to service said Lot #18, which system will entail installation of piping, distribution box, septic tank, effluent connection lines with appurtenances thereto and/or sewer pipes which shall be connected to a series of leaching pipes, (which hereinafter shall be referred to as the "septic system" ) , which septic system shall be located on Lot #17 . WHEREAS, in order for the Grantee to effect such construction, it will be necessary to enter upon the Grantor' s property. NOW, THEREFORE, for and in consideration of the sum of One and 00/100 ($1 . 00) Dollar and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, Grantor does hereby grant, convey and release unto the Grantee, its successors, legal representatives and assigns, a permanent right and easement to enter upon certain property known as Lot #17 , to construct, lay, operate, maintain, inspect, repair, remove and replace a sewer pipe and leaching pipes and to lay, operate, maintain, inspect, repair, remove and replace any part or the whole of the septic system as described in plan. entitled "Sanitary Disposal System designed for Timberland Builders , Inc . , Lots 17 & 18 Sherwood Drive, North Andover, Mass . , prepared by Thomas E. Neve Associates, Inc. of Topsfield, Mass . dated October 1, 1996" and approved by the North Andover Board of Health on , ;1997, together with a right of ingress and egress for any and all said purposes, including the removal of growing crops, trees, or shrubs, therefrom, and i the right to bring upon said Easement such equipment as may be necessary to do any and all acts deemed necessary to maintain, operate, inspect, repair, excavate and replace sewer and leaching moi.?les or any other element of the septic system in or over that portion of the said property which is owned by the Grantor. Grantee agrees to return theremis p e. to its present state following construction of the project and following each subsequent entrance upon the property for the purpose of maintaining the system. Grantee agrees to maintain the sewer pipe and leaching pipes and all other elements of the septic system, including necessary repairs and replacements . Said elements of the septic system shall be the property of the Grantee and shall not become a fixture to Grantor' s property and shall forbid the introduction of hazardous or toxic materials which may interfere with the proper operation of the septic system. Any action by the Grantee pursuant to this Easement and Agreement shall not be deemed a trespass and the Grantor does hereby indemnify and hold harmless the Grantee for any and all damages incurred by said Grantee as a result of this Easement and Agreement other than willful or intentional acts of the Grantee, its agents, employees or assigns . The Grantor, his heirs, successors, transferees and assigns shall be prohibited from placing, constructing or maintaining any driveways, fixtures, structures, trees or I shrubbery on the easement area, and shall be prohibited from placing, constructing or maintaining any underground utilities or fences on the property that would have the effect of impeding access from Lot 18 to Lot 17, for purposes of maintaining, inspecting, operating, repairing and replacing the septic system. It is the intention of the parties that the Easement area shall be loamed and seeded, and shall remain a lawn area. .l This Easement shall terminate at such time as the Grantee extends and completes a connection to a public sewer or treatment works, to include services to Grantor' s property and the properties shown on the referenced Plan No. 12805 . It is expressly provided that this Easement is appurtenant to Lots 17 and 18 and shall run with the land. To have and to hold the aforementioned described Easement to the proper use and benefit of the Grantee, its successors, legal representatives and assigns . Executed on the day and date first above written. GRANTOR: GRANTEE: 1 V qi • COMMONWEALTH OF MASSACHUSETTS Essex, ss . 