HomeMy WebLinkAboutMiscellaneous - 524 REA STREET 4/30/2018 524 REA STREET 210/038.0-0317-0000.0 OQ Se�jC-.z� North Andover Board of Assessors Public Access, Page 1 of 1 NORT„ North Andover Board of Assessors of t, .° COU AQProperty Record Card Click Seal To Return Parcel ID:210/038.0-0317-0000.0 FY:2009 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales Summary Residence J Detached Structure Condo 524 REA STREET `• • Commercial Location: 524 REA STREET Owner Name: WOLF,DANIELLE WOLF,JOHN Owner Address: 524 REA STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6-6 Land Area: 1.00 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 3022 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 650,500 673,700 Building Value: 441,800 465,000 Land Value: 208,700 208,700 Market Land Value: 208,700 Chapter Land Value: LATEST SALE Sale Price: 690,500 Sale Date: 08/02/2004 Arms Length Sale Code: Y-YES-VALID Grantor: RAMSEY,PETER Cert Doc: Book: 8971 Page: 296 http://csc-ma.us/PROPAPP/display.do?linkld=1459668&town=NandoverPubAcc 7/20/2009 MAP # LOT: # PARCEL #� 5 `����. STREETr_L&A2� __ N_S. T1RD HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN' APPROVAL: ', DATE dam- APP. BY- DESIGNER: !yl f}C/G ��� PLAN DATE � ,� CONDITIONS WATER SUPPLY: + TOWN WELL WELL PERMIT DRILLER WELL TESTS: _ CHEMICAL DATE APPROVED _BACTERIA I DATE APPROVED,.__.__...__._.___.__. BACTERIA II DATE APPROVED. - COMMENTS: ,r FORM U APPROVAL: APPROVAL T ISSUE `(:YED NO DATE ISSUED BY CONDITION : FINAL APPROVAL: ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO .. OTHER YES NO ANY VARIANCE NEEDED YES / NO DATE:L�v FINAL BOARD OF HEALTH APPROVAL: j_BY �•._ __ t J JS THE INSTALLER LICENSED? YES NO : .TYPE OF CONSTRUCTION: EW REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW NO CONDITIONS OF.:APPROVAL YES NO (FROM FORM U) ; ISSUANCE OF DWC PERMIT c YES NO DWC PERMIT N0. / . INSTALLER: BEGIN INSPECTION r Y N0: EXCAVATION . INSPECTION: NEEDED: PASSED BY !' _ CONSTRUCTION INSPECTION: NEEDED: AS BUILT PLAN SATISFACTORY: YES: APPROVAL TO BACKFILL: DATE:_ �d FINAL . GRADING APPROVAL: DATE �OI"� By _ r FINAL CONSTRUCTION APPROVAL: DATE: / r� r Or I �1LE COPY BOARD OF HEALTH /boa -90 OSGOOD STREET NORTH ANDOVER,MA 01845 TELEPHONE#(978) 688-9540 APPLICATION FOR ABANDONMENT OF SUBSURFACE DISPOSAL SYSTEM (SEPTIC SYSTEM Pursuant to Section 310 CMR 15.354 of the State Environmental Code, Title V Name l '�� Phone ` -7 S l ' -53-7't Address Contractor hired for work: Name)az.--4z--,-,Phone Address Date for scheduled abandonment 7 The septic system at the above address has been abandoned according to Title V specifications. Signature of Contractor Method of septic tank abandonment(check one). ( )removal AA- sandfill crush ( ) other Name of Offal Hauler This form must be returned to the North Andover Board of Health. P EASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH REPRESENTATIVE'S USE ONLY. 7-ice pecting Agent Date • RECEIVED r 2683 JUL 14 2009 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT APPLICATION FORS R SERVICE CONNECTION North Andover, Mass. �`; U�� Application by the undersigned is hereby made to connect with the town sewer main in iJ 4 �_ Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. Z Street or ubdivision lot no Owner Address Contractor Addr ss applicant's Signature ,' PERMIT TO CONNECTITH SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at , i Street - — -subject to-the-rules and regulations of the Division of Public Works.. - ivi n of Public Works By / Inspected by Date See back for rules and regulations � o M �1�11 ► - Homes and Demolition PROPOSAL New Construction-Additions-Site Work- Tank Removal l ��; (� I t~ Fully Insured-MA Lic#065128 1 Rob Hardacre Shawn Dufresne WORK TO BE PERFORMED AT: 978-361-7430 978-457-0494 NAME_1 -11 t t lam-' _ NAME ADDRESS–', LI a� _ ADDRESS_ PHONE NO. � ,(��� I " fJ�1� PHONE NO. We hereby propose to furnish the materialsandperform the labor necessary for the completion of � Su . "l, M yrsAh III ,,,�. PLZ'}, l c a 'v > ` � 3 ane- uiaitti a,Acnru, P a r�"Iyn TO W'Lflll 00> ,ul (� Cor y6cty ncf I( ons d►l,+UvOI Or (00rirV SM11 11 IW � SI '1 All material is guaranteed to be as specified,and the above work to be performed in accordance with the drawings and specifigations submitted.for above work and pom leted in a.substantial workma manner for the sum of ' � _---- Dollars($ ) With payments to be made as follows. j Respectfully submitted-7:;;a ` ----�-' Per Any alteration or deviation from above specifications NOTE -This proposa ay be withdrawn by us involving extra costs will be executed only upon written if not accepted withi _ days. order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes. accidents,or delays beyond our control. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Signature Date Signature .. i Form No.4 Town of North Andover, Massachusetts BOARD OF HEALTH October 24 19-97 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( x) or repaired ( ) by David Maynard INSTALLER at Lot D, Rea St—North AndoverMA 01845 SITE LOCATI. N has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No.. Rg; dated ,Tan• 30 19 97 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD OF HEALTH ENGINEER ' i ;I V TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTTFICATTON The undersigned hereby certify that the Sewage,Disposal System(✓ constructed; )repaired; by HAS_"A n r2 CC IJS�ML461_100 -- -- located at DA IiZGE'I` was installed in confbrmance with the North Andover Board of Health approved plan,System Design Peru# 6,dated :7 with an approved design flow of .gallons per day. 