199.7 Thenpersonally appeared the above-named, and acknowledged the foregoing instrument to be free act and deed, before me, Notary Public My Comm. Exp. COMMONWEALTH OF MASSACHUSETTS Essex, ss . 1997 Then personally appeared the above-named, and acknowledged the foregoing instrument to be free act and deed, before me, Notary Public My Comm. Exp. 03-21-1996 14:36 617 932 7615 DEP NORTHEAST REGIONAL P-02 • 1 y FORM L' - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS 1\ M44 k, 'V L , Massachusetts Percolation Test' Date: 510 Time: �n Observation Hole # Depth of Perc �� Start Pre-soak Z� Pw1 End Pre-soak Time at 12" 2',35 Time at 9" Z S Time at 6" Zlo Time (9°-6" 337 Rate Min./Inch �\ l • Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed EIZSite Failed ❑ Performed By: ''� Witnessed By:\. Comments: oZ?XM0V=rORM-n/97M i i 11 i FORM 11 - SOIL LVALUATOR FORM Location Address or Lot No. Determination,for Seasonal High Water Fable Method Used: ❑ Depth observed standing in observation hole........... inches ❑ Depth weeping from side of observation hole ........ . inches KDepth to soil mottles ...UP inches ❑ Ground water adjustment .................. feet Index Well Number .. .. ...... Reading Date . ...... Index well level Adjustment factor .... .......... Adjusted ground water level . ..._ .._..._.... Depth of Naturally Occurring Pervious Material r' Does at least four feet of naturally occurring pervious material exist in ajl 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 `� (date) I have passed the soil evaluator examination j approved by the Depar mens 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. Si9 nature3- Date DEP APPROVED FORAi- 12/07195 10 FOR 111 - SOIL EVALUATOR FORM Location .-address or Lot ,vo. On-site Review Deep Hole Number Date:. V 428`� i ime: WeatherA�l(Z Location (identify on site plan) Land Use Slope M Surface Stones Vecetation Landform ESU��- Position on landscape (sketch on the back)-�F_ Distances from: / Open Water Body l`�Dy feet Drainage way tom/ feet Possible Wet Area Q9&/—feet Property Line 140-+/—feet Drinking Water Well 4PK feet Other DEEP OBSERVATION HOLE =OG* Deoth from Soil Horizon ` Soil Texture Soil Color Soil Other Surface(Inches) ( I (USDA) (Munsell) I Mottling (Structure, Stones, Boulders, Consistency, % Gravel) i n t Adjk✓�tl CI C eta•tt--� QD"_ CSq I I MINIMUM I HULt6 riF-UUlHEJ A i cVbnY HHUPUSF-DAL Parent Material (geologic) Oj5fu,-A��tA DepthtoSedrock: DNK5- Deoth to Groundwater: Standing Water in the Hole: � +�� Weeping from Pit Face: ta Estimated Seasonal High Ground Water. O DEP APPROVED FORM-12/07/95 - i FORM 11 - SOIL EVALUATOR FORM � Location .-kddress or Lot :4o. �� 8 On-site Review Deep bole Number 9�-2-9 Date:. 0 I gs Time: n Weather s(� Location (identify on site plan) 5 T(� . n—Ar—, Lsnd Use Slope M Surface Stones Vegetation W?i � Position on landscape (sketch on the back! Distances from: Open Water Body 1-o+/ feet Drainage way N lq fest Possible Wet Area 1'10+iLfeet Property Line est Drinking Water Well � f 113/p,113/p, eet Other OBSERVATION HOLE �E�r ! _!G Oeoth from Soil Horizon Soil Texture Sod Color Soil Other Surface (Inches) I I (USDA) (Ivlunseill I Mottling ( (Struciure,Stones. 9oulders, Consistency, % Graved d (> s 2 G L��S Yv�P",cc%,j tZrv\ I I MINIMUMHoLtS RE UIAT EVERY PROPOSEDSALA �C Parent Material (geologic) L'4 Oepthtoi3edrock: Oeoth to Groundwater: Standing Water in the Hole:: n`e Weeping from Pit Face: Estimated Seasonal High Ground Water: ►y w DEP APPROVED FORD%1-1:107195 FOR 111 - SOIL EVALUATOR FORM Location .a.ddress or Lot ,4o. ZI On-site Review Deep Hole Number 9 C-2—?A Date:.. �.