'Ile materials used were in conformance with those specified on the approved plan;the system waainstalled 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. Installer: Lic. #: Date: Design Engineer' Date: K L No.31IN 9 � f T TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( ')constructed; ( )repaired; by r - _ located at was installed in conformance with the North Andover Board of Health approved plan, System Design Permit# dated ~/- lc2 j,with an approved design flow of /In 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. Installer: `�<'� !' � Lic. #: Date: - Design Engineer: Date: 75-- Town of North Andover, Massachusetts Form No. 1 p%ORT11 d BOARD OF HEALTH P 3�Oh ST�EO ib�vO0 C, 19 ��-- OCX1CXeW1CK,� APPLICATION FOR SITE TESTING/INSPECTION �9 AORAre° 9SSACHUS�� .Applicant NAME ADDRESS TELEPHONE Site Location �� Engineer �� V%� NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. „ORTk t BOARD OF HEALTH 14,6 MAIN STREET TEL. 688-9 540 SAc„usEt � NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: LOCATION OF SOIL TESTS: Assessor's map & parcel number: (a OWN ER:tflej urs C) TEL. NO.: 7'1`-' ADDRESS: 47{- tFl) 121CL S ENGINEER: ,P�Crc�a,�rf! v . TE—L. NO.: 4 S - �� SS CERTIFIED SOIL EVALUATOR: It k _ r�.► w�5� Intended use of land: residential subdivision, Ingle family home ommercial THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $175.00 per lot for new construction. This covers the two deep holes and two percolation tests required for each lot. Fee of $75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than 1”-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. iB 3.�', ,��zz L. ,a•'♦. '•..CI l=�,., y�!'t1s'wl'kl�,'���.€,{' ,g�• ('• *irF°ei'�.tit i i€' f .zit t i at .c r-,r>rm -T7{� Si „(��, .c t � '�s.rtw �.amu' t a kf*�T'f�,li•- .,i - ia.„". , 5 •Y•Y I � . - � I I I I I i L.— ii I i I 2 I I I I 3 - - -- --1Tt 1 I �_ _ 1 - - -- - --- - - --- - - --- - - - ----- - I I _ I I I � , - I 7f � I I I - 1. � -r-r I� II FOR.Ni 11 - SOIL EVALUATOR FO&NI Page 1 No. Commonwealth, of Mass'achusetts'-OWN OF BOARD OF'JEA�TA Massachusetts ttts --�--�- - --� Soil Sutabili Assessment or n-site # .3 0 f997 ewa a Ih osal Performed By: .... ...:.....1�...��.. Witnessed By: a........................ r . ���ref,a ............ ......... ....:.... .... __. . . ... . L.«. S7� ... orne.i Name. c f � r• _ Ta�sYam /ryO '`1R! /ltitA.t�sj ele 6, 510 ' New Construction (� Repair ❑ Office Reviw%, ` Published Soil Survey Available: N0 ❑ Yes [ { Year Published ., i r HLF/ Publication Scale,/..%Sc�YO Drainage Class SSoil Map Unit ....... Soil Limitations .. Surficial Geologic Report Available: No Y ❑ Yes ED Year Published Publication Scale ................. Geologic Material (Map Unit) Landform ... _ . ......:_..... . . ............. ` ..... ... ..... ............ Flood Insurance Rate Map: Above 500 year flood-boundary No ❑ Yes Within 500year flood boundary. No Yes Withirti' 100 year flood boundary - W No []� y Wetland Area: es ❑ i National Wettand Inventor Map P (map unit) W .....:.... :. etlands Conservancy Program Ma ...... P (map unit) ............................................. 1 Current Water Resource Conditions (USES): Month .:.........:...... Range : Above Normal ❑ Normal ❑ Below Normal [� Other References Reviewed: Ci C ^ FORA 11 - SOIL EVALUATOR FORA Page 3 Opt-site Review Deep Hole Number 07�P... Date: J-11-f6 Time: Weather Location (identify on site plant . .. ,S-,e.s"`. l'1� .... .................................................................I............ Land Use ..0 Y..,............. .. Slope (461 0-Sr'k Surface Stones .....— ..................................... ... Vegetation .... -�� .......... Landform ..... ..... ..... .. ...... ....... ..... .. ................ . Position on landscape (sketch on the back) ..... ............................................................. . Distances from: I Open Water Body- feet Drainage way>« feet Possible Wet Area >IOD f feet Property Line ... feet Drinking Water Well>Ip(9` feet Other DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) IMunsell) (Structure,Stones,Boulders, Consistencv. %Gravel) Ap g— 10 YXI i Parent Material (geologic) /L�..._......_...._.._....................._.. Depth to Bedrock: Death to Groundwater: Standing Wave; in the Hole: Weeping from Pit Face: .—'- Estimated Seasonal High Ground Water: 385�` FORM 11 - SOIL EVALUATOR FORM Page 3 On-site Review Deep Hole Number ... Date: Time: Weather Location (identify on site plan) . ...1%/b`a,....,..... .............................................................................. E Land Use ....q;�40ev,........... Slope (°sol 0-5`a Surface Stones ........ .. .................................. ... Vegetation .....�1.0r..rC�,t?....... . .. . _. ................._. . ......... ......... _.. ... ... ........... . LandformIkCA .. ......... ........._.. ............................................... . Position on landscape (sketch on the back) ..... ............................................................... .................. ..... Distances from: I Open Water Body J'.WO( feet Drainage way 7(CAV feet Possible Wet Area >(d&f feet Property Line ..50.6.tfeet Drinking Water Well >k291 feet Other . ............ .. DEEP OBSERVATION HOLE LOU Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) (USDA) (Munsell) (Structure,Stones, Boulders, Consistency. Rio Gravel) C� 4r S(, , to YM,3b 10 vr- c, Esc , Parent Material (geologic) .Lf. .......................................... Depth to Bedrock: Depth to Groundwater: Standing Wave: in the Hole: Weeping from Pit Face: Estimated Seasonal Hign Ground Water: �lr r FORM 11 - SOIL EVALUATOR FORM Page 3 Determination for Seasonal High Water Table Method Used': ; ❑ Qepth observed standing in observation hole ........... inches ❑ Depth weeping from side of observation hole ................. inches U CD�De! pth to'.soil mottles inches Ground water adj:usiment feet Index Well Number .............. Reading Date .............. Index well level .................. Ad'ustrrient factor ` ! Adjusted: ground water E*evel ....................:............................. Deoth of Naturally Occurring; Pervious Material Does at least four feet of naturallyoccurrin g pervious material exist in all areas observed throughout the area proposed for the. soil absorption system? . -eS If not, what is the depth-of naturally occurring pervious. material? Certification I certify that ons � 4 (date) I have passed the examination approved by the Department of Environmental Protectiona,nd that the above analysis was perforn)ed by'me consistent with the req'-ired training, -expertise and experience described in 310 CMR .15.017. : Signaturet&2-,A� D.,�� nate COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION Sy0 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_524 Rea Street _North Andover_ Owner's Name: Peter Ramsey Owner's Address:_524 Rea Street_ _North Andover,MA 01845_ Date of Inspection:_5/26/2004_ 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 fimction and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fa' T�AInspector's Signature: Date: _5/26/2004_ 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. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:_524 Rea Street _North Andover_ Owner: Ramsey_ Date of Inspection:_5/26/2004 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:_524 Rea Street —North Andover — Owner: Ramsey_ Date of Inspection:_5/26/2004 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 system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if 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 1 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: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 524 Rea Street_ —North Andover Owner•_Ramsey_ Date of Inspection:_5/26/2004_ D. System Failure Criteria applicable to all systems: You must indicate`yes"or`no"to each of the following for all inspections: Yes No No Backup of sewage into facility or system component due to overloaded or cloggggd 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 1/2 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. No Any 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:_524 Rea Street _North Andover — Owner: Ramsey_ Date of Inspection:_5/26/2004_ 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?(If they were not available note as N/A) 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. _No 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)J Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 524 Rea Street_ _North Andover– Owner: Ramsey_ Date of Inspection:_5/26/2004_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_440 Number of current residents:_3 Does residence have a garbage grinder(yes or no):_No Is laundry on a separate sewage system(yes or no):_No_ Laundry system inspected(yes or no): Seasonal use:(yes or no):_No Water meter readings: Yes_ Sump pump(yes or no):­NO-- Last o_Last date of occupancy:_Current COMMERCLU-Z"USTRIAL 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 2years ago,owner_ Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1500-gallons--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):_ Approximate age of all components,date installed(if known)and source of information:_7 years old,9/30/1997, As built plan_ Were sewage odors detected when arriving at the site(yes or no): No Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_524 Rea Street _North Andover— Owner: Ramsey_ Date of Inspection:_5/26/2004_ BUILDING SEWER_X_ (locate on site plan) Depth below grade:—24"_ 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 floor to septic tank,3"PVC in house,no leaks_ SEPTIC TANK: X_(locate on site plan) Depth below grade:_12"_ 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 4' Sludge depth: 6"_ Distance from top of sludge to bottom of outlet tee or baffle: 21"_ Scum thickness:_8" 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:_Difference between tee Iength&scum&sludge depths_ 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 tank leaking out._ 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 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_524 Rea Street_ _North Andover— Owner: Ramsey_ Date of Inspection:_5/26/2004 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 BOX: X (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: _011 _ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.):_D-box level& distribution equal.No evidence of leakage out of d-box. Evidence of carryover,pumped d-bog 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.): k Page 9 of 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_524 Rea Street _North Andover_ Owner: Ramsey_ Date of Inspection: 5/26/2004_ 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:—4 trenches 37'long_ leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):_Soil oL Vegetation oL No sign of ponding to surface._ CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication 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 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_524 Rea Street_ _North Andover_ Owner• Ramsey_ Date of Inspection:_5/26/2004_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. D- Boz 37' A to Tank=21' Septic Tank A to D-Boz=54' B to Tank=41' B to D-Boz=55' B A Driveway House Water Meter Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_524 Rea Street _North Andover — Owner:_Ramsey_ Date of Inspection:_5/26/2004 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 4'_ Please indicate(check)all methods used to detennine the high ground water elevation: X_ Obtained from system design plans on record-If checked,date of design plan reviewed:_9/11/1996— 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_ W .._ :r/y .�.. try'ps :�fp _ h -: rMs- :r- •,t, •1 4.�':' t L- � .. •� :Y._ , 'gig-,.�;N. tt+t :'?-r„$t, _:'�.;� mak,;^ yy�< .,f- - i� 'f�,�1 ��,fi�..ii. - 1 I ................. �. f,lf�3 1�. t. 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Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service I 1 I Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 524 Rea Street, North Andover Owner: Ramsey Date of Inspection: 5/26/2004 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. Neil4Bason Bateson Enterprises,Inc. rm l # v J �v [ C� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION �Y V TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: @_' RCp, i 2re ii Owner's Name: C Kt4Q 1_l:5 P,06456-LL- Owner's ,0SSLLL- Owner's Address: 115-4 R Eft mar Date of Inspection: q 6 C,-Z, Name of Inspector: (please print) i �2 Company Name: _���' 1�-'AJ&W{,v> Ent GIN L'L 2tN!- Mailing Address:(o o 3C C c 1-(yJ o0 p D-Z t UC Telephone Number:��6 000 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 Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: (2 Date: ell& C 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 �- g ' ****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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) 'ROPERTY ADDRESS:524 REA STREET NORTH ANDOVER,MA )WNER:CHARLES RUSSELL )ATE OF INSPECTION: 9/6/00 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: V/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 feplacement or repair,as approved by the Board of Health,will pais. E 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: Title 5 Inspection Form 6/15/2000 2 f M,n7 ! � J 17, rl - • /�� - ,�' Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) ROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA )WNER: CHARLES RUSSELL )ATE OF INSPECTION: 9/6/00 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation bytthe Board of Health in order to de mune if the system is iling to protect public health,safety or the environment. 1. stem will pass.unless Board of Health determines in accordance with 31 CMR 15303(1)(b)that the s em is not functioning in a manner which will protect public health, ety and the environment: C spool or privy is within 50 feet of a surface water Cess ool or privy is within 50 feet of a bordering vegetated we nd or a salt marsh 2. System will fail unless t Board of Health(anti blic Water Supplier,if any)determines that the system is functioning in a man r that protects the ublic health,safety and environment: _ The system has a septic tank d soil a oiption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a urf a water supply. The system has a septic tank an A d the SAS is within a Zone 1 of a public water supply. _ The system has a septic to and SAS and SAS is within 50 feet of a private water supply well. The system has a septi tank and SAS and the SA is less than 100 feet but 50 feet or more from a private water supply well .Method used to determine di ce "This system passe if the well water analysis,performed at a P certified laboratory,for coliform bacteria and vola ' organic compounds indicates that the well is a from pollution from that facility and the presence of onia nitrogen and nitrate nitrogen is equal to or 1 s than 5 ppm,provided that no other failure criteri are triggered.A copy of the analysis must be attached to s form. 3. Ot er: Title 5 Inspection Form 6/15/2000 3 Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE,DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) ROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA )WNER: CHARLES RUSSELL )ATE OF INSPECTION: 9/6/00 m. system Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _ ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ' Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than %Z day flow _✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. —✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. f s _ ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. _ 7 Any portion of a cesspool or privy is within 50 feet of a private water supply well. _✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] (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. arge Systems: To be nsidered a large system the systemmust serve a facility with a design flow of 10 gpd to 15,000 gpd. You must indica ither"yes"or"no"to each of the following: (The following criteria ly to large systems in addition to the criteria above yes no the system is within 400 feet of a ace drinking r supply the system is within 200 feet of a tributa o ace drinking water supply the system is located in a ni