�..�g Time: Weather (L Location (identify on site plan) Land Use Slope (°'o) Surface Stones Vegetation vj7Liv�vt5e--'>` Landform � � Position on landscape (sketch on the back) ISECi Distances from: - Open Water Body 2AC —feet Drainage way �S/pl. feet Possible Wet Area `2(p•-feet Property Line -30.4-/-feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) I (USDA) ( (Munselq I Mottling I (Structure.Scones. Boulders, Consistency, % Gravel) Otl Zell 2 t/� �� i l ) MINIMUM OF 2 H t5 nt i EVEriY PROPOSED6At A r.�� ���y�1 Parent Material (geologic) Qa ,wf-�' �S Depthtoi3edrock: \� Oeoth to Groundwater: Standing Water in the Hale: Weeping from Pit Face: Estimated Seasonal High Ground Water: DEP APPROVED FORA)-1«07195 FORM 11 - SOIL EVALUATOR FORM I Location .-.ddress or Lot :�o. �-j lC� On-site Review Deep 'Hole Number ate:. 1 �.��I9S Time: Weather I Location (identify on site plan) Land Use Slope Surface Stones Vecetation l,1sCt��6� Landform Position on landscape (sketch on the back) Distances from: Open Water Body 'Z-Z-04/—feet Drainage way V4A feet Possible Wet Area 7-2!C3+/— feet Property Line 2-Ci-+./feet Drinking Water Well t--�/A feet Other DEEP OBSERVATION HOLE LOG* ueoth from Soil Horizon Soil Texture Sod Calor Soil I Other Surface (Inches) I I (USDA) I (Munsell) I Mottling ! (Structure.Stones. Boulders, Consistency, Gravel) �r1_��� . � • ,gam eA' 61 MINIMUM OF t i I I L HUL:-.-3m-SUU7ED AT EVERY PROPOSEDIS SALA Parent Material (geologic) C:�O--tyj05CA Depthto8edrock: Oeoth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: UEP APPROVED FORM-1:107195 i FORM 11 - SOIL EVALL-ATOR FORM Loc--tion .address or Lot ;vo. On-site Review Deep Hole Number 22—?�" Date:. .' 9rj Time: Weather Location (identify on site plan) : Land Use Slope (°sol Surface Stones Vecetation t.rtvo6r� Lanaform �i(,c�Z Position on landscape (sketch on the back) Distances from: Open Water Body (c�3'0'+�feet Drainage way feet Possible Wet Area 12e+/ feet Property Line t feet Drinking Water Well �-� feet Other DEEP OBSERVATION HOLE LOG* Death from Sail Horizon Soil Texture Soil Color Sod Other Surface (Inches) I I (USDA) I (Munseil) I Mottling (Structure,Stones, Boulders, Consistency, % Gravel) \\_ i 1 ) sem- 64u f I H to REUL)IRED A; EVERY PROPOSEDA A Parent Material (geologic) W Pr� Oepthtai3edrock: y , Death to Groundwater: Standing Water in the Hale: i-1�w"� Weeping from Pit Face: Estimated Seasonal High Ground Water: DEP APPROVED FORJst- 1.:07/95 FORM 11 - SOIL EVALUATOR FORM I Location Address or Lot ;Jo. On-site Review Deep Hole Number Z2-2 Date:. �}IZ�,95 lime: ArA Weather r"PItrL Location (identify on site plan) S Pi,—' Land Use Slope (9Joi Surface Stones Vegetation Landform Le—_SeC2, Position on landscape (sketch on the back) -tri; PL..t ' Distances from: - - Open Water Body Zdp / f}� feet Drainage way J,�� feet Possible Wet Area 2-,4D4-/—feet Property Line Z-ot/--feet Drinking Water Well Q`q feet Other DEEP OBSERVATION MOLE LOG* Oepth from; Soil Horizon Sail Texture Sod Color Soil Other Surface (Inches) I (USOA) (Munsell) I Mottling (Structure,Stones, 3ouiders; Consistency, % Gravel) r I 28 u u 6- C-����5 nn#�ss+vE v -,✓ i I I MINIMUMHULES REQUIRED 1 cJEriY PRUFOSi-0 LASPOSALA A Parent Material (geologicf Q;'ruV Sr} Depttitogedrock: -1c, Deoth to Groundwater: Standing Water in the Hate: Weeping from Pit Face: -`�—� Estimated Seasonal High Ground Water: DEP APPROVED FORM-1-'107195 i i 03-21-1996 14:36 617 932 7615 DEP NORTHEAST REGIONAL P.02 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS } Nun) 4.1,9mez,, Massachusetts Percolation Test' Date: 128 J5 Time: Observation Hole V2 ' Depth of Perc Start Pre-soak Vi0LILO �jo fl- 1�bAyb End Pre-soak Time at 12" Time at 9" Time at 6" Time (9"-6") Rate Min./inch . Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed 9-- Site Failed ❑ Performed By: Witnessed By:`. 1, WLf Comments: :_...... . ,..._ _._ .... D17 AJ"OYM TORN-U/07/y! FORA 11 - SOIL LVALUATOR FORA 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 ........ '. inches Depth to soil mottles ?3' Z 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 �/ / (date) I have passed the soil evaluator examination j 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 s Date /a Z /Z�6 DEP APPROVED FORM-12/07/95 6 FORM 11 - SOIL EVALUATOR FOK11 Location .address or Lot Igo. < 1 g On-site Review Deep Hole Number 72 -1 Date:.. IZTime: AWV� Weather Location (identify on site plan) Land Use Slope (%) Surface Stones . Vecetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body 'Z3O+/feet Drainaae way "/A- feet Possible Wet Area 73/— feet Property Line feet Drinking Water Well. W/A feet Other DEEP OBSERVATION HOLE =OG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) ( I (USDA) I (Munsell) I Mottling (Structure,Stones. Boulders,-Consistency, % Gravel) A cp 3� �07, I I H t AT t tUlbi'USALAREA Parent Material (geologic) DepthtoSedrock: 1 � Deoth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: 1-� Estimated Seasonal High Ground Water: �UfZ �Z4 DEP APPROVED FORM- 11107195 i. n r- STOWN pA F OR t 11 SOIL EVALUATOR FOR. t � 11996 No. � }9 - l�l 18 Date: kc:A t 90 Commonwealth of Massachusetts moarttA -, Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: _._ Dace: .... ................... Witnessed Bv: SAsro>... _ S.( � l.ouuon Addtus a �- 0w is"4.=. T� ��c„�1,(p�jv�y(����,+,.�`/ �6Zi]�ci's n`✓��• 1 \ 10Etas.1N -/90 �1�J� • 1�--�-� ^�'��'l,'� tic^norc ! NIJc.>ovG9, It-AA 0%&0 1 ew Construction . L_Repair ❑ (500 A-15-81 k-5- Office SOffice Review Published Soil Survey Available: No ❑ Yes L' _ ✓ ����� Year Published �. �..... Publication Scale 1 ....` � Soil Map Unit ��fl a�,� ....... Soil Limitations `' '! j:.� - �� _�' .. t�' E� Drainage Class �._....... �¢ Surficial Geologic Report Available: No E,._ Yes ❑ Year PublishedPublication Scale Geologic Material (Map Unit) .'tw�yl...:........................................... __..._ LandformX51"(rrz.................................. ......................_..... Flood Insurance Rate Map: �-�/ Above 500 year flood boundary No F,Yes E Within 500 year flood boundary No LJ Yes ❑ Within 100 year flood boundary No l 'Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ............................... • ....................................................................__..... Wetlands Conservancy Program Map (map unit) .............•.. ....................... Current Water Resource Conditions (USGS): Month Range :Above Normal []Normal BelcS1! Normal ❑ Other References Reviewed: DEP APPROVED FOP-M.12/07/95 INS/ 51,19 OV - - - _7 / -- --- ` SRO_Pse>��D I�`O T.t•i�- ` -' .,.,,_ ,_- or 95-7 �hM'f /F1- t✓1.- )•A•Co•`� ,1h CaA1Z. ��L• - \ \ r ' 150'0 5p Z TOP OFF = 1Co`I.O . CaAV"VL'E:L.• L• E1-• 153• - - L- - - - I •.© �/ 158 °� 43 160-VAN r2 I N I \\\ �I x �\ •• SEPTIG �' ` N � �T _ \ w \ �1sct r \ \ ` �- Pooh � >�S'�`�J \ � �\ M4 \ fr _`--/� ------=- _• � \\ G \\ \\ ��\ \\ 5�'E S�5?EM P Ro F I L.� i� �/ � 1 hZ I LOT Loy• 0�• ' 151.3 .' + � \ \ \ �\ � 1 �� . •. , -`Z, ````- - _=-- -' - - - �•-�- sOwe73 (\ t'�•� ' 1\ 1\ `� _- ,/moi /moi / i / / lam ' 18' R =375.70' +�xistii/y Wood -� --- �' ---- 111 .95, w4/k •41.00 ICY \ / e I / R= 17 00 f � ---- --�— �_ 15;de walk ! �� Xis�tiny i 60 4 _ i d 5 W, / �_— — I _ _'_•--� -- , 1 _ VA IATERI , w