en sensitive area(Interim Ihead Protection Area—IWPA)or a mapped Zone II of a public w supply well If you have answe yes"to any question in Section E the system is considered a sig ' ant threat,or answered "yes"in Se ' D above the large system has failed.The owner or operator of any large sys 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 d OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST ROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA )WNER: CHARLES RUSSELL )ATE OF INSPECTION: 9/6/00 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _ Pumping information was provided by the owner-,occupant,or Board of Health V/ Were any of the system components pumped out in the previous two weeks? x_ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) E ✓/_ Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Existing information.For example,a plan at the Board of Health. _ V 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)(6)] Title 5 Inspection Form 6/15/2000 5 V Page 6 of I I ter• 1 r a OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA DWNER: CHARLES RUSSELL DATE OF INSPECTION: 9/6/00 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: _ Does residence have a garbage grinder(yes or no): N� Is laundry on a separate sewage system(yes or no):W[if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no):ALO Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): F 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: Al t1-?eT— P-:AA P p Was system pumped as part of the inspection(yes or no):Al If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM 1C Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):AW Title 5 Inspection Form 6/15/2000 6 Page 7 of 11 �`;. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PROPERTY ADDRESS:524 REA STREET NORTH ANDOVER,MA OWNER: CHARLES RUSSELL DATE OF INSPECTION: 9/6/00 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): nr; y J9C z C, SEPTIC TANK:_(locate on site plan) Depth below grade: 12 Material of construction: u---concrete_metal_fiberglass polyethylene _other(explain) i If tank is metal list age:_ Is age confirmed by a Certificate ofrCompliance(yes or no):_(attach a copy of certificate) Dimensions: 15-00 &-IQ�5 Sludge depth: Z'` Distance from top of sludge to bottom of outlet tee or baffle: 2-01 Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: y , Distance from bottom of scum to bottom of outlet tee or baffle: 15— How 5How were dimensions determined: 1"CA r R E n c►L Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): ��g✓►c t v Gcu�� �o .>P 17)[)A/- -C s iAU 6-0() 0)1 uit/ )Z C( µGni 9 tN5 A-LL ni 71U �- rtAj,51-1 C-12k O, GREASE TRAP:11/glocate 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.): Title 5 Inspection Form 6/15/2000 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA OWNER:CHARLES RUSSELL DATE OF INSPECTION: 9/6/00 TIGHT or HOLDING TANK:0(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.): i � F DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): 0OX 1n) (roo7 CJ 10pt1-1%3 / pj a°Qk) A20 �U1�L%uGl? t�F SoLios e- .9-('-(Y n.)e.t. C)PL Lt;t+g, ►4G-L 1 •v �� ,Z v✓i PUMP CHAMBER: Af6ocate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - CYSTEM INFORMATION(continued) PROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA OWNER: CHARLES RUSSELL DATE OF INSPECTION: 9/6/00 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: leaching trenches,number,length: f3'7 t-c N 6- 3',,,-' D leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: t✓omments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication 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.): Title 5 Inspection Form 6/15/2000 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'ROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA )WNER: CHARLES RUSSELL )ATE OF INSPECTION: 9/6/00 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. t J� til J� Title 5 Inspection Form 6/15/2000 10 V) 72 Page 11 of 11 t`' t.; OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'ROPERTY ADDRESS: 524 REA STREET NORTH ANDOVER,MA )WNER: CHARLES RUSSELL )ATE OF INSPECTION: 9/6/00 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water & feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: ✓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: f You must describe how you established the high ground water elevation: Vi(;Ir "C(4 TP,eL C_ c,., .t>C.&I(r-AV P LAlA,/ l✓- lid 1- rqe _ CEN f!( 1.6'7 7D 14 L-C-O CL- L-1 , &0 0'_j' y L-D Title 5 Inspection Form 6/15/2000 11 Town of North Andover, Massachusetts Form No.3 f „ORT., BOARD OF HEALTH • o�t,� o .,�tio ' FO m 19 _ ''s•,.•o^•'tom DISPOSAL WORKS CONSTRUCTION PERMIT .. .. SACHUSE ft Applicant � lei i 1-14 NAME ADDRESS TELEPHONE Site Location_ �T ✓ E�2 ��- Permission is hereby granted to Construct (Wo-r--Repair ' ( ) an Indivi �� Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAAN, OARD OF HEALTH = D.W.C. No. APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: `J' — /ly — 1�7 CURRENT INSTALLER'S LICENSE# l/ LOCATION: LICENSED INSTALLER: � cx y'�Iis y ��•�� SIGNATURE:` .G% TELEPHONE# 4103 — 51el a CHECK ONE: / REPAIR: NEW CONSTRUCTION: L/ IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As-Built? Yes L'� No Approval d j; j (_� Date: �� Town of North Andover, Massachusetts Form No.2 f MOR7ly BOARD OF HEALTH 19 a DESIGN APPROVAL FOR 14U SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM 1416 Applicant_ Test No. Site Location_ Reference Plans and Specs. /! /�f 7 ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee V Site System Permit No. �� SEPTIC PLAN SUBMITTALS LOCATION: S�- NEW PLANS: YES $60.00/Plan REVISED PLANS: S $25.00/Plan DATE: 1 21 P Gi G DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary SEPTIC PLAN SUBMITTALS LOCATION: %� fa. �, NEW PLANS: YES $60.00/Plan REVISED PLANS $25.00/Plan DATE: --2 R7 �7 DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary Town of North Andover f 40RTN OFFICE OF �a o�' 40 COMMUNITY DEVELOPMENT AND SERVICES ° . p 146 Main Street " t � o, North Andover,Massachusetts 01845 � "•,iEO-.••�,y VALLIAM J.SCOTT ssAcwuse Director February 7, 1997 Merrimack Engineering 66 Park Street Andover, MA 01810 Re: Lot D Rea Street Dear Bill: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. No perc tests in system. (3 10 CMR 15.104(4)) Prior perc tests of 1984, although not shown on plan but used for design, are, according to expired plan of 10/27/92, roughly 50-65 feet from system and cannot be used. 2. Impossible to check system size without peres. 3. Foundation drain missing. (N.A. 6.02v) 4. Profile not to scale. (N.A. 6.02(b)(2) & 6.02r) 5. Please show stepped trenches on section with existing grades. 6. Wetlands disclaimer missing. (N.A. 6.020) 7. Assessor's map & parcel missing. (N.A. 6.02a) 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 cc: Messina Development Bill Scott, Director, P&CD File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 dle 3��UJ'4 PLAN REVIEW CHECKLIST ADDRESS ENGINEER G GENERAL / 3 COPIES STAMPS/ LOCUS NORTH ARROW SCALE CONTOURS L/' PROFILE �� SECTION i/ BENCHMARK SOIL &. PERCS 4 ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED?Ak DRIVEWAY ✓(E1ev) WATER. LINE ��� FDN DRAIN SCH40 `'�J TESTS .CURRENT? L/ SOIL EVAL ,ULIGC5�1 SEPTIC TANK MIN 150OG t� . 17'. INVERT. DROP GARB, GRINDER/mob (2 comps +200) 10 ' TO FDN MANHOLE ELEV `'' GW_6�e # COMPS . GB D-BOX SIZE # LINES ,`:. FIRST 2 ' LEVEL STATEMENT INLET I V ,.a 7'- .OUTLET J' Z%I'b17 (2" OR . 17 FT) TEE REQD? LEACHING MIN 440. GPD? RESERVE AREA 4' FROM -PRI MARY? 2% SLOPE 100 ' TO. WETLANDS. 100:' TO WELLS 4 ' TO S.H.GW �� (5 ' >2M/IN.) . 20' TO FND & . INTRCPTR DRAINS C�-' 400 ' TO SURFACE H2O SUPP' 4 ' PERM. .SOIL BELOW FACILITY MIN 12" COVER FILL? ( 15 ' ) BREAKOUT MET? : TRENCHES. MIN 440 gpd SLOPE (min .005 or 6"/1.00 ' ) SIDEWALL DIST_ 3X EFF. W OR D- .(MIN"6' ,) t/r RESERVE BETWEEN TRENCHES? �'� IN FILL? MUST BE 10 ' MIN. ✓'. 4„" PEA STONE? y VENT? /vim (>3 ' COVER; LINES >50 ' ) BOT + SIDE X LDNG = TOT (L x W x ##) (DxLx2x##) (G/ft2) Copyright © 1996 by S.L. Starr NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: PERMIT # &9(3 DATE RECEIVED �/ 6 A APPLICANT /1E551Aj, ,!/�/e EZ- i'I /I,��"' MAP 1 L PARCEL r ems_ ADDRESS 44 Ue-PT 7�. Dle, 619Zj LOT ## STREET ## ENG. I�1� /I�l3c,� �UG.��S/U6" STREET ENG. ADDRESS Co �` ��•�,� �/ /7/U Qt)6�C c��6 PLAN DATE �/al/ REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED T REASONS FOR DISAPPROVAL: • /(�p �E.C'C' T C5�5 !A.) s Y v 7-4Tr-f '�1Z10 �E2G TCST� �� /Sr8¢� I-qZ-r1oC»/t ,VoT stfow/-) O�v �L�4•v $UT 115EJ� TD,e DE5/6A,-,1 /9.L°E, /�l�'a•�L�//�6 TU L=7X1'ib 'F,L/91u (0 f 161,W9A, �v uG�� y �a -��C' z2©,v 67vu7-45�4- C,qA.)nJor -3(-- L)56-b . 6 %ov�v�i4rsry D,e/�/� Nt is�iivC� ( 0,1 V� C7 1L-3, —Te6,c/L E i4JDT TD 5 cam/ (�✓ /� OA-) 6� GUETL�iUAS /sG,c.¢//�9�� 1'�9/s:i/�� �/�/•/�. O) � /gzj5 e6 Sop 14115�p 91- �r,�c�� x,6511V6 C,�/ R Q) 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 local or state law regulations or requirements. , ****************Applicant fills out this segtion***************** APPLICANT: Phone Lig C� LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street St. Number ************************Official Use Only************************ RECOMIEN IO WN AGENTS: Date Approved j r Conservation 6ministtrator Date Rejected Comments i s, l L;U -� Date Approved Town. Planner Date Rejected Comments Food Ins ector-Health Date Approved Date Rejected G Date A — tic spector-Health ed Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date NOovm Of RTH Andover No. M LAXE dover, Mass., 7Z19 v7 * � o _ s . 9166qCOCHHEs�'�, CACK PERMI " BOARD OF HEALTH Food/Kitchen Septic System�.LX// THIS CERTIFIES THAT..................................................� ............ BU0:,bING INSPECTOR //0................................... eas permission to erect:..............;. T. Foundation ..: ..... .....Y........:. buildincA on.......... .Z. �. ............-Z... ........ to be occupied . tFinal or .. . .�.. ......... /�S himneypecsoncdepting this permit shall in every respect conform to t Q:ter of the application on file mthis officeovided hai%El=,go tie peojisiolis of the Codes and B -Laws relatinBuildin Y g to the Inspec ion,'Akeration and Construction of ri t e Town!o;;N.Wh Andover. � r � PLUMBIN IN PEC OR V3oL T1,01'of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST r LELECTRIC SPE ........ .. ....B ING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner to ► 73 • Street No. Ghw� Smoke Det. ��� . Town of North AndoverNORTry OFFICE OF 3a�'``"e 1�OOL COMMUNITY DEVELOPMENT AND SERVICES 1; 30 School Street North Andover,Massachusetts 01845 WILLIAM J.SCOTT SSACNUSE Director July 28, 1997 Merrimack Engineering Services 66 Park Street Andover, MA 01810 RE: Rea Street Dear Bill: This letter is to inform you that the proposed septic plans for Lots A (3D- 1) and D (3A-1) Rea Street have been approved. 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 cc: Wm. Scott, Dir. CD&S Bob Messina Colonial Village Dev Gina Armano File CONSFRVA.TTON 6RR-9519) NFATT'; 699-QS4{} p•,�*,n*rp;ra.F��_9535 FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained.This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT bn t£S r14)y PHONE rG,2 -- ASSESSORS MAP NUMBER OT NUMBER SUBDIVISION LOT NUMBER STREET ij fL�L on STREET NUMBER Bassoon ................. ................................ .............. OFFICIAL USE ONLY RECONaffiNDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADNIINISTRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COM&IENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPT SP OR-HEALTH DATE REJECTED COMMENTS pzd- PUBLIC WORKS-SEWER 7 WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONRVIENTS I RECEIVED BY BUILDING INSPECTOR DATE of 7 " _�;ra �,. } 9 -A75J1 FRI_I H IAiE ,. DOHERTY E } r ii` •ti �i i. 1 � .�. 0\ ('v 1- r-, as � by•�� � �,! e r t i F r o r le- ..,(/ 'G'-. 05RU, 'e-4,w4glGs .4��/•4�+�' "e'2- --e--' _ •+'P"P ��,'�i•,� r'B��✓�6/�''•G o�p +trl��.�TIGFTc'�J�•�f� �,di✓�� �i utSWK�' a �pax w . - 2 -►E TAJ4le. 0 0� (�E o. "►Z E T AS BUILTPLANOF s UBSURSACE' DISPOSAL LOCATED IN SYSTEM �0��� ��►.jDtvY'.�+2 , tMA.ss. � LoT D AS PREPARED FOR DATE: 1,9,9-7 SCALE: i '- 'rL GZ 5DL d j � pORTi4 O��g6ED 16 q�� O C, '�b y O [OCMi<lwKM y1T ��SSA40 C HUS���y PUBLIC HEALTH DEPARTMENT (ommunity Development Division MEMORANDUM To: File From: Susan Sawyer, Public Health Dir. Date: July 6, 2009 Re: 524 Rea Street On this date,the owner of this property came to the Building Dept. counter. The Building Inspector informed me that the owner had been identified building a covered deck without a building permit. I reviewed the file and informed her of the following; 1) File indicates she has town sewer available 2) Provided her with the sewer tie in regulation(gave copy) 3) Informed her of the process if she did go ahead with the building application a. A review would be conducted b. A letter of denial would likely be written requiring tie-in to sewer I informed her that this is not a formal denial as there is no application to review at this time. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townofnorthandover.com JO <Le D✓Z'77 t �^_ L4 4A t? u ci!::) L.i i C ` _0 !� 7f lr %TRCff A �� S/6 � D CC,,' F� is .f l G et .au C t mar / �e L o /U / l( S �74-61 f'G17t < -S a � ' GH a2A S �� � � SUrtrvt� i2 S �', l�" D av a rz�'7l v'r,v d cx��j2 ��G GfSz -- 8"oy3 r `� 1►ORTh BOARD OF HEALTH F p It • 120 MAIN STREET TEL. 682-6483 oAT­ SACMUSEtth NORTH ANDOVER, MASS. 01845 Ext. 32 December 2, 1993 Mr. Ernest Romano 64 Greene Street North Andover, MA 01845 Dear Mr. Romano: This is to notify you that your septic plans for Lot 3A Summer Street, North Andover have been rejected for the following reasons: p� 1) Insufficient leach area due to unallowed interpolation of perc rate (N.A. 4. 14) . 2) Reserve area must be minimum 4 ' from primary area (N.A. 2 .23) . 3) Need confirming deep hole test - (soil tests expired) (N.A. 4. 06 & 4.07) . If you have any questions concerning this letter or the North Andover regulations, please do not hesitate to call me at the Board of Health Office on Monday, Wednesday, or Friday. Sincerely, Sandra Starr / Health Agent SS/cjp cc: Joe Barbagallo • z. Form ldo.2 �R. N Town of North Andover,Massachusetts BOARD OF HEALTH 1 -_19`Lhow st . p� ��a• yqM° r DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Test No ApplicantUmrnp� �f Site Location //4 DAT UsiGN r5�v Lr Reference Plans and Specs. E iNEER sewage disposal system to be installed Permission is granted for an individual soil absorption , in accordance with regulations of Board of Health. AIRIV AN,BOAR OF HEALTH Site System Permit No. Fee (p j ` yz FORK U — IAT RELEASE FMZK 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****/*******,,***** APPLIGAZl'T: ,AAL- s:SiAf - (,ti Phone bO.S'S7�J LOCATION: A_sSasscr' s Mac Nunaher � Parcel �6a Subdi': cn � P iYl Lot;s) 3A Stree= �r1St. Nu.-.ter *,e* iie* i* ei*�cii**iee�t****Cf=-cial Use On�'� t'ecFye* F�e*x�c*icci�e*xxcc* ci REC0Y-MENCATIONS OF TOWN AGENTS: Daze Accr:,vec Cc::___ :a-_z-, Ac-_^is�.raccr Daze Re ; ec�__ Cc �A- Q Daze Appr:.ved 4 q Tcwn ?'inner Daze Reeczed Da- Arr:=;ed �i�.� 2; Daze Acr ec Da-=_ Rei ec-__ __ rycr..c - =_e*.:er,'-4a-er ccnnecz_ons _ F__e Derar,:er.- Rece_:!ed by Buildincg Ins=eczcr Da--=- p0RT#q 3?°° °�° BOARD OF HEALTH O D • 9 °« 120 MAIN STREET TEL. 682-6483 S, CHUSNORTH ANDOVER, MASS. 01845 Ext23 December 19, 1994 64 Greene Street North Andover, MA 01845 RE: Lot 3A Summer Street Dear Mr. Romano: This letter is to confirm that on December 15, 1994, the North Andover Board of Health granted an extention on the plans for the proposed septic system for Lot 3A Summer Street, North Andover. Approval for the plans has been extended to January 4 1996. This shall be the final extention granted for these plans. If you have any questions, please do not hesitate to call the office at the above number. Sincerely, ?J'&x L Sandra Starr, R.S. Health Administrator Town of North Andover, Massachusetts Form No.s MOR*M BOARD OF HEALTH z" c �• o ` 3-- 19-1 S s^ i DESIGN APPROVAL FOR CH SOIL SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM •r L� . . Applicant I� ,C1 .,.�..r L._ Test No Site Location Reference Plans and Specs. E INEER DESIGN DATE r• Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CFTAIRMAN,BOAR OF HEALTH [. ( ,• Fee w Site System Permit No. 711-V 4 1 E C gORTh O "to � , . . bG? - °p BOARD OF HEALTH ♦ s 120 MAIN STREET TEL. 682-6483 SACMUS NORTH ANDOVER, MASS. 01845 Ext. 32 TO: Joseph Barbagallo DATE: 9/14/92 1 Westward Circle No. Reading, MA FROM: Sandra Starr RE: Lot 3 Summer Street Dear Joe: This is to inform you that the proposed septic design plans for the above site dated 7/15/84 have been APPROVED. If you have any questions about the next step in the process, please call the Board of Health office. APPROVED WITH THE FOLLOWING CONDITIONS: ' DISAPPROVED FOR THE FOLLOWING REASONS: 1 . No locus (N.A. 6. 02b5) 2 . No foundation drain (N.A. 6 . 02v) 3 . Soil tests not current. New fee and re-testing required. (N.A. 4 . 06 & 4 . 07) 4. Abutters not noted (N.A. 6 . 02f) 5. All pipe to be SCH40 (N.A. 18 . 15) 6. Septic tank not 25 ' from dwelling (N.A. 4 :18) 7 . Leach field not 35 ' from dwelling (N.A. 4 . 18) 8 . Need full lot area and dimension (N.A. 6. 02d) 9 . Note that excavation of top and subsoil must extend at least 6 inches into the parent material. (N.A. 2. 18) cc: Ernest Romano, Karen Nelson, file NORTN 3?�`'.,. �410 BOARD OF HEALTH O " N 9 t ' ' 120 MAIN STREET TEL. 682-b483 . o SACHU E<t� NORTH ANDOVER, MASS. 01845 Ext. 32 TO: Joseph Barbagallo DATE: 9/14/92 1 Westward Circle . No. Reading, MA FROM: Sandra Starr RE: Lot 3 Summer Street Dear Joe: This is to inform you that the proposed septic design plans for the above site dated 7/15/84 have been APPROVED. If you have any questions about the next step in the process, please call the Board of Health office. APPROVED WITH THE FOLLOWING CONDITIONS: DISAPPROVED FOR THE FOLLOWING REASONS: 1. No locus (N.A. 6 . 02b5) 2 . No foundation drain (N.A. 6 . 02v) 3 . Soil tests not current. New fee and re-testing required. (N.A. 4 . 06 & 4 . 07) 4 . Abutters not noted (N.A. 6 . 02f) 5. All pipe to be SCH40 (N.A. 18 . 15) 6 . Septic tank not 25 ' from dwelling (N.A. 4: 18) 7 . Leach field not 35 ' from dwelling (N.A. 4. 18) 8 . Need full lot area and dimension (N.A. 6 . 02d) 9 . Note that excavation of top and subsoil must extend at least 6 inches into the parent material. (N.A. 2 . 18) cc: Ernest Romano, Karen Nelson, file DATE //�% /�7i Sheet Of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE ( PERMIT # QJ3-8 DATE RECEIVED C-T/0��, APPLICANT (x,7 , &22� ASSESSOR' S MAP ADDRESS -201, PARLOTC#L # 3 STREET # ENGINEER ADDRESS PLAN DATE REVISION DATE CONDITIONS OF APPROVAL: APPROVED DISAPPROVED /. `'UC) AID 10�J� c�ccT-�piu r�ru1 /v A5 116 fed A1/ �ape /d Z21 l /,��,,� mel•��q o _ /V�e c� DATE o2 9 z1 Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE 0 Z S 4e,0 PERMIT # DATE RECEIVED APPLICANT ASSESSOR'S MAP__ S ADDRESS PARCEL # Coote LOT # -:3,-q ENGINEER STREET 5Q&A- BP GU5T. �/�- ,�q,pRA�'ACC ADDRESS / E57woop PLAN DATE 4;4-74�P4' REVISION DATE 16 7A9 CONDITIONS OF APPROVAL: APPROVED DISAPPROVED X J) Z/150FF/e/e417- 9,E/9 DUE TO UNALGo�c>Ejj >V>�.P/�bGigTiGv�/ OG —7-:�'6RC -i ATE (X A. 4. /4) 2� --RESERj/& SPEP u67- -3Z- MIA11Muly 3) N,�F CFD 0-0A11`1,lM1/V6 -DEEP ffOGE ( 50/6 T�sT 5 EXP�,p�O� <M,/9. 4.6 4. 07) DATE /9// 9 zl Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE 026- 1-60 PERMIT # DATE RECEIVED APPLICANT ASSESSOR'S MAP 38 ADDRESS PARCEL # 40oz LOT # 1:3 1-7 STREET 5U/T9ME� 5; . ENGINEER `�•�q�PRq<'.4L�� ADDRESS _/ GUE57-ivooD �3/.PGCE /v —w,&A.)iiyc PLAN DATE s5/-Z4/ REVISION DATE 16107A9 CONDITIONS OF APPROVAL: APPROVED DISAPPROVED X )> 2N5uF'1--/e1,-Nr AfeI9 DUE T6 VAIAL.1-61,0,6b 14) u57' �� N/iNiMu�f q` •��'o/� -j/�ilq�qA,ey 3) IVeeb O-OA11-1,i1,91iY6 �,-EP fVOGE ( 50/6 7-e57-6 EXP/p�cJ�� (lV-A. 4.aG 91-4. 07) DATE X02 h z,,l Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE 026- ,--60 PERMIT # DATE RECEIVED APPLICANT Z--, --�F6Ag1--2A/O ASSESSOR'S MAP 38 ADDRESS PARCEL # _ C/ ' LOT # --3 A STREET -5U�ME,P ST ENGINEER `�//- ?�q,PRA�,'A, GC �, ADDRESS PLAN DATE REVISION DATE /61Z719l, CONDITIONS OF APPROVAL: APPROVED DISAPPROVED X )) Z/VSUFF/C/ENS ,C �f�C•'� A�E/� DoE TO L)NALGo tc>Ed U!5 7- 73Z Al 3) lv E,D COA11--P M11Y6 -DFEP ( 50/G 7-6-67-6 EXP/�LtD� 9,4-4, 07) m ge1�� w Ta..►�c. I F pTnl. � � .roP. EL1�13.8.7 I /�• by al X1.0° 13G.4G� AS BUI LT PLAN OF SUBSURFACE DISPOSAL SYSTEM LOCATED IN AS PREPARED FOR J. DATE: ,7eri- -�c, i-iq:-7 SCALE: I 's ' 'rL LZ. MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 or TEL (617) 475-3553, 373-5711 Tp� FOUNDATION AS-BUILT S : 161597 LOCATION: MAP 38 LOT 62 r -- S,14 REA STREET NORTH ANDOVER ,MA. DATE: 9-9-97 SCALE: 1" = 20' ZONING DISTRICT: R MINIMUM SETBACKS: FRONT YARD = 30' A• SIDE YARD = 30' REAR YARD = 30' I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE GROUND AS SHOWN, AND THAT IT CONFORMS TO THE DIMENSIONAL SETBACKS OF THE ZONING BYLAW OF THE TOWN OF NORTH ANDOVER . OF 6'• FRANK ` IEBBA Ne.37734 A9�FfSS0�P� FESSION L LAND SURVEYOR lb DATE: �14e9_ b 35.5' - vJ PREPARED BY fel• �,�; �/%�/ , l ESSEX SURVEY w 6�• �� ENGINEERS AND LAND SURVEYORS a � � P.O. BOX 62022 X06 NEWTON, MASSACHUSETTS 02162 TELEPHONE: (617) 553-0299 GxAPM SCRZ 136.96' o 10 so 40 so (vim") REA STREET ACAD DRAWING:REA.DWG Nwh -40 e. UILDI ES UH1-4A Y OF lislV PARTS Dt,tKZv4ga A 0 G D 4 E SO 4 V g 1&4,-7 7 — — E G 10z'+4 sne S4 55, 1 I g2,z3 +/ r,I, 5i' l oz,64 11 Oa 1f•83 " 1 4 0.03 ('t3,-71 s8 3 SR, �3 `' 4T12�r�rlEs (?Qax Q ii% W 0 �jE�fw �w _ TANK 1 by � pp, V,T 1 M-ilk AS BUILT PLAN OF SUBSURFACE DISPOSAL. SYSTEM LOCATED IN AS PREPARED FOR J. 00'v'>wsoes'L-L.o DATE: ,�Err SCALE: I '= 'i'L LZ MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER. MASSACHUSETTS 01810 TEL (617) 475-3533, 